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B GU'  _IntroductionR.Ivnika, b, c,Level 1Level 2Level 3Level 4Level 5$35;?CGKOS31.1111111 Rickerglioblastomamultiformemisdiagnosedreduplicativeparamnesiaresubmission W GU'  _TheWorkSampleJ.E.MorganandJ.Ricker6#)4Quick a. T  .0 T Diplomatenonabrasive [ GU'  _RepeatingtheOralExaminationC.Boake,Ph.D.H j GU'  _TheOralExamination:WorkSampleandFactFindingM.Schmidt($     d d dP Pd d Level 1 Level 2 Level 3 Level 4 Level 5)ddfgACfgACfgAC(3;$ !  aaaa'dxd  k;"  _ X LivingArrangement. Hasbeenmarried28years.Husbandretiredfromthemilitary  andpresentlyhasajobthattakeshimoutoftownregularly.Theyhavenonaturalchildren  andhaveadopted3children.   X WorkHistory. Hasworkedmostlyinclericalpositions.Hasntworkedforseveral  years.   X Activities. Sheisahomemakerandlivesinasemiruralsettingwheresheandher  familyhavehorses.Volunteerswithherchurch,4H,andatherchildrensschools. (CEKQW]cioAutoList81.a.1.1.1.1.1.1. G k;"  _ X Age 0  00` 8years,1month` `   X Handedness 0  0` Right` `   X Ethnicity 0  0` Caucasian  k;"  _ X Shewasfriendly,polite,andappropriatethroughouttheexamination.Shewas  anxiousattimesbutdidnothaveexcessiveemotionaldisplays.Shewastestedoverseveral  visitsduetofatigue.Sheexhibitedmemoryandwordfindingproblemsduringhistorytaking,  withfrequentverbal_paraphasias_.Speechvariedfromfluidtohesitant.Sheusedreading  glassesandwouldcockherheadtolistenwithherrightear.Sheneededclarificationand  elaborationoftestdirections.  k;"  _ ) XXVinelandAdaptiveBehaviorScales 0 0   0hStandardScore 0hh 0pAgeEquivalent pp  InterviewEdition,motherinformant    X Communication0  0` 0 ` ` 0  0h920hh00p77pp  X DailyLiving0  0` 0 ` ` 0  0h360hh00p33LLpp  X Socialization0  0` 0 ` ` 0  0h790hh00p57pp  X AdaptiveBehaviorComposite0 0  0h640hh00p56pp  Conner sParentRatingScale 0 ` 0 ` ` 0   0hTScore hh  Mother  ZZ  X ConductProblems0 ` 0 ` ` 0  0h53hh  X LearningProblems0 ` 0 ` ` 0  0h86 hh  X Psychosomatic0  0` 0 ` ` 0  0h55 hh  X ImpulsiveHyperactivity0 ` 0 ` ` 0  0h55hh hh  X Anxiety  0  0` 0 ` ` 0  0h50, , hh  X Hyperactivity0  0` 0 ` ` 0  0h65 hh  Conners TeacherRatingScale 0 ` 0 ` ` 0   0hTScore  hh  Teacher  v v   X ConductProblems0 ` 0 ` ` 0  0h728 8 hh  X Hyperactivity0  0` 0 ` ` 0  0h61 hh  X InattentionPassive0 ` 0 ` ` 0  0h70 hh  X HyperactivityIndex0 ` 0 ` ` 0  0h65hh  AchenbachChildBehaviorChecklist 0 0   0hTScore HHhh  Mother      X Internalizing0  0` 0 ` ` 0  0h46hh  X Externalizing0  0` 0 ` ` 0  0h34hh  X TotalScore0  0` 0 ` ` 0  0h47TThh  X AttentionProblems0 ` 0 ` ` 0  0h70hh  Father    X Internalizing0  0` 0 ` ` 0  0h63hh  X Externalizing0  0` 0 ` ` 0  0h51bbhh  X TotalScore0  0` 0 ` ` 0  0h64&&hh  X AttentionProblems0 ` 0 ` ` 0  0h73hh  X SocialProblems0  0` 0 ` ` 0  0h73hh  Teacher  rr   X Internalizing0  0` 0 ` ` 0  0h8144!hh  X Externalizing0  0` 0 ` ` 0  0h71"hh  X TotalScore0  0` 0 ` ` 0  0h79#hh  X AttentionProblems0 ` 0 ` ` 0  0h93$hh  X ThoughtProblems0 ` 0 ` ` 0  0h80DD%hh  X SocialProblems0  0` 0 ` ` 0  0h76&hh  X Withdrawn0  0` 0 ` ` 0  0h73'hh  PiersHarrisChildren sSelfConceptScale0  0h TScore TT)hh  X Behavior0  0` 0 ` ` 0  0h36  *hh  X Intellectual&SchoolStatus0 0  0h38 +hh  X PhysicalAppearance&Attributes0 0  0h49!!,hh  X Anxiety0  00` 0 ` ` 0  0h52b"b"-hh  X Popularity0  0` 0 ` ` 0  0h36&#&#.hh  X Happiness&Satisfaction0 ` 0 ` ` 0  0h56##/hh  X TotalScore0  0` 0 ` ` 0  0h44E ) 6 k;"  _ X Grade. 3rdgrade   X History. Hewasenrolledinaninfantstimulationprogram,laterattendedapreschool  specialneedsprogram,andhasbeeninthepublicschoolsforthepast4years,wherehe  receivesspecialeducationalservices,includingaclassroomaide,limitedresourceroom  instruction,speech/languagetherapy,occupationaltherapy,andphysicaltherapy.   X AcademicPerformance. Heperformsadequatelyinallacademicareasexceptmath  andhandwriting.Apsychologicalevaluationatage6years,4monthsproducedaWISCR  VIQ=102,PIQ=95,andFSIQ=99.   X OtherSchoolProblems. Heisdescribedashavinglongstandingdifficultiesinthe ll classroomwithattention,listening,taskcompletion,distractibility,selfcontrol,and \\   sportsmanship. p GU'  _TheOralExamination:EthicsandProfessionalIssuesA.J.McSweeny  k;"  _ Test  X     0 ` 0 ` `    h Raw 0  0 Transformed   MultilingualAphasiaExamination    X VisualNaming0 ` 0 ` ` 0  0h520hh039Percentile  X SentenceRepetition0 ` 0 ` ` 0  0h90hh07Percentile  X ControlledOralWordAssociation0  0h270hh010Percentile  X OralSpelling0  0` 0 ` ` 0  0h90hh015Percentile  X WrittenSpelling0 ` 0 ` ` 0  0h100hh039Percentile  X TokenTest0  0` 0 ` ` 0  0h370hh05Percentilett  X AuralComprehensionof ``  X   WordsandPhrases0 0  0h170hh041PercentileLL   X ReadingComprehensionof 8 8   X   WordsandPhrases0 0  0h180hh059Percentile$ $   VerbalConceptAttainmentTest 0 0  0h90hh01Percentile   (SeeAttention/ConcentrationforSpeechPerceptionTest.SeeExecutiveFunctionsand   AbstractionfortheStroopTest.) t k;"  _ Test 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformed   FingerLocalizationTest    X RightHandErrors0 ` 0 ` ` 0  0h40hh0  X LeftHandErrors0 ` 0 ` ` 0  0h70hh0  FingertipNumberWriting    X RightHandErrors0 ` 0 ` ` 0  0h10hh0WithinNormalLimits  X LeftHandErrors0 ` 0 ` ` 0  0h50hh0  DoubleSimultaneousVisualStimulation  tt  X RightErrors0  0` 0 ` ` 0  0h10hh0WithinNormalLimits``  X LeftErrors0  0` 0 ` ` 0  0h10hh0WithinNormalLimitsLL   DoubleSimultaneousTactualStimulation  8 8   X RightErrors0  0` 0 ` ` 0  0h30hh0$ $   X LeftErrors0  0` 0 ` ` 0  0h10hh0    DoubleSimultaneousAuditoryStimulation     X RightErrors0  0` 0 ` ` 0  0h00hh0WithinNormalLimits   X LeftErrors0  0` 0 ` ` 0  0h10hh0WithinNormalLimits   TotalErrorsonHalsteadReitanExtendedSensoryPerceptualExam    X RightErrors0  0` 0 ` ` 0  0h110hh028TScore,1Percentile  X LeftErrors0  0` 0 ` ` 0  0h170hh018TScore,1Percentile  X TotalErrors0  0` 0 ` ` 0  0h280hh023TScore,1Percentile  PocketSmellTest (Screeningtestforolfaction)0 h 0/30hh0Impairedpp (SeeAttention/ConcentrationforSeashoreRhythmTest) (CEKQW]cioAutoList91.a.1.1.1.1.1.1. 6(CEKQW]cioAutoList11.a.1.1.1.1.1.1. k;"  _ Test 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformed   ControlledOralWordAssociation    X FAS0  00` 0 ` ` 0  0h150hh015Percentile  HalsteadCategoryTest 0 ` 0 ` ` 0  0h50errors0hh43TScore,24Percentile  WisconsinCardSortingTest    X CategoriesAchieved0 ` 0 ` ` 0  0h60hh0>16Percentile  X Correct0  00` 0 ` ` 0  820h0hh  X Errors0  00` 0 ` ` 0  0h160hh051TScore,55Percentilexx  X PerseverativeErrors0 ` 0 ` ` 0  0h80hh061TScore,87Percentiledd  X PerseverativeResponses0 0  0h80hh051TScore,55PercentilePP   X PercentConceptualLevelResponding0 h 80.60hh052TScore,58Percentile< <   X FailurestoMaintainSet0 0  0h10hh0>16Percentile( (   StroopColorandWordTest(GoldenVersion)      X Word0  00` 0 ` ` 0  0h660hh033TScore,4Percentile   X Color0  00` 0 ` ` 0  0h560hh037TScore,10Percentile   X ColorWord0  0` 0 ` ` 0  0h240hh034TScore,5Percentile  (SeeAttention/ConcentrationforTrailMakingTest.SeeLanguageforVerbalConcept  AttainmentTest.) a k;"  _ X Age 0  00` 47years,11monthsatthetimeoftesting` `   X Handedness 0  0` Right` `   X Ethnicity 0  0` Caucasian k k;"  _ X HighestGrade. 14years   X History. Perhapsalittleslowlearningtoread,otherwisenoproblems.Norepeated  grades.Graduatedhighschool.Hasattendedcollegesporadicallyandhasabout2yearstotal  collegeeducation. k;"  _ X Thereisafamilyhistoryofdyslexiaandhyperactivityinanuncleandseizuredisorder  inamaternalgrandmother.  k;"  _ X Heseparatedwithoutanydifficultyfromhismother.Hewalkedwiththeaidofbraces  andforearmcrutches.Hewasdifficulttoengageintestingbecauseoflimitedattentionspan  anddistractibility.Hewasimpulsiveattimes.Hispragmaticlanguagewasnoteworthyfora  _pseudomature_,cocktailpartylikequalityandfordifficultieswithturntakingandtopic  maintenance.Overall,heshowedadisorganizedapproachonmanytasks.Attimes,  _perseverations_Ԁinbehaviorandlanguagewerenoted.Hedemonstratedimmaturesocial  pragmatics.Hefrequentlycoughedintheexaminersfacewithoutawarenessofsocial  etiquette.Throughoutthetestingheappearedconcernedthathedowellandthattheexaminer tt likehim. "underemphasizedMentoredSubcortical  k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh0 Transformed   HalsteadReitanFingerOscillationTest    X Right0  00` 0 ` ` 0  46taps0h0hh049TScore,46Percentile  X Left0  00` 0 ` ` 0  37taps0h0hh046TScore*,34Percentile  X Total0  00` 0 ` ` 0  830h0hh0Impaired**  GripStrength    X Right0  00` 0 ` ` 0  32kg0h0hh055TScore,69Percentile  X Left0  00` 0 ` ` 0  26kg0h0hh054TScore*,66Percentilett  TactualPerformanceTest  ``  X Right0  00` 0 ` ` 10.0min,8blocksplaced0  37TScore,10PercentileLL   X Left0  00` 0 ` ` 8.0min,10blocksplaced0  39TScore,14Percentile8 8   X Both0  00` 0 ` ` 5.3min,10blocksplaced0  40TScore,16Percentile$ $   X Total0  00` 0 ` ` 23.3min,28blocksplaced0  36TScore,8Percentile    NameWriting     X Right0  00` 0 ` ` 0  15(27letters)00!   X Left0  00` 0 ` ` 0  58(27letters)00!   X Total0  00` 0 ` ` 0  0.74Letters/Second0Impaired** *Rawscoreissignificantlylowerthanrighthand.  **Using_Dodrill_Ԁnorms. k;"  _ X      `     h 0  0AgeCorrected   WAISRSubtests 0  0` 0 ` ` 0   ScaledScore 00 ScaledScore   X Information0  0` 0 ` ` 0  0h70hh00p8pp  X DigitSpan0  0` 0 ` ` 0  0h80hh00p8pp  X Vocabulary0  0` 0 ` ` 0  0h80hh00p8pp  X Arithmetic0  0` 0 ` ` 0  0h90hh00p9pp  X Comprehension0 ` 0 ` ` 0  0h60hh00p6pp  X Similarities0  0` 0 ` ` 0  0h70hh00p8ttpp  X PictureCompletion0 ` 0 ` ` 0  0h70hh00p9``pp  X PictureArrangement0 ` 0 ` ` 0  0h110hh00p13LL pp  X BlockDesign0  0` 0 ` ` 0  0h60hh00p78 8 pp  X ObjectAssembly0 ` 0 ` ` 0  0h60hh00p7$ $ pp  X DigitSymbol0  0` 0 ` ` 0  0h90hh00p11  pp  X   VerbalIQ0 ` 0 ` ` 0  88   X   PerformanceIQ0 0  96   X   FullScaleIQ0 ` 0 ` ` 0  90<  p`+CourierTT  k;"  _ Test  X     0 ` 0 ` `    