Treatment Improvement Protocol (TIP)
Treatment for Stimulant Use Disorders:
Methamphetamine & Cocaine - 1999
Treatment Improvement Protocol (TIP) Series 33
Center for Substance Abuse Treatment
Appendix C --Screening Tests for Cognitive Impairments
The following list provides a number of tests that can be used to screen for cognitive impairments in stimulant users. The first two can generally be administered by counselors who are culturally competent for their client population. The other six tests should be administered and interpreted by a psychological testing specialist.
These tests can be administered quickly and easily and are used extensively in batteries created by neuro- and cognitive psychologists. Although the tests are very sensitive in revealing the existence of cognitive problems, particularly when several of the tests are administered in combination, they do not provide information on the exact nature or depth of the impairment. Positive screens should be referred to an appropriate collaborator (e.g., a neuropsychologist) for more extensive assessments.
Cognistat (Neurobehavioral Cognitive Status Examination)
This test is designed to assess intellectual functioning in five areas in adults 18 years of age and older. Administration of the test takes about 10 minutes for cognitively intact individuals and from 20 to 30 minutes for those who are cognitively impaired. Cognistat is available from:
Psychological Assessment Resources, Inc.
P.O. Box 998
Odessa, FL 33556
1-800-331-TEST
Brief Neuropsychological Cognitive Examination (BNCE)
This test is designed to evaluate the cognitive status of clients with psychiatric disorders or psychiatric manifestations of neurological disease. The reading level required for the test is minimal, and it is recommended for assessing mood disorders and substance use disorders. Both adolescents and adults can be tested in about 30 minutes. The BNCE is available from:
Western Psychological Services
12031 Wilshire Boulevard
Los Angeles, CA 90025-1251
1-800-648-8857
Backward Digital Span
This test is simply saying numbers at the rate of one per second and asking the client to repeat them backwards. For example, you might say "3, 8, 6" and would expect a response of "6, 8, 3." The examiner starts with three digits and goes up to nine digits. Three different number strings are presented at each level. If the client misses all three at a particular level, then the test is stopped. This test takes about 5 minutes to administer. It is a test of working memory capacity.
FAS Test of Verbal Fluency
The client is asked to say as many words (excluding proper names) that start with the letter F as she can in 1 minute. This is then repeated with the letter A, and again with the letter S.
Digit Symbol Subtest of the WAIS-R
This test taps the same thing as the Symbol Digit Modalities Test (i.e., the ability to manipulate simple information and pay attention). It is part of the revised Wechsler Adult Intelligence Scale (WAIS-R) and can be obtained from:
The Psychological Corporation
Harcourt Brace & Co.
15 East 26th Street
15th Floor
New York, NY 10010-1505
1-800-211-8378
Trail Making Test, Parts A and B
This test is very sensitive to brain function, is essentially connecting the dots, and takes about 5 minutes for both parts. The citation for the test is as follows:
Reitan, R.M. Validity of the trail making test as an indication of organic brain damage. Perceptual and Motor Skills 8:271-276, 1958.
Stroop Color Word Interference Test
Many versions of this test exist. It taps selective attention and the ability to ignore irrelevant information. A version can be obtained from either of the testing companies listed above.
Shipley-Hartford Tests of Vocabulary And Abstract Thinking
This is a short-form IQ test that takes a maximum of 20 minutes to administer. It is old but still widely used--particularly in the aging literature. The citation for the test is as follows:
Shipley, W.C. A self-administering scale for measuring intellectual impairment and deterioration. Journal of Psychology 9:371-377, 1940.
Repeated Memory Test (RMT)
The RMT, which was developed by Sara L. Simon, Ph.D., has five different versions, each equivalent in word frequency and length. Because the test is so simple, giving it multiple times does not seem to involve a learning curve. Each test consists of 25 words each printed 3/4 inches high on a 3-inch x 5-inch card.
The client is first told that she will be shown some words and that she will be asked to remember them. Then the words are presented to the subject, one at a time for 1 second each. When the client has seen all of the cards, there is an approximately 10-minute interval filled with distracter tasks. During this interval, other tests--such as the Digit Symbol, Trail Making A, and Trail Making B tests--may be administered.
The client is then given the recall test and told to write down any words that she remembers. The client is allowed as much time as she needs to complete the test. However, if 2 minutes have gone by without the client responding, suggest that she stop because no one remembers them all.
Next the client is given the recognition test and asked to circle the words that she remembers being shown.
A copy of the test follows, but for further information on the RMT, contact
Sara L. Simon, Ph.D.
Los Angeles Addiction Treatment Consortium
1001 W. Carson St., Suite U.
Torrance, CA 90502
310-224-4670
310-782-9140 (fax)
Scoring:
The recall test has two measures.
1. Number correct
2. Number of false positives (items remembered but not shown)
The recognition test has two measures.
1. Number correct
2. Number of false positives (items remembered but not shown)
A large number of false positives suggests that the patient was guessing and probably is having memory problems.
Test 1 Words
SAW SALTSHAKER
OWL ANCHOR
TIE MONKEY
CAP CANNON
KITE SWEATER
NAIL BICYCLE
PLUG OSTRICH
DEER THIMBLE
CHAIR AIRPLANE
TRAIN CIGARETTE
STOVE WATERMELON
CIGAR GARBAGE CAN
GLOVE
Recognition Test 1
Circle any items that were shown to you today during the testing session.
