In the search to understand the basis of performance discrepancies, many clinicians are recognizing that, often, factors with no direct relationship to brain functioning influence performance on neuropsychological measures of cognition among children and adolescents. The emergent research on cross-cultural neuropsychology indicates that while the test performance discrepancies do indeed exist, they can be explained by a number of other factors, some of which are known and others that have yet to be operationalized or even identified. While a review of all such factors is beyond the scope of this article, an examination of those that have received the most attention is presented: factors associated with the examinee, factors associated with the neuropsychological measures, cultural competency of the examiner, and factors at the organizational/political level.

Neuropsychologists are increasingly requested to identify specific deficits in cognitive abilities and determine the ways in which these deficits will affect a client's everyday functioning. The demand for prescriptive diagnostic endeavors that provide recommendations for rehabilitation has drawn attention to the necessity of considering the ecological validity of instruments. Most of the current knowledge regarding the ecological validity of neuropsychological measures is the result of studies examining adult and older adult populations. The relationship of test performance and everyday functioning in children has been less examined and is, therefore, less understood. The purpose of this article is to provide a brief history of ecological validity in neuropsychology, discuss why this is an important consideration when working with child populations, and provide suggestions for continued research in this field.

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Chronic childhood illnesses have been demonstrated to negatively impact family functioning by introducing new or additive stress on all members of the family system, as well as by increasing financial burden and social isolation. Although these factors have not necessarily been shown to have a direct causal effect on increased rates of abuse in children with chronic illnesses, these children have nonetheless been demonstrated to be at greater risk for neglect and physical and sexual abuse. Children with chronic health care needs are increasingly likely to be referred for neuropsychological evaluation. Thorough assessment of maltreatment would be a valuable addition to all neuropsychological evaluations of children presenting with chronic health conditions.

Introduction: Evaluation is an important aspect of any evidence-based rehabilitation program, as it helps to determine the course and scope of the prescribed therapy. Several brief, empirically validated measures of depression are available, yet these measures lack a few innovative features that are useful when evaluating rehabilitation and other medical populations. Such features include a retrospective self-report of premorbid psychological status, embedded symptom validity measures, and means of quickly accounting for physiological symptoms directly resulting from injury or illness that may not indicate psychological distress. Objective: This was a preliminary study investigating the utility and psychometric properties, including normative data, of the Neuropsychology.Org Measures of Anxiety and Depression (NOMAD) Depression scale. This brief screening measure for rehabilitation and other medical patients provides ratings of current and preinjury/illness depression levels, and a screening for symptom magnification and minimization. Design: Clinical and control participants completed the NOMAD Depression scale. Clinical participants also completed some or all of the following criterion standard measures: Beck Depression Inventory-Second Edition (BDI-II), Hospital Anxiety and Depression Scale (HADS), and Symptom Checklist-90-Revised (SCL-90-R). Setting: University hospital-based rehabilitation psychology and neuropsychology clinic and a private neuropsychology and pain psychology practice. Participants: Convenience sample of 575 adults referred for neuropsychological or psychological evaluation, along with 85 undergraduate control subjects. Main Outcome Measurements: NOMAD Depression scale results were correlated with criterion standards. Diagnostic sensitivity and specificity were calculated. Results: The NOMAD Depression scale demonstrated moderate convergent validity with other brief mood measures: correlation coefficients (r = .76 to .87, P < .001). Adequate diagnostic sensitivity and specificity were found (area under the curve [AUC] = .81). Suggested cut-off scores for severity ranges are presented for the NOMAD Depression scale Total score and separately for the Cognitive-Affective subscale. Conclusions: These preliminary results suggest that the NOMAD Depression scale may be clinically useful for quick assessment of mood and mood change following injury/illness in rehabilitation and other health care contexts.