h Raw 0  0 Transformed   BostonNamingTest 0  0` 0 ` ` 0  0h490hh0>99Percentile  PeabodyPictureVocabularyTest 0 0  0h930hh050Percentile (SeeExecutiveFunctionsforFAS) k;"  _ WoodcockJohnsonPsychoeducationalBatteryRevised   X StandardBattery ` 0 0  0hStandardScore hh  X LetterWordIdentification 0  0h0hh138  X PassageComprehension 0  0h0hh119  X Calculation  0 ` 0 ` ` 0  0h0hh89  X AppliedProblems ` 0 0  0h0hh80  X Dictation  0 ` 0 ` ` 0  0h0hh106  X WritingSamples ` 0 0  0h0hh104tt  X Science  0 ` 0 ` ` 0  0h0hh101``  X SocialStudies ` 0 0  0h0hh112LL   X Humanities  0 ` 0 ` ` 0  0h0hh1138 8   X StandardBatteryCluster  $ $   X BroadReading ` 0 0  0h0hh127    X BroadMathematics ` 0 0  0h0hh82   X BroadWrittenLanguage 0  0h0hh107   X BroadKnowledge ` 0 0  0h0hh109   X Skills  0 ` 0 ` ` 0  0h0hh110  d>a=:20 TABLE A  k;"  _ Test 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformed   FingerLocalizationTest    X RightHandErrors0 ` 0 ` ` 0  0h00hh0WithinNormalLimits  DoubleSimultaneousVisualStimulation    X RightErrors0  0` 0 ` ` 0  0h00hh0WithinNormalLimits  X LeftErrors0  0` 0 ` ` 0  0h00hh0WithinNormalLimits  k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh Transformed   StoryLearningTest    X Learning0  0` 0 ` ` 0  6.170h0hh31TScore,3Percentile  X 4hrDelayPercentLoss0 0  18.90h0hh44TScore,27Percentile  InterferenceLearningTest (awordlistlearningtest)   X PerformanceSummary0 0  2/360h0hh62Percentile  X Trial1Recall0  0` 0 ` ` 0  50h0hh50TScore,50Percentile  X Trial4Recall0  0` 0 ` ` 0  140h0hh50TScore,50Percentilexx  X CategoryClustering0 ` 0 ` ` 0  800h0hh69TScore,97Percentiledd  X SourceErrors0  0` 0 ` ` 0  70h0hh45TScore,31PercentilePP   X Confabulations0 ` 0 ` ` 0  00h0hh56TScore,73Percentile< <   X 30MinDelayedRecall0 0  110h0hh49TScore,46Percentile( (   X Recognition_Discriminability_0 0  0.680h0hh47TScore,38Percentile    FigureLearningTest     X Learning0  0` 0 ` ` 0  8.00h0hh40TScore,16Percentile   X 4hrDelayPercentLoss0 0  0.00h0hh57TScore,76Percentile   ContinuousVisualMemoryTest    X Hits0  00` 0 ` ` 0  310h0hh2Percentile  X FalseAlarms0  0` 0 ` ` 0  190h0hh91Percentile  X d0  00` 0 ` ` 0  0.940h0hh2Percentile  X TotalCorrect0  0` 0 ` ` 0  650h0hh3Percentilett  X 30minDelayedRecognition0 0  20h0hh5Percentile``  TactualPerformanceTest  LL  X Memory0  0` 0 ` ` 0  80h0hh49TScore,46Percentile88  X Localization0  0` 0 ` ` 0  30h0hh46TScore,34Percentile$$  BrownPetersonConsonantTrigramLearning    X 0SecDelay0  0` 0 ` ` 0  150h0hhWithinNormalLimits  X 9SecDelay0  0` 0 ` ` 0  120h0hh50Percentile  X 18SecDelay0  0` 0 ` ` 0  120h0hh68Percentile  X 36SecDelay0  0` 0 ` ` 0  100h0hh52PercentileX6 XXXi) ] GU'  _PreparingfortheExaminationR.L.Mapou,Ph.D.  k;"  _F.0 X   Findingsareconsistentwiththeliteratureonneurobehavioralconsequencesof_spina_  bifidaandshuntedhydrocephalus.(The_examinee_Ԁmightalsomentionbrain  abnormalitiesassociatedwith_myelomeningocele_Ԁaswellasincreasedriskofseizures.)F+kXX   F.0 X   Findingssuggestanonverballearningdisabilityor righthemispherelearning  disability.FkXX   F.0 X   FindingsalsosuggestADHDwithrelateddeficitsinexecutivefunctions.FkttXX   F.0 X   Differentialdiagnosismightincludesemanticpragmaticdisorder,pervasive LL  developmentaldisorder/Aspergerssyndrome,and_prodromal_Ԁschizotypaldisorder.Fk8 8 XX   F.0 X   Childsfunctioningalsomightreflect,inpart,thefamilysroleinencouragingover    dependency.Althoughthereisnoinformationaboutthefamilysroleinthecase   summary,thisisacommonprobleminchildrenwith_spina_Ԁbifidawhohavevarious   orthopedicandrelateddifficulties. (EhCEKQW]cioAutoList2a.a.a.a.a.a.a.a.<  p`+CourierTT(UhCEKQW]cioAutoList3a.a.a.a.a.a.a.a. k;"  _ X Referral. Shewasreferredtodeterminehercurrentcognitivestatusandtoprovide  treatmentrecommendations,includingpossiblesupportsneededforindependentliving.   X PatientsComplaints. Problemswith:anosmia,hearingwiththeleftear,lowenergy,  attention,memory,visuospatialabilities,problemsolving,spelling,readingcomprehension,  andarithmetic.Nosignificantemotionalsymptomsarenoted.Shehasstoppeddrivingacar,  hassomedifficultymaintainingherhousehold,andhassomeanxietywhenherhusbandis  calledoutoftown.   X Shehasanepisodeofalteredconsciousnessaboutonceevery3months.Initiallythese || camewithoutwarningbutrecentlytheyareprecededbyinabilitytotalkandwantingtosay hh  _eee_.Theyareshorterthaninitially.[Withholdthefollowinginformationuntilafterthe TT  _examinee_Ԁcompletesaformulation.]Hersister,whoisanurse,witnessedanearlyepisodethat @ @  lasted3minutesanddescribeditasamajormotorseizure. , ,   X CourseofIllness. Uponfindingher,thedaughtercalled911andthepatientwas    takentothehospital,wheretheadmittingGlasgowComaScalewas12.Neurologicalexam    wasnormal,exceptforconfusionandinabilitytoanswerquestions.Subsequently,shehad   fluentspeechbutreceptiveaphasiawithneologisms,wordsubstitution,and_perseverations_.   