Assessing cognition means evaluating your mental abilities, including your thought process, memory, problem-solving, attention, language (receptive and expressive), and other intellectual functions. We provide cognitive testing that involves a cognitive assessment as a stand-alone service or as part of a more extensive psychological assessment. Of course, you can contact us any time to discuss the possibility that our services would be helpful, including what cognitive tests we might give, how they might help, and the process involved.
What is “Cognition”
Cognition refers to the mental process of acquiring, understanding, and using knowledge. It involves various aspects of thinking, including perception, attention, memory, reasoning, problem-solving, and decision-making. Cognition encompasses how we process information from the world around us, organize and interpret it, and use it to make sense of our experiences and interact with the environment. It’s essentially the entire spectrum of mental activities that allow us to perceive, learn, remember, reason, and communicate.
The Parts of Cognition We Assess
Assessing cognition encompasses various specific aspects, including:
- Perception: The process of recognizing, organizing, and interpreting sensory information from our environment, such as sight, sound, touch, taste, and smell.
- Attention: The ability to focus on specific stimuli while ignoring others, which is crucial for processing information and completing tasks effectively.
- Memory: The mental capacity to store, retain, and recall information. It includes short-term memory for immediate tasks and long-term memory for storing information over extended periods.
- Language: The communication system combines symbols, words, and rules to convey meaning. Language involves comprehension, production, and understanding of verbal and written information.
- Problem-solving: Finding solutions to complex or novel situations using reasoning, analysis, and evaluating potential solutions.
- Decision-making: The process of selecting a course of action among various alternatives. It often involves assessing risks, weighing options, and considering consequences.
- Executive Function: This involves higher-order processes like planning, organizing, and managing time, as well as cognitive flexibility and self-control.
- Learning: Acquiring knowledge or skills through study, experience, or teaching. Learning involves various cognitive processes, such as attention, memory, and problem-solving.
Considerations in Assessing Cognition
When assessing cognition, we must consider cultural background, generational influences, and educational experience. These can impact cognitive testing results. Additionally, results regarding an individual’s overall health, medical history, and current circumstances should be interpreted. A comprehensive evaluation often involves a combination of methods to provide a more accurate picture of a person’s cognitive abilities.
When your therapist requests an evaluation, we will consider the implications of your testing for diagnosis and treatment. We will also consider conducting follow-up testing to track changes or improvements in cognitive functioning as your treatment progresses.
Assessing Cognition: Tests Used
Neuropsychological Testing for Assessing Cognition
A battery of standardized neuropsychological cognitive tests measure different aspects of cognitive function, such as memory, attention, executive function, and language. They are often used to diagnose cognitive disorders, brain injuries, or neurodegenerative diseases. Brief cognitive assessments can quickly identify potential cognitive challenges and strengths.
Observational Assessments
We will interview you, and our interactions can often be used informally to assess your cognitive strengths, challenges, and opportunities for improvement. We also perform a “mental status exam” to understand your general functioning.
IQ Testing for Assessing Cognition
Intelligence quotient Intelligence Quotient (IQ), such as the Wechsler Intelligence Scale for Children (WISC) or the Wechsler Adult Intelligence Scale (WAIS), evaluates a person’s cognitive abilities in various domains, including verbal, non-verbal, and problem-solving skills.
History Review
We might look back on your performances on past assessments like the SAT, ACT, or various standardized school tests that measure cognitive abilities related to academic performance. We would also want to review any occupational assessments you’ve had.
Self-Report Questionnaires and Surveys for Assessing Cognition
We use standardized questionnaires to test memory problems, attention issues, or cognitive performance. These questionnaires are “normed” with various populations so you can see how you rank compared to others in your profession or who have had specific academic accomplishments.
Assessing Cognition: The Process
When assessing cognition, we follow a similar process for each client we serve. These are the general steps, which could vary slightly depending on your presenting concerns and questions.
Define Your Objectives
Before assessing cognition, it’s essential to define your objectives clearly. What specific cognitive functions or processes are you interested in studying? Common domains include memory, attention, perception, language, problem-solving, and executive functions. Are you hoping to use this cognitive assessment as a baseline for further cognitive testing, or do you want it to stand alone and help you answer some pressing current questions?
Select Assessment Tools for Assessing Cognition
The first step will help us choose appropriate cognitive tests. As you can see above, those measures can range from standardized cognitive tests and neuropsychological assessments to self-report questionnaires and observational methods. We will ensure that the cognitive tests we select are valid (they measure what they are supposed to measure) and reliable (they provide consistent results). We will review it with you so you can be assured that we are pointed in the right direction.
