title: The importance and challenges of assessing cognition in Indigenous Australians.
abstract: OBJECTIVE
  The aim of this paper was to investigate the importance and challenges involved in conducting serial cognitive assessments among healthy Indigenous adolescents.
  
  
  METHODS
  Cognitive assessments were conducted at fortnightly intervals for 2 months and again at 6 and 12 months among a group of Indigenous students from a boarding school in the Northern Territory. These students were to be the healthy control group in a long-term study of substance abuse. Recruitment and attrition rates were reviewed and related challenges for assessing participants were identified.
  
  
  RESULTS
  From the recruited sample (n=49), 18% reported heavy or frequent use of alcohol, cannabis or petrol. Males were more likely to have used these substances compared to females. Attrition increased as the follow-up interval increased with 49 recruits reducing to 32 in the first 2 months and only 15 and 13 of the initial group remaining for the 6 and 12 month follow-ups respectively.
  
  
  CONCLUSIONS
  Main challenges included (i) appropriateness of tests and assessment processes, (ii) high rates of substance abuse and other illness in the control group and (iii) high attrition rates. The importance of assessing cognition appropriately is highlighted by a lack of information regarding mental health issues in Indigenous populations.
authors: Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia. Kylie.Dingwall@menzies.edu.au
authors: Kylie
authors: K
authors: Dingwall
authors: Sheree
authors: S
authors: Cairney
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D003071:Cognition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008603:Mental Health; D015876:Northern Territory / Q000453:epidemiology; D011594:Psychometrics; D013334:Students; D019966:Substance-Related Disorders / Q000453:epidemiology