Nosensorydefectsorvisualfielddefectswerenoted.   X Sixweeksaftertheinitialeventshedevelopedincreasingheadache,fever,and  episodesofdisruptedconsciousness.ShehadbeenprescribedDilantinandthiswaschanged  to_Tegretol_Ԁbecauseofpossiblemedicationrelatedfever.Shehadsomeadditionalmedical  procedures[If_examinee_Ԁaskswhat,respondthatshehada_craniotomy_Ԁbutdetailsarent || available.]andherneurologicalstatusreturnedtobaselineinabouttwoweeks. hh  X [Withholdthefollowinginformationuntilafterthe_examinee_Ԁprovidesaformulation.] TT Oninitialhospitalization,_neurosurgical_Ԁconsultrevealedright_hematympanum_,rightBattle @@ sign,andraccooneyes(rightworsethanleft).Slightright_hyperreflexia_Ԁandaright_Babinski_ ,, signwerenoted.   X [Alsowithholdthis.]Priortothesecondhospitalization,shehadalossof  consciousnesswithtonguebiting.Themedicalproceduredoneduringthishospitalization  wasalefttemporal_craniotomy_Ԁwithopenbiopsyandremovalofabloodclot.Brainbiopsy  wasnegativeforneoplasmandinfection.(ehCEKQW]cioAutoList41.1.1.1.1.1.1.1.(uhCEKQW]cioAutoList51.1.1.1.1.1.1.1. (CEKQW]cioAutoList61.a.1.1.1.1.1.1. (CEKQW]cioAutoList71.a.1.1.1.1.1.1.Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5(EGMSY_ekqAutoList131.1.1.1.1.1.1.1.*+ (_2623  ..*G+M (_25   /%` ` hp x /23  ..  5+ ` hp x 5  *D+M (_24   ," hp x ,23  ..  5+ ` hp x 5    k;"  _ PastMedicalHistory    X Noprenatalorperinatalmedicalproblemsandnodevelopmentaldelaysnoted.  Pneumoniain4thgradeandagaininhighschool.Brokenrightwristin8thgrade(healedwell).  Hashad12miscarriagesandahysterectomy15yearspriortothisevaluation.Rightknee  surgery9yearspriortothisevaluation.Hasallergiesandhashistoryofepisodicvertigo.   X Psychiatric. Somedepressionseveralyearsago.Nosubstanceabuse.   X Family. Theoldest(13yearold)adopteddaughterhasahistoryoflearningproblems  andanxiety.Hasbeenverballyabusivetowardspatientandpushedherononeoccasion. ||  X PriorCognitiveEvaluations. Aspeech/languageevaluationwasdone4daysafter hh thefirstincidentandrevealedverbalandreadingcomprehensiondefects,reducedattention, XX  difficultyreading,anomia,_paraphasias_,neologisms,milddisorientationtotimeandplace,and D D  labileaffect. 0 0   X Apsychologicalevaluationwasdonetwoweeksafterthefirstincident.Thisfound    thatthinkingabilitieshadimproved(withsomeresidualproblemsinlanguage,memory,and    _visuospatial_Ԁabilities),therewerenoemotionalproblems,insightwasgood,buta_dysexecutive_   syndromeandmild_impulsivity_Ԁwereseen    NeurologicalandMedicalFindings    X CerebrospinalFluid. Thiswasdoneduringhersecondhospitalizationandshowed  increasedproteinat105,42whitebloodcells(82%lymphocytes),glucoseof50,andallCSF  cultureswerenegative.   X _Neuroimaging_. [Note:Withholdthisinformationuntilaninitialformulationismade. ll Thisinformationmaythenbegiven,followedbyaskingthe_examinee_Ԁhowthiswouldaffect \\ formulation].AseriesofCTandMRIstudiesduringherfirsthospitalizationrevealedalarge HH (3X4cm)lefttemporal_intraparenchymal_Ԁhematomaandhemorrhagiccontusionoftheleft 44 frontalpole,andasmallfocalrightcerebellarlesion._MR_Ԁ_angiogram_ԀofthecircleofWillis    revealednodefinite_AVM_Ԁbutsomemasseffectontheleftmiddlecerebralarteryfromthe    hematoma.FollowupCTscan2weekslaterrevealedthelefttemporalhematomawas  resolving.   X Duringthesecondhospitalization,_neuroimaging_Ԁrevealedlefttemporal  _encephalomalacia_Ԁbutnoabscess,leftcerebralmasseffectwithincreased_vasogenic_Ԁedema  extendingintotheposteriorexternalandextremecapsules,_uncal_Ԁswellingthatcausedslight  effacementoftheleftcerebralpeduncle,andquestionableabnormalityintheleft_anterolateral_   temporallobe.Therightcerebellarlesionwasdecreasinginsize. !  X AnMRIdone10monthsposttheinitialhospitalizationrevealedresolutionoftheleft ll" temporalhematomawithresidual_encephalomalacia_,_gliosis_,andhemosiderin.Asmallold X X # rightcerebellarinfarctwasnoted. D!D!$  X EEG. [Note:Withholdthisinformationuntilaninitialformulationismade.This 0"0"% informationmaythenbegivenandaskthe_examinee_Ԁhowthiswouldaffectformulation].An  # #& EEGdoneduringthesecondhospitalizationshowedslowingandoccasionalspikesintheleft  $ $' temporallobe. $$(  Medicines. _Depakote_,2500mgdaily;_Neurontin_,300mg_tid_;_Ambien_,5mg_hs_.   k;"  _ PastMedicalHistory    X Birth/DevelopmentalHistory. Productofafullterm,uncomplicatedpregnancy.  DeliverywasbyCesareansection,andtheumbilicalcordwaslooselywrappedaroundhis  neck._APGARS_Ԁwere8and9at1and5minutes,respectively.HewasbornwithL3L4  _myelomeningocele_Ԁwhichwassurgicallyrepaired,aright_equivarus_,andleftinternaltibial  torsion.Hehas_neurogenic_Ԁbladderandbowel,andpartialparalysisofhislowerextremities.  