Academic literature on the topic 'Wechsler Memory Scale – Cross-cultural studies'

Background: Various studies have documented age-related changes in cognitive abilities and neural basis. Objectives: To investigate the role of neuropsychological function tests in predicting amnestic mild cognitive impairment in the elderly. Materials & Methods: In this cross-sectional study with a correlational design, the study population included elderly people over 60 years old residing in Bojnord City, Iran, in the spring of 2019. The participants were selected by cluster sampling method (n=128). The study instruments included the Bender-Gestalt test, Wechsler memory scale-revised, Wechsler adult intelligence scale third edition, and behavior rating inventory of executive functions. According to the scores of the elderly in the Wechsler memory scale (cut-off score=70), the participants were divided into two groups with amnestic mild cognitive impairment (MCI) and no MCI. For analyzing data, the discriminant analysis was performed using SPSS v. 23. Results: Discriminant analysis showed that the obtained discriminant function had a significant diagnostic power (χ2 =166.001, P<0.0001) and 70% of the difference between the two groups with amnestic mild cognitive impairment and no mild cognitive impairment was explained by scores of fluid intelligence, visual-motor coordination, and executive functions. The predictor variables correctly classified 96.9% of the elderly in the groups of amnestic MCI and no MCI. Visual-motor coordination (coefficient=0.53) and fluid intelligence (coefficient=-0.54) were strong variables in predicting amnestic MCI. Conclusion: Neuropsychological function tests can help predict amnestic MCI in the elderly

Aim and background: One of the most important psychological disorders after stroke is depression, which leads to reduced quality of life, optimal rehabilitation failure, loss of cognitive tasks and decrease in the recovery process. In this research, relation between patterns of depression and cognitive, motor and function deficits in people with chronic stroke was studied. Methods and materials: In a pilot cross-sectional study, 40 patients with chronic stroke (more than 6 months) were enrolled. Depression (Beck Depression Inventory), cognition (attention test TMT-A & B and Wechsler memory), motor (Motorcity index), basic activities of daily living (Barthel scale) and instrumental activities of daily living (Lawton scale) were evaluated. Results: The results of the study revealed a significant positive correlation between post stroke depression and verbal memory (r=0.440،P<.05), attention (r=0.615،P<.05), motor function(r-0.368،P<.05), independence in basic activities of daily living (r=0.781،P<.05) and instrumental activities of daily living (r=0.741, P<.05). Conclusion: According to the findings, further studies of factors affecting post stroke depression (PSD) clinical and practical aspects are necessary. Cognitive rehabilitation programs with motor rehabilitation can decrease depression and gain independence in activities of daily living and more participation in society activities.

Objective: Functional imaging studies of post-traumatic stress disorder (PTSD) have shown an increased activation of posterior cingulate gyrus (PCG) of the brain. The aim of this study was to explore white matter integrity of PCG in PTSD subjects.Methods: White matter integrity, as determined from fractional anisotropy (FA) value using diffusion tensor imaging, was assessed for PCG in subjects with and without PTSD from a severe mine accident. All subjects were also measured by the PTSD Checklist Civilian Version (PCL-C), the State-Trait Anxiety Inventory (STAI), the logical memory subtest and the visual reproduction subtest of the Wechsler Memory Scale-Revised in China. Sixteen PTSD subjects (8 subjects in each group) in the longitudinal study and 13 PTSD subjects as well as 14 non-PTSD controls in the cross-sectional case–control study were respectively recruited.Results: In the longitudinal study, subjects with PTSD showed increased FA values in left PCG during the follow-up scan. In the cross-sectional study, FA values in bilateral PCG in PTSD subjects were higher than controls. Within the PTSD group (n = 13), FA values in the left PCG correlated positively with logical memory and negatively with PCL-C intrusion and STAI-trait (STAI-t) subscores. FA values in right PCG correlated negatively with STAI-t and STAI-state subscores.Conclusion: These findings suggest that alterations of white matter integrity in PCG link to mnemonic and affective processing in PTSD over the long-term follow-up period.

