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COGNITIVE ASSESSMENT Cognitive I o WAIS-IV Block Design o Verbal Paired Associates I o WAIS-IV Symbol Search o WAIS-IV Digit Span o Grooved Pegboard Test o Brief Smell Identification Test o WAIS-IV Similarities o Verbal Paired Associated II o WAIS-IV Picture Completion o Grip Test o WAIS-IV Vocabulary Cognitive II o WAIS-IV Matrix Reasoning o Rey Auditory Verbal Learning Test I o Trail Making Tests, A and B o WAIS-IV Arithmetic o CANTAB Reaction Time (Computerised data) o CANTAB Visual Paired Associates (Computerised data) o Rey Auditory Verbal learning Test II o CANTAB Rapid Visual Information (Computerised data) o WAIS-IV Information o Balance Test Phase 38 Data Directory SECTION 5

Phase 38 Data Directory - The Dunedin Studydunedinstudy.otago.ac.nz/files/1381454184_Section 5_Cognitive... · o WAIS-IV Block Design o Verbal Paired Associates I o WAIS-IV Symbol

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COGNITIVE ASSESSMENT

Cognitive I o WAIS-IV Block Design o Verbal Paired Associates I o WAIS-IV Symbol Search o WAIS-IV Digit Span o Grooved Pegboard Test o Brief Smell Identification Test o WAIS-IV Similarities o Verbal Paired Associated II o WAIS-IV Picture Completion o Grip Test o WAIS-IV Vocabulary

Cognitive II o WAIS-IV Matrix Reasoning o Rey Auditory Verbal Learning Test I o Trail Making Tests, A and B o WAIS-IV Arithmetic o CANTAB Reaction Time (Computerised data)

o CANTAB Visual Paired Associates (Computerised data)

o Rey Auditory Verbal learning Test II o CANTAB Rapid Visual Information (Computerised data)

o WAIS-IV Information o Balance Test

Phase 38 Data Directory

SECTION 5

Page 1 of 3 

 

Phase 38 Neuropsychological Testing Session: Session I

Interviewer Introduction

I'll be asking you to try a lot of different questions, puzzles, and brain teasers.

We gave you these exact same tests when you were 13 years old, so you might recognize some of them. But that was 25 years ago!

The reason for these tests is that we want to see how much study members have changed on their mental performance after 25 years of life experience.

    Phase 38: Impairment Questions

Page 2 of 3 

 

ID No Before we get started, we just want to check… Interviewer ID IM1. Do you have any difficulties using your 0 1

hands to hold a pencil or pick up small things? Notes:________________________________ _____________________________________

IM2. Do you have any difficulties with your 0 1

hearing? Notes ________________________________

______________________________________

IM3. Do you have any difficulties with your 0 1

vision? Notes ________________________________

______________________________________

IM4. Do you have any difficulties with your 0 1

speech? Notes ________________________________

______________________________________

IM5. Do you have any other difficulties such as 0 1

  

No Yes (0)           (1) 

 

 

 

 

 

being jet lagged, lacking sleep, or being hung over?

Notes ________________________________

______________________________________

Page 3 of 3 

 

Phase 38 Neuropsychological Testing Session: Interviewer Introduction (Continued)

Each task asks you to do something different, because everybody has things they do well and things they don't do so well, and we want everyone to have a chance to succeed and have fun.

Each task will only last about 3 minutes, so if you don't enjoy a task, don't worry, we will be switching to a different task in a minute.

Each task starts out easy and gets harder, and the questions go all the way up to the genius level, so don't be surprised when you get some wrong.

It is important to do the very best you can.

So sit back and relax, so you can concentrate as well as possible.

Ready for the first test?

Page 1 of 3

PHASE 38: BLOCK DESIGN INTRODUCTION

We want to see how well you can re-create a design that is shown to you using blocks within a specified time limit. Materials: Stimulus Book 1 Block Design Blocks Stopwatch Show: Block Design Blocks. The stimulus book should be placed at the SM’s midline, approximately 18cm from the edge of the table. The blocks should be placed to the side of the stimulus book on the side of the SM’s dominant hand. Present only the blocks needed to construct each item. Remove all unnecessary blocks from the SM’s view. Record the completion time in seconds for each item. Items completed after the time limit are scored 0 points.

Scoring: Items 5-8: Score 4 points if the SM constructs the design correctly, w/o rotation errors, & w/in time limit. Items 9-14: Score 4, 5, 6, or 7 points if the SM constructs the design correctly, w/o rotation errors, & w/in the time limit. Refer to Record Form for time-bonus scores. *For all items, score 0 points if the SM does not construct the design correctly, has rotation errors, or exceeds the time limit

Page 2 of 3 Source: WAIS-IV 2008

Place two blocks in front of the study member. Pick up one block. See these blocks? They are all alike. On some sides, they are all red (show red side); On some sides, all white (show white side); And on some sides, they are half red and half white (show red/white side). What hand do you use to write? SAMPLE QUESTION Place two blocks in front of the SM. Watch me put these blocks together to look like this picture. Point to pictured design. Slowly assemble the model. Place two more blocks in front of the SM. Now you try it. Discontinue: After 2 consecutive scores of 0 Design Time Score Limit (4 blocks) BD3 Turn to Item 3 30” 0 2 in Stimulus Book & Refer to Model _______ Now well’ use 4 blocks. You need to make the blocks look just like the picture. Work as fast as you can and tell me when you are finished. Go ahead. Begin timing and allow 30 seconds.

BD5 Turn to Item 5 1 Minute 0 4 in Stimulus Book _______ You need to make the blocks look just like the picture. Work as fast as you can and tell me when you are finished. Go ahead. Begin timing and allow 1 minute.

BD7 Turn to Item 7 1 Minute 0 4 in Stimulus Book _______ Remember that you need to make the blocks look just like the picture. Go ahead. Begin timing and allow 1 minute.

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Discontinue: After 2 consecutive scores of 0 31-60 21-30 11-20 1-10 BD9 Turn to Item 9 1 Minute 0 4 5 6 7 in Stimulus Book _______ Work as fast as you can and tell me when you are finished. Go ahead. Begin timing and allow 1 minute. 76-120 61-75 31-60 1-30 (9 Blocks)

BD11 Turn to Item 11 2 Minutes 0 4 5 6 7 in Stimulus Book ________ Now we’ll use 9 blocks. Work as fast as you can and tell me when you are finished. Go ahead. Begin timing and allow 2 minutes. 76-120 61-75 31-60 1-30

BD13 Turn to Item 13 2 Minutes 0 4 5 6 7 in Stimulus Book ________ You need to make the blocks look just like the picture. Begin timing and allow 2 minutes. Ok, great job! Now we will be moving on to the next set of questions.

Page 1 of 5

PHASE 38: VERBAL PAIRED ASSOCIATES I INTRODUCTION

Now I am going to see how well you can memorize words. Read the word pairs at the rate of one pair of words every 3 seconds. Say the words about 1 second apart, with 2 seconds separating the pairs. Pause 5 seconds after reading each list and before asking for recall. During recall, if the SM does not respond within 5 seconds or if the SM gives an incorrect response, provide the correct response. If the SM begins to repeat the word pairs as you are reading, stop and instruct him or her to wait until you are finished.

