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Objective The Latina(o)/Hispanic (L/H) population represents the largest and fastest-growing ethnic group in the United States. Migration patterns have evolved and greater diversity (i.e. country of origin) is evident, highlighting the ever-changing heterogeneity of this community and the need for the field of neuropsychology to ensure equitable care for linguistically and culturally diverse communities. This paper aims to provide a flexible protocol of neuropsychological instruments appropriate for primarily Spanish-speaking adults residing in the United States. Method Spanish measures were selected based on availability, translations/cultural modifications, accompanying normative data sets, and clinician experience/acumen. Bilingual/bicultural providers of neuropsychological services to Spanish speakers across the training spectrum working at U.S.-based medical centers implemented a multimodal approach (i.e. literature search, clinical practice parameters, and focus groups) in the development of a multi-domain primary protocol that includes core and supplemental measures that are appropriate for individuals with varying linguistic proficiency and sociocultural demographic characteristics. Results A multi-domain, evidence-based, flexible neuropsychological protocol is presented. Recommendations for test selection based on sociocultural demographic factors and examples of clinical assessment practices are provided via a case illustration. Most instruments included may be applied across cultural and regional backgrounds. Conclusion Provision of neuropsychological services to primarily Spanish-speaking adults presents unique challenges. Existing Spanish measures and accompanying data rarely capture the heterogeneity of L/H individuals. Although Spanish has the largest number of neurocognitive instruments, relative to other languages, robust and representative norms continue to be scarce. Future studies should prioritize collecting normative data from educationally and geographically diverse samples. [ABSTRACT FROM AUTHOR]

Objective As the third largest immigrant population in Houston, Texas, Brazilians represent a large bloc of the community in need of culturally and linguistically informed healthcare. In particular, the number of older adults within this population is rapidly growing, emphasizing the increased need to develop socially responsible neuropsychological assessment practices that can meet the needs of this demographic. Additionally, early symptoms of cognitive decline in Brazilian older adults can be culturally perceived as normal aging and may be masked by cultural and lifestyle practices (i.e. scaffolding by family members) that result in lack of appreciation for cognitive and functional decrements. With increased knowledge and awareness of Brazilian culture and customs, we can better understand and assess brain–behavior relationships, provide tailored assessment services, and determine the clinical implications for this population. Methods Test instruments in Portuguese were identified through systematic literature searches, and in consultation with clinicians serving the Portuguese community in the United States, and cultural brokers involved in Brazilian-based neuropsychology. Results A multidomain neuropsychological battery with accompanying normative data for use with adults from this community is presented. A case illustration is utilized to highlight limitations and strengths of the proposed battery, which includes core and supplemental measures. Conclusion Neuropsychologists are encouraged to familiarize themselves with the proposed protocol, understand the psychometric limitations of the available tools, and make an earnest attempt toward providing socially responsible neuropsychological care via the appropriate use of culturally and linguistically tailored instruments and clinical practices. [ABSTRACT FROM AUTHOR]

Objective Provision of supervision is an integral component of training in psychology, a view that was solidified in 2014 with the development of the American Psychological Association created Guidelines for Clinical Supervision in Health Service Psychology (APA, 2014). Current supervisory standards require several components before a relationship is considered supervisory. Among these are assumptions that the supervisory relationship is respectful and collaborative, that feedback is bidirectional, and that it focuses on the development of competency and professional identity by the supervisee. Although clinical and counseling psychology has created supervision models with a variety of different theoretical orientations focused on multiculturalism, neuropsychology as a specialty lacks cohesive, culture-centric, bidirectional supervisory models. Method A systematic review of two electronic databases (PubMed and PsycInfo) was conducted to search for supervision models designed specifically for training in neuropsychology. Results A new model for supervision in neuropsychology was developed, coined the Culturally Expressive and Responsive (CER) Model for Supervision in Neuropsychology. The model is dynamic, multifaceted, and bidirectional, integrating sociocultural and linguistic considerations throughout the supervisory relationship. Conclusions The different facets of the CER Model are discussed, including its place embedded within a larger equitable healthcare model designed to increase healthcare equity. The CER Model highlights the bidirectional supervisory relationship and is designed to be tailored to the developmental level of the learner, encouraging high quality training and evidenced-based practice. Furthermore, the model encourages a process of identity development that is ongoing and emphasizes self-evaluation and cultural humility rather than a static sense of "competence." [ABSTRACT FROM AUTHOR]

