Tim Brady Review Sheet
Personal information
Tim Brady is a 39-year-old man. The assessment was carried out on 15th of December 2016.
Reason for referral
The patient was referred for a neuropsychological assessment by a General Practitioner Dr. Lewis, M.D. The doctor wants to know whether there was a decrease in memory capacity of the patient after a road accident. Therefore, he requested an examination of patient’s cognitive abilities to see whether they are within a normal range.
Background information
Tim is married and has two daughters. He has a high level of education. In terms of career, he owns a sports equipment business. One day while driving to work, he got in a car accident because he was blindsided by an oncoming car. As a result, he suffered a head injury. …show more content…
Tim’s cognitive complaints include headaches, difficulties maintaining concentration and problems with memory. He reported forgetting important tasks he had to do at work or home. As for emotional complaints, his family and friends added that he became anxious and his mood has been down for a continuous period of time. His wife also noted that it became hard to communicate with Tim when he is frustrated about his forgetfulness and takes the stress out on his family.
Behavioral observation
Tim arrived at Erasmus University Hospital with his wife. They were late for 15 minutes because Tim forgot his phone at home. He looked irritated and argued with his wife about it, blaming her for coming late. Tim readily made contact with the psychologist before the start of the assessment.
During the first test, he listened carefully to the words and paid close attention to the task. However, he appeared dissatisfied with his performance. He was muttering excitedly that he could do better. During the second test, Tim was tensed about his performance. He kept clicking a pen when listening to the instructions. When his phone suddenly rang, he immediately rushed to turn it off. He had a nervous tone of voice when he asked the psychologist whether he did well. During the third test, Tim yawned and looked out the window when listening to the instruction. He looked quite distracted.
After the three tests, Tim told his wife that he thinks he did not perform well. He was discontent about his performance. When she asked him about the tests, he responded nervously that he cannot remember these minor details.
Assessment procedure
Three tests were administered to the patient in the following order: The Fifteen Word Test (15WT), The Trail Making Test (TMT), and The Digit Span Test. All of the tests are widely used in clinical practice. The Fifteen Word Test assesses verbal memory and learning capacity of patients with a brain damage. The Trail Making Test measures cognitive processing speed, visual scanning, mental flexibility and executive functioning. It is sensitive to different kinds of brain damage. It consists of two parts, TMT-A and TMT-B. The Digit Span Test measures capacity of attention, working memory and mental tracking. It comprises two parts, Digit Forward and Digit Backward.
Test results and interpretation
For the Fifteen Word Test, Tim obtained a total score of 40 with the z-score of -1.29 (M= 50.1, SD= 7.8). The norm group for this test comprised men of age 40 with a high education level. This score is classified as below normal, with only 9.2 % of people falling within this range. In terms of Tim’s cognitive functions, his verbal learning ability is below normal within his norm group. Therefore, he has difficulties remembering words because of the relatively poor verbal memory.
The learning curve is shown in Figure 1 of appendix 1. As shown in the figure, there was a gradual increase in Tim’s performance from the 1st to the 3rd trial. During the 3rd and the 4th trials, his performance was at the highest level. Then, it slightly decreased during the 5th trial. This pattern suggests that Tim remembered the biggest number of words during the 3rd and the 4th trials, and the smallest number at the beginning of the test.
The serial position curve is shown in Figure 2 of appendix 1. As the figure indicates, Tim could not remember the first four words throughout all trials. Consequently, his performance increased and slightly fluctuated. After the 10th word, it soared again and levelled out at its peak until the last word. The curve shows a substantial recency effect, which implies that Tim recalled the last words he heard during the test much better than the first ones. In terms of Tim’s abilities, this suggests a good short-term memory capacity. As for the primacy effect, it is strongly reduced. Tim could not recall the first words throughout the whole test. This defect in the primacy effect indicates that his long-term memory is impaired to a certain degree.
For the Trail Making Test, a norm group of healthy people between the age of 35 and 44 with a high education level was chosen.
For the first part of the test (TMT-A), Tim obtained a score of 32 which corresponds to the 30th percentile. This indicates that his performance exceeds that of 30% of people within his norm group. As for the second part of the test (TMT-B), Tim’s score was 68 which is located on the 20th percentile. This suggests that slightly more than 70% of people from his norm group performed similarly or better than Tim on this test. In terms of Tim’s cognitive abilities, his mental flexibility and visual scanning are below average. He has some degree of difficulty with evaluating the arrangement of objects in space and processing two tasks simultaneously. His motor and information processing speed are both low compared to his norm group. In addition, low performance on the TMT is related to brain …show more content…
damage.
For the Digit Span Test, Tim scored 5 for the first part of the test (Digit Forward). His performance on the Digit Forward falls within marginal to normal limits. In terms of Tim’s cognitive abilities, his efficiency and capacity of attention are at a normal level, but it is likely that he has problems related to his memory. As for the second part (Digit Backward), Tim scored 4. His performance on the Digit Backward can be classified as within normal limits. In terms of his cognitive abilities, he does not have difficulties with conceptual tracking. His ability to memorize information for further retrieval is also at a normal level.
Summary and conclusion
The neuropsychological assessment was requested for a patient named Tim Brady to test his cognitive abilities after sustaining a head injury in a car accident.
Overall, Tim’s performance on certain tests suggests a poor memory capacity. He has difficulties retaining information in his long-term memory. This could be related to forgetting the phone at home before arriving at the hospital. As for other cognitive abilities, Tim processes information slowly compared to his norm group. His executive functions also deteriorated after the accident. This may explain Tim’s anxiety and dissatisfaction, as dealing with these impairments on a daily basis may cause a certain amount of
stress.
