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While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood. This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate-severe TBI (n = 47). We used caregiver education and household poverty level as predictors, and multiple quality of life and health behavior domains as outcomes. Differences at 6, 12, and 24 months from baseline ratings of pre-injury functioning were compared by SES. We examined the association between measures of SES and domains of functioning over the 24 months post-injury in children with a complicated mild or moderate- severe TBI, and determined how this association varied over time. Parental education was associated with recovery among children with complicated mild TBI; outcomes at 6, 12, and 24 months were substantially poorer than at baseline for children with the least educated parents. After moderate-severe TBI, children in households with lower incomes had poorer outcomes compared to baseline across time. Parental education and household income were associated with recovery trajectories for children with TBI of varying severity. [ABSTRACT FROM AUTHOR]

This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n= 35 complicated mild or moderate TBI;n= 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). Individuals with complicated mild/moderate TBI performed more poorly than controls on the Working Memory Index (WMI), Processing Speed Index (PSI), and Full Scale IQ (FSIQ), and on four subtests: the two processing speed subtests (SS, CD), two working memory subtests (AR, LN), and a perceptual reasoning subtest (BD). Participants with severe TBI had significantly lower scores than the complicated mild/moderate TBI on PSI, and on three subtests: the two processing speed subtests (SS and CD), and the new visual puzzles test. Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI. [ABSTRACT FROM AUTHOR]

This study was designed to examine the construct validity of the Wechsler Memory Scale–Fourth Edition (WMS–IV) in individuals with traumatic brain injury (TBI). One hundred individuals with TBI (n= 35 complicated mild/moderate TBI;n= 65 severe TBI) and 100 matched controls from the WMS–IV normative dataset completed the WMS–IV. Multivariate analyses indicated that severe TBI participants had poorer performance than matched controls on all index scores and subtests. Individuals with complicated mild/moderate TBI performed more poorly than controls on all index scores, as well as on tests of visual memory (Designs I and II; Visual Reproduction I and II) and visual working memory (Spatial Addition; Symbol Span), but not on auditory verbal memory tests (Logical Memory I and II; Verbal Paired Associates I and II). After controlling for time since injury, severe TBI participants had significantly lower scores than the complicated mild/moderate TBI on 4 of the 5 WMS–IV index scores (Auditory Memory, Visual Memory, Immediate Memory, Delayed Memory) and 4 of the 10 WMS–IV subtests (Designs I and II, Verbal Pairs II, Logical Memory II). Effect sizes for index and subtest scores were generally moderate for the complicated mild/moderate group and moderate-to-large for the severe TBI group. Findings provide support for the construct validity of the WMS–IV in individuals with TBI. [ABSTRACT FROM PUBLISHER]

Purpose: Virtual reality (VR) is a relatively new technology that is currently utilized in a wide variety of settings to test and train individuals in specialized skills. This study examines methods for improving driver retraining protocols for persons with spinal cord injury (SCI). Method: We compared a VR driving simulator, under two different display conditions, a head mounted display (HMD) and a three screen display (TSD) to identify the best method for retraining driving skills following SCI. Results: Although there was minimal evidence for driving performance difficulties in the HMD condition relative to the TSD condition (e.g. greater number of times for being off course and longer stopping latencies for the HMD condition), rates of simulator sickness did not differ between display conditions. Conclusions: Taken together, findings suggest that both the HMD and the TSD are reasonable simulator options for driver retraining in SCI. [ABSTRACT FROM AUTHOR]

Analysis of the discrepancy between intellectual functioning and memory ability has received some support as a useful means for evaluating memory impairment. In recent additions to Wechlser scale interpretation, the WAIS-III General Ability Index (GAI) and the WMS-III Delayed Memory Index (DMI) were developed. The purpose of this investigation is to develop base rate data for GAI-IMI, GAI-GMI, and GAI-DMI discrepancy scores using data from the WAIS-III/WMS-III standardization sample (weighted N = 1250). Base rate tables were developed using the predicted-difference method and two simple-difference methods (i.e., stratified and non-stratified). These tables provide valuable data for clinical reference purposes to determine the frequency of GAI-IMI, GAI-GMI, and GAI-DMI discrepancy scores in the WAIS-III/WMS-III standardization sample. [ABSTRACT FROM AUTHOR]