Objective Becoming culturally competent healthcare providers depends on the ability of practitioners to acquire knowledge, awareness, and skills related to other cultures. In building these areas of competence, it is essential to consider geopolitical factors that may influence health and health-seeking behaviors, particularly when working with immigrant populations. When care is sought, they are likely to experience significant barriers to effective care, including lack of providers who speak their language and failure of practitioners to integrate cultural beliefs into treatment plans. This is further complicated by the presence of geopolitical issues, including immigration status, war/conflict in the patient's country of origin, and/or human rights violations. Method The current study uses a sample case of a Burmese-speaking, Myanmar national to illustrate a culturally informed approach to the assessment of neurobehavioral changes within complex geopolitical circumstances. The sample represents an amalgam of several patients, designed to represent common presentations, sociodemographic situations, and concerns that arise during the neuropsychological assessment process. Results Description of relevant case information including background, clinical observations, and performance on testing is provided. Discussion Awareness of the impact of these life experiences not only has the potential to deepen our understanding of our patients but also results in a more holistic, accurate, and culturally competent conceptualization of their physical and mental health needs. [ABSTRACT FROM AUTHOR]

Objective The training competency of individual and cultural diversity is an advanced, fundamental competency to health service psychology since 2015. However, there is minimal instruction on how to integrate it into training curricula in neuropsychology, especially at the postdoctoral fellowship level. Our objective was to operationalize the individual and cultural diversity standard to provide a tangible application for educational programs on how to develop a competency-based training model for Latinx/a/o-Hispanic (L/H) cultural neuropsychology across the lifespan. Method The knowledge-based and applied-based competencies necessary to train to be a cultural neuropsychologist delivering services to L/H patients and families are defined. For learners to complete these competencies, training programs need to implement clinical, didactic, research, and professional development core guidelines grounded in cultural neuropsychology. We provide a framework on how to transform each core guideline, including a Didactics Core with foundational readings across a range of L/H topics, and a Report Template to guide the documentation of sociocultural information, language usage, normative data, and other relevant factors in a neuropsychological report. Conclusions These cultural neuropsychology competencies and core guidelines need to become a basic core requirement for all neuropsychologists in training. With focused education in culturally based competencies, training programs can cultivate a sense of responsibility, inclusion, justice, and equity to train a generation of neuropsychologists, who intentionally and consistently practice socially responsible neuropsychology. [ABSTRACT FROM AUTHOR]

Objective Epilepsy is one of the most common reasons for referral for a pediatric neuropsychological evaluation due its high prevalence in childhood and our well-established clinical role in tertiary care settings. Emerging evidence indicates that racial and ethnic minority populations experience increased epilepsy burden compared with White peers. Although there has been heightened recognition in our specialty regarding the dire need for culturally and linguistically responsive evaluations, the scientific evidence to support effective neuropsychological service delivery for bi/multilingual and bi/multicultural youth with epilepsy is comparatively scant and of poor quality. As a result, significant patient and clinical challenges exist, particularly in high stakes presurgical pediatric epilepsy evaluations of bi/multilingual and bi/multicultural children. Method Given that Spanish is the most common language spoken in the United States after English, this paper will focus on Spanish and English measures, but will provide evidence-based practice considerations that can inform practices with other non-English speaking communities. Cultural and linguistic factors that affect clinical decision-making regarding test selection, test interpretation, and feedback with families are highlighted. Results We offer a review of neuropsychological profiles associated with pediatric epilepsy as well as a flexible, multimodal approach for the assessment of linguistically and culturally diverse children with epilepsy based on empirical evidence and the clinical experiences of pediatric neuropsychologists from diverse backgrounds who work with children with epilepsy. Conclusion Limitations to this approach are discussed, including the lack of available measures and resources for culturally and linguistically diverse pediatric populations. A case illustration highlights a culturally informed assessment approach. [ABSTRACT FROM AUTHOR]

Objective To assemble a comprehensive neuropsychological battery appropriate for differential diagnosis of dementia in Farsi-speaking Iranian adults in the United States. Method Systematic searches of PubMed, PsychInfo, and Google Scholar databases were conducted to obtain test instruments relevant to Farsi speakers in consultation with a Farsi-speaking cultural broker. Results A proposed battery assessing the domains of attention, executive function, verbal and visual episodic memory, language, visuospatial/visuoconstruction abilities, and mood/anxiety was assembled that includes core measures developed, either specifically for a Farsi-speaking Iranian population or validated/normed with a Farsi-speaking Iranian sample. Though not ideal, additional measures were selected that can be administered using translated instructions with English normative data to supplement the limited tests available for use in this population. The rationale for test selection and caveats for their clinical use are presented along with a case study. Conclusions The number of neuropsychological measures available in Farsi and/or with normative data for Farsi speakers is extremely limited. Cognitive tests either developed for or validated with a bilingual Farsi-English sample also represent a significant gap in the literature. Appropriate measures for these populations are urgently needed to provide a culturally competent assessment of a growing older adult segment of an underserved community. [ABSTRACT FROM AUTHOR]

