PICA Programs
Testing Precision Since 1967
Bruce Porch, Ph.D - Professor Emeritus, University of New Mexico Speech and Hearing Science and Neurology Departments
Welcome to the PICA website, a source for information about topics related to the Porch Index of Communicative Ability (PICA), a test of brain processing and communicative processing. Information is also available about the Porch Index of Communicative Ability in Children (PICAC).
Test Description.
The PICA continues to be among the most reliable and sensitive measures of communicative ability available to clinicians who assess brain injured adults. As discussed in Vol. I of the manuals, the PICA has very high inter-scorer agreement, test-retest stability, and internal consistency. These excellent psychometric characteristics result from a powerful binary choice multidimensional scoring system, standardized administration, and homogeneous test items. The test battery has 18 subtests that revolve around ten common objects sampling communicative ability in the modalities of speaking, auditory processing, gesture, writing, reading, copying, and visual matching. The test averages about one hour to administer.
Test Interpretation.
The test scores are used to compare the patient to his pre-morbid communicative levels and the percentiles compare him to a large random sample of patients with similarly localized brain lesions. There are separate norms for patients with damage in the left hemisphere, right hemisphere, or bilateral damage. Discriminant analyses sort aphasia from non-aphasia patterns and left from bilateral/diffuse damage. Scores may be plotted as test profiles by modalities or on ranked response summary graphs that present the subtests in order of difficulty. These profiles offer information about the locus of the lesion(s), the nature of the communicative deficits, and appropriate task selection for treatment. The score sheet yields a variety of prognostic indices as early as one month post onset. It should also be mentioned that the PICA scoring system is widely used for quantifying the patient's responses during treatment. (See: PICA PAD)
Training To Use the PICA.
As with most complex test instruments, the PICA is best mastered through direct training by an experienced PICA user or qualified instructor. Training program availability is discussed in more detail under PICA TRAINING COURSES.
PICA 2001 Revision
Over the years, the PICA subtests with their objects and tasks have gone essentially unchanged. However, with the sensitivity of the scoring system and the test interpretation has undergoing the major refinements. In the 2001 edition one of the test objects has been changed. With the growing concern about the effects of smoking on one's health, the prohibition of smoking in medical centers, and the patients' negative response to it, eliminating the cigarette from the battery seemed necessary. Therefore, a project was undertaken to select an alternate object and to determine whether it was equivalent to the cigarette. This "Scissors for Cigarette" study is described more fully in the Revised Volume 1. The new Volume 2 incorporates all of the test changes and provides the necessary guidelines for administering and scoring 'scissors' responses. For the experienced PICA user there will be a short but slightly awkward period of readjustment.
In addition to the change in scissors, there are some additions to the test format that have been taught in PICA courses but had not been updated in the format booklet. Also, Volume 2 contains more details and examples of scoring, especially diacritical scoring that has added so much to preserving the subtleties of response behavior. Other significant changes include the constructs, models and terminology that have evolved during many years of using the test clinically and in research, and reflect the growing interest in systems analysis approaches to understanding brain function and in planning more detailed treatment methods. The new PICA models of how communication is organized in the brain have been found very useful in localizing the site of lesions and in differentiating left hemisphere lesion from right and bilateral lesions. Right hemisphere norms have been added to the left hemisphere and bilateral lesion norms in the new 2000 edition.
The PICA continues to be among the most reliable and sensitive measures of communicative ability available to clinicians who assess brain injured adults. As discussed in Vol. I of the manuals, the PICA has very high inter-scorer agreement, test-retest stability, and internal consistency. These excellent psychometric characteristics result from a powerful binary choice multidimensional scoring system, standardized administration, and homogeneous test items. The test battery has 18 subtests that revolve around ten common objects sampling communicative ability in the modalities of speaking, auditory processing, gesture, writing, reading, copying, and visual matching. The test averages about one hour to administer.
Test Interpretation.
