WMS-IV Webinar September 2011 Handout PDF

WMS-IV: Administration, Scoring, Basic Interpretation
Gloria Maccow, Ph.D., Assessment Training Consultant
Administration, Scoring, and

Basic Interpretation
Memory and Learning

 Learning - process of acquiring new
information.
 Memory - persistence of learning in a state
that can be revealed at a later time”
(Squire, 1987).
 WMS-IV measures ability to learn and
remember information presented verbally
and visually.
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Process of Learning and

Remembering
External information is transformed into

Encoding
mental representations or memories and
stored in STM.
Information from immediate memory is

Consolidation
solidified into long-term memory stores.
Information is brought into conscious

Retrieval
awareness.
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Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 1

WMS-IV and Long-term Memory

 Ability to store and retrieve bits of
information or knowledge consciously –
declarative memory (Squire & Butters,
1992).
 Ability to store and retrieve information
that is situation and context specific –
episodic memory.
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Test Structure and Scores

See Record Form
WMS-IV: TWO Batteries
Optional: BCSE
Ages 16-69
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WMS-IV: TWO Batteries
Optional: BCSE
Ages 65-90
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WMS-IV Flexible Approach
WMS-IV WMS-IV Older

Standard Battery Adult/Abbreviated Battery
(IMI DMI AMI VMI VWMI) (IMI DMI AMI VMI)
Logical Memory / Visual Logical Memory / Designs

Reproduction Battery Battery
(IMI DMI AMI VMI) (IMI DMI AMI VMI)
Visual Reproduction /
Logos / Names Battery
Logos Battery
(AVIMI AVDMI AVMI)
(IMI DMI VMI)
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Index Structure of
WMS-III / WMS-IV
WMS-III Index/Subtest WMS-IV Index/Subtest
Auditory Immediate Auditory Memory
Logical Memory I Logical Memory I
Verbal Paired Associates I Verbal Paired Associates I
Auditory Delayed Logical Memory II
Logical Memory II Verbal Paired Associates II
Verbal Paired Associates II
Auditory Recognition Delayed
Logical Memory II Recognition
Recognition
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Index Structure of
WMS-III / WMS-IV
Visual Immediate Visual Memory
Faces I Designs I
Family Pictures I Visual Reproduction I
Visual Delayed Designs II
Faces II Visual Reproduction II
Family Pictures II Visual Working Memory
Working Memory Spatial Addition
Letter-Number Sequencing Symbol Span
Spatial Span
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Index Structure of
WMS-III / WMS-IV
Immediate Memory Immediate Memory
Logical Memory I Logical Memory I
Verbal Paired Associates I Verbal Paired Associates I
Faces I Designs I
Family Pictures I Visual Reproduction I
General Memory Delayed Memory
Logical Memory II Logical Memory II
Faces II Verbal Paired Associates II
Verbal Paired Associates II Visual Reproduction II
Family Pictures II Designs II
Logical Memory II Recognition
Verbal Paired Associates II Recognition
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Brief Cognitive Status Exam

This optional subtest assesses a variety of
cognitive functions. The examinee performs
simple tasks in a number of different areas
including
 orientation to time,
 mental control,
 clock drawing,
 incidental recall,
 automaticity and inhibitory control, and
 verbal production.
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Auditory Memory Index
Logical Memory I
 This subtest assesses narrative memory
under a free recall condition.
 Two short stories are presented orally.
 For older adults, one story is presented
twice.
 The examinee is asked to retell each
story from memory immediately after
hearing it.
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Logical Memory II
The delayed condition assesses long-term
narrative memory with free recall and
recognition tasks.
• The examinee is asked to retell both
stories from the immediate condition.
• Then the examinee is asked yes/no
questions about both stories -
Recognition.
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Verbal Paired Associates I

 This subtest assesses verbal memory for
associated word pairs.
 The examiner reads 10 or 14 word pairs to
the examinee. Then, the examiner reads
the first word of each pair, and asks the
examinee to provide the corresponding
word.
 There are four trials of the same list in
different orders.
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 The delayed condition assesses long-term
recall for verbally paired information with
cued recall and recognition tasks, and
includes a free recall task.
 The examinee is orally presented with the
first word of each pair learned in the
immediate condition and asked to provide
the corresponding word.
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 The examinee is then read a list of word
pairs and asked to identify each as either
one of the word pairs he or she was asked to
remember or a new word pair.
 Finally, during the optional word recall task,
the examinee is asked to say as many of the
words from the pairs as he or she can recall.
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California Verbal Learning Test-II:

Substitution
 CVLT-II Total Trials 1-5 can be

substituted for VPA I
 CVLT-II Long Delay Free Recall can be

substituted for VPA II
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Interpretive Considerations:
LM and VPA
 Both measure aspects of semantic and

auditory memory.
 Presentation of information is organized/
meaningful for LM and unorganized for VPA.
 VPA requires single word responses; LM
requires longer, more cohesive responses.
 VPA is multi-trial learning measure. For Adult
Battery, LM represents single-trial learning
ability.
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Visual Memory Index

Visual Reproduction I
 This subtest assesses memory for
nonverbal visual stimuli.
 A series of five designs is shown, one at
a time, for 10 seconds each.
 After each design is presented, the
examinee is asked to draw the design
from memory.
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Visual Reproduction: Scoring

 See Appendix B (Adm Manual) for
scoring criteria for each item.
 Do not penalize or mistake poor motor
control for memory or orientation
issues.
 Use scoring template.
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Instructions Linking
Immediate and Delayed Tasks
VR is first subtest administered.

Say, Later I will ask you to draw all of the
designs again, so try to remember
them.
If VR is not administered, present adapted
statement after the first subtest you
administer.
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Visual Reproduction II
The delayed condition assesses long-term
visual- spatial memory with free recall and
recognition tasks, and includes a direct copy
task.
• First, the examinee is asked to draw the
designs shown during the immediate
condition. Designs are drawn from memory
in any order.
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Visual Reproduction II
• Second, the examinee is asked to choose
which of six designs on a page matches the
original design shown during the immediate
condition.
• Third, for an optional copy task, the

examinee is asked to draw the designs while
looking at them.
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Designs I
 This subtest assesses spatial memory for
unfamiliar visual material.
 The examiner shows examinee a grid with 4–8
designs on a page for 10 seconds, and then
removes the page from examinee’s view.
 The examinee then selects the designs from a
set of cards and places the cards in a grid in
the same place as previously shown.
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Designs II
 The delayed condition assesses long-

term spatial and visual memory with
free recall and recognition tasks.
 First, the examinee is asked to recreate
the pages shown in the immediate
condition with the cards and grid.
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Designs II
 Then he or she is shown a series of grids
and asked to select the two designs that
are correct and in the same place as on
the pages shown in the immediate
condition.
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VR and DE
 Both measure aspects of visual details

and spatial memory.
 Response process for VR includes more

visual-construction and fine motor
abilities than DE.
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VR and DE
 DE has greater recognition memory component

than VR which uses a free recall response
format.
 DE evaluates spatial memory explicitly; VR
does not.
 Stimuli for VR are easier to name than stimuli
on DE. This may facilitate memory by using
verbal cues.
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Visual Working Memory Index
Spatial Addition (Ages 16-69)

 Spatial Addition replaces Spatial Span.
 Assesses visual-spatial working memory using a
visual addition task.
 Examiner shows the examinee, sequentially,
two grids with blue and red circles. [5 sec.]
 Then, examiner asks examinee to add or
subtract the location of the circles based on a
set of rules.
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Symbol Span
 This subtest assesses visual working
memory using novel visual stimuli.
 The examinee is briefly shown a series of
abstract symbols on a page and then asked
to select the symbols from an array of
symbols, in the same order they were
presented on the previous page.
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SA and SSP
 SA taps spatial location memory and the
ability to compare spatial images.
 SSP is highly focused on recall of visual
details and the sequence of the images
must also be maintained in memory.
 SA uses a free recall format.
 SSP uses a recognition memory format.
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Scores

Types of Scores
 Primary Subtest Scaled Scores
(mean=10, sd = 3; range 1 – 19)
 Index Scores (mean=100, sd = 15; range
40 – 160)
 Process Scores (Scaled Score or
Cumulative Percentage)
 Contrast Scaled Scores
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Contrast Scores – Note!

