Test usage patterns and perceived ecological utility of neuropsychological assessment techniques: A survey of North American clinical neuropsychologists

Laura Alyson Rabin, Fordham University


The present study surveyed neuropsychological test usage patterns, determined usage rates of ecologically oriented instruments, and explored the perceived ecological utility of commonly used neuropsychological assessment techniques. Respondents were 747 North American doctoral level psychologists (40% usable response rate) with membership affiliations in the American Psychological Association (Division 40), the National Academy of Neuropsychology, and/or the International Neuropsychological Society. This study utilized a 6-page, 35-item questionnaire with two main sections. First, respondents provided basic demographic and practice-related information. Second, respondents read a brief vignette about a TBI patient experiencing cognitive difficulties resulting from a sports-related injury. Respondents then reported the instruments they would use to assess this patient's specific cognitive symptomatology, general cognitive abilities, and capacity to return to work. Subsequently, respondents rated levels of confidence in their ability to use their chosen instruments to assess aspects of this patient's real-world functioning. This dissertation resulted in several findings that have significant implications for the field of clinical neuropsychology and its practitioners. First, this study updated and greatly expanded knowledge about neuropsychologists' assessment practices and test usage patterns. Second, results indicated that while approximately one-third of neuropsychologists incorporate ecologically oriented instruments into their assessment batteries, many others could benefit from the utilization of similar techniques. Third, results revealed that neuropsychologists are more confident in their ability to use instruments to assess general aspects of cognitive functioning than to address ecological concerns. This finding contributes to a growing body of literature that questions the ability of traditional neuropsychological instruments to handle the complex, real-world outcome issues increasingly addressed during the assessment process. It is argued that practitioners must afford ecological issues a greater role in discussions on all fronts of neuropsychological inquiry, including research literature, professional conferences, and graduate training programs. Further, at the individual level, neuropsychologists must critically evaluate their own assessment batteries and modify existing practices to incorporate the latest, most ecologically meaningful techniques. It is hoped that these efforts will culminate in neuropsychological evaluations better able to offer diagnostic and predictive information essential to the provision of optimal patient care.

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Recommended Citation

Rabin, Laura Alyson, "Test usage patterns and perceived ecological utility of neuropsychological assessment techniques: A survey of North American clinical neuropsychologists" (2002). ETD Collection for Fordham University. AAI3061338.