Scoring: 1 point - If SM gives a correct response 0 points - If examinee gives an incorrect response or says that he/she does not know the answer, or does not respond within 5 seconds

Page 2 of 5 Source: WMS-III 1997

I am going to say a list of word pairs. Listen carefully because when I am finished I will say the first word, and I want you to tell me the word that goes with it. For example, if the word pairs were Fruit-West, Gold-Walk, then when I say the word Fruit, you would answer (pause) West. When I say the word Gold, you would answer (pause) Walk. Do you understand? List A Truck-Arrow Insect-Acorn Reptile- Clown Bank-Cartoon Star-Ladder Badger-Paper Rose-Bag Elephant-Glass Can you tell me what word goes with... SM Answer PAIA-1 Bank (Cartoon) ____________________ 0 1 PAIA-2 Reptile (Clown) ____________________ 0 1 PAIA-3 Star (Ladder) ___________________ 0 1 PAIA-4 Rose (Bag) ___________________ 0 1 PAIA-5 Elephant (Glass) ____________________ 0 1 PAIA-6 Truck (Arrow) ____________________ 0 1 PAIA-7 Insect (Acorn) ____________________ 0 1 PAIA-8 Badger (Paper) ___________________ 0 1

Incorrect Correct (0) (1)

Page 3 of 5 Source: WMS-III 1997

I am now going to read you our next list of word pairs. The word pairs are the same but listed in a different order. Remember to listen carefully because when I am finished I will say the first word, and I want you to tell me the word that goes with it. List B Star-Ladder Elephant-Glass Insect-Acorn Truck-Arrow Reptile- Clown Bank-Cartoon Badger-Paper Rose-Bag What word goes with... SM Answer PAIB-1 Elephant (Glass) ____________________ 0 1 PAIB-2 Insect (Acorn) ____________________ 0 1 PAIB-3 Reptile (Clown) ___________________ 0 1 PAIB-4 Rose (Bag) ___________________ 0 1 PAIB-5 Star (Ladder) ____________________ 0 1 PAIB-6 Badger (Paper) ____________________ 0 1 PAIB-7 Bank (Cartoon) ____________________ 0 1 PAIB-8 Truck (Arrow) ____________________ 0 1

Incorrect Correct (0) (1)

Page 4 of 5 Source: WMS-III 1997

We are moving on to the next list. Once again, the word pairs are the same but the order in which they are being read is different. After I have finished reading this list, when I say the first word, I want you to tell me the word that goes with it. List C Rose- Bag Badger-Paper Star-Ladder Reptile- Clown Elephant-Glass Insect-Acorn Bank-Cartoon Truck-Arrow

What word goes with... SM Answer PAIC-1 Insect (Acorn) ____________________ 0 1 PAIC-2 Star (Ladder) ____________________ 0 1 PAIC-3 Truck (Arrow) ____________________ 0 1 PAIC-4 Rose (Bag) ____________________ 0 1 PAIC-5 Elephant (Glass) ____________________ 0 1 PAIC-6 Reptile (Clown) ____________________ 0 1 PAIC-7 Bank (Cartoon) ____________________ 0 1 PAIC-8 Badger (Paper) ____________________ 0 1

Incorrect Correct (0) (1)

Page 5 of 5 Source: WMS-III 1997

OK, great job so far! We are on our last word pair list. Ready? List D Badger-Paper Truck-Arrow Star-Ladder Insect-Acorn Rose-Bag Reptile- Clown Bank-Cartoon Elephant-Glass What word goes with... SM Answer

PAID-1 Star (Ladder) ____________________ 0 1 PAID-2 Rose (Bag) ____________________ 0 1 PAID-3 Insect (Acorn) ____________________ 0 1 PAID-4 Badger (Paper) ___________________ 0 1 PAID-5 Elephant (Glass) ____________________ 0 1 PAID-6 Bank (Cartoon) ____________________ 0 1 PAID-7 Reptile (Clown) ____________________ 0 1 PAID-8 Truck (Arrow) ____________________ 0 1 Ok, great job! Now we will be moving on to the next set of questions.

Incorrect Correct (0) (1)

PHASE 38: SYMBOL SEARCH INTRODUCTION

Next I will ask you to look for matching symbols. Materials: Response Booklet 1 #2 Pencil without eraser Stopwatch Coding Scoring Template Ensure a smooth work surface. Use the demonstration items to explain and illustrate the task to the SM, then allow the SM to practice by completing the sample items If the SM marks a symbol using anything other than a slash mark, point to the error and say, Draw ONE line through the symbols or NO boxes that you mark. Do not provide the SM with an eraser. If a mistake is made, say, That’s OK. Just keep working as fast as you can. If the SM marks one of the target symbols as a response, say, You should make your marks over here (point across search group and NO box). If SM omits an item or begins to complete a page in reverse order, say, Do them in order. Don’t skip any. Point to the first omitted item and say, Do this one next. Scoring: Use the Coding Scoring Template to score the SM’s

responses. Align the template so that the correct responses are above the SM’s responses. -If SM completes all test items before the 2 minute time limit expires, stop timing and record the completion time. Score 1 point for each correct response. -If the SM does not complete all of the test items within the time limit, record the completion time as 2 minutes.

Page 1 of 4

Place the Response Booklet in front of SM. Make sure that the SM sees only the Demonstration and Sample Items. DEMONSTRATION ITEMS

Look at these shapes. Point across first Demonstration Item.

One of these shapes (point to each target symbol in the grey area) is the same as one of these shapes here (point across search group).

This shape (point to target symbol in the grey area) is the same as this

shape here (point to matching symbol in search group), so I draw a line through it, like this (draw a diagonal line through matching symbol in search group).

Point across the second demonstration item.

Look at these shapes.

This shape (point to target symbol in the grey area) is the same as this shape here (point to matching symbol in search group), so I draw a line through it, like this (draw a diagonal line through matching symbol in search group).

If you see a shape over here (point across search group for the second

demonstration item) that is the same as one of these shapes (point to each target symbol of second demonstration item), draw a line through the shape (point to marked symbol for second demonstration item).

Point across the third demonstration item.

Now look at these shapes.

In this case, neither one of these shapes here (point to each target symbol in the grey area) is the same as any of the shapes here (point across search group), so I draw a line through the NO box, like this (draw a diagonal line through NO box).

If you do not see a shape over here (point across search group for the

third demonstration item) that is the same as one of these shapes (point to each target symbol of third demonstration item), draw a line through the NO box (point to the marked NO box for third demonstration item).

Page 2 of 4 Source: WAIS-IV 2008

SAMPLE ITEMS Hand the SM a #2 pencil without an eraser and point to Sample Items.

Now you do these here. Go ahead. CORRECT RESPONSE: That’s right. Now you know how to do them. INCORRECT RESPONSE: If the SM does not mark the matching symbol on the first and third sample items, say, That’s not quite right.

Look here (point to target symbols). Here are the shapes. Now look over here (point across search group). Here is the same shape (point to matching symbol), so you should draw a line through it.

If SM does not mark the NO box on the second sample item, say, That’s not quite right.

Look here (point to both target symbols). Here are the shapes. Now look over here (point across search group). None of these shapes are the same, so you should draw a line through the NO box.

TEST ITEMS Open the Response Booklet to expose pages 2 and 3.

When I say go, do these the same way.

Start here (point to first Test Item on page 2), go in order, and don’t skip any.

Work as fast as you can without making mistakes until I tell you to

stop. You will have 2 minutes to get as many completed as possible.

When you finish the first page, go to the second page (point to page 3) and the following pages (briefly show SM pages 4-7). Are you ready?

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Page 4 of 4 Source: WAIS-IV 2008

Remove Response Booklet and pencil from the SM’s view before proceeding to the next subtest. Discontinue: After 2 minutes

Completion Time

ss_min Minutes: ss_sec Seconds: ss_tsec Tenths of a Second:

ss_cor Number Correct:

ss_inc Number Incorrect: _

ss_tot Total Score:

Great work! We will now go to the next set of questions.

Page 1 of 4

PHASE 38: DIGIT SPAN INTRODUCTION

Now, I will test your memory. Read each trial verbatim at the rate of one digit per second, dropping your voice slightly on the last digit in the sequence. Pause to allow the SM to respond. Do not repeat any trial. If the SM asks you to repeat a trial say, I cannot repeat the sequence. Just take your best guess.

