认知能力评估双语昆明医学院课件

认知能力评估文伟光 副教授香港理工大学昆明医学院客座教授认知能力评估双语昆明医学院学习目标学习目标n nTo analyze分析structure结构of a screening test on mental staten nTo study cognitive assessments评估used in OT practicein the following areas:n nMental stateMental staten nExecutive functionExecutive functionn nMemoryMemoryn nAttentionAttention认知能力评估双语昆明医学院Screening test of mental staten n简短智能测试(Chinese version of Mini-Mental State Examination,CMMSE)认知能力评估双语昆明医学院What is a screening筛选 test?n nScreening tests are not designed to be Screening tests are not designed to be diagnostic but are sensitive to detect cognitive diagnostic but are sensitive to detect cognitive abnormalities abnormalities 认知不正常认知不正常 for further for further assessmentsassessmentsn nScreening tests are generally short and fastScreening tests are generally short and fastn nScreening tests usually have a cutoff Screening tests usually have a cutoff 界线界线 score score to indicate normal/abnormal functioningto indicate normal/abnormal functioning认知能力评估双语昆明医学院简短智能测试Folstein et al.,1975Folstein et al.,1975认知能力评估双语昆明医学院简短智能测试的结构分析n n简短智能测试是由以下各项认知评估结合而成简短智能测试是由以下各项认知评估结合而成n nOrientation Orientation n nShort-termShort-termmemorymemoryn nlong-term memorylong-term memoryn nWorking memoryWorking memoryn nCalculationCalculationn nL Languageanguagen nVisuo-spatial abilityVisuo-spatial ability认知能力评估双语昆明医学院简短智能测试n nCut-off score of original MMSE was 23/24(Folstein,Cut-off score of original MMSE was 23/24(Folstein,1975)1975)n nLocal study show the cut-off score is 19/20.Local study show the cut-off score is 19/20.n nwhy the local one was lower than the original one?why the local one was lower than the original one?n nLevel of educational attainment was found associating Level of educational attainment was found associating with CMMSE scores,so optimal cutoffs for HK elderly with CMMSE scores,so optimal cutoffs for HK elderly people(Chiu et al,1998)are:people(Chiu et al,1998)are:n n22(more than 2 years of schooling)22(more than 2 years of schooling)21(1-2 years of schooling)21(1-2 years of schooling)18(illiterate18(illiterate文盲文盲)认知能力评估双语昆明医学院To conclude总结n nIntelligence is not of a single dimension,but has multiple dimensionsn nWhich type of intelligence is stronger in you?认知能力评估双语昆明医学院Structure and scoring of CMMSEn nItems 1 and 2Items 1 and 2Time of dayPlaceDay Day 日日City City 城市城市Date Date 日期日期DistrictDistrictMonth Month 月份月份Street Street 街道街道Year Year 年份年份Building Building 大厦大厦Season Season 季节季节Floor Floor 层数层数认知能力评估双语昆明医学院CMMSEtest of orientation Time and Place Time and Placen nProblems with new learning or anterograde Problems with new learning or anterograde memorymemoryn nProblems with temporal orientation and Problems with temporal orientation and topographic orientation(Hasse,1997)topographic orientation(Hasse,1997)PersonPerson An internal awareness of self within a persons An internal awareness of self within a persons surrounding(Dietz,Beeman&Thorn,1993)surrounding(Dietz,Beeman&Thorn,1993)n nRetrograde memory loss of autobiographical Retrograde memory loss of autobiographical informationinformation认知能力评估双语昆明医学院Item 3&5n nRead out three unrelated objects 无关“apple苹果,newspaper报纸,train火车”认知能力评估双语昆明医学院Item 4 Serial subtraction(Serial 7s)Serial subtraction(Serial 7s)Subtract Subtract减减 7 from 100,and then 7 until for the 7 from 100,and then 7 until for the 5th time(5th time(连续减连续减5 5次次).).n nORORn nOROR认知能力评估双语昆明医学院Scoring of serial 7s认知能力评估双语昆明医学院CMMSEtest of memoryn nItems 3 and 5 examine short-term and long-term episodic memory respectively.n nItem 4 evaluate评估working memory(i.e.memory functioning together with the functioning of information processing).