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Copyright © 2012, Emerald Group Publishing Limited
Brief Cognitive Status Exam
Article Type: Review From: The British Journal of Forensic Practice, Volume 14, Issue 3
Wechsler, Pearson Clinical Assessment, 2011, www.pearsonclinical.co.uk
This instrument is designed to swiftly determine general cognitive functioning in individuals aged 16-90 years. It has been designed as a quick screen of such cognitive ability, offering an overview as to an individual’s profile. It uses their age and educational level to determine their ability across the domains of average to very low cognitive ability. It is intended only as a brief screen for significant cognitive difficulties, and can be a helpful first step in determining this. It can be used to explore a number of clinical and research questions, such as suspected memory deficits, including dementia. It exams areas including a clients orientation to time, mental control and ability to inhibit a learned response. Whilst these are not undertaken in extensive depth, the instrument nonetheless offers a robust, initial and valuable analysis of such areas.
The user of this instrument is required to have training and experience in the administration and interpretation of other clinical instruments, with any interpretation being undertaken by those with appropriate raduate or professional training in assessment.
A key advantage of this instrument is its speed and ease of use. It takes up to 15 minutes to administer. Whilst designed only as a quick screen, it can be an effective way of determining if there is a need for further assessment, or if the results gained are sufficient to answer the question posed. For example, if the query is around general cognitive ability and the client is noted to fit in the average ranges, this can be helpful and may mean there is no need for further assessment. Alternatively, it may be helpful for those clients with considerable difficulty in sustaining attention and focus. Importantly this ensures a client’s time is used effectively, and not via more time-consuming instruments that may provide a similar result. It is also an easy instrument to score and interpret; although the scoring for sub-test “Clock Drawing” can take a little time to work through.
The examiners manual is clear to follow and neatly presented. It addresses a wide range of queries and considerations that a clinician may have when undertaking assessments of cognitive ability. I especially liked the clarity it offered in ensuring the administration conditions for the instrument remained constant, and how this may be achieved.
Outside of the administration and scoring considerations, this is an instrument that has been carefully and skilfully developed, with thorough and considered attention around issues of validity and reliability. As such, it presents as a robust instrument that can withstand appropriate scrutiny, providing it is used for the right clinical questions to which it was designed.
This instrument is never going to be a replacement for a detailed and extensive cognitive assessment; and neither does it profess to be. Yet, if your clinical or research question is around a brief assessment of general cognitive ability, then this may be an extremely effective method of answering this question, and ensuring a client or research participants time is used effectively. It allows helpful decision making as to whether there is a need to continue with further assessment or whether its findings suffice. I would definitely recommend this instrument to both clinicians and researchers.
Carol A. Ireland, CPsychol, MBAForensic Psychologist, Chartered Scientist, University of Central Lancashire and CCATS (Coastal Child and Adolescent Therapy Services), UK.