Elsevier

Brain and Cognition

Volume 52, Issue 3, August 2003, Pages 326-333
Brain and Cognition

The impact of culture and education on non-verbal neuropsychological measurements: A critical review

https://doi.org/10.1016/S0278-2626(03)00170-2Get rights and content

Abstract

Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influence by the individual’s culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.

Introduction

For almost a century of intelligence testing, efforts have been made to develop “culture free” tests (Jensen, 1980). Different attempts are found in the history of psychological testing to construct measures that would be “culture-free” (Anastasi, 1988; Cattell, 1940). For some time, it was supposed that the effect of culture could be controlled if verbal items were eliminated, and only non-verbal, performance items were used. However, this assumption turned out to be wrong. Researchers using a wide variety of cultural groups in many countries have sometimes observed even larger group differences in performance and other non-verbal tests than in verbal tests (Anastasi, 1988; Irvine & Berry, 1988; Vernon, 1969). Therefore, not only verbal, but also non-verbal tests may be culturally biased. The use of pictorial representations itself may be unsuitable in cultures unaccustomed to representative drawings, and marked differences in the perception of pictures by individuals of different cultures have been reported (Miller, 1973). Furthermore, non-verbal tests often require specific strategies and cognitive styles characteristic of middle-class Western cultures (Cohen, 1969).

Regardless of the contrary evidence, the idea that non-verbal cognitive tests can be culturally free has significantly remained. Currently, there is a diversity of intellectual tests that are presented as “culture-free,” or “culture-fair” just because they include mostly non-verbal items (e.g., Alexander, 1987; Crampton & Jerabek, 2000). This point of view contradicts available anthropology and cross-cultural psychology evidence (e.g., Berry, Poortinga, & Segall, 1992; Harris, 1983; Irvine & Berry, 1988). Cole (1999), for example, has argued that the notion of culture-free intelligence is a contradiction in terms. He points out that cross-cultural test construction makes it clear that tests of ability are inevitably cultural devices, and hence a culture-free test is an illusion.

In clinical neuropsychology, it has often been considered that the use of non-verbal items ameliorates the impact of culture on testing. A significant portion of the assessments used in intercultural settings typically emphasizes non-verbal skills such as visual-spatial abilities (Boivin, Giordani, & Bornefeld, 1995). Furthermore, the performance of some non-verbal tasks such as drawing a map and copying figures are frequently considered in neuropsychological assessment to be universal skills of most normal adults (Lezak, 1995). In contrast, it has also been argued that drawing a map or copying figures represent abilities that are absent in many cultures (Ardila & Moreno, 2001; Berry et al., 1992; Irvine & Berry, 1988), and are highly school-dependent skills (Ardila, Rosselli, & Rosas, 1989).

Culture is understood as the way of living of a human group and includes behaviors, ways of thinking, feeling, knowledge, values, attitudes, and belief (Harris, 1983). Cultural elements (the physical elements characteristic of that human group such as symbolic elements, clothes, ornaments, houses, instruments, weapons, etc.) are also included in the definition of culture. Education can be regarded as an element of culture (Ardila, Ostrosky, & Mendoza, 2000) and includes literacy and schooling. Literacy refers to the acquisition of reading and schooling to the process of learning at school. Culture and formal education (as a cultural element) have significant effects on cognition (Berry, 1979; Cole, 1997). Greenfield stated “the major factor that makes a culture more or less different from the culture conventions surrounding ability testing is the degree of formal education possessed by the participants” (Greenfield, 1997, p. 1119). Culture prescribes what is learned and at what age (Ferguson, 1954; Irvine & Berry, 1988). Formal education is a most significant element in culture, even though formal education can be interpreted a kind of transnational culture. The fundamental aims of school are equivalent for all schools and school reinforces certain specific values regardless of where they are located. Hence, school could be seen as a culture unto itself, the culture of school. School not only teaches, but also helps in developing certain attitudes that will be useful for future new learnings (Ardila et al., 2000).

The question that this article raises is whether the use of non-verbal neuropsychology tests commonly used with American children and adults are appropriate for populations from diverse cultures and different educational levels. To approach this question, this paper analyzes the findings from different published studies of the influence of culture and schooling on non-verbal neuropsychological measurements. This paper will compare the following. (1) The performance in non-verbal test among groups with different educational levels and same cultural background (inter-education intra-culture comparison). Studies in different cultures will be presented. (2) The performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons).

Section snippets

Different educational level, same cultural background

Education has an important influence on cognitive test performance. Groups with higher levels of education perform better on most neuropsychological tests (Ardila et al., 1989; Ostrosky, Ardila, & Rosselli, 1999; Rosselli, Ardila, & Rosas, 1990). This effect has been well documented in intelligence tests (Matarazzo, 1972) and in verbal neuropsychological tests (Acevedo et al., 2000; Reis & Castro-Caldas, 1997; Rosselli et al., 1990). The effect of education, however, has been less studied in

Same educational level, different cultural background

Culture can affect the development of non-verbal skills (for a review see Ardila & Keating, in press). Ecological demands and cultural practices are significantly related to the development of perceptual and cognitive skills (Cole & Means, 1986). Cross-cultural differences in perceptual and constructional abilities have been extensively studied in anthropology and cross-cultural psychology (e.g., Berry, 1971, Berry, 1979; Brislin, 1983; Gay & Cole, 1967; Hudson, 1960, Hudson, 1962; Laboratory

Conclusions

Great caution is needed in using non-verbal neuropsychological tests with individuals from cultures different from the one that provided the normative sample. The interpretation of the performance of individuals from other cultures using US norms might result in significant errors in assessment, particularly if the examiner’s intention is to evaluate the integrative of the brain–behavior relationship (Boivin et al., 1995).

Drawing a map and copying figures as measured by neuropsychological tests

Acknowledgements

Our sincere gratitude goes to Dr. Erika Hoff for her valuable suggestions and editorial support

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