from Section I - Theory and models
Published online by Cambridge University Press: 07 May 2010
Introduction
Neuropsychological assessment has the ability to detect a variety of brain-based pathologies and their impact on cognitive and behavioral functioning across the lifespan. Yet, despite this capability, it has become increasingly clear that neuropsychological assessments are not a pure measure of an individual's abilities, nor do they directly or specifically demonstrate brain–behavior interactions. Rather, research has indicated that many facets of an individual's cultural background impact the assessment procedure and its interpretation. In response, it has become increasingly important to understand the effects cultural and environmental factors have on the practice of neuropsychological assessment and diagnosis. Without an understanding of the unique contribution of culture and environment to a patient's performance on tests, neuropsychologists may risk misdiagnosis as well as fail to notice important opportunities to engage the patient and family in the eventual rehabilitative or treatment process.
The importance of understanding the role of culture in assessment and treatment of neurological issues has been very well highlighted in the last decade. As one example, Anne Fadiman, in her book The Spirit Catches You and You Fall Down, writes about a young girl born into a family of Hmong refugees from Laos living in Merced, California [1]. The author discusses the treatment of and eventual tragedy that results when this young Hmong girl, Lia, is diagnosed with epilepsy, by emphasizing the interweaving role that culture plays in the diagnostic and treatment process.
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