Proper cognitive function is among the spheres of human health. As part of efforts to ensure that cognitive faculties perform as required, various psychological testing tools have been developed. The Neuropsychological Assessment Battery is among these tools. This test was the focus of a previous assignment and is the subject explored in this paper. Essentially, Neuropsychological Assessment Battery (NAB) is a test that is used to assess various aspects of cognitive performance. For example, it is employed when evaluating memory, language and attention. In order to understand how this test functions, it is necessary to explore such issues as the its materials and the procedures that are followed during its implementation.
Test Items Type/Format
In this section, an overview of various aspects of the items and format of the Neuropsychological Assessment Battery is provided.
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Available Formats
The NAB is available in a number of formats. One of these formats involves a computer-based online administration of the test (Feenstra et al., 2018). This format allows individuals to self-administer the test, eliminating the need for the involvement of a professional. The test is also available in a pencil and paper format (“Neuropsychological Assessment Battery”, n.d). A software that contains the test has also been developed. The various formats enhance the versatility of the NAB. It is important to note that the types of the test items that make up the NAB are varied given that this test is composed of smaller tests (referred to as modules) that evaluate various aspects of cognitive function. For example, some of the items in the memory module are of the multiple-choice format (PAR, n.d). List and task formats are other types that the test items in different modules assume.
Scores
As the name suggests, NAB combines different tests that are concerned with the assessment of cognitive function. It therefore follows that various scores can be obtained when this test is administered. The main scores include memory, attention, spatial and language indices (Brooks, Iverson & White, 2009). Individually, these scores serve as measures of the respective spheres of cognitive function. However, they can be combined to gain an overall understanding of the general state of a patient’s cognitive capacities. It should be noted that the test scores obtained from the different modules of the NAB are norm-referenced. This means that to understand the implication of a test taker’s scores, these scores are compared against established averages or standards (Brooks, Iverson & White, 2009).
Positive Aspects of Test Items, Formats, Directions, Answer sheets, Score Reports
There are various positive elements of the test items, formats directions, answer sheets and scores that constitute the NAB. The main positive aspect of the test items is that they are formulated such that they are relevant to the sphere of cognitive performance that is being measured. For example, to assess memory, the items are in a list format and the test-taker is required to recall the items. As noted earlier, the NAB is available in various formats and this allows professionals and test-takers to access it conveniently. For instance, where computers are unavailable, the pencil and paper format of the test may be administered. The publisher of the NAB, the Psychological Assessment Resources (PAR) supplies simple yet detailed instructions and tutorials that guide administrators of the test (“Neuropsychological Assessment Battery”, n.d). One of the strengths of the score reports is that they allow for standardization of individual scores and for comparisons to be made. The answer sheets that accompany the NAB also possess some positives. One of these is that they allow the test-taker enough room to provide a response. For example, the spatial module of the NAB involves an exercise where the test-taker needs to draw a figure (PAR, n.d). Adequate space is provided for the drawing.
Negative Aspects
The NAB is so well designed that it is rather difficult to identify flaws or areas that require improvement. Nearly all the elements addressed above (i.e. test items, formats, answer sheets, score reports and directions) have no flaws. However, this test is not perfect. One of the main shortcomings can be seen in the test items. Some of the procedures that accompany the test are somewhat complex and may cause confusion, especially given that the test is usually administered on individuals who are known to suffer cognitive impairment. For example, there is a test where the test-taker is shown a series of a set number of dots before another series is displayed with the test-taker being required to identify the series with the extra dot (PAR, n.d). This task can be daunting, thereby limiting the reliability of the NAB.
Quality and Appropriateness
The quality and appropriateness of the test items and format, directions, answer sheets and score reports of the NAB cannot be questioned. Such researchers as Zgaljardic and Temple (2010) have concluded that the NAB is indeed reliable, accurate and credible. In reaching this conclusion, these researchers must have scrutinized the items, format, answer sheets, score reports and directions and found them to be of high quality and appropriate. An evaluation of these individual elements confirms their quality and appropriateness. For example, as noted earlier, the formats of the NAB deliver convenience while the test items ensure versatility. The answer sheets offer freedom since they are not unduly restrictive or inadequate whereas the directions are as clear and detailed as they are useful and informative.
Fair and Appropriate Materials
Now that the tools that constitute the NAB have been evaluated, the stage is set for an assessment of how the test materials minimize offensive content and language. This assessment is discussed below.
