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Division of Clinical Neuropsychology
Newsletter 40
American Psychological Association
Volume 15, Number 2 Summer/Fall 1997

DIVISION 40 OFFICERS AND COMMITTEE CHAIRS
AUGUST 1996 - AUGUST 1997

PRESIDENT -EILEEN B. FENNELL, PhD

PRESIDENT-ELECT -LINAS BIELAUSKAS, PhD

PAST-PRESIDENT -KENNETH M. ADAMS, PhD

SECRETARY -ANN C. MARCOTTE, PhD

TREASURER-WILDRED G. VANGORP, PhD

MEMBERS-AT-LARGE:
RICHARD BERG, PhD.
JILL S. FISCHER PhD
KERRY HAMSHER, PhD

COUNCIL REPRESENTATIVES-
GERALD GOLDSTEIN, PhD
THOMAS J. BOLL. PhD

COMMITTEE CHAIRS (STANDING COMMITTEES)

FELLOWS - STAN BERENT, PhD

MEMBERSHIP - WILLIAM B. MENEESE. PhD

ELECTIONS - KENNETH M. ADAMS, PhD

PROGRAM -
KEITH YEATES, PhD
MARK BONDI. PhD

COMMITTEE HEADS (AD HOC COMMITTEES/TASK FORCES)

SCIENCE ADVISORY -ANN C. MARCOTTE, PhD

EDUCATION ADVISORY -KERRY HAMSHER, PhD

PRACTICE ADVISORY -JOSEPH D. EUBANKS, PhD

PUBLIC INTEREST ADVISORY -BARBARA C WILSON, PhD

ETHICS - BRUCE BECKER, PhD

MINORITY AFFAIRS -DUANE E DEDE, PhD

NEWSLETTER -JOHN DE LUCA, PhD

TRAINING PROGRAMS DATA BANK-LLOYD CRIPE, PhD

AWARDS COMMITTEE -IDA SUE BARON, PhD

INTERNATIONAL RELATIONS -ROBERT HEILBRONNER, PhD

CPT CODE -ANTQNIO PUENTE, PhD

ASHA/DIV 40 TASK FORCE -JILL FISCHER, PhD

On the History of Neuropsychology
An Interview with Arthur Benton, Ph.D.

(Editor's Note:This is the second of our interviews with eminent neuropsychologists in this series on the history of neuropsychology. As you may know, Dr. Arthur Benton has had a long and distinguished career in neuropsychology, and made numerous contributions to the development of our discipline as a science and clinical specialty. Dr. Benton was interviewed at his home in Iowa City, Iowa, in December, 1996. )

How did you first get interested in the field?
    "I was inspired by two professors at Oberlin, where I was an undergraduate pre-med student. I thought I'd become a physician. The first was Raymond H. Stetson, who had earned his Ph.D. at Harvard under Hugo Munsterberg about 1901. He was an unusually talented and brilliant man. His grasp of psychology was extraordinary. Of course, at that time he was a complete behaviorist. And incidentally, he was the prime influence on Roger Sperry (Roger W. Sperry, Ph.D., the only psychologist to have been awarded the Nobel Prize in Medicine, for his split-brain research, earned his undergraduate degree at Oberlin College, as did Dr. Benton - Ed.) Sperry was just a little after my time at Oberlin. At any rate, Stetson was a man who seemed to know everything, science, art, music, history, politics, and he had taught such diverse subjects as French, German, zoology, and chemistry at various colleges. He was a man whose life seemed entirely devoted to the intellect. He was not interested in everyday things. His introductory course was an eye-opener to me; the human mind and human behavior could be studied scientifically.
    The other teacher who influenced me greatly was Lawrence Cole, a man with a deep cultural background. Cole wrote an excellent textbook on general psychology in the 30's, which was very demanding for its day. He taught social and comparative psychology. He led a seminar on speech and language and he assigned me the task of reviewing Henry Head's book, Aphasia and Kindred Disorders of Speech (published in 1926). So this was my first introduction to some of the elements of neuropsychology, so to speak.
    What happened was, that in Christmas 1930 - the great depression - Professor Stetson asked if I'd be interested in having a graduate assistantship and working for an M.A. degree. I would assist in the

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 experimental laboratory course, studying reaction times, sensory processes and the like. The assistantship paid $750 and remission of tuition. Well, I was paying $3 a week for a beautiful big room - with twin beds, sharing it with my friend, the future psychologist Joseph R. Miller. I ate in the best restaurants in town for $5.50 a week; movies were 10 cents. These were depression times, but I was never richer! Anyway, by that time, I was hooked on psychology.
    I did my Master's thesis on eyelid conditioning. Then I moved to Columbia University and had a graduate assistantship at New York State Psychiatric Institute. The stipend was room, board, and laundry, and from Columbia I received $200 a year, which would be equivalent, I think, to about $3,500 a year today. All I had to do was go to the class in abnormal psychology and take attendance. The psychiatric residents got room, board, laundry, and $25 a month! Well, as I said, I was hooked on psychology. And I guess that my interest in neuropsychology had been there all along, in a latent and vague form. Stetson and Cole were physiologically minded, but did very little with it. Don't forget that this was the pre-EEG era, when learning theory and behaviorism were on the rise. Clark Hull was formulating his theory about this time - the early 30's - and Watsonian behaviorism was very popular then. Our texts in introductory psychology, by the way, were William James' Principles of Psychology (published 1890!) and Watson's Behaviorism (published 1925). Even today James' book would be a wonderful supplement to psychology reading lists.
    I wanted to study general paretics (tertiary syphilis) for my dissertation and I tested a few of them. I proposed a study of conditioning in paretics for my dissertation to Carney Landis, my mentor at the Psychiatric Institute, but he did not agree. He had his own agenda and had me do a study of a personality questionnaire that he had developed with Joseph Zubin.
    At the Psychiatric Institute, I met George Jervis, who was in the Department of Neuropathology and also an attending neurologist at Rikers Island Prison, who incidentally had earned a Ph.D. in psychology in Italy. He asked me to come with him and illustrate the application of psychological tests at his clinics. (Actually, I think he just wanted some company!) And so he would call on me to give a few tests to patients with brain disease and, once in a while, to an aphasic patient.
    This was before David Wechsler first introduced his tests at a meeting at the New York Academy of Medicine in 1937. I recall that when David Wechsler introduced the Wechsler-Bellevue, Dr. Bernard Sachs, a prominent neurologist at the time, dismissed the test battery, saying,I do not believe I need psychological tests,I can judge a patient's intelligence!”But Paul Schilder, a prominent neuropsychiatrist who had a swarthy complexion, a constant five o'clock shadow, and a high-pitched falsetto voice defended Wechsler's efforts. ... I disagree with Dr. Sachs; I find psychological tests very useful!”By the way, George Jervis went into the field of mental retardation; he elucidated the metabolic mechanism underlying phenylketonuria.
    In 1936 I went to work at the New York Hospital where I assessed pediatric and psychiatric patients. I was often called upon to evaluate children in whom the question of organicity” was raised. I used the Stanford-Binet, the Seguin Form Board, Porteus Mazes, Kohs Block Design Test (the original test, 19 19, later adapted by David Wechsler), and the Continued on page fourteen

In This Issue

On the History of Neuropsychology 1

From The Editor: 3

From The Membership: 3

Clinical Corner: 4
Some Ways To Keep The Clinical In
"Clinical” Neuropsychology

Science Scene: 6
The Neuropsychology Clinic
As Laboratory

Summary; Program For 9
Division 40,Division 22 Conference,
August 15-18

Division 40 Executive Committee
Meeting Minutes 17

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 Newsletter 40

From the Editor

    We are very pleased to present the second installment of our column, "On the History of Neuropsychology”, in this issue. Dr. Arthur Benton, clearly one of the luminaries in our field, graciously agreed to be interviewed for the column. We hope our readership will enjoy Dr. Benton's oral history' and views of the contemporary scene. He remains an energetic, active, and thought-provoking member of our profession.
    The current issue also brings an announcement concerning the upcoming Houston Conference on Training in Clinical Neuropsychology. With the passage last year of specialty status for Clinical Neuropsychology by APA, the Houston Conference was organized with the goal of integrating and standardizing training models in our field. As such, it certainly has the potential for significant historical importance, and we urge our readership to keep informed of this all-important issue as it continues to develop.
    Along with columns on clinical matters (The Clinical Corner” - Robert Heilbronner), the scientific-research arena (Science Scene” - Wallace Deckel), letters to the editor and other announcements, we have the Division 40 Program for the APA Convention in Chicago, which really looks terrific. I would like to remind our readership once again, that this is YOUR Newsletter, so please keep the correspondence coming.
    I hope to see you in Chicago and hope you all enjoy this issue.

