Identifying culturally acceptable cognitive tests for use in remote northern Australia

Abstract

Background A lack of culturally appropriate tests hampers accurate assessment of cognition in remote Australian Aboriginal communities. In Arnhem Land, this study employed a community consultation process to evaluate commonly used Western tests of executive function, memory, attention, and visuospatial function. Methods An initial consultation process and a follow-up pilot study resulted in the rejection of some common tests, the development of new tests, and culturally adapted versions of others. In the subsequent 30-person main trial, adult Aboriginal volunteers were examined on nine tests, plus the Kimberly Indigenous Cognitive Assessment screen, and a brief literacy test. Results Executive function, memory, and attention tests were found to group separately after an exploratory principal components analysis. Correlations between new tests and similar Kimberly screen items were not significant, but ceiling effects may be relevant. Six of 13 test scores were found to correlate with the literacy measure. Conclusions A selection of cognitive tests were identified that Aboriginal people found culturally acceptable and engaging. In particular, Self-Ordered Pointing, Trail-Making, a verbal-switching task, and a new test “Which car?” show promise for further development. This work may contribute to the need for culturally appropriate cognitive testing in Aboriginal communities.

Neuropsychological assessment in the multicultural memory clinic: development and feasibility of the TULIPA battery

“…First, future studies might examine ways to improve the feasibility of neuropsychological testing. Both the international literature and the individuals from diverse backgrounds that were consulted stress the importance of providing patients from culturally, educationally, and linguistically diverse backgrounds and their caregivers with sufficient information about the purpose of, need for, and rationale behind the assessment and the individual tests (Aghvinian et al, 2021; Franzen on behalf of the European Consortium on Cross-Cultural Neuropsychology, 2021; Rock & Price, 2019). Although this need is in no way unique to diverse populations (see e.g.…”

“…In diverse populations, it is therefore even more important than usual to consider the patient's understanding of neuropsychological testing in general and of each individual test specifically, and to provide additional explanations if needed (Aghvinian et al, 2021; Franzen on behalf of the European Consortium on Cross-Cultural Neuropsychology, 2021). Additional practice items may need to be provided (Rock & Price, 2019).…”

Impairment in Working Memory and Executive Function Associated with Mercury Exposure in Indigenous Populations in Upper Amazonian Peru

“…Stimuli in this version of the task was abstract Attneave shapes [ 61 ]. The use of shapes that are abstract is a departure from other versions that have been used in cultural adaptations of the task [ 62 ] but were chosen for two reasons: (1) to avoid participants’ use of a verbal strategy that may reduce the use of executive functions, and (2) to choose stimuli that could potentially be used with other groups of people being studied because of Hg exposure. During the practice and test trials, the same Attneave shapes were presented on each page during a trial but with the locations of each shape shifted between pages.…”

“…Other versions of the TMT have been created that are language-free and use accuracy for the outcome measure but are still not appropriate for the Matsigenka because the modifications involve the use of numbers and/or involve memorizing stimuli [ 67 ]. Although using accuracy as a dependent variable eliminates the possibility of comparing outcomes with other studies using a traditional TMT task, it does not seem to change the underlying cognitive processes being captured, as demonstrated by a culturally adapted version of the TMT developed to assess Northern Aboriginal people in Northern Australia [ 62 ].…”

Development of Functional Cognitive Scale for Children Aged 7-12 Years: A Neglected Domain in Pakistan

“…East Asian and Western cognitive development differ due to the interaction children have with symbols, tools, and with the members of their culture (Barrett, 2020). As tests are sensitive to the culture in which they are used, therefore, the process of accurate assessment of cognitive skills is hampered due to the use of inappropriate or irrelevant tools (Rock & Price, 2019). The trend to assess cognitive skills of children is less in third world countries as compared to the west.…”