Neuropsychological Testing in a Multi-Lingual Society: Normative Data for South African Adults in More Than Eight Languages

Authors: Sharon Truter, Ann B. Shuttleworth-Edwards

Abstract:

South Africa is a developing country with significant diversity in languages spoken and quality of education available, creating challenges for fair and accurate neuropsychological assessments when most available neuropsychological tests are obtained from English-speaking developed countries. The aim of this research was to compare normative data on a spectrum of commonly used neuropsychological tests for English- and Afrikaans-speaking South Africans with relatively high quality of education and South Africans with relatively low quality of education who speak Afrikaans, Sesotho, Setswana, Sepedi, Tsonga, Venda, Xhosa or Zulu. The participants were all healthy adults aged 18-60 years, with 8-12 years of education. All the participants were tested in their first language on the following tests: two non-verbal tests (Rey Osterrieth Complex Figure Test and Bell Cancellation Test), four verbal fluency tests (category, phonemic, verb and 'any words'), one verbal learning test (Rey Auditory Verbal Leaning Test) and three tests that have a verbal component (Trail Making Test A & B; Symbol Digit Modalities Test and Digit Span). Descriptive comparisons of mean scores and standard deviations across the language groups and between the groups with relatively high versus low quality of education highlight the importance of using normative data that takes into account language and quality of education.

Keywords: cross-cultural, language, multi-lingual, neuropsychological testing, quality of education