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SPECIALTY IN PSYCHOLOGY
Petition for recognition of a specialty in psychology submitted to the American Psychological Association by the American Board of Professional Neuropsychology.
Criterion I.Distinctiveness.
1. Title of new proficiency: Clinical Neuropsychology
2. Provide a brief description of the specialty.
Clinical Neuropsychology focuses on the clinical problems of assessment and treatment of disorders of higher cortical functions in humans. Clinical neuropsychology is based upon objective psychological tests that meet recognized psychometric standards of validity and reliability.
3. Detailed description of how this proposed specialty differs from and is similar to existing specialty practices.
a. Specific populations Clinical neuropsychology populations are generally those manifesting neurological disorders and brain syndromes. These include Alzheimer disease, memory disorder, traumatic brain injury, cerebral vascular disorder, epilepsy, Parkinson's disease and Huntington disease, among others. In addition, neuropsychological evaluations may be helpful in helping mental disorders such as attention deficit disorders, learning disabilities, mental retardation as well as infectious disorders such as AIDS/HIV in immunological disorders. specialty may overlap, While in some cases other psychological the defining aspect of the specialty of clinical neuropsychology is the focus upon the organic integrity of higher cortical structures.
b. Psychological, biological, or social problem
The specific problem addressed by clinical neuropsychology is that which emanates from an insult to the biological integrity of higher cortical structures in humans. That is to say that the particular problems involving clinical neuropsychology even though they may include psychological and social components are essentially due to a disordered condition of the cerebral cortex. Because of cognitive sensory-perceptual, motor and emotional deficits which result from brain impairment, there can be other vocational, social, personal, or organizational problems which develop. The essential element is the compromise of the organic integrity of
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the higher cortical structures.
C. Procedure and techniques
In clinical neuropsychology, although there is overlap often in terms of the assessment on intelligence, academic skills and personality with other disciplines, such as clinical and school psychology, nonetheless, there is an identifiable core of psychometric talents which have been specifically designed and validated for the assessment of brain behavior relationships. Perhaps the most common or popular of these are the Halstead-Reitan Neuropsychological test battery and related procedures and the Luria-Nebraska Neuropsychological Test Battery. Other test batteries do exist but the point is that these test batteries were specifically designed and validated for the differentiation of individuals with compromised higher cortical functioning from individuals without higher cortical functioning. These batteries are typically supplemented by other test procedures that assess other cognitive processes.
4. Theoretical and Scientific Knowledge required for the specialty and provide references.
The Theoretical and Scientific Knowledge required for the specialty concerns brain-behavior relationships and includes considerable portions of the human neurosciences and theories of hemispheric specialization, in addition, knowledge of psychometrics and measurement theory is important. References are available in 2 handbooks: Ph.D., The Neuropsvcholosv Handbook edited by Dandy Wedding, Arthur MacNeill Horton, Jr., Ed-D, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City,and the Handbook of Clinical Neuroosvcholosv edited by Susan Filskov and Thomas J. City in 1981, Boll published by Wiley in New York and the Handbook of Clinical Child Neuropsvcholosv edited by Cecil R.Reynolds and Elaine Fletcher-Janzen published by Plenum Publishing Corporation in New York City in 1989, all contain chapters dealing with theoretical and scientific issues in clinical neuropsychology.
5. Knowledge required in Seven Core Professional Practice Domains
a. Assessment
Knowledge of brain-behavior relation ships, neuropathology, abnormal psychology, tests and measurement and interviewing skills. References are available in 3 handbooks: The Neuroosvcholosv Handbook edited by Dandy Wedding, Ph.D., Jr., Ed-D, Arthur MacNeill Horton, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City, and the Handbook of Clinical Neuroosvcholosv edited by Susan Filskov and Thomas J. Boll published by Wiley in New York City in 1981, and the Handbook of Clinical Child Neuropsvcholosv edited by Cecil R. Reynolds and
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Elaine Fletcher-Janzen published by Plenum Publishing Corporation in New York City in 1989.
b. Intervention
Knowledge of brain-behavior relationships, behavio r therapy, family therapy, and, cognitive retraining. References are available in 3 handbooks: Ph.D., The Neuropsvolosv Handbook edited by Dandy Wedding, Arthur MacNeill Horton, Jr., Ed.D, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City, and the Handbook of Clinical Neuroosvcholosv edited by Susan Filskov and Thomas J. City in 1981. Boll published by Wiley in New York and the Handbook of Clinical Child Neuroosvcholosv edited by Cecil R. Reynolds and Elaine Fletcher-Janzen published by Plenum Publishing Corporation in New York City in 1989.
C. Consultation
Knowledge of brain-behavior relationships, organizational behavior, behavior modification, systems analysis. See Arthur MacNeill Horton, Jr., Ed.D. Consultins in child neuroosvcholosical and rehabilitation settinss. New York: Plenum. (in preparation).
d. Supervision.
Knowledge of brain-behavior relationships, training and credentialing behavior modification, theory. in neuropsychology, References and management are available in 3 handbooks: The Neuropsvcholosv Handbook edited by Dandy Wedding, Ph.D., Arthur MacNeill Horton, Jr., Ed.D, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City, and the Handbook of Clinical Neuropsvcholosv edited by Susan Filskov and Thomas J. Boll published by Wiley in New York City in 1981. and the Handbook of Clinical Child Neuropsycholosvgy edited by Cecil R. Reynolds and Elaine Fletcher-Janzen published by Plenum Publishing Corporation in New York City in 1989. Also, the TCN Guide to Professional Practice i n Clinica l Neuroosvcholosv edited by Kenneth M. Adams and Byron P. Rourke published by Swets & Zeitlinger in Amsterdam contains some relevant chapters.