Joel E. Morgan, Ph.D.
Division 40 Newsletter
Associate Editor

From The Membership

    In the fall 1966 issue of Newsletter 40, Aaron Smoth reported that he had been given to understand that there were no four-year graduate training programs in the United States leading to a PhD or PsyD in neuropsychology. Presented in those narrow terms, Dr. Smith's statement is probably correct. However, we would like to point out that for the past 25 years, City University of New York has had a Doctoral Program in Neuropsychology housed at Queens College. The Program has had a clinical neuropsychology component, based on the guidelines put forward by the Division 40 task force, since 1983, and has offered respecialization in clinical neuropsychology since 1986. It has 14 full-time and 14 adjunct faculty, as well as four clinical associates. Completion of the clinical neuropsychology program is not a four-year process, of course, since an internship, with all of its academic and clinical prerequisites is required, as well as a research-based dissertation. Nevertheless, we believe that this is the essential issue: we are a university-based, independent graduate training program in clinical neuropsychology.
    The program is a large one. Since 1983, it has had 86 graduates, of whom 5 1 completed the clinical neuropsychology program. Most of these individuals are now hospital-based or in private practice; many of them are professionally prominent, both in research and in the clinical neuropsychology arena.We take justifiable pride in our graduates anad in the effectiveness of our training program, and would like to be sure that our existence is not overlooked.

Richard Bodnar, Neuropsychology 1Program Head, 1993 to present
Doreen Berman, Neuropsychology  Program Head, 1981-1993

Members of the Neuropsychology Clinical Training and Curriculum Committee: Joan Borod, Daniel Caputo, Jeffrey Halperin, Sandra Shapiro, Queens College, City University of New York, Flushing, NY

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 Newsletter 40

Clinical Corner

Some Ways To Keep The Clinical In "Clinical” Neuropsychology
comments by Robert L. Heilbronner, Ph.D.

    In its original version, this article was meant to be a treatise on the importance of conducting psychotherapy with neurologically-impaired adults and how graduates of psychology programs with a neuropsychological emphasis should be required to have skills in psychological treatment as well as assessment techniques. After all, our patients (clients? subjects? consumers?) are not rats or four-legged primates, but human beings with personal histories, personalities, and emotions. However, it occurred to me that there are several other areas in our field, besides psychotherapy, that require a strong clinical emphasis. These areas have not always received the necessary attention in our journals and they are often overshadowed by empirical studies focusing exclusively on test scores and hard data”. But, I would submit to you that even neuropsychologists who focus exclusively on assessment and/or research still need to wear their clinician hats” and not simply interpret test results without any regard to the person who has spent the time and effort to participate in the process that produced the data.It is to these folks, and to our graduate students, to whom this paper is directed.
    If all of this sounds a bit prejudiced, it is only because I have heard stories and been witness to several situations where this has occurred, i.e., where a person who is being tested is regarded as merely a producer of data and that whatever anxieties, concerns, and fears they exhibit during the testing process are irrelevant and not the subject of the examination process.It is my hope that if this brief article does nothing more than give you a moment to reflect upon how you act and interact with the examinee during the assessment process then it will have accomplished its goal.
    I am operating on an assumption that might not be entirely correct: that the great majority of us who have become clinical neuropsychologists have done so because we like to work with people. We want to, in some way, help them out in their efforts to understand their coxndition or to at least assist those who are working with them to better understand how damage to the brain impacts upon the person's capacity to manage certain ADL's or other more complex tasks. Some of us may be frustrated neurosurgeons who would prefer to really see the brain, study it, and mend it through neurosurgical techniques. Others might like to be neurologists, physically examining the gross sensory and motor systems, independent of the complex cognitive and psychological functions which so well define the brain. There are also those of us who prefer to be strictly researchers and not directly interact with patients, yet who hope to ultimately be helpful through the results our research.
    The motivations for becoming a neuropsychologist are infinite and none should be criticized. But, I believe that there is a responsibility associated with being a clinical neuropsychologist... one must be willing and able to address the psychological andemotional concerns of the people who participate in the evaluation. In fact, this is one of the guiding principles of the APA Ethical Principles of Psychologists and Code of Conduct (Principles E and F: Concern for Others' Welfare and Social Responsibility). Please understand that I am not advocating that we treat all the patients we see for an evaluation, even when some kind of therapy appears clinically warranted. Simply being sensitive and responsive to patients' concerns and to the situation they find themselves may be all that is necessary.
    What are the ways in which we can keep the clinical in clinical neuropsychology a priority? From my perspective,there are three primary components of the neuropsychological evaluation process that require our attention: the initial contact, clinical interview, and feedback session. These are in addition to the testing itself, a situation that provides plenty of opportunity for clinicians and psychometricians alike to support, educate, and set limits with a patient who might have a catastrophic response to their perceived performance on the tests or whose behavior might require some brief

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 intervention. All of these points in the evaluation process provide an opportunity to exercise clinical expertise and to establish oneself as someone who is emotionally available and willing to enter into the phenomenological world of the patient. If a patient perceives us as uninterested, unempathic, or even as withholding and punitive, this might lead to a whole host of negative emotions which could undermine the reliability and validity of the test results. For those of us in independent practice, it might even result in a diminution of referrals if patients were to relay their dissatisfaction back to the referring party! On the other hand, a little empathy, understanding, and emotional availability will most assuredly lead to better effort and more reliable and valid test results.

Initial Contact: When the person is initially contacted by phone or first comes into the waiting room, it is important for the clinical neuropsychologist (and their supporting staff) to act warmly receptive and polite. I am quite certain that I am not saying anything new that your mother or father didn't already tell you when you were young. But, it is important to understand that transference (and countertransference) reactions arise almost immediately, sometimes even before the person comes to your office. Indeed, almost as soon as they arrive for the evaluation, patients quickly begin to vigilantly scan the environment and the authority figure” for any kind of negative response which serves to satisfy some preconceived (or predetermined) notion. Perception (or misperception) of same begins the process of reenacting early developmental patterns (i.e., responding to the clinical neuropsychologist as if he/she were some parental figure from the past) which could potentially determine how the rest of the evaluation process will proceed. There is no simple way to dispel or diffuse the transference reaction (some might even say that it is important to promote or encourage it) in a singular examination. Simply being empathic and making an effort to hear the patient's story” might be the best way to limit or circumvent a potentially negative response style even before the testing begins. Presenting as a competent clinician and researcher is appropriate and clinically relevant; acting out one's own narcissistic need to impress, control, or dominate is both counterproductive and exploitative.

