Research in clinical neuropsychology with Hispanic American participants: a review.

Research on the neuropsychological assessment of adult Hispanic Americans has used mostly elderly, poorly educated, Spanish-speaking participants, resident in the United States for more than 15 years. Studies have involved comparisons with Anglo-Americans, the effects of moderator variables (e.g., bilingualism) and test standardization and validation. Most neuropsychological studies comparing Hispanic and Anglo-Americans have methodological weaknesses, such as overly liberal Type I error rates and inappropriate statistical controls for educational differences. What intergroup discrepancies do exist are likely due to educational (quantitative and qualitative) differences, non-equivalent Spanish/English translations and/or acculturation/ bilingualism related factors. Research suggests that Spanish-language neuropsychological test battery norms should be stratified by age, education (including lower grade levels), and to a limited extent gender, but there is little data to support separation by ethnicity. Acculturation/bilingualism variables can suggest when English-language tests are more appropriate to use with Hispanic Americans.