Date of this Version
Published in The Future of Testing, edited by Barbara S. Plake & Joseph C. Witt (Hillsdale, NJ: Lawrence Erlbaum Associates, 1986).
PERSPECTIVES ON THE FUTURE OF NEUROPSYCHOLOGICAL ASSESSMENT
The relationship between human behavior and the functioning of the brain has intrigued scholars for centuries. Although the antecedents are clear, our present knowledge of the relationship between observable behavior and the physiology of the central nervous system owes more to the research vigor of the past 40 years than any other time in history . Of continuing interest to psychologists and other neuroscientists has been evidence of the correspondence between the functioning of the brain and cognitive, sensorimotor and affective dimensions of behavior. With such knowledge as a foundation has come the development and continuing validation of psychological methods which allow inferences concerning individuals' cortical functioning . Thus, what has become known as neuropsychological assessment attempts to re late behavior culled under standardized conditions to the functional efficiency of the brain . Although we are far from consensus on the role neuropsychological assessment should play in routine clinical examinations, numerous authors have argued in favor of a neuropsychological perspective in our understanding of psychiatric as well as neurological disorders (e .g. , Dean, 1982a, Golden, 1978; Hartlage & Hartlage, 1977; Reitan, 1955, 1976).
The intent of this chapter is to examine the present status and approaches to neuropsychological assessment in light of a half century of research in the area . Following a review of the critical issues and psychometric adequacy of assessment procedures, this paper pursues developments within the neurosciences which may shape the direction of neuropsychological assessment during the next two decades.
As in most areas of measurement, neuropsychological assessment grew out of a need in an applied area. In the case of neuropsychology , the most salient influence has been the desire on the part of the medical community to more fully describe the behavioral effects of brain damage (Reitan, 1966). The administration of experimental and standardized psychological measures to patients with documented structural brain lesions gave rise to a data base which allowed investigation of the sensitivity of these measures to brain damage (Halstead & Settlage, 1943; Hunt, 1943; Reitan , 1955). In the post-World War II years, these data were expanded with the relatively large number of patients with documented brain lesions resulting from head wounds (Boll, 1974; Luria, 1963; Reitan, 1966). Such events when combined with the growing empirical emphasis beginning in the decade just prior to World War II nurtured a quantitative approach which continues to characterize neuropsychological assessment in North America (Dean , 1982a; Luria & Majovski, 1977). Moreover, theoretical notions concerning brain function mattered less than the utility of assessment procedures in predicting and localizing cortical damage.