Wide Range Assessment of Memory and Learning Second Edition

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Wide Range Assessment of Memory and
LearningSecond Edition

• David Sheslow, PhD
• Wayne Adams, PhD

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Presented byKathleen M. Woodward, Ed.S., NCSP

• Clinical Assessment Consultant, PAR, Inc.
• School Psychologist in the Colorardo public
  school system for 3 years
• RTI committee for policy and procedural
  development
• Autism ESY program coordinator/service provider
• kwoodward_at_parinc.com 720.224.3151

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About the authors

• Dr. David Sheslow
• PhD in Clinical Psychology, University of North
  Carolina at Greensboro
• 29 years at the DuPont Hospital for Children as
  chief psychologist and co-director of the
  Division of Behavioral Health, Department of
  Pediatrics
• Teaches at the DuPont Hospital Pediatric and
  Psychology Residency Programs
• Private, Clinical Psychology practice
• Published over 48 professional articles

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About the authors

• Dr. Wayne Adams
• PhD in Developmental and Child Clinical
  Psychology from Syracuse University
• 23 years at DuPont Hospital for Children,
  Director of the Division of Psychology, Chief
  Psychologist within the Division of Behavioral
  Medicine
• Associate Professor at Jefferson Medical College
• Published gt30 articles, gt60 presentations at
  conventions of professional organizations
• Diplomat status, Clinical Psychology, American
  Board of Professional Psychology
• Currently a tenured professor and chairperson of
  the APA accredited Graduate Department of
  Clinical Psychology at George Fox University,
  Newberg, OR

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• Evaluation of Memory
• Our Clinical and
• Empirical Roots

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Historical Roots

• Hans Ebbinghaus (1850 1909)
• Immediate memory (digit span)
• Chunking
• Nonsense syllables
• Meaningfulness
• Rehearsal
• Interference
• Disadvantage of age
• Memory illusions

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Historical Roots

• Alfred Binet (1857 1911)
• Qualitative analysis
• Serial position effect
• Importance effect
• Acoustic vs. semantic recall effects
• Frederic Barlett (1886-1969)
• Visual and motor memory

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Historical Roots

• Sigmund Freud
• Repressed memory effects
• Theodule Ribot (1839-1916)
• Encoding, storage, retrieval
• Procedural and volitional memory
• Study of amnesias
• Developmental aspects of memory
• Immediate memory improves during school years
• Declining long-term retention with age

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Historical Roots

• Associationism
• Function of habit strength
• Simple association between external stimulus and
  observable response
• Introduction of the Computer
• People are active information processors
• Memory is a storage system with stages

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Historical Roots

• Broadbent (1958)
• serial processing
• Atkinson and Shiffrin (1968)
• Sensory register, short-term store, long-term
  store
• Control processes
• Craik and Lockhart (1972)
• levels of processing

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Historical Roots

• Developmental Aspects
• Immediate recall improves during school years
• Improvement on immediate memory tasks is
  particularly noticeable until 13 years of age
• Childrens performance across ages does differ
• Long-term retention declines with increasing age
• Gender differences are small or non-existent
• Memory performance is related to IQ but the
  correlation is not very high

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Historical Roots

• Neuropsychological Influences
• H.M. (hippocampal lesion)
• Intact short-term, severely impaired long-term
• Support for multi-store model?
• Non-localized dimension?
• Executive processes

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Contemporary Status

• Neuroimaging studies
• Computational/connectionist models
• Multi-system nature, active, dynamic
• Interaction of
• Memory
• Executive functions that control and regulate
• Knowledge and skills of learner

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A sampling of historical memory concepts found
on WRAML2

• Primacy/Recency
• List Learning
• Learning Trials and Learning Curve
• Recognition Memory
• Immediate vs. Delayed Recall

• Sustained Attention
• Working Memory
• Gist vs. Verbatim
• Verbal vs. Visual
• Rote vs. Meaningful

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Early Memory Measures

• Rey (list learning of 15 words) 1958
• Rey-Osterrieth Complex Figure Task (1944)
• Wechsler Memory Scale (1945)
• Wechsler Memory Scale Revised (1987)
• Wechsler Memory Scale III (1997)
• Wide Range Assessment of Memory and
• Learning (1990)

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Test Revision

• WRAML WRAML2
• (1990) (2004)

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Major ModificationsWRAML to WRAML2

• Upper age range extended from 17 to 90 years
• Indexes better reflect factor structure Verbal
  Memory, Visual Memory, Attention/Concentration
• Number of Core Subtests (6 vs. 9)