Clinical interview: There is really not alot to include in this section above and beyond what we have already learned in graduate school about how to conduct a sound clinical interview. All of the basic principles apply, whether you adopt a Sullivanian, Rogerian, object-relations, or simply a coherent information-gathering approach. What sets apart a neuropsychological interview from a clinical psychological interview is the part that emphasizes brain function and seeks to understand how the suspected damage manifests in the cognitive, emotional, and behavioral realms. It requires a recognition that a brain-impairing event may lead to a complex interaction of neurological, psychological, and social factors which determine the symptomatic behavior that is seen (Jarvis & Barth, 1984).
    When you think about it, the clinical interview is kind of a unique thing: you have one hour (more or less) to gather as much information as you possibly can about the person in the chair across from you. To do this, you have to establish rapport rather quickly and provide an environment in which patients can feel comfortable revealing some very important and personal things about themselves. This has to be established from the moment they enter into the waiting room and venture toward your office. Some things to keep in mind during that walk: Do you lead the patient or follow behind closely? Do you sit down before or after they do? Do you explain what is about to take place during the next hour and throughout the remainder of the day? Do you start out by asking the most personal questions first? Do you simply ask the patient to provide a list of their symptoms without regard to the emotional, behavioral, and interpersonal consequences?
    One of the first things that is important to establish from the outset is the patient's understanding of why he/she was referred for the neuropsychological evaluation. This can provide an opening from which to start and it can also assist us because we often do not have a good sense about what the referring party has told them about the

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 Newsletter 40

Science Scene

The Neuropsychology Clinic As Laboratory
A. Wallace Deckel, PhD, ABPN
Neuropsychology Service, Dept. of Psychiatry,
University of Connecticut Medical School, Farmington, CT

    It was only over the past few years that it occurred to me just how much data I gather doing my routine”neuropsychological testing. My colleagues at UCONN medical school, who are engaged in various aspects of neuropsychological research, often work very hard to recruit 80 or 90 subjects over the course of a calendar year for the various studies that they have underway. On the other hand, the Neuropsychology Clinic sees approximately 200 individuals yearly for thorough evaluations. I have discovered that the data generated by these referrals can be rich and fertile ground for doing a slightly different kind of research than what I, and most of us, are accustomed to calling research. However, in order to use data generated by the Neuropsychology Clinic as information that can advance the science and practice of neuropsychology, both a new way of thinking about research, and a kind of clinical discipline”, is required by those of us who practice clinical neuropsychology.
    What is the new way of thinking? First, those of us in the clinic need to realize that not all useful scientific data is gathered only by the scientific method”, i.e.,generating a hypothesis, and then testing that hypothesis on a control group and an experimental group that are independently recruited. Although this may be the best way of doing research, we in the clinic do not have this as an option most of the time. However, we can test post-hoc a number of questions from naturalistically gathered data that may provide very useful information about the issues we are most concerned about. For example, my primary area of research at this time is the study of how frontal lobe functioning generally, and executive functioning in particular, is related to the risk of alcoholism. Most of my recently published research came out of rigorously designed and executed studies completed by my collaborators .  The results from this work indicate that subtle deficits in executive functioning exist in individuals with the risk for alcoholism even before they show problems with alcohol dependency themselves. While these findings are interesting (at least to me), it is unclear if they have any generalization to individuals who do not meet the kind of rigorous inclusion criteria that such studies generally have. However, I see patients in the clinic who are definitely real world” and come from a heterogeneous background. On most of these individuals, I administer tests of executive functioning and, frequently, the MMPI. The MMPI has an excellent measure of the proclivity towards alcohol-related problems, the MacAndrew Alcoholism scale. I routinely administer neuropsychological history questionnaires to patients prior to taking their history clinically during which I give quitebrief but standardized questionnaires about alcohol and drug usage. Thus in the clinic I have data that relates to alcohol use, alcohol problems, and executive functioning, and using this data I have recently been able to complete a study replicating the findings in the laboratory. I have used a similar strategy to publish on Huntington's disease and to complete a recent paper on the use of malingering tools developed in the research lab. Be prepared for the occasional rejection from journals accusing your work of being naturalistic. Bear in mind, however, that this very objection is, in fact, the very strength of your work. Who else can examine the psychometric properties of malingering instruments that have only been developed in the laboratory? Who can better relate a theoretical construct to its practical application in clinical populations than a clinical neuropsychologist?Remember, when rejected from a journal, revise and resubmit to another. Its a strategy that works! !
    However, to translate neuropsychologically gather data to the clinical/experimental literature, clinical neuropsychologists need to develop a certain kind of discipline. We tend to be a rather free-wheeling sort, using whatever test we prefer, or

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 group of tests, to answer a particular question on a particular day. What is needed, however, is a thoughtful plan of evaluation that is consistent, highly relevant clinically, yet standardized and structured within the context of our practice. I tend to get many patients with a few diagnoses - mild head injury, toxic exposure, LD/ADD, Huntington's Disease, and dementia workups top the list of who comes into my clinic. I have developed a particular battery of tests that I give for each of the above referrals. These batteries are clinically relevant and as brief as possible given the managed health care environment that we all live in now. If there is a particular reason to add onto a battery, I will, but in truth the referral questions are usually quite similar and what is appropriate for one patient referred with Huntington's Disease (for example) is usually appropriate for the next HD patient as well. The batteries vary from one referral question to another - my patients referred for dementia workups don't need to be given the Word Attack subtest from the Woodcock Johnson as do my LD patients, for example - but tend to have a fair amount of overlap as well. In those areas of overlap, I have the ability to compare and contrast findings across widely diverse patient populations. However, this would not be possible if I gave different batteries on different days to patients with the same referral question, a practice which is in fact quite common. This strategy alone generates data that is comparable across different patient populations and allows the clinician/scientist to compare and contrast findings across populations in a near approximation to the scientific method.
    Secondly, we must develop the discipline to develop and maintain a data base of our findings. Excel, Lotus, and many other spread sheets are importable into common statistical analysis programs. Such data bases are now widespread and user friendly, and certainly within the means for use by any practicing neuropsychologist. It is true that entering the data does take time (non-billable, at that), and I tend to do this at times of the day I usually accomplish little else of value (towards the end of the day at the end of the week works for me).
    Finally, if you don't have a good statistical program to analyze your data, or don't feel as if you remember statistics well enough to do your own analyses, remember this one important word - Newsletter 40 collaboration! Somewhere there is an academic psychologist, statistician, or other individual who is no further than an e-mail stroke away from you and who would love to work with you FOR FREE, provided he/she is given a co-authorship on your paper.
    So, gather your data systematically, be disciplined about what data you gather and what you do with it when the clinical evaluation is done, collaborate and, when necessary, resubmit. Follow these rules, and I'll look forward to reading your next paper in any of dozens of (excellent) journals That publish such work.

    With the recent approval of specialty status of Clinical Neuropsychology by the American Psychological Association, the development of new guidelines for the education and training of neuropsychologists has begun in earnest. Along with the Education Advisory Committee of APA Division 40, a number of other neuropsychology organizations have been working together toward the ultimate goal of establishing such guidelines for :ducation and training. These include the American 3oard of Clinical Neuropsychology (ABCN), the Association of Postdoctoral Programs in Clinical Neuropsychologyy(APPCN), the National Academy of Neuropsychology (NAN), the American Academy of Clinical Neuropsychology (AACN), and the newest organization, the Association for Internship Training in Clinical Neuropsychology (AITCN), representing predoctoral neuropsychology nternship sites.
    A Planning Committee, chaired by Dr. H. Julia Hannay of the University of Houston representing these organizations, was established, with the goal of planning a conference to develop an integrated node1 of training in clinical neuropsychology. In March, the Planning Committee mailed an announcement of the Houston Conference on specialty Education and Training in Clinical Neuropsychology, to neuropsychologists involved in

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 Newsletter 40

Continued from page five

evaluation process. The patient may think that he/she is going to undergo some invasive procedure, get neuropsychologically immunized” by some kind of shot, or that they must be crazy if their doctor has referred to them to a neuroshrink”. Dispelling their fears or validating their expectations and hopes can be very curative and get things started on the right foot. Failure to do so can set-up the assessment process as just another point in a long line of impersonal and alienating procedures the patient has already been asked (forced?) to endure.
    When conducting a neuropsychological interview, one should inquire not only whether certain events have occurred, but also how the patient and significant others have perceived them and responded to them. The patient's perception depends on such factors as their level of awareness, intelligence, and certain personality traits among other things. Two patients with essentially the same condition could respond differently depending upon their premorbid personality. A person with a history of low self-esteem may react to his/her deficits by feeling inadequate, worthless, and depressed; another person may project blame for the changes in functioning onto others.Thus, more than simply possessing knowledge of brain-behavior relationships, the clinical neuropsychologist should also have a sound understanding of personality dynamics and personality disorders. Keep in mind throughout the interview that you may be the first person who has taken the time and has the energy to listen” to the person's story. That can be curative for many folks and it could also help to uncover some very important facts that cannot be derived from test scores.

