The Wisconsin Card Sorting Test (WCST; Heaton, Chelune, Talley,

Kay, & Curtiss, 1993) is considered a neuropsychological instrument

particularly sensitive to frontal lobe dysfunction (Gouvier, O´Jile, &

Ryan, 1998; Lezak, Howieson, & Loring, 2004) because it evaluates

the patient tendency to perseveration, originated by a failure in the

flexible choice of new alternatives (Andrewes, 2001).

In the Heaton et al., (1993) version, this instrument consists in four

stimulus cards and 128 response cards, organized in two packs

containing 64 cards each. All this cards (stimuli and response) vary

in colour, geometric form, and number.

The WCST is useful in the evaluation of executive functions

(Andrewes, 2001; Lezak et al., 2004) because it involves planning,

the use of environmental feedback for mental set shifting, oriented

behaviour to achieve a specific goal, and the modulation of impulsive

responses (Chelune & Baer, 1986, Gnys & Willis, 1991, Perrine,

Cuprensa, Welsh, & Pennington, 1988, as cited in Heaton et al.,

1993).

Given its characteristics, this instrument may also be used in

intervention procedures addressing executive functions rehabilitation

(Portellano, 2005). However, this last type of use raises several

questions.

The aim of the present study was to develop alternative versions of

the WCST suitable for the neuropsychological rehabilitation context.

PARTICIPANTSPARTICIPANTS

Two adult patients (age: 22 and 25 yrs; education: 9 and 7 yrs), both

with impairment of executive functions, undergoing

neuropsychological rehabilitation.

MATERIAL AND PROCEDUREMATERIAL AND PROCEDURE

Three experimental alternative version of the WCST.

To avoid learning effects, the stimuli on the new versions differ from

the stimuli presented in the original instrument, but the underlying

principles are the same. Each version is composed of four stimulus

cards and only 64 response cards, in order to minimize fatigue and

frustration.

In the first alternative version, the cards are matched by three

criterions: colour (black, grey, orange, rose), form (sun, cloud, ray,

moon) and number (one, two, three, four) (cf. Figure 1).

In the second version, the cards can be matched by other three

criterions: large form, small form and the location of the small form

inside the larger one (cf. Figure 2).

In the third and last version, the cards can be matched by the

following criterions: circle colour, line colour, union or separation

between line and circle (cf. Figure 3).

Each one of the three new versions were analysed, separately, by

three independent experts in the field.

The preliminary results are encouraging, since all experts and

patients responded well to each of the three versions of the

WCST developed.

These results support the beginning of next level of instrument

development.

WISCONSIN CARD SORTING TEST IN NEUROPSYCHOLOGICAL WISCONSIN CARD SORTING TEST IN NEUROPSYCHOLOGICAL REHABILITATION: ALTERNATIVEREHABILITATION: ALTERNATIVE VERSIONSVERSIONS

Susana V. Silva1, Luís Simões da Cunha1, Rute F. Meneses1, Joana Pais21 Faculdade de Ciências Humanas e Sociais – Universidade Fernando Pessoa, Porto; 2 Laboratório de Neuropsicologia, Serviço de

Neurologia, Hospital de São Sebastião, Santa Maria da Feira

AIMAIM

METHODMETHOD

Figure 1. First alternative version. Figure 2. Second alternative version.

Figure 3. Third alternative version.

RESULTS AND CONCLUSIONRESULTS AND CONCLUSION

REFERENCESREFERENCES

Andrewes, D. (2001). Neuropsychology from theory to practice. New York: Psychology Press.

Gouvier, W. D., O´Jile, J. R., & Ryan, L. M. (1998). Neuropsychological assessment forplanning cognitive interventions. In G. Goldstein, & S. R. Beers (Eds.), Rehabilitation (pp. 181-200). New York: Plenum Press.

Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G., & Curtiss, G. (1993). Wisconsin Card Sorting Test Manual: Revised and expanded. Odessa, FL: Psychological Assessment Resources.

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychology assessment (4th

ed.). Oxford: Oxford University Press.

Portellano, J. A. (2005). Introducción a la neuropsicología. Madrid: McGraw-Hill.

1st International Symposium on Neuropsychology and Rehabilitation CRPG – 26th-28th October, 2006