Scoring: 2 point – SM gives correct response 0 points – SM gives an incorrect response, says that he or she does not know the answer, or does not respond

Page 2 of 4 Source: WAIS-IV 2008

I am going to say some numbers. Listen carefully, I can only say them one time. When I am through, I want you to say them back to me in the same order. Just say what I say. Discontinue: After 2 consecutive scores of 0. FORWARD Item Trial Item Score DSF_1 9 – 7 0 2 DSF_2 5 - 8 – 2 0 2 DSF_3 7 – 2 – 8 – 6 0 2 DSF_4 4 – 2 – 7 – 3 – 1 0 2 DSF_5 3 – 9 – 2 - 4 - 8 – 7 0 2 DSF_6 4 – 1 – 7 – 9 – 3 – 8 – 6 0 2 DSF_7 3 – 8 – 2 – 9 – 6 – 1 – 7 – 4 0 2 DSF_8 2 – 7 – 5 – 8 – 6 – 3 – 1 – 9 – 4 0 2

Page 3 of 4 Source: WAIS-IV 2008

Now, I am going to say some more numbers. This time when I stop, I want you to say the numbers backward. If I say 7-1, what would you say? CORRECT RESPONSE (1-7): That’s right. INCORRECT RESPONSE: That’s not quite right. I said 7-1, so to say them backward, you should say 1-7. Let’s try some more. Remember to say them backwards. Discontinue: After 2 consecutive scores of 0. BACKWARD Item Trial Correct Response Item Score DSB_1 3 – 1 1 – 3 0 2 DSB_2 4 – 6 6 – 4 0 2 DSB_3 6 - 2 – 9 9 – 2 – 6 0 2 DSB_4 8 – 2 – 7 – 9 9 – 7 – 2 – 8 0 2 DSB_5 6 – 5 – 8 – 4 – 3 3 – 4 – 8 – 5 – 6 0 2 DSB_6 5 – 3 – 7 – 4 – 1 – 8 8 – 1 – 4 – 7 – 3 – 5 0 2 DSB_7 8 – 1 – 4 – 9 – 3 – 6 – 2 2 – 6 – 3 – 9 – 4 – 1 – 8 0 2 DSB_8 9 – 4 – 3 – 7 – 6 – 2 – 1 – 8 8 – 1 – 2 – 6 – 7 – 3 – 4 – 9 0 2

Page 4 of 4 Source: WAIS-IV 2008

I am going to say some more numbers. After I say them, I want you to say the numbers in order, starting with the lowest number. Some numbers may be repeated so please say all of the numbers you hear. If I say 2-3-3-1, what would you say? CORRECT RESPONSE (1-2-3-3): That’s right. INCORRECT RESPONSE: That’s not quite right. I said 2-3-3-1, so to say them in order from lowest to highest, you should say 1-2-3-3. Let’s try some more. Remember to say them in order. Discontinue: After 2 consecutive scores of 0. SEQUENCING Item Trial Correct Response Item Score DSS_1 1 - 2 1 – 2 0 2 DSS_2 3 – 1 – 6 1 – 3 – 6 0 2 DSS_3 8 – 7 – 9 – 2 2 – 7 – 8 – 9 0 2 DSS_4 2 – 6 – 9 – 1 – 7 1 – 2 – 6 – 7 – 9 0 2 DSS_5 2 – 1 – 7 – 4 – 3 – 6 1 – 2 – 3 – 4 – 6 – 7 0 2 DSS_6 7 – 5 – 7 – 6 – 8 – 6 – 2 2 – 5 – 6 – 6 – 7 – 7 – 8 0 2 DSS_7 5 – 8 – 7 – 2 – 7 – 5 – 4 – 5 2 – 4 – 5 – 5 – 5 – 7 – 7 – 8 0 2 DSS_8 5 – 0 – 1 – 1 – 3 – 2 – 1 – 0 – 5 0 – 0 – 1 – 1 – 1 – 2 – 3 – 5 – 5 0 2 Ok, good work! We will now be moving on to the next set of questions.

Page 1 of 4

PHASE 38: DIGIT SYMBOL CODING INTRODUCTION

Now, I will test how quickly you can work. Materials: Response Booklet 1 #2 Pencil without eraser Stopwatch Coding Scoring Template Ensure a smooth work surface. Use the demonstration items to explain and illustrate the task to the SM, then allow the SM to practice by completing the sample items Do not provide SM with an eraser. If SM asks what to do if a mistake is made, say, That’s OK. Just keep working as fast as you can.

Scoring: Use the Coding Scoring Template to score the SM’s responses. Align the template so that the correct responses are above the SM’s responses. -If SM completes all test items before the 2 minute time limit expires, stop timing and record the completion time in seconds. Score 1 point for each correct response. -If the SM does not complete all of the test items within the time limit, record the completion time as 2 minutes.

Page 2 of 4 Source: WAIS-IV 2008

The Coding subtest is on the back of Response Booklet 1. Turn the Response Booklet over so the Coding subtest is visible and place it in front of the SM. Ensure that the SM sees only Coding. DEMONSTRATION ITEMS Point to the key at the top of the page.

• Look at these boxes. Each box has a number in the top part (point across the numbers from 1 to 9) and a special mark in the bottom part (point across the symbols).

• Each number has its own mark (point to 1 and its symbol, then to 2

and its symbol). Point to the demonstration items

• Down here, the boxes have numbers in the top parts but are empty in the bottom parts.

• You are to draw the marks that belong in the empty boxes.

Point to the first demonstration item (6)

• Here is a 6. The 6 has this mark (point to the key to show its corresponding symbol), so I draw that mark in the box, like this (write the symbol).

Point to the second demonstration item (8)

• Here is an 8. The 8 has this mark (point to the key to show its corresponding symbol), so I draw that mark in the box (write the symbol).

Point to the third demonstration item (3)

• Here is a 3. The 3 has this mark (point to the key to show its corresponding symbol), so I draw that mark in the box (write the symbol).

Proceed to Sample Items.

Page 3 of 4 Source: WAIS-IV 2008

SAMPLE ITEMS Hand the SM a #2 pencil without an eraser.

• Now you do these (point to the sample items).

• Stop when you get to this line (point to the heavy line that separates the sample items from the test items).

Allow the SM to work alone on the remaining sample items. If the SM completes the sample items correctly, say, Right. Now you know how to do them. If the SM makes a mistake on a sample item, correct the error immediately. Continue to help the SM, if necessary, until the SM correctly completes the sample items. Use explanations such as, You see, this is a 9. The 9 has this mark, so I draw that mark in the box (write the symbol). Do not proceed with the test items until the SM understands the task. If it is clear that the SM will not be able to understand the task with further instruction, discontinue the subtest. When the SM has successfully completed the sample items, proceed to test items

Page 4 of 4 Source: WAIS-IV 2008

TEST ITEM

• When I say go, do these the same way.

• Start here (point to the first test item), go in order, and don’t skip any.

• Work as fast as you can without making mistakes until

I tell you to stop.

• Are you ready? If the SM is still working at 2 minutes, stop timing and say, Stop. Record the completion time as 2 minutes. Remove the Response Booklet and pencil from the SM view before proceeding to the next subtest. Discontinue: After 2 minutes.

Completion Time

DSC_MIN Minutes:

DSC_SEC Seconds: DSC_TSEC Tenths of a Second:

DSC_TOT Total Score: (Maximum = 135) Ok, great job! We will now move on to the next set of questions.

Page 1 of 2

PHASE 38: GROOVED PEGBOARD TEST INTRODUCTION We are looking at your hand-eye coordination, how fast is it? This activity was also given to you when you were 13 years old, and again, we are interested in knowing how people learn and change as they grow older.

Place the pegboard mid-line with the subject so that the board is at the edge of the table and peg tray immediately above the board. Do not tilt pegboard or let SM move pegboard in any direction.

Scoring: Record, in seconds, the length of time required to perform each trial beginning when the SM starts the task until the last peg is put in, or the test is discontinued, after 5 minutes.