e. Research and Inquiry
Knowledge of brain-behavior relationships, tests and measurements, neuropsychological
tests, research design and statistics. References are available in 3 handbooks:
The NeuroosvcholosV Handbook edited by Dandy Wedding, Ph.D., Jr., Ed.D,
Arthur MacNeill Horton, and Jeffrey Webster, Ph.D. in 1986 and published
by Springer Publishing company in New York City, and the Handbook of Clinical
Neuroosvcholosv edited by Susan Filskov and Thomas J. Boll published by
Wiley in New York City in 1981. and the Handbook of Clinical Child Neuropsvcholosv
edited by Cecil R. Reynolds and Elaine Fletcher-Janzen published by Plenum
Publishing Corporation
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in New York City in 1989.
f. Consumer Protection
Ethical principles of psychologists and practice guidelines as well as knowledge of brain-behavior relationships, behavior modification, tests measurement theory and neuropsychological tests. References are available in 3 handbooks: The Neuroosvcholoov Handbook edited by Dandy Wedding, Ph.D., Arthur MacNeill Horton, Jr., Ed.D, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City, and the Handbook of Clinical Neuroosvcholocrv edited by Susan Filskov and Thomas J. Boll published by Wiley in New York City in 1981. and the Handbook of Clinical Child Neuronsvcholocv edited by Cecil R. Reynolds and Elaine Fletcher-Janzen published by Plenum Publishing Corporation in New York City in 1989. In addition, the current APA version of the Ethics code and Ethics casebook are necessary.
g. Professional Development
Knowledge of brain-behavior relationships, professional practice issues, trends in the delivery of clinical neuropsychological services and continuing education issues. References are available in 3 handbooks: The Neuropsvcholosv Handbook edited by Dandy Wedding, Ph.D., Arthur MacNeill Horton, Jr., Ed.D, and Jeffrey Webster, Ph.D. in 1986 and published by Springer Publishing company in New York City, and the Handbook of Clinical Neuroosvcholosv edited by Susan Filskov and Thomas J. New York City in 1981. Boll published by Wiley in and the Handbook of Clinical Child Neuronsvcholosv edited by Cecil R. Reynolds and Elaine Fletcher- Janzen published by Plenum Publishing Corporation in New York City in 1989. Also, the TCN Guide to Professional Practice in Clinical Neuroosvcholosv edited by Kenneth M. Adams and Byron P. Rourke published by Swets & Zeitlinger in Amsterdam contains some relevant chapters.
6. Professional Practice Activities Associated with Seven Core Professional Practice Domains.
a. Assessment
This consists in verbally interacting with and observing a patient and having him or her respond to verbal requests and manipulate objects and material on command. The clinical neuropsychologist scores the test results and provides an interpretation to the patient and/or other interested parties in written and/or verbal formats.
b. Intervention
This consists of either verbally interacting in counseling or
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psychotherapy or arranging either special materials (i.e., cognitive retraining) by hand or computer or manipulating environmental contingencies to promote learning socially valuable skills or reinforcing more adaptive behavior.
C. Consultation
This consists of the clinical verbal interactions exchanging information between neuropsychologist and another professional, paraprofessional or relative/care giver of the patient for the benefit of the patient.
d. Supervision
This consists of monitoring and evaluation of the behavior and work products of another professional, paraprofessional or relative/care giver of the patient, by a clinical neuropsychologist, for the benefit of the patient.
e. Research and Inquiry
This consists of manipulating procedures, subjects and instruments for the purpose of producing new knowledge and insights in clinical neuropsychology. The research results are communicated to others by written and /or spoken means.
f. Consumer Protection
This consists of adjusting practice activities and procedures for the purpose of protecting the rights and interests of consumers of clinical neuropsychological services.
g. Professional Development
This consists of the clinical neuropsychologist maintaining and increasing his/her knowledge, skills and abilities in relevant professional practice domains.
Criterion II. Structures and Models of Education and Training in the Specialty
1. Characteristics of a typical sequence of training.
a. Courses Psychological Science: This would include specific knowledge in terms of abnormal psychology, life span developmental psychology, cognitive psychology, psychological measurement, human learning and memory, and physiological psychology, psychological measurement,
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individual differences and descriptive psychopathology would form psychological prerequisites for dealing with specific populations. Research courses should include elementary, and multivariate statistics as well as courses in experimental design and research practica.
Neurological Science: This would include functional neuroanatomy, clinical neurology with emphasis on neuropathology and neuroimaging as well as other specialized diagnostic or neural diagnostic techniques,and clinical psychopharmacology would be helpful. It is considered highly advisable that an individual wishing to develop a specialty in clinical neuropsychology obtain specific experience in a neurological (i.e. hospital/medical school) setting where the neurological aspects can be easily taught. These experiences in a neurological setting can be done through day to day contact with neurologists and neurosurgeons on bed rounds and in seminars.Actual instruction in neuropsychological assessment and treatment methods with brain damaged patients is best accomplished in clinical care settings that support postdoctoral training,residency/internships or continuing educationexperiences for doctoral level psychologists.
Teaching methods: This would include didactic -experience in academic settings,directive readings, experience on bed rounds in neurological settings, and also instructional readings, neuropathology rounds, neurology and neurosurgery grand rounds, observations of brain impaired individuals and supervised practice in clinical neuropsychological assessment dealing with patients with disorders with neurological functioning in a variety of settings.
Reading Materials: Ralph M. These would be volumes such as the series by Reitan and others which deal with specific aspects of neurologically impaired individuals or articles from such journals as Archives of Clinical Neuronsvcholosv The Clinical Neuronsvcholosist, Cortex, The Journal of Clinical and Experimental Neuropsychology Neuropsychology and Neuroosvcholosia as well as the Journal of Neuropsychiatry and Clinical Neurosciences and also major handbooks such as the Neuronsvcholosv Handbook (Springer) and the Handbook of Clinical Child Neuropsychology (Plenum).
Supervision: These activities would be required in educational experiences
are specifically focused on learning and assessment with respect to neuropsychological
test batteries, either fixed batteries or batteries developed for specific
purposes or in learning intervention techniques or research skills. While
some didactic instruction is necessary, this particular sort of task is
largely one of learning various procedures and as such is best done through
supervised experience. Most often this is done in a
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practicum situation where by the use of the procedure can be modeled and specific feedback can be given to the student. The specific learning objective, of course, is to that the student would be able to use the procedure or intervention in a reliable and valid manner.
