Clinical-actuarial detection and description of brain impairment with the W-B form I

Assessed the clinical utility of four cross-validated discriminant functions derived on Wechsler-Bellevue (W-B) variables (Leli & Filskov, 1981) through a clinical-actuarial prediction paradigm. These functions were constructed to be actuarial indices of the presence, chronicity, extent, and lateralization of brain impairment. From W-B and demographic data gathered on brain-impaired and nonimpaired individuals, 6 students and 6 clinicians were asked to identify the presence and describe the nature of brain impairment with (Clinical-Actuarial condition) and without (Clinical Judgment condition) the four functions. Relative to the Clinical Judgment condition, Clinical-actuarial prediction was significantly better in identifying and determining the extent of brain impairment. Actuarial classification was significantly more superior in lateralizing deficits than were the other conditions. In both judgment conditions, students and clinicians did not differ significantly in classification accuracy. These results indicate that with actuarial indices, the adult Wechsler scales can be used accurately to identify and lateralize brain impairment.