Page 2 of 2

(Pick up peg to show SM.) All of these pegs have a round side and a square side and so do the holes in the boards. Match the groove of the peg with the groove of the board and put these pegs into the holes like this. (Demonstrate on the top row, work from SM’s left to SM’s right. Remove the pegs, putting them back into the tray.) Which hand do you use to write? Use that hand first. Put the other hand behind you or in your lap. Fill the top row completely from this side (SM’s left) to this side (SM’s right). Then go down to the next row. Do not skip any holes. If you drop a peg, don’t pick it up, just take another one from the tray. When I say go, start here and put the pegs into the board as fast as you can. Any questions? Ready, as fast as you can, Go! DH1. Which is the dominant hand? Right=1 Left =2 Discontinue: After 5 minutes

Completion Dominant hand

cdh_min. Minutes:

cdh_sec. Seconds:

cdh_tsec. Tenths of

a Second:

Good job. Now we are going to do the same thing with the other hand. When I say go, start here and work as fast as you can. Ready? Go!

Completion Non-dominant hand

cndh_min. Minutes:

cndh_sec. Seconds:

cndh_tsec. Tenths of

Seconds: peg_drop. Dropped? No = 0 Yes = 1

If yes, how many? peg_miss. Missed data? No = 0 Yes = 1 Why? ____________________

Source: Lafayette Instrument Company, Inc. 2002

Page 1 of 2

PHASE 38: BRIEF SMELL IDENTIFICATION TEST

INTRODUCTION Now, we are looking at your ability to identify different common smells. Materials: B-SIT booklet Ask SM to scratch and sniff all twelve odors in the B-SIT booklet. They must indicate verbally the answer that best matches each smell. If SM is unsure, say, Though you may be unsure, make your best guess. Circle SM’s answer. Allow SM to keep their B-SIT booklet as a gift.

Record all responses Scoring: 1point- SM gives correct response 0 point- SM gives incorrect response

Page 2 of 2

Place B-SIT booklet on table in front of SM and open to the first page.

Here we have a brown strip with a particular smell (point to brown strip at the bottom right of booklet page) and here we have the possible answers for identifying the smell, (point to the four possible answers on the right side of the booklet page).

Watch how I use this pencil to make a few scratches across the strip. (scratch the strip with pencil to demonstrate) This releases the smell. Lift the booklet to your nose to sniff the strip (have SM smell strip). Then tell me which of these answers you think the strip smells most like.

You will do this one first (point to first page) and then complete the rest of the booklet in the same way. Please tell me each answer as you go. If you are unsure about a smell, just make your best guess.

Place the closed booklet and pencil in front of SM to begin.

BSIT0. Is there any reason you may not be able to smell as well today as you normally would (for example a cold or allergies)?

No = 0 Yes = 1 If yes, why? ____________________ Item Response Score BSIT1. A. fruit B. cinnamon C. woody D. coconut 0 1

BSIT2. A. turpentine B. soap C. dog D. black pepper 0 1

BSIT3. A. motor oil B. garlic C. rose D. lemon 0 1

BSIT4. A. apple B. grass C. smoke D. grape 0 1

BSIT5. A. lemon B. chocolate C. strawberry D. black pepper 0 1

BSIT6. A. mint B. rose C. lime D. fruit 0 1

BSIT7. A. watermelon B. peanut C. rose D. paint thinner 0 1

BSIT8. A. banana B. garlic C. cherry D. motor oil 0 1

BSIT9. A. smoke B. whiskey C. pineapple D. onion 0 1

BSIT10. A. rose B. lemon C. apple D. gasoline 0 1

BSIT11. A. soap B. black pepper C. chocolate D. peanut 0 1

BSIT12. A. chocolate B. banana C. onion D. fruit 0 1

Source: Sensonics, Inc. 2001

Page 1 of 3

PHASE 38: SIMILARITIES INTRODUCTION

We are looking at how well you can take two words that represent common ideas and describe how they are similar. Read each item verbatim to the examinee. Each item may be repeated AS OFTEN AS NECESSARY, but do not alter the wording in any way. If the examinee’s response is unclear or too vague to be readily scored or is followed by a (Q) in the sample response, say, What do you mean? or Tell me more about it.

All responses are written verbatim. Scoring: 2 points – Any major classification that is pertinent for both members of the item pair 1 point – Any specific property that constitutes a minor or less pertinent similarity; any major classification that is less pertinent for both members of the item pair 0 points – Any property that is not pertinent to both members of the item pair, is too general in nature, or describes differences between members of the item pair; any clearly incorrect answer

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I’m going to say two words and ask you how they are alike. To the best of your ability, please respond with clear and complete responses. Discontinue: After 3 consecutive scores of 0 SAMPLE QUESTION

In what way are TWO and SEVEN alike? How are they the same? ___________________________________________________________ CORRECT RESPONSE: Any response with the word numbers. That’s right. TWO and SEVEN are both numbers. INCORRECT RESPONSE: Any response without the word numbers, a clearly incorrect response, or no response. TWO and SEVEN are both numbers. Let’s try another one. Proceed to the next question.

Sim4 In what way are a HORSE and a TIGER alike? 0 1 2 __________________________________________________ (2 points: Animals, mammals, quadrupeds, members of animal kingdom) (1 point: Both have four legs and a tail (Q), both can be tamed, can be pets) (0 points: You see them at the zoo/circus, used for hunting, tigers eat horses, both have a mane)

Sim6 In what way are a BOAT and a CAR alike? 0 1 2 __________________________________________________ (2 points: Vehicles, way of getting from one place to another, means/form of transportation) (1 point: Ride in both (Q), both move (Q), carry people/things(Q), both used for pleasure or recreation) (0 points: Both mechanical (Q), both have motors/engines/seats/steering wheel (Q), they’re expensive Run on/require gas/fuel(Q))

Sim8 In what way are FOOD and PETROL alike? 0 1 2 __________________________________________________ (2 points: Resources, are consumed, give/make/used for energy/power, forms/types of fuel/energy) (1 point: Replenish, consumer goods, things that are burned, fill up on them, necessities(Q), get you started) (0 points: For trips, have odors, use them daily, need to exist/survive/live (Q), cost money (Q) buy/found at stores (Q))

Incorrect Correct (0) (1) (2)

Page 3 of 3 Source: WAIS-IV 2008

Discontinue: After 3 consecutive scores of 0

Sim10 In what way are a BUD and BABY alike? 0 1 2 __________________________________________________ (2 points: Young, beginning stages of life, new/early forms of life, beginning/start/initial stages of development, infant stages/newborn) (1 point: Will grow/mature (Q), beginning/start (Q), new/new things (Q), offspring (Q)) (0 points: Small (Q), need care, begin with “B”, delicate/soft/rosy)

Sim12 In what way are a POEM and a STATUE alike? 0 1 2 __________________________________________________ (2 points: Art, artistic creations, expression of artistic feeling) (1 point: Represent something, have meaning, stir/evoke feelings, are memorials, symbolic(Q)) (0 points: Tell stories(Q), are timeless, solid structures, a poem describes a statue, things that are looked at, represent history, represent culture (Q), people like them)

Sim14 In what way are WISH and EXPECT alike? 0 1 2 __________________________________________________ (2 points: Forms of anticipation, things that have not yet happened, forecasting, future events) (1 point: Forms of thought (Q), things that will happen in the future, feelings, dreams/hopes/desires/wants (Q)) (0 points: Outcomes (Q), cause anxiety, disappointments, expectations (Q))

Sim16 In what way are ALWAYS and NEVER alike? 0 1 2 __________________________________________________ (2 points: Extremes, both definite/definitive, all encompassing/inclusive, absolutes) (1 point: Eternal things (Q), related to time/frequency (Q), time (Q), final (Q), rarely exist (Q)) (0 points: When things happen (Q), decisions, answers, finite, promises, things you have to so/say)

Sim18 In what way are ALLOW and RESTRICT alike? 0 1 2 __________________________________________________ (2 points: Levels/degrees of granting/giving privileges, rules that guide behaviour, methods/ways/forms of shaping/molding/guiding/conditioning behavior) (1 point: Access (Q), permissions/privileges (Q), limits/exclusions (Q), methods/ways/forms of limiting/controlling behaviour(Q)) (0 points: rules/laws/standards (Q), boundaries (Q), show power, actions, commands, something parents do, means/forms of discipline (Q))

You are doing a good job! On to the next set of questions.