Object Although the mechanisms underlying neurocognitive changes after carotid endarterectomy (CEA) are poorly understood, intraoperative ischemia and postoperative hemodynamic changes may play a role. Methods Data from 81 patients who underwent unilateral CEA with routine shunt use for carotid artery stenosis were retrospectively evaluated. These patients underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale–Third Edition and the Wechsler Memory Scale–Revised before and 6 months after CEA. Results of NPEs were converted into z scores, from which pre- and postoperative cognitive composite scores (CSpre and CSpost) were obtained. The association between the change of CS between pre- and postoperative NPEs (that is, CSpost − CSpre [CSpost – pre]) and various variables was assessed. These latter variables included ischemic or hemodynamic parameters such as 1) intraoperative hypoperfusion detected by somatosensory evoked potential (SSEP) change—that is, an SSEP amplitude reduction more than 50% and longer than 5 minutes (SSEP< 50%, > 5 min); 2) new lesions on postoperative diffusion-weighted imaging studies; and 3) preexisting hemodynamic impairment. Paired t-tests of the NPE scores were performed to determine the net effect of these factors on neurocognitive function at 6 months. Results A significant CSpost – pre decrease was observed in patients with SSEP< 50%, > 5 min when compared with those without SSEP< 50%, > 5 min (−0.225 vs 0.018; p = 0.012). Multiple regression analysis demonstrated that SSEP< 50%, > 5 min independently and negatively correlated with CSpost – pre (p = 0.0020). In the group-rate analysis, postoperative NPE scores were significantly improved relative to preoperative scores. Conclusions Hypoperfusion during cross-clamping, as verified by SSEP amplitude reduction, plays a significant role in the subtle decline in cognition following CEA. However, this detrimental effect was small, and various confounding factors were present. Based on these observations and the group-rate analysis, the authors conclude that successful unilateral CEA with routine shunt use does not adversely affect postoperative cognitive function.

INTRODUCTION: Sickle cell disease (SCD), a complex genetic blood disorder involving multicellular interactions between blood and endothelial cells, is often accompanied by central nervous system (CNS) complications. Effects range from silent cerebral infarct (SCI) to abnormal blood flow, and consequent overt stroke. This study assessed the humanistic and economic burden associated with CNS complications in patients with SCD and identified patient-reported outcome (PRO) instruments for future research. METHODS: MEDLINE, Embase, Cochrane CENTRAL/CDSR and 11 congresses were searched to identify English language studies published from January 2000 to May 2020 and screened with predefined criteria by two independent researchers. Clinical trials (CT) or observational studies assessing humanistic burden, economic burden, or instruments used to measure burden in patients with SCD and CNS complications (N≥15) were included. Humanistic burden was broadly defined to include quality of life (QoL), symptoms and function. RESULTS: Of the 3194 articles identified, 34 were included. Study designs were 29% retrospective observational (10/34), 29% cross-sectional (10), 26% prospective (9), 9% randomized CT (3), and 6% systematic reviews (2). Study size varied widely (16-4,485 patients with SCD and CNS complications). 77% (26) focused on pediatric patients. Separately, 77% (26) were in a US setting. Overt stroke (12), stroke and SCI (11), or SCI only (7) were the most frequently described CNS complications. Twenty-five studies reported on humanistic burden, 18 of which measured cognitive function using the Wechsler Intelligence Scales. A significant decrease was reported in full scale (FS) (stroke vs. no stroke: 73.5 vs. 84.7; P=.04), verbal (abnormal vs. normal MRI: 74.1 vs. 84.6; P=.02), and performance IQ (stroke vs. no stroke: 69.5 vs. 81.5; P=.02) for patients with overt strokes or SCI compared to non-stroke SCD controls. Greater impairment was reported for overt stroke compared with SCI (multivariate meta-analysis of mean IQ difference: -10.3; P=.0013). In addition to stroke/SCI, socio-environmental factors (i.e., family income level, lack of college education) were significantly associated with a decrease in IQ (P=.005 and P=.023, respectively). Five studies assessed motor function, reporting significantly impaired function for patients with stroke compared to non-stroke SCD controls (Purdue Pegboard both hands: 7.5 vs. 10.1; P=.0001). Among children with SCD who had experienced their first stroke, those receiving hydroxyurea (HU) for prevention of recurrent stroke had significantly less moderate to severe motor disability (physician assessed) than children not receiving HU (23.1 vs. 88.9%; P&lt;.001). Nine studies reported economic outcomes related to healthcare resource use (HCRU) (8) and direct costs (5). HCRU and cost to manage CNS complications are high, with a median LOS of 5 days (IQR 3-9) and median hospitalization charges of $18,956 (2012 USD) for patients with SCD and stroke. Treatment costs were also substantial in patients with SCI, with annual transfusion plus chelation costs ranging between $18,149 and $67,361/year (2016 USD). No studies reported indirect costs. While many studies used clinician-administered performance outcome (PerfO) measures such as the Wechsler Scales, only 1 study employed a PRO instrument: the Children's Depression Index. In addition to the Wechsler Scales, PerfO measures of cognitive function included the Woodcock-Johnson Psychoeducational Battery (6 studies), Children's Memory Scale (4), and California Verbal Learning Test for Children (4). CONCLUSIONS: This systematic review found that SCD patients with CNS complications often experience diminished cognitive/motor function and incur substantial costs. In particular, the mean FSIQ for SCD patients with stroke and SCI was reported to be 'extremely low' to 'low' (65.9 to 83.6) and 'low' to 'average' (77.2 to 95.9), respectively across studies. The Wechsler Scales were the most commonly used PerfO measure of cognitive function, while use of disease-specific PRO instruments was extremely limited. Given that the majority of published data focuses on children, future research is needed to evaluate the burden of disease for SCD adults with CNS complications, and to assess patient perspectives and QoL to better quantify aspects of burden beyond cognitive performance. Disclosures Lee: Novartis Pharmaceuticals Corporation: Current Employment. Nellesen:Analysis Group, Inc.: Consultancy. Lucas:Analysis Group, Inc.: Consultancy. Paulose:Novartis Pharma AG: Current Employment.

