Using the Halstead–Reitan Battery to Diagnose Brain Damage: A Comparison of the Predictive Power of Traditional Techniques to Rohling’s Interpretive Method

Cross-validation and initial investigation of two abbreviated methods of the finger tapping test

The Finger Tapping Test (FTT) is a widely utilized measure to assess lateralized motor speed and dexterity. The current study sought to cross-validate an abbreviated version of the FTT (i.e., M of Trials 3-5) and to evaluate a novel abbreviated method (i.e., M of three trials within five taps of each other; "3 within 5") to examine their respective effectiveness as a predictor of full-score performance based on a traditional administration procedure. The results showed that the abbreviated methods accurately predicted the full-test score, and any statistically significant differences that emerged were small based on effect size analysis and unlikely to be clinically meaningful. These findings were consistent across genders, among older adults, and among individuals displaying significant inter-trial tapping variability and thus requiring lengthier administration time. Classification accuracy statistics for the detection of impairment and performance validity status were high for both abbreviated methods. The results support two valid options for shortening the duration of the FTT. Both methods, used independently or in combination, are compatible with traditional administration procedures.

Education quality, reading recognition, and racial differences in the neuropsychological outcome from traumatic brain injury

Ethnically diverse examinees tend to perform lower on neuropsychological tests. The practice of adjusting normative comparisons for the education level and/or race to prevent overpathologizing low scores is problematic. Education quality, as measured by reading recognition, appears to be a more accurate benchmark for premorbid functioning in certain populations. The present study aimed to extend this line of research to traumatic brain injury (TBI). We hypothesized that a measure of reading recognition, the Wechsler Test of Adult Reading (WTAR), would account for racial differences in neuropsychological performance after TBI. Fifty participants (72% African American, 28% Caucasian) with moderate to severe TBI underwent neuropsychological testing at 1-year post-injury. Reading recognition accounted for all the same variance in neuropsychological performance as race and education (together), as well as considerable additional variance. Estimation of premorbid functioning in African Americans with TBI could be refined by considering reading recognition.

Level of Performance Accuracy for Core Halstead-Reitan Measures by Pooling Normal Controls from Published Studies: Comparison with Existing Norms in a Clinical Sample

The Halstead-Reitan Neuropsychological Test Battery offers a multifaceted, empirically supported interpretive framework for neuropsychological assessment founded upon raw scores referenced to a brain-damaged sample. Complementary approaches have used T scores from normal samples often composed of community volunteers or medical patients, augmented by regression. By pooling normal controls of all types from published studies, a sample large enough for stratification of core Halstead-Reitan measures by age and education was obtained (206 studies, N = 17,980). Comparisons based on T scores with two published normative systems in an outpatient sample produced a continuum: liberal norms for medical patients, intermediate pooled values from many types of subjects, and stringent norms for community volunteers. Features recommending clinical application of pooled norms include enhanced accuracy in clinical situations precluding a full battery, few empty cells or inversions for nonelderly subjects, and a screening application based upon a very large Trail Making Test sample (Trails B: n > 14,000).

The Repeatable Battery for The Assessment of Neuropsychological Status (RBANS): Clinical Utility in a Traumatic Brain Injury Sample

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Randolph, 1998), a neuropsychological screening measure initially designed to assess the cognitive deficits associated with dementia, has since been clinically implemented with other neurological populations including traumatic brain injury (TBI). This study evaluated the clinical utility of the RBANS in a TBI population by comparing the profiles of 51 TBI cases and 34 non-head-injured controls. Across RBANS' Index Scores, the TBI group performed at a significantly lower level than the controls; sensitivity to TBI and likelihood ratios ranged from modest to strong; and specificity was high. Particularly efficacious was the clinical efficiency exhibited by the Total Scale Index (summary score) of the RBANS.