Incorrect Correct (0) (1) (2)

Page 1 of 2

PHASE 38: VERBAL PAIRED ASSOCIATES II INTRODUCTION

Administer 25-30 minutes after Verbal Paired Associates I. Allow approximately 10 seconds for the SM to respond. Do not tell the SM if his or her response is correct or incorrect.

Scoring: 1 point – When the SM gives a correct response 0 points - If examinee gives an incorrect response or says that he/she does not know the answer

Page 2 of 2 Source: WMS-III 1997

RECALL Remember the word pairs that you learned earlier? I told you a word and gave you another word that went with it. I want you to recall as many of those word pairs as you can remember, one more time. I will say the first word of the pair, and you say the word that goes with it. Ready? Present the Recall section as follows: Which word goes with ______________? Recall Correct Response PAII-1 Truck (Arrow) 0 1 PAII-2 Insect (Acorn) 0 1 PAII-3 Reptile (Clown) 0 1 PAII-4 Bank (Cartoon) 0 1 PAII-5 Star (Ladder) 0 1 PAII-6 Badger (Paper) 0 1 PAII-7 Rose (Bag) 0 1 PAII-8 Elephant (Glass) 0 1 Good job!

Incorrect Correct (0) (1)

Page 1 of 3

PHASE 38: PICTURE COMPLETION INTRODUCTION

Next I will ask you to look at some pictures and tell me what is missing. Materials: Stimulus Book 2 Stopwatch If the SM gives a verbal response that is ambiguous or incomplete, ask him or her to provide a pointing response by saying, Show me where you mean. Provide this prompt AS OFTEN AS NECESSARY. If the SM does not respond to an item within 20 seconds or if the SM responds incorrectly in less than 20 seconds, proceed to the next appropriate item if the discontinue criterion has not been met. Corrective feedback may be given if SM has given an incorrect answer or time limit is reached. You may say, Though that may seem like what is missing in the picture, it is not, would you like to keep looking or move on to the next picture?”. If they say move on to the next picture, mark the answer as a 0. If they use up the rest of their time trying to find what is missing and time runs out, mark it as a 0 and tell them, “You showed good effort but your time is up and we need to move on to the next picture”.

Scoring: Record the completion time in seconds. -Score 1 point if the SM correctly identifies the missing part within 20 seconds. -Score 0 points if the SM responds incorrectly, says that he or she does not know the answer, or does not respond within 20 seconds.

Page 2 of 3 Source: WAIS-IV 2008

Place the Stimulus Book 2 in front of the SM. SAMPLE ITEM I am going to show you some pictures. There is a part missing in each picture. Look at each picture carefully and tell me what is missing. Open the Stimulus Book 2 to Sample Item and say, Look at this picture. You will have 20 seconds to tell me what is missing. Don’t worry if you cannot find what is missing. We will simply move on to the next one. Begin timing and allow 20 seconds. CORRECT RESPONSE (Tooth; Bristle; Prong; Tine): Point to the place where the tooth is missing and say, That’s right, the (insert SM’s response) is missing. INCORRECT RESPONSE: Point to the place where the tooth is missing and say, You see, the tooth is missing. The time limit for each item is 20 seconds Discontinue: After 4 consecutive scores of 0 Item Verbal Sample Score Response Responses PC4. Glasses __________________________ (nosepiece, nose bridge, 0 1 frame/rim over nose) PC6. Knife __________________________ (serrated edge, serrated 0 1 part/teeth on knife/blade) PC8. Roses ___________________________ (thorns on middle/center 0 1 rose, spikes/stickers on 2nd stem) PC10. Cow ___________________________ (cleft in hoof/foot, cut, 0 1 groove, slit split, indentation in hoof)

Incorrect Correct (0) (1)

Page 3 of 3 Source: WAIS-IV 2008

The time limit for each item is 20 seconds Discontinue: After 4 consecutive scores of 0 Item Verbal Sample Score Response Responses PC12. Trees __________________________ (tree trunk, one tree 0 1 doesn’t have a trunk) PC14. Karate __________________________ (man’s belt/sash) 0 1 PC16. Walking __________________________ (her/woman’s shadow, 0 1 doesn’t have a shadow) PC18. Shoes __________________________ (eyelet, metal around 0 1 hole, ring around hole) PC19. Tent __________________________ (Backpack holder, 0 1 Backpack (handles/ Loops/harness) PC22. Basket __________________________ (part/piece/section of 0 1 basket weave, line/strip/ row/strand of weave) PC24. Stove __________________________ (drip/pan/ring around 0 1 burner) Good job! We will now move on to the next set of questions.

Incorrect Correct (0) (1)

May 25, 2010 1

GRIP TEST Next, we are going to measure your grip strength. I’ll have you sit here with your elbow flexed at 900, the thumb should be pointing up.

I will have you grip this machine as fast and as tight/ hard as you can. We’ll do both your right and left hands, three times each with a bit of a rest in between. Remove rings? (if rings cannot be removed, code on first page) Ready?

GRP1. a. Right time 1 __________

b. Left time 1 __________ c. Right time 2 __________ d. Left time 2 __________

e. Right time 3 __________ f. Left time 3 __________

.

.

.

.

.

.

Page 1 of 4

PHASE 38: VOCABULARY INTRODUCTION

When you were 13 years old, we asked you questions to test your knowledge of words. We are asking these again 25 years later because we are interested in knowing how people learn and change as they grow older. Materials: Stimulus cards VOCA and VOCB If you are not sure if an answer is sufficient, query, Can you tell me more about that. Write a circled Q at the place where you queried to help you score the response later. Code any clearly incorrect response 0 as you go.

All responses are written verbatim, to score 2 versus 1 points later. Use the WAIS-IV Scoring manual, pp 104-124. Scoring: 2 points - The response shows good understanding of the word 1 point – In general, the response is correct but shows poverty of content 0 points – Any clearly incorrect response.

Page 2 of 4 Source: WAIS-IV 2008

Place card VOCA in front of SM and point to each word on the card as you read it aloud. I’m going to say some words, please listen carefully and tell me what each word means. Discontinue: After 3 consecutive scores of 0 Vocabulary Items VOC4 Bed ____________________________________________0 1 2 (2 points: Furniture you (sleep, lie, rest) on, to sleep on, for sleeping) (1 point: Place where you (lie down, rest) (Q), Furniture (Q), something you (relax, recline, get comfortable) on, place where you relax) (0 points: Sleep, rest, an (iron, wooden) thing)

VOC6 Glove __________________________________________ 0 1 2 (2 points: Clothing/covering for your hands, something you wear on your hands, protect your hands, keeps hands from getting cold/dirty) (1 point: Wear them (Q), wear them (for protection/warmth/when it’s cold, cleaning/working/playing/baseball/exercise) (Q), protection) (0 points: For winter, mittens, made of (leather/cotton), come in pairs)

VOC8 Curious ________________________________________ 0 1 2 (2 points: Predisposition to seek/acquire knowledge, intellectual wonder, have interest piqued, investigative, eager to investigate/learn, asking questions about things) (1 point: To investigate/seek information (Q), nosy (Q), suspicious, asking (Q)) (0 points: Curious George (Q), eager)

VOC10 Consume _______________________________________ 0 1 2 (2 points: To expend/use up, use completely, to destroy the substance of, burn up, squander, to take in all of something/everything, to eat/drink/ingest/devour) (1 point: Use [no reference to using completely] (Q)), buy/purchase (Q), intake/(gather/take) in (Q), (to) envelop (Q) (0 points: Do away with (Q), using products (Q), digest, take (something/food) (Q), consume (something/a lot of food) (Q) )

