Despite the very high literacy rate in developed and most developing countries, there remains a small, but non-trivial, percentage of the population in some countries that has had limited access to formal education or poor-quality education due to socioeconomic factors. While in most countries illiterate individuals are typically, although not exclusively, older, they are also the cohort most likely to require neuropsychological assessment as part of diagnostic procedures for potential neurocognitive decline. Moreover, illiteracy and low literacy are often associated with social and environmental factors including poverty, deprivation, war, low socioeconomic level, rural environment, and others, leading to life-long limitations with respect to opportunities related to work, health, etc. Although illiteracy and low literacy may seem irrelevant to many neuropsychologists given their relative rarity, the growing numbers of displaced individuals due to war and other adverse conditions relocating to Western countries suggests that this issue remains pertinent. Thus, we will discuss the association between illiteracy and low levels of literacy primarily with respect to late life cognitive abilities and potential for neurocognitive decline and/or misdiagnosis, as well as pitfalls and challenges in clinical assessment. This discussion will include factors affecting neuropsychological performance, above and beyond factual knowledge. The findings presented may have implications not only for individuals undergoing assessment and treatment, but also for policy makers in terms of early life experiences setting the stage for late life cognitive decline.
Number of Credit Hours: 1.0
Level of Instruction: Intermediate
Learning Objectives:
1. Summarize basic information on the factors associated with the neuropsychological functioning in illiterate and low literate individuals.
2. Recognize the potential pitfalls in the neuropsychological assessment of illiterate and low literate individuals.
3. Select and apply appropriate procedures to the neuropsychological assessment of illiterate and low literate individuals.
Presenter(s):
Mary Kosmidis, PhD
Aristotle University of Thessaloniki
Mary H. Kosmidis, Ph.D. is a Professor and Chair of the School of Psychology at Aristotle University of Thessaloniki (AUTh) in Greece. She received her Ph.D. in Clinical Psychology from American University, Washington, DC (1992) and worked as a staff fellow at the NIMH conducting research in psychophysiology and neuropsychology, while also working in private practice. Since 1999, she has been on the faculty of the School of Psychology at AUTh, teaching and doing research in clinical neuropsychology and supervising students’ clinical and research training. She currently represents Greece (via the Association of Greek Psychologists) as a member of the Standing Committee on Clinical Neuropsychology of the European Psychologists’ Associations. Over the course of her career, she has organized national and international conferences and the Vivian Smith Summer Institute for Neuropsychology sponsored by the INS, was president of the Hellenic Neuropsychological Society and board member of the Hellenic Society of Northern Greece, vice-dean of the Faculty of Philosophy at AUTh, and has served on the editorial board of several scientific journals. Her research has been awarded several grants (US, European Commission, Hellenic Ministry of Education, AUTh) and conference prizes. Most recently, her research has focused on early signs and protective and predisposing factors for the development of dementia (e.g., Mediterranean diet, sleep, normal cognitive trajectories related to aging, early exposure to adverse life factors such as war, pesticide use, low SES); the neurocognitive dimensions of illiteracy and implications for a) accurate clinical neuropsychological assessment and b) the effects of literacy on cognitive functioning; cultural factors relevant to neuropsychological assessment, e.g., determining the cultural appropriateness of neuropsychological tests and adapting existing, or developing new, tests and normative data for the Greek population, among others.