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Major ModificationsWRAML to WRAML2

• Delay Memory Tasks (7 vs. 4)
• 2 Working Memory
• Recognition Memory (4 vs. 1)
• Qualitative Analyses (25 vs. 0)
• Updated stimulus materials

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WRAML2 Structure

• Core Subtests
• Optional Subtests
• Qualitative Analyses

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Core Indexes and Subtests
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Psychometric Properties of the WRAML2
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Test Development

• Focus group meetings, research
• Inclusion of working memory and recognition
• Item tryout (n 140)
• Item Response Theory, Rasch analysis
• Development of Standardization Edition

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Standardization

• Stratified Sampling Using
• Age
• Gender
• Geographic Region
• Education Level
• Ethnicity
• N1,200, 80 for each of 15 age groups

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Reliability Core Subtests
r values
Subtest Interscorer Reliability .98
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Internal Validity

• Item separation .98 to 1.00
• Factor Analysis
• Three-factor Core Model Verbal Memory, Visual
  Memory, Attention/Concentration
• Applies to all demographic groups
• Working Memory Attention/Concentration r .99
• Three-factor Optional Model Working Memory,
  Verbal Recognition, Visual Recognition
• Differential Item Functioning most in high .90s,
  .88 on Story Memory between Hispanic and White

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External Validity
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Pediatric Clinical Groups
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Adult Clinical Groups in Manual
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Administration

• General Points
• Clipboard
• Pronunciation
• Practice
• Organize Forms
• Administration Time
• Core Subtests 30 - 40 minutes

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Age-Based Normative Scores

• Scaled Scores - Subtests
• Mean 10, SD 3
• Standard Scores - Indexes
• Mean100, SD 15
• Percentiles - Indexes
• Age Equivalents
• 5 16 years

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Other Data Available

• Confidence Intervals
• Index Discrepancy Data
• Statistical significance
• Prevalence data
• Scaled and/or Cut Scores for qualitative analyses
• Qualitative Analyses (with quantitative support)
• Age-based descriptive statistics and clinical
  base rates (prevalence) are provided
• Computer scoring program available

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Core Indexes and Subtests
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Story Memory SubtestCore Subtest (1), Verbal
Memory Index

• Two Stories read to Participant
• A B 5-8 years
• B C 9 years and older
• Immediate Recall Trial
• Upper case scoring criteria requires an exact
  response
• Lower case scoring criteria acceptable gist
  responses listed in manual

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Story Memory SubtestCore Subtest (1), Verbal
Memory Index

• Tips
• Practice reading stories out loud
• Use a pencil to point to each word as it is read
• Note unusual gist responses so can score later
• Transfer to Verbatim and Gist columns later

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Story Memory SubtestAssociated Optional Subtests
and Qualitative Measures

• Story Memory Delay Recall
• Story Memory Retention
• Individual Story Comparison
• Verbatim and Gist Measures
• Story Memory Delay Recognition

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Verbal Learning SubtestCore Subtest (3), Verbal
Memory Index

• List-learning task
• 13 words, 8 years and younger
• 16 words, gt 9 years
• Common words
• Four learning trials

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Verbal Learning SubtestCore Subtest (3), Verbal
Memory Index

• Tips
• One second pause between words
• Number repetition order IF have time
• Write first letter of word in free space

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Verbal Learning SubtestAssociated Optional
Subtests and Qualitative Measures

• Verbal Learning Delay Recall
• Trials 1 4
• Verbal Learning Slope
• Verbal Learning Retention
• Verbal Learning Intrusion Errors
• Verbal Learning Recognition
• Semantic vs. Phonological Error analysis for
  Recognition

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Design Memory Subtest Core Subtest (2), Visual
Memory Index

• 5 Design Memory Cards
• Design Memory Response Form
• Copying aid for judging accuracy
• Young examinees
• Any age with poor visual-motor skills
• Drawing task
• 5 second exposure
• 10 second pause before drawing

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Design Memory Subtest Core Subtest (2), Visual
Memory Index

• Tips
• Take back the pencil each time after drawing is
  complete
• Hold the pencil to deter grabbing
• Let clock run and note time vs. resetting
• Scoring guidelines in manual
• Associated Optional Subtest
• Design Memory Recognition

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Picture Memory SubtestCore Subtest (4), Visual
Memory Index

