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

ObjectiveThe 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. MethodChinese Australian Neuropsychological Normative Study (CANNS) test data (based on N=145 community dwelling Chinese Australians aged 55-87years) 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. ResultsThe 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 ScaleThird 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. ConclusionThe findings of the current study caution against the use of Western tests for which CALD-specific norms are not available, particularly non-verbal tests.