Neuropsychological Evaluation

On August 25th and 26th Dr. Mayer administered the Wechsler Adult Intelligence Scale III IQ test to Will. He adminstered all the subtests, including the optional ones. The final report isn't yet done, but Dr. Mayer shared his preliminary findings with us yesterday.

Here they are at a high level:

1. Will's basic intelligence is intact.
2. On timed tests, Will's accuracy was 100% or nearly so, but his speed was very slow.
3. Will currently has deficits in most types of memory, but not all.
4. Will is currently weak in the executive function of the brain.

Some additional observations:

1. Will scored in the percentile range of 80 to 91 on many conceptual and analytical subtests. This is compared to the total population his age. If the test were normed to all people who had completed medical school, his percentile scores would have been lower.
2. In tests where speed was a factor, Will scored below the 10th percentile. Removing the adjustment for speed would have put those scores in the percentile range of 30 to 50. My own speculation is that Will thought this evaluation was important and cared about the results, so he chose to optimize on accuracy and to let timings be what they may. He may never have thought of balancing speed and accuracy.

• The Stroop test is an example. There is a long list of words that are the names of colors (the names of only 4 colors are used). Each name of a color is printed in a colored font. The color of the font is always different from the color described by the word. I.e., the word 'Blue' is always printed in red, or green, or tan type. The first time through you say the words. (If the word is 'Blue' you say 'blue.') The second time through you say the color of the font. (If the word 'Blue' is printed in red, you say 'red.') The first time through Will did well. The second time he only got halfway through the list in the alloted time. But in that time he only made one mistake.

1. Dr. Mayer talked about 7 or 8 types of memory:

• Long-term: The adage for this one is "First learned, most rehearsed, last lost." Long-term memory is usually not affected by a stroke, and this is true for Will.
• Short-term: This is working memory and is important to attention and concentration. Will scored quite high in this area and got corresponding high marks in attention and concentraton.
• Aural/Verbal and Visual: Not so high. Will has a learning curve, which means he improves with repetition, but his learning curve is not as steep as for most people, i.e., his rate of improvement with repetition is lower.
• Immediate and Delayed: Not so high. Immediate is being able to tell a story back right after he's heard it. Delayed is being able to tell it back after 30 minutes filled with other activities. When telling a story back, Will does well in relating appropriate story themes, but not so well in including the details.
• Episodic: This is being able to relate your experiences. [I don't remember the evaluation of this one. This might be part of long-term memory.]
• Prospective: Not so high. This is remembering what you plan to do.

1. Prospective memory is related to the brain's executive function, but is not the same thing. Prospective memory is keeping a task or goal in mind. Executive function is figuring out how to do it and then making yourself do it. Will currently has deficits in both.