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Guidance on Neuropsychological Testing with Individuals who have Intellectual Disabilities

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This guidance aims to provide clinical and other qualified psychologists with information to support them in carrying out neuropsychological assessments with adults with intellectual disabilities.

This document is derived from the document Guidance on the use of neuropsycholgical tests in learning disabilities services (4th edition, January 2012). It was developed for use in Surrey and Borders Partnership NHS Foundation Trust and Croydon Health Services NHS Trust.

The following people have contributed to the development of the document: Editions 1 and 2: Heather Liddiard & Carol Hagland; Edition 3: Heather Liddiard & Julian Morris; Edition 4: Zillah Webb, Heather Liddiard & Karen Dodd.

 

Contents

Section 1: Introduction

  • Objectives
  • Rationale
  • Clinical population
  • National Institute for Health and Care Excellence (NICE) guidance

Section 2: Context

  • Definition of intellectual disabilities
  • Causes of intellectual disabilities
  • Understanding cognition
    • Understanding and measuring general intellectual ability
    • General intellectual ability in people with intellectual disabilities
  • Understanding and measuring memory
    • Memory in adults with intellectual disabilities
  • Understanding and measuring attention
    • Development of attention in typically developing individuals
    • Attention in adults with intellectual disabilities
  • Understanding and measuring executive functioning
    • Executive functioning in adults with intellectual disabilities
  • Understanding language
    • Language in adults with intellectual disabilities
  • Understanding and measuring perception
    • Perception in adults with intellectual disabilities
  • Cognitive profiles of some conditions associated with intellectual disabilities
    • Autism spectrum conditions
    • Down's syndrome
    • Fragile X syndrome 15
    • Klinefelter syndrome
    • Prader-Willi syndrome
    • Turner's syndrome
    • William's syndrome
  • Factors that can impact on cognitive functioning/test performance
    • Motivation and effort
    • Fatigue
    • Epilepsy
    • Medication
    • Use of drugs/alcohol
    • Head injury/concussions
    • Physical and mental health
    • Motor/sensory impairments
    • Culture and diversity

Section 3: Guidance

  • Ethical testing
    • Capacity and consent
    • Confidentiality
    • Emotional distress
  • Information gathering
  • Identification of areas to be assessed/questions to be answered
  • Test selection
    • The question to be answered
    • Characteristics of the individual
    • Characteristics of the tests
  • Setting up the test situation
    • Safety
    • Presence of others in the test situation
    • Ensuring the individual is prepared
    • Structuring the testing process
  • Test administration
    • Standardised administration
    • Non-standard administration
    • Computerised test administration
    • Observation during testing
  • Scoring tests
    • Computerised scoring systems/report writers
  • Interpretation of results and formulation
  • Recommendations for therapy, rehabilitation and mitigation of deficits
  • Presenting and disseminating findings
    • Feedback
    • Report writing
  • Storage of test record forms
  • Outcomes
  • Service user evaluations
  • Reassessment

Section 4: Tests

  • Tests of general intellectual ability
  • Measures of learning
  • Tests of memory
  • Tests of executive functioning

Section 5: Summary

  • References

Appendices

  • Appendix 1: Consent form for IQ and neuropsychological testing
  • Appendix 2: Accessible information leaflet about cognitive assessment
  • Appendix 3: Suggested report headings and issues to consider
  • Appendix 4: Comparison of scores from different versions of the Wechsler Adult Intelligence Scale

 

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