ABPP Clinical Neuropsychology cheat sheet

Broca's area (left inferior frontal gyrus) supports expressive language; damage causes nonfluent aphasia with relatively preserved comprehension.

Wernicke's area (left posterior superior temporal gyrus) supports language comprehension; damage causes fluent aphasia with impaired repetition and poor comprehension.

The hippocampus is critical for declarative memory consolidation; bilateral damage produces anterograde amnesia with intact procedural learning.

The dorsolateral prefrontal cortex mediates working memory and cognitive flexibility; ventromedial prefrontal cortex mediates reward-based decision making and social behavior.

The basal ganglia modulate motor initiation and procedural learning; Parkinson's disease shows loss of dopaminergic neurons in the substantia nigra pars compacta.

Alzheimer's disease is characterized by amyloid-beta plaques and tau neurofibrillary tangles, beginning in medial temporal lobe structures.

Frontotemporal lobar degeneration often presents with behavioral variant (personality/social changes) or primary progressive aphasia (language decline).

The corpus callosum enables interhemispheric transfer; agenesis or resection can produce disconnection syndromes (e.g., left-hand apraxia to verbal command).

Test selection should match the referral question, patient's sensory/motor abilities, language proficiency, and cultural background.

Reliable change indices compare an individual's change score to measurement error, not to normative group change.

Base rates of low scores in healthy populations must inform interpretation; multiple low scores can occur without impairment.

Differential diagnosis of dementia vs. depression relies on effort testing, informant report, and patterns of memory encoding vs. retrieval deficits.

Normative data must be appropriate for age, education, sex, and culture; using mismatched norms can misclassify performance.

Effort and validity testing should be included whenever secondary gain or questionable effort is suspected; embedded validity indicators supplement standalone measures.

Diagnosis requires integration of history, test data, behavioral observations, and collateral information; a single test score is insufficient.

Serial assessment should use alternate forms to reduce practice effects and should account for test-retest reliability.

Attention comprises phasic alerting, orienting, and executive control networks; tests such as the Trail Making Test and Digit Span tap different components.

Working memory capacity is limited (often estimated at 4±1 chunks); tasks like Digit Span Backward and n-back assess this system.

Episodic memory involves encoding, consolidation, and retrieval; recognition and cued recall help differentiate encoding from retrieval deficits.

Language assessment includes fluency, naming, repetition, comprehension, and reading/writing; aphasia classification follows fluency and repetition patterns.

Visuospatial processing includes visual perception, construction, and spatial attention; neglect is more common after right hemisphere lesions.

Executive functions include inhibition, set-shifting, planning, and generativity; the Stroop, Wisconsin Card Sorting Test, and verbal fluency tasks assess these.

Motor examination includes strength, tone, coordination, and praxis; apraxia is assessed via pantomime and imitation of gestures.

Academic skills (reading, math, writing) are assessed with achievement tests; discrepancy models and response-to-intervention inform learning disability identification.

CT is fast and useful for acute hemorrhage and skull fractures; MRI provides superior soft-tissue contrast for stroke, tumors, and demyelination.

Diffusion-weighted imaging (DWI) detects acute ischemic stroke within minutes; apparent diffusion coefficient (ADC) maps help confirm restricted diffusion.

Functional MRI (fMRI) measures blood-oxygen-level-dependent (BOLD) signal and is used for presurgical language/motor mapping.

PET with FDG measures glucose metabolism; amyloid PET detects amyloid plaques and can support Alzheimer's diagnosis.

EEG detects seizure activity and encephalopathy; quantitative EEG may show focal slowing in structural lesions.

Neuropsychological assessment can detect functional deficits before imaging abnormalities appear, especially in early neurodegenerative disease.

Lumbar puncture and CSF biomarkers (amyloid, tau) support diagnosis of Alzheimer's disease and other CNS conditions.

Imaging findings must be interpreted in the context of clinical history; incidental findings (e.g., white matter hyperintensities) are common with aging.

