The Chinese Australian Neuropsychological Normative Study sample performance on Western and Chinese norms: Caveats for cross‐cultural neuropsychology

Abstract

Objective

The use of neuropsychological tests and norms developed for use with dominant culture English‐speaking Westerners when assessing persons from culturally and linguistically diverse (CALD) backgrounds has been appropriately questioned. Some authors have argued, however, that demographic corrections reduce or eliminate cross‐cultural differences. The primary purpose of the current study was to determine the suitability of using existing demographically adjusted Chinese and Western norms with Chinese Australians.

Method

Chinese Australian Neuropsychological Normative Study (CANNS) test data (based on N = 145 community dwelling Chinese Australians aged 55–87-years) were converted to demographically adjusted standard scores on the basis of comparison normative samples to examine whether the results were comparable across the CANNS and other Western and Chinese normative datasets.

Results

The CANNS sample performed poorer than Westerners on the learning trials of the Rey Auditory Verbal Learning Test (RAVLT) but better than both Westerners and Chinese from China/Hong Kong on Trial 7. Performance on non‐verbal tests including the Rey‐Osterrieth Complex Figure Test (ROCFT) Copy, Wechsler Adult Intelligence Scale—Third Edition (WAIS‐III) Digit Symbol Coding (DSC) and Matrix Reasoning (MR), the Five‐Point Test, and the Clock Drawing Test was poorer than that of Westerners despite controlling for age and education. Use of Western norms resulted in significant false positive rates for all non‐verbal tests except MR.

Conclusion

The findings of the current study caution against the use of Western tests for which CALD‐specific norms are not available, particularly non‐verbal tests.

Key words:

• CALD
• Chinese
• cross‐cultural neuropsychology
• dementia
• norms
• tests