Abstract Background Sickle cell disease (SCD) -related neurological complications include overt stroke, silent infarctions and cognitive impairment (CI). CI significantly impacts developmental growth and quality of life. Despite the high prevalence of SCD in sub-Saharan Africa, there is limited information on the burden of neurological dysfunction. To address this gap, we conducted a study to elucidate the prevalence and correlates of CI in SCD-children in an urban tertiary care setting in Nigeria. Method This case-control, cross-sectional study was approved by the University of Pittsburgh IRB, Lagos University Teaching Hospital (LUTH) and Lagos State University Teaching Hospital (LASUTH) in Nigeria. Participants were recruited from the LUTH sickle cell clinic and the Sickle Cell Foundation-associated clinics, which included a transcranial Doppler (TCD) clinic. Participants were English-speaking children between the ages 6-16 with laboratory-diagnosed homozygous SCD (HbSS, sickle cell anemia). Children who had an on-going sickle cell crisis or who received a blood transfusion within 3 months were excluded from the study. HbAA siblings of the patients and unaffected age-matched children from the LASUTH pediatric primary care clinic were recruited as control subjects. For a comprehensive assessment of cognitive function, subtests of the Wechsler Intelligence Scale for Children (WISC IV) were administered to assess processing speed (Symbol Search, Coding subtests) and Working Memory (Digit Span, Symbol search subtests) indices. Baseline hemoglobin levels were obtained via a Stat-site hemoglobin analyzer, and oxygen saturation levels were obtained using a pulse oximeter. Baseline demographic data was obtained by surveying the parents/guardians. Lastly, children recruited from the Sickle Cell Foundation TCD clinic (n=24) were stratified by stroke risk levels (standard, conditional, high and indeterminate) based on the TCD velocity values. Results A total of 56 children diagnosed with sickle cell disease (M=29, mean age=9.2, SD: 2.76) and 42 unaffected children (M=24, mean age= 9.41, SD: 2.75) participated in this study. We found a higher prevalence of cognitive deficits, especially in areas of processing speed (p=0.013) and short-term auditory memory (p=0.002) in SCD patients as compared to controls. There was also a close association with working memory deficits (p=0.07). Surprisingly, we did not find an association between the cognitive performance of SCD children and their levels of anemia, oxygen levels or body mass index. TCD high risk level was marginally associated with a lower hemoglobin and severe anemia (p=0.05) although there was no significant correlation with working memory and processing speed indices. Conclusion Children with SCD in Nigeria suffer from cognitive deficits in the areas of memory and attention when evaluated with subtests of the Wechsler Intelligence Scale for Children. We found that, unlike other studies of cognitive function in SCD, our study did not find a correlation between cognitive function and hemoglobin level. It is, therefore, possible that other local environmental or disease-specific factors may be associated with CI in our SCD cohort, or that anemia may affect other cognitive domains not explored by our research. Larger, longitudinal studies should be performed to further elucidate the cognitive function of pediatric SCD patients in Nigeria so that appropriate, locally targeted, preventive interventions can be developed. Disclosures: No relevant conflicts of interest to declare.

