highly concrete manner. Some of the more com-
monly used tests to assess abstract reasoning abilities
include the Similarities subtest of the WAIS-IV (see
Chapter 7) and the Wisconsin Card Sorting Test, or
WCST (Heaton, 1981). The Similarities subtest
requires the patient to produce a description of
how two objects are alike. The WCST consists of
decks of cards that differ according to the shapes
imprinted, the colors of the shapes, and the number
of shapes on each card (see Figure 18-3). The patient
is asked to place each card under the appropriate
stimulus card according to a principle (same color,
same shapes, same number of shapes) deduced from
the examiner’s feedback (“that’sright” or“that’s
wrong”). At various points during the test, the
examiner changes principles; this can only be
detected from the examiner’sfeedbackregarding
the correctness of the sorting of the next card.
Memory. Brain damage is often marked by mem-
ory loss. To test for such loss, Wechsler (1945) devel-
oped the Wechsler Memory Scale, or WMS. The
Wechsler Memory Scale-III, or WMS-IV (Wechsler,
2009), is the most recent revision of the WMS. The
WMS-IV was developed in conjunction with the
WAIS-IV because clinicians often measure intellectual
ability and memory concurrently. The WMS-IV is
comprised of seven subtests, and performance on the
WMS-IV is summarized using five index scores: Audi-
tory Memory, Visual Memory, Visual Working
Memory, Immediate Memory, and Delayed Memory.
In addition to interpretations based on single subscale
and single index scores, patterns of discrepancy
between index scores are also informative. These are
called contrast scores. For example, problems with
retention of previously learned material might be indi-
cated by relatively higher Immediate versus Delayed
Memory index scores. Another example that incorpo-
ratesintelligencetestscoresisapatternofscoresin
which relatively lower Visual Working Memory and
Immediate Memory index scores occur in the context
of relatively higher intelligence scores. This pattern
suggests that some impairment in attention is affecting
the patient’s ability to initially learn the material.
Two additional tests also assess memory loss. On
these tests, the patient must demonstrate spatial
perception and perceptual-motor coordination as
well as recall. The Benton Visual Retention Test
(Benton, 1963) is basically a test of memory for
designs. Ten cards are presented for 10 seconds each.
After a card is withdrawn, the patient must draw the
design from memory. There are several variants of this
procedure. Scoring instructions and some normative
data are available (e.g., Benton, 1974).RedGreen
YellowBlueF I G U R E 18-3 The Wisconsin Card Sorting Test
SOURCE: FromNeuropsychological Assessment, 3rd edition, by Muriel Deutsch Lezak, p. 621. Copyright © 1995 by Oxford University Press, Inc.
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