VOC12 Tranquil _______________________________________ 0 1 2 (2 points: Peaceful/at peace/peacefulness, placid, soothing, serene/calm/calm feeling, still, quiet/silent) (1 point: Relaxed (Q), at ease/at rest (Q), content (Q), satisfied, easygoing/laid back/mellow/sedate) (0 points: To relax/rest (Q), happy (Q), state of mind, lazy, sleepy/tired, to slow something down)

Incorrect Correct (0) (1) (2)

Page 3 of 4 Source: WAIS-IV 2008

Discontinue: After 3 consecutive scores of 0

VOC14 Reluctant _______________________________________0 1 2 (2 points: Hesitant, resistant, reticent, unwilling/disinclined/averse, have reservations about doing something, uneasy/dubious/afraid to do something) (1 point: Cautious/wary/leery/apprehensive (Q), hold back (Q), oppositional/refusing to do something, dubious/doubtful/sceptical (Q), fearful/afraid, not confident about a decision) (0 points: Tentative (Q), not ready (Q), undecided (Q), shy/timid, sort of slow (Q), pulling away (Q), careless, apathetic)

VOC16 Remorse _______________________________________ 0 1 2 (2 points: Penitence, guilt/shame/regret, to feel bad/sorry/apologetic for something you did, feeling of distress/sorrow/sadness caused by guilt) (1 point: Feel sorry/bad (Q), sadness/sorrow (Q), wishing you had/hadn’t done something (Q), apologize for something you did) (0 points: Feel sorry for someone/pity/sympathy (Q), anger, to show feelings/emotions, grief/depression/unhappiness) Place card VOCB in front of SM.

VOC18 Acute __________________________________________ 0 1 2 (2 points: Sudden/rapid/quick onset with a short duration/course, intense/severe/sharp/excruciating, sharp/pointed up, sensitive/keen/astute, highly/very/extremely serious, critical/ urgent/needs immediate attention) (1 point: Sudden/rapid/quick (Q), happens unexpectedly (Q), serious/important (Q), strong (Q), painful, to the point, not long lasting/ short/brief (Q), angle/triangle (Q), observant, specific/precise/accurate) (0 points: It hurts/smarts (Q), small (Q), concentrated (Q), acutely aware (Q), bad, attack, sick/very sick)

VOC20 Compassion ____________________________________ 0 1 2 (2 points: Pity/empathy/sympathy, feeling sorry/sorrow for someone, having mercy, loving concern with charity, to relate to others’ hardships, concern/feeling for other’s pain/illness/difficulties) (1 point: Sorrow (Q), caring/concern, understanding, to feel bad for someone (Q), to console, charity, feeling for another person/someone (Q)) (0 points: Care for/about someone (Q), feeling/emotion, show affection, kindness/thoughtfulness (Q), tolerance, passionate) VOC22 Evolve _________________________________________ 0 1 2 (2 points: To change and grow/progress over time, grow/change into something better, become refined by circumstances, adapt, develop, transformation of simple life forms to higher ones) (1 point: Improve, progress, get better, move ahead/forward (Q), mature/grow (Q), go from one stage to another/the next (Q), metamorphosis, the process by which people/animals come into being) (0 points: Come out of something/come about (Q), become (Q), bring forth/create/to bring forth from the beginning, turn/go/move around, rotate)

Incorrect Correct (0) (1) (2)

Page 4 of 4 Source: WAIS-IV 2008

Discontinue: After 3 consecutive scores of 0

VOC24 Fortitude _______________________________________ 0 1 2 (2 points: Resoluteness, courage/bravery, perseverance, pluck/guts/grit/gumption, endurance/stamina, the drive to succeed in spite of failure, mental/physical/emotional strength, strength to overcome/withstand/endure adversity) (1 point: Steadfastness (Q), willpower/drive/will, determination (Q), persistence/ability to stay with something, strong willed/minded) (0 points: Strong/tough (Q), power, integrity, prepared, enhance, looking into the future, being able to do something (Q)) VOC26 Encumber ______________________________________ 0 1 2 (2 points: Burden/overloaded, to weigh/bog down, handicap/hamper, give an extra load, to impede, a legal attachment, overwhelm) (1 point: To make harder/difficult (Q), complicate (Q), add on (Q), take on/get involved (Q), keep from happening (Q)) (0 points: Hold, too big/large, person in public office, include, take in/gather something together, encircle/surround/encompass) VOC28 Tirade _________________________________________ 0 1 2 (2 points: An angry speech, verbal browbeating, rant/ranting and raving, monologue of anger/displeasure, a diatribe/a harangue, hostile/punishing/angry flow of words) (1 point: Verbal fuss/argument, outburst, yelling/screaming, upset and going on and on, loud series of exclamations/opinions) (0 points: Rampage, a fit on inner feeling, raising a commotion, temper tantrum, anger/angry/mad, tyrannical/bossy person/ bully)

VOC30 Palliate ________________________________________ 0 1 2 (2 points: Reduce/decrease/ease/moderate/relieve/diminish the intensity, abate/appease/alleviate/soothe, extenuate/mitigate, gloze/gloss over/ whitewash, to make more comfortable) (1 point: reduce/decrease/ease/moderate/relieve diminish (Q), weaken/ fade/wane, make better (Q), calm/calm down, to cloak/conceal/shelter/hide (Q)) (0 points: palliative care (Q), care for older people (Q), show emotion, to cure, be articulate, something to do with eating/taste/savor, help someone who is sick/ has a disease/ is in pain (Q))

You did an excellent job! Module No

Incorrect Correct (0) (1) (2)

0 4 8

Page 1 of 3 

 

Phase 38 Neuropsychological Testing Session: Session II

Interviewer Introduction

I'll be asking you to try a lot of different questions, puzzles, and brain teasers.

We gave you these exact same tests when you were 13 years old, so you might recognize some of them. But that was 25 years ago!

The reason for these tests is that we want to see how much study members have changed on their mental performance after 25 years of life experience.

    Phase 38: Impairment Questions

Page 2 of 3 

 

ID No Before we get started, we just want to check… Interviewer ID IM1. Do you have any difficulties using your 0 1

hands to hold a pencil or pick up small things? Notes:________________________________ _____________________________________

IM2. Do you have any difficulties with your 0 1

hearing? Notes ________________________________

______________________________________

IM3. Do you have any difficulties with your 0 1

vision? Notes ________________________________

______________________________________

IM4. Do you have any difficulties with your 0 1

speech? Notes ________________________________

______________________________________

IM5. Do you have any other difficulties such as 0 1

  

No Yes (0)           (1) 

 

 

 

 

 

being jet lagged, lacking sleep, or being hung over?

Notes ________________________________

______________________________________

Page 3 of 3 

 

Phase 38 Neuropsychological Testing Session: Interviewer Introduction (Continued)

Each task asks you to do something different, because everybody has things they do well and things they don't do so well, and we want everyone to have a chance to succeed and have fun.

Each task will only last about 3 minutes, so if you don't enjoy a task, don't worry, we will be switching to a different task in a minute.

Each task starts out easy and gets harder, and the questions go all the way up to the genius level, so don't be surprised when you get some wrong.

It is important to do the very best you can.

So sit back and relax, so you can concentrate as well as possible.

Ready for the first test?

Page 1 of 4

PHASE 38: MATRIX REASONING INTRODUCTION

Now I am going to ask you to look at some patterns. Materials: Stimulus Book 1 Go through both Sample A and Sample B. Make sure SM understands what needs to be done. Choice must be indicated either by pointing to or saying the number of the selected response option. If the SM responds with any other type of verbalization, say, Show me. If there is no response in approximately 30 seconds, prompt by saying, Do you have an answer? Adjust the timing of this prompt and/or grant additional time if a pattern has been established of providing delayed but correct responses as the item difficulty increases.

Scoring: 1 point – SM gives correct response 0 points – SM gives an incorrect response, says that he or she does not know the answer, or does not respond

Page 2 of 4 Source: WAIS-IV 2008

Open the Stimulus Booklet to Sample Item A • Look at this picture. You will choose which one of these (point across response

options) goes here (point to box with question mark).

