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WMS-III India: Adaptation and Standardization Project
 
WMS-III-India
Author information:
The adaptation and standardization of the WMS-III India was carried out as part of a doctoral thesis by Dr. Pushpalatha Gurappa in the Department of Mental Health and Social Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Dr. Pushpalatha G is currently working as a Product Development Leader at Pearson Clinical and Talent Assessment, Bangalore, India. The publication of the project work was carried out by Pearson Clinical and Talent Assessment, Bangalore, India.
 
Rationale for adapting and standardizing the WMS-III for India
Rationale for adapting and standardizing the WMS-III for India

The extensive modification and joint re-standardization of the Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale (WMS) resulted in their publication in the USA in 1997 as the WAIS-III and WMS-III. Larger standardization samples were used than previously, both tests were extensively updated in content and presentation, their age and ability ranges were extended, and a greater range of scoring options was introduced. For the first time the two tests were standardized using the same normative sample and scoring systems were brought into line, making comparisons between them much easier.

Publication of a revised version of the test in USA (1997) yielded an Anglicization of the scale in UK and changes were made in the scale so as to be applicable to the British population. The previous versions of WMS- III i.e. WMS (1945), and WMS – R had been adapted in UK, and had been anglicized to be used on the British population. However, the tests had not been standardized in the UK, and the appropriateness of the tests to the UK population was being questioned. Hence there was a need for the WMS-III test battery to be anglicized to investigate the applicability of the USA norms. Therefore, to utilize to the fullest extent a large body of USA data, the UK project took the form of a validity and comparability study between the American norms and the scores of a representative sample of the UK population. This project was carried out with the intention of providing sufficient information to allow well-informed use of the USA norms in the UK.

Despite the standardization work carried out in the UK for the WMS-III, the utility of the same test battery in India was considered inadequate. Many limitations, such as cultural specificity, test sophistication and educational background of the subjects, are considered as confounding factors for the test results. Therefore, a need was felt for a culture specific comprehensive memory scale, suitable for the Indian population. The WMS-IIIIND research project was carried out to develop Indian norms and to establish the reliability and validity of the scale. The WMS-IIIIND is considered appropriate for use not only within India but also within the Indian subcontinent, due to cultural similarities among the countries in this geographical area.

Rationale for adapting and standardizing the WMS-III for India
 
Project Details
Project Details
Changes in Subtests

The first stage of the India study involved inspection of the WMS – IIIUK item pool and its adaptation for the Indian population, where necessary, to ensure that items were appropriate for the Indian population. A thorough item review was undertaken. The India adaptation process was carried out very conservatively in order to minimize any changes in item difficulty. The limited nature of the changes which were necessary reflects the efforts made in the India standardization project to minimize cultural biases and produce an instrument which would require little modification for use in different cultures. The early work included consultation with users of the WMS-IIIUK whose comments were taken into account in the final versions of the adaptation of the scale.

Changes were made to the following subtests   No changes were made to the following subtests
     
  • Information and Orientation
  • Logical Memory
    • Recall
    • Recognition
  • Faces
  • Verbal Paired Associates
    • Recall
    • Recognition
  • Family Pictures
  • Word Lists
    • Recall
      • List A
      • List B
    • Recognition
 
  • Visual Reproduction
  • Letter-Number Sequencing
  • Spatial Span
  • Mental Control
  • Digit Span
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Language translations
Subsequent to the modifications in the subtests, the verbal subtests in the scale were translated into Bengali, Guajarati, Hindi, Kannada, Malayalam, Marathi, Tamil and Telugu. In order to strengthen the translation, back translation of the subtests was done. Both the translation and back translation were carried out by language experts in the respective languages. Recommended language translations in these eight languages are provided for the verbal subtests in the WMS-IIIIND Administration Manual.
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Sample
This stage of the project involved the production of a sampling frame to guide the testing of the representative sample of the India population, followed by the lengthy testing process itself. This took place in various regions of southern parts of India under the guidance of experts in the field.
The sample consisted of 240 participants. The following categories were used for the normative data :
  • Age: Two categories
    • 16-30
    • 31-50
  • Educational Level: Two categories
    • School educated (≤ 10 years of education)
    • College educated (>10 years of education)
  • Gender: Two categories
    • Male
    • Female
  • Socio-economic status: Three categories
    • Lower Socio-Economic Status (Monthly Income Range = Rs. <2000)
    • Middle Socio-Economic Status (Income Range = Rs. 2001 - 4000)
    • Higher Socio-Economic Status (Income Range = Rs. > 4000)
  • Domicile: Three categories
    • Rural
    • Urban
    • Semi urban
  • Medium of language for test administration
    • English
    • Kannada
    • Tamil
    • Telugu
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Reliability and Validity Study
Reliability
Reliability of the WMS-IIIIND was established using the test-retest method. WMS-IIIIND was administered on a sample of 80 participants, who were selected from the standardization sample group to obtain test-retest reliability. 10 successive participants who met the inclusion criteria were selected from each of the 8 subgroups of standardization sample (N=240). The retest was carried out after a reasonable time period of six weeks for test-retest reliability. The scores obtained on the first and second assessment were correlated to obtain the reliability coefficient. To establish the reliability coefficient, Bivariate Correlations procedure was used.
Validity
Criterion Validity
WMS-IIIIND was validated on the clinical population. Profiles of participants with Intractable Epilepsy, Head injury and Alcohol Dependent Syndrome were studied to establish the criterion validity of the present test battery. These profiles were studied with reference to the norms i.e. the percentiles.
Factorial Validity

