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The Memory Assessment Scales (MAS): A new clinical memory battery
234
Abstracts of 10th Annual Meeting
Developmental Efiects of Executive Function Disturbances following Traumatic Brain Injury in Middle Childhood: Case Studies of Two Gifted Children. Follow-up studies were conducted on two boys injured at 8 and 11 years of age. Both children had been identified as academically gifted prior to injury (IQ and Achievement test scores > 130). Both children demonstrated self-regulatory deficits characteristic of executive function compromise, including impulsivity, distractibility, inappropriate social behaviors, and lack of insight into deficits. Results of serial neuropsychological testing showed substantial recovery of intellectual and academic skills at one year post injury. Subsequent periodic follow-up testing over 8.0 and 3.5 years, respectively, showed age-appropriate growth of those abilities usually considered “fluid”, with absence of growth in some “crystallized” abilities. These findings are generally contrary to conventional wisdom and suggest modification of criteria for prediction of recovery and for treatment planning.
50. Williams, J. M., Gillard, E., 81 Coleman, R. Hahnemann University School of Medicine The Recovery of Memory Function During the Acute Recovery Period Following Traumatic Brain Injury. This study reports findings from a neuropsychological tracking protocol utilized in a trauma center to continuously monitor cognitive function as the patients emerged from coma. Following admission to the trauma center, 137 patients who sustained closed head injury were systematically administered orientation and memory tests as they recovered from the brain injury. Each was administered the Hahnemann Orientation and Memory Examination (HOME) and the Memory Screening l&t of the Memory Assessment Scales. These instruments assess orientation to person, place and time, duration of retrograde amnesia and duration and severity of post-traumatic anterograde amnesia. Results suggest a highly characteristic pattern in the recovery of orientation. Personal orientation recovers first, followed by place, and then time orientation. The recovery of orientation closely follows the recovery of anterograde amnesia and the construct independence of anterograde amnesia and retrieval of old, well-learned information. Essentially, personal information is well-learned and more resistant to the effects of injury. Place and time information periodically changes and must be relearned. Patients with anterograde amnesia cannot relearn this information and remain disoriented to place and time. The patients become oriented to place and time once memory function recovers sufficiently to allow for the consolidation of this new information. In general, recovery of orientation and memory ability was strongly related to injury severity, as measured by coma level and duration. Coma level and duration predicted approximately 65% of the variance in memory scores (R = .Sl).
51. Williams, J. M., Williams, K., & Gillard, E. Hahncmann University S&ool of MeaBk%-P
Session 2
235
The Memory Assessment Scales (MAS): A New Clinical Memory Battery.
This study presents normative validity and reliability studies for a new memory test battery intended for clinical use. The MAS consists of verbal list learning and prose memory sections, visual-spatial recall and recognition and immediate recall procedures in both verbal and visual spatial domains. It even includes a name-faces memory procedure. Normative studies were conducted using 846 community volunteers across the age range and education levels conforming to the U.S. Census figures and estimates for population distribution. Validity studies were conducted with 35 patients who sustained traumatic brain injury, 31 patients with dementia-related illness, 15 patients with brain lesions lateralized to the left hemisphere and 20 patients with right hemisphere lesions. Findings from normative comparisons strongly indicate age and education effects on memory test performance. There was a precipitous decline of memory function after age 50, and subjects with less than 12 years of education performed significantly worse than subjects with higher education levels. Reliability estimates, including internal consistency and stability measures were all within the range of .7 to .92. Validity comparisons revealed that demented patients performed worse, followed by trauma patients and patients with lateralized lesions. Finally, lateralized lesions produced predicted effects on memory tests. Dominant hemisphere lesions produced relative impairment on verbal tests: non-dominant hemisphere lesions resulted in visual-spatial memory impairment. In general, these findings strongly support the clinical utility of the MAS for use in neuropsychological assessment settings. 52. Williams, K. S. & Horn, L. J. Magee Rehabilitation
Hospital
Reduplicative Paramnesia following Severe Traumatic Brain Injuty
Reduplicative paramnesia is a syndrome of focal disorientation to place. Patients with this syndrome are able to remember the name of the hospital they are in but consistently mislocate it to a place that has been significant earlier in their lives. They will continue to do this even in the face of compelling counter evidence. We report on a case of reduplicative paramnesia which is of particular interest due to the nature of the reduplication and the effects of various forms of psychopharmacological treatment. A 21 year old male college student fell out of the back of a pick-up truck and sustained an occipital skull fracture and multiple hemorrhagic contusions in the frontal lobes. Coma duration was 14 days with PTA for an additional four months. A consistent disorientation to place occurred after the patient was transferred from his acute care hospital to Magee Rehabilitation Hospital. The patient believed he was in “Magee Hall” which he stated was a building on the campus of American University where he attended college in the past. This aspect of the reduplication syndrome is unique in that previously reported cases in the literature have reduplicated to other familiar hospitals, not to other types of settings. In addition to cognitive and physical rehabilitation, psychopharmacological treatment was initiated to increase attention and arousal and attempt to improve
Abstracts of 10th Annual Meeting
Developmental Efiects of Executive Function Disturbances following Traumatic Brain Injury in Middle Childhood: Case Studies of Two Gifted Children. Follow-up studies were conducted on two boys injured at 8 and 11 years of age. Both children had been identified as academically gifted prior to injury (IQ and Achievement test scores > 130). Both children demonstrated self-regulatory deficits characteristic of executive function compromise, including impulsivity, distractibility, inappropriate social behaviors, and lack of insight into deficits. Results of serial neuropsychological testing showed substantial recovery of intellectual and academic skills at one year post injury. Subsequent periodic follow-up testing over 8.0 and 3.5 years, respectively, showed age-appropriate growth of those abilities usually considered “fluid”, with absence of growth in some “crystallized” abilities. These findings are generally contrary to conventional wisdom and suggest modification of criteria for prediction of recovery and for treatment planning.