• The right answer will work going across (point across now with question mark) and going down (point down column with question mark).

• You should only look across and down to find the answer. Do not look diagonally

(point across boxes on both diagonals).

• Which one here (point across response options) goes here (point to box with question mark)?

CORRECT RESPONSE (5): That’s right!

• When you go across the top row (point across boxes in top row), the blue star changes to a yellow circle.

• This means that when you go across the bottom row (point across boxes in bottom

row), the blue star should change to a yellow circle too.

• When you go down the first column (point down column on SM’s left), the boxes have the same shape in the same color, blue stars.

• This means that when you go down the second column (point down column with

question mark), the boxes should also have the same shape in the same color, yellow circles.

INCORRECT RESPONSE: Let’s look again.

• To get the right answer going across, look at the boxes in the top row (point to top row).

• When you go across the top row (point across boxes in top row), the blue star

changes to a yellow circle.

• This means that when you go across the bottom row (point across boxes in bottom row), the blue star should change to a yellow circle too.

• To get the right answer going down, look at the boxes in this column (point to

column on SM’s left).

• When you go down the first column (point down column on SM’s left), the boxes have the same shape in the same color, blue stars.

• This means that when you go down the second column (point down column with question mark), the boxes should also have the same shape in the same color, yellow circles.

Sample Item Response SA 1 2 3 4 5

Page 3 of 4 Source: WAIS-IV 2008

Turn to Sample Item B • This is another kind of problem. The boxes are in order going across (point

across boxes, from SM’s left to right).

• The right answer will follow the order you see across the other boxes.

• Which one here (point across response options) goes here (point to box with question mark)?

CORRECT RESPONSE (4): That’s right!

• When you look across the boxes, you see that they go in this order: (point to appropriate box, from the SM’s left to right, as you say) large circle, small circle, large circle, small circle, large circle.

• The small circle (point to response option 4) goes here (point to box with question

mark) because it would go next. INCORRECT RESPONSE: Let’s look again.

• When you look across the boxes, you see that they go in this order: (point to appropriate box, from the SM’s left to right, as you say) large circle, small circle, large circle, small circle, large circle (point to response option 4) goes here (point to box with question mark) because it would go next.

• A small circle comes after a large circle as you go in order across the boxes.

Sample Item Response SB 1 2 3 4 5

Page 4 of 4 Source: WAIS-IV 2008

Though this exercise is not being timed, please work at a steady pace and if you find yourself stuck, either guess or move on. Point to the visual stimuli, the response options, and the box with the question mark, just as in the sample questions.. Ready? Let’s Begin. Discontinue: After 3 consecutive scores of 0 Item Response Score MR4 1 2 3 4 5 0 1 MR6 1 2 3 4 5 0 1 MR8 1 2 3 4 5 0 1 MR10 1 2 3 4 5 0 1 MR12 1 2 3 4 5 0 1 MR14 1 2 3 4 5 0 1 MR16 1 2 3 4 5 0 1 MR18 1 2 3 4 5 0 1 MR20 1 2 3 4 5 0 1 MR22 1 2 3 4 5 0 1 MR24 1 2 3 4 5 0 1 MR26 1 2 3 4 5 0 1 Ok, great job! On to the next set of questions.

Page 1 of 2

PHASE 38: REY AUDITORY VERBAL LEARNING TEST I INTRODUCTION

Now I am going to ask you to recall some words that I will say to you. SM is read a list of words and is asked to recall the words in any order. This procedure is repeated for four trials.

Scoring: -Score 1 point for each correct response -Score 0 points for each incorrect response Note: Each word recalled is given credit only once for each trial.

Page 2 of 2 Source: Rey Auditory Verbal Learning Test

I am going to say a list of words to you. Please say them back to me once I have finished reading the list to you. You can say them back to me in any order. We will do this four times. Ready? Trial 1 Responses

Drum Curtain Bell Coffee School Parent Moon Garden Hat Farmer Nose Turkey

Color House River

rey1_trl1.Trial 1 Recall

Trial 2

Responses

Drum Curtain Bell Coffee School Parent Moon Garden Hat Farmer Nose Turkey

Color House River

rey1_trl2.Trial 2 Recall

Trial 3

Responses

Drum Curtain Bell Coffee School Parent Moon Garden Hat Farmer Nose Turkey

Color House River

rey1_trl3. Trial 3 Recall

Trial 4

Responses

Drum Curtain Bell Coffee School Parent Moon Garden Hat Farmer Nose Turkey

Color House River

rey1_trl4. Trial 4 Recall

Trial 1

Trial 2 Trial 3

Trial 4

Good job! We will now move on to the next set of question.

Page 1 of 3

PHASE 38: TRAIL MAKING TESTS, A AND B INTRODUCTION This next one is a dot-to-dot game. Materials: Response Forms Stopwatch Black pencil without eraser Start with Sample A. If SM can do the sample, give Trail Making Test A. Do not show SM the main test forms until you’re ready to say “GO”. This will prevent pre-scanning of the path. Give Sample B second. If SM can do the sample, give Trail Making Test B. If SM makes an error, stop SM, but continue timing. Don’t tell SM where to go next, just point out where to start from. Correct quickly, to avoid adding time to the SM’s score.

Scoring: Record, in seconds, the length of time required to perform each trial beginning when the SM starts the task until the task is completed. Discontinue test after 2 minutes.

Page 2 of 3

TRAILS A Give SM sample for Trails A.

• On this page (point) there are some numbers.

• Begin at the number 1 (point to 1) and draw a line from 1 to 2 (point to 2), 2 to 3 (point to 3), 3 to 4 (point to 4), and so on, in order, until you reach the end (point to the circle marked “END”).

• Do not lift your pencil from the paper once you begin.

• Draw the line to get the idea.

• Good! Let’s try the next one. • Work as quickly as you can without making mistakes, and

don’t take the pencil off the paper. • Tell me when you have finished

Do not turn over the form until you’re ready to say go. Turn the paper over. Now GO! (Start stopwatch) Discontinue: If A takes longer than 2 minutes.

Completion Time Trails A

TMTA_MIN. Minutes:

TMTA_SEC. Seconds:

TMTA_TSEC. Tenths of

a Second:

Good job! Now we will move on to the next one.

Source: Reitan Neuropsychology Laboratory 1992

Page 3 of 3

TRAILS B For Trails B, repeat. Show sample.

• On this page are some numbers and letters.

• Begin at number 1 (point to 1) and draw a line from 1 to A (point to A), A to 2 (point to 2), 2 to B (point to B), B to 3 (point to 3), 3 to C (point to C), and so on, in order, until you reach the end, (point to the circle marked “END”).

• Remember, first you have a number (point to 1), then a

letter (point to A), then a number (point to 2), then a letter (point to B), and so on.

• Draw the line to practice.

• Good! Let’s try the next one.

• Remember to work as quickly as you can without making

mistakes, and don’t take the pencil off the paper.

• Let me know when you have finished. Do not show SM the form until you’re ready to say go. Turn the paper over. Now GO! (Start stopwatch) Discontinue: If B takes longer than 2 minutes.

Completion Time Trails B

TMTB_MIN. Minutes:

TMTB_SEC. Seconds:

TMTB_TSEC. Tenths of

a Second: Great work!

Source: Reitan Neuropsychology Laboratory 1992

Page 1 of 3

PHASE 38: ARITHMETIC INTRODUCTION

These next few questions were also asked when you were 13 years old. We are looking to test your ability to mentally solve arithmetic problems. We are asking these again 25 years later because we are interested in knowing how people learn and change as they grow older. Materials: Stopwatch Timing: The time limit for each item is 30 seconds Begin timing after saying the last word of each question Repeat a question ONLY ONCE per item & KEEP THE STOPWATCH GOING even if repeating a question.