Mercury an important therapeutic substance in Tibetan Medicine undergoes complex “detoxification” prior to inclusion in multi-ingredient formulas. In an initial cross-sectional study, patients taking Tibetan Medicine for various conditions were evaluated for mercury toxicity. Two groups were identified: Group 1, patients taking “ Tsothel” the most important detoxified mercury preparation and Group 2, patients taking other mercury preparations or mercury free Tibetan Medicine. Atomic fluorescence spectrometry of Tibetan Medicine showed mercury consumption 130 µg/kg/day (Group 1) and 30 µg/kg/day (Group 2) ( P ≤ 0.001), levels above EPA (RfDs) suggested threshold (0.3 µg/kg /day) for oral chronic exposure. Mean duration of Tibetan Medicine treatment was 9 ± 17 months (range 3–116) (Group 1) and 5 ± 1.96 months (range 1–114) (Group 2) (NS) with cumulative days of mercury containing Tibetan Medicine, 764 days ± 1214 (range 135–7330) vs. 103 days ± 111 (range 0–426), respectively ( P ≤ 0.001). Comparison of treatment groups with healthy referents (Group 3) not taking Tibetan Medicine showed no significant differences in prevalence of 23 non-specific symptoms of mercury toxicity, abnormal neurological, cardiovascular and dental findings and no correlation with mercury exposure variables; consumption, cumulative treatment days, blood/ urine Hg. Liver and renal function tests in treatment groups were not significantly increased compared to referents, with mean urine Beta2 Microglobulin within the normal range and not significantly associated with Hg exposure variables after correcting for confounding variables. Neurocognitive testing showed no significant intergroup differences for Wechsler Memory Scale, Grooved Pegboard, Visual Retention, but Group1 scores were better for Mini-Mental, Brief Word Learning, Verbal Fluency after correcting for confounding variables. These results suggest mercury containing Tibetan Medicine does not have appreciable adverse effects and may exert a possible beneficial effect on neurocognitive function. Since evidence of mercury as a toxic heavy metal, however, is well known, further analysis of literature on mercury use in other Asian traditional systems is highly suggested prior to further studies.

Abstract Background Verbal memory is one of the most affected cognitive domains in patients with schizophrenia and related psychoses. Several studies have found associations between cognitive abilities and white matter fractional anisotropy (FA) in schizophrenia; however, only a few tractography studies have investigated FA relative to verbal memory in patients with a first episode of psychosis (FEP) compared with healthy controls (HC). Although white matter tractography differences have been well established between chronic patients and HC, the direction of findings from FEP studies has been inconsistent. Thus, the present study aims to examine whole-brain white matter differences and its association with verbal memory in individuals with a FEP relative to HC using tractography. Methods Diffusion-weighted images were acquired on a 1.5T scanner for patients (n=65) and controls (n=54) at baseline. The Wechsler Memory Scale was used as a measure of verbal memory. Pre-processing was performed on a subject-by-subject basis using MRtrix. Diffusion tractography was generated using a probabilistic anatomically-constrained tractography algorithm, which constrains the reconstruction to specific biological priors. Furthermore, the spherical-deconvolution informed filtering of tractograms (SIFT) tool will be used to ensure the tractogram is biologically meaningful. This results in subject-specific connectomes defining the mean FA between two regions of interest that were defined using the Desikan- Killiany atlas. A linear model was used to test for main effect of group and main effect of verbal memory on white matter tract FA, covarying for age and sex. For both sets of analyses, results were corrected for multiple comparisons using false discovery rate (FDR). Results A significant main effect of group on whole-brain average FA was observed, with patients displaying lower average FA compared to healthy controls (Patients=0.291, controls=0.300, p&lt;0.05). Whole-brain white matter tract FA analysis revealed that there are widespread differences between controls and individuals with a FEP. Group most strongly predicted white matter tract FA differences between left caudal anterior cingulate and left lateral orbitofrontal (patients mean FA=0.302, controls mean FA=0.342), left hippocampus and right isthmus cingulate (patient mean FA= 0.217 controls mean FA= 0.318), and finally left lingual and left rostral anterior cingulate (patients mean FA=0.162, controls mean FA= 0.249. However, none survived correction for multiple comparisons. Further, there was no significant association between verbal memory and white matter tract FA in FEP or HC. Discussion Findings from this study suggest there are some significant differences in whole-brain average FA between individuals experiencing a FEP and healthy controls. However, when analyzing whole-brain tract FA, none of the connections survived corrections for multiple comparisons. These findings might be limited by the scanner resolution included in this study, which may not capture more subtle differences. Nonetheless, these results are consistent with a cross-sectional study comparing healthy individuals to chronic and first-episode patients suggesting that modest differences are present early in the disease and increase as the disease progresses. We suggest that future studies analyze white matter tract using a longitudinal design to identify disease progression.