Providing feedback: Most people who participate in the neuropsychological test process expect that the test results will be discussed with them as part of the assessment or treatment. But many, if not most, neuropsychological evaluations do not include the feedback session as part of the assessment: this could be because many neuropsychologists are reluctant to discuss the test results with patients. But, the patient has a right to be informed of the test findings and we have a professional responsibility to take reasonable steps to ensure that appropriate explanations of results are given...using language  that is reasonably understandable to the person assessed or to another legally authorized person on behalf of the client” (APA Ethical Principle 2.09).
    In a special issue devoted to providing test feedback to clients, Butcher (1992) identified a number of reasons for psychologists' apparent reluctance to provide feedback. Some clinicians are simply unsure of the propriety of sharing test information with patients. Many practitioners are unaware of or have not been trained in test feedback techniques and they feel uncertain as to how to present information, particularly negative results, to patients. Finally, some clinicians are unsure of the potential effects that disclosing critical information might have on patients and they are concerned that there might be negative consequences from the patient receiving potentially negative feedback. This special section (including the fine article on neuropsychological test feedback by Gass and Brown) should be required reading for anyone who is about to embark on a career in clinical neuropsychology.
    Several points need to be emphasized when discussing the topic of neuropsychological test feedback. First, feedback is a dynamic, interactive process that is one aspect of the larger process of assessment (Pope, 1992). Consequently, this component part may be viewed by many neuropsychologists as simply a method of closure or an obligation in which the results” are dumped in the lap of the client. This view is so negative and unproductive that some neuropsychologists may decide not to give feedback altogether. A thoughtful discussion with the patient of what the results mean and what they do not mean may help to circumvent this negative view of feedback. But, how many of us really take the time to sit down and think through how we are going to present the results to the patient or to their family? Do we simply leave it up to the referral source to explain the results and then make our escape” without having to come face to face with the patient and their possible feelings of disappointment, sadness, anger about the results? Perhaps, we do not have the patient come back for a feedback session because it is not covered under their health insurance? Is this a valid enough reason not to provide feedback?

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Newsletter 40

Division 40 Program

Friday, August 15

8-9:50
Poster Session: Lifespan Clinical Neuropsychology
Chairs: Christopher Randolph, Michael Westerveld
Room: River Exhibition Hall, Sheraton Chicago Hotel and Towers

10-10:50
Award Ceremony: American Psychological Association Award for Distinguished Professional Contributions
Award Recipient: Paul Satz
Room: Grand Ballroom A, Hyatt Regency Chicago

11-12:50
Symposium: Neuropsychological Development in Pediatric Epilepsy
Chair: Michael Westerveld
Room: Grand Ballroom C North, Hyatt Regency Chicago

11-11:50
Symposium: Defining Normal Cognitive Aging in the Extreme old
Chair: Margery Silver
Room: Grand Ballroom B, Hyatt Regency Chicago

1-1:50
Discussion: International Perspectives on Education, Training, and Credentialing in Clinical Neuropsychology
Chair: Robert Heilbronner
Room: Grand Ballroom D North, Hyatt Regency Chicago

2-2:50
Invited Address: Jack Fletcher Title: Behavior-Brain Relationships in children with developmental disabilities: Concepts and methods
Chair: Paul Satz
Room: Grand Ballroom B, Hyatt Regency Chicago

3-5:50
Division 40 Executive Committee Meeting
Room: Huron Room, Sheraton Chicago Hotel and Towers

Saturday, August 16

8-8:50
Division 40 Science Committee
Chair: Ann Marcotte
Room: Wright Room, Hyatt Regency Chicago

8-9:50
Concurrent Poster Session: Neuropsychological Assessment
Chair: Joseph Ricker
Room: River Exhibition Hall, Sheraton Chicago Hotel and Towers

8-9:50
Concurrent Poster Session: Neuropsychology of Head Injury, Medical Illness, and Psychiatric Disorder
Chair: Pamela Keenan
Room: River Exhibition Hall, Sheraton Chicago Hotel and Towers

10-10:50
Paper session: Division 40 Blue Ribbon Winners
Chair: Keith Yeates
Room: Regency Ballroom A, Hyatt Regency Chicago

11-11:50
Invited Address: Leslie Ungerleider Title: Functional Brain Imaging Studies of Learning and Memory
Chair: Ida Sue Baron
Room: Regency Ballroom A, Hyatt Regency Chicago

12-12:50
Discussion: Ethics and Neuropsychology
Chair: John McSweeny
Room: Gold Coast Room, Hyatt Regency Chicago

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 Newsletter 40

l-2:50
Symposium: The Clinical Utility of WAIS-III and WMS-III: Implications for Neuropsychology
Chair: David Tulsky
Room: Regency Ballroom A, Hyatt Regency Chicago

3-4:50
Symposium: Innovative Strategies and Analysis of Methods for Detecting Malingering
Chair: Jerry Sweet
Room: Regency Ballroom D, Hyatt Regency Chicago

5-5:50
Symposium: Neuropsychology and Very Low Levels of Education: Some Preliminary Results
Chair: Lidia Artiola y Fortuny
Room: Regency Ballroom D, Hyatt Regency Chicago

Sunday, August 17

8-8:50
Pediatric Neuropsychology Interest Group Meeting
Chair: Keith Yeates
Room: Columbian Room, Hyatt Regency Chicago

9-10:50
Symposium: The Neuropsychologist's Guide to Electrical Injuries
Chair: Neil Pliskin
Room: Sheraton Ballroom I, Sheraton Chicago Hotel and Towers

1 l-11:50
Paper session: Robert A. and Phyllis Levitt, and Student Awards
Chair: Ida Sue Baron
Room: Regency Ballroom A, Hyatt Regency Chicago

l-1:50
American Psychological Foundation Arthur Benton Lectureship
Participant: Oscar Parsons
Title: Clinical Neuropsychology in the Decade of the Brain
Chair: Joseph Matarazzo
Room: Grand Ballroom B, Hyatt Regency Chicago

2-2:50
Invited address: Louis Costa Title: Professionalization in Neuropsychology: The Early Years
Chairs: Ann Marcotte and Byron Rourke
Room: Grand Ballroom B, Hyatt Regency Chicago

3-3:50
Division 40 Presidential Address
Participant: Eileen Fennel1
Title: Cognitive Impact of Pediatric Brain Tumors
Chair: Kenneth Adams
Room: Grand Ballroom B, Hyatt Regency Chicago

4-4:50
Division 40 Business Meeting
Room: Grand Ballroom B, Hyatt Regency Chicago

5-6:50
Interdivisional Collaborative Social Hour with Divisions 22 and 38 Co-sponsors: The Psychological Corporation and Psychological Assessment Resources, Inc.
Room: Grand Ballroom E, Hyatt Regency Chicago

Monday, August 18

9-9:50
Symposium: Performance Curve Analysis of Feigned Impairment and Response Invalidity
Chair: Richard Frederick
Room: Grand Ballroom C North, Hyatt Regency Chicago

l0-11:50
Symposium: Persian Gulf War Veteran's Complaints: Psychological Studies Chair: Roberta White 10
Room: Chicago Ballroom IX, Sheraton Chicago Hotel and Towers

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 l-1:50
Invited address: Alfred Kaszniak
Title: Understanding Anosognosia for Dementia: Theoretical Considerations and Clinical Implications
Chair: Mark Bondi
Room: Grand Ballroom B, Hyatt Regency Chicago