Objective Acculturation has been linked to health outcomes in Hispanics/Latinos (H/Ls). However, there is equivocal evidence of a relationship between acculturation and neuropsychological outcomes. Various factors limit the ability to subject the evidence to systematic/meta-analytic review. We sought to examine the current state of the literature in the context of H/Ls and neuropsychology and describe the various limitations of measuring acculturation across the lifespan. Method Applying a scoping review approach, we identified unique stand-alone (e.g. questionnaires) measures of acculturation. We focused on psychometric (e.g. internal consistency) and other characteristics (e.g. language, structure/format) and description of the validation samples (e.g. cultural background/country of origin). Results A total of 40 unique acculturation measures were identified. Measures spanned various domains (e.g. language proficiency, food preference, music choice), and relied heavily on linguistic behavioral characteristics. Internal consistency varied from unacceptable to clinically acceptable ranges. Variable approaches to development and validation were reported. Validation samples varied from 22 to 2,048 respondents (median = 380), most of which represented a general adult population. Only eight measures were validated for use in pediatric populations; none were developed specifically for use with older adults. Conclusions Published measures are outdated, evidence highly variable psychometric and methodological weaknesses, and lack a lifespan perspective. Several themes in the types of items considered elemental to the acculturative process are revealed and findings are summarized via an "ABC" framework, categorizing items as antecedents, behaviors, and consequent acculturative changes, that lends itself to clinical and research settings. [ABSTRACT FROM AUTHOR]

Objective Asians of Chinese origin are the largest single Asian origin group in the United States and are also the third largest group in Harris County, TX (i.e. the Houston metropolitan area). Mandarin speakers constitute the majority of the group. The linguistic gaps between Chinese (Mandarin) and English make it essential to use appropriate tests and normative data when working with the Mandarin-speaking population. Although it is ideal to develop original tests and/or normative data for Mandarin-speaking patients residing in the United States, the process can be lengthy. Although these indigenous tests are being developed, a neuropsychological battery with tests validated in Mandarin-speaking regions (e.g. Mainland China, Taiwan, and Singapore) can provide valuable information for Mandarin-speaking patients who identify with their home culture/country/region. Methods A systematic review of two electronic databases (PubMed and PsycInfo) was conducted. Results A neuropsychological battery to assess cognitive domains, including global intellectual function, attention/processing speed, executive function, visuospatial/visuoconstruction, language, learning and memory, and emotion, was developed. Cognitive screeners and performance validity measures were also included. The battery consists of core and supplementary measures validated in the Mandarin-speaking population. A case illustration is provided. Conclusion Strengths and limitations of the battery and the role of interpretation in service delivery are discussed. The battery is recommended to clinicians for the evaluation of Mandarin-speaking older adults residing in the United States and other non-Mandarin-speaking regions where local norms are not available. [ABSTRACT FROM AUTHOR]

Objective To serve the over 1.82 million people of Korean descent who reside in the United States, we assembled a core and supplemental battery of culturally and linguistically appropriate neuropsychological measures for differential diagnosis of dementia for Korean-speaking patients. Method Test instruments in Korean were identified through systematic searches of PubMed and Google Scholar, US-based website searches in Korean, and in consultation with Korean-speaking cultural brokers, residing in the United States and Korea. Results A battery assessing cognitive domains and mood was assembled using core measures developed specifically for Korean-speaking individuals within the United States and supplemental English measures that can be administered using translated instructions and English normative data. The rationale for test selection and clinical utility, including strengths and limitations of the proposed measures, is presented. Additionally, a case illustration using the proposed battery is included. Conclusions Given the large and aging population of Korean-speaking residents in the United States, it is imperative to utilize appropriately designed and normed instruments to provide culturally competent assessments to better serve the Korean community. [ABSTRACT FROM AUTHOR]