Abstract Abstract 521 Patients undergoing HCT are at risk for neurocognitive impairment because of exposure to potential neurotoxic agents such as total body irradiation (TBI) and agents used for prophylaxis/ treatment of graft vs. host disease (GvHD). However, extant studies reporting neurocognitive outcome have been hindered by small sample size, retrospective or cross-sectional study design, limited prospective post-HCT follow-up, and restriction of study populations to either autologous or allogeneic HCT recipients, with inability to compare the two groups. Additionally, no prior studies have systematically assessed the impact of cognitive changes on the ability to return to work. This study addressed these gaps in knowledge by using a prospective longitudinal study design to examine neurocognitive changes from pre-HCT to 2 y after HCT in 284 patients undergoing HCT between 2005 and 2008. This study examined clinical and demographic predictors of neurocognitive function as well as the impact of neurocognitive function on return to part-time (PT) or full-time (FT) work post-HCT. Mean age at HCT was 50 years (range, 18-73); 40% were females; 69% were non-Hispanic whites and 21% were Hispanics. Primary diagnoses included NHL (33%), MM (26%), AML (16%), HL (10%), ALL (7%), and other (8%); 63% received autologous, 16% allogeneic related, and 20% unrelated donor HCT. A standardized 2-hour battery of neurocognitive tests was administered to the study participants at pre-HCT (n=284), 6 mo (n=202), 1 y (n=173), and 2 y (n=97) post-HCT to assess neurocognitive functioning in 8 domains: processing speed, executive function, immediate memory, general memory, working memory, psychomotor speed, verbal speed, and verbal fluency. The Wechsler Abbreviated Scale of Intelligence was used to measure cognitive reserve. Test scores were age-adjusted using normative data. Changes in neurocognitive functions over time and correlates of change were examined using the linear mixed effects model. Demographic factors examined included age at HCT, sex, race/ ethnicity, marital status, annual income at HCT, and education. Clinical factors included primary diagnosis, risk of relapse at HCT, stem cell source, presence of GvHD (for allogeneic HCT), conditioning (specific chemotherapeutic agents or TBI), and GvHD medications (allogeneic HCT only). Compared to pre-HCT, neurocognitive function generally remained unchanged or improved over the 2 years after HCT. At both pre- and post-HCT, higher cognitive reserve and education level were significantly associated with better neurocognitive function. Furthermore, women tended to have significantly better neurocognitive scores than men. However, after adjustment for significant covariates, allogeneic HCT recipients demonstrated significantly worse scores after HCT in processing speed, executive function, and verbal fluency when compared to autologous HCT recipients (p=0.001, p<0.05, p=0.04, respectively) (Figure). No differences were evident by GvHD status among allogeneic patients. Among patients who were employed prior to HCT, 66% were working either PT (27%) or FT (39%) at 1 y post-HCT. Patients with better scores in immediate memory (p=0.02), those who were either <35 y or >55 years of age at HCT (p=0.05), and those who had a primary diagnosis of lymphoma (p=0.03) were more likely to return to work either FT or PT. On the other hand, patients with chronic GvHD were less likely to return to work (p=0.02). Patients working FT at 1 y were more likely to have scored better for verbal speed (p=0.01); were more likely to have had pre-HCT income of $20,000 or more (p=0.002); and were less likely to have received allogeneic HCT (p=0.003). In summary, patients receiving allogeneic HCT are at risk for domain-specific neurocognitive deficits that persist for at least 2 years post-HCT and that are associated with inability to return to work. This study identifies vulnerable subgroups that could benefit from targeted surveillance and early intervention to facilitate smooth reintegration into society. Disclosures: No relevant conflicts of interest to declare.