This paper presents the Delayed Memory Index (DMI) as an alternative to the General Memory Index (GMI) of the Weschler Memory Scale-Third Edition (WMS-III). The WMS-III Immediate Memory Index (IMI) and the GMI are not parallel in structure, making a direct comparison between these index scores (i.e., immediate vs. delayed memory variables) difficult. The IMI is composed of the sum of scaled scores of four subtests (Logical Memory I, Verbal Paired Associates I, Faces I, and Family Pictures I) while the GMI is composed of the sum of scaled scores of five subtests (Logical Memory II, Verbal Paired Associates II, Faces II, Family Pictures II and Auditory Recognition Delayed). Inclusion of Auditory Recognition Delayed in the GMI is also problematic as it is highly skewed and limited by extreme ceiling effects (see Tulsky, Chiaravalloti, Palmer, & Chelune, 2003). To remedy these problems, we present a new index score that does not include auditory recognition, the Delayed Memory Index. Normative tables for the new Delayed Memory Index based on the inclusion of the Faces subtest, or alternatively the Visual Reproduction subtest, are presented, and initial estimates of their psychometric properties are described. [ABSTRACT FROM AUTHOR]

The Wechsler Memory Scale, Third Edition (WMS-III) was published in 1997 and marked an ambitious and substantial revision of the traditional memory scale. Since publication, however, clinical experience has led many practitioners to raise questions about the validity and clinical utility of the new subtests and new index scores. The impetus of this special issue was to address some of the questions with which clinicians have been struggling. The articles contained in this special issue present new empirical research on the WMS-III, and several include new methods and scoring techniques that go beyond what has been published in the WAIS-III-WMS-III Technical Manual (The Psychological Corporation, 1997, 2002). It is hoped that the new scores and techniques will prove useful in clinical practice and that this research will benefit future revisions of the Wechsler Memory Scale. [ABSTRACT FROM AUTHOR]

A number of studies have shown visuospatial memory deficits following anterior temporal lobectomy (ATL) in the right, nondominant temporal lobe (RATL). The current study examines 26 patients with intractable temporal lobe epilepsy who underwent ATL in either the right (RATL, n = 16) or left temporal lobe (LATL, n = 10) on two tests of facial memory abilities, the Wechsler Memory Scale-III (WMS-III) Faces subtest and the Graduate Hospital Facial Memory Test (FMT). Repeated measures ANOVA on the FMT indicated a significant main effect of side of surgery. The RATL group performed significantly below the LATL group overall. Both groups showed a slight, but non-significant, improvement in performance from pre- to postsurgery on the FMT immediate memory, likely due to practice effects. Repeated measures ANOVA on the WMS-III Faces subtest revealed a significant interaction of group (RATL vs. LATL) by delay (immediate vs. delayed). Overall, the LATL group showed an improvement in recognition scores from immediate to delayed memory, whereas the RATL group performed similarly at both immediate and delayed testing. No effects of surgery were noted on the WMS-III. Following initial data analysis the WMS-III Faces I and II data were re-scored using the scoring suggested by Holdnack and Delis (2003), earlier in this issue. Repeated measures ANOVA revealed a trend toward significance in the three-way interaction of group (RATL vs. LATL) × time of testing (pre- versus postop) × delay (immediate vs. delayed memory). On the Faces I subtest, both the RATL and LATL groups showed a decline from preoperative to postoperative testing. However, on Faces II the LATL group showed an increase in performance from preoperative to postoperative testing, while the RALT group showed a decline in performance from preoperative to postoperative testing. While the FMT appears to be superior to the WMS-III Faces subtest in identifying deficits in facial memory prior to and following RATL, the application of the scoring methodology presented by Holdnack and Delis earlier in this issue does serve to increase the clinical utility of the WMS-III Faces subtest in this population. [ABSTRACT FROM AUTHOR]

Within discrepancy analysis differences between scores are examined for abnormality. Although larger differences are generally associated with rising impairment probabilities, the relationship between discrepancy size and abnormality varies across score pairs in relation to the correlation between the contrasted scores in normal subjects. Examinee ability level also affects the size of discrepancies observed normally. Wechsler Memory Scale - Third Edition (WMS-III) visual index scores correlate only modestly with other Wechsler Adult Intelligence Scale - Third Edition (WAIS-III) and WMS-III index scores; consequently, differences between these scores and others have to be very large before they become unusual, especially for subjects of higher intelligence. The substitution of the Faces subtest by Visual Reproductions within visual memory indexes formed by the combination of WMS-III visual subtests (creating immediate recall, delayed recall, and combined immediate and delayed index scores) results in higher correlation coefficients, and a decline in the discrepancy size required to surpass base rate thresholds for probable impairment. This gain appears not to occur at the cost of a diminished sensitivity to diverse pathologies. New WMS-III discrepancy base rate data are supplied to complement those currently available to clinicians. [ABSTRACT FROM AUTHOR]

Objective : To examine whether processing speed or working memory is the primary information processing deficit in persons with MS. Design : Case-control study. Setting : Hospital-based specialty clinic. Participants : 215 adults with clinically definite MS. Main Outcome Measure : Mean demographically corrected T -scores, prevalence rates of impairment and relative risk of impaired Processing Speed and Working Memory Index Scores from the WAIS-WMS III. Results : Deficits in Processing Speed were much more common than Working Memory in all comparisons. This was observed for both relapsing remitting (RRMS) and secondary progressive MS (SPMS) subjects, but accentuated in the latter group. Conclusions : Results strongly suggest that the primary information processing deficit in persons with MS is in speed of processing. [ABSTRACT FROM AUTHOR]