The basis of the comparison for
contrast scores
is other people
of similar performance levels
on the initial/control skill,
not age-based peers.
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Contrast Score Overview

 Scored on 1-19 Scaled Score Metric.
 Does not replace normative scores.
 Answers specific hypothesis about an
examinee’s performance relative to
his/her performance on other measures.
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Contrast Score Overview

 Normative score asks: Is this person’s
delayed memory impaired?
 Contrast score asks: Is this person’s
delayed memory impaired given his/her
initial encoding ability?
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Contrast Score Interpretation

High scores (13 and above) indicate better
than expected performance on the
dependent variable given performance on
the control variable.
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Low scores (7 and below) indicate poorer
than expected performance on the
dependent score given performance on the
control score.
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Scores in the average range (8-12)
indicate no difference in performance
between the control and dependent
measures.
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Contrast Scores: Example

Normative Scores
• Joe obtained a 6 on VR I and a 6 on VR II
• Interpret VR I and VR II as impaired in
comparison to his same age peers
Simple Difference Discrepancy Analysis
• VR I (6) – VR II (6) = 0
• Difference is not statistically significant
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Final Interpretation Using Simple
Difference
 Both VR I and VR II are impaired but are
not significantly different from one
another
Suggested Intervention
 Target interventions toward both
encoding and retrieval deficits
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Normative Scores
• Joe obtained a 6 on VR I and a 6 on VR
II
Contrast Score
• VR I vs. VR II Contrast Scaled Score is 8
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Final Interpretation Using Contrast
Scaled Score
• In relation to his peers, both immediate
and delayed memory are impaired.
• Contrast score shows that VR Delayed is
actually within average range (SS=8)
when adjusted for his immediate ability.
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Final Interpretation Using Contrast
Scaled Score
• His delayed memory performance is being
impacted by his immediate memory
ability.
• Thus, his critical memory problem may be
in initial encoding ability.
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Suggested Intervention
 Target intervention toward encoding
difficulties.
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Interpretation
Interpreting WMS-IV Data
1. Auditory Memory
─ Index Score
─ Subtest Scores
─ Process Scores
─ Forgetting and Retrieval
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2. Visual Memory
─ Index Score
─ Subtest Scores
─ Process Scores
─ Forgetting and Retrieval
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3. Modality Specific Memory Ss and Ws

4. Visual Working Memory
5. Visual Memory Abilities Compared to
Visual Working Memory Abilities
6. Immediate and Delayed Memory
(Retention of Information)
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See Sample Interpretive Report
Sofia
Sofia Estrange
Estrange
Age
Age 40 years
40 years 33
months
months
Data from WMS-IV Administration and Scoring Manual
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Summary of Needs
 Sofia displayed a notable amount of forgetting
between the immediate and delayed tasks of the
WMS–IV.
 Her delayed memory is much lower than expected
given her level of initial encoding.
 Sofia may benefit from using associative linkages
when encoding information. By linking new
information to what has been previously learned, she
may be able to gain a more global understanding of
the information and improve recall.
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Recommendations
 Encourage Sofia to use external memory
sources such as lists, date books,
calendars, and pocket-size recorders for
information that must be remembered.
 Teach Sofia “self-cueing” strategies may

help facilitate her retrieval of information.
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Technical Properties

Standardization Sample
16–90 years, n = 1400 total
• 100 per age band (14 age bands)
Based on 2005 US Census
Exclusionary Criteria
Stratified proportionately
• Age
• Gender
• Race/Ethnicity (White, African American, Hispanic,
Asian, and Other)
• Education level
• Geographic region
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Reliability
Average r Average r
Index
(Ages 16-69) (Ages 65-90)
Auditory Memory .95 .95
Visual Memory .96 .97

Visual Working
.93
Memory
Immediate Memory .95 .95
Delayed Memory .94 .92
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Construct Validity
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Studies of Concurrent Validity

 WMS-III  RBANS
 WMS-III Abbreviated  DKEFS
 CVLT-II  WIAT-II
 Children’s Memory Scale  ILS
 ABAS-II
 WAIS-IV
 Brown ADD Scales
 WAIS-III
 BDI-II
 WISC-IV
 BDI-Fast Screen
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WAIS-IV and WMS-IV