Cognitive rehabilitation targets compensatory strategies (external aids, environmental modification) and restorative approaches (drill-based exercises).

Errorless learning reduces false memories in amnesia; it involves preventing mistakes during skill acquisition.

Spaced retrieval training improves memory for functional information by expanding intervals between recall trials.

Behavioral interventions for challenging behavior use functional analysis (antecedent-behavior-consequence) to design environmental and reinforcement strategies.

Psychosocial interventions for patients and caregivers reduce burden and improve quality of life; caregiver education and support groups are evidence-based.

Pharmacological interventions (e.g., cholinesterase inhibitors for Alzheimer's) may modestly slow symptom progression but do not cure disease.

Rehabilitation should be goal-directed, individualized, and culturally sensitive; patient and family values guide treatment planning.

Interdisciplinary teams (neuropsychology, PT, OT, speech, social work) coordinate care to maximize functional independence.

Informed consent requires disclosure of purpose, procedures, risks, benefits, alternatives, and the right to withdraw.

Confidentiality may be breached when there is imminent risk of harm to self or others, suspected abuse, or court order.

Competence to consent to treatment requires understanding, appreciation, reasoning, and expression of choice.

Forensic roles require objectivity; the neuropsychologist should clarify whether they serve as treating clinician or expert consultant.

Test security is an ethical obligation; releasing raw test data may be required by law but should be done cautiously to protect test integrity.

Supervision must be documented and within the supervisor's scope of competence; supervisors are responsible for supervisee's professional conduct.

Cultural competence is an ethical requirement; clinicians must recognize limitations of their knowledge and seek consultation or refer when needed.

Record keeping must comply with legal and institutional requirements; records should be accurate, timely, and secure.

Sensitivity is the proportion of true cases correctly identified; specificity is the proportion of non-cases correctly identified.

Positive predictive value depends on prevalence; a test with high sensitivity and specificity can have low PPV in low-prevalence settings.

Effect size (e.g., Cohen's d) quantifies magnitude of difference; statistical significance does not imply clinical significance.

Reliability refers to consistency (test-retest, inter-rater); validity refers to accuracy in measuring the intended construct.

Evidence-based practice integrates best available research, clinical expertise, and patient values and preferences.

Randomized controlled trials provide the strongest evidence for treatment efficacy; meta-analyses synthesize results across studies.

Confidence intervals indicate precision of an estimate; wider intervals reflect greater uncertainty.

Base-rate neglect is a common reasoning error; clinicians should consider prevalence when interpreting test results.

Acculturation and language proficiency affect test performance; using interpreters and culturally appropriate norms improves validity.

Education quality and literacy must be considered when interpreting neuropsychological scores; years of education may not reflect quality.

Normal aging involves declines in processing speed and some memory functions, with preserved vocabulary and semantic knowledge.

Developmental norms are essential for pediatric assessment; brain development continues into early adulthood.

Cultural bias can occur in test content, administration, and interpretation; clinicians should use multiple methods and informants.

Stereotype threat can depress performance; creating a supportive testing environment reduces its impact.

Lifespan considerations include changing sensory abilities (vision, hearing) that may affect test performance in older adults.

Family and community values vary across cultures; treatment planning should incorporate culturally relevant goals and supports.

Consultation models include client-centered, consultee-centered, and program-centered; the neuropsychologist may serve as expert or process consultant.

Effective consultation requires clear communication of findings in jargon-free language tailored to the audience (e.g., physicians, educators, family).

Supervision should include goal setting, direct observation, feedback, and evaluation; developmental models (e.g., integrated developmental model) guide supervisor behavior.

Interprofessional collaboration requires respect for each discipline's expertise and clear role delineation.

When consulting in medical settings, neuropsychologists must integrate findings with medical, psychiatric, and social information.

Supervisors must ensure supervisees practice within their competence and provide appropriate oversight for ethical and legal issues.

Documentation of consultation and supervision should include recommendations, rationale, and follow-up plans.

Cultural humility and awareness of power dynamics are essential in supervision and consultation relationships.