INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #93 Is Counting Dots a Universal Skill? The Use of the Dot Counting Test for Measuring Effort in the Hispanic Population Erin Curtis, Teacher's College, Columbia University, New York, United States Avraham Schweiger, Center for Cognition and Communication, New York, United States Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience Keyword 1: cross-cultural issues Keyword 2: neuropsychological assessment Keyword 3: effort testing Objective: With the rapidly increasing cultural diversity in the United States, the need for neuropsychological assessment, and accordingly, instruments of performance validity (an essential component for assessing effort) that are valid in diverse cultures and languages has become especially relevant. Whereas language-based performance validity assessments (PVAs) have clear limitations with respect to culturally diverse/non-English speaking individuals, even nonverbal PVAs may have subtle biases that render their data of questionable validity, misrepresenting credible effort as non-credible or malingering. In the current preliminary study, we examined a nonverbal PVA, the Dot Counting Test (DCT), in both Western (U.S. born and educated) individuals and Hispanics from Latin America undergoing a neuropsychological evaluation for traumatic brain injury. Participants and Methods: Archived DCT data of 53 adult patients (age range 18-67) with mild to moderate traumatic brain injury (TBI) undergoing neuropsychological assessment in an outpatient clinic were collected. 20 (37.7%) patients were born and received an average of 14.6 years (SD = 2.7) of education in the United States, while the remaining 33 (62.3%) were born, raised and educated in Latin American countries (M = 10.82 years of education, SD = 3.956). All patients included obtained a Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Index score of 3 or below to further rule out malingering or suboptimal effort. Results: All patients (N=53) were included in the analysis. There was a significant difference found between Hispanic and non-Hispanic DCT e-scores (p <.001, Cohen’s d = 1.755), with the average DCT among the Hispanic group reaching 12.09 (SD = 3.32), while e-scores among the non-Hispanic group averaged 7.2 (SD = 1.508). More specifically, there was a significant difference in completion time of the final six cards (containing grouped dots) found between the groups (p = .005, Cohen’s d = 1.364), with Hispanic patients averaging 20.76 seconds (SD = 8.7) and non-Hispanic patients averaging 10.3 seconds (SD = 5.507). No significant difference was found between groups on the first six cards. The significant difference between Hispanic and non-Hispanic groups on the final six cards suggests potential cultural-educational differences in the approach to task instructions, grouping, or multiplication. Conclusions: A considerable proportion of culturally diverse, credible respondents (confirmed by the EI of the RBANS) may run a greater risk of being misclassified as potentially providing poor effort on the DCT’s North American norms. As such, the DCT exhibits notable limitations in its ability to assess performance validity and overall effort in culturally diverse populations and cannot be considered ‘culture-free.’ Accessibility and cultural sensitivity are critical considerations in the testing of marginalized groups, yet have been largely ignored in the literature. The results of this study serve as a preliminary step in identifying concerns with cultural issues in nonverbal performance validity assessment and may assist in developing more culturally appropriate norms and testing.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #93

Is Counting Dots a Universal Skill? The Use of the Dot Counting Test for Measuring Effort in the Hispanic Population

Erin Curtis, Teacher's College, Columbia University, New York, United States
Avraham Schweiger, Center for Cognition and Communication, New York, United States

Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience

Keyword 1: cross-cultural issues
Keyword 2: neuropsychological assessment
Keyword 3: effort testing

Objective:

With the rapidly increasing cultural diversity in the United States, the need for neuropsychological assessment, and accordingly, instruments of performance validity (an essential component for assessing effort) that are valid in diverse cultures and languages has become especially relevant. Whereas language-based performance validity assessments (PVAs) have clear limitations with respect to culturally diverse/non-English speaking individuals, even nonverbal PVAs may have subtle biases that render their data of questionable validity, misrepresenting credible effort as non-credible or malingering. In the current preliminary study, we examined a nonverbal PVA, the Dot Counting Test (DCT), in both Western (U.S. born and educated) individuals and Hispanics from Latin America undergoing a neuropsychological evaluation for traumatic brain injury.

Participants and Methods:

Archived DCT data of 53 adult patients (age range 18-67) with mild to moderate traumatic brain injury (TBI) undergoing neuropsychological assessment in an outpatient clinic were collected. 20 (37.7%) patients were born and received an average of 14.6 years (SD = 2.7) of education in the United States, while the remaining 33 (62.3%) were born, raised and educated in Latin American countries (M = 10.82 years of education, SD = 3.956). All patients included obtained a Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Index score of 3 or below to further rule out malingering or suboptimal effort.

Results:

All patients (N=53) were included in the analysis. There was a significant difference found between Hispanic and non-Hispanic DCT e-scores (p <.001, Cohen’s d = 1.755), with the average DCT among the Hispanic group reaching 12.09 (SD = 3.32), while e-scores among the non-Hispanic group averaged 7.2 (SD = 1.508). More specifically, there was a significant difference in completion time of the final six cards (containing grouped dots) found between the groups (p = .005, Cohen’s d = 1.364), with Hispanic patients averaging 20.76 seconds (SD = 8.7) and non-Hispanic patients averaging 10.3 seconds (SD = 5.507). No significant difference was found between groups on the first six cards. The significant difference between Hispanic and non-Hispanic groups on the final six cards suggests potential cultural-educational differences in the approach to task instructions, grouping, or multiplication.

Conclusions:

A considerable proportion of culturally diverse, credible respondents (confirmed by the EI of the RBANS) may run a greater risk of being misclassified as potentially providing poor effort on the DCT’s North American norms. As such, the DCT exhibits notable limitations in its ability to assess performance validity and overall effort in culturally diverse populations and cannot be considered ‘culture-free.’ Accessibility and cultural sensitivity are critical considerations in the testing of marginalized groups, yet have been largely ignored in the literature. The results of this study serve as a preliminary step in identifying concerns with cultural issues in nonverbal performance validity assessment and may assist in developing more culturally appropriate norms and testing.