'Straya, we have a problem: evaluating neuropsychological assessment approaches for diverse populations

Neuropsychological assessment (NA) denotes the process of evaluating brain-behaviour relationships and subsequent intervention (Brickman et al., 2006). NA has predominantly normed Western, educated, industrialised, rich and democratic (WEIRD) populations’ functioning, thus omitting culturally and linguistically diverse (CALD) backgrounds from test development (Casaletto et al., 2015; Sayegh, 2015). This has produced bias, misdiagnosis, and poor representativeness (van de Vijver, 1997). Current Australian demographic shifts have heightened demand for inclusive neuropsychological services providing accurate diagnoses, identifying treatment needs and tracking clients’ progress(Berry et al., 2019).

The current essay aims to evaluate approaches adopted by clinicians for diverse populations, and the factors influencing their validity.

The review examined 35 peer-reviewed publications, and found that tailored NA (including the International Shopping List Test) consistently demonstrated robust test-retest reliability, and construct and cross-cultural validity for diverse samples (Lim et al., 2012). This owes to translatability, universally relevant stimuli, and reduced verbal items to mitigate translation difficulties.

CALD-adjusted norms for batteries including the Wechsler Memory Scale also demonstrated robust criterion, factorial, convergent, discriminant, and concurrent validity (Walker et al., 2010).This owes to rectifying prevalent limitations of WEIRD-normed NA, including non-representative norms, item bias, intracultural variance, poor accessibility and limited CALD training (Carstairs et al., 2006; Cory, 2020; Lim et al., 2012).

NA approaches can thus be enhanced by increasing CALD-inclusive NA administration, test design, and clinical training (academically and professionally), thus facilitating increased cross-cultural fluency for Indigenous, multiracial, migrant and acculturated groups (Berry et al., 2018; Brickman et al., 2006). Through such action, CALD NA can improve diagnostic accuracy and intervention efficacy.