2-3:50
Symposium: Cultural Considerations in the Assessment and Treatment of Nemobehavioral Disorders
Chair: Tony Strickland Room: Grand Ballroom B, Hyatt Regency Chicago Division 22 Program

Saturday, August 16

8:00- l0:50
Division Business Meeting
Chair: Marie DiCowden
Room: Columbus Room A&B, Sheraton Chicago Hotel and Towers

1 l:00-12:50
Symposium: Psychological Practice in Health Care Settings: Marketability and Outcome Analysis
Chair: Robert L Glueckauf
Room: Grand Ballroom D North, Hyatt Regency Chicago
(Co-sponsored by Division 40)

1:00-2:50
Symposium: Adapting Rehabilitation Psychology: 50th Anniversary Rusk Rehabilitation Medicine, NYU
Chair: Leonard Diller
Room: Toronto Room, Hyatt Regency Chicago
(Co-sponsored by Division 40)

3:00-4:50
Invited Address: Rehabilitation Psychology Fellows Addresses
Chair: Mitchell Rosenthal
Room: Toronto Room, Hyatt Regency Chicago

4:00-4:50
Symposium: Post-Concussive Syndrome: A Perspective on Current Treatment
Chair: Robert T Fraser Efficacy
Room: Water Tower Room, Hyatt Regency Chicago
(Co-sponsored by Division 40)

5-6:50
Social Hour: Social Hour/Presidential Comments/Rusk Institute NYU-50th Chair: Marie DiCowden
Room: Regency Ballroom B, Hyatt Regency Chicago

Sunday, August 17

8:00-8:50
Discussion: American Board of Rehabilitation Psychology
Chair: Bernard Brucker
Room: Haymarket Room, Hyatt Regency Chicago

9:00-9:50
Invited Address: Lawrence LeShan
Title: Bringing Psychotherapy into the 21st Century
Chair: Marie DiCowden
Room: Grand Ballroom C North, Hyatt Regency Chicago

10:00-11:50
Symposium: Golden Opportunities for Psychology in the 21st Century
Chair: Marie DiCowden
Room: Grand Ballroom C North, Hyatt Regency Chicago

12:00-12:50
Invited Address: Karl Pribram
Title: The Deep and Surface Structure of Memory: Import for Rehabilitation Chair: Marie DiCowden
Room: Grand Ballroom C North, Hyatt Regency Chicago
(Co-sponsored by Division 40)

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1 :00-2:50
Symposium: Prescription Privileges for Psychologists: A Larger Perspective Chair: Marie DiCowden
Room: Grand Ballroom C North, Hyatt Regency Chicago

3:00-3:50
Symposium: Contemporary Ethical Challenges in Rehabilitation Psychology Chair: Fong Chan
Room: Toronto Room, Hyatt Regency Chicago

Monday, August 18

8:00-9:50
Symposium: Biscayne Institutes Health Care Community Model: A Holistic  Transdisciplinary Approach
Chair: Maya Bat-Ann
Room: Toronto Room, Hyatt Regency Chicago

10:00-11:50
Symposium: The Role of Psycho-Spirituality in Coping with Chronic Illness Chair: Barry Nierenberg
Room: Grand Ballroom C North, Hyatt Regency Chicago

12:00-1:50
Symposium: Women and Disability: A Lifetime Perspective
Chair: Susan Buckelew
Room: Grand Ballroom D North, Hyatt Regency Chicago

2:00-3:50
Symposium: Issues in Mentoring Students of Color in Psychology
Chair: Dennis C Harper
Room: Grand Ballroom D North, Hyatt Regency Chicago

4:00-5:50
Symposium: American Indian Issues in Rehabilitation
Chair: Dan Clay
Room: Grand Ballroom D North, Hyatt Regency Chicago

Tuesday, August 19

8:00-9:50
Symposium: Reauthorization of the Rehabilitation Act of 1973: Psychology's Role
Chair: Diane L. Schneider
Room: Gold Coast Room, Hyatt Regency Chicago

10:00-10:50
Poster Session: Rehabilitation Psychology: Science and Practice
Chair: Dennis C Harper
Room: River Exhibition Hall, Sheraton Chicago Hotel and Towers

11:00-11:50
Symposium: An International Perspective in Rehabilitation Psychology: Australia/United States
Chair: Kathleen S. Brown
Room: Gold Coast Room, Hyatt Regency Chicago

1:00-2:50
Symposium: Opportunities for Rehabilitation Psychologists in the Era of Managed Care
Chair: Glenn Ashkanazi
Room: Gold Coast Room, Hyatt Regency Chicago

3:00-4:50
Symposium: Ethical Decision Making in Health Care: Respect for Autonomy Room: Gold Coast Room, Hyatt Regency Chicago
Chair: Stephanie L. Hanson

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Continued from page eight

    Its fairly safe to say that working with psychiatric and brain-injured patients brings forth a whole host of personal, intense, sometimes conscious and othertimes unconscious, reactions to the person taking the tests. Such reactions can influence and distort the feedback process. The neuropsychologist who, for whatever reason, is irritated or angry at a patient can use the feedback session to punish the patient in an overt or a passive-aggressive manner. They can present their opinions and conclusions in a way that is self-serving and may simply validate their pre-conceived notions about what is really going on” with the patient. It is critical that we remain alert, open, and sensitive to such reactions, act promptly to ensure that we do not distort the feedback process and, if necessary, seek consultation from colleagues to help us become more aware of the personal factors that can undermine our ability to provide effective and meaningful feedback to our patients (Pope, 1992).
    Some things to be aware of as you provide feedback to patients. Are you simply reporting test scores without regard to their meaning? Do you just compare the patient's scores to established norms and simply compare numbers to each other? When (if) you describe certain aspects of brain function, are you using technical jargon or doing it in a manner that the patient can understand? Do you ask the patient to repeat to you what you have said so that you know he/she has understood what you are trying to tell them? What do the results mean in terms of treatment or prognosis? Do you acknowledge andidentify potential sources of bias or error or do you present the test results with an aura of infallibility” (Pope, 1992). Failure to indicate any significant reservations” about the accuracy or limitations of (our) interpretations is in direct violation of APA Ethical Principle 2.05 (Interpreting Assessment Results).
    In closing, I hope that some of the issues which I have raised have served to heighten your awareness about how you behave in the neuropsychological assessment process. Keeping a vigilant eye toward your own, as well as your patients', emotions, behavior, and interpersonal communications is an important part of that process which can have some very real implications for the person who is sitting across the testing table from you.

REFERENCES

Butcher, J. N. (1992). Introduction to the special Gass, Jarvis, Pope, section: Providing psychological test feedback to clients. Psychological Assessment, 4, 267.

Gass, C.G. & Brown, M.C. (1992). Neuropsychological test feedback to patients with brain dysfunction. Psychological Assessment, 4, 272-277.

Jarvis, P.E. & Barth, J. T. (1984). Halstead-Reitan Test Battery: An interpretive guide. Psychological Assessment Resources: Odessa, FL.

Pope, K.S. (1992). Responsibilities in providing psychological test feedback to clients. Psychological Assessment, 4, 268-271.

training. Individuals interested in attending were asked to submit a vita and personal statement outlining the reasons why they should be selected, noting their role as an educator in neuropsychology. The conference participants will consist of the planning committee and 42 other clinical neuropsychologists selected by the committee. The conference is scheduled for September and application deadlines are June 30, 1997. Interested educators of neuropsychology at all levels are encouraged to apply.
    The Houston Conference will address important issues facing the future of the field. For what professional roles is it necessary to have education and training in clinical neuropsychology? What knowledge base and skills are needed? How should education and training in the specialty of clinical neuropsychology be accomplished? How should different levels of education and training be integrated? How should the outcome of the conference be implemented (e.g., at which levels are program accreditation warranted)?
    The Houston Conference should be a historic meeting for the development of the profession. It will undoubtedly affect the future generation of clinical neuropsychologists for some time to come, as well as have a significant impact on education and training in the larger profession of psychology as a whole.