Evaluation:Performance feedback can be accomplished by grades in particular courses and practicum experiences as well as comprehensive examinations,thesis and dissertation experiences and regular personal conferences with faculty advisors and internship and post-doctoral supervisors and presentations at seminars and professional meetings.
Research: Research activities should be integrated within the core of all didactic and clinical experiences. Students should be encouraged to identify research questions and supervised in the conduct of small scale research projects as part of their clinical neuropsychological course work.Major research experiences should be the master's thesis and doctoral dissertation.
2. List of training programs
See attached.
3. Four Representative doctoral and/or postdoctoral-level programs in psychology in this specialty.
See attached.
Criterion III. Doctoral Education and Training Prerequisites to Specialty Preparation.
1. . Four representative doctoral programs
See attached.
Criterion IV.Advanced Scientific and Theoretical Preparation.
1. See attached materials explaining course requirements for the biological, cognitive-affective, social, and individual bases of behavior.
Criterion V.Advanced Preparation in the Parameters of Practice.
A specialty identifies the substantial, specific, and distinctive psychological
knowledge and skills that provide the bases for service with respect to
at lease one of the essential parameters of practice. The parameters to
be considered include: population(s), a) specific b) psychological, biological,
and/or social problem, c) procedure and techniques. These parameters should
be described
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in the context of the range of settings or organizational arrangement(s) in which practice occurs.
1. Describe the advanced didactic and experiential preparation for specialty practicein each of the following parameters of practice:
a. population(s).
The specific populations that are addressed by clinical neuropsychology include Alzheimer Disease, traumatic brain injury, cerebral vascular disorder, epilepsy, Parkinson's Disease, Huntington's Disease, and a number of other dementias. In addition, developmental disorders such as attention deficit disorder, learning disabilities, populations and mental retardation may also be that require services. In addition, infectious disorders such as AIDS/HIV, and immunological disorders are frequently seen by neuropsychologists. Also, substance abuse and alcoholism is an area in which clinical neuropsychologists are becoming frequently involved. The organizational settings which these populations are served by neuropsychologists can vary from private practice office settings to neurology wards in major teaching hospitals. In addition, in educational settings, neuropsychologists may practice substance abuse treatment programs and various other institutions and at times neuropsychologists may consult in psychiatric wards and in internal medicine settings. The specific knowledge and skills with respect to populations that characterized neuropsychologist have to do with knowledge of neural anatomy and neuropsychological deficit with respect to the particular populations studied and also with respect to comorbidities of neurological syndromes with various psychological disorders such as affective disorders, schizophrenia and psychotic states, and anxietyand post-stress disorders and personality disorders. Neuropsychologists must understand the interrelationship between functional brain behavioral relationships and also how these brain relationships are altered in specific populations. The key insight is how neurological deficit can manifest itself in terms of disordered and disorganized behavioral functioning in specific populations.
b. problem (psychological, biological, or social).
Essentially, the biological problem that clinical neuropsychology address is that of impaired brain disfunction. functioning due to cerebral The distinctive knowledge and skills that define the specialty which the reflect the problem are knowledge of functional neuroanatomy, neurology, and clinical neurology and neurosurgery, behavior neuropathology and psychopharmacology. The essential understanding is how the brain functions and how the functioning of the brain on multiple levels is related to behavioral functioning at various levels. The problem of impaired neuropsychological functioning can be seen in a number of varied settings with respect 8
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to physical and organizational aspects. Impaired functioning may be relatively obvious in terms of a stroke victim or relatively subtle in terms of a child with attention deficit disorders syndrome. The range of settings in which disordered brain functioning may cause behavioral disturbances can range from a private practice setting, an educational setting, an industrial or occupational setting, a substance abuse treatment facility, a rehabilitated setting,a neurology or psychiatry ward in a major teaching hospital or in a community hospital. In all these settings, impaired brain functioning may cause disturbances which cause persons to have specific problems in terms of adapting to the behavioral demands of the setting. The sorts of problems that the biological insult causes may be related to cognitive skills, sensory-perceptual abilities,motor skills or emotional/personality functioning. This may have psychological ramifications with respect to the person's adequacy or inability to self-managed their own behavior or may have social complications with respect to the person's ability to interact with others to maintain a productive lifestyle. The person may be unable to contribute through vocational activities to the welfare of society and also limited with respect to the person's ability to assume mature roles in relationships and family activities such as patenting. The problem in terms of psychological or social aspects to a degree as related to the fit of the person in the special circumstances in which he or she finds themselves.
