Clinical neuropsychologists are currently using instruments that are derived predominantly from monolingual, monocultural, and homogenous populations. According to U.S. Census projections, the U.S. is expected to continue becoming a more racially and ethnically pluralistic melting pot. As the number of White Americans is expected to decrease, the Hispanic population is projected to nearly double over the next few decades. The need for cultural responsiveness will only increase as the population becomes more diverse. In this episode, we talk with Dr. Monica Rivera Mindt, a board-certified neuropsychologist and President of the Hispanic Neuropsychological Society (HNS), about various cross-cultural considerations in the context of neuropsychological assessment, including bilingualism, “culturally neutral” tests, and the role of acculturation in cognitive performance.
A pdf of the transcript for this episode is available here.
Topics Covered (with time stamps)
- Definition of culture (1:02) and Latinx (1:30)
- APA cultural competency (3:30)
- How do we recognize our own biases? (8:30)
- Concept of “cultural humility” in cultural responsiveness (13:00)
- Organizations that provide resources for neuropsychologists to acquire cultural skills (14:09)
- Important considerations for diverse populations during the clinical interview (19:23)
- Assessing patients from diverse cultural backgrounds (23:29)
- Strategies for assessing patients who are bilingual (26:04)
- Tips for neuropsychologists who do not have bilingual staff (29:06)
- How to assess quality of education (33:03)
- Culturally based idioms of emotional distress (35:20)
- Cultural considerations when discussing the issues of an older Latinx patient with their family (37:50)
- Acculturation assessment (40:05)
- How do we interpret scores on tests that measure acculturation? (42:55)
- Are there any culturally neutral tests? (45:00)
- Implications for timed tests (46:55)
- Rivera Mindt’s “a-ha” moment (49:00)
- After controlling for education, what is the effect of culture? (51:55)
- The role of monolingualism and bilingualism in cognitive performance (52:47)
- Are there norms for bilinguals? (58:22)
- Interpretation of neuropsychological profile in ethnically diverse populations (1:00:01)
- Cultural considerations during feedback (1:04:10)
Monica Rivera Mindt, Ph.D., ABPP-CN, is a Professor of Psychology and Director of the Clinical Psychology Doctoral Program at Fordham University. She has a joint appointment in Neurology at Icahn School of Medicine at Mount Sinai in New York City. Dr. Rivera Mindt’s mission is to advance equity in brain health. She is focused on developing culturally tailored interventions to improve health outcomes among disenfranchised populations. Specifically, she is interested in the underlying mechanisms driving the effects of sociocultural, behavioral, medical, and genetic factors on neurocognitive function and decline in persons of culturally/linguistically diverse backgrounds. In addition to serving as the President of the Hispanic Neuropsychological Society (HNS), she is the inaugural Editor for the Culture & Gender in Neuropsychology Department of The Clinical Neuropsychologist journal. She is a Fellow of the American Psychological Association and the National Academy of Neuropsychology.
American Psychological Association. (2003). Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists. Am Psychol, 58(5), 377-402.
Postal, K. (2018). President’s Annual State of the Academy Report. The Clinical Neuropsychologist, 32(1), 1-9.
Rivera Mindt, M., Arentoft, A., Coulehan, K., & Byrd, D. (2013). Considerations for the neuropsychological evaluation of older ethnic minority populations. In Handbook on the Neuropsychology of Aging and Dementia (pp. 25-41): Springer.
Rivera Mindt, M., Byrd, D., Saez, P., & Manly, J. (2010). Increasing culturally competent neuropsychological services for ethnic minority populations: A call to action. The Clinical Neuropsychologist, 24(3), 429-453.
Rivera Mindt, M., & Hilsabeck, R. C. (2018). TCN culture and gender in Neuropsychology Department: inaugural editorial. Clin Neuropsychol, 32(8), 1353-1355.