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. 2022 Aug 23;13:962025. doi: 10.3389/fpsyg.2022.962025

Table 1.

Wechsler memory scales: history of visual memory assessment and assessment rationale.

Wechsler Memory Scale (WMS): Version
Original
(WMS: Wechsler, 1945)
Revised
(WMS-R: Wechsler, 1987)
Third Edition
(WMS-III: Wechsler, 1997a,b)
Fourth Edition
(WMS-IV: Wechsler, 2009a,b)
Adult Battery
Verbal Memory Subtests 1 Logical Memory (immediate)
Associate Learning
10-word pairs (six easy, semantically related, four hard, semantically unrelated).
Logical Memory (immediate and delayed)
Verbal Paired Associates (immediate and delayed)
Revised name for Associate Learning from WMS. Word-pairs reduced to 8 (four easy, four hard). The procedure matched that of the newly introduced Visual Paired Associates (minimum of three presentations; maximum of six). Delayed trial introduced.
Logical Memory (immediate and delayed)
Verbal Paired Associates (immediate and delayed)
Word pairs changed—removing all “easy” pairings. Eight pairs across four trials.
Word Lists (immediate and delayed)
Optional 12-item list-learning test presented over four trials, followed by a new list (interference trial), and short- and long-delayed testing.
Logical Memory (immediate and delayed)
Verbal Paired Associates (immediate and delayed)
Number of word-pairings increased to 10 with more “easy” items added to reduce floor effects.
Visual Memory Subtest(s) Visual Reproduction
The examinee is required to observe, and then draw from memory, a number of abstract geometric designs.
Visual Reproduction (immediate and delayed)
As per WMS, but with modified content, revised scoring criteria, and the inclusion of a delayed-memory component.
Figural Memory
Requires the test taker to study modular designs for 5–15 s each, depending on complexity, and then to identify the figure(s) from an array in a recognition-memory format.
Visual Paired Associates
Six nonsense designs are each paired with one of six colors for at least three but no more than six learning trials. To achieve “criterion,” the examinee is required to identify all drawing-color pairs (i.e., select the correct color in response to presentation of a specific design), but, regardless of performance, the task is discontinued after six learning trials. The score is calculated from the first three trials and a delayed condition is included.
Visual Reproduction (immediate and delayed)
Similar in format to WMS-R, but with modifications to the visual stimuli.
Faces (Immediate and Delayed)
Forced-choice recognition—Faces I (immediate) and Faces II (delayed) components. In Faces I, 24 target faces as shown, 1 at a time for 2 s. Then 48 faces (24 targets and 24 distractors) are presented sequentially, and test takers are asked to identify the target faces by responding “yes” or “no” to each face. They are then prompted to keep the target faces in mind for later recognition. Following a 30-min delay, 48 faces (the 24 targets and 24 new distractors) are shown and the task is again to identify the target faces.
Family Pictures (immediate and delayed)
Assesses recall and recognition of complex visually presented information.
Visual Reproduction (immediate and delayed)—but re-introduced as core rather than optional.
Same items from WMS—III Visual Reproduction; Scoring rules simplified; Recognition testing procedure revised—now uses old visual discrimination format of several items—examinee needs to select correct design; and Optional copy condition introduced to control for visual/ spatial skills.
Designs (immediate and delayed).
Assesses recognition memory for visual details of abstract designs and their spatial locations within an array. Both immediate and delayed testing employed.
Other Subtests Mental Control
Digit Span (Forward and Backward)
Orientation
Personal and Current Information
Mental Control
Digit Span (Forward and Backward)
Visual Memory Span
a new subtest designed as a spatial analog to digit span
Spatial Addition:
  • Designed as a test of visual working memory.

Letter-number sequencing:
  • A new subtest designed to assess auditory working memory. A series of interspersed numbers and letters are read aloud to the examinee, and they are required to repeat them in numerical and then alphabetical order.

Spatial Addition:
Symbol Span
  • (Essentially a visual version of digit span)

General Cognitive Screener
Key Scores Memory Quotient (MQ):
A single MQ incorporating memory for verbal material (Logical Memory/Associate Learning) and Visual Reproduction is derived.
The WMS-R test scores generate four “memory indices”: as well as an Attention/Concentration Index
General Memory Index:
Logical Memory I, Verbal Paired Associates I, Figural Memory, Visual Reproduction I, Visual Paired Associates I.
Verbal Memory Index:
Logical Memory I, Verbal Paired Associates I.
Visual Memory Index:
Figural Memory, Visual Reproduction I, Visual Paired Associates I.
Delayed Memory Index:
Logical Memory II, Verbal Paired Associates II, Visual Reproduction II, Visual Paired Associates II.
Attention/Concentration Index:
Mental Control, Digit Span, Visual Memory Span.
The core WMS-III test scores generate seven primary “memory indices” as well as a Working Memory Index:
Auditory Immediate Index
Logical Memory I, Verbal Paired Associates I
Visual Immediate Index
Faces I, Family Pictures I
Immediate Memory Index
Logical Memory I, Verbal Paired Associates I, Faces I, Family Pictures I
Auditory Delayed Index
Logical Memory II, Verbal Paired Associates II
Visual Delayed Index
Faces II, Family Pictures II
Auditory Recognition Delayed
Logical Memory II Recognition, Verbal Paired
Associates II Recognition
General Memory Index
Logical Memory II, Verbal Paired Associates II, Faces II and Family Pictures II
Working Memory Index
Letter-Number Sequencing, Spatial Span
The core WMS-IV test scores generate four primary “memory indices”:
Immediate Memory Index
Logical Memory I, Verbal Paired Associates I or CVLT-II (Delis et al., 2000) Trials 1–5, Designs I, Visual Reproduction I
Delayed Memory Index
Logical Memory II, Verbal Paired Associates II or CVLT II Delayed Free, Designs II and Visual Reproduction II
Auditory Memory Index
Logical Memory I and II; Verbal Paired Associates I and II Or CVLTII LRN and Delayed Free
Visual Memory Index
Designs I and II, Visual Reproduction I and II
Visual Working Memory Index
Spatial Addition and Symbol Span
Early critiques (sample) Dujovne and Bernard, 1971; Kear-Colwell, 1973, 1977; Russell, 1975; Prigatano, 1977; Lezak, 1983 Brown et al., 1987; Powel, 1988;
Loring, 1989; Loring et al., 1989; Chelune et al., 1990; Elwood, 1991; Lezak et al., 2004
Horton and Larrabee (1999); Millis et al., 1999; Tulsky et al., 2003; Lezak et al., 2004; Chapin et al., 2009 Drozdick et al., 2011; Hoelzle et al., 2011; Kent, 2016
Revisions from earlier edition ----- Five major changes made (Wechsler, 1987, p 2):
  • Provision of norms stratified at nine age levels.