Co-normed
• Allows more accurate estimation of
correlations between measures
Important to consider context
• WMS-IV evaluates memory within a context
(e.g., Visual, Auditory)
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Correlation Between
WAIS-IV and WMS-IV Indexes
Verbal Perceptual Working Process Full
GAI
Comp Reasoning Memory Speed Scale
Auditory
.53 .44 .50 .40 .57 .54
Index
Visual
.44 .62 .47 .45 .61 .58
Index
Visual
Working .53 .66 .62 .51 .71 .66
Memory
Immediate
.57 .61 .57 .51 .70 .66
Index
Delayed
.51 .55 .51 .44 .61 .58
Index
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Clinical Studies
 Alzheimer’s Disease  ADHD
 Mild Cognitive  Reading Disorder
Impairment  Mathematics Disorder
 Major Depression  Autism
 Traumatic Brain Injury  Asperger’s
 Right and Left  Intellectual Disability
Temporal Lobectomy
 Schizophrenia
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Mild Cognitive Impairment

WMS-IV Clinical Control Mean Effect
Index Mean Mean Diff. p value Size
AMI 89.9 105.6 15.65 <.01 1.05
VMI 89.3 102.1 12.84 <.01 0.89
VWMI 91.6 107.2 15.54 <.01 1.22
IMI 90.8 105.8 15.00 <.01 1.09
DMI 87.5 103.5 16.00 <.01 1.01
n = 50 (ages 55-84)
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Probable Dementia of the

Alzheimer’s Type

AMI 68.5 107.1 38.60 <.01 2.24
VMI 69.7 102.5 32.85 <.01 2.00
IMI 71.7 107.4 35.71 <.01 2.16
DMI 63.6 104.6 40.98 <.01 2.39
n = 48 (ages 65-89)
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Intellectual Disability-
Mild Severity

AMI 64.4 98.3 33.84 <.01 2.47
VMI 68.9 97.6 28.66 <.01 2.40
VWMI 63.0 96.6 33.53 <.01 2.96
IMI 63.1 97.2 34.13 <.01 3.27
DMI 63.1 97.9 34.83 <.01 3.13
n = 32 (ages 16-58)
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References
Squire, L. R. (1987). Memory and brain. New
York: Oxford University Press.
Squire, L. R., & Butters, N. (Eds.) (1992).
Neuropsychology of memory. New York: The
Guilford Press.
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Customer Service
1-800-211-8378 (USA)
1-866-335-8418 (Canada)
Questions
Gloria Maccow, Ph.D.
gloria.maccow@pearson.com
Ph 724-
724-766-
766-7692
www.wais-iv.com
www.wms-iv.com
www.acsw4w4.com

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WMS-IV: Administration, Scoring, Basic Interpretation

Gloria Maccow, Ph.D., Assessment Training Consultant

Administration, Scoring, and

Memory and Learning

2 | Copyright © 2011 | 09/09/2011

Process of Learning and

External information is transformed into

Information from immediate memory is

Information is brought into conscious

3 | Copyright © 2011 | 09/09/2011

Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 1

WMS-IV and Long-term Memory

4 | Copyright © 2011 | 09/09/2011

Test Structure and Scores

WMS-IV: TWO Batteries

6 | Copyright © 2011 | 09/09/2011

Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 2

WMS-IV: TWO Batteries

7 | Copyright © 2011 | 09/09/2011

WMS-IV Flexible Approach

WMS-IV WMS-IV Older

Logical Memory / Visual Logical Memory / Designs

8 | Copyright © 2011 | 09/09/2011

9 | Copyright © 2011 | 09/09/2011

Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 3

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Brief Cognitive Status Exam

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Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 4

Auditory Memory Index

Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 5

Verbal Paired Associates I

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Verbal Paired Associates II

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Verbal Paired Associates II

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Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 6

California Verbal Learning Test-II:

 CVLT-II Total Trials 1-5 can be

 CVLT-II Long Delay Free Recall can be

19 | Copyright © 2011 | 09/09/2011

 Both measure aspects of semantic and

20 | Copyright © 2011 | 09/09/2011

Visual Memory Index

Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 7

22 | Copyright © 2011 | 09/09/2011

Visual Reproduction: Scoring

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VR is first subtest administered.

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Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 8

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• Third, for an optional copy task, the

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Copyright © 2011, Pearson, Inc., or its affiliates. All rights reserved. 9

 The delayed condition assesses long-