Abstracts

Demographic changes in the US have led to increasing referrals of Hispanic American patients to neuropsychologists. An important factor associated to the assessment of Hispanic-Americans include issues of [underline]language proficiency[/underline]. According to Centeno and Obler (2001), [ldquo]the major concern in a clinical setting is to evaluate a bilingual speaker[apos]s language dominance or balance in order to determine the language to be used during the diagnostic process[hellip] A second concern is to determine the extent to which lack of proficiency can falsely mimic or exaggerate neuropsychological deficits.[rdquo]
A relatively common current testing practice, involves administering psychological tests in English to patients for whom this is not a dominant language. A subgroup that is especially at risk of being inadequately assessed is that of patients who [underline]appear[/underline] to [ldquo]speak well enough to be tested in English.[rdquo] Other current testing practices include assessments through non-verbal measures and with the use of interpreters.
Most of these practices are outside the boundaries of accepted American Psychological Association ethical standards because they can easily result in inaccurate measurements. However, in the last nine months, three cases were evaluated in our center that had recently been tested at other centers using the above mentioned techniques. We present the neuropsychological profiles of these cases when tested in their non-dominant English or through an interpreter and when tested in their dominant language by a bilingual neuropsychologist. Three presurgical epilepsy patients referred to our service were tested in their dominant language, Spanish, utilizing instruments that were standardized on a Spanish-speaking, Hispanic American population (Neuropsychological Screening battery for Hispanics and Woodcock-Mu[ntilde]oz Bater[iacute]a Cognitiva). A comparison between the results (intellectual functioning, language, verbal and visual memory, and visual spatial skills) obtained from this assessment and from a previous one conducted in English using interpreters and/or predominantly non-verbal measures one year earlier was performed. The major differences noted between the evaluations were that when performed in English many language and language-based tests could not be administered leading to missing data. Moreover, the use of visual spatial (non-verbal) tests that were administered in English and through an interpreter and later interpreted using mainstream English (American) norms also led to incongruent results. Results in English were inconsistent with imaging studies and electroencephalographic results. Neuropsychological testing in the patient[apos]s non-dominant language produces equivocal findings that may be partial and incomplete.
Accurate assessments will include testing in the patient[apos]s dominant language (which will be determined through language proficiency assessment) using tests that have been standardized for use with Spanish, Hispanic American populations.