Neuropsychological assessment difficulties associated with "hard-to-assess" individuals: a retrospective review

This paper presents the first phase of a wider research programme examining neuropsychological assessment as it applies to individuals with physical and sensory disabilities to such a degree as to make them "hard-to-assess" (HTA). The aim of this paper was to investigate the extent to which physical and sensory disabilities interfered with the neuropsychological assessments of individuals referred following traumatic brain injury. A retrospective review of 288 individuals with brain injury revealed 22 who met the criteria for being HTA on the basis of physical or sensory disabilities. The modifications necessary to standard techniques for assessment of these individuals, and the domains in which assessment was difficult or impossible are discussed. Most HTA were individuals who had impairment in two or three of the visual, motor and speech domains.