Saturday, March 16, 2013

If you really, really want to be good

I know the Mini Mental State Examination by heart. No need for forms.


I think I am no longer able to administer it without breaking copyright. Even though the MMSE and various studies about cutoffs and scores were published in an open-access journal. Wikipedia, the source of all wisdom, says that the authors gave Psychological Assessment Resources an exclusive rights to publish, licence and manage all intellectual property rights for MMSE in all countries of the world. Apparently, this was legal at the time, but the legal loophole is now closed, so we don't need to panic about our other tests.

For all I know the whole copyright issue does not apply to Australia, and I'd really love if somebody could comment on that.

However, being a good little Neuropsychologist and needing to use MMSE recently for a client unable to manage anything more complex, I have decided to do the right thing and pay for the privilege.

For those of you who are as paranoid as I am about copyright, the process is as follows:

1. register as a PAR user if you are not registered yet. Preferably note down your password, unlike yours truly who could not remember what it was and had to re-set it.

2. search the app store for MMSE (not Mini-Mental, not Examination, not PAR - nothing but MMSE works). Download the free app.

3. log in and pay for some administrations. This is an in-app purchase - it is relatively painless to pay. Make sure you claim it off tax.

5 administrations = $7.49
20 administrations = $35.99
50 administrations = $69.99
100 administrations = $134.99

4. Administer MMSE

Some issues here:
- there is no 'don't know' or 'couldn't do for love or money so I discontinued' options on recording serial sevens - 5 numbers are required
- although they say you can use the 'world backwards' as a second option, I did not see a way of doing so. I had a relatively quick look, so it may still be hiding there somewhere - I don't feel like paying for another administration to have a look
- there is a nice option of taking a picture of the client's writing or drawing so all your records are within the program

5. Get the scores for each question, the total raw score and the T score at the end of the test. The lovely thing here is that there are proper norms for age and education.

You can then e-mail the document to yourself and, if you want a paper record, print it.

6. Go to PAR toolbox or your paper conversion tables to translate the T score to a percentile.

7. Lie down for a rest - you've earned it!


Tuesday, March 5, 2013

Let the computer do the testing

Hello after a long blog break. My private practice has became nicely popular, which leaves very little time for everything else. Which is of course very good, although it doesn't leave much time for fun.

Anyway, while I was diligently working, there has been progress in the matter of computerised testing.

The iPad version of WAIS-IV, WISC-IV, CVLT and D-KEFS is getting very much closer, with Australian trials about to start. More about this a bit later.

Schuhfried Australia, another provider of computer-based neuropsychological tools, are working on translating their multiple references into English and have new manuals (currently available on request from John Ferguson, Schuhfried representative for Australia -, soon to be on their updated website).

There is also a small number of testing software available for a loan to clinicians for month of two to gain feedback on clinicians' experience and for research purposes. Schuhfried is also interested in getting universities to do some research on their software.

This is an good development: the Schuhfried software appears very convenient to use and much superior to our current instruments in areas such attention, information processing, or cognitive assessment related to fitness to drive. At least as much as one can judge by having a look at the software and its description. It appears that soon we will also be able to read some research on this.