Neurocognitive Profiles Associated With Limited English Proficiency in Cognitively Intact Adults

Geographic variability in limited English proficiency: A cross-cultural study of cognitive profiles

OBJECTIVE

This study was designed to evaluate the effect of limited English proficiency (LEP) on neurocognitive profiles.

METHOD

Romanian (LEP-RO; n = 59) and Arabic (LEP-AR; n = 30) native speakers were compared to Canadian native speakers of English (NSE; n = 24) on a strategically selected battery of neuropsychological tests.

RESULTS

As predicted, participants with LEP demonstrated significantly lower performance on tests with high verbal mediation relative to US norms and the NSE sample (large effects). In contrast, several tests with low verbal mediation were robust to LEP. However, clinically relevant deviations from this general pattern were observed. The level of English proficiency varied significantly within the LEP-RO and was associated with a predictable performance pattern on tests with high verbal mediation.

CONCLUSIONS

The heterogeneity in cognitive profiles among individuals with LEP challenges the notion that LEP status is a unitary construct. The level of verbal mediation is an imperfect predictor of the performance of LEP examinees during neuropsychological testing. Several commonly used measures were identified that are robust to the deleterious effects of LEP. Administering tests in the examinee's native language may not be the optimal solution to contain the confounding effect of LEP in cognitive evaluations.

Verbal fluency in Lebanese children: Preliminary normative data, sociodemographic determinants, and patterns of clustering and switching

This study assessed the quantitative and qualitative performance of Lebanese-speaking children on verbal fluency (VF) tasks and investigated the effects of sociodemographic characteristics. This study included 219 Lebanese children aged between 5 and 12 years and 11 months, whose native language is Lebanese-Arabic. Semantic and letter VF tasks were assessed using a range of categories and letters. Switching and clustering strategies were analyzed for 177 Lebanese children. The number of words produced presented a significant increase with age (p < .004) in semantic (SVF), while in letter (LVF), the differences were significant between extreme age groups. Females generated more words in the clothes (p = .003) and household items (p = .002) categories. The total number of switches and clusters showed a significantly increasing pattern with age (p < .05). The number of switches was higher for participants with high maternal (p < .001) and paternal (p < .013) educational levels. Regression analyses showed that the total number of switches and clusters, and the mean cluster size had a significant effect on SVF performance (p < .001). The current study generated preliminary norms for VF tasks for Lebanese-speaking children. The results of the current study have an important contribution to neuropsychology research and clinical practice.

Cross-Cultural Performance Validity Testing: Managing False Positives in Examinees with Limited English Proficiency

Base rates of failure (BR_Fail) on performance validity tests (PVTs) were examined in university students with limited English proficiency (LEP). BR_Fail was calculated for several free-standing and embedded PVTs. All free-standing PVTs and certain embedded indicators were robust to LEP. However, LEP was associated with unacceptably high BR_Fail (20-50%) on several embedded PVTs with high levels of verbal mediation (even multivariate models of PVT could not contain BR_Fail). In conclusion, failing free-standing/dedicated PVTs cannot be attributed to LEP. However, the elevated BR_Fail on several embedded PVTs in university students suggest an unacceptably high overall risk of false positives associated with LEP.

The sensitivity of the IOP-29 and IOP-M to coached feigning of depression and mTBI: An online simulation study in a community sample from the United Kingdom

Assessing the credibility of symptoms is critical to neuropsychological assessment in both clinical and forensic settings. To this end, the Inventory of Problems-29 (IOP-29) and its recently added memory module (Inventory of Problems-Memory; IOP-M) appear to be particularly useful, as they provide a rapid and cost-effective measure of both symptom and performance validity. While numerous studies have already supported the effectiveness of the IOP-29, research on its newly developed module, the IOP-M, is much sparser. To address this gap, we conducted a simulation study with a community sample (N = 307) from the United Kingdom. Participants were asked to either (a) respond honestly or (b) pretend to suffer from mTBI or (c) pretend to suffer from depression. Within each feigning group, half of the participants received a description of the symptoms of the disorder to be feigned, and the other half received both a description of the symptoms of the disorder to be feigned and a warning not to over-exaggerate their responses or their presentation would not be credible. Overall, the results confirmed the effectiveness of the two IOP components, both individually and in combination.