• 4 Memory Stimulus Cards
• Picture Memory Response Form
• Red China Marker
• 10 second exposure
• Put an X on each part of the picture that has
  been changed, moved or added.
• Correct Zoo card only

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Picture Memory SubtestCore Subtest (4), Visual
Memory Index

• Tips
• Put Memory Stimulus Cards in order
• Can use a crayon liquid markers typically bleed
• Familiarize yourself with the Zoo responses, in
  particular, so can quickly correct if needed
• Associated Optional Subtest/Qualitative Measure
• Commission Errors
• Picture Memory Recognition

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Finger Windows SubtestCore Subtest (7),
Attention/Concentration Index

• Finger Windows Card
• Start places determined by age
• 5-8 years A
• 9 years older 4
• 1 second in window, 1 second between windows
• Correct A, B, and C only
• If 4 is incorrect, go to A

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Finger Windows SubtestCore Subtest (7),
Attention/Concentration Index

• Tips
• May be easier to write numbers in order while
  looking at card
• Can place pencil on table between windows to aid
  timing

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Number Letter SubtestCore Subtest (9),
Attention/Concentration Index

• 1 per second
• Examinee repeats the sequence in the same order

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Verbal Working MemoryOptional Subtest (14),
Working Memory Subtests

• Only administer to 9 and older
• 9 to 13 years Level A and B
• 14 to adult Level B and C
• A Repeat animals first, then non-animals
• B Repeat animals small to large first, then
  non-animals
• C Repeat animals small to large first, then
  non-animals small to large

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Verbal Working MemoryOptional Subtest (14),
Working Memory Subtests

• Example Level B, Item B-6
• Examiner nail, elephant, lake, crab, kangaroo
• Participant crab, kangaroo, elephant, nail,
  lake
• Scoring 1 for animal grouping, 1 for non-animal
  grouping, bonus of 1 if both groupings are
  correct intrusions are not accepted
• Can teach on items A-1, A-2, A-3, B-1 but score
  first response

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Verbal Working MemoryOptional Subtest (14),
Working Memory Subtests

• Tips
• Directions are lengthy and wordy so must practice
  frequently before administering to ensure correct
  pronunciation. Use inflection to aid
  understanding.
• If size dimensions are questioned (i.e. nose to
  scissors) say, Think of the most usual size.

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Symbolic Working MemoryOptional Subtest (16),
Working Memory Subtests

• Administered to 9 years and older only
• Auditory input, non-verbal response
• 2 Levels
• A Numbers in order
• Number Stimulus Card
• B Numbers order, then letters in order
• Number-Alphabet Stimulus Card
• Training items for each level

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Symbolic Working MemoryOptional Subtest (16),
Working Memory Subtests

• Tips
• Stress numerical and alphabetical order when
  reading directions
• Remove or flip card after every item response
• Subjects often point very quickly so may want to
  remember visually or write series on paper while
  watching

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Sound Symbol Optional Subtest (13), Additional
Subtests

• 5 8 years only
• Phonemes paired with visual symbols
• Sound Symbol Booklet
• Learning Trial
• 4 Test Trials (I to IV)
• Provide positive feedback or correct responses on
  the first 3 Test Trials
• If no response in 5 seconds, provide response and
  flip or just flip if Trial IV

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Sound SymbolAssociated Optional Subtest and
Qualitative Measures

• Sound Symbol Delay Recall
• Trial 1 4
• Sound Symbol Retention
• Sound Symbol Slope

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Sentence MemoryOptional Subtest (15), Additional
Subtests

• 8 and younger Begin with Item 1
• 9 to adult Begin with Item 8 (go back if
  necessary)
• Say each sentence once only
• 2 points 0 error
• 1 point 1 error
• 0 point 2 errors or more
• Can teach 1 until they understand but score
  first attempt

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Sentence MemoryOptional Subtest (15), Additional
Subtests

• Scoring
• Response must be verbatim
• Additions, omissions, changing word form, and
  contracting are one error
• Tips
• Place pencil on each word to decrease error
• Record incorrect response for scoring and analysis

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Story Memory Delay RecallOptional Subtest (5),
Delay Recall Subtests

• Return to Story Memory (1) scoring pages
• Administer same story set as Story Memory
• Do not read story to examinee
• Indicate performance in the Delay Recall column
• No Verbatim or Gist columns for delay but must
  comply with same scoring guidelines

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Verbal Learning Delay RecallOptional Subtest
(8), Delay Recall Subtests