This study had two goals. One was to assess whether the WMS-III Spatial Span subtest operates as a visual analogue of Digit Span while the second was to determine whether backward span is a more sensitive measure of working memory than the forward span condition. Analyses based on the WAIS-III-WMS-III standardization and clinical group data revealed some important distinctions between Digit and Spatial Span. The two tasks exhibited differences in patterns of performance on the forward versus backward conditions, in their relationships with age, and in their methodology. Moreover, the backward conditions of both Digit and Spatial Span did not appear more affected by risk factors such as aging or pathology than the forward scores. This runs contrary to the widespread notion that backward span provides differential sensitivity regarding working memory processing. [ABSTRACT FROM AUTHOR]

The Letter Number Sequencing subtest of the WAIS-III and WMS-III was administered at the end of the standardization edition of the WMS-III. It was not administered as part of the WAIS-III standardization battery. Nevertheless, the subtest was included in the published version of the WAIS-III. This study examines differences between examinees administered the Letter Number Sequencing subtest at three different times during a psychological battery: (1) as part of the published battery, (2) as part of the WMS-III when the WMS-III was administered as the first test in a sequence, and (3) as part of the WMS-III standardization when the WAIS-III was administered immediately preceding the WMS-III. The participants were 372 examinees (n = 124 in each condition) who were matched on key demographic variables. A repeated measures MANOVA yielded no difference in subtest scores when administered in any of these conditions. The results show no evidence of fatigue or ordering effects on the Letter Number Sequencing subtest. [ABSTRACT FROM AUTHOR]

Tables included in the WAIS-III report the frequency of discrepancies between IQ and index scores independent of the directionality of the score. If an examiner does not have any a priori hypothesis about which skill may be more developed and which skills may be weaknesses, it is appropriate to use these tables as they are. In this case the examiner would be looking for unusually large discrepancies between scores irrespective of direction. When an examiner has a hypothesis about which skills may be weaknesses and strengths for an individual, the frequencies that are based upon an absolute value of the discrepancy will cause examiners to overestimate the frequency of the occurrence of the discrepancy score in question. Sattler and Ryan (1998) and Tulsky, Zhu, and Vasquez (1998) suggested dividing the frequencies reported in the WAIS-III tables in half to obtain the correct base rate. This suggestion is tested in this paper. New observed frequency tables were derived from the WAIS-III and WMS-III standardization samples and these frequencies were compared against the estimated frequencies using the method described by Sattler and Ryan (1998) and Tulsky et al. (1998). The differences between these two methods were calculated and are, for the most part, insignificant. In light of the similarity between the methods, the implications of using observed frequencies versus estimated frequencies is discussed. [ABSTRACT FROM AUTHOR]

Test-order effect on the WAIS-III and WMS-III scores was evaluated using the WMS-III standardization sample. Participants completed the standardization editions of the WAIS-III and WMS-III in one session, with the tests administered in roughly counterbalanced order. Repeated measure MANOVA analyses were conducted to determine if there was an overall test-order effect for subtest, index, or IQ scores. No significant test-order effects were found for either the WAIS-III index or IQ scores or for the WMS-III index scores. At the subtest level, the majority of the WAIS-III and WMS-III subtests did not show a significant test-order effect. The exceptions were Digit Span and Digit Symbol-Coding on the WAIS-III and Faces II and Logical Memory II on the WMS-III. Although statistically significant test-order effects were found on these subtests, the effect sizes were small. This study indicates that the test-order effect is not a potential threat to the internal validity of the WAIS-III and WMS-III normative data. The practical implications of the current study are discussed. [ABSTRACT FROM AUTHOR]

Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III; The Psychological Corporation, 1997) scores of patients with mild traumatic brain injury (MTBI, n = 23) to moderate-severe traumatic brain injury (M-S TBI, n = 22) were compared to those of 45 matched normal control patients. WAIS-III results revealed that IQ and index scores of MTBI patients did not significantly differ from those of controls, whereas M-S TBI patients received significantly lower mean scores on all measures. All M-S TBI patients' WMS-III index scores also revealed significantly lower scores in comparison to those of control participants, with the exception of Delayed Auditory Recognition. MTBI patients showed significantly lower mean index scores compared to normal controls on measures of immediate and delayed auditory memory, immediate memory, visual delayed memory, and general memory. Eta-squared analyses revealed that WMS-III visual indexes and WAIS-III processing speed showed particularly large effect sizes. These results suggest that symptomatic MTBI patients obtain some low WMS-III test scores comparable to those of more severely injured patients. [ABSTRACT FROM AUTHOR]