C. procedures and techniques.
The particular procedures or techniques specific to clinical neuropsychology are the particular tests which have been developed and validated to discriminate individuals with brain injuries from individuals without brain injuries. The most commonly used procedures are those from the Halstead-Reitan Neuropsychological Test Battery with the Luria-Nebraska Neuropsychological Test Battery as another frequently used battery. There are also other techniques that have been validated for the purposes of distinguishing individuals with brain impairment and those without. In addition some of these procedures are particularly helpful in terms of differentiating a particular type of brain impairment from individuals with other impairments. Those particular procedures and techniques for specific populations can be utilized in a wide variety of settings from private practice offices to educational institutions to a rehabilitation setting or a neurology ward in a major teaching hospital or others. The major point, however, is the use of the particular procedures to assess brain behavior relationships. It might be suggested that the best procedures are the Halstead-Reitan Neuropsychological Test Battery and allied procedures. As noted by Ralph M. Reitan and Deborah Wolfson in their chapter, "The Halstead-Reitan Neurological Test Battery" which was published in the Neuropsychology Handbook in 1986,
"The Halstead-Reitan has probably been researched in more
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detail than other sets of neuropsychological tests. Through close operation between neuropsychologists, neurologists, neurological surgeons, and neuropathologists, it has been possible to compose groups with definite, unequivocal evidence of cerebral damage and to compare these persons with subjects with no history or present evidence of cerebral damage or disease. This approach has a tremendous advantage over research oriented towards the development of constructs such as intelligence,affective disorders, emotional maturity, and so forth. To attempt to validate psychological measurements against such constructs,there has been a continual problem of not having an unequivocal definition of the condition being evaluated. In neuropsychology, however, is been possible not only to identify the presence or absence of cerebral damage but also to provide more detailed information regarding localization, type, duration, the lesion. and acuteness or chronicity of The approach in developing the Halstead-Reitan Battery was to compare control subjects to persons known to have diversified cerebral damage (heterogenous lesions in various locations) and, based on these comparisons, to identify the tests to the general condition to the cerebral hemisphere. Numerous reports document the efficacy of the Halstead-Reitan Test Battery have appeared in literature (including Boll, Heaton, & Reitan, 1974; Chapman & Wolff, 1959; Doehring & Reitan, 1961; Doehring & Reitan, 1961B; Fitzhugh & Reitan, & Reitan, 1960, 1961, 1962A, 1965; Heimburger, DeMyer 1964; Heimburger & Reitan, 1961; Matthews, Shaw, & Klove,1966; Reed& Reitan,1962, 1963A, 1963B, 1963C; Reitan, 1955A, 1955B, 1958, 1959A, 1959B, 1960, 1964, 1970A, 1970B; Reitan & Boll,1971; Reitan & Fitzhugh, 1971; Reitan, Reid, & Duyken, 1971; Ross & Reitan, 1955; Shure & Halstead, 1958; Vega & Parsons,1967; Wheeler, Burke, & Reitan, 1963, Wheeler, & Reitan, 1962, 1963," (p.140)
The chapter includes a number of investigations with respect to evaluating
the role of the Wechsler scales in brain-behavior relationships. In addition,
the chapter includes research on positive correlation between lateralized
psychological correlates from brain injury in Wechsler scales. Moreover,
other lateralization tests based on tests in the Halstead-Reitan are also
included in other investigations including in the chapter. These include
both the effects of frontal versus posterior lesions in each cerebral hemisphere.
Moreover, other types of cerebral deficits have also been studied with
the Halstead-Reitan and include aphasia, emotional problems, and epilepsy,
as cognitive deficits, well as other neurological disorders cerebral including
vascular disease, brain tumors, multiple sclerosis, Huntington's chorea,
head injury, alcoholism, drug abuse, mental retardation, and aging effects.
All references for the investigations are included in the Reitan and Wolfson
chapter on the Halstead-Reitan Neuropsychological Test Battery contained
in the Neuropsychology Handbook edited by Wedding, Horton, and Webster
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in 1986.
Criterion IV. Public Need for Specialty Practice. The services of a specialty are responsive to identifiable public needs.
1. Demonstrate the public needs this psychological specialty serves
The public need this psychological specialty of clinical neuropsychology serves is that of identifying for the public neuropsychologists are capable to practice this specialty of clinical neuropsychology. It might be fairly stated that neuropsychological skills are difficult for the lay public to evaluate a priori. The public, quite clearly, could be harmed through the inappropriate or poor practice of neuropsychology by incompetent or poorly trained practitioners. Poorly trained practioners of this specialty may make inaccurate statements or make flawed recommendations thus exposing members to the public to risk and costs of ineffective treatment of various serious brain injury problems. Poor practice of a psychological specialty such as clinical neuropsychology could serve to reduce public confidence in psychology. Quite clearly there is an information asymmetry between the ability of the lay public to evaluate the skills of a psychological practitioner in clinicalneuropsychology. Therefore, it is necessary for the profession to protect the public by taking on the role of identifying competent clinical neuropsychologists.
2. Describe how practitioners in this specialty attend to public need and to issues of human diversity.
One critical public need is for national credentialing in clinical neuropsychology at the specialty level. This matter has not been addressed at the state level of government. As far as individuals submitting this petition are aware there are no official regulatory or educational statute or regulation of this specialty with the exception that in the state of Louisiana recently the title of clinical neuropsychologist has become regulated by state law. Some states licensing boards,such as the commonwealth of Virginia, will identify particular psychologists who are licensed at a generic level as to whether they can engage in clinical neuropsychology with respect to professional privileging. Also, many hospitals and medical schools professional privilege psychologists to use neuropsychological testing and or cognitive retraining. These privileging activities are quite varying and often would be substantially aided by a national credential which identifies significant numbers of practitioners with a specialty in clinical neuropsychology. By attempting to provide standards for the evaluation of clinical neuropsychologists, practitioners of this specialty are addressing an urgent public need.
Regarding issues of human diversity, clinical neuropsychologists
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are sensitive to the possible misuse of their skills and abilities when non-majority group populations are assessed or treated with an intervention. Recent chapters in clinical neuropsychology books such as the Handbook of Clinical Child Neuropsychology the senior editor of which, Cecil R. Reynolds,is the president elect of ABPN, published by Plenum Publishing Company in New york City in 1989 and the Antonio Puente and Robert J. McCaffrey edited Handbook of Neuroosvcholosical Assessment which was also published by Plenum Publishing Company in new York City contain chapters dealing with disabling conditions such as epilepsy as well as sex differences, bilingualism and socioeducational variables and assessment of children and the elderly.
3. Describe how the recognition of this specialty will increase the availability and quality of services that professional psychologists provide without reducing access to needed services.
Many psychologists would like to be able to offer services as clinical
neuropsychologists but are unable to publicly document their level of training
and experience in clinical neuropsychology due to a lack of appropriate
credentials. This lack of appropriate credentials hinders their privileging
by various hospitals and other institutions which in their individual institutional
professional privileging activities would like to credential these individuals
but lack a sophisticated mechanism for internal peer review of clinical
neuropsychological expertise. It is worth noting that the number of settings
in which clinical neuropsychologist practice is quite numerous. To take
the situation only with head injury retaining programs, it is estimated
that there are well in excess 400 injury rehabilitation programs in the
United States. Observations of many head injury rehabilitation programs
have suggested to a number of clinical neuropsychologists that speech pathologists,
occupational therapists, and physical therapists,in many cases,have started
to use neuropsychological tests to provide assessments of cognitive functioning
of head injured patients in these rehabilitation programs. Such a situation
presents a significant danger that inadequate clinical neuropsychological
services being rendered to brain impaired patients by non-psychologists.