认知能力评估双语昆明医学院影响记忆的因素n n记忆结果可能受到以下因素影响:n nAttentionAttentionn nSensory impairmentsSensory impairmentsn nMoodMoodn nMotivationMotivationn nBeware of the impacts of these factors that may lead to an inaccurate 不准确interpretation 解释 of memory functioning认知能力评估双语昆明医学院Items 6-8认知能力评估双语昆明医学院Items 9-10认知能力评估双语昆明医学院CMMSEtest of language语言 functioningn nAbility of naming,word-finding,and repetition重复n nAuditory comprehension 听觉理解n nVisual comprehension,Reading 阅读认知能力评估双语昆明医学院Item 12认知能力评估双语昆明医学院认知能力评估双语昆明医学院CMMSEtest of visuo-spatial abilityn nCopying pattern demonstrates clients ability of spatial functioning 认知能力评估双语昆明医学院记忆评估记忆评估n nDigit Recalln nRivermeadbehavioral memory test(RBMT)n nHong Kong list learning test(HKLLT)认知能力评估双语昆明医学院Digit Recall Tasks(Adapted from Wechsler-Bellevue Intelligence Test)n nDIGITS FORWARDDIGITS FORWARD顺序顺序顺序顺序I am going to say some numbersI am going to say some numbers(1 second per digit).Listen(1 second per digit).ListenCarefullyCarefully小心听小心听,and when I am,and when I amThroughThroughsay them right after me.say them right after me.6-1-9-4-7-36-1-9-4-7-35-9-1-7-4-2-85-9-1-7-4-2-85-8-1-9-2-6-4-75-8-1-9-2-6-4-72-7-5-8-6-2-5-8-42-7-5-8-6-2-5-8-4 n nDIGITS BACKWARDDIGITS BACKWARD由后面由后面由后面由后面读回前面读回前面读回前面读回前面n nNow I am going to say some Now I am going to say some more numbers(1 second per more numbers(1 second per digit),but this time when I digit),but this time when I stop I want you to say them stop I want you to say them backward.For example,If I backward.For example,If I say“7-1-9”what would you say“7-1-9”what would you say?(If correct,say:“Here say?(If correct,say:“Here are some others”)are some others”)1-5-2-8-61-5-2-8-65-3-9-4-1-85-3-9-4-1-88-1-2-9-3-6-58-1-2-9-3-6-59-4-3-7-6-2-5-89-4-3-7-6-2-5-8认知能力评估双语昆明医学院Digit Recall n nForward recall and Backward recalln nTest of memory span记忆长度and attention专注n nBackward recall also assesses working memory认知能力评估双语昆明医学院n nTest of Everyday Attention专注力评估认知能力评估双语昆明医学院Attention n nEssential必须for information processing,memory and recall(Toglia,1992)认知能力评估双语昆明医学院Test of Everyday Attention(TEA)n nAimsAims目的目的to measure four aspects of attention to measure four aspects of attention that are important for daily functioningthat are important for daily functioning n nSelective Selective 选择选择 attentionattentionn nSustained Sustained 保留保留 attentionattentionn nAttentional switchingAttentional switchingn nDivided Divided 分别分别 attentionattentionn nApplicable for clients with brain injuries,Alzheimers Applicable for clients with brain injuries,Alzheimers disease disease 老人痴呆老人痴呆,and age range of 18 to 80 years,and age range of 18 to 80 yearsn n3 parallel versions 33 parallel versions 3个版本个版本n nAdministration time is about 45 to 60 minutesAdministration time is about 45 to 60 minutes需时需时45-6045-60分钟分钟n nLicensed training is requiredLicensed training is required认知能力评估双语昆明医学院Test of Everyday Attention(TEA)n n8 test items8 test itemsn nMapMap地图地图 searching(search symbols on the map)searching(search symbols on the map)n nElevator countingElevator counting计数计数 (count a series of tones presented on an(count a series of tones presented on an audiotapeaudiotape录音机录音机,that represents floors reached on the elevator),that represents floors reached on the elevator)n nElevator counting with distractionElevator counting with distraction混乱混乱 (count only low tones)(count only low tones)n nVisualVisual视觉视觉 elevator(follow a series of visually presented floors)elevator(follow a series of visually presented floors)n nElevator counting with reversalElevator counting with reversal倒转倒转n nTelephoneTelephone电话电话 search(look for key symbols in a directory)search(look for key symbols in a directory)n nTelephone search while countingTelephone search while countingn nLottery(listen for their winning number and write down Lottery(listen for their winning number and write down 写下写下the two letters preceding all numbers ending in given digits)the two letters preceding all numbers ending in given digits)认知能力评估双语昆明医学院Referencesn nGloag,D.