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Continued from page two

Rorschach. I was busy learning new diagnostic techniques because I had had very little previous experience. I took evening courses on the Rorschach with Bruno Klopfer, Emil Oberholser and the Schachters, and attended seminars by Kurt Goldstein, which he gave Saturday afternoons at Montefiore Hospital in the Bronx. I think I became a pretty good Rorschacher in my day. These were exciting times for me and a valuable introduction to clinical neuropsychology.
    One day in 1937, I came across a paper by Wendell Muncie in the Bulletin of The Johns Hopkins University Hospital in which he described and discussed the Gerstmann Syndrome - linger agnosia,right-left disorientation, acalculia, and agraphia. I was intrigued and began to give relevant tests to my young patients. Only twice did I find kids with the syndrome, both of whom were dyslexic and rather dull. So I had an interest in the syndrome and in research in general, but I never really pushed it. I didn't have very much research drive in those days. That came later on.
    During World War II, I was at the Naval Air Training Base in Livermore, California, and there was a Naval Hospital at Oak Knoll, which was close to Livermore. There was a neurosurgeon there from Des Moines and, at his invitation, I went over there to assess some of his patients. In 1943, I was sent to the San Diego Naval Hospital. There I met Morris Bender, the New York neurologist, who was Chief of Neurology. He was full of vigor and enthusiasm and we started to work together. I learned a lot from him, including the phenomena of visual neglect, the method of double simultaneous sensory stimulation and visual object agnosia. He was primarily interested in the visual deficits associated with brain disease. I remember seeing one of his patients with a gunshot wound who had a central scotoma. I asked him about the location of the lesion that would produce such a symptom. Bender said, ...oh don't worry about that, look at the patient's behavior, his deficits!”So the psychologist wanted to be a neurologist and the neurologist wanted to be a psychologist! At any rate, Morris Bender was very encouraging and supportive; he introduced me to the classic German neuropsychological literature. Now I knew enough German to read Kleist, Lange and other classic works, and it was then that I became 14 strongly interested in neuropsychology.
    At the San Diego Naval Hospital I had some M.A.-level technicians helping me. We gave the patients a standard battery: Wechsler-Bellvue, Rorschach, sometimes supplemented by the MMPI, which was already available. I'd give the technicians their assignments at 8:30; by 1 l:00, I'd review their findings and write the reports on the 3 or 4 patients that had been seen. By 3:00 I'd write the reports on the patients that had been seen in the early afternoon. This was quite a caseload. It was during this time that I felt the need for a reliable non-verbal, visual memory test. I drew the designs roughly myself. There was a graphic artist nearby who produced a finished product and printed the cards. This was 1944. I started using the test. After the War, the Psychological Corporation published it. After about two years the edition ran out and Psych Corp wasn't interested in publishing it. They were growing very rapidly in the post-war era and were interested in larger projects. Harold Seashore, the chief of the test division, said to me why don't you produce it and sell it to us. That worked fairly well. Later, I decided it was a skimpy test and expanded it from 7 to 10 designs. About 1955, I developed the different forms, administrations, error scores, and the like. That was my first test. Then I produced a second edition. Before this we didn't have many memory tests. Wechsler did the WMS after the war, and Lauretta Bender introduced the Bender Gestalt about that time. By the way, her husband was Paul Schilder, the neuropsychiatrist I mentioned before. She took her designs from Max Wertheimer, the Gestalt psychologist.
    To backtrack... in 1939 I realized there was not much future for me at the New York Hospital. I moved to City College as a counsellor. A friend of mine, Edward Strongin at the Westchester Division of New York Hospital, mentioned that the Director was looking for a part time psychologist. I applied and got the job. I went up there once a week (more often in the summer) and got $15 a day, plus carfare, and an excellent lunch!! It was there that I published my first avowedly neuropsychological paper, The Use of Psychological Tests inthe Diagnosis of Brain Damage. This was a report of an interesting case of a man with a head injury sustained in an accident, without any neurological findings, who was diagnosed as a post-traumatic neurosis.? showed

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 that he was cognitively impaired on testing and the diagnosis was changed to indicate a post-traumatic organic condition.
    In 1946-48 I did a stint in Louisville. Dr. Glen Spurling was the top neurosurgeon in town, and very prominent nationally as well. Occasionally he would call on me to see one of his patients. When I came to Iowa in 1948 I had enough interest in neuropsychology to go across the Iowa River to talk to Dr. Adolph Sahs, who was head of the Department of Neurology, and to Dr. Russell Meyers, Professor of Neurosurgery (who, by the way, had an M.A. in psychology from Brown). To my delight, they readily agreed that I could see their patients, bring my students over and undertake research projects. The first two neuropsychological Ph.D. dissertations were completed in 1954. At about that time I started investigating the Gerstmann Syndrome, originally thinking it was necessarily part of a larger syndrome, like a dementia or a large stroke (cf., The Fiction of the Gerstmann Syndrome”, 1961). Later I had to recant and eat crow, so to speak, when reports of a more-or-less pure form appeared (Gerstmann's Syndrome, 1992). By the way, Norman Geschwind did not accept my earlier views on the Gerstmann Syndrome; he believed it could exist in isolation. He was right.

Since you mentioned Norman Geschwind, what are your thoughts about him and others?

    Geschwind was a fine, brilliant, and passionate person. He was a warm and generous man who made a great contribution to the field. He was a great story teller. In fact once we had a story-telling contest in Ann Arbor. Edith Kaplan set it up in a hotel room at a meeting of the Academy of Aphasia. His death was a real loss. You know his views on the relationship of left-handedness, allergies, stuttering, dyslexia and so forth are most interesting. Something seems to be there, but we haven't quite parsed it out yet.
    Now Alexander Luria, he was a very bright and pleasant man. He came to the United States about 1959 and spoke at the American Orthopsychiatric Society. In fact, I was the discussant of his paper. Well, anyway, he saw that I smoked and he gave me a big box of Russian cigarettes - that was labeled Sputnik! Back then, the Russians had just gotten a man into space and there was a tremendous surge of Newsletter 40 interest in science and technology. In 1966 we were to meet in Florence, Italy. But the Soviet authorities wouldn't let him out. In the 1930's he was apparently exiled to an institution for mental defectives for a time, as punishment for some alleged political crimes. But he used it to good end by studying the patients there.
    There are some others who come to mind. For instance, in 1966, I participated in an APA symposium on frontal lobe function. Karl Pribram was the speaker before me. Apparently he had nothing formally prepared and said, ...I really don't have very much to say..., and then proceeded to go on and on for 25 minutes, 35 minutes. Josephine Semmes, the moderator, tried to remind him that he had gone over the 20-minute time limit. Finally, 45 minutes later, he finished.1 was the next speaker. I began by saying, ... .like Dr. Pribram, I don't have much to say, but I won't take as long to say it.” The whole house exploded in laughter and applauded. It's a tribute to Karl's good nature that he's still a friend of mine.

What do you think about more contemporary issues such as the growth of the profession, training and credentialing?

    Neuropsychology has shown exponential growth over the past decades. When INS first started it was a small group, maybe 75 people with a half dozen or so papers presented at a meeting. It really wasn't getting anywhere. When I was president of INS, I was concerned and so I latched onto a bright and energetic young fellow named Paul Satz. I appointed him membership secretary, and Paul did the rest. Our first real meeting occurred in New Orleans in 1973. Then came NAN, leading to real growth. And now, I guess Division 40 has about 4,000 members. I think there are probably too many - that is, I wonder if we need so many neuropsychologists. First of all, I think the well-trained clinical psychologist should be a kind of garden-variety neuropsychologist, like a competent internist can do enough neurology to spot something significant. I think neuropsychology has expanded beyond reason. As a specialty, it should be limited to a relatively small group, perhaps a couple of thousand, highly trained people.

