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Table 2 Considerations for test interpretation in an Indigenous context

From: “People like numbers”: a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory

Interpretation guide
1. Detailed History
• Info from others
Have I talked to family, teachers, or others to find out about behaviour at home?
Self care
Social interaction or romantic relationships
Memory, bizarre behaviour, any violation of cultural norms
Activities of daily living
Comparison to peers re language development & abilities
Money management, knowledge of pension etc
• Medical History
 Have I got a medical history from doctors, the client, family or medical files?
Hearing and vision
Medication use
Previous head injury or other mental health or neurological condition
• Info from client
 Have I got a social history from the client?
Biographical information, family structure (e.g. genogram)
Any personal or parental substance use (alcohol, tobacco, cannabis, petrol)
Social circumstances, are their basic needs met (e.g. food, shelter, power, meds)?
Schooling, work, jobs, or meaningful occupation
Relationships/family functioning
Legal issues
2. Testing Process
Were there any factors influencing the assessment process and what was the impact?
Context – could anything about the setting have impacted the results?
Background noise, interruptions, clinician/client gender difference, away from homelands, chaotic setting, pain, discomfort, hunger, family worries, house worries, health worries?
Motivation – Were they motivated to do well? Do they distrust mainstream systems?
Engagement – Were they engaged in the process? Was the relationship affable & appropriate?
Tiredness/alertness – Did they sleep last night? Do they have a place to sleep?
Intoxication/medications? – Are they taking any drugs and/or do they need medications?
Perceptual issues – Hearing/vision. Do they need a hearing aid or glasses? Was there background noise/distractions?
Understanding – Did they understand what you asked them to do?
Language – Do they need an interpreter? Is the interpreter an appropriate person/relationship?
Item format – Timed?, question/answer?, pencil/paper?
3. Test Results
What is the pattern of scores?
Where are the discrepancies and is it what I would expect based on my hypotheses about the source of impairment?
4. Triangulating
Is there concordance between scores, clinical impression, daily functioning and other information?
   If not, why not? Did the factors above impact?
5. Implications
All things considered, is this a reliable assessment?
If not, do I need more information and can I get it?
Is further assessment required?
What can I responsibly do with/say about the results?
How will this impact their everyday functioning?