The situation is particularly difficult as head injured patients in institutions
are often not able to provide feedback to these institutions regarding
the patients' level of satisfaction with clinical neuropsychological services
because of the severity of the patients' brain injuries. Rather, they must
suffer these indignities. It is important for organized psychology to be
sensitive to this important problem and also to the fact that a very significant
market for clinical neuropsychological services which has been invaded
by poorly trained subdoctoral non-psychologist personnel and access to
well trained and experienced doctoral-level clinical neuropsychologists
has been restricted.
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Criterion V. Administrative Organizations. The proposed specialty is represented by one or more organizations of psychologists that provide systems and structures which make a significant contribution to the organized development of the specialty.
1. Name and address of your organization petitioning for specialty recognition.
The American Board of Professional Neuropsychology
c/o Michael J. Raymond, Ph.D., ABPN
Executive Director
c/o John Heinz
150 Mundy Street
Wilkes-Barre, PA 18702
717-826-3771
717-826-3898 (Fax)
2. Contact person:
Robert W. Elliott, Ph.D., ABPP, ABPN
Aviation Science Center
629 27th Street
Manhattan Beach, CA 90266
310-545-6400
310-318-5166 (Fax)
3. Signatures of officials submitting the petition:
name title w date
Richard A. Berg, Ph.D. President, ABPN 4/17/95 ABPN 47156
name title date
Robert W. Elliott, Ph.D. Chair, ABPN Committee ABPP(CN), ABPN 4/17/95 on Specialty and Proficiency Recognition title date
Arthur MacNeill Horton, Jr. Past-President, ABPN 4/17/95 ABPP(BP) name
ABPP(CL), ABPN,
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4. Year this organization founded?
1982
5. Is this organization incorporated? In what state?
Yes. In Georgia.
Copy of charter and articles of incorporation enclosed.
6. Please enclose by-laws.
By-laws enclosed.
7. Please provide the following information for all officials in the organization, including the Executive Officer or responsible petitioning staff person.
See attached sheet for names, mailing addresses, telephone numbers and FAX numbers,and APA membership status of officers.
8. Describe the purpose and objectives of this administrative organization.
The purpose of the American Board of Professional Neuropsychology (ABPN) is to establish interprofessional standards of expertise for the practice of clinical neuropsychology. It is crucial for today's mental health professionals to be able to identify their areas of expertise of practice. Neuropsychology skills are exceedingly difficult for the public to evaluate a priori. various mechanisms, Through ABPN offers to the health care community the public and the individuals who need neuropsychological services procedures for identifying well qualified neuropsychologists. The particular objectivesin the ABPN are 1) validate the clinical skills of professional neuropsychological practitioners; 2) identify competent professional neuropsychological practitioners; 3) provide public information about professional neuropsychology; 4) document the maintenance or competence of neuropsychologist through continuing education programs; organizations, and 5) provide individuals, or agencies that utilize neuropsychological services with a referral ABPN referrals.
9. Outline the structure and functions of the petitioning organization
(frequency of meetings, membership size, number of meetings per year, functions
performed, of committees, how decisions are made, types etc.). dues structure,
publications Annual meeting of members is held at a time and location designated
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by the board of directors to conduct business that may become before
the meetings and to report to the board and members the state of the affairs
of the corporation. Special meetings of the members may be called by the
president. Meetings of the board of directors are generally held 3 times
a year. The membership size is approximately between 175 members at the
present time. The primary functions of the organization are to administer
examination of the competence of clinical neuropsychologist and to decide
their levels of skill. The primary committee of the board is a credentials
committee which makes determinations regarding the review of applications
for memberships, schedules and conducts oral examinations, reviews work
samples and and makes recommendations to the board of directors regarding
the award of diplomates. Other committees may be established by the board
of directors as they see fit. The dues structure is $50 per year and the
current publications include a brochure on the organization and also a
membership directory.
1 0. What was its annual budget for the previous three fiscal years?
Please attach a copy of treasurers reports for the last three years
11. List other organizations that are associated with, that promote,
or that certify practitioners specialty. in this psychological Please provide
letters of support from these other organizations supporting your petition.
American Board of Clinical Neuropsychology
12. Please present a rationale for representative and responsible for
your organization as nationally dominant views and practices of your proposed
specialty.
The American Board of Professional Neuropsychology is national in scope
as seen by the distribution of ABPN membership in over 24 states. There
are, of course, greater numbers of neuropsychologists in states such as
California which have greater populations. The board is also nationally
representative from the stand point that applications are drawn from the
majority of states in the United States and the board has achieved a remarkable
level of recognition which is truly national in scope.
Criterion IV. Effectiveness. A specialty is characterized by a body
of evidence which demonstrates its effectiveness.
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1. Provide at least five psychological manuscripts published in refereed
journals (or equivalent that demonstrate the efficacy of the specialty's
services for dealing with the types of clients or population served by
this specialty.
See attached manuscripts.
2. Provide at least five psychological manuscripts published in refereed
journals (or equivalent that demonstrate the efficacy of the specialty's
services for dealing with the types of psychological,biological and/or
social problems addressed by this specialty.
See attached manuscripts.
3. Provide at least five psychological manuscripts published in refereed
journals (or equivalent that demonstrate the efficacy of the specialty's
procedures and techniques when compared with services rendered by other
specialties or practice modalities.
See attached manuscripts.
4.Provide at least five psychological manuscripts published in refereed
journals (or equivalent that demonstrate the efficacy of the specialty's
services for dealing with the types of settings or organizational arrangements
where this specialty is practiced.
See attached manuscripts.
Criterion VII. Quality Improvement. A specialty promotes ongoing investigations
and procedures to develop further the quality and utility of its knowledge,
skills, and services.