• Return to Verbal Learning (3) scoring pages
• Do not read the list to the examinee

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Sound Symbol Delay RecallOptional Subtest (17),
Delay Recall Subtests

• Return to Sound Symbol (13) scoring pages
• Sound Symbol Booklet
• Do not name any symbols
• Delay Recall Trial is the same set as the
  Learning Trial

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Story Memory RecognitionOptional Subtest (6),
Recognition Subtests

• Administer same story set as Story Memory
• Give automatic credit for any correct detail
  given during Story Memory Recall

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Design Memory RecognitionOptional Subtest (10),
Recognition Subtests

• Design Memory Recognition Booklet
• Pencil or Marker
• Review directions until examinee independently
  understands
• Make sure page is correctly oriented
• Do not let examinee go back once a page is
  finished

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Picture Memory RecognitionOptional Subtest (11),
Recognition Subtests

• Picture Memory Recognition Booklet
• Pencil or Marker
• Review directions until examinee independently
  understands
• Do not let examinee go back once a page is
  finished
• Can clarify that picture can appear on either the
  Picture Stimulus Card (cards with scenes) or
  Picture Memory Response Form (marked changes)

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Verbal Learning RecognitionOptional Subtest
(12), Recognition Subtests

• Administer if Verbal Learning and Verbal Learning
  Delay Recall have been administered
• Ask for recognition of each word on list
• Optional Qualitative Analysis
• Semantic Error Total
• Phonological Error Total

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WRAML2 Screening Form

• 1st Four Core Subtests
• Story Memory
• Design Memory
• Verbal Learning
• Picture Memory
• Administration Time 20 - 30 minutes
• Memory Screening Index and General Memory Index
  correlation .91

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Scores

• Raw Scaled Sum of Scaled Index
• Graphic Representation
• Index Score Discrepancy Analyses
• Core Subtest vs. Recognition Discrepancy
• Retention Subtest minus Recall raw score

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Qualitative Analyses - Scores

• Story Memory
• Individual Story/Verbatim and Gist Scale Score
• Picture Memory
• Commission Errors - Descriptive
• Verbal Learning
• Trials/Slope/Intrusion Errors Graph and
  Descriptive
• Verbal Learning Recognition
• Semantic and Phonological Errors - Descriptive
• Sound Symbol
• Trials/Slope/Retention Graph and Descriptive

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Qualitative Analyses - Possible Implications

• Story Memory
• Forgetting chunks - Limited sustained attention
• Delay better than recall - Need for memory
  consolidation
• Reliance on Gist related to Reading Disability
• Poor Delay Recall common in dementia or left
  temporal lobe head injury or stroke
• Retention is particularly poor with moderate to
  severe brain injury, although immediate recall
  can be intact

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Qualitative Analyses - Possible Implications

• Verbal Learning
• Flat curve could suggest adequate auditory memory
  but difficulty recalling rote information
• Slight curve suggests subject may benefit from
  repetitive review
• Variable curve could suggest attention/organizatio
  n issues
• Poor slope suggests limited or decreased
  learning adequate slope suggests learning
  efficiency

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Qualitative Analyses - Possible Implications

• Verbal Learning, continued
• Retention score lt the 5th percentile could
  suggest recent brain injury or progressive
  dementia
• Frequent intrusion errors may suggest limited
  self-monitoring, difficulty using feedback to
  change performance, disorganized processing, or
  confusion
• Poor recognition may be associated with
  congenital developmental delay or neurologically
  based illness or injury

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Qualitative Analyses - Possible Implications

• Picture Memory
• Low Recognition and adequate Memory (rare) could
  suggest developmental delay, neurologically-based
  illness or injury, fatigue, poor
  motivation/attention, or malingering
• Poor Memory and adequate Recognition may suggest
  early-to-mid-stage Alzheimers
• High Commission Errors may be associated with
  poorly modulated work style, disinhibition, and
  poor impulse control as often seen in AD/HD, TBI,
  and mania

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Qualitative Analyses - Possible Implications

• Sound Symbol
• Retention score lt the 5th percentile may suggest
  memory loss typical of phonologically-based
  reading disability, recent brain injury, or
  recent seizure disorder
• Phonological/visual associates (tabe, wah, haa)
  are similar to the decoding aspects of reading

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Clinical Examples

• ADHD

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Clinical Examples Language-Based Learning
Disability
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Clinical Examples Nonverbal Learning Disability
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• Clinical Examples
• Mild Closed Head Injury

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