(1985).Rehabilitation after head injury.Gloag,D.(1985).Rehabilitation after head injury.British Medical British Medical Journal,290Journal,290,834-837.,834-837.n nHasse,B.(1997).Cognition.In J.Van Deusen&D.Brunt Hasse,B.(1997).Cognition.In J.Van Deusen&D.Brunt(Eds.),(Eds.),Assessment in occuputional therapy and physical Assessment in occuputional therapy and physical therapytherapy(pp.333-356).Philadelphia:W.B.Sauders.(pp.333-356).Philadelphia:W.B.Sauders.n nItzkovich,M.,Elazar,B.,Averbuch,S.,&Katz,N.(1990).The Itzkovich,M.,Elazar,B.,Averbuch,S.,&Katz,N.(1990).The Loewestein Occupational Therapy Assessment(LOTCA)maunal.Loewestein Occupational Therapy Assessment(LOTCA)maunal.Pequanock,NJ:Maddock,Inc.Pequanock,NJ:Maddock,Inc.n nKatz,N.,Hartman,M.A.,Ring,H.,&Soroker,N.(2002).Katz,N.,Hartman,M.A.,Ring,H.,&Soroker,N.(2002).Relationships of cognitive performance and daily function of clients Relationships of cognitive performance and daily function of clients following right hemispheric stroke:predictive and ecological validity following right hemispheric stroke:predictive and ecological validity of the LOTCA battery.Occupational Therapy of Research,20,3-17.of the LOTCA battery.Occupational Therapy of Research,20,3-17.n nLam,L.C.W.et al.(1998).Clock-Face Drawing,Reading and Setting Lam,L.C.W.et al.(1998).Clock-Face Drawing,Reading and Setting Tests in the Screening of Dementia in Chinese Elderly Adults.Tests in the Screening of Dementia in Chinese Elderly Adults.Journal Journal of Gerontologyof Gerontology,53B,353-357,53B,353-357认知能力评估双语昆明医学院Referencesn nCosta,L.D.(1975).The relation of visuospatial dysfunction to digit span Costa,L.D.(1975).The relation of visuospatial dysfunction to digit span performance in patients with cerebral lesions.Cortex,11,31-36.performance in patients with cerebral lesions.Cortex,11,31-36.n nGardner,H.(1993).Frames of mind:The theory of multiple intelligence(2nd ed.).Gardner,H.(1993).Frames of mind:The theory of multiple intelligence(2nd ed.).New York:Basic Books.New York:Basic Books.n nHunt,E.(1995).The role of intelligence in modern society.American Scientist(July-Hunt,E.(1995).The role of intelligence in modern society.American Scientist(July-August).August).n nKaufman,A.S.,&Lichtenberger,E.O.(1999).Essentials of WAIS-III assessment.Kaufman,A.S.,&Lichtenberger,E.O.(1999).Essentials of WAIS-III assessment.New York:John Wiley&Sons,Inc.New York:John Wiley&Sons,Inc.n nLezak,M.D.(1995).Neuropsychological assessment(3rd ed.).New York:Oxford Lezak,M.D.(1995).Neuropsychological assessment(3rd ed.).New York:Oxford University Press.University Press.n nToglia,J.P.(1998).A dynamic interactional model to cognitive rehabilitation.In N.Toglia,J.P.(1998).A dynamic interactional model to cognitive rehabilitation.In N.Katz(Ed.),Cognition and occupation in rehabilitation(pp.5-50).Bethesda:AOTA.Katz(Ed.),Cognition and occupation in rehabilitation(pp.5-50).Bethesda:AOTA.n nUnsworth,C.(1999).Cognitive and perceptual dysfunction:A clinical reasoning Unsworth,C.(1999).Cognitive and perceptual dysfunction:A clinical reasoning approach to evaluation and intervention.Philadelphia:F.A.Davis.approach to evaluation and intervention.Philadelphia:F.A.Davis.n nWilson,B.,Cockburn,J.,&Baddeley,A.(1991).RBMT-The RivermeadBehavioural Wilson,B.,Cockburn,J.,&Baddeley,A.(1991).RBMT-The RivermeadBehavioural Memory Test.Bury St.Edmunds,London:Thames Valley Test Company.Memory Test.Bury St.Edmunds,London:Thames Valley Test Company.n nZoltan,B.(1996).Vision,perception and cognition:A manual for the evaluation and Zoltan,B.(1996).Vision,perception and cognition:A manual for the evaluation and treatment of neurologically impaired adult.Thorofare:Slack.treatment of neurologically impaired adult.Thorofare:Slack.n n认知能力评估双语昆明医学院