BASEBALL BAT FOOTBALL OSTRICH
CLOWN MITTEN SALTSHAKER
DESK BICYCLE RUG
BROOM WATERMELON CHICKEN
CHAIR OWL ROOSTER
BUS DEER GLOVE
TRAIN PIPE ANCHOR
WINDOW SWEATER GRAPES
SAW BELT STOVE
ENVELOPE NAIL IRON
KITE CANNON MONKEY
THIMBLE GARBAGE CAN CIGAR
TREE GRASSHOPPER AIRPLANE
MOON KANGAROO TIE
LEG BREAD CIGARETTE
PLUG COAT CAP
CLOCK MUSHROOM COW
Test 2 Words
RING CHURCH
ANT BEETLE
CAT BLOUSE
POT WRENCH
CARROT PEPPER
CORN GORILLA
STAR PEACOCK
LION UMBRELLA
LAMP SUITCASE
BEAR ACCORDION
PEACH TENNIS RACKET
COUCH CLOTHESPIN
CHAIN
Recognition Test 2
Circle any items that were shown to you today during the testing session.
ACCORDION PEACH TOOTHBRUSH
BEETLE PEPPER CARROT
JACKET EAGLE LETTUCE
HANGER CAMEL BEAR
RACCOON WRENCH PLIERS
ROLLING PIN POT RABBIT
TENNIS RACKET FENCE CHAIN
GORILLA ARM PEACOCK
UMBRELLA SKIRT SAILBOAT
MOTORCYCLE CAR LAMP
CUP ANT GIRAFFE
SWING SUITCASE TELEPHONE
FOOT LION FOX
CORN CLOTHESPIN BLOUSE
CAT LEAF CHURCH
STAR SOCK RING
DRESSER CONCH SHOE
Test 3 Words
TOP WATCH
PIG PENCIL
EAR BARREL
LIPS BASKET
REFRIGERATOR DONKEY
FISH TRUMPET
PAINTBRUSH PENGUIN
SHOE CHISEL
SWAN SCISSORS
HORSE SNOWMAN
RULER ALLIGATOR
CROWN ARTICHOKE
ONION
Recognition Test 3
Circle any items that were shown to you today during the testing session.
DOORKNOB REFRIGERATOR ALLIGATOR
TOMATO BARN ARTICHOKE
WATCH CELERY HELICOPTER
CHISEL PANTS PENGUIN
POTATO TRUMPET TABLE
KETTLE SHEEP SCISSORS
ASPARAGUS PENCIL SNOWMAN
FINGER HORSE WINDMILL
SLED HAT SHOE
CROWN LOBSTER BARREL
SWAN WINEGLASS DONKEY
POCKETBOOK NUT BASKET
BALL RULER DOG
KEY FORK PAINTBRUSH
DOLL PEANUT LIPS
PIG EAR ONION
TOP FISH BOAT
Test 4 Words
BED PIANO
TOE BOTTLE
COW GUITAR
BOOK SPIDER
GOAT LEOPARD
WHEEL PITCHER
BELL BALLOON
FLAG SEA HORSE
DRESS RHINOCEROS
STOOL BUTTERFLY
SNAIL LIGHT SWITCH
MOUSE TOASTER
THUMB
Recognition Test 4
Circle any items that were shown to you today during the testing session.
PITCHER LIGHT SWITCH TOE
BUTTERFLY VIOLIN GUITAR
LADDER ASHTRAY CAKE
PUMPKIN SNAIL BOWL
SCREWDRIVER SEA HORSE CANDLE
APPLE BOOK HAMMER
BOTTLE IRONING BOARD THUMB
TOASTER DRESS ROLLERSKATE
BANANA FLAG AXE
SPOON LIGHTBULB BALLOON
LEOPARD KNIFE PIANO
SPIDER HEART RHINOCEROS
HAIR MOUSE BIRD
WHEEL BOW TIGER
STOOL SHIRT BED
SUN BELL GOAT
Test 5 Words
EYE WAGON
BEE COMB
FLY CHERRY
GUN ORANGE
HARP FLOWER
DUCK WHISTLE
LOCK FRYING PAN
LEMON SANDWICH
BRUSH NECKLACE
BUTTON PINEAPPLE
ARROW TELEVISION
SCREW CATERPILLAR
GLASS
REcognition Test 5
Circle any items that were shown to you today during the testing session.
COMB NAIL FILE PINEAPPLE
ORANGE EYE TURTLE
SANDWICH MOUNTAIN WHISTLE
FROG WAGON SCREW
TELEVISION HARP BOOT
GLASS PEN TRAFFIC LIGHT
CHERRY CATERPILLAR GLASSES
FLOWER NEEDLE NOSE
ROCKING CHAIR SNAKE SQUIRREL
TRUCK BUTTON STRAWBERRY
LEMON FRYING PAN PEAR
BEE VEST FLUTE
SKUNK GUN BRUSH
SEAL ELEPHANT DUCK
CLOUD FLY BOX
NECKLACE ARROW LOCK
DOOR VASE SOFA
Name __________________________________________ Date ___________________
Recall Test for Words
Please write down all of the test words that you remember below:
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