Doctor of Philosophy (PhD)
First Committee Member
Daniel N. Allen
Second Committee Member
Third Committee Member
Fourth Committee Member
Number of Pages
There are existing disparities in Attention-Deficit/Hyperactivity Disorder (ADHD) assessment, diagnosis, and treatment among ethnic/racial minority children. Thus, greater empirical attention must be given to the neuropsychological assessment of Spanish-speaking children to address linguistic diversity and psychometric equivalence of commonly used measures, like the Wechsler Intelligence Scales for Children (WISC), across cultural groups. Therefore, this dissertation addressed the following aims: (I) examined the factor structure of the WISC–Fourth Edition Spanish (WISC-IV Spanish) in Hispanic children with ADHD, (II) evaluated the feasibility of developing short forms of the Spanish version of the WISC to expand the assessment toolbox for Spanish-speaking children with ADHD by examining short form accuracy in estimating Full Scale Intelligence Quotient (FSIQ), and (III) examined the cognitive cluster profiles (as measured by the WISC-IV Spanish) of Spanish-speaking Hispanic children with ADHD. Secondary analyses were conducted on data primarily derived from a consecutive series of 392 pediatric cases referred for neuropsychological evaluation primarily to the Neurology Section of the University of Puerto Rico Medical School. Specifically, n = 148 for Aim I and n = 165 for Aims II and III. Participants were Hispanic children whose primary language was Spanish and who had a primary ADHD diagnosis and been administered the WISC-IV Spanish as part of a clinical evaluation. Findings for children with ADHD support interpretation of WISC-IV Spanish Index scores based on the 4-factor model identified in Spanish- and English-speaking normative samples. Moreover, results showed that short forms of the WISC-IV provide accurate estimations of FSIQ. Additionally, cluster profiles revealed cognitive heterogeneity in Spanish-Speaking Children with ADHD and further showed that ADHD may be associated with specific cognitive deficits, such as working memory and processing speed deficits. There is much to be learned about children from ethnic minority backgrounds with ADHD, but this dissertation research conducted with Hispanic Spanish-speaking children is an important step toward reducing mental health disparities. Findings have important implications as they provide clinicians with empirical evidence supporting the validity of the WISC when assessing children with ADHD, including the feasibility of using short forms as practical and readily available means of expanding the cross-cultural psychological assessment tool box. Lastly, findings elucidate understanding for the presence of cognitive heterogeneity in Spanish-speaking children with ADHD and highlight the importance of demographic influence on intellectual functioning. In sum, results across the three studies provide valuable information that may help inform treatment and guide new research directions for this understudied population.
ADHD; Cross-cultural; Ethnic minority; Hispanics; Neuropsychological assessment
University of Nevada, Las Vegas
Nuñez, Alicia, "Addressing Disparities in Cross-Cultural Neuropsychological Assessment" (2020). UNLV Theses, Dissertations, Professional Papers, and Capstones. 4017.
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