Neuropsychological Assessment Battery (NAB) is among the test that are commonly used to measure cognitive function. The application of this test indicates that the practitioners are confident that it delivers the desired outcomes. While the confidence that the practitioners express lends credibility to this test, it is important to analyze how this test performs on other measures of quality. Reliability and validity are some of the measures that are used to evaluate tests. Tests that are both valid and reliable offer accurate results and allow practitioners to conduct an actual measurement of the variable in question. Various scholars have conducted tests to establish the validity and reliability of the Neuropsychological Assessment Battery test. There appears to be consensus within the scholarly community that Neuropsychological Assessment Battery is indeed valid and reliable.
Before investigating the findings that researchers have obtained regarding the validity and reliability of NAB, it is important to begin with a general assessment of this test. One of the indicators of an effective test is practical utility. Unless a test can be deployed in real and practical settings, it is useless. Jaywant, Toglia, Gunning and O’Dell (2018) are among the researchers who have explored the clinical utility of the NAB test. After administering this test on a group of patients undergoing stroke rehabilitation, Toglia and his colleagues confirmed that the test is indeed clinically useful. Furthermore, they noted that NAB possesses internal consistency and that it allows practitioners to assess various dimensions of cognitive function. It is true that in evaluating the clinical usefulness of NAB, Toglia and the other researchers used a small group of patients who do not necessarily represent the many situations and settings where the test can be used. However, it can be concluded that NAB is a practical and immensely useful device for measuring cognitive competence.
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As noted above, validity is among the measures that allow for an understanding of the quality of a testing instrument to be established. Essentially, validity offers an indication of how well a test measures the factor or variable for which it is designed. For example, the NAB was developed with the goal of measuring cognitive performance (Vanderploeg, 2014). If it is found to be valid, the conclusion to be made is that NAB does indeed measure cognitive function. DiCarlo, McCain, Ernst and Haggerty (2016) joined forces to evaluate the validity of NAB. The validity that they examined is of the ecological type. Ecological validity is concerned with the extent to which an instrument offers an accurate prediction of experiences and factors witnessed in real settings. After applying NAB to a group of patients who have suffered brain injury, DiCarlo et al. established that this test possesses ecological validity. In their article, these researchers give focus to the evidence of the validity of NAB. The implication of their finding is that when practitioners use this test, they can do so with confidence since the test allows them to measure cognitive function among real patients grappling with real issues.
DiCarlo and his colleagues are not isolated in examining the validity of NAB. They are joined by Margolis, Miele, Rabinovitz and Schaffer (2013) who also conducted a study to examine the validity of their NAB. Instead of being a single test, the NAB is a collection of various instruments which measure various dimensions of cognitive function. For their study, Margolis and his colleagues employed a version of NAB that had a naming component. The results of their study can be extended to understand the general validity of the larger NAB test. Construct is the specific type of validity that they reviewed and their purpose was to present evidence that NAB is a valid tool. According to these researchers, NAB has construct validity. What this means is that NAB actually measures cognitive performance.
It has already been stated that NAB was developed for the primary purpose of assessing cognitive performance. This test can be administered on such patients as those who have sustained concussion as a result of activities like sport. Johnson, Kegel and Collins (2011) partnered to explore the validity of NAB when administered to footballers who have suffered concussion. Apart from validity, Johnson and his team also investigated the sensitivity, reliability and prognostic value that NAB possesses. The observations that they made are consistent with the findings by other researchers. They noted that NAB is a valid tool that can be reliably used to develop interventions for patients who have developed difficulty with cognitive function. What is clear from the discussion this far is that scholars agree that NAB is a valid equipment. More importantly, it should be noted that all the researchers used this test on different groups of patients with varying conditions and illnesses that impaired their cognitive function. Since the NAB has been used on a wide range of patient populations, its general validity can be affirmed.
Above, some of the researchers who have scrutinized the NAB test to ensure validity have been identified. Thanks to the studies that these researchers have conducted, it is clear that validity is among the features that accurately and properly define the NAB test. However, while it is critical for a test to possess validity, it is also important for tests to be defined by other measures of quality. Reliability is another measure that offers insights into the usefulness and quality of a test. Basically, reliability refers to the level of consistency and stability of the results that a particular test yields. Ideally, a test should produce the same results when employed multiple times and in different settings. In the following discussion, focus is given to how various scholars have proven that NAB is a reliable test.
Among the researchers who have focused their efforts on the reliability of the NAB test is Zgaljardic, Oden, Dickson, Plenger, Lambert and Miller (2013). To determine how reliable the NAB test is, these researchers worked with patients whose cognitive function had been rendered poor due to brain injury. They worked with a specially modified version of the NAB test which was designed to assess such competencies as verbal memory and semantic fluency. Alternate form reliability is the particular form of reliability that Zgaljardic and his colleagues investigated. According to these researchers, the NAB test has alternate form reliability. Essentially, alternate form reliability determines whether if administered to the same group of patients at different points in time, different versions of the same test yield the same outcomes. The fact that they confirmed that the NAB test has this type of reliability means that its reliability and quality is not hindered by such circumstances as time. Whereas it is true that the researchers do not offer any mathematical figures for reliability estimates, their discussion establishes NAB as a highly reliable implement for cognitive function assessment.