Objectives To assemble a core battery of culturally and linguistically appropriate neuropsychological measures that can be administered to Vietnamese-speaking patients with suspected dementia. Methods Test instruments in Vietnamese were identified through systematic searches of PubMed, PsychInfo, and Google Scholar, and in consultation with two Vietnamese-speaking cultural brokers. Results A battery assessing the domains of attention, executive function, verbal and visual episodic memory, basic language abilities, visuospatial/visuoconstruction abilities, and mood/anxiety was assembled that included core measures developed either specifically for a Vietnamese-speaking population, or were validated/normed with a Vietnamese-speaking sample either in Vietnam or Vietnamese-speaking persons in the U.S. Supplemental measures were selected that can be administered using translated instructions with U.S. English normative data. The rationale for test selection and caveats for their clinical use are presented. Conclusions The number of neuropsychological measures identified in Vietnamese and/or with Vietnamese normative data was sparse. Given the large and growing population of Vietnamese-speaking residents in the U.S. and the aging of these communities, it is imperative to develop additional, appropriately designed and normed instruments to provide culturally competent assessments to better serve these individuals. [ABSTRACT FROM AUTHOR]

Objective: The Verbal Naming Test (VNT) is an auditory-based measure of naming or word finding. The current multisite study sought to evaluate the reliability and validity of the VNT in the detection of major and mild neurocognitive disorder (NCD). Method: This study analyzed clinical data from two outpatient neuropsychology clinics (N = 188 and N = 77) and a geriatric primary care clinic (N = 104). Cronbach's alpha and Spearman correlations with other measures were calculated. ROC analyses were used to calculate sensitivity, specificity, positive predictive power, and negative predictive power for the detection of major and mild NCD per DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria. Results: The VNT was found to have strong reliability (Cronbach's alpha =.90) and high convergent validity with a commonly used picture-naming task (NAB Naming, Spearman's rho =.65, p <.001). The VNT showed good sensitivity and specificity for the detection of NCDs, particularly major NCD, with an area under the curve of.85, sensitivity of.80, and specificity of.75. A possible discontinue rule is also suggested for clinicians to use. Conclusions: These findings provide compelling evidence for the use of the VNT to detect neurocognitive impairment in a clinical setting. The VNT provides a reliable alternative to picture-naming tasks, which may be advantageous when working with visually impaired patients or conducting evaluations over telehealth. [ABSTRACT FROM AUTHOR]

Objective Neuropsychological assessments with monolingual Spanish and bilingual Spanish/English-speaking adults present unique challenges. Barriers include, but are not limited to, the paucity of test norms, uncertainty about the equivalence of translated neuropsychological tests, and limited proficiency in the provision of culturally competent services. Similar issues generalize to telephone- and video-based administration of neuropsychological tests or teleneuropsychology (TeleNP) with Hispanics/Latinos (as), and few studies have examined its feasibility and validity in this group. The sudden onset of the COVID-19 pandemic prompted neuropsychologists to identify alternative ways to provide equitable care. Clinicians providing TeleNP to this population during (and after) the pandemic must consider safety, professional factors, and systemic barriers to accessing and benefitting from virtual modalities. Method This clinical process manuscript describes how cross-cultural neuropsychologists across five U.S. academic institutions serving Hispanics/Latinos (as) developed TeleNP models of care during the pandemic. Results Workflows, test batteries, and resources for TeleNP assessment with monolingual and bilingual Spanish-speaking patients are included. Factors guiding model development and informing decisions to incorporate virtual administration of neuropsychological tests into their practice are also discussed. Conclusions Provision of TeleNP is a promising modality. Additional research in this area is warranted with focus on cultural and contextual factors that support or limit the use of TeleNP with this community. [ABSTRACT FROM AUTHOR]

Objectives: To describe the phenomenology and prevalence of leg stereotypy syndrome (LSS), characterised chiefly by repetitive, rhythmical, stereotypic leg movement, especially when sitting.Methods: We sought to characterise LSS in two groups of subjects: (1) general population (GP) group, defined as individuals accompanying patients during their visits to Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic who are not genetically related to the patients; and (2) movement disorders (MD) group, composed of consecutive patients with diagnoses of restless legs syndrome, Parkinson's disease, Tourette syndrome and tardive dyskinesia.Results: There were 92 participants enrolled in this study; 7% of 57 individuals in the GP group and 17% of those in the MD group met the diagnostic criteria for LSS. The mean age of individuals with LSS was 44.5 (±11.9) years and mean age at onset of LSS was 17.5 (±5.7) years. In half of the individuals, the 'shaking' involved predominantly one leg. All had a positive family history of similar disorder and none had diurnal variation. The seven-item Leg Stereotypy Syndrome Questionnaire was developed as a screening tool to aid in differentiating LSS from other movement disorders.Conclusions: LSS is a common condition, occurring in up to 7% of otherwise healthy individuals, and it is even more common in patients with hyperkinetic movement disorders. Although it phenomenologically may overlap with other stereotypic disorders, we argue that it is a distinct, familial, neurological syndrome. [ABSTRACT FROM AUTHOR]