The factors i.e., the underlying dimensions, or constructs of the WMS-IIIIND were investigated by Exploratory Factor Analysis, using the Principal Component method. The Principal Component method provides a matrix of correlations, which explains the interrelationships among the variables. For the factor analysis, 20 variables were selected in the ratio of 1:10 for the standardization sample of 240 individuals. These 20 test variables constituted the main scores of the subtests.

Four components were extracted from the 20 variables. Factor 1 comprises of Logical Memory test; Factor 2, General Memory, comprises of Word Lists, Visual Reproduction, Letter-Number Sequencing, Spatial Span, Mental Control and Digit Span tests; Factor 3, Associative Learning, includes the tests of Verbal Paired Associates and Family Pictures and Factor 4, Recognition Memory, comprises of the Faces test.

Please contact us for more information, including statistics, related to the validity measures obtained for the WMS-IIIIND project.

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India Norms
Normative data was developed on the standardization sample. Percentiles were calculated as the norms for each age (16-30 yrs & 31-50 yrs) education (school & College) and gender group. 15th percentile point was considered as cut-off score for each test variable. A score which referenced an accuracy measure was considered as deficit, if it fell below the 15th percentile point of the normative data. The test score was referenced to the norms i.e., the cut-off score based on the patient’s age, education and gender.
India Norms
 
Applications
Applications

The WMS–IIIIND was developed for assessing learning and memory abilities of individuals in the age range of 16–50 years. The test items, materials, and administration directions were selected for suitability and effectiveness with individuals within this age range. In the case of out-of-age-range testing, the norms may not be representative and additional clinical judgement should be exercised. It should also be borne in mind that the norms for WMS-IIIIND could be established up to Percentile Scores. All Index and Scaled Scores are based on the original US and UK data. Additional clinical judgment should be exercised when interpreting the test results using the WMS-IIIIND.

The WMS–IIIIND is designed to provide relevant information for general clinical and neuropsychological evaluations, as well as for rehabilitation evaluations. Traditionally, the Wechsler scales have been a standard for clinical research. The addition of multiple subtest scores and indexes in the WMS–IIIIND will provide those conducting clinical research with multiple, standardized scores, which should further research and further knowledge of memory assessment.

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Clinical Applications
As a clinical assessment instrument, the WMS–IIIIND provides measures of important memory functions. This information, within the context of other information collected in the evaluation process, will provide the clinician with a wealth of information about level of memory functioning and memory processes. The primary subtests and Primary Indexes, along with the Auditory Process Composites and supplemental subtest scores, are intended to provide information directly relevant to clinical diagnosis.
Specific clinical uses of the WMS–IIIIND may include:
  • diagnosis and identification of memory impairment
  • early identification of dementias and degenerative conditions
  • quantification of memory impairment
  • profiling of spared and impaired memory functions
  • evaluation of encoding vs. retrieval deficits
  • evaluation of modality-specific memory (e.g., auditory vs. visual)
  • measurement of the efficacy of treatment interventions
    (e.g., pharmacological treatment, surgery, cognitive rehabilitation)
  • description of the qualitative aspects of memory functioning
  • objective monitoring of disease course (e.g., deterioration, recovery)
  • identification of relative strengths and weaknesses for treatment planning
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Research Applications
The sensitivity of the WMS–IIIIND to alterations in memory functioning indicates that it has valuable potential as a research instrument. Continued research beyond that presented in WAIS-III-WMS–III Technical Manual will provide important information about the clinical utility of these measures across a wide variety of clinical groups.
Specific research applications of the WMS–IIIIND may include:
  • effects of age-related changes on specific memory processes
  • effects of education on specific memory processes
  • effects of gender on specific memory processes
  • effects of medication
  • effects of somatotherapies (e.g., electroshock therapy)
  • effects of stress, fatigue, or sleep deprivation
  • effects of environmental changes (e.g., hypo- or hyperbaric alterations)
  • profiles of specific memory processes across clinical groups
Research Applications
 

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