  • Replacement of a single global summary score (the Memory Quotient) with five composite scores

  • Addition of new subtests measuring figural and spatial memory.

  • Addition of measures of delayed recall.

  • Revision of the scoring procedures for several subtests to improve scoring accuracy.

  • Figural Memory, Visual Paired Associates, and Visual Reproduction were replaced with two new tests of visual memory: Faces and Family Pictures

  • Focus changed from material-specific to modality-specific memory

  • Family Pictures was dropped, in order to meet the design goal of reducing verbalization of visual memory tasks.

  • Faces was dropped because of floor and administration limitations.

  • VR was re-introduced.

  • New visuospatial test (Designs) introduced.

  • Reconfiguration of Index

Major Critique of visual memory component(s) and component scores
  • The Visual Reproduction subtest cannot be considered a test of nonverbal memory: simplicity of designs mean they lend themselves readily to verbal mediation

  • Requires a drawing component

  • No delayed memory assessment

  • Visual Reproduction and VPA cannot be considered tests of nonverbal memory: simplicity of VR designs and the nature of the VPA stimuli mean they lend themselves readily to verbal mediation.

  • VR requires a drawing component

  • Visual Memory Index is based on immediate memory alone—and it incorporates the Figural Memory subtest that, according to Loring (1989), appears to assess higher-order visual attention span rather than retention of information over time (i.e., memory).

  • General Memory Index is based on immediate memory scores alone, and it fails to distinguish between verbal and visual memory functions.

  • Delayed Memory Index fails to distinguish between verbal and visual memory tests—treating delayed memory as a unitary construct.

  • Index scores are composites, and, therefore, subject to criticism.

  • Visual Reproduction—now an optional subtest that does not form part of the core indices.

  • Faces—employed a yes/no recognition memory format that was subject to floor effects. It also failed to distinguish between poor memory for faces and “guessing” and poor effort (Chapin et al., 2009).

  • Family Pictures—widely criticized because of the extent of verbal mediation.

  • Computation of Index scores continued (see, for example, Visual Immediate, Visual Delayed, Immediate Memory, General Memory).

  • General Memory Index: remains a composite of both verbal and visual memory albeit now assessing delayed memory rather than immediate memory as in the WMS-R.

  • Visual Reproduction—cannot be considered a test of nonverbal memory: simplicity of designs mean they lend themselves readily to verbal mediation

  • VR requires a drawing component —that although taken into account to some extent in scoring might still impact performance.

  • Designs—Unlike Visual Reproduction, DE evaluates spatial memory explicitly, but uses a grid that can facilitate use of a verbal mnemonic to recall locations.

  • Index Scores are computed from a number of test scores.

Rationale for revision From WMS to WMS-R.
  • To introduce new subtests to better balance the assessment of verbal and visual memory.

  • To incorporate delayed memory assessment.

  • To clarify the directions for administration” (Wechsler, 1987, p. 43).

From WMS-R to WMS-III.
  • To address a need to include visual material that is difficult to encode verbally, as well as increase the ecological validity of the instrument (Wechsler, 1997a,b).

  • To reflect more accurately what is being assessed by the subtests. In describing changes in the Indexes, the test developers say: “There are two notable changes in the index nomenclature. First, the “verbal” label used in the WMS-R was changed to reflect the modality of presentation rather than the index content more accurately. Therefore, the term “auditory,” which is the parallel to “visual,” is used instead of “verbal.”

  • They then deal with the change in nomenclature, and content, of the Attention/Concentration index of the WMS-R, becoming the Working Memory Index in the WMS-III (WMS-III Manual).

From WMS-III to WMS-IV.
  • One of the stated design goals of the revision was to reduce confounding factors, and, of considerable interest is the fact that amongst the objectives were:

    1. Reduce or eliminate motor requirements in administration or scoring where possible;

    2. Reduce verbal processing on visual memory subtests;

    3. Develop Contrast Scores to partial out confounding cognitive effects (e.g., Spatial Versus Detail; Immediate Versus Delayed);

    4. Reduce language level of verbal tasks where possible.

From WMS-IV to its successor:
  • Changes to the WMS-IV (i.e., development of a fifth edition of the WMS) have not yet been outlined by the test developers, but a further update is almost inevitable (see Kent, 2016 for suggested revisions).

1

Re-named as auditory memory subtests in the WMS-III.