How are adults assessed? In terms of cognitive, psychological, and social assessments, there are six
primary methods (Edelstein & Kalish, 1999): interview, self-report, report by others, psychophysiological assessment, direct observation, and performance-based assessment.
Clinical interviews are the most widely used assessment method (Stoner et al., 2009). They are useful because they provide both direct information in response to the questions and nonverbal information such as emotions. Interviews can be used to obtain historical information, determine appropriate follow-up procedures, build rapport with the client, obtain the client’s informed consent to participate in the assessment, and evaluate the effects of treatment. All these tasks are important with adults of all ages. When interviewing older adults, though, it is important to use somewhat shorter sessions, learn something about the social history of the cohort, and be aware of sensory deficits and cognitive and medical conditions that may interfere with the interview.
As described in Chapter 1, self-report instruments include a wide array of measures in which the client responds to surveys and questionnaires. Many commonly used assessment measures are presented in a self-report format. As noted in Chapter 1, a major concern is the reliability and validity of these measures with older adults.
Family members and friends are an important source of information. In some cases, such as Alzheimer’s disease, discrepancies between the client’s and others’ description of the problem can be diagnostic. Such sources also are valuable if the client is unlikely or unable to tell the whole story. Such information can be obtained through interviews or self-report.
Psychophysiological assessment examines the relation between physical and psychological functioning. One common psychophysiological measure is the electroencephalogram (EEG), which measures brain wave activity. Other measures include heart rate, muscle activity, and skin temperature. Such measures provide a way to measure the body’s reaction to certain stimuli, especially when the client gets anxious or fearful in response to them.
In some cases it is possible to observe the client through systematic or naturalistic observation (see
Chapter 1). Direct observation is especially useful when the problem involves specific behaviors, as in eating disorders. A variety of techniques exist for structuring observations, and they can be used in a wide array of settings, from homes to nursing homes.
Finally, performance-based assessment involves giving clients a specific task to perform. This approach underlies much cognitive and neuropsychological assessment. For example, a person’s memory is assessed by giving him or her a list of items to remember and then testing retention. Some neuropsychological tests involve drawing or copying pictures.