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Q2. Present an overview of tests measuring conceptual thinking.

Tests of conceptual thinking differ from most other mental tests in that they focus on the quality or process of thinking more than the content of the response. Many of these tests have no ‘right’ or ‘wrong’ answers. Their scores stand for qualitative judgements of the extent to which the response was abstract or concrete, complex or simple, apt or irrelevant. Tests with right and wrong answers belong in the category of tests of abstract conceptualization to the extent that they provide information about how the patient thinks.

Patients with moderate to severe focal or multiple lesions or with significant diffuse injury tend to do poorly on all tests of abstract thinking, regardless of their mode of presentation or channel of response. However, patients with mild, modality specific, or subtle organic defects may not engage in concrete thinking generally, but only on those tasks that directly involve an impaired modality, are highly complex, or touch upon emotionally arousing matters.

The major conceptual thinking tests are as follows:

  1. Tests in Verbal formats:
    1. Proverbs: They require the subject to translate a concrete statement into its abstract, metaphorical meaning. The Gorham’s proverbs test, Luria’s tests, Wechsler tests, the L-M edition of the Stanford-Binet scales, and Mental Status Examinations include proverb interpretation items.
    2. Analogies: Verbal analogies involve comparison between two subjects or concepts based on their relations (ex. similarities). Example: The Raven Progressive Matrices Test contains analogy items, even though they use pictorial matter.
  2. Assessment in Visual formats/pattern recognition:
    1. Halstead Category Test: In this, 208 pictures consisting of geometric figures are presented. For each picture, individuals are asked to decide whether they are reminded of the number 1, 2, 3, or 4. They press a key that corresponds to their number of choice. If they chose correctly, a chime sounds. If they chose incorrectly, a buzzer sounds. The pictures are presented in seven subtests.
    2. Raven’s Progressive Matrices, Raven’s Coloured Progressive Matrices (RCPM) and Advanced Progressive Matrices: RPM is a 60 item test used in measuring abstract reasoning and regarded as a non-verbal estimate of fluid intelligence. The format is designed to measure the test taker’s reasoning ability, the eductive component of Spearman’s g. RCPM and APM are variants of RPM. RCPM is designed for children, elderly and mentally and physically impaired individuals. APM is designed for adults and adolescents of above average intelligence.
    3. Symbol patterns: Deductive reasoning combines with ability for conceptual sequencing in symbol pattern tests. Ex: Thurstone’s Reasoning Tests in Primary Mental Abilities battery.
      1. Abstraction subtest of Shipley institute of Living Scale: A series of 20 sequential completion items comprises the test. They include variations on word meanings and constructions, and number and letter patterns. 
  3. Sorting and other similar tests: Subject must sort collections of objects, blocks, tokens or other kinds of items into subgroups following instructions. Most sorting tests assess the ability to shift concepts as well as the ability to use them.
    1. Kasanin-Hanfmann Concept Formation Test (Vygotsky Test): Purpose is to “evaluate an individual’s ability to solve problems by the use of abstract concepts and provide information both on the subject’s level of abstract thinking and his preferred type of approach to problems.
    2. Modified Vygotsky Concept Formation Test: Divides the above into two parts – convergent thinking test and divergent thinking test and introduces a shifting request.
    3. Card sorting: This test uses two sets of 32 3X5 cards with a word printed on each card. Four cards from each of eight categories make up one set; the second set consists random words. The subject is simply asked to group the shuffled cards. Performance is evaluated on the basis of the number and appropriateness of the sorts.
    4. Object Sorting Test (Goldstein and Scheerer): Its design to measure “abstract attitude” is based on the same principles as the block and token sorting tests and generally follows the same administration procedures.
    5. Sorting Test (ST) (Delis, Kaplan and Kramer): It was designed to provide separate measures of initiation, concept formation, problem solving, cognitive flexibility, perseverative responding, and regulation
    6. Wisconsin card sorting test: This test begins with color as the basis of sorting, shifts to form, then to number, returns again to color, and so on.
    7. Modified Card Sorting Test (MCST): This modification of the WCST eliminates all cards from the pack that share more than one attribute with a stimulus card.
    8. Colour Sorting Tests: The subject is asked to select as skein of her or his preference, and to pick out the other skeins that can be grouped with it.
    9. Twenty Questions Task: The subject in this test has to self initiate sorting strategies– strategies for narrowing the possibilities to arrive at the correct answer.
  4. Arithmetic and Estimation assessment:
    1. Arithmetic story problems: Luria used arithmetic problems of increasing difficulty to examine reasoning abilities. These problems do not involve much mathematical skill. They implicitly require the subject to make comparisons between elements of the problem, and they contain intermediate operations that are not specified.
    2. Block counting (Cube analysis/Cube counting): The subject must count the total number of blocks in each pile by taking into account the ones hidden from view. 
    3. Estimations: Estimations of sizes, quantities, etc. test patients’ ability to apply what they know, to compare, to make mental projections and to evaluate conclusions. Examples include the set of Cognitive Estimation questions by Shelly and Evan.
  5. Practical Strategy Tasks and other methods:
    1. Practical strategy Tasks: Participant forms a strategy to perform a task in a optimally effective and successful way. Ex: Multiple errands test and Modified Six Elements Test.
    2. Calculations: These tests give the patients an opportunity to demonstrate that they recognize the basic arithmetic symbols and can use them to calculate problems mentally and on paper. Examples include arithmetic subtest of the Wide Range Achievement Test (WRAT), Calculations of the Woodcock Johnson III Tests of Achievement and Graded Difficulty Arithmetic Test (GDA).
    3. Generalisation: When the same response is made to a continuum of stimuli.
    4. Equivalence Range: Assess an individual’s tolerance for variability in stimulus characteristics within some category.

* * * 

The tests for assessing the conceptual thinking form an important part of the neuropsychological tests. They are of various types viz. tests in verbal formats, visual formats/pattern recognition, sorting and similar tests, arithmetic and estimation assessment and practical strategy tasks. The prominent ones are analogies and proverb tests, performance tests, colour sorting tests, Halstead category test and Wisconsin card sort test, the Haufmann Kasanin Concept Formation Test and the Twenty Questions task.


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