Positive and Negative Aspects of Test Materials Minimizing Offensive Content/Language
Ensuring that a test is free of any content or language that may cause offense is one of the markets of a properly-developed assessment tool. This is according to Reynolds and Suzuki (2012) who authored an article in which they underscore the need to rid assessment tests of any content or language that may be considered offensive. As part of efforts to understand how the test materials of the NAB minimize offensive content and language, a search for literature was conducted. Such terms as phrases as “bias”, “offensive language” and “offensive content” were entered into the search fields of online databases like Google Scholar. Unfortunately, this search did not return any relevant or helpful results. The implication is that the NAB test has not received adequate scholarly examination. However, it is still possible to evaluate this test on how it avoids causing offense. In their review of how assessment tools eliminate offensive content, Reynolds and Suzuki point out that before a tool is made available for use, it is subjected to rigorous scrutiny. PAR, the organization that publishes the NAB prides itself in the tremendous effort that goes into the development of this test. Therefore, it is fair to conclude that PAR ensured that the NAB does not contain any content or language that may offend test-takers or administrators. More importantly, Zgaljardic et al. (2013) are among the scholars who have resoundingly endorsed NAB as a reliable tool and encourage practitioners to use it. This endorsement can be taken as an indication that the NAB contains no offensive content.
Modifications/Accommodations
When creating an assessment tool, it is critical to ensure that it can be used by various groups, including individuals with special needs. As is the case with the question of avoiding offensive language, how the NAB can be modified to accommodate those with special needs has not received sufficient attention from the research community. However, using the scanty available research and employing conjecture, it is possible to determine if and how NAB accommodates diverse groups. In their text, Hill-Briggs, Dial, Morere and Joyce (2007) identifies some of the modifications and accommodations that characterize various neuropsychological assessment devices. They note that it is common for the developers of the test to allow for the test selection, timing, response format, and presentation format of the test to be modified so as to better suit the needs and circumstances of the test takers. An investigation of the NAB reveals that it does indeed make accommodations. For example, according to PAR, the NAB is highly flexible. This test is made up of various modules that can be selected or abandoned, depending on the needs and purpose of the assessment. However, there is no indication that the NAB accommodates the needs of individuals with special needs. If anything, this test appears to be highly rigid and prohibitive, particularly in its format. As noted earlier, the test is available in computer and, pencil and paper formats. It would be nearly impossible for those who are blind to use this test since their disability makes it difficult for them to engage with the two formats of the NAB.
AERA Standard
The American Educational Research Association (AERA) has developed standards designed to guide the development of assessment tools. One of these standards concerns fairness. The AERA requires test developers to ensure that their tests yield the same outcomes, promote equality, offer opportunities for learning and eliminates bias (“Summary of the Standards”, 2003). It can be argued that the attempts to accommodate different needs are part of NAB’s efforts to uphold the fairness standard. For example, as noted above, the NAB is highly flexible. This flexibility makes the test accessible and versatile enough to be adapted for a wide variety of settings and test-takers.
Use of Technology
Technology is among the tools that are redefining neuropsychological testing. In the following section, the paper examines how NAB incorporates technology.
Incorporation of Technology for Test Items and Format
In a previous section, it was stated that the NAB is available in an online software format. This format is among the ways through which this test is leveraging developments in technology. It can be argued that since it is available online, the NAB has become more accessible. With an internet connection and a digital device such as a laptop, theoretically, it should be possible for an individual to access this assessment tool. Unfortunately, the incorporation of technology into the format has not been extended to the test items. The items have retained their original form.
Technology for Fair and Appropriate Materials
It was observed in an earlier discussion that it is difficult to find literature that explores how the NAB ensures fairness and achieves appropriateness by minimizing offensive content and language. This difficulty also impacts the discussion on how the NAB incorporates technology to avoid bias and limit offensive content or language. In his text, Drasgow (2015) observes that technology is a critical tool for enhancing fairness in testing. His remarks can be used as the basis for the argument that since it integrates such technologies as the internet and digital devices, the NAB facilitates fairness. The particular mechanisms through which it achieves this remain unclear given the lack of any helpful literature.
Synthesis of Findings
This far, the discussion has addressed various aspects of the NAB. In order to achieve greater coherence, a synthesis of the different issues addressed is needed. This synthesis, giving special focus to the main strengths and weaknesses of the NAB’s test items and materials is performed in the following section.
