Inclusion of education with WTAR is more problematic, since we cannot know what the maximum educational level achieved will be for the younger participants in our sample (i.e., some participants were in full-time education and/or may not have reached their peak level of achievement at the time of testing). [1] 3099067 Clinicians should consider alternative estimation measures in this TBI subpopulation. In addition to the WTAR, all participants were administered a standardized battery of neuropsychological tests. In this paper, we consider a range of common methods for producing this estimate, including those based on current best performance, embedded hold/no-hold tests, demographic information, and word reading ability. Despite the modest disparity among the subtest and index means, marked within-subject variability in performance was found. This study aimed to compare 3 common measures and assess their accuracy: the Test of Premorbid Functioning (TOPF), Oklahoma Premorbid Intelligence Estimate (OPIE-3), and what is commonly referred to as the Barona equation. In addition, paired sample t-tests were used to assess for within-group effect of time for each group. Fifty-two participants with mild, moderate, or severe TBI were administered the ToPF and WAIS-IV between two weeks and 19 months post-injury. With large samples, however, reliable stimulus-specific coefficients can be computed in which the predictive value of each stimulus is individually weighted. Although individuals with mTBI perform commensurate with healthy, demographically matched controls at 1 and 12 months post-injury, the WTAR-estimated IQ of those with msevTBI is significantly lower than matched controls during the first year following injury. Correlation coefficients, although significant, were relatively small, even though statistical power (1 - ) in all cases exceeded .8 (two-tailed). A year later, 15% of individuals with msevTBI continued to have a WTAR-predicted IQ 1.5 SDs below the mean. Clipboard, Search History, and several other advanced features are temporarily unavailable. NART, National Adult Reading Test; WTAR, Wechsler Test of Adult Reading; WAIS-IV Wechsler Adult Intelligence Scale Fourth Edition. They concluded that the WTAR is a valid estimate of premorbid intelligence in a recovering moderate-to-severe TBI population. Comparing the North American Adult Reading Test (NAART) and the Test of Premorbid Functioning (TOPF) to estimate premorbid Wechsler Adult Intelligence Scale - 4th edition FSIQ in a clinical sample with epilepsy. Subsequent post hoc tests revealed that the msevTBI group had a greater proportion of men than those with mTBI (2=6.516, p=.011) and controls (2=5.120, p=.024). However, a higher percentage of Actual and Predicted scores were discrepant from FSIQ compared with the other three TOPF estimates, arguing against their use as independent premorbid estimates. By closing this message, you are consenting to our use of cookies. B., et al. All participants completed the WTAR and a battery of neuropsychological measures at each visit. Proper TOPF scoring procedures are presented. Less commonly, Picture Completion (now a supplementary rather than core test) and Matrix Reasoning are also employed but will not be included here. (, Kay, T., Harrington, D., Adams, R., Anderson, T., Berrol, S., Cicerone, K., et al. NART, National Adult Reading Test; WTAR, Wechsler Test of Adult Reading; WAIS-IV, Wechsler Adult Intelligence Scale Fourth Edition. Copyright 2010 NCS Pearson, Inc. All rights reserved. Register to receive personalised research and resources by email. Test of Premorbid Functioning Point-by-point comparison against predicted WAIS and WAIS-R IQs included in the British NART-R test manual shows similar estimates at the high end of the distribution (but lowest for WAIS-IV), with estimates at the lower end falling between the WAIS (higher) and WAIS-R (lower) FSIQ estimates (Figure 2). Neuropsychological assessments are helpful in tracking changes that may affect daily functioning as cognitive impairment and dementia progress. Adaptive Functioning Among Older Adults: The Essence of Information Processing Speed in Executive Functioning, Psychological Correlates of Self-Rated Resilience in the Context of Subjective Cognitive Concerns in Older Adults, An Examination of Visual Quality of Life and Functional Vision Among Collision and Non-Collision Athletes Over a Competitive Season, The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes, A Neuropsychological Battery for the Evaluation of Dementia Among Mandarin-Speaking Older Adults in the United States, About Archives of Clinical Neuropsychology, About the National Academy of Neuropsychology, Dwan, Ownsworth, Chambers, Walker, & Shum, 2015, Green, Melo, Christensen, Ngo, Monette and Bradbury's (2008), Mathias, Bowden, Bigler, and Rosenfeld (2007), Receive exclusive offers and updates from Oxford Academic. HHS Vulnerability Disclosure, Help All levels of occupation and education were represented. Unauthorized use of these marks is strictly prohibited. Figure 