Studies which are exclusively dedicated to an explicit examination of reliability are most ideal for determining how reliable the NAB test is. However, there are other studies which despite having a broader focus, allow one to establish the reliability of this test. Pinsker, Lo, Haslam and Pinsker (2018) are among the scholars who have conducted such a study. They set out to investigate the contributions that neuropsychological testing has had on the field. As they attempt to establish the impact of this testing, the share the thoughts of various scholars on the applicability of the NAB test. They identify various scholars who have found the test to be as reliable as it is valid. Whereas the insights that Pinsker and his team share are not original, they underscore the reliability of the NAB test. It is clear that a majority of researchers are of the view that when administered properly, the NAB test should deliver consistent and reliable results.
This far, focus has been given to the validity and reliability of the NAB test. These two measures offer the best indication of the quality and effectiveness of a test. However, such other measures as flexibility allow one to understand how well a test functions. One of the defining features of the NAB test is that it is highly flexible. In their text, Casaletto and Heaton (2017) explore the role that flexibility plays in neuropsychological assessment. They indicate that a test that is flexible can be applied in a wide range of settings. More importantly, flexibility makes it possible for practitioners to customize and tailor the test to suit their individual needs and the demands of their assignments. Given its highly flexible nature, the NAB test presents practitioners with these advantages. The advantages set NAB apart from other tests which tend to be restrictive in the range of settings where they can be administered.
All the scholars whose work has been cited above have found that NAB is a reliable and valid tool. In the debate on whether this tool is indeed valid and reliable, the voices of these scholars prevail. However, it is important to consider the views of the researchers and academicians who have raised doubts about the quality of the NAB. Pawlowski, Segabinazi, Wagner and Bandeira (2013) are among these scholars. They set out to examine the literature on the validity of the NAB. Their literature review led them to conclude that a majority of researchers confirm that the NAB is valid. However, Pawloski et al. suggest that many researchers have used short-sighted approaches and have failed to offer a comprehensive examination of the NAB. Basically, while they do not declare the NAB to be invalid, they indicate that this test has not been subjected to rigorous scrutiny. In their article, the researchers call for the adoption of more stringent procedures for establishing the validity of NAB. It is true that Pawloski and his colleagues say that there is some chance that NAB may not possess the validity it has been found to have by other researchers. However, the doubts that Pawloski et al. raise are not sufficient to erode the validity and reliability of the NAB. Since an overwhelming majority of researchers have concluded that NAB is both valid and reliable, the only reasonable and fair conclusion to make is that the test does indeed possess these features.
In conclusion, practitioners have numerous tools that they can use to evaluate cognitive functioning among their patients. The availability of a wide range of tools raises the question of why a practitioner should choose the NAB test over its alternatives. Reliability and validity are the answer to this question. Various scholars have conclusively proven that the NAB test is both reliable and valid. The implication is that when they administer this test, practitioners will obtain results that are consistent, accurate and reflective of the situation on the ground. The NAB test has also been observed to be flexible and to possess clinical utility. It can be deployed in many different clinical settings. Despite being based on a theoretical framework, the NAB test has real-world implications and benefits. Therefore, practitioners should remain confident in their use of this test as it presents a wide range of benefits that would be lacking if other tests were used in the place of NAB.
References
Casaletto, K. B., & Heaton, R. K. (2017). Neurological assessment: past and future. Journal of the International Neuropsychological Society, 23 (9-10), 778-90.
DiCarlo, McClain, M., Ernst, N., & Haggerty, K. (2016). Ecological validity of the neuropsychological battery-screening module and Texas function living scale in a post-acute acquired brain injury population. Archives of Clinical Neuropsychology, 31 (6). DOI: https://doi.org/10.1093/arclin/acw043.121
Jaywant, A., Toglia, J., Gunning. F. M., & O’Dell, M. W. (2018). The clinical utility of a 30-minute neuropsychological assessment battery in inpatient stroke rehabilitation. Journal of the Neurological Sciences, 390, 54-62. DOI: https://doi.org/10.1016/j.jns.2018.04.012
Johnson, E. W., Kegel, N. E., & Collins, M. W. (2011). Neuropsychological assessment of sport-related concussion. Clinical Sports Medicine, 30, 73-88.
Margolis, S., Miele, A., Rabinovitz, B., & Schaffer, S. (2013). B-67 construct validity of the neuropsychological assessment battery naming test in patients with intractable epilepsy. Archives of Clinical Neuropsychology, 28 (6), 518-626.
Pinsker, D., Lo, A. H. Y., Haslam, C., Pachana, N. A., & Pinsker, H. (2018). Hit or miss? Diagnostic contributions of neuropsychological assessment in patients with suspected dementia. International Journal of Clinical Neurosciences and Mental Health. DOI: https://doi.org/10.21035/ijcnmh.2018.5.2
Pawlowski, J., Segabinazi, J. D., Wagner, F., & Bandeira, D. R. (2013). A systematic review of validity procedures used in neuropsychological batteries. Psychology & Neuroscience, 6 (3), 311-29.
Vanderploeg, R. D. (2014). Clinician’s guide to neuropsychological assessment. London: Psychology Press.
Zgaljardic, D. J., Oden, K. E., Dickson, S., Plenger, P. M., Lambert, M. E., & Miller, R. (2013). Naming test of the neurological assessment battery: reliability and validity in a sample of patients with acquired brain injury. Archives of Clinical Neuropsychology,28 (8), 859-65.