Ethical Considerations When Assessing Cognition
Ethical considerations are paramount when assessing cognition in our clinical practice. We will gather informed consent from you, meaning that you fully understand what the testing entails and have been given enough time to ask any questions. We’ll explain how we protect their privacy, use electronic means to administer and interpret tests, and follow general ethical guidelines in data collection and reporting.
Data Collection, Analysis and Interpretation
At this point, we administer the selected cognitive tests according to standardized procedures. We try to ensure that conditions are consistent across assessments to reduce extraneous variables. We give you instructions for any measures you will need to take at home or homework you need to do to help us get the data we need.
After we have all the data to answer your questions, we will categorize them using statistics and qualitative analysis techniques. Then, we interpret the cognitive assessment results in the context of your objectives. For example, what do any relative strengths or weaknesses mean about your questions?
Reporting the Results
At this point, we will communicate our findings clearly and transparently, directly and with a report. Our methods, results, and interpretations will be well-documented. We use the pillars described above (“The Parts of Cognition We Assess”) as a guide and focus on the questions you came in with and your particular strengths and challenges. The report includes suggestions on maximizing what you are good at and overcoming barriers in other areas. Each report is uniquely tailored, and we offer a feedback session where you can ask questions and get more information.
Cognitive Assessment Example
Here is a fictitious example of a cognitive assessment, broken down into some typical sections and tasks you might encounter. Remember that cognitive testing can vary widely depending on the specific test or purpose, but this gives you a general idea.
1. Cognitive Tests for Memory
- Short-Term Memory:
- Digit Span Cognitive Assessment Test: We read a series of digits, and the person being tested must repeat them back in the same order, then in reverse order. For example, the examiner might say “4-2-7,” and the person has to repeat “4-2-7.” In the reverse task, the person would have to repeat “7-2-4.”
- Long-Term Memory:
- Word List Recall: A list of 10-15 words is read aloud, and the person must recall as many as possible immediately after hearing the list. Then, after a short delay (often 10-30 minutes), they’re asked to recall the words again.
2. Cognitive Tests for Attention and Concentration
- Continuous Performance Test (CPT): The person is shown a series of letters or numbers on a screen, and they must respond (e.g., press a button) whenever a specific target is displayed, such as a repeated letter like “X.” This cognitive assessment test measures sustained attention and response inhibition (impulse control).
- Stroop Test: The participant is shown color words (like “red,” “blue,” “green”) that are printed in ink of a different color. For example, the word “red” might be printed in blue ink. The task is to say the color of the ink, not the word itself. This cognitive assessment test measures selective attention and cognitive flexibility.
3. Problem-solving and Executive Functioning
- Tower of London Test: This cognitive assessment test involves a series of puzzle-like tasks in which the person has to move disks on pegs to match a target configuration with the fewest moves possible. It tests planning, problem-solving, and executive functioning.
- Wisconsin Card Sorting Test (WCST): The participant is given a set of cards with various symbols, colors, and shapes. They must match the cards according to a rule (e.g., by color or shape), but the rule changes without warning. This tests cognitive flexibility, problem-solving, and adjusting to new information.
4. Cognitive Testing for Language Skills
- Word Fluency Test: The person is asked to name as many words as they can that start with a certain letter (e.g., “F”) in one minute. This tests verbal fluency and lexical access.
- Comprehension Cognitive Assessment Test: The participant may be asked to read a short passage and answer questions about it to assess their understanding and language processing abilities.
5. Cognitive Testing for Processing Speed
- Symbol Search: In this cognitive testing task, a person might be shown a set of symbols and asked to quickly determine whether a target symbol is present in the set. This tests how quickly the person can process and react to visual information.
- Trail Making Test: This is a timed test in which the participant must connect numbered circles (1, 2, 3, etc.) in sequence, then switch to connecting alternating numbers and letters (1-A-2-B-3-C, etc.). It tests processing speed, cognitive flexibility, and visual attention.
6. Visual-Spatial Processing
- Block Design: The participant is given a set of colored blocks and asked to arrange them to match a pattern. This cognitive assessment test evaluates visual-spatial processing, problem-solving, and motor coordination.
- Rey-Osterrieth Complex Figure: The person is asked to copy a complex figure and then later draw it from memory. This tests visual memory, spatial organization, and planning.