Hehashad2hipstabilizationsurgeries.Hewalksindependentlywith_KAFO_Ԁbracesand  _Lofstrand_Ԁcrutches. xx  X Complications. Hedevelopedhydrocephaluswhichrequiredsurgicalplacementofa dd rightVPshuntonthe8thdayoflife.Theshunthasneverrequiredrevision. TT   X Psychiatric. None @ @   _Neuroimaging_ԀFindings      X CTScan. [Note:Withholdthisinformationuntilaninitialformulationismade.This    informationmaythenbegiven,followedbyaskingthe_examinee_Ԁhowthiswouldaffect   formulation].Done2yearsearlierandshowedmildleftventriculardilation.The   _interhemispheric_Ԁfissurewaswidenedwithpossiblecorpuscallosumdysgenesis.Thereisa  _Chiari_ԀIImalformationwithcaudaldisplacementofthecervicalmedullaryjunctionand  inferiorcerebellar_vermis_ԀtoapproximatelyC2C3level.   X EEG. Done1yearearlierandwaswithinnormallimits.   Medicines. None(Vm$0   1, 2, 3,Level 1Level 2Level 3Level 4Level 5(,!$0  0` (#(#    k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh0 Transformed   WISCIIIDigitSpan 0  0` 0 ` ` 0  0h0hh012ScaledScore  TrailMakingTest    X PartA 0  00` 0 ` ` 0  42Sec.0h0hh079Percentile  X PartB 0  00` 0 ` ` 0  110Sec.,3Errors090Percentile  CancellationTest (_Rudel_,_Denkla_,&_Browman_)   X TargetStimulus   X   Number(592)0 ` 0 ` ` 0  206Sec.0090Percentile  X      `    22Errors*0  027Percentilepp  X   Shape(Diamond)0 0  120Sec.00>99Percentile\\   X      `    2Errors**0  027PercentileH H   X *0  11commission,11omission4 4   X **0  0commission,2omission*A+M (_23  ` ) hp x )23  ..  5+ ` hp x 5   G k;"  _ Index 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformation   HalsteadImpairmentIndex 0 ` 0 ` ` 0  0h0.70hh033TScore,4Percentile  AverageImpairmentIndex 0 ` 0 ` ` 0  0h1.580hh034TScore,5Percentile  NeuropsychologicalDeficitScale 0 0  0h460hh0ModerateImpairment*>+M (_22   &hhp x &23  ..  5+ ` hp x 5   % k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh0 Transformed   WAISRDigitSpan 0  0` 0 ` ` 0  5forward,4back08ScaledScore  TrailMakingTest    X PartA 0  00` 0 ` ` 0  35Sec.0h0hh043TScore,24Percentile  X PartB 0  00` 0 ` ` 0  135Sec.,1Error029TScore,2Percentile  SeashoreRhythmTest 0 ` 0 ` ` 0  22Correct0036TScore,8Percentile  SpeechPerceptionTest 0 ` 0 ` ` 0  11Errors0035TScore,7Percentile I., II.,Level 1Level 2Level 3Level 4Level 54#X2Quick I.  .0 *;+M (_21   #p x #23  ..  5+ ` hp x 5    k;"  _Thispatientapparentlysufferedafall,forwhichshehasnomemory,andshewasthenfound  byherdaughter.Shesubsequentlyhadacomplexcourse.  F.0 X   Fivedaysafterthefall,herhospitaldischargediagnosiswasbasilarskullfracture,left  _intraparenchymal_Ԁhemorrhage,rightcerebellar_contrecoup_Ԁinjury,andleft  _frontotemporal_Ԁedema.Differentialdiagnosis(withoutneuroimagingresults)wouldbe  anacuteevent,mostlikelyheadtraumaversusCVA.Apsychiatric(e.g.,conversion  disorder)etiologymightalsobeconsidered.FkXX   F.0 X   Uponreturntothehospitalaboutsixweeksaftertheinitialevent,shewasdiagnosed `` withviralencephalitis.Dischargediagnosiswasdelayedposttraumaseizures, LL  traumaticlefttemporalhematomawithedemaand_gliosis_,inappropriateADH, 8 8  _SIADH_,and_hyponatremia_.Withoutneuroimaging,the_examinee_Ԁmightnoterisk $ $  factorsofexposuretohorses(andtheywerehealthy)andpossibletraveloutsidethe    U.S.withherhusbandsmilitarycareer(infact,shehadnevertraveledoutsidethe   U.S.).  k;"  _F.0 X   Sj XXAudiologicalevaluationtoassessleftearhearingloss.F+kXX   .0 X Psychotherapytohelpherwithdepressionandanxiety.XX F.0 X   Psychiatricconsulttoconsidermedicationforanxietyanddepression.FmkXX   .0 X Developmentofcompensatorystrategiesformemoryandothercognitive  problems.XX F.0 X   Brieffamilycounselingtoaddressresidualfamilyissuesandhelpthefamily   copemoreeffectivelyandpositivelywiththechangesinherfunctioning.  Sj#X6 X S# k;"  _ WISCIIISubtests 0  0` 0 ` ` 0  0h ScaledScore hh  X Information0  0` 0 ` ` 0  0h0hh10  X Similarities0  0` 0 ` ` 0  0h0hh16  X Arithmetic0  0` 0 ` ` 0  0h0hh8  X Vocabulary0  0` 0 ` ` 0  0h0hh13  X Comprehension0 ` 0 ` ` 0  0h0hh9  X DigitSpan0  0` 0 ` ` 0  0h0hh12  X PictureCompletion0 ` 0 ` ` 0  0h0hh4tt  X Coding0  00` 0 ` ` 0  0h0hh9``  X PictureArrangement0 ` 0 ` ` 0  0h0hh5LL   X BlockDesign0  0` 0 ` ` 0  0h0hh98 8   X ObjectAssembly0 ` 0 ` ` 0  0h0hh5$ $   X SymbolSearch0 ` 0 ` ` 0  0h0hh6    X   VerbalIQ0 ` 0 ` ` 0  0h107 hh  X   PerformanceIQ0 0  0h78 hh  X   FullScaleIQ0 ` 0 ` ` 0  0h92 hh  X   VerbalComprehension0  0h111hh  X   PerceptualOrganization0  0h76hh  X   FreedomfromDistractibility0  0h101hh  X   ProcessingSpeed0 0  0h88<  p`+CourierTT a k;"  _ Test 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformed   ControlledOralWordAssociation    X FAS0  00` 0 ` ` 0  0h150hh015Percentile  WisconsinCardSortingTest    X TotalCorrect0  0` 0 ` ` 0  0h52hh  X TotalErrors0  0` 0 ` ` 0  0h760hh05Percentile  X PerseverativeResponses0 0  0h500hh07Percentile  X PerseverativeErrors0 ` 0 ` ` 0  0h420hh07Percentilett  X CategoriesCompleted0 ` 0 ` ` 0  0h20hh01116Percentile``  X FailurestoMaintainSet0 0  0h10hh0>16PercentileLL   X PercentConceptualLevelResponding0 h 230hh05Percentile8 8  (SeeAttention/ConcentrationforTrailMakingTest)  k;"  _ X LivingArrangement. Heliveswithhis42yearoldmother,41yearoldfather,and  14montholdbrother.   