1. Provide a description of the types of investigations that are designed
to evaluate and increase the usefulness of the skills and services in this
specialty. Estimate the number of researchers conducting these types of
studies, the scope of their efforts, and how your organization and/or organizations
associated with the specialty will act to foster these developments. It
also is appropriate to provide evidence of current efforts in these areas.
In terms of the investigations clinical neuropsychology, that are currently
ongoing in it is perhaps simplest to reflect on the most recent issue of
Psychspan: Neuropsychology an abstract journal published by the American
Psychological Association. The most recent issue, volume 4, no. 1 for March
19, 1995 summarizes the research for the proceeding quarter of the year
for the section on clinical neuropsychology, the listing for clinical neuropsychology
includes some 964 abstracts represent one quarter of the number of investigations
published before 1995 and therefore one would estimated that a number close
to 4000 separate papers in clinical
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psychology may be published in this single calendar year. With respect
to the number of investigations currently conducting these types of studies,it
might be projected that when one looks at the number of authors that have
contributed papers to this particular issue of Psvchscan: Neuropsychology
the order of 1500 separate authors.a rough total is something on The scope
of the efforts involved in these studies might be seen by simply noting
the list of headings under clinical neuropsychology, this includes neuropsychological
assessment and evaluation, neuroimaging, as methods.Under the section titled
neurological disorders and brain syndromes, disorders, this includes Alzheimer
Disease, other dementias, memory brain damage, and traumatic brain injury,
cerebral vascular disorder, spinal cord injuries and paralysis, epilepsy,
aphasia, Parkinson's Disease, Huntington's Disease, cerebral palsy, and
other syndromes. Under psychological disorders is included affective mood
disorders, schizophrenia and psychotic states, anxiety and post-traumatic
stress disorder and personality disorders. In addition, substance abuse,
alcoholism, behavior disorders in criminal behaviors and development disorders
such as attention deficit disorder, learning disabilities, and mental retardation
are also listed. In addition, the issue includes infectious disorders such
as AIDS and also treatment and prevention of neuropsychological disorders,
including psychotherapy and psychotherapeutic counseling, behavior therapy,
clinical pharmacology,rehabilitation and medical health care services.
The Psychspan: Neuropsychology volume also includes basic non clinical
neuropsychology including cognitive psychoneuroimmunology, neuropsychology,
neuropsychopharmacology, toxicology, neuroendocrinology, neurophysiological
processes, and electrophysiology research. awarding ABPN encourages scientific
efforts by prizes for individuals who have made contributions to professional
neuropsychology. outstanding In the last year, the award for adult clinical
neuropsychology was given to Ralph M. Reitan, Ph.D.; and the award for
contributions to child neuropsychology was awarded to Lawrence C. Hartlage,
Ph.D.
2. Describe how the specialty seeks ways to improve the quality and
usefulness of its practitioners' services beyond its original determinations
of effectiveness.
Clinical neuropsychologists continually evaluate the effectiveness of
their services through ongoing research investigations. Efforts are continually
initiated for the purposes of further improving the validity of tests as
well as increasing the ease of use. For example, some neuropsychologists
develop short forms of neuropsychological tests to further economize saving
in health care. and promote cost ABPN has a requirement for continuing
professional education as do many states and this helps to further and
improve the quality of neuropsychological services provided.
3. Describe how the research and practice literature are regularly reviewed
for developments which are relevant to the specialty's
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skills and disseminated.
Specifically, reviewed and other books. services, and how this information
is publicly the research and practice literature regularly published and
disseminated in various handbooks and For example, members of the American
Board of Professional Neuropsychology helped in editing the Neuroosvcholosv
Handbook that was mentioned earlier and published by the Springer Publishing
Company in 1986 and a second edition is forthcoming. In addition, other
handbooks that are published by members of the American Board of Professional
Neuropsychology include the Handbook of Clinical Child Neuropsychology
the senior editor of which, Cecil R. Reynolds, is the president elect of
ABPN, was published by Plenum Publishing Company in New york City in 1989.
A second edition is forthcoming. Another handbook that was published by
members of the American Board of Professional Neuropsychology includes
the Antonio Puente and Robert J. McCaffrey edited Handbook of Neuroosvcholosical
Assessment which was also published by Plenum Publishing Company in new
York City. Moreover Richard Berg,Ph.D., the current president of ABPN,
published, with others, the second edition of Screening for Brain Impairment
in 1994.
4. How specialty promotes and participates in the process of accreditation.
At this point,clinical neuropsychology programs are not accredited as
the specialty has yet to be recognized by APA. Within current accreditation
mechanisms clinical neuropsychology tracks or subspecializations are present
in a number of types of psychology programs that are accredited as clinical-counseling,
or school psychology. ABPN members are now, and will in the future be,
available to serve as site visitors on American Psychological Association
accreditation teams.
Criterion VIII. Standards for Specialty Service Delivery. Specialty
practitioners conform their professional activities, not only to the profession's
general practice standards and ethical principles but also to appropriate
specialty standards.
1. Describe how the specialty's practitioners assume effective and ongoing
communication to members of the discipline and the public as to the specialty's
practices, practice enhancements, and/or new applications.
There are a number of journals devoted to clinical neuropsychology in
addition to Psychspan: Neuroosvcholosv which is published by the American
Psychological Association and is an abstract journal primary journals in
neuropsychology include Archives of Clinical Neuroosvcholosv, The Clinical
Neuropsychologist, Journal of Cortex, Clinical The and Experimental Neuroosvcholosv
Neuroosvcholosv and Neuroosvcholosia as well as the Journal of
[Page 19]
Neuroosvchiatrv and Clinical Neurosciences.
2. How does your specialty encourage the development of standards of
practice?
The specialty of clinical neuropsychology encourages development of
standards of practice through various documents and guidelines which have
been published at various times by Division 40 (clinical neuropsychology)
of the American Psychological Association and the International Neuropsychological
Society and the National Academy of Neuropsychology as well as the American
Board of Professional Neuropsychology and the American Board of Clinical
Neuropsychology. Also, the American Board of Professional Neuropsychology
reserves the right to revokethe status of a member when it has been determined
that the member no longer practices under same standards of practice that
existed when the original certification that was made. The American Board
of Professional Neuropsychology expects Diplomates to be leaders in their
field, and communities and to take initiative in terms of helping to continue
to develop more appropriate standards for practice.
