The history of psychological test translation includes problems of inaccuracy and unintentional or intentional racial, ethnic, and linguistic discrimination. Methods for accurate and fair psychological test translation, adaptation, and development have advanced, but neuropsychology has been slow to implement these methods. Inadequate translations and adaptations of neuropsychological tests may substantially impact their psychometric properties for target populations, increasing risk of clinical errors and other harms.

The International Test Commission's (ITC) 2017 Guidelines for Tests Translation and Adaptation summarize current technologies for tests whose constructs depend upon the semantic content of the items. This is helpful, but insufficient because many neuropsychological tests focus on cognitive, linguistic, and emotional constructs that are measured by processes other than semantic content. Neuropsychological tests may depend on word length, familiarity, written form, visual stimuli, culture-dependent behavioral expectations, or other features apart from meaning. Furthermore, the ITC Guidelines were developed primarily from experiences of translation and adaptation among European languages, with populations with a restricted range of education and cultures, hindering their generalization to more diverse populations. To make the guidelines practical for neuropsychological users, the Assessment Workgroup of the INS Cultural Neuropsychology Special Interest Group has developed neuropsychological commentary on the ITC Guidelines. The Workgroup has also sponsored a discussion group among members involved in neuropsychological test translation, adaptation, and development projects around the world. Our objectives in this symposium are to present an overview of our neuropsychological commentary on the ITC Guidelines and illustrate the relevance of these guidelines and commentaries through presentations of projects from around the world. At the 2022 INS New Orleans meeting our group presented lessons learned from Africa, Australia, Europe, South America, and South Asia. In the current Part 2 presentation we will present projects from Australia, India, and Vietnam and lessons derived from comparisons among many projects. Our panel will discuss lessons learned from these projects and outline potential future diversity strategies, including the following:

• The concept of universal or culture-fair tests is unrealistic, naive, and potentially harmful.

• The concept of culture-broad tests and test paradigms is viable but requires empirical verification in all applications.

• Even with viable culture-broad tests, multicultural neuropsychology requires specific cultural and linguistic knowledge, skill, and sensitivity.

• Drawing is a learned skill that is viable for neuropsychological testing only when baseline abilities are well-understood.

• Verbal fluency is a cognitive task that varies in its nature depending upon characteristics of specific languages and their writing systems as well as the nature of education.

• One pragmatic possible strategy for better serving speakers of relatively rare languages is to develop ways of doing neuropsychology designed for those who speak popular languages moderately well as their second language.