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In terms of training, I think it should be basically in neuroscience (anatomy, that is functional neuroanatomy, neurological disorders), cognitive science, and clinical psychology, and especially psychopathology. I think the competent neuropsychologist should know an hysteric when he/she sees one, or an obsessive character, or inadequate personality, as well as the various other forms of psychopathology. They must be competent, but it seems to me that they need not come from some inflexible training program. Some of the best people we trained in our program didn't have their degrees in clinical psychology but in experimental and physiological. Of course, they needed the clinical training and they received it, but that training doesn't need to be in any specified order. For example, at Iowa it was agreed in the department that, if I took a clinical student, he/she wouldn't have to do psychotherapy practicums, but instead take neuroanatomy or some other course. I think the trainee should take at least one course in psychopathology. I cannot conceive of a clinical neuropsychologist who doesn't know psychopathology.
    In terms of the survival of the profession, there is the possibility that we may become the psychometricians' of the neurologist. The medical profession is much better organized than we are, and much better at coming together to protect their perceived interests. But I do think that at this time, with the approval of the specialty status of Clinical Neuropsychology by APA, we have an excellent chance to be a true profession. But this will happen only if our activity is supported by basic knowledge of brain-behavior relationships. Just knowing an assortment of assessment procedures will not do.

Announcement

APA's public education campaign is helping to make the public more aware of psychology's presence in the health care community. Through various media and community outreach efforts, APA is educating the public about the value of psychology. Advertising, another component of the campaign, will complement these activities at the state and local levels. Your contribution of $100 to the campaign will be used to provide funding for state and local associations and APA division to help pay for local advertising. Get involved. Send your check to: Accounting/Public Education Campaign, American Psychological Association, 750 First Street, NE, Washington, DC 20077-0522

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DIVISION 40 EXECUTIVE COMMITTEE MEETING MINUTES February 5, 1997
Fuschia Room, Hilton at Disney Village, Orlando, Florida

Present: Adams, Baron, Becker, Berg, Bieliauskas, Bondi, Cripe, Crosson, DeLuca, Eubanks, Fennell, Fischer, Goldstein, Hamsher, Marcotte, Meneese, Puente, Trenerry, Wilson, Yeates.

Absent: Berent, Boll, Van Gorp, Heilbronner

1. The meeting was called to order at 1:l0 p.m. by President Dr. Fennell.

2. Minutes of last EC meeting held on August 9, 1996 and the Division 40 Annual Business meeting held on August 11, 1996 were reviewed. The minutes of both meetings were approved with the following corrections. For the EC meeting minutes, item 2, Drs. Crosson and Eubanks should also have been thanked, in addition to Dr. Manfred Meier, for their efforts at helping attain specialty recognition for clinical neuropsychology by APA. For the business meeting minutes, item 11 is corrected to read, Dr. Dodrill presented Dr. Adams with a plaque, and on behalf of the Division 40 membership, thanked him for his work this year as Division President.”

3. Treasurer's Report: Dr. Marcotte reported for Dr. Van Gorp, who was unable to attend the meeting. As of December 3 1, 1996, Division 40 assets were as follows: $13 1,952.27 in Division dues, monies carried over from past budgets and interest; a certificate of deposit valued at $34,849.59; bringing Division 40 current total assets to $167,501.86.

4. Council Representatives' Report: Drs. Goldstein and Puente reported that they will be attending the mid-winter APA Council meeting next week in Washington, D.C. Division 40 has secured a third seat in council through this year's apportionment balloting. Division 40 is playing a more active role in the coalitions within APA Council to forward our mission. Drs. Fennel1 and Bieliauskas are also working closely with APA to increase our presence and representation in the organization. With the new specialty recognition of clinical neuropsychology, our Division will need to take a very active role in helping to define training and educational guidelines which will need to be developed in the near future.

5. Newsletter: Dr. DeLuca reported that the special edition Newsletter honoring the career of Dr. Nelson Butters was mailed to all members in December, 1996. Arlene Butters wrote a very kind note thanking the Division for the tribute to her husband. The Winter/Spring edition will be mailed somewhat behind the normal schedule in March, 1997. Dr. DeLuca also reported that the Newsletter interviewed Dr. Arthur Benton, and an article based on the interview will be featured in the Summer Newsletter. This edition will also publish the Division 40 Convention schedule of events. There was a discussion about advertising in future Newsletters. The Editor has been approached by organizations offering to exchange advertisement for Division 40 in their publications for advertising in the Newsletter. The EC discussed this offer, and decided to not accept advertising under such arrangements in the Newsletter at this time. Items to be included in the Summer edition need to be sent to Dr. DeLuca by May 1, 1997.

6. Membership: Dr. Meneese presented the names of 259 applicants for membership in Division 40 (59 members, 4 associate members, 196 student affiliates). The EC unanimously voted to extend membership to all applicants. This brings the total Division 40 membership to 4,410 full and associate members, and 354 student affiliates. Dr. Meneese also presented a proposed duofold postcard to be used in the upcoming membership drive. After discussion, the card was approved with an additional statement to be included noting that clinical neuropsychology is the first new area to receive specialty recognition from APA. The EC unanimously approved Dr. Meneese's program to increase membership.

7. Elections/Nomination Statements: Dr. Adams reported that a Call for Nominations was mailed to the membership, listing positions available, but not indicating the names of individuals being placed up for nomination. Deadline for nominations is set for March 7, 1997. Positions available this year include: President-elect, Secretary, Treasurer, one EC Member-at-Large, and one APA Council Representative. A discussion ensued regarding the Nominations Committee recommendation that all members running for elected office be asked to sign an Ethical Disclaimer form, which has been reviewed by the APA Legal Office. This form is similar to one used for the National Register. The EC voted to adopt this recommendation. Dr. Adams will explain this new procedure to all candidates, and will forward the forms to them. Candidates will be asked to submit nominations statements to be mailed to the membership in May, to coincide with elections ballots being mailed by APA. The Nominations Committee will review the statements to ensure their accuracy prior to the mailing.

8. Fellows: Dr. Bieliauskas presented a report for Dr. Berent, who was unable to attend the meeting. Dr. Berent received 30 inquiries/requests for application materials. Ten individuals submitted complete applications for Fellow status by the December deadline. The Fellowship Committee presented the names of all ten applicants (9 men, 1 woman) to the EC for consideration. The EC voted to forward the names and materials of all ten members to APA for further consideration.Decisions will be announced in August. The EC expressed continuing concern by the low numbers of applications being received from minority and female Division 40 members. A subcommittee, comprise of Drs. Berent, Fennel1 and Puente has been formed to try to solicit such applications. Dr. Marcotte will contact APA to obtain information about members to help these recruitment efforts.

9. Program: Drs. Yeates and Bondi received 143 submissions for papers, posters and symposia presentations for the 1997 APA Convention. Their 16 member committee reviewed all submissions, and 108 were accepted (76% acceptance rate). There will

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be 42 hours of programmed events. Invited addresses are being presented by Drs. Jack Fletcher, Leslie Ungerleider, Alfred Kazniak and Karl Pribam. As part of the APA celebration of the 50th anniversary of the founding of Divisions, Division 40 has arranged for Dr. Louis Costa to present an invited address entitled, Professionalization of Neuropsychology: The Early History”. Division 40 will also have a booth at the Division Fair” on Sunday, August 17, 1997. Divisions 40, 22 and 38 will be holding a joint social hour to honor the past Presidents of the three Divisions. This year's Student Award goes to Konstantine Zakzanis, a graduate student at York University in Toronto who works with Dr. R. Walter Heinrichs.

Ad- Hoc Committees

10. Ethics: Dr. Becker reported that there are 3 new members on the Ethics Committee: Drs. Lidia Artiola, Laurence Binder and Laetitia Thompson. The committee will be meeting on February 8, 1997. The committee continues to discuss issues of third party observers in evaluations, and the evaluation of non-English speaking clients.