Criterion IX. recognizes Provider Identification and Evaluation. A specialty
the public benefits of developing sound methods for permitting individual
practitioners to secure an evaluation of their knowledge and skill and
to be identified as meeting the qualifications for competent practice in
the specialty.
1. Describe how and by whom the specialty identifies those who are qualified
to practice in the specialty.
The American Board of Professional Neuropsychology has developed a multi-step
process to evaluate and judge excellence in clinical neuropsychology. The
process consists of a detailed application, approximately 10 pages in length,
and review of clinical work sample and an oral examination. The application
is obtained from the ABPN and then it is filled out by the applicant and
is sent to the Chair of the examination committee. sections on the applicant's
education, The application includes training, neuropsychology, experiences
in including particular populations served, specific test instruments used,
includes a self report of the number of times that a person has used each
particular test. The application also includes an essay examination that
requires the individual to respond to various case examples and describe
what he/she would do in that situation in writing. The application is then
returned to
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the Chair of the examination committee, who sends it out to two experienced
diplomates of ABPN who, using a prepared structured form with opportunity
to comment,rate the application on over 10 separate criteria and provide
comments on strengths and weaknesses with each individual. The completed
forms sent back to the chairperson of the examination committee. If the
person passes the application phase, they're instructed to send in a work
sample, including at least two case examples. Work samples must include
at least one case of assessment but can also include as a second case of
a neuropsychological intervention. For the work sample, at least two separate
cases of different individuals must be presented. With respect to evaluation
or assessment cases, the person is asked to provide a rationale as to why
various assessment measures were selected, why the conclusions were drawn
and why various recommendations were made. These are also evaluated by
two diplomates independently and structured rating forms are returned to
the coordinator of the work samples. If the work sample phase is passed
then the candidate is invited to sit for an oral examination. In the oral
examination, will examine the candidate, in turn, three separate diplomates
for one hour on specialized knowledge in clinical neuropsychology, and
for one hour on the actual work sample and a third diplomate examines the
candidate for a third hour on ethical practice. Each of these individuals
prepares a rating and if all three examiners rate the candidate as passing,
then the Chair of the examination committee makes a recommendation to award
the diplomate to the ABPN board which then makes the decision whether or
not to accept the recommendation and the president of ABPN then writes
a letter to the candidate informing him/her regarding their passing or
failing of the oral examination.
2. Describe how and by whom the specialty assesses the actual knowledge
and skills if individuals who wish to be identified as practitioners in
this specialty.
The actual skills and knowledge are assessed in the application relative
to the persons' background and training and also their response to the
essayexamination which is composed of case examples for whom appropriate
answers are determined. The raters, of the applications are diplomates
who have gone through specific training and whose skills and abilities
have evaluated. already been diplomates The work sample is evaluated also
by different two than those that evaluated the application. These diplomates
then independently rate and evaluate the persons' work sample. The candidates'actual
knowledge and skills are evaluated for a third time in the oral examination.
The first part being in the specialized knowledge when the candidate is
assessed on current knowledge of neuropsychological practice especially
relevant his/her work setting, background knowledge relative to his/her
special circumstances as well as his/her scientific knowledge in clinical
neuropsychology. In the work sample which was already passed based on a
paper review,separate examiners again review the
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findings and conclusions with the candidate being asked to explain and
elaborate on various aspects of the work sample for the examiner.
3. Describe how and by whom the specialty educates the public and the
profession concerning those who are identified as a practitioner of this
specialty.
As respect to the American Board of Professional Neuropsychology, a
directory of diplomates is published and has been widely disseminated.
Copies may be obtained from the executive director of ABPN. In addition,officers
of ABPN are often asked to verify the status of an individual as being
a member of ABPN or not.
4. Estimate how many practitioners there are in this specialty (e.g.,
spend 25%or more of their time in services characteristic of this specialty)
and provide whatever demographic information is available.
Perhaps the most reasonable estimate would be to reflect that a conservative
number would be the number of psychologists who are members of either the
division of 40 (clinical neuropsychology) American Board of neuropsychological
Association and the National Academy of Neuropsychology. Both groups have
approximately 3000 members of which the majority are members of both organizations.
The number of 3000 based on division 40 or National Academy of Neuropsychology
membership is probably a conservative figure. A more liberal figure would
be to estimate that at least twice that number of some 6000 practitioners
are psychologists spend 25% or more of their time in services characteristic
of clinical neuropsychology. The majority of clinical neuropsychologists
are white males in their 30's to 50's but larger numbers of women and minorities
are entering the field.
Criterion X. Continuing Professional Development and Education. A specialty
provides its practitioners a broad range of regularly offered opportunities
for continuing professional development in the specialty practice and mechanisms
to assess the acquisition of knowledge and skills.
1. Describe the opportunities for continuing professional development
in the specialty practice.
Continuing professional development opportunities are offered at various
professional associations related to clinical neuropsychology, for example,
the National Academy of Neuropsychology, the International Neuropsychological
Society, and the American Psychological Association. Among other organizations,
the ones named above periodically offer continuing educational workshops.
In addition,various state psychological associations and local neuropsychology
associations also provide continuing
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education opportunities. Clinical neuropsychologists may join study
groups, seminars series, take formal course work at universities or in
medical school curricula or conduct research activities as published papers,chapters
and books on their own. Moreover, clinical neuropsychologists may serve
roles in the editing process of journals and books and also in terms of
reviewing articles for journals and there by contribute to their professional
development.
2. Describe the formal requirements, if any, for continuing professional
developments in the specialty. What credits are required?