1. These potential problems can be avoided by eschewing estimates based on current test performance, i.e., by using demographic data only, but demographic-based approaches raise other concerns. . It is a word reading The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Statistically, the tests provided equally precise predictions of WAIS-IV performance, with the strongest effects observed for FSIQ, GAI and VCI. Obtaining accurate estimates of premorbid intelligence allows clinicians to more accurately quantify the extent of cognitive impairment that a patient has sustained following traumatic brain injury (TBI). Wide variability is observed in performance across subtests in intelligence batteries, along with poor inter-test correlations. Additionally, WTAR-estimated intelligence was similar to that predicted by the Crawford and Allan (1997) demographic equation. National Adult Reading Test (NART): For the assessment of premorbid intelligence in patients with dementia: Test manual. In our sample, the ToPF/demographic predicted FSIQ underestimated intelligence in a substantial portion of our participants (31%), particularly in those with high average to superior intelligence. The TOPF Actual and Predicted scores were related to FSIQ. We aimed to investigate the predictive accuracy of the Potential differences in demographic characteristics between control and TBI groups were analyzed using one-way analysis of variance (ANOVA; age, years of education) or Pearson's chi-square tests (gender, race). Future studies should aim to identify methods optimally adapted to specific conditions, so that, to the greatest extent possible, like is compared with like. measure of premorbid intelligence. Bold values indicate significant single predictor models and stepwise multivariate models in which the fit is significantly improved. WebWechsler Test of Adult Reading. Windsor: NFER-Nelson. WebThe Test of Premorbid Functioning (ToPF), a word reading test co-normed with the Wechsler Adult Intelligence Scale 4 th Edition (WAIS-IV), was examined as a tool for 1 Degrees of freedom corrected for violation of sphericity assumption using the Greenhouse-Geisser method. WebTest of Premorbid Functioning estimates an individual's pre-morbid cognitive and memory functioning. sharing sensitive information, make sure youre on a federal The sample range was lower in our WTAR data, with 33 predicted FSIQ values, but the regression analysis revealed a wider distribution of estimates ranging from 59 (50 WTAR errors) to 120 (0 WTAR errors). None of the controls were taking medications known to affect cognition. For permissions, please e-mail: journals.permissions@oup.com. WebFor all three groups, raw LOFT scores were converted to standard scores (estimated IQ) based on existing WTAR normative data. They reported significantly higher NART scores upon second testing. Paired t-tests (two-tailed) revealed significant differences between hold and no-hold combined measurements. 5 Howick Place | London | SW1P 1WG. It was hypothesized that performance on these measures would improve over time whereas the WTAR remained stable. All rights reserved. Two of these measures were chosen for analyses as they assess areas of cognition known to be sensitive to the effects of head injury (Rabinowitz & Levin, 2014): Trail Making Test (TMT), Part A and B (Reitan & Wolfson, 1993), and the California Verbal Learning Test-II (CVLT-II) Trials 15 Total (Delis, Kramer, Kaplan, & Ober, 2000). In the present study, for example, NART and WTAR performance was only moderately sensitive to current working memory and perceptual reasoning ability, implying limited utility of such tests for estimating premorbid nonverbal/fluid intelligence in neurological patients. sharing sensitive information, make sure youre on a federal All patients were administered the RBANS-Update and the Advanced Clinical SolutionsTest of Premorbid Functioning (TOPF) according to standardized instructions. Moreover, the msevTBI group had a significant improvement in WTAR performance over the 1-year period. The value of the NART and WTAR for estimating WAIS-IV index scores is more questionable, showing large correlations with the VCI and GAI but relatively modest correlations with WMI and PRI, suggesting that caution should be employed in drawing inferences about premorbid executive function and fluid ability. A., Pattie, A., Whiteman, M. C., Lemmon, H. A., et al. Results indicate that word-reading tests may underestimate premorbid intelligence during the immediate recovery period for patients with msevTBI. Table 1 provides demographic and WAIS-IV FSIQ data. ; Nelson, H. E., & Willison, J. National Library of Medicine Consistent with these findings were the large correlations between test performance and age, indicating that both the NART and WTAR tap crystallised knowledge (which typically improves across our sample age range) rather than fluid ability (which typically peaks in early adulthood and subsequently declines; Cattell, Citation1971). Nevertheless, the scarcity of very low WTAR