When I was in my 3rd year of graduate school, I became interested in neuropsychology and purchased the first (1976) edition of Muriel Lezak's Neuropsychological Assessment to help prepare for my qualifying examination. It was the first neuropsychology book I ever owned and it was one of the few textbooks I have ever read from cover to cover. Neuropsychological Assessment is one of the classics in the field of clinical neuropsychology. It and the subsequent three editions of this classic have both reflected and shaped the field it represents. The book, often referred to as “Lezak,” is without question the most widely-consulted source on neuropsychological assessment as a clinical enterprise. The fourth edition continues in the great tradition of its predecessors, except that the sheer scope and magnitude of current work in neuropsychological assessment has now made an exhaustive and inclusive review of available tests impossible. As indicated in the preface, the revised goal of “Lezak IV” is to provide a “broad but necessarily and selectively restricted range of the information that is currently relevant and necessary for understanding and undertaking neuropsychological assessment.”

The content and organization of the book remains the same as in previous editions. However, in the fourth edition, Lezak, who on her last three tours was a solo performer, has commissioned a distinguished band of colleagues to enrich and deepen the overall tenor of the work this time around. The primary co-authors (Diane B. Howieson, David W. Loring) are distinguished neuropsychologists with established track records as scientists and practitioners in the field. Their contributions are visible in what amounts to significant reworking and updating of the introductory chapters. Two additional co-authors (H. Julia Hannay and Jill S. Fischer), themselves well-known for their clinical and research work, make more limited but valuable contributions. Their contributions are noted by authorship designations on selected chapters, while the two primary co-authors have made contributions to all chapters in the book. This ensemble of co-authors enriches the book's content by reflecting a broader and more complete accounting of the empirical basis of practice and of the conceptual foundations of neuropsychological test interpretation.

As happens to many of us, the book has gotten heavier and larger as time has passed. The newly-released fourth edition is 1016 pages long, actually shorter by 10 pages than the third edition, but the size of the book has increased to 8′′ × 11′′ and the primary font has been reduced to the point where reading glasses are advised! Readers who have owned previous editions will recognize the familiar organization that has characterized previous editions. The book begins with eight chapters under the broad heading of “Theory and Practice of Neuropsychological Assessment.” Several of these chapters have been extensively re-written though the basic organization, even down to the subhead level, is largely unchanged. Overall, chapters in this section are more extensively referenced and comprehensive than before, though it still has the feel of a brief helicopter ride over the complex landscape of neuropsychological assessment rather than an in-depth analysis of critical issues. The extensive referencing occasionally makes for choppy reading, but the real value of the book is not in its prose but in its stature as a beginning roadmap to the field. I have always viewed Neuropsychological Assessment as a good “entry point” for finding basic test materials and clinical references to begin a process of further study, but I have typically relied on original sources, rather than on Lezak itself, to bolster substantive points in clinical assessments or manuscripts. This opinion has not changed with the publication of the fourth edition. In fact, the addition of a greater amount of introductory material, and more extensive links to the \.empirical literature, may make it even more important to have more than just passing knowledge of neuropsychology and assessment in order to benefit from the reviews found here.

The real “meat” of the volume, the “Compendium of Tests and Assessment Techniques” takes up the final 11 chapters, ordered in precisely the same way as in previous editions. It is hard to find fault with the impressive, broad coverage of major instruments, inventories, and approaches to neuropsychological assessment that is offered here. Again, however, readers should be prepared to consult original sources for the kind of extensive normative, psychometric, or descriptive data they will need to actually implement specific instruments in their practice. As the authors themselves indicate, advancements in the field are occurring so rapidly that some sections are already out of date. This is probably unavoidable with a book of this size and scope, but readers should take heart that they get excellent initial bearings on the assessment landscape from the descriptions offered in the compendium. On occasion, I found myself wanting more critical in-depth analysis of the strengths and weaknesses of various measures, but overall the balance between breadth and depth of coverage is excellent. Many sections are greatly improved over previous editions. As a prominent example, the final chapter, previously entitled, “Testing for Functional Complaints,” is now entitled “Testing for Response Bias and Incomplete Effort,” and contains a dramatically expanded discussion of techniques and concepts in this important area. However, since effort research is exploding, the reader should understand that much new work has taken place since the book went to production.

Despite this issue, the reference list alone is almost worth the price of admission. It spans 189 pages and makes much better contact with the medical and experimental literatures than did previous editions. Also included is a test index, which allows the reader to directly access the description of individual instruments. The author index has been dropped, apparently due to the fact that many authors would have been listed so numerously that its usefulness would have been diminished.

In addition to showing the added weight and girth of advancing age, Neuropsychological Assessment IV is thus in many respects wiser than its predecessors. Its value as a reference to be used regularly by professionals and trainees alike is undisputed. Some of us have had one or another version of Lezak in active use in our offices for almost 30 years. The book has been made over again, extensively though not extremely. Overall, the results are well worth making a new, extended visit to our old friend to check out the “new look.”