Elaboration of Neuropsychological Evaluation of Children: Structural Analysis of Test Results

Background: Modern neuropsychology is discussing the possibility of combining qualitative and quantitative approaches in the evaluation of cognitive functions. In Russia a battery of tests called "Methods of neuropsychological assessment for children 6-9 years old" (Akhutina et al., 2016) has been proposed; it is based on the Lurian approach to diagnosis and combines qualitative and quantitative approaches to testing. The present paper describes the development of this combined qualitative and quantitative assessment of various groups of cognitive functions in preschool and primary school children. Structural modeling enables us to analyze a possible combination of integral indices of functions that includes the results of both a face-to-face neuropsychological assessment and computerized testing.

Objective: To develop a combined qualitative and quantitative neuropsychological assessment of children, in order to 1) check the structural reliability of integral indicators of various cognitive functions; and 2) confirm the correctness of combining the results of face-to-face and computerized tests.

Design: A sample of 299 children between the ages of 6 and 9 years old (111 preschoolers, 82 first graders, and 106 second graders) underwent a Lurian face-to-face neuropsychological examination adapted for 6-to-9 year-old children, and five tests from the Computerized Neuropsychological Assessment for 6-9 Year-old Children. The five were the "Dots" test, the Schulte Tables, the Cancellation test, the Corsi Tapping Block test, and the Understanding of Similar Sounding Words test. In each of the tests (face-to-face and computerized), key parameters were identified to evaluate various cognitive functions.

Results: A confirmatory factor analysis verified the composition of the neuropsychological indices that were based on the results of the face-to-face neuropsychological assessment. At the same time, when the computer test data were added to the model, the fit indices of the model considerably improved.

Conclusion: The confirmatory factor analysis confirmed the validity of the identification of eight neuropsychological indices that indicate the component processes underlying complex cognitive functions in children: 1) programming and control of voluntary actions (executive functions); 2) serial organization of movements and speech; 3) the processing of kinesthetic information; 4) the processing of auditory information; 5) the processing of visual information; 6) the processing of visual-spatial information; 7) hyperactivity/impulsivity; and 8) fatigue/slowness.