Tim Brady is a 39-year-old man. The assessment was carried out on 15th of December 2016.
Reason for referral
The patient was referred for a neuropsychological assessment by a General Practitioner Dr. Lewis, M.D. The doctor wants to know whether there was a decrease in memory capacity of the patient after a road accident. Therefore, he requested an examination of patient’s cognitive abilities to see whether they are within a normal range.
Background information
Tim is married and has two daughters. He has a high level of education. In terms of career, he owns a sports equipment business. One day while driving to work, he got in a car accident because he was blindsided by an oncoming car. As a result, he suffered a head injury. …show more content…
Tim’s cognitive complaints include headaches, difficulties maintaining concentration and problems with memory. He reported forgetting important tasks he had to do at work or home. As for emotional complaints, his family and friends added that he became anxious and his mood has been down for a continuous period of time. His wife also noted that it became hard to communicate with Tim when he is frustrated about his forgetfulness and takes the stress out on his family.
Behavioral observation
Tim arrived at Erasmus University Hospital with his wife. They were late for 15 minutes because Tim forgot his phone at home. He looked irritated and argued with his wife about it, blaming her for coming late. Tim readily made contact with the psychologist before the start of the assessment.
During the first test, he listened carefully to the words and paid close attention to the task. However, he appeared dissatisfied with his performance. He was muttering excitedly that he could do better. During the second test, Tim was tensed about his performance. He kept clicking a pen when listening to the instructions. When his phone suddenly rang, he immediately rushed to turn it off. He had a nervous tone of voice when he asked the psychologist whether he did well. During the third test, Tim yawned and looked out the window when listening to the instruction. He looked quite distracted.
After the three tests, Tim told his wife that he thinks he did not perform well. He was discontent about his performance. When she asked him about the tests, he responded nervously that he cannot remember these minor details.
Assessment procedure
Three tests were administered to the patient in the following order: The Fifteen Word Test (15WT), The Trail Making Test (TMT), and The Digit Span Test. All of the tests are widely used in clinical practice. The Fifteen Word Test assesses verbal memory and learning capacity of patients with a brain damage. The Trail Making Test measures cognitive processing speed, visual scanning, mental flexibility and executive functioning. It is sensitive to different kinds of brain damage. It consists of two parts, TMT-A and TMT-B. The Digit Span Test measures capacity of attention, working memory and mental tracking. It comprises two parts, Digit Forward and Digit Backward.
Test results and interpretation
For the Fifteen Word Test, Tim obtained a total score of 40 with the z-score of -1.29 (M= 50.1, SD= 7.8). The norm group for this test comprised men of age 40 with a high education level. This score is classified as below normal, with only 9.2 % of people falling within this range. In terms of Tim’s cognitive functions, his verbal learning ability is below normal within his norm group. Therefore, he has difficulties remembering words because of the relatively poor verbal memory.
The learning curve is shown in Figure 1 of appendix 1. As shown in the figure, there was a gradual increase in Tim’s performance from the 1st to the 3rd trial. During the 3rd and the 4th trials, his performance was at the highest level. Then, it slightly decreased during the 5th trial. This pattern suggests that Tim remembered the biggest number of words during the 3rd and the 4th trials, and the smallest number at the beginning of the test.
The serial position curve is shown in Figure 2 of appendix 1. As the figure indicates, Tim could not remember the first four words throughout all trials. Consequently, his performance increased and slightly fluctuated. After the 10th word, it soared again and levelled out at its peak until the last word. The curve shows a substantial recency effect, which implies that Tim recalled the last words he heard during the test much better than the first ones. In terms of Tim’s abilities, this suggests a good short-term memory capacity. As for the primacy effect, it is strongly reduced. Tim could not recall the first words throughout the whole test. This defect in the primacy effect indicates that his long-term memory is impaired to a certain degree.
For the Trail Making Test, a norm group of healthy people between the age of 35 and 44 with a high education level was chosen.
For the first part of the test (TMT-A), Tim obtained a score of 32 which corresponds to the 30th percentile. This indicates that his performance exceeds that of 30% of people within his norm group. As for the second part of the test (TMT-B), Tim’s score was 68 which is located on the 20th percentile. This suggests that slightly more than 70% of people from his norm group performed similarly or better than Tim on this test. In terms of Tim’s cognitive abilities, his mental flexibility and visual scanning are below average. He has some degree of difficulty with evaluating the arrangement of objects in space and processing two tasks simultaneously. His motor and information processing speed are both low compared to his norm group. In addition, low performance on the TMT is related to brain …show more content…
damage.
For the Digit Span Test, Tim scored 5 for the first part of the test (Digit Forward). His performance on the Digit Forward falls within marginal to normal limits. In terms of Tim’s cognitive abilities, his efficiency and capacity of attention are at a normal level, but it is likely that he has problems related to his memory. As for the second part (Digit Backward), Tim scored 4. His performance on the Digit Backward can be classified as within normal limits. In terms of his cognitive abilities, he does not have difficulties with conceptual tracking. His ability to memorize information for further retrieval is also at a normal level.
Summary and conclusion
The neuropsychological assessment was requested for a patient named Tim Brady to test his cognitive abilities after sustaining a head injury in a car accident.
Overall, Tim’s performance on certain tests suggests a poor memory capacity. He has difficulties retaining information in his long-term memory. This could be related to forgetting the phone at home before arriving at the hospital. As for other cognitive abilities, Tim processes information slowly compared to his norm group. His executive functions also deteriorated after the accident. This may explain Tim’s anxiety and dissatisfaction, as dealing with these impairments on a daily basis may cause a certain amount of
stress.