The test scores are used to compare the patient to his pre-morbid communicative levels and the percentiles compare him to a large random sample of patients with similarly localized brain lesions. There are separate norms for patients with damage in the left hemisphere, right hemisphere, or bilateral damage. Discriminant analyses sort aphasia from non-aphasia patterns and left from bilateral/diffuse damage. Scores may be plotted as test profiles by modalities or on ranked response summary graphs that present the subtests in order of difficulty. These profiles offer information about the locus of the lesion(s), the nature of the communicative deficits, and appropriate task selection for treatment. The score sheet yields a variety of prognostic indices as early as one month post onset. It should also be mentioned that the PICA scoring system is widely used for quantifying the patient's responses during treatment. (See: PICA PAD)
Training To Use the PICA.
As with most complex test instruments, the PICA is best mastered through direct training by an experienced PICA user or qualified instructor. Training program availability is discussed in more detail under PICA TRAINING COURSES.
PICA 2001 Revision
Over the years, the PICA subtests with their objects and tasks have gone essentially unchanged. However, with the sensitivity of the scoring system and the test interpretation has undergoing the major refinements. In the 2001 edition one of the test objects has been changed. With the growing concern about the effects of smoking on one's health, the prohibition of smoking in medical centers, and the patients' negative response to it, eliminating the cigarette from the battery seemed necessary. Therefore, a project was undertaken to select an alternate object and to determine whether it was equivalent to the cigarette. This "Scissors for Cigarette" study is described more fully in the Revised Volume 1. The new Volume 2 incorporates all of the test changes and provides the necessary guidelines for administering and scoring 'scissors' responses. For the experienced PICA user there will be a short but slightly awkward period of readjustment.
In addition to the change in scissors, there are some additions to the test format that have been taught in PICA courses but had not been updated in the format booklet. Also, Volume 2 contains more details and examples of scoring, especially diacritical scoring that has added so much to preserving the subtleties of response behavior. Other significant changes include the constructs, models and terminology that have evolved during many years of using the test clinically and in research, and reflect the growing interest in systems analysis approaches to understanding brain function and in planning more detailed treatment methods. The new PICA models of how communication is organized in the brain have been found very useful in localizing the site of lesions and in differentiating left hemisphere lesion from right and bilateral lesions. Right hemisphere norms have been added to the left hemisphere and bilateral lesion norms in the new 2000 edition.
A SYSTEMS ANALYSIS APPROACH TO THE TREATMENT OF STUTTERING
A Cybernetic View by Bruce Porch, Ph.D.
A NEW APPROACH TO STUTTERING AND ITS TREATMENT
A Cybernetic View by Bruce Porch, Ph.D.
A NEW APPROACH TO STUTTERING AND ITS TREATMENT
"Stuttering is a switching problem, not a fluency problem!"
A concise book that combines current neuroanatomical finding, plasticity theory, PICA treatment theory and methodology, and systems analysis to explain how the person who stutters can abandon the age old focus on fluency by restoring the use of the original cortical speaking system in the brain. Designed for the clinician but of interest to anyone interested in stuttering information, it includes detailed treatment procedures.
During several decades of treating brain processing problems and also treating people with stuttering problems, Dr. Porch evolved an approach to treating stuttering which recognizes that the person with a stuttering system has two speech systems: a normal left hemisphere cortical system that has been largely ignored in the stuttering literature and a misprogrammed system that activates other areas of the brain that disrupt speech in an effort to avoid the stuttering event.
This concise work is written as a guide to clinicians. It contrasts the two systems, explains how they operate, the problems with focusing on fluency that reinforces and strengthens the stuttering system, and outlines the steps necessary in reactivating the normal speech system.
A concise book that combines current neuroanatomical finding, plasticity theory, PICA treatment theory and methodology, and systems analysis to explain how the person who stutters can abandon the age old focus on fluency by restoring the use of the original cortical speaking system in the brain. Designed for the clinician but of interest to anyone interested in stuttering information, it includes detailed treatment procedures.
During several decades of treating brain processing problems and also treating people with stuttering problems, Dr. Porch evolved an approach to treating stuttering which recognizes that the person with a stuttering system has two speech systems: a normal left hemisphere cortical system that has been largely ignored in the stuttering literature and a misprogrammed system that activates other areas of the brain that disrupt speech in an effort to avoid the stuttering event.
This concise work is written as a guide to clinicians. It contrasts the two systems, explains how they operate, the problems with focusing on fluency that reinforces and strengthens the stuttering system, and outlines the steps necessary in reactivating the normal speech system.