International variation in neuropsychological test use practices: Implications for test adaptation and fair assessment

Neuropsychological test selection varies substantially across countries and languages, yet which instruments clinicians use internationally remains poorly documented. Using a survey of International Neuropsychological Society members (INSConnect, 2023), we examined instrument endorsement among 147 respondents across 30+ countries. English-language administrators endorsed more instruments per cognitive domain clinically than non-English administrators, particularly in memory, executive functioning, language, intelligence, and performance validity. Multilingual status showed little association with instrument breadth. Regional patterns indicated uneven access to proprietary instruments and greater reliance on locally available tools. These findings provide an empirical foundation for prioritizing test adaptation, guiding normative development, and valid, fair cross-cultural assessment.