Assing Cognition in an Adult
- Age of Participant: 30
- Primary Areas Assessed: Memory, Attention, Executive Function, Language, Processing Speed
- Results:
- Memory: Average recall in both short-term and long-term tasks, with slight difficulty in delayed recall.
- Attention: Strong performance on continuous tasks, but slower response times noted on selective attention cognitive tests.
- Executive Function: Some difficulty adjusting to rule changes in the WCST, indicating mild cognitive flexibility challenges.
- Language: High fluency in word generation, but slight difficulty with comprehension under time pressure.
- Processing Speed: Slightly below average in timed visual cognitive tests.
Here’s a breakdown of how to interpret the cognitive testing in this example:
1. Memory
Interpretation:
- Short-Term Memory: The person performed well on this cognitive testing, recalling information immediately after hearing it.
- Long-term Memory: While immediate recall was solid, recalling the information after a short delay was somewhat difficult.
Suggestions:
- Practice memory exercises that emphasize both short-term and long-term memory.
- Try using mnemonic devices (like chunking or associating words with images) to enhance recall.
- Engage in activities that require recalling information after delays, such as journaling or quizzing oneself on facts throughout the day.
2. Attention
Interpretation:
- The person did well on continuous cognitive tests requiring sustained attention, but there were delayed response times during selective attention measures, suggesting mild difficulty in filtering out distractions.
Suggestions:
- Consider mindfulness training or meditation to improve focus and attention. These practices help one stay present and reduce distractions.
- Engage in tasks that require focus under pressure, like reading in noisy environments, to simulate distractions.
- Break tasks into smaller, manageable chunks to prevent becoming overwhelmed.
3. Executive Function
Interpretation:
- The individual showed some difficulty adjusting to rule changes in the Wisconsin Card Sorting Test (WCST), which suggests mild issues with cognitive flexibility and the ability to shift thinking when needed.
Suggestions:
- Engage in activities that challenge executive functioning, like puzzles or games that require flexible thinking, such as chess or strategy-based games.
- Practice decision-making in various scenarios where rules or contexts change to improve adaptability.
- Use visual or written cues to help structure tasks and support transitions when rules or routines change.
4. Language
Interpretation:
- The person demonstrated high verbal fluency but faced mild difficulties with language comprehension under time pressure during cognitive testing.
Suggestions:
- Regularly engage in word games or conversations that challenge vocabulary and fluency (e.g., Scrabble, crossword puzzles).
- Practice reading comprehension exercises under timed conditions, such as reading articles or short passages and summarizing them afterward.
- Engage in activities that require both speaking and listening under pressure, like debates or timed storytelling, to improve language processing.
5. Processing Speed
Interpretation:
- The individual’s performance in cognitive testing requiring quick decision-making and visual processing was slightly below average, suggesting mild processing speed difficulties.
Suggestions:
- Engage in activities that improve processing speed, such as timed exercises or activities where quick responses are necessary (e.g., card games like Speed or Memory).
- Consider brain-training apps that target processing speed and quick thinking.
- Practice multitasking in controlled environments to build up speed while maintaining accuracy.
Cognitive Testing: Overall Recommendations
- Physical Health: Physical health has a significant impact on cognitive performance. Ensure adequate sleep, exercise, and nutrition, as they all contribute to cognitive function.
- Brain-Training Exercises: Engage regularly in activities that promote cognitive health, such as puzzles, strategy games, reading, and learning new skills.
- Stress Management: High stress can impact function—practice relaxation techniques, such as deep breathing, yoga, or progressive muscle relaxation.
- Social Engagement: Maintain strong social connections and engage in meaningful conversations, as social interaction is beneficial for cognitive health.
- Follow-up: If there are concerns about specific areas (e.g., memory, attention), further assessment or professional guidance (like therapy or neuropsychological counseling) may be helpful.
Conclusions and Our Services
Our services are available for assessing cognition for a wide variety of purposes. We can provide services to help you at work, home, and school. Assessing cognition can support decision-making in your career and potential educational pursuits. Cognitive testing can also serve as a baseline should you want to improve or are worried about decline. We stay up-to-date with the latest research and developments in cognitive assessment – new tools and methodologies are continually emerging.
Please feel free to contact us any time to discuss your goals for testing, and we can let you know how assessing cognition, whether just cognitive tests or part of a larger test battery, might help.