11. Science Advisory: Dr. Marcotte reported that the Division membership, particularly the members of the Science Committee have been active in APA Science Directorate efforts, in attempts to continue to improve the image of Division 40 as a science division within APA. To this end, members have volunteered to serve as reviewers for Student Research Grant Awards, as well as Travel Awards. The committee will be meeting later today to continue work on developing a Division 40 student research fund, the Science Corner articles for the Newsletter, and other efforts. Dr. Marcotte will be stepping down as Chair of this committee in August, and Dr. Russell Bauer has been appointed to assume the Chair at that time.

12. Education Advisory Report and EC Discussions Regarding Snecialty Recognition: Dr. Crosson reported that the Education Advisory Committee met in Toronto on 8/9/96. The recognition of clinical neuropsychology as a new specialty area has passed, and will have profound implications for this committee's work in the future. This committee, in concert with CNS has arranged to hold a meeting during this INS meeting for internship sites to open a dialogue about training needs at this level. It is becoming increasingly clear that Division 40 alone will no longer be in a position to set the guidelines for training. We will continue to work on developing a model for the continuum of education neuropsychology with other groups. To this end, Division 40 will be an official co-sponsor of a conference to develop such a model to be held in Houston in October, 1997. The EC voted to tentatively set aside $5,000.00 to be used for this conference, including financial support to send representatives to the meeting. As Dr. Van Gorp was not present, the final amount will be approved by the EC, pending his review of our current financial state. It appears that the first area of training in neuropsychology to be addressed for accreditation will be the post-doctoral fellowship. Dr. Crosson has resigned as Chair of the Education Advisory Committee; Dr. Fennel1 has appointed Dr. Kerry Hamsher to this position. The EC extended its sincere thanks to Dr. Crosson for his tireless efforts these past years as Chair of this committee.

13. Practice Advisory: Dr. Eubanks reported that the brochure describing neuropsychology and neuropsychological services developed by this committee has been published in The Clinical Neuropsvcholoeist. He will be ordering reprints for Divisional use. The Practice Advisory Committee will be meeting on 2/6/97.

14. Public Interest Advisory: Dr. Wilson has recruited members to participate on this committee, which will hold its first meeting under her leadership on 2/6/97.

15. Program Listings: Dr. Cripe reported that the current data base contains the listings for 39 doctoral programs, 44 internship programs and 69 post-doctoral fellowship programs. The listing is scheduled to be updated during 1997. Any members with ideas for what information should be added to the current listing information should contact Dr. Cripe. He also reported that the entire list can now be found on the Swets homepage. It can be accessed through the address: http//www.swets.nl.sps.ntp.ntphome.html

16. CPT Code Task Force: Dr. Puente reported that CPT codes have been updated and approved by HCFA. Medicare code changes in 1997 now finds codes clustered into Psychiatry Codes (50% reimbursement), CNS Assessment/Test Codes (80% reimbursement), and Medicare Psychotherapy Codes. The newly created codes include one for the provision of biofeedback/psychophysiological treatment.

17. Minority Affairs: Dr. Strickland reported that the committee last met in Toronto in August 1996. There was discussion about changing the name of the committee. Dr. Fennel1 reminded the committee that such a decision was an EC decision, and not a committee decision. The discussion was tabled until August, 1997, with Dr. Fennel1 to check with APA regarding this issue. Dr. Strickland steps down as Chair of this committee this month, and a new Chair will be appointed. The EC thanked Dr. Strickland for efforts these past years.[Secretary's Note: Following the EC meeting, Dr. Fennel1 announced that Dr. Duane Dede has been appointed to a 3 year term as Chair of this committee.]

18. International Affairs: Dr. Marcotte presented the committee report for Dr. Heilbronner, who was unable to attend. Dr. Heilbronner was able to attend the Autumn CIPR meeting in DC. He and the International Affairs Committee members continue to correspond with international colleagues, setting up meeting times and visits with local neuroscience professionals. He has also been invited with other CIRP members to develop a protocol manual for visiting foreign countries and hosting foreign visitors. This committee, in concert with the Program Committee, jointly developed a discussion hour for the 1997 APA convention to discuss international issues in accreditation and training in neuropsychology.

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19. Awards (Benton. Levitt): Dr. Baron reported that committee will be meeting on 2/6/97 to select a nominee for the Benton Award. Their nominee will then be reviewed by the APE The committee will also review the applications and select this year's winner for the Levitt Early Career Award at this meeting.

20. Hecaen Award: Dr. Hamsher's term as Chair of this committee ended in 8/96. A new Chair has not yet been appointed. The EC unanimously approved the motion that the Hecaen Award Committee and the Awards Committee charged with administering the Levitt and Benton Awards be merged into one Division 40 Award Committee, with Dr. Baron to Chair this committee.

21. ASHA/Div 40 Task Force: Dr. Fischer has been appointed to be the Division 40 representative to this resurrected committee. The mission of the committee is to enhance the relationship between speech pathologists and neuropsychologists. She will attend the first meeting on 2/8/97.

22. Bylaws Revision Committee: Dr. Bieliauskas presented the revised Bylaws developed by this committee for the EC to consider forwarding to the Division membership for ratification. The revised Bylaws include an updated Mission Statement (consistent with the one developed by the Division 40 Planning Committee), and clarifies the term limits for committee members and chairs. Ad Hoc Committees will be recognized as Continuing Committees”, and the process by which a Division Council Representative will be rotated off in the event of a lost council seat are clarified. The revised Bylaws also have changes pertaining to nomination of members for elected positions, changing the current requirement of 5 nominations to 1% of the current Division membership required for having a name placed on the ballot. After discussion, the EC unanimously voted to accept the Bylaws Revisions as outlined by the committee, and to forward them on to the membership for ratification. They will be mailed to all eligible voting Division 40 members in the May mailing. A letter from Dr. Bieliauskas outlining the major changes will also be included in the materials. To be approved, 2/3 of the voting members must vote to accept the changes.

Other Business

23. Neurology letters: Dr. Fennel1 provided EC members with a copy of the letter written by the Division, ABCN and the AACN in response to the article published in a 1996 edition of Neurolor gy pertaining to neuropsychological practice. The NAN Board has also written a letter. Dr. Fennel1 has been informed that the Editors have decided to publish the letter in an upcoming edition of the journal.

24. Predoctoral Internship results: Dr. Fennel1 also provided the EC with recently available information from APA about predoctoral internship matches. In 1996, 78.7% of applicants were successfully able to match on uniformed notification day. No information specific to neuropsychology internships was available for review.

25. CODOPAR Division Fair at APA Convention: Dr. Fennel1 also updated the EC about the plans for the Division Fair” to be held on the Sunday of the APA Convention.Dr. Keith Yeates, Program Chair, will be in charge of coordinating the Division 40 Table. Volunteers are being sought to help out on that day.

26. Announcment of International Upcoming Meetings: Dr. Puente announced two international meetings that may be of interest to Division 40 members. From October 4-7, 1997, the Annual Meeting of the Latin American Neuropsychological Society will be meeting in Guadalajara, Mexico. The First International Luria Memorial Conference will be held September 24-26, 1997 in Moscow. The group has appealed to neuropsychological groups for monetary support; the EC voted to approve that $250.00 be sent to support this meeting, with monies to be drawn from the Science Advisory Committee funds.

27. Other New Business: Dr. Fennell announced the formation of a formal Division 40 Liaison to NAN. This Fall, she also attended an interdivisional meeting, held in conjunction with Divisions 12 (section 5), 38, and 22 to work on coalition issues, as all groups are broadly interested in health issues. This coalition will meet again at APA.

28. There being no other business, the meeting was adjourned at 3:55.

Respectfully Submitted,
Ann C. Marcotte, Ph.D.,
Secretary, Division 40

[Page 20]

 Newsletter 40

Newsletter 40 is the official publication of Division 40. The Editor is John DeLuca; the Associate Editor is Joel E. Morgan. Submissions and correspondence regarding the newsletter should be addressed to the editor, Dr. John DeLuca, Neuropsychology and Neuroscience Laboratory, Kessler Institute for Rehabilitation, 1199 Pleasant Valley Way, West Orange, NJ 07052

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