INSNET, Fall 1997

exists with both European and US universities, favoring exchanges of students and visiting professors. At the present time, there are only 5 Brazilian members of INS. However, there is a growing movement that aims at training and educating neuropsychologists on Brazilian soil, focusing the efforts at forming future professionals in Brazilian universities and rehabilitation hospitals. Basic articles, reviews and research papers written by Brazilian professionals are occasionally published in the Brazilian psychology and neurology journals, or in international neuropsychology journals.

Neuropsychologists practicing in Brazil today have been very effective at establishing an interdisciplinary approach to their work, collaborating on research and clinical practice with neuroradiologists and neurophysiologists.

An important issue that must be addressed in the development of neuropsychology in Brazil is the evaluation instruments. Some professionals in the field use more of a qualitative approach based on Lfuia. Regardless of this focus, there is a great need for many standardized instruments because they will facilitate both qualitative and quantitative analysis. Many neuropsychological evaluation tools have been developed throughout the world, including Brazil, but not all of the more important instruments elaborated in other countries have been translated and applied to normal populations in this country.

Presently, various neuropsychologists in Brazil have been working at adapting and applying internationally recognized tests on normal populations. Such efforts are profoundly needed due to the variety of demographic, cultural, educational and ethnic differences (illiterates represent 15.6 percent of the population). Because of these challenges and the more recent development of neuropsychological instruments, specific instruments and norms that are compatible with the Brazilian population remain to be established.

The neuropsychologist in Brazil has the option of practicing in various work settings and environments, such as the public health care system, private practice, or in universities and university hospitals helping to educate and train new professionals in the field.

Given the growing needs and interest in Brazilian neuropsychology, we are faced with a number of exciting clwlenges. Priorities need to be identified with reference to the demands of health care. An optimal articulation of complementary areas of activities has to be found. Clinical practice (assessment and rehabilitation), university training (collaboration of medicine and psychology faculties), and applied research (e.g., validation of tests and epidemiological studies) need to support each other. To these aims, collaboration with more advanced countries in the field, together with others need to be developed on the basis of a mutual interest in the progress of health care and knowledge, and for the benefit of quality of life of brain injured persons.

References

Brazil. Ministry of Health. DATASUS, Jan. -May, 97 (http//www.datasus.gov.br) Brazil.Ministry of Education and Culture. JuIy, 97 in (http//www.mec.gov.br)

NEUROPSYCHOLOGY IN SINGAPORE

By Donald Yeo, B.S.

SGH Brain Centre

Singapore General Hospital

Outram Road Singapore 169608 Email: gnryhh@sgh.gov.sg

This is a brief article on the state of neuropsychology in Singapore, from the limited viewpoint of a practitioner involved in the clinical and research aspects of neuropsychological assessment.

The history of psychology in Singapore is short and that of neuropsychology is even shorter. Our experience in all aspects of neuropsychology is very limited, primarily due to the small pool of expertise currently in existence in our country. However, with the proliferation of neurological and neurosurgical resources in this Decade of the Brain, I foresee many opportunities to extend the contributions of neuropsychology in both the clinical and research arenas in the near future.

Singapore is a multi-racial, multi- religious society where traditional cultures and values have greatly influenced the peoples' social outlook and moral beliefs. Although western influences have significantly changed Singapore's society through industrialization and globalization, the older generation of Singaporeans predominantly cannot speak or understand English. The major languages used are Mandarin, Malay and Tamil. English is widely spoken by the post-independence generation. (Singapore gained independence from British rule in 1965.)

The practice of neuropsychology in Singapore is set against this cultural backdrop. The challenges of neuropsychological assessment stem primarily from the issue of multilingualism. Apart from the four- major languages spoken by the population, many elderly Singaporeans also speak a variety of dialects as well as other rarer languages. This issue becomes especially pertinent in the assessment of language abilities. Neuropsychological instruments requiring verbal responses also become difficult to administer, although adjustments could be made in certain instances.

The linguistically and culturally inappropriate nature of most neuropsychological batteries developed in western countries has challenged many practitioners to adapt and customize them for the local population. However, the unavailability of local norms has also posed even greater challenges for neuropsychologists in Singapore in arriving at accurate conclusions with sufficient confidence. Hence, even if English is generally well-understood among the post-independence generation, the interpretation of the neuropsychological test results is inhibited by the lack of appropriate norms for comparison.

Some research efforts have been made

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