We studied 40 male and 37 female ( M age = 63 yr.) Greek alcoholic patients and an equal number of control subjects. Both groups were evaluated with the Mini-Mental State Examination, the Syndrome Short Test, the Verbal Fluency Test (Category & Letter), the Clock Test, and the Digit Span (Forward and Backward from the Wechsler Adult Intelligence Scale-Revised). Alcoholic patients had statistically significant lower scores on MMSE, Verbal Fluency Test, and Digit Span, and higher scores on the Syndrome Short Test, while positive correlations were found among MMSE, Verbal Fluency Test, Clock Test, Digit Span-Backward, and age. These findings point to frontal lobe dysfunction in Greek alcoholic patients which is not different from that shown in patients from diverse ethnic and cultural backgrounds.

A comprehensive battery of commonly used neuropsychological tests, including the WMS Associate Learning and Visual Reproduction subtests, forming the focus of this study, were administered to a southern African sample (n = 33, age range 18-40). This sample composed of black South African, IsiXhosa speakers with an educational level of Grade 11 and 12, derived through DET and former DET schooling. The gender demographics were as follows; females n = 21 and males n = 12. This sample was purposefully selected based on current cross-cultural research which suggests that individuals matching these above-mentioned demographics are significantly disadvantaged when compared to available neuropsychological norms. This is due to the fact that current norms have been created in contexts with socio-cultural influences; including culture, language and quantity and quality of education distinctly dissimilar to individuals like that composed in the sample. Hence the purpose of this study was fourfold namely; 1) Describe and consider socio-cultural factors and the influence on test performance 2) Provide descriptive and preliminary normative data on this neuropsychologically underrepresented population 3) Compare test performance between age and gender through stratification of the sample and finally to 4) Evaluate the current norms of the two WMS subtests and assess their validity for black South Africans with DET and former DET schooling with comparisons to the results found in the study. Information derived from the statistical analyses indicated that a higher performance in favour of the younger group over the older age range was consistently found for both WMS subtests. With regards to gender, some higher means were evident for the male population in the sample than was produced by the female group. Lastly, due to the fact that most scores derived from the sample were considerably lower when compared to the available norms, it is felt that socio-cultural factors prevalent to this population are a significant cause of lower test performance and thus warrant the development of appropriate normative indicators.

The Wechsler Memory Scale –iii is the newest version of a six-decade old neuropsychological inventory. Since its conception, the Wechsler Memory Scale has been highly utilized by practitioners to accurately assess various memory functions in adult subjects. Revisions made within this inventory include the Faces I subtest, a facial recognition scale, which was added in order to strengthen the instrument’s accuracy at measuring episodic memory. Facial recognition, both cross-race and within-race, has been researched extensively and consistent biases have been found between race of test taker and cross-racial identification. Theories of exposure/contextual interaction (environment) and biological foundations have been the subject of study in the past in order to determine from where these racial identification deficits stem. The current study focuses on revealing bias in the Faces I subtest, regarding to an unequal distribution of racially representative faces in the testing materials. Eighty-eight college students were recruited to view forty-eight pictured faces from the Faces I subtest and determine the racial category to which the pictured face belonged. The subjects’ categorical responses were the basis for calculating a percent agreement score for racial category of each face. It was determined, using the results of subjects’ responses, that the Faces I subtest contained an unequal distribution of racially representative faces in both the Target and Interference testing material. This confirmed the presence of an inherent bias within the subscale. The implications of memory accuracy for the WMS-iii are discussed as it relates to different fields of study, but none more directly than the criminal justice system. Eyewitness testimony is a pivotal evidentiary tool in the criminal justice system, and ramifications of cross-racial identification deficits and biases in the tools to accurately assess memory are increasingly bringing this once heavily relied upon tool into question.