All responses are written verbatim. Scoring: 1 point - If examinee gives a correct response within time limit 0 points - If examinee gives an incorrect response, says that he/she does not know the answer, or does not respond within the time limit

Page 2 of 3 Source: WAIS-IV 2008

I am going to read you some problems. Sit back and relax. I need you to listen carefully, you can only ask me to read each problem one more time. If you are having difficulty answering the problem after 30 seconds, we will move on to the next one. Remember, questions will gradually get more complicated so do not get discouraged. Discontinue Criterion: After 3 consecutive scores of 0 The time limit for each item is 30 seconds SAMPLE QUESTION Lou has six baseballs. He loses three. How many baseballs does he have left? CORRECT RESPONSE (3): That’s right. Let’s try some more. INCORRECT RESPONSE (or no response): That’s not quite right. To solve this problem you start with six baseballs and take away three baseballs. This leaves three baseballs. Let’s try some more. Items Correct Score Response AR6 Lee has four blankets. He buys four more. How many 8 0 1 blankets does he have all together? _______ AR8 Bill has 4 children and 20 toys. If each child gets an equal 5 0 1 number of toys, how many should each child get? _______ AR10 John has 28 books. He sells half of them to a used 5 0 1 bookstore and gives 9 more away. How many books does he have left? _______ AR12 There are 25 pieces of chewing gum in a pack. How 200 0 1 many pieces are in 8 packs? _______ AR14 Ying runs 22 minutes each day on Monday through 140 0 1 Friday. She runs 30 minutes on Saturday. How many minutes does she run all together? _______ AR16 You can bake 2 cakes in 31 minutes. How long does it 186 0 1 take to bake 12 cakes? _______

Incorrect Correct (0) (1)

Page 3 of 3 Source: WAIS-IV 2008

Discontinue Criterion: After 3 consecutive scores of 0 The time limit for each item is 30 seconds Items Correct Score Response AR18 Frank worked 188 hours in 4 weeks. If he worked an 47 0 1 equal number of hours each week, how many hours did he work each week?_______ AR20 Pam usually rides her horse 60 laps around a track. 51 0 1 She rides 15 percent fewer laps today. How many laps does she ride today?_______ AR22 A post office sorts 20,000 pieces of mail in October. 23, 100 0 1 In November, the pieces of mail sorted increase by 10 percent. In December, the pieces of mail sorted increase by another 5 percent. How many pieces of mail are sorted in December after both increases? _______ Terrific work! We will be moving on to the next set of questions. Administer CANTAB Reaction Time (RTI) followed by CANTAB Visual Paired Associates (PAL) next

Incorrect Correct (0) (1)

Page 1 of 2

PHASE 38: REY AUDITORY VERBAL LEARNING TEST II

INTRODUCTION

I am going to ask you to recall some words that I have said to you a short while back. Administer 25-30 minutes after Word Lists I. For recall, SM is asked to recall List A from Word Lists I. List A is not reread to the SM.

Scoring: -Score 1 point for each correct response -Score 0 points for each incorrect response Note: Each word recalled is given credit only once for each trial.

Page 2 of 2 Source: Rey Auditory Verbal Learning Test

Now try to recall as many words as you possibly can from that list of words I had read to you a short while ago. List Responses WL1. Drum WL2. Curtain WL3. Bell WL4. Coffee WL5. School WL6. Parent WL7. Moon WL8. Garden WL9. Hat WL10. Farmer WL11. Nose WL12. Turkey WL13. Color WL14. House WL15. River WC_TOT. Recall Total Score Good job! Administer CANTAB Rapid Visual Info (RVP) next

Page 1 of 1

PHASE 38: MENTAL CONTROL INTRODUCTION

Materials: Stopwatch Now I would like you to say the days of the week, starting with Monday (do not time this). Now, please say the days of the week backwards starting with Sunday. Ready? (begin timing)

Item Correct Response Score MC1. Days Sunday Saturday Friday Thursday 0 1 Backwards Wednesday Tuesday Monday

Response Time:

MC1_MIN. Minutes:

MC1_SEC. Seconds:

MC1_TSEC. Tenths of

a Second:

Now I want you to say the months of the year, starting with January (do not time this). Please say the months of the year backwards, starting with December. Ready? (begin timing) Item Correct Response Score MC2. Months December November October September 0 1 Backwards August July June May April March February January

Response Time: MC2_MIN. Minutes:

MC2_SEC. Seconds:

MC2_TSEC. Tenths of

a Second: Good job!

Incorrect Correct (0) (1)

Incorrect Correct (0) (1)

Source: WMS-III 1997

PHASE 38: INFORMATION INTRODUCTION

We are looking at how well you can answer questions that address a broad range of general knowledge topics. Read each item verbatim to the study member. Each item may be repeated AS OFTEN AS NECESSARY, but do not alter the wording in any way. If the study member’s response is unclear or too vague, say, What do you mean? or Tell me more about it. Then, write a Q with a circle around it (Q) at that point on the data recording form and write their second response after the (Q).

Scoring: 1 point - If SM gives a correct response 0 points - If SM gives an incorrect response or says that he/she does not know the answer

Page 1 of 3

I’m going to ask you a series of questions. Please answer them to the best of your ability. Discontinue: After 3 consecutive scores of 0

INF3 What is a thermometer used for? (Temperature) 0 1 _____________________________________________________ INF6 What is the imaginary line that divides the Earth into 0 1 northern and southern halves? (Equator) _____________________________________________________ INF8 Who wrote Hamlet? (Shakespeare) 0 1 _____________________________________________________ INF9 On what continent is Brazil? (South America) 0 1 _____________________________________________________ INF11 Who was the Prime Minister of England during the 0 1 Second World War? (Churchill) _____________________________________________________ INF13 What is the capital of Italy? (Rome) 0 1 _____________________________________________________ INF15 Whose name is usually associated with the theory of 0 1

Incorrect Correct (0) (1)

relativity? (Einstein) _____________________________________________________ Discontinue: After 3 consecutive scores of 0

Page 2 of 3 Source: WAIS-IV 2008

Page 3 of 3 Source: WAIS-IV 2008

INF17 At what temperature does water boil? (212F, 100C, 373K) 0 1 _____________________________________________________ INF19 Tell me the names of three types of blood vessels in the 0 1 human body. (Arteries, veins, capillaries, arterioles, venules) _____________________________________________________ INF21 What is the largest organ of the human body? (Skin) 0 1 _____________________________________________________ INF23 Who created the character Sherlock Holmes? 0 1 (Sir Arthur Conan Doyle) _____________________________________________________ INF25 Who wrote Alice in Wonderland? (Lewis Carroll) 0 1 _____________________________________________________ Ok, great job!

Module No

5 0 8

Incorrect Correct (0) (1)

May 24, 2010 1

BALANCE TEST SNUM We are going to do a quick test of your balance. Show card (balance1) Interviewer ID I’m going to ask you to stand on one leg with your eyes shut. I will be timing you to see how long you can maintain your balance, without moving your arms or putting your foot down, for up to 30 seconds. You’ll have 3 tries to do this. You’ll have this chair in front of you to grasp if you feel like you are about to fall.

Please remove your shoes and stand on this square.

Now, holding your arms across your chest, raise one foot off the floor and try to balance. Go ahead and practice balancing 5-10 seconds on each leg.

Ok, choose your favourite leg and raise the other foot off the floor; find your balance and then close your eyes. I’ll start the timer when you close your eyes. Your goal is to maintain your balance for 30 seconds without moving your arms or putting your foot down or opening your eyes. We’ll have you try this 3 times.

Start stop watch when they are balanced with eyes closed. Stop the watch if they, open eyes, move arms, or put their foot down. Wait 30 seconds and then have them try again. Repeat for up to 3 times. (if they make 30’ in first or second trial enter “30” for remaining trials).

Record time for each trial. (Max equals 30).

. BAL1. a. Trial 1 _____________

b. Trial 2 _____________

c. Trial 3 _____________

Module No 8 0 0