Background & Objective:Post Stroke Cognitive Impairments (PSCI) occur frequently in stroke survivors resulting in devastating consequences affecting daily living of survivors. Currently, there exists scarcity of sound assessment tools for the evaluation of PSCI as most of the commonly used scales offer a number of clinical (requires motor and linguistic skills) and cultural limitations (requires academic exposure). Therefore, current study was aimed at evaluating the efficacy of Neuro-Cognitive Assessment Battery for Stroke patients (N-CABS) in Pakistan.Methods:The participants were randomized in two groups including clinical and non-clinical group. N-CABS was administered on 61 clinical and 60 non-clinical participants (mean age=45 years; SD=5.55). Both groups were matched on all demographic variables including; age, gender, education and occupation. The psychometric properties of N-CABS were established through a number of robust measures of validity (construct, concurrent and discriminant validity) and reliability (internal consistency and test retest reliability).Results:The factor analysis suggested a two-factor solution (labeled as Verbal Cognitive Abilities and Visual Cognitive Abilities) for N-CABS explaining 67% of total variance. A significant test-retest reliability was found (α = 0.92, ***p<0.001). The findings of concurrent validity recommended a significant correlation between N-CABS and Montreal Cognitive Assessment (MoCA) (α = 0.82, ***p<0.001). Similarly, discriminant validity also revealed significant group differences to exist on N-CABS (***p<0.001) suggesting N-CABS be able to discriminate between patients and healthy controls.Conclusion:The results of the current study favor N-CABS as a psychometrically strong screening instrument to screen PSCI in our culture.
Selective Mutism (SM) is a rare condition which is even rarer in collectivistic cultures. Firstly, SM is most often mistaken/misdiagnosed as autism spectrum disorder (ASD) and other related conditions due to lack of awareness of SM and the presence of mimicking characteristics of autistic behaviors in SM. Secondly, submissive behaviors in collectivistic societies further veil this rare condition by considering SM rather desirable than a problem. Especially in situations where developmental delay is a comorbid condition it became a great challenge to correctly diagnose among related conditions. We had a twelve years old girl with developmental delays who remained falsely diagnosed with ASD for five years. We have highlighted the diagnostic issues in SM and other related conditions especially ASD that might hinder the development of an appropriate management plan. The study also emphasized the need to develop a standardized assessment tool to diagnose SM considering cultural aspects into account.
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