X ParentsOccupations. Hismothercompletedcollegeandtwoyearsofgraduate  study.Shewasaparalegalbeforebecomingahomemaker.HisfatherhasaMastersdegree  andhasacivilservicepositionasaprogramanalyst.   X Activities. Hewatchestelevisionexcessively.Recentlyhehasparticipatedinlittle  leaguebaseballandCubScouts.  k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh0 Transformed   WideRangeAssessmentofMemoryandLearning (_Sheslow_Ԁ&Adamsnorms)   X StoryMemory0  0` 0 ` `     X   ImmediateRecall0 0  0h0hh012ScaledScore0     X   DelayedRecall0 0  62%Retention0BorderlinePerformance0 0@ hh0@     X   DelayedRecognition0 0  12/15Correct00AveragePerformance  X SentenceMemory ` 0 0  130h0hh08ScaledScore  X PictureMemory ` 0 0  180h0hh010ScaledScorexx  CaliforniaVerbalLearningTestChildrensVersion  dd  X Acquisition0  0` 0 ` ` 0  94257008PercentilePP   X   Trial10  0` 0 ` ` 0  90h0hh098Percentile< <   X   Trial50  0` 0 ` ` 0  70h0hh016Percentile( (   X SemanticClustering0 ` 0 ` ` 0  10%0h0hh010Percentile    X _Perseverations_0  0` 0 ` ` 0  7%0h0hh018Percentile   X Intrusions0  0` 0 ` ` 0  26.8%0h0hh0>99Percentile   X FreerecallShortDelay0 0  70h0hh031Percentile   X CuedRecallShortDelay0 0  100h0hh069Percentile  X FreeRecallLongDelay0 0  100h0hh069Percentile  X CuedRecallLongDelay0 0  80h0hh031Percentile  X RecognitionHits0 ` 0 ` ` 0  150h0hh084Percentile  X RecognitionFalsePositives0 0  30h0hh050Percentilett  ReyOsterriethComplexFigure  ``  X ImmediateRecall ` 0 0  5.50h0hh05PercentileLL  X DelayedRecall0 ` 0 ` ` 0  50h0hh04Percentile88   k;"  _ X Referral. Hewasreferredforassistanceindevelopinganappropriateeducational  plan.   X PatientsComplaints. Notobtained.   X FamilysComplaints. Bothofhisparentswereconcernedthathissocialskillsare  immature.Hedoesnotappeartoknowhowtointeractwithotherchildren.Hecanbetoo   forwardwithstrangers.Heis_hyperverbal_Ԁandlikestobethecenterofattention.Heis  ofteninattentive,impulsive,and_distractible_.Hecanbecomeupsetandscaredeasily. p k;"  _ Test 0 X 0XX00` 0 ` ` 0  0h Raw 0hh0 Transformed   HooperVisualOrganizationTest 0 0  0h23.50hh066Percentile  KaufmanAssessmentBatteryforChildren    X GestaltClosure0 ` 0 ` ` 0  0h140hh07ScaledScore  RavenColouredProgressiveMatrices    X A0  00` 0 ` ` 0  0h70hh013Percentile  X AB0  00` 0 ` ` 0  0h40hh018Percentile  X B0  00` 0 ` ` 0  0h40hh031Percentilexx  ReyOsterriethComplexFigure  dd  X Copy0  00` 0 ` ` 0  0h110hh05PercentilePP   BeeryDevelopmentalTest < <   X ofVisualMotorIntegration 0 0  0h120hh084StandardScore( (   WISCIII      X PictureCompletion0 ` 0 ` ` 0  0h0hh04ScaledScore    X BlockDesign0  0` 0 ` ` 0  0h0hh09ScaledScore   X ObjectAssembly0 ` 0 ` ` 0  0h0hh05ScaledScore   X SymbolSearch0 ` 0 ` ` 0  0h0hh06ScaledScore c k;"  _ Test 0 X 0XX00` 0 ` ` 0   Raw 0h0hh0 Transformed   HalsteadReitanFingerOscillationTest    X Right0  00` 0 ` ` 0  38.4taps0038Percentile  X Left0  00` 0 ` ` 0  30.8taps0018Percentile  GripStrength    X Right0  00` 0 ` ` 0  10kg0h0hh015Percentile  X Left0  00` 0 ` ` 0  8.25kg0h0hh07Percentile  GroovedPegboard  tt  X Right0  00` 0 ` ` 0  97sec,1drop00>99Percentile``  X Left0  00` 0 ` ` 0  105sec,0drop0>99Percentile  k;"  _F.0 X   RegularSj XXclassroomplacementwithappropriatemodificationsandassistance.F+kXX   .0 X Specificassistancewithmathandwrittenexpression.XX F.0 X   Socialskillstraining.F~kXX   .0 X Parenttraininginbehaviormanagementtechniques.XX F.0 X   Increasedstressondevelopmentofdailylivingskills.F{kXX   .0 X Possiblemedicationtrialforattentionproblems.#XnX Sj[#TABLE A*8+M (_20  h  p x 23  ..  5+ ` hp x 5  *5+M (_19   pp x 23  ..  5+ ` hp x 5  *2+M (_18    x 23  ..  5+ ` hp x 5  * (_1723  Ԁ*GM (_16   /%` ` hp x /23  Ԁ  5+ ` hp x 5  *DM (_15   ," hp x ,23  Ԁ  5+ ` hp x 5  *AM (_14  ` ) hp x )23  Ԁ  5+ ` hp x 5  *>M (_13   &hhp x &23  Ԁ  5+ ` hp x 5  *;M (_12   #p x #23  Ԁ  5+ ` hp x 5  *8M (_11  h  p x 23  Ԁ  5+ ` hp x 5  *5M (_10   pp x 23  Ԁ  5+ ` hp x 5  (2M &_9    x 23  Ԁ  5+ ` hp x 5  ( &_823  (GM &_7   /%` ` hp x /23   5+ ` hp x 5  (DM &_6   ," hp x ,23   5+ ` hp x 5  (AM &_5  ` ) hp x )23   5+ ` hp x 5  (>M &_4   &hhp x &23   5+ ` hp x 5  (;M &_3   #p x #23   5+ ` hp x 5  (8M &_2  h  p x 23   5+ ` hp x 5  (5M &_1   pp x 23   5+ ` hp x 5  &2M $_    x 23   5+ ` hp x 5  <:zBottom of 7(X7  ?%2A`Arial?  S\  `&Times New RomanS7g(X7=)1dxd<:zTop of For7(X7  ?%2A`Arial?  S\  `&Times New RomanS7g(X7=)2dxd cEGMSY_ekqAutoList101.a.1.1.1.1.1.1. cEGMSY_ekqAutoList111.a.1.1.1.1.1.1.(EGMSY_ekqAutoList121.1.1.1.1.1.1.1.%2A`Arial\  `&Times New Roman3$37;?CGKOS-*+x'r Z 6Times New Roman Regular #$%&hEGKOSW[_cAutoList15)1)a) #$%&hEGKOSW[_cAutoList16)1)a) #$%&hEGKOSW[_cAutoList17)1)a) #$%&hEGKOSW[_cAutoList18)1)a) #$%&hEGKOSW[_cAutoList19)1)a) #$%&hEGKOSW[_cAutoList20)1)a) #$%&`EGKOSW[_cAutoList21)1)a) #$%&hEGKOSW[_cAutoList22)1)a) #$%&`EGKOSW[_cAutoList23)1)a) #$%&`EGKOSW[_cAutoList24)1)a)\  `*Times New RomanTT O GU'  _TheWrittenExaminationJ.Spector !  _"XFXXX      XnXX"XF8nXXdd8AMERICANACADEMYOFCLINICALNEUROPSYCHOLOGY  STUDYGUIDEFORBOARDCERTIFICATIONINCLINICALNEUROPSYCHOLOGY  RobertL._Mapou_,Ph.D.,Editor L  Version1.1!October2002 8  2002AmericanAcademyofClinicalNeuropsychology  `L @@9CONTRIBUTORS    AllcontributorshaveareBoardCertifiedinClinicalNeuropsychologybytheAmericanBoardof  ProfessionalPsychology t LinasA.Bieliauskas,Ph.D. L  ExecutiveDirector,AmericanBoardofClinicalNeuropsychology 8  ExecutiveSecretary,AmericanAcademyofClinicalNeuropsychology $ t CorwinBoake,Ph.D.  L  _Neuropsychologist_,TheInstituteforRehabilitationResearch,Houston,TX  8  AssistantProfessor,DepartmentofPhysicalMedicineandRehabilitation $  UniversityofTexasHoustonMedicalSchool,Houston,TX   RobertIvnik,Ph.D.   ProfessorofPsychology,DepartmentofPsychiatryandPsychology   MayoClinicandFoundation,RochesterMN p A.JohnMcSweeny,Ph.D. H ProfessorofPsychiatryandNeurology 4 MedicalCollegeofOhio,Toledo,OH  p RobertL._Mapou_,Ph.D. H IndependentPractice,SilverSpring,MD 4 ResearchAssociateProfessorofPsychiatryandResearchAssistantProfessorofPsychology   UniformedServicesUniversityoftheHealthSciences,Bethesda,MD   ClinicalAssociateProfessorofNeurology(Psychology)  GeorgetownUniversitySchoolofMedicine,Washington,DC  JoelE.Morgan,Ph.D. l AssistantProfessorof_Neurosciences_ X  UniversityofMedicineandDentistryofNewJerseyNewJerseyMedicalSchool,Newark,NJ D! JosephRicker,Ph.D. #l! AssociateDirector,NeuropsychologyLaboratory $X" KesslerMedicalRehabilitationResearchandEducationCorporation,WestOrange,NJ $D # AssociateProfessor,DepartmentofPhysicalMedicineandRehabilitation %0!$ UniversityofMedicineandDentistryofNewJersey,Newark,NJ &"% MichaelSchmidt,Ph.D. (#' IndependentPractice,ColoradoSprings,CO )$(   h+&* _JackSpector,Ph.D.  IndependentPractice,Baltimore,MDandChevyChase,MD  AssistantClinicalProfessor,DepartmentofPsychiatryandHumanBehavior  UniversityofMarylandSchoolofMedicine,Baltimore,MD  t @;CONTENTS     Vm  Vm 0     INTRODUCTION#""o(#. (#(##1Vm  ݌ t Ќ  !  ! 0  0` (#(#    RobertJ.Ivnik,Ph.D.! ݌`` (#` (# Ќ  Vm  Vm{0     THEAPPLICATIONPROCESS#""o(#.&(#(##7Vm{݌ 8  Ќ  !  !B0  0` (#(#    LinasBieliauskas,Ph.D.!B]݌$ t` (#` (# Ќ  Vm  Vm0     THEWRITTENEXAMINATION#`"`"n(#.&(#(##12Vm݌  L  Ќ  !  !0  0` (#(#    JackSpector,Ph.D.!݌ 8 ` (#` (# Ќ  Vm  Vm0     THEWORKSAMPLE#`"`"n(#.  (#(##23Vm݌   Ќ  !  !E0  0` (#(#    JoelE.Morgan,Ph.D.andJosephRicker,Ph.D.!E`݌ ` (#` (# Ќ  Vm  Vm0     THEORALEXAMINATION:OVERVIEW,WORKSAMPLE,ANDFACTFINDING#`"`"n(#.r r L(#(##29Vm7݌   Ќ  !  ! 0  0` (#(#    MichaelSchmidt,Ph.D.! $݌p` (#` (# Ќ  Vm  Vm0     THEORALEXAMINATION:PROFESSIONALANDETHICALISSUES#`"`"n(#.~~D(#(##61Vm݌ H Ќ  !  !0  0` (#(#    A.JohnMcSweeny,Ph.D.!݌4` (#` (# Ќ  Vm  Vml0     REPEATINGTHEABCNORALEXAMINATION#`"`"n(#.2(#(##69Vml݌  \ Ќ  !  !@0  0` (#(#    CorwinBoake,Ph.D.!@[݌H` (#` (# Ќ  Vm  Vm0     PREPARINGFORTHEABCNEXAMINATION#`"`"n(#.1(#(##72Vm݌   Ќ  !  !0  0` (#(#    RobertL.Mapou,Ph.D.!݌ ` (#` (# Ќ        8nXXdXXd8S@9  INTRODUCTION  XԈ  @4  RobertJ.Ivnik,Ph.D.  Ԉ  *,X'XX*OverviewoftheAmericanBoardofProfessionalPsychologyandtheAmericanBoardofClinical t Neuropsychology `  ' Atthestartoftheyear2000,theAmericanBoardofProfessionalPsychology(ABPP)isa L  federationof11memberboards,eachofwhichcertifiespsychologistsinadifferentspecialty 8  area.TheABPPwasestablishedin1947(Bent,Packard&Goldberg,1999)asanoutgrowth, $ t andontherecommendation,oftheAmericanPsychologicalAssociation(APA,1946).The  ` AmericanBoardofClinicalNeuropsychology(ABCN)istheABPPspecialtyboardthatdeals  L  withallissuesrelatingtoClinicalneuropsychology.TheABCNwasformallyincorporatedas  8  partofTheABPPin1984. $  Ѐ ' Originally,boththeABPPandABCNweremembershiporganizations.However,in1996   TheABPPreorganizeditself.Oneofthereasonsforthisreorganizationwasthatitisnot   appropriateforentitiesthatexisttocertifyprofessionalstoalsoengageinadvocacyonthepartof   thosesameprofessionals.Apotentialconflictofinterestexistsifanorganizationengagesin   bothcertificationandadvocacy.Intheprocessofreorganization,TheABPPestablisheditselfas p afederationofboards,withtheABCNbeingoneofthoseboards.TheABPPsonly members \ arerepresentativesfromeachofitsaffiliatedboards.Onerepresentativefromeachaffiliated H boardservesontheABPPBoardofTrustees. 4    ' AspartoftheABPPreorganization,eachofitsaffiliatedspecialtyboardsalsoreorganized.  p ParallelingtheABPP,theABCNbecameanorganizationthatexiststoevaluateandcertify  \ clinicalneuropsychologists.TheABCNgaveupbeingamembershiporganizationofallABPP H certifiedclinicalneuropsychologistsandanewmembershiporganization,theAmerican 4 AcademyofClinicalNeuropsychology(AACN),wasformed.TheABCNnowhasaBoardof   Directorscomposedof15memberswhoserve5yeartermsandareelectedbyallboardcertified   neuropsychologistswhoareAACNmembers.TheBoardofDirectorsoftheABCNdeveloped  andnowrefines,maintains,andadministerstheABPPapprovedapplication,credentialreview,  examination,andcertificationprocedureswhichleadtoABPPcertificationinClinical  neuropsychology(ABPPCN). l    ' ConsistentwiththeABPPmissionandasarticulatedinitsbylaws,theABCNexistsforthe X  followingpurposes: D!  ' #$%&(.x3"3"  6,Xw` X,X'X63f'2.3  0 '   Toarrangeandconductinvestigationsandexaminationstodeterminethequalificationsof #l! individualswhoapplytotheBoardforcertificationoftheircompetenceinClinical $X" neuropsychology.3f''݌$D #'(#'(# Ќ  "3"  39)2.3  0 '   TocertifycompetenceinthefieldofClinicalneuropsychologyforqualifiedapplicantswho %0!$ havedemonstratedadvancedknowledgeandskillsinClinicalneuropsychologybyvirtueof &"% educationandtrainingandbysuccessfullycompletingallexaminationsrequiredbythe '#& Board.39)f)݌(#''(#'(# Ќ  "3"  3=+2.3  0 '   Tomaintainaregistryofpersonswhohavecompletedtheexaminationandarecertifiedby )$( theABCNandABPPashavingcompetenceinClinicalneuropsychology.3=+j+݌|*%)'(#'(# Ќ  "3"  3,2.3  0 '   Toservethepublicwelfarebypreparingandfurnishinglistsofpersonswhohavebeen h+&* awardedCertificatesbytheBoardtoproperpersonsandagencies.3,,݌d'(#'(# Ќ    TheABPPandABCNCredentialReviewandExaminationProcesses <  ' AlthoughthegeneraloutlineoftheABCNscredentialreviewandexaminationprocesses (  hasbeenconstantsincetheorganizationsinception,thesesameproceduresarecontinually   examinedandrefined.Theprocessisafourstepprocedurewitheachlatersteprequiring   successfulcompletionofallearliersteps.Thefourstepsthatconstitutetheentireapplicationand   examinationprocessinclude:  t 0 ' 1.0'(#'(#Successfulcompletionofthewrittenapplicationandcredentialreviewprocess,during L  whichtheapplicantseducation,training,andsupervisedexperiencesareevaluated 8  accordingtoestablishedandpubliclyknownstandards$ (#(# 0 ' 2.  Completinga100item,multiplechoiceWrittenExaminationt '(#'(# 0 ' 3.0'(#'(#SubmittingaWorkSample(twocases)thatisevaluatedbythreeAACNmemberswith `  regardtotheiracceptabilityforatthecandidatesOralExamination,andL (#(# 0 ' 4.  CompletinganOralExamination.8 '(#'(#  ' Regardingthefirststep,applicantsmustholdadoctorateinPsychology,belicensed,befree  ofunresolvedoroutstandingethicalcomplaintsandviolations,andbebothtrainedand  supervisedinClinicalneuropsychology.Thestandardsthatareusedtojudgeeachapplicants  credentialsarebasedupontheyeartheapplicantreceivedthedoctoraldegree.Therefore,the p ABCNstandardsareappropriatetothetimeperiodduringwhichtheapplicanttrainedandhave \ evolvedasourprofessionhasmatured.Forexample,thereisnoformalsupervisionrequirement H forapplicantswhocompletedtheirdoctoratebefore1981.Forpersonswhocompletedtheir 4 doctoratebetween1981and1989,1600hoursofclinicalneuropsychologicalexperienceatthe   preorpostdoctorallevelssupervisedbyaclinicalneuropsychologistarerequired.Personswho p  graduatedafter1989arerequiredtohavetwoyearsofclinicalneuropsychologicaltraining \ supervisedbyaclinicalneuropsychologist,oneyearofwhichmaybepredoctoral. H  ' Thecurrent higheststandardsfortraininginClinicalneuropsychologyarearticulatedin 4  thePolicyStatementoftheProceedingsofthe1997HoustonConferenceonTraininginClinical  ! Neuropsychology(Hannayetal.,1998).ApplicantstotheABPPandABCNarenotcurrently  " judgedbyHoustonConferencestandards.However,theABCNsBoardofDirectorsmonitors " educationandtrainingopportunitiesandwilleventuallydecidewhentoapplytheHouston #  Conferencestandards. $l!    ' AfteranapplicantscredentialsareacceptedbytheABPPandABCN,theapplicant %X" becomesa candidateforABPPCNcertificationandisnotifiedinwritingofthisfact. &D # Candidateshaveamaximumofsevenyearsfromthedateoftheirnotificationletterto '0!$ accomplishallremainingstepsintheABCNcertificationprocess.Candidatesareresponsible ("% formonitoringtheirownprogresstowardABPPCNcertification. l)#&    ' Thesecondstep,theWrittenExamination,assuresthatcandidatespossessasufficient X*#' breadthanddepthofknowledgeinClinicalneuropsychology.Amultiplechoiceexamination D+$( achievesthispurpose.TheABCNcontractedwiththeProfessionalExaminationService(PES) 0,%) todevelopandvalidateawrittentest.TheWrittenExaminationwasconstructedbyhaving d practicingneuropsychologistssubmitmultiplechoicequestionsaboutfactsthattheythought P experiencedclinicalneuropsychologistsshouldknow.PESoversawamultistageprocessduring < whichotherboardcertifiedclinicalneuropsychologistsdebated,refined,andeventuallyapproved (  everyquestion.ThecontentareascoveredintheWrittenExaminationcannotbespecified,butit   isreasonabletoanticipatethatquestionsmightrelatetosomeofthefollowingexamplesof   contentareas:   "3"  3GA2.3  0 '   Neuropsychologicalconditions(e.g.,amnesia,dementia)3GAtA݌ `'(#'(# Ќ  "3"  34B2.3  0 '   Theneurosciences(e.g.,neuroanatomy)34BaB݌L '(#'(# Ќ  "3"  3C2.3  0 '   Normaldevelopment(bothneurologicandpsychologic)3C=C݌8 '(#'(# Ќ  "3"