Developing a cultural context for conducting a neuropsychological evaluation with a culturally diverse client: the ECLECTIC framework.

Objective: With the increasing diversification of the American population, the discipline of neuropsychology is challenged to develop appropriate tools and conceptual models to meet its evolving client base. Thus far, the focus has been on developing appropriate tests and norms to obtain accurate testing data. By contrast, far less attention has been paid to the contextual impact of culture on an evaluation. This paper attempts to address this shortcoming.

Methods: This manuscript introduces the ECLECTIC framework for conceptualizing different facets of culture pertinent for understanding a culturally diverse client when conducting a neuropsychological evaluation. Individual components of the framework (E: education and literacy; C: culture and acculturation; L: language; E: economics; C: communication; T: testing situation: comfort and motivation; I: intelligence conceptualization; and C: context of immigration) are introduced and potential biases to fairness in testing are described. In this manner, the framework specifies how individual facets of culture can impact neuropsychological test performance.

Conclusions: Clinical implementation of the framework will be illustrated with a case sample. Strengths and weaknesses of the framework are discussed as well as recommendations for implementation.