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Neuropsychological Assessment: Past and Future

  • Kaitlin B. Casaletto (a1) and Robert K. Heaton (a2)


Neuropsychological assessment tools are the staple of our field. The development of standardized metrics sensitive to brain-behavior relationships has shaped the neuropsychological questions we can ask, our understanding of discrete brain functions, and has informed the detection and treatment of neurological disorders. We identify key turning points and innovations in neuropsychological assessment over the past 40–50 years that highlight how the tools used in common practice today came to be. Also selected for emphasis are several exciting lines of research and novel approaches that are underway to further probe and characterize brain functions to enhance diagnostic and treatment outcomes. We provide a brief historical review of different clinical neuropsychological assessment approaches (Lurian, Flexible and Fixed Batteries, Boston Process Approach) and critical developments that have influenced their interpretation (normative standards, cultural considerations, longitudinal change, common metric batteries, and translational assessment constructs). Lastly, we discuss growing trends in assessment including technological advances, efforts to integrate neuropsychology across disciplines (e.g., primary care), and changes in neuropsychological assessment infrastructure. Neuropsychological assessment has undergone massive growth in the past several decades. Nonetheless, there remain many unanswered questions and future challenges to better support measurement tools and translate assessment findings into meaningful recommendations and treatments. As technology and our understanding of brain function advance, efforts to support infrastructure for both traditional and novel assessment approaches and integration of complementary brain assessment tools from other disciplines will be integral to inform brain health treatments and promote the growth of our field. (JINS, 2017, 23, 778–790)


Corresponding author

Correspondence and reprint requests to: Kaitlin B. Casaletto, Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158. E-mail:


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Woods, S.P., Dawson, M.S., Weber, E., Gibson, S., Grant, I., Atkinson, J.H., & HIV Neurobehavioral Research Center Group. (2009). Timing is everything: Antiretroviral nonadherence is associated with impairment in time-based prospective memory. Journal of the International Neuropsychological Society, 15(1), 4252. doi: 10.1017/S1355617708090012
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Woods, S.P., Iudicello, J.E., Morgan, E.E., Cameron, M.V., Doyle, K.L., Smith, T.V., & HIV Neurobehavioral Research Center Group. (2016). Health-related everyday functioning in the internet age: HIV-associated neurocognitive disorders disrupt online pharmacy and health chart navigation skills. Archives of Clinical Neuropsychology, 31(2), 176185. doi: 10.1093/arclin/acv090
Woods, S.P., Morgan, E.E., Dawson, M., Scott, J.C., & Grant, I., HIV Neurobehavioral Research Center Group. (2006). Action (verb) fluency predicts dependence in instrumental activities of daily living in persons infected with HIV-1. Journal of Clinical and Experimental Neuropsychology, 28(6), 10301042. doi: 10.1080/13803390500350985
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Woods, S.P., Iudicello, J.E., Morgan, E.E., Verduzco, M., Smith, T.V., & Cushman, C., HIV Neurobehavioral Research Center Group. (In press). Household everyday functioning in the Internet age: Online shopping and banking skills are affected in HIV-associated neurocognitive disorders. Journal of the International Neuropsychological Society.
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