DEVELOPMENT OF A COMPUTER-BASED BATTERY DESIGNED TO SCREEN ADULTS FORNEUROPSYCHOLOGICAL IMPAIRMENT

The initial step in the development of a new computer-based neuropsych ological testing system is described. A new hardware-software system a nd a screening battery consisting of an orientation task and five cogn itive tests has been implemented. This novel screening battery is desi gned for use in identifying individuals among exposed groups who may r equire more extensive follow-up neuropsychological evaluation. Sophist icated, but currently available, and relatively inexpensive hardware a nd software technology are employed, introducing an improvement over e xisting computer-based batteries. Use of a digitized speech production device for producing instructions facilitates testing of illiterate s ubjects, use of auditory stimulus materials, and relatively easy trans lation of the testing instructions to other languages. Use of a pen-ba sed notebook computer enables responding by the subject in a manner th at is both natural and analogous to that used in existing paper-and-pe ncil testing instruments. Five neuropsychological tests were developed to cover a range of cognitive domains: 1) verbal list learning and re cognition memory, 2) visual memory span, 3) conceptual and motor track ing, 4) psychomotor speed and accuracy, and 5) delayed verbal recognit ion. The screening instrument has been pilot-tested for feasibility of use among outpatients at an occupational medicine clinic and among co mmunity-dwelling older adults. This instrument is intended to provide a standardized, efficient, cost-effective method for widespread use in occupational medicine and public health to detect and track subclinic al neurotoxic effects and to prevent additional harmful exposures. Add itional aspects of development of the computer-based testing system ar e discussed.