Chosen aspects of cross-cultural adaptation of neuropsychological tests
Anna Marcinkowska1, Emilia Sitek2,3
Neuropsychological test outcomes are influenced by education, literacy, ethnic origin and the culture background of the patient. One of the greatest neuropsychological challenges in the 21st century is to create a diagnostic tool that measures a pure cognitive process, regardless of the level of education or the national and cultural background of the patient. The paper is aimed at presenting selected problems associated with the adaptation of neuropsychological tests focusing on their feasibility in another culture. Culture-fairness of testing is associated with tasks used, their content and the testing context. In some non-Western cultures, psychometric testing is inadequate, as testing as such is atypical. Cognitive tests not only need normative data for each culture, but they also require cultural adaptation of tasks. Visuospatial tests are considered to be more “culture-fair” than verbal tasks, but some of the test results may be dependent on semantic knowledge. Likewise, the praxis tasks requiring performance or imitation of communicative gestures depends on their prior knowledge and use in a given culture. When adapting memory tests (especially tests of logical memory) for use in a new cultural context, particular emphasis should be put on the relevance of the material for the target population. As executive function tests engage more basic cognitive processes (such as language and visuospatial function, praxis and memory), their adaptation is associated with all of the elements outlined above. Also, since culture influences problemsolving strategies, some tasks may be irrelevant for a different culture due to the problem structure and not the task content. Creating culture-free cognitive measures, including screening tests, is very challenging. Further studies should focus on devising new tools adapted to specific cultural contexts with the proper understanding of the population at which the test is targeted.