50. Williams, J. M., Gillard, E., 81 Coleman, R. Hahnemann University School of Medicine The Recovery of Memory Function During the Acute Recovery Period Following Traumatic Brain Injury. This study reports findings from a neuropsychological tracking protocol utilized in a trauma center to continuously monitor cognitive function as the patients emerged from coma. Following admission to the trauma center, 137 patients who sustained closed head injury were systematically administered orientation and memory tests as they recovered from the brain injury. Each was administered the Hahnemann Orientation and Memory Examination (HOME) and the Memory Screening l&t of the Memory Assessment Scales. These instruments assess orientation to person, place and time, duration of retrograde amnesia and duration and severity of post-traumatic anterograde amnesia. Results suggest a highly characteristic pattern in the recovery of orientation. Personal orientation recovers first, followed by place, and then time orientation. The recovery of orientation closely follows the recovery of anterograde amnesia and the construct independence of anterograde amnesia and retrieval of old, well-learned information. Essentially, personal information is well-learned and more resistant to the effects of injury. Place and time information periodically changes and must be relearned. Patients with anterograde amnesia cannot relearn this information and remain disoriented to place and time. The patients become oriented to place and time once memory function recovers sufficiently to allow for the consolidation of this new information. In general, recovery of orientation and memory ability was strongly related to injury severity, as measured by coma level and duration. Coma level and duration predicted approximately 65% of the variance in memory scores (R = .Sl).
51. Williams, J. M., Williams, K., & Gillard, E. Hahncmann University S&ool of MeaBk%-P
Session 2
235
The Memory Assessment Scales (MAS): A New Clinical Memory Battery.
This study presents normative validity and reliability studies for a new memory test battery intended for clinical use. The MAS consists of verbal list learning and prose memory sections, visual-spatial recall and recognition and immediate recall procedures in both verbal and visual spatial domains. It even includes a name-faces memory procedure. Normative studies were conducted using 846 community volunteers across the age range and education levels conforming to the U.S. Census figures and estimates for population distribution. Validity studies were conducted with 35 patients who sustained traumatic brain injury, 31 patients with dementia-related illness, 15 patients with brain lesions lateralized to the left hemisphere and 20 patients with right hemisphere lesions. Findings from normative comparisons strongly indicate age and education effects on memory test performance. There was a precipitous decline of memory function after age 50, and subjects with less than 12 years of education performed significantly worse than subjects with higher education levels. Reliability estimates, including internal consistency and stability measures were all within the range of .7 to .92. Validity comparisons revealed that demented patients performed worse, followed by trauma patients and patients with lateralized lesions. Finally, lateralized lesions produced predicted effects on memory tests. Dominant hemisphere lesions produced relative impairment on verbal tests: non-dominant hemisphere lesions resulted in visual-spatial memory impairment. In general, these findings strongly support the clinical utility of the MAS for use in neuropsychological assessment settings. 52. Williams, K. S. & Horn, L. J. Magee Rehabilitation
Hospital
Reduplicative Paramnesia following Severe Traumatic Brain Injuty
Reduplicative paramnesia is a syndrome of focal disorientation to place. Patients with this syndrome are able to remember the name of the hospital they are in but consistently mislocate it to a place that has been significant earlier in their lives. They will continue to do this even in the face of compelling counter evidence. We report on a case of reduplicative paramnesia which is of particular interest due to the nature of the reduplication and the effects of various forms of psychopharmacological treatment. A 21 year old male college student fell out of the back of a pick-up truck and sustained an occipital skull fracture and multiple hemorrhagic contusions in the frontal lobes. Coma duration was 14 days with PTA for an additional four months. A consistent disorientation to place occurred after the patient was transferred from his acute care hospital to Magee Rehabilitation Hospital. The patient believed he was in “Magee Hall” which he stated was a building on the campus of American University where he attended college in the past. This aspect of the reduplication syndrome is unique in that previously reported cases in the literature have reduplicated to other familiar hospitals, not to other types of settings. In addition to cognitive and physical rehabilitation, psychopharmacological treatment was initiated to increase attention and arousal and attempt to improve