This paper reviews the literature on assessing elderly Hispanic Americans within the current neuropsychological context. The focus is on operationalizing multicultural competency through developing awareness, knowledge, and skills. More than in any other area of psychology, neuropsychological training, assessment instruments, and research reflect a traditional White male culture. Because of this influence, this paper considers multicultural competency primarily as it applies to non-minority clinicians. Yet most of the points considered also apply to non-Hispanic minority clinicians. In the realm of developing awareness, multiculturally competent neuropsychologists will strive to be aware of their own limitations and those of their specialty when assessing Hispanic American elders. They will strive to be aware of their own personal biases and areas in which their values may differ from those of their patients. In the realm of acquiring knowledge, it is important to pursue specific cultural knowledge, training, and experience in working with Hispanic elders. Even so, our knowledge of how cultural variables affect test performance is limited. In the realm of developing skills, it is important to recognize that intelligence may be characterized differently in various cultures and that commonly used assessment instruments may be inappropriate for use with Hispanic elders. Besides this, well-validated tests within the dominant community may violate Hispanic values. Interpersonal cultural variables will influence the patient-examiner relationship and thus test results as well. Interpreting scores within the patient's ecological context will likely lead to more accurate diagnoses and the most useful treatment plans. By looking for ways to build awareness, knowledge, and skills in these and other ways, neuropsychologists can begin to develop multicultural competency for assessing elderly Hispanic Americans.
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