scores in our sample suggests that these lower FSIQ estimates should be interpreted with caution. Includes scoring and reporting digital-only when used separately from WMS-IV. Controls were excluded if they had been diagnosed with psychiatric disorders (except mild depression), substance abuse, or neurologic diseases. official website and that any information you provide is encrypted WebTest of Premorbid Functioning (TOPF)-Raw Score : FITBIR : Federal Interagency Traumatic Brain Injury Research Informatics System Start of main content Unique Data Element: Test of Premorbid Functioning (TOPF)-Raw Score General Details Basic Attributes Classifications Keywords and Labels Specific Details Change History Similarly, a comparison of participants mean lowest subtest scaled score (7.85) against their highest subtest scaled score (14.77) revealed a mean difference of 6.92 scaled points. Neuropsychological Assessment Battery, Judgment Subtest. Estimating Premorbid Ability in Rehabilitation Patients Using the Test of Premorbid Functioning and Wide Range Achievement Test-Fourth Edition. . (Citation2003) provide evidence that the Oklahoma Premorbid Intelligence Estimate (OPIE; Scott, Krull, Williamson, Adams, & Iverson, Citation1997), based on combined hold WAIS subtest and demographic information, produces estimates in cognitively impaired patients which may be closer to their current than premorbid IQ (i.e., the method underestimates patient deficit). No differences were observed among the index scores (p>.05 in all cases). Published by Oxford University Press. Participants were initially assessed at 36 months post-injury and again 6 months later. Figure 1 provides an indication of comparative popularity of NART, WTAR and TOPF in research year-by-year. Comparing the North American Adult Reading Test (NAART) and the Test of Premorbid Functioning (TOPF) to estimate premorbid Wechsler Adult Intelligence Scale - 4th edition FSIQ in a clinical sample with epilepsy. The Top-J takes approximately 10 minutes to administer and score. Method: The appropriateness of a given approach is likely to depend on the patient under investigation, but those based on reading ability/word knowledge are among the most widely employed, particularly in North America, UK and Australia (e.g., Crawford, Stewart, Cochrane, Parker, & Besson, Citation1989; Mathias, Bowden, & Barrett-Woodbridge, Citation2007; Skilbeck, Dean, Thomas, & Slatyer, Citation2013). Windsor: NFER-Nelson.) M-ACE. In practice, the clinician considers evidence from multiple sources when estimating the degree of cognitive impairment (if any), but to avoid bias and constrain subjectivity, it is crucial to employ evidence-based assessment approaches in this process (e.g., Youngstrom, Choukas-Bradley, Calhoun, & Jensen-Doss, Citation2015). All TOPF scores were significantly correlated with WAIS-IV FSIQ scores (range r = 0.56-.73). The unadjusted premorbid IQ is based on published tables developed through regression with TOPF alone as a predictor of IQ. Bookshelf The Test of Premorbid Functioning (TOPF), a revision of the Wechsler Test of Adult A board-certified rehabilitation neuropsychologist assigned a TBI severity level of either mTBI (n=43) or msevTBI (n=40) using diagnostic criteria from TBI Model Systems (Bushnik, 2008), which has been well-described previously (Brasure et al., 2012; Kay et al., 1993). In contrast, those participants with mTBI did not significantly differ from healthy controls and both the mTBI and control groups demonstrated stability on the WTAR over time. NART consistently produced higher WAIS-IV estimates than WTAR for a given level of performance, with the level of disparity increasing as a function of error. Linear correlation between National Adult Reading Test/Wechsler Test of Adult Reading (NART/WTAR) errors and Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) full-scale IQ (FSIQ). This methodology has been used previously in TBI samples to provide evidence that word-reading tests are valid in the context of cognitive recovery (Green et al., 2008; Orme, Johnstone, Hanks, & Novack, 2004). Note: Values are meanSD or n (%).GCS = Glasgow Coma Scale; GOAT = Galveston Orientation and Amnesia Test; mTBI = mild traumatic brain injury; msevTBI = moderate-to-severe traumatic brain injury; NA = not applicable. However, we also found that predictive accuracy can be modestly but significantly improved through the use of combined test scores with demographic information (NART with age, and WTAR with education). Bethesda, MD 20894, Web Policies Participants with mTBI did not significantly differ from healthy controls at any time during the 1-year period, and both the mTBI and control groups demonstrated stability on the WTAR over time. Register a free Taylor & Francis Online account today to boost your research and gain these benefits: Comparison of methods for estimating premorbid intelligence, Department of Psychology, Anglia Ruskin University, Cambridge, UK; Vision & Eye Research Unit (VERU), Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK, Vision & Eye Research Unit (VERU), Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK; Department of Computing & Technology, Anglia Ruskin University, Cambridge, UK, A demographically based index of premorbid intelligence for the WAISR, The National Adult Reading Test: Restandardisation against the Wechsler Adult Intelligence Scale Fourth Edition, The national adult reading test as a measure of premorbid intelligence: A comparison with estimates derived from demographic variables, Estimating premorbid WAISR IQ with demographic variables: Regression equations derived from a UK sample, The NART as an index of prior intellectual functioning: A retrospective validity study covering a 66-year interval, Estimating premorbid intelligence by combining the NART and demographic variables: An examination of the NART standardisation sample and supplementary equations, Construct validity of the national adult reading test: A factor analytic study, Criterion validity of new WAISIII subtest scores after traumatic brain injury, Methods of estimating premorbid functioning, Estimating premorbid intelligence: Comparison of traditional and contemporary methods across the intelligence continuum, Accuracy of the Wechsler Test of Adult Reading (WTAR) and National Adult Reading Test (NART) when estimating IQ in a healthy Australian sample, From aisle to labile: A hierarchical National Adult Reading Test scale revealed by Mokken scaling, A critical note on Lezaks best performance method in clinical neuropsychology, Dementia: The estimation of premorbid intelligence levels using the New Adult Reading Test, Office of Population, Censuses and Surveys. Shura RD, Ord AS, Martindale SL, Miskey HM, Taber KH. Objective: Both TBI groups experienced at least some degree of initial cognitive impairment on traditional neuropsychological measures (TMT, CVLT-II) with notable improvement over the first year. Although this mean change did not meet criteria for a clinically significant difference in testretest scores according to the Wechsler (2001) manual (>10.8 point difference), it should be noted that 23% individuals with msevTBI did meet this cutoff. Not designed to diagnose reading disorder. The UAB Institutional Review Board approved the study procedures. NART, National Adult Reading Test; WTAR, Wechsler Test of Adult Reading; WAIS-IV Wechsler Adult Intelligence Scale Fourth Edition; FSIQ, WAIS-IV full-scale IQ; ***p<.001; **p<.01. Participants were assessed at 1 and 12 months post-injury with a 2-week scheduling window on either side, in accordance with TBI Model System's guidelines (Hanks et al., 2008; Kalmar et al., 2008). Fax: +1 (800) 232-1223, Digital Assessment Library for Schools (K-12), Digital Assessment Library for Universities, Guidanceon using this test in yourtelepractice. Notes: All scores are age-corrected standard scores based on normative data in the test manuals (except the MMSE, which is raw score). Bold values indicate significance at p < .05. Comparison of methods for estimating pre . https://doi.org/10.1080/09602011.2018.1445650, https://doi.org/10.1037/0022-006X.52.5.885, http://doi.org/10.1080/09602011.2016.1231121, https://doi.org/10.1017/S1355617702860131, https://doi.org/10.1080/13854049708407050, https://doi.org/10.1017/S0033291701003634, https://doi.org/10.1016/0191-8869(90)90028-P, https://doi.org/10.1016/0191-8869(89)90043-3, https://doi.org/10.1016/S0887-6177(01)00136-6, https://doi.org/10.1080/00050060600827599, https://doi.org/10.1016/S0887-6177(02)00135-X, https://doi.org/10.1016/S0887-6177(97)00051-6, https://doi.org/10.1080/13854049708407043, https://doi.org/10.1080/09602011.2012.747968, https://doi.org/10.1037/1040-3590.8.4.404, https://doi.org/10.1016/j.cbpra.2013.12.005. The raw score can be transformed to an age-adjusted standard score, which is used to predict IQ (M = 100; SD = 15). In this study, we compare the precision of a range of approaches for estimating WAIS-IV full-scale IQ (FSIQ) and constituent indices and offer new combined methods that clinicians and researchers may wish to consider adopting in their work. The British NART, WTAR and WAIS-IV were then administered (in that order) according to standardised instructions. Since the NART (and NART-R) were published, similar tests of reading/vocabulary knowledge have also been proposed that provide predicted scores incorporating one or more demographic variables (the WTAR against WAIS-III and the TOPF against WAIS-IV). We are unable to identify your country location. By comparing estimated pre-injury intelligence to measures of current cognitive functioning, clinicians can approximate the level of decline that a patient has experienced. Categories based on occupational status and education, for example, are arguably too coarse to provide an accurate premorbid IQ for a specific individual. Utility of the Montreal Cognitive Assessment and Mini-Mental State Examination in predicting general intellectual abilities. The WTAR (Wechsler, 2001)comprises 50 words with irregular pronunciations that participants read aloud. de Erausquin GA, Snyder