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PART IV
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INTERPRETATION OF THE WAIS-III PROFILE
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Age Group 20 24 25 29 30 34 35 44 45 54 55 64 65 69 70 74 75 79 80 84 85 89
Digit Symbol-Coding Mean 10.3 9.9 9.8 9.4 8.8 7.6 6.8 6.6 5.6 5.6 5.2
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ple items that they need to copy the symbols legibly, but not perfectly. Be attentive to changes in the person s response rate during the subtest (perhaps by noting progress at the end of each 30-second interval; Milberg et al., 1986) because such changes may relate to motivation, distractibility, fatigue, memorizing some or all of the symbols, boredom, and so forth. Scores are likely to be impaired for depressed individuals. Verbally encoding the symbols may facilitate performance; testing the limits (by asking the person about his or her strategy at the end of the subtest) should uncover this intelligent use of verbal mediation. Neuropsychological Analysis of Digit Symbol-Coding Digit Symbol scores are extremely sensitive to cerebral damage, regardless of its localization in the right or left hemisphere; hence, it is of great use for indicating the presence of damage but useless for inferring lateralization of the lesion. Reitan (1986): Digit Symbol calls on functions of the left hemisphere when dealing with symbols, and on the right hemisphere by the requirement of drawing various shapes (p. 20); the task s various components, including the timed element, combine to produce a test that is generally sensitive to the condition of the cerebral cortex (p. 20). Therefore, it is not useful for determining the laterality of the lesion (Lezak, 1995). Digit Symbol is the WAIS-III task that is most sensitive to brain injury in that its score is most likely to be depressed even when damage is minimal, and to be among the most depressed when other tests are affected as well (Lezak, 1995, p. 378). Examine the symbols that are drawn: Are they rotated, flipped upside down, or transformed into perceptually similar letters ... Does the patient use the box as part of the symbol,...consistently make incorrect substi-
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Aging patterns on the WAIS-R Digit Symbol subtest showed a significant decline in mean scaled scores across the age span, with a high mean scaled score of 10.5 at ages 20 24 and a low mean scaled score of 5.5 at ages 70 74. Clinical Analysis of Digit Symbol-Coding Visual impairment must be ruled out before interpreting a low score. Testing the limits by determining how many symbol pairs were committed to memory (either directly following the task or after administering Similarities, the last subtest given) provides useful information about a person s incidental learning and efficient application of an intelligent problem-solving strategy. Illiterates may be at a disadvantage because four of the symbols are letters (L, O, U, X); so may people who rarely write because of the pencil-and-paper aspect of the task. The most common errors tend to be perseverative runs in the first line, the only place where sequences of any kind occur (Zimmerman & Woo-Sam, 1973, p. 124). Individuals who have demonstrated perfectionistic or compulsive tendencies prior to Digit Symbol should be told during the sam-
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PROFILE INTERPRETATION: WHAT THE SUBTESTS MEASURE
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tutions, or skip spaces or lines of the task (Milberg et al., pp. 72 73).
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UNIQUE ABILITIES OR TRAITS MEASURED BY BLOCK DESIGN Analysis of whole into component parts Nonverbal concept formation Spatial visualization Empirical Analysis of Block Design g loading: r = .72 (6th best overall, best measure on Performance Scale, along with Matrix Reasoning) Reliability: split-half = .86, test-retest = .82 Practice effect: Moderate to Large, ages 16 54 (gain of 0.7 1.0 scaled-score points); Trivial, ages 55 89 (gain of 0.2 0.3 point) Subtest specificity/Error variance: 27% vs. 14% (adequate specificity) Primary Oblimin Factor Loading: Ages 16 74: Perceptual Organization factor = .67 Ages 75 89: Processing Speed factor = .51 Secondary Oblimin Factor Loading: Ages 75 89: Perceptual Organization factor = .39 Most related to: Object Assembly (r = .61) and Matrix Reasoning (r = .60) Least related to: Digit Span (r = .36) Aging Analysis of Block Design Mean scaled score across the adult age range (controlling for education at ages 20 89):
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Age Group 16 17 18 19 20 24 25 29 30 34 35 44 45 54 55 64 Block Design Mean 9.9 10.1 10.2 10.3 10.1 9.7 9.0 8.7
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