ABSTRACT
As this chapter is being written in the spring of 2004, it is probably safe to say that a majority of contemporary practicing clinical neuropsychologists use tests, observational techniques, or interpretive logic that were influenced by or directly derived from what is now called “The Boston Process Approach to Neuropsychological Assessment” (Milberg, Hebben, & Kaplan, 1986, 1996). Such tests as the California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober, 1987), the Wechsler Adult Intelligence Scale-Revised as a Neuropsychological Instrument (WAIS-R NI; Kaplan, Fein, Morris, & Delis, 1991), the Delis–Kaplan Executive Function System (Delis, Kaplan, & Kramer, 2001) and the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV; Wechsler, 2003) were directly based on or influenced by the Boston Process Approach. The Boston Process Approach or Process Approach is sometimes discussed as if it is a test battery or a set of specific tests that have been modified to collect data relevant to the assessment of brain damage. Although there are indeed sets of tests and modifications of tests that are associated with this label (e.g., CVLT and WAIS-NI), it is probably more accurate to think of the Process Approach as a general paradigm for assessing the effects of brain damage: a paradigm that emphasizes the observation and analysis of problem-solving strategies used by patients in the course of test taking. The ultimate goal of this approach is the development of a portrait of the elemental cognitive strengths and weaknesses that a patient will bring to deal with the various problems and challenges of the real world. Instead of emphasizing empirical demonstrations of sensitivity to the presence of brain damage per se, the strength of the Process Approach is its ability to yield rich and intuitively appealing descriptions of a patient or client, and as such, has humanized the process of neuropsychology for many clinicians.
