SUMMARY

Clinical neuropsychology has been developed mainly within the English language context. The clinical practice of our specialty in the Spanish-speaking world has been hindered by the lack of instruments and normative data applicable to the Spanish speaking population.  There is a need for neuropsychological assessment procedures that can be used within the general clinical or educational evaluation scheme of the Spanish-speaking patient. There are some Spanish adaptations and translations of test procedures and batteries originally developed in the English language.  However, the lack of a comprehensive demographically adjusted normative system appropriate for Spanish speaking populations continues to be a real problem to this date.  The normative system and test battery described in this manual constitutes an important contribution to the armamentarium of resources designed specifically for the neuropsychological evaluation of the Spanish
speaking individual.  The battery was designed to examine the neuropsychological status of Spanish speaking adults from North America, Spain, and the rest of the Spanish speaking world.
    This manual is the product of a normative research program carried out for the past four years with Spanish speaking populations in two geographically distinct regions: Madrid, Spain and the USA/Mexico border region.  The manual describes a comprehensive system of procedures and normative data designed to assist the clinical researcher and the clinical practitioner in the  neuropsychological assessment and diagnosis of adults whose main language is Spanish.
    Together the procedures comprise a brief and practical battery of eight tests for a basic examination of attention, learning and memory, and executive function.  The level of performance on these tests is assessed according to normative data. This is accomplished by adjusting test scores according to demographic criteria that simultaneously take into account the traditional factors of age and education, as well as the patient's place (country) of origin.
    The normative data described in the manual are based on a total sample of 390 healthy male and female individuals: 205 of these individuals resided in the metropolitan area of Madrid, Spain, and 185 in the USA/Mexico Border region.   Given its continuity with Heaton et al's (1991) normative work with English speaking populations, our demographic adjustment system is based on similar methodological design and procedures.  The basic design strategy involved collecting data on the neuropsychological test performance of the representative Spanish speaking populations, quantifying the relationship between test performance and relevant demographic factors (i.e., age, education, and place of birth), and calculation of the demographic correction formulas to adjust for the effects of these factors on neuropsychological test performance.  We employed multiple regression analysis to quantify the demographic contributions to test performance. The results obtained with these formulas, that is, the T-Scores, are described in Appendix B tables.  We present normative data separately for each of the two geographical regions of origin (USA/Mexico Borderland and Spain).  Normative data for each region are presented according to age (range 18 to 65 yrs) and level of education (0 to 16 yrs).  Data for each of the five age groups are presented separately for each of the seven education groups.
    The first chapter of this manual describes the methodological criteria applied to develop each test in the battery.  Chapter two describes the characteristics of the populations considered for the development of the normative system and the statistical analyses conducted to assess the effects of demographic factors on test performance; it also describes and explains the development of the demographic correction criteria and the statistical analyses to assess their validity.  Chapter three describes the general conditions that must be met to conduct the examination with the battery, as well as the methodological and practical guidelines that must be followed for correct administration and scoring of each test in the battery.   Chapter four describes actual clinical cases to illustrate correct application of the demographic adjustment system. Appendix A presents tables of Scaled Score equivalents of Raw Scores for the two samples.  Appendix B presents tables of T-Score equivalents of test Scaled Scores for each sample separately.  Appendix C presents the items for the Recognition section of the Visual Memory Test.
    Appendix D presents the story paragraph to administer the Verbal/Prose Memory Test and the word lists for the    Word Learning Test.  Appendix E presents an additional set of means and standard deviations obtained on each test by a group of adolescents from each geographic region.  Score Summary Sheets and Test Protocols containing administration instructions and response record sheets are commercially available. 

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