Major Strengths and Weaknesses
The main strength of the NAB test items and materials lies in their versatility. As already observed, this test allows administrators to select the modules that are relevant. Another strength can be seen in the fact that the test can be access in various formats. It is available in both digital and pencil and paper forms. This further enhances the test’s versatility. The third strength that can explain why NAB remains highly popular is how it leverages technology. It has already been stated that using a computer, an individual is able to take the test. There is no doubt that the creators of NAB recognize the tremendous effect of technology.
The discussion above has identified some of the key strengths of the NAB’s items and materials. It is worth noting that this test also suffers some weaknesses. Among these weaknesses is its failure to accommodate different needs and fully exploit the power of modern technology. Additionally, this test has items that can be quite confusing. Given that these weaknesses are rather minor, the validity and reliability of the test is not compromised. However, it can benefit from improvements.
Conclusions and Recommendations
In conclusion, the NAB remains the preferred test for assessing cognitive function for many practitioners in the field of neuropsychology. Various factors can be linked to the test’s popularity, continued use and relevance. How it incorporates technology, the fact that it is highly versatile and its availability in various formats are some of these factors. However, there are some shortcomings that limit the usefulness and impact of the NAB. These shortcomings include the lack of modifications that accommodate the needs of the disabled and the complexity of the test items which can cause confusion, thereby eroding the reliability of the test. Fortunately, these flaws can be fixed through simple interventions.
From the discussion above, it is clear that there are a number of weaknesses that require urgent solutions. It is recommended that PAR, the maker of NAB should begin by simplifying the items. It should make the procedure to be followed by examinees much simpler. As it implements this recommendation, PAR will be complying with the AERA standard which demands fairness. The second recommendation that PAR is advised to adopt concerns joining forces with the research community for the purpose of conducting research on different aspects of the test. For example, researchers may conduct a study that examines whether the NAB adequately meets the needs of individuals with disabilities. The implementation of this recommendation is in line with the AERA standard that of fairness as well. Making the test available in such other formats as braille is another proposal that PAR is urged to adopt as it revises NAB to make it more reliable. This recommendation is informed by such AERA standards as fairness.
References
Brooks, B. L., Iverson, G. L., & White, T. (2009). Advanced interpretation of the neuropsychological assessment battery with older adults: base rate analyses, discrepancy scores, and interpreting change. Archives of Clinical Neuropsychology, 24 (7), 647-57.
Drasgow, F. (2015). Technology and testing: improving educational and psychological measurement. London: Routledge.
Feenstra, H. E. M., Vermeulen, I. E., Murre, J. M. J., & Schagen, S. B. (2018). Online self-administered cognitive testing using the Amsterdam cognition scan: establishing psychometric properties and normative data. Journal of Medical Internet Research, 20 (5). DOI: 10.2196/jmir.9298
Hill-Briggs, F., Dial, J. G., Morere, D. A., & Joyce, A. (2007). Neuropsychological assessment of persons with physical disability, visual impairment or blindness, and hearing impairment or deafness. Archives of Clinical Neuropsychology, 22, 389-404.
Neuropsychological Assessment Battery. (n.d). Psychological Assessment Resources. Retrieved March 1, 2019 from https://www.parinc.com/products/pkey/260
Reynolds, C. R., & Suzuki, L. A. (2012). Bias in psychological assessment. Assessment Psychology. DOI: https://doi.org/10.1002/9781118133880.hop210004
Summary of the standards for educational and psychological testing. (2003). California State Personnel Board. Retrieved March 1, 2019 from http://www.spb.ca.gov/content/laws/selection_manual_appendixf.pdf
Psychological Assessment Resources (PAR). (n.d). NAB_A,S,&I_Manual_May16. PAR. Retrieved March 1, 2019 from https://www.parinc.com/webuploads/productinfo/nab/NAB_AS&I_Chap1.pdf
Zgaljardic, D. J., & Temple, R. O. (2010). Neuropsychological assessment battery (NAB): performance in a sample of patients with moderate-to-severe traumatic brain injury. Applied Neuropsychology, 17 (4), 283-8.
Zgaljardic, D. J., Oden, K. E., Dickson, D., Plenger, P. M., Lambert, M. E., & Miller, R. (2013). Naming test of the neuropsychological assessment battery: reliability and validity in a sample of patients with acquired brain injury. Archives of Clinical Neuropsychology, 28 (8), 859-65.