The American Board of Professional Neuropsychology requires members
to obtain 18 credits of continuing education per calendar year. The courses
in which the 18 continuing education hours can be obtained in institutions
certified by APA to offer continuing education credit or approved by individual
states neuropsychological associations or boards of psychology. Requirements
may be met by developing or presenting activities that meet the criteria
or approval by the institutions authorized by APA to approve psychological
credit or by preparing or presenting a scientific paper at a meeting or
a scientific conference for up to 3 hours of credit for each of the presentations
to a maximum of 6 hours percredit per paper presentation or performing
as the author, editor, or serving as a reviewer of a professional publication,
with credits earned only in the year of publication. For professional books,27
credits may be earned, at a maximum, in the year of publication. Book chapter
may earn nine credits as a the maximum,in the year of publication. 18 credits
is the maximum that can be claimed in a year of service as a journal editor
or reviewer.
3. Describe the assessment of an individual's professional development
in the specialty.
Members of ABPN are required to attest to their obtaining continuing
education credits at the time of yearly renewal of their membership in
ABPN. Members are required to keep a list of all reported continuing education
credits including titles, presenters, and number of credits. For publications
they must list the date, author, editor, reviewer,and citation and keep
in their files all documentation of the continuing education credit.
Respectfully submitted by:
Arthur MacNeill Horton, Jr.,Ed.D., ABPP, (CL), ABPN, ABPP (BP).
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AMERICAN BOARD OF PROFESSIONAL NEUROPSYCHOLOGY
LIST OF OFFICERS-1995
President
President-Elect
Past-President
Secretarv
Treasurer
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Executive Director
Executive Board
Francis J. Fishburne, Ph.D., ABPP(CL), ABPP(CN), ABPN
Kathleen B.Fitzhugh-Bell, Ph.D., ABPN
J. Randall Price, Ph.D., ABPN
Dorrie L. Rapp, Ph.D., ABPN
[Page 25]
Criterion II. the Specialty Structures and Models of Education and Training
in
3. Four Representative doctoral and/or postdoctoral-level programs in
psychology in this specialty.
Please see listings inList of training programs provided in response
to Criterion II. No. 2. Specific post-doctoral programs would be those
at the Long Beach Veterans Aministration Medical Center (p.400), University
of Maryland Medical School Albert Einstein Medical Center (p-416), (p.407),
and Western State Hospital and the University of Virginia (p.418). Relevant
information will be requested.
Criterion III. Doctoral Education and Training Prerequisites to Specialty
Preparation.
1.Four representative doctoral programs
Please see listings in List of training programs provided in response
to Criterion II. No.2. Specific doctoral programs would be those at Ball
State university (p.3751, University of Kentucky (p.376), Texas A&M
University (not listed in training list as the program was recently established,
below), Memphis for listing information see State University University
of Memphis) (p.380-381) (recently renamed as the Relevant information will
be requested.Materials from the University of Memphis and Texas A&M
University (both APA approved programs) are enclosed.
Listing for Texas A&M University
Institution:Texas A&M University
Person to contact for more information on neuropsychology training:
Cecil R.Reynolds. Ph.D., ABPN
Degrees offered: Ph.D.
(End of text)
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Copies of the appropriated documents are attached.
American Board of Professional Psychology
American Board of Vocational Neuropsychology
Letters will be requested.
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17
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Papers relevant to neuropsychology may also be published in Perceptual
& Motor Skills, and the Journal of Head Trauma Rehabilitation among
other journals. In addition, there are various newsletters such as the
Bulletin of the National Academy of Neuropsychology, and the newsletter
of Division 40 of the American Psychological Association in which communicate
information. In addition, practitioners publish a number of books that
were previously mentioned.
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20
21
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Richard A. Berg, Ph.D, ABPN
Wilmington Health Associates
1202 Medical Center Drive
Wilmington, NC 28401
(910) 341-3388
FAX (910) 341-3419
APA Fellow
Cecil R. Reynolds. Ph.D., ABPN
Department of Educational Psychology
704 Harrington Education Center
Texas A&M University
College Station, TX 77843
(409) 845-1884
FAX (409) 845-2209
APA Fellow
Arthur MacNeill Horton, Jr., Ed.D., ABPP(CL), ABPN, ABPP(BP)
5903 Lone Oak Drive
Bethesda, MD 20814
(301) 530-3417
FAX (410) 583-9957
APA Member
Karen A.Steingarten, Ph.D., ABPN
The Neuropsychology Center
3000-11 Hartley Road
Jacksonville, FL 32257
(904) 268-8636
FAX (904) 267-7020
APA Member
Thomas L. (Tim) Bennett, Ph.D., ABPN
Brain Injury Recovery Program
1049 Robertson
FT. Collins, CO 80524
(303) 493-6667
FAX (303) 493-8016
APA Fellow
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Michael J. Raymond, Ph.D., ABPN
John Heinz Rehabilitation Institute
150 Mundy Street
Wilkes-Barre, PA 18702
(717) 826-3771
FAX (717) 826-3898
APA Member
Barry M. Crown, Ph.D., ABPN
7800 Red Road
Suite 310
South Miami, FL 33143
(305) 665-0771
FAX (305) 665-9246
APA Member
121 Congressional Lane
Rockville, MD 20852
(301) 340-0707
FAX (301) 309-2278
APA Fellow
Neuropsychology-Neurology
Indiana University School of Medicine
702 Barnhill Drive #3751
Indianapolis, IN 46202-5200
(317) 259-4968
FAX (317) 259-4968
APA Member
1221 Abrams Road
Suite 109
Richardson, TX 75081
(214) 644-8686
FAX (214) 644-8688
APA Member
53 Neal Road
White River Jct., VT 05001-3704
(802) 295-1763
FAX (802) 295-1704
APA Member
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Department:Educational Psychology
Director of Neuropsychology emphasis: Cecil R. Reynolds. Ph.D., ABPN
Director of School Psychology Doctoral Program: Jan Hughes, Ph.D.
Training Setting: University
Phone:(409) 845-1884
FAX: (409) 845-2209
Address:
Department of Educational Psychology
704 Harrington Education Center
Texas A&M University
College Station, TX 77843
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