The purpose of this study was to compare the WISC-R subtest score scatter patterns and obtain preliminary normative data on the WISC-R Adjunctive tests (Digit Span Forward; Digit Span Backward; Digit Supraspan; Coding Immediate Recall and Coding Delayed Recall) on a non-clinical population of South African English (n= 15) and Xhosa (n= 12) speaking, standard six children, studying in English medium schools. Tests were administered to 27 subjects, both male (n=19) and female (n=8), with a mean age of 14.1 years (range = 13.3-15.3). The results show that White English speaking children outperform Black Xhosa speaking children on Verbal, Performance and Full Scale IQs and all subtests, but that these differences tended to disappear when Full Scale IQ and school grade average were controlled for. No subtest score scatter was present for either group although more specific test items appeared to be more difficult for Xhosa speaking subjects and may have contributed to generally lowered scores. Results suggest that caution must be employed in assigning Xhosa speaking South African children to absolute IQ categories. However, the WISC-R has validity for diagnostic use on both White English speaking and Black Xhosa speaking South African children as there was no evidence of a significant Verbal IQ/Performance IQ discrepancy, or significant low subtest scatter for either group. Normative tables are presented for the use of WISC-R Adjunctive tests.
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his study builds on South African cross-cultural research which demonstrated the importance of careful stratification of multicultural/multilingual normative samples for quality of education in respect of English and African language (predominantly Xhosa) speaking adults and children tested with the WAIS-III and WISC-IV, respectively. The aim of the present study was to produce an expanded set of preliminary comparative norms on the WISC-IV for white and coloured Afrikaans, white English and black Xhosa speaking Grade 7 children, aged 12 to 13 years, stratified for advantaged versus disadvantaged education. The results of this study replicate the findings of the prior South African cross-cultural studies in respect of quality of education, as groups with advantaged private/former Model C schooling outperformed those with disadvantaged former DET or HOR township schooling. Furthermore, a downward continuum of WISC-IV IQ test performance emerged as follows: 1) white English advantaged (high average), 2) white Afrikaans advantaged and black Xhosa advantaged (average), 3) coloured Afrikaans advantaged (below average), 4) black Xhosa disadvantaged (borderline), and 5) coloured Afrikaans disadvantaged (extremely low). The present study has demonstrated that while language and ethnic variables reveal subtle effects on IQ test performance, quality of education has the most significant effect – impacting significantly on verbal performance with this effect replicated in respect of the FSIQ. Therefore caution should be exercised in interpreting test results of individuals from different language/ethnic groups, and in particular those with disadvantaged schooling, as preliminary data suggest that these individuals achieve scores which are 20 – 35 points lower than the UK standardisation.

Research reveals that the level as well as the quality of education plays a role in the determination of an individual's intellectual capacity. Substantial differences in quality of education for black and white individuals were experienced in South Africa due to Apartheid. Compared to the traditionally white Private and Model C schools, Township/ DET schools had limited resources, as well as a separate syllabus and examination system, a situation that has not improved substantially since democratisation in 1994. Research on black South African adults with the WAIS-III has confirmed significant influences on IQ in association with exposure to either such advantaged (Private/Model C) schooling, or disadvantaged (Township/DET) schooling. However to date there has been no published research on the use of the Wechsler intelligence tests on a black South African child population similarly stratified for quality of education. Therefore, for the purposes of this study, the latest Wechsler Intelligence Scale for Children (WISC-IV) was administered to a sample of 36 Grade 7 learners between the ages of 12-13 (mean 13.01 years), stratified for quality of education to form three comparative groups. Data analyses revealed significant differences on the WISC-IV Factor Indices and Full Scale IQ with the English speaking Private/Model C school group performing the best, followed by the Xhosa speaking Private/ Model C school group, and the Xhosa speaking Township/ DET school group performing the worst. This continuum of lowering is understood to occur abreast of a continuum of decreased exposure to relatively advantaged education. These normative indications are considered to have vital implications for the use of the WISC-IV in the South African cross-cultural situation where vastly differential educational opportunities continue to exist.