H, Brugha TS, Seshadri S, Carrillo M, Sagar R, Huang Y, Newton C, Tartaglia C, Teunissen C, Hkanson K, Akinyemi R, Prasad K, D'Avossa G, Gonzalez-Aleman G, Hosseini A, Vavougios GD, Sachdev P, Bankart J, Mors NPO, Lipton R, Katz M, Fox PT, Katshu MZ, Iyengar MS, Weinstein G, Sohrabi HR, Jenkins R, Stein DJ, Hugon J, Mavreas V, Blangero J, Cruchaga C, Krishna M, Wadoo O, Becerra R, Zwir I, Longstreth WT, Kroenenberg G, Edison P, Mukaetova-Ladinska E, Staufenberg E, Figueredo-Aguiar M, Ycora A, Vaca F, Zamponi HP, Re VL, Majid A, Sundarakumar J, Gonzalez HM, Geerlings MI, Skoog I, Salmoiraghi A, Boneschi FM, Patel VN, Santos JM, Arroyo GR, Moreno AC, Felix P, Gallo C, Arai H, Yamada M, Iwatsubo T, Sharma M, Chakraborty N, Ferreccio C, Akena D, Brayne C, Maestre G, Blangero SW, Brusco LI, Siddarth P, Hughes TM, Zuiga AR, Kambeitz J, Laza AR, Allen N, Panos S, Merrill D, Ibez A, Tsuang D, Valishvili N, Shrestha S, Wang S, Padma V, Anstey KJ, Ravindrdanath V, Blennow K, Mullins P, ojek E, Pria A, Mosley TH, Gowland P, Girard TD, Bowtell R, Vahidy FS. 3, 53 The M-ACE consists of 5 items with a maximum score of 30. This approval level enables you to buy our assessments that require no professional degree, accreditation, organization membership, or license/certificate. The authors report no conflicts of interest. However, such methods typically require large datasets and replication studies and for this reason we have not presented these statistics here. Use of the TOPF as was designed is recommended. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. WebThe Test of Premorbid Functioning Score Report can be generated with a maximum of four assessment records. 2020 Jan;34(1):43-52. doi: 10.1037/neu0000569. Occupation information unavailable for 14 participants; education data lists maximum qualification obtained (or in progress). The WTAR was co-normed with the Wechsler Stepwise regression using standard inclusion (p=.05) and exclusion (p=.1) criteria indicated that the best model in all cases contained two predictor variables (with the demographic variable explaining an additional 5% of the variance in FSIQ scores). Note: Full sample statistics are indicated in bold. For example, Powell et al. The control, mTBI, and msevTBI groups did not differ with regard to age, education, or race. HHS Vulnerability Disclosure, Help The validity of this test depends on 2020 May 14:acaa025. Word pronunciation tests are the most commonly used hold test and have been used to estimate premorbid intelligence in a wide variety of clinical populations (Dwan, Ownsworth, Chambers, Walker, & Shum, 2015; Hanks et al., 2008; McGurn et al., 2004). The site is secure. In conclusion, WTAR performance appears to be negatively affected by msevTBI 1 month post-injury with improvement during the first year. Finally, the hold/no-hold approach, like best performance, requires that we accept the assumption that neurologically healthy populations perform similarly across all subtests. Knowledge of intelligence is essential for interpreting cognitive performance following traumatic brain injury (TBI). This was the case for equations incorporating NART, WTAR, and the sum of these test scores (Table 5). We also consider an abbreviated form of the NART (mini-NART, McGrory, Austin, Shenkin, Starr, & Deary, Citation2015), developed in order to expedite the test and remove words that provide little additional predictive power. Additionally, there was a positive correlation between the WTAR and change in these measures for those with msevTBI, providing additional evidence that the word-reading ability is influenced by cognitive recovery. In most cases PF must be estimated, and specific tests have been designed to produce these estimates. Such variability in neurologically healthy participants renders estimation of premorbid IQ using a straightforward best performance approach problematic, and likely to produce markedly inflated predicted scores. WebThe Test of Premorbid Functioning enables clinicians to estimate an individuals level of cognitive and memory functioning before the onset of injury or illness. Table 4 provides correlations of these test scores with WAIS-IV FSIQ, constituent indices and core subtest scaled scores. The ToPF frequently underestimated post-injury intelligence and is therefore not accurately measuring premorbid intelligence in our sample, particularly in those with above average to superior intelligence. Although both TBI groups improved over time, those with msevTBI continued to be impaired relative to controls at 1 year post-injury. Chronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium. Keywords: Therefore, the low average WTAR score at baseline is presumably attributable to the effects of msevTBI. Additionally, scores on the VCI and PRI subtests contribute to a General Ability Index (GAI), typically employed in cases in which disproportionate working memory and/or processing speed difficulties complicate the interpretation of FSIQ (Wechsler, Citation2008).
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