Neuropsychological Domains: Attention, Memory, Language, Visuospatial, Executive, Motor, and Academic Skills
Core concepts to master
Each domain has a functional architecture you must be able to describe and probe. Attention spans arousal, vigilance, selective, divided, and sustained attention. Memory divides into working memory, episodic (encoding, consolidation, retrieval), semantic, and procedural systems, with dissociable medial temporal and frontal contributions. Language includes phonology, semantics, syntax, and naming. Visuospatial skills include perception, construction, and spatial attention (with neglect as a right-hemisphere syndrome). Executive function covers initiation, planning, set-shifting, inhibition, and monitoring. Motor and academic skills (reading, writing, arithmetic) round out the profile.
Know which tests tap which construct and the common dissociations - e.g., encoding versus retrieval failure, ideomotor versus ideational apraxia, phonological versus surface dyslexia.
Traps
Confusing a retrieval deficit (benefits from cueing) with an encoding/consolidation deficit (does not). Labeling any frontal-lobe test as "executive" without considering task demands. Assuming visuospatial deficits are always right-hemisphere. Overlooking that attention problems can masquerade as memory failure.
Rule of thumb
For memory, ask whether cues help: improvement suggests retrieval/frontal; no improvement suggests consolidation/medial temporal. For language, separate fluency, comprehension, repetition, and naming to localize.
Worked example: A patient recalls few words free but nearly all with semantic cueing - a retrieval pattern consistent with frontal-subcortical dysfunction, not amnestic consolidation failure.