The reliability and validity of qualitative scores for the Controlled Oral Word Association Test

The reliability and validity of two qualitative scoring systems for the Controlled Oral Word Association Test [Benton, A. L., Hamsher, de S. K., & Sivan, A. B. (1983). Multilingual aplasia examination (2nd ed.). Iowa City, IA: AJA Associates] were examined in 108 healthy young adults. The scoring systems developed by Troyer et al. [Troyer, A. K., Moscovich, M., & Winocur, G. (1997). Clustering and switching as two components of verbal fluency: Evidence from younger and older healthy adults. Neuropsychology, 11, 138-146] and by Abwender et al. [Abwender, D. A., Swan, J. G., Bowerman, J. T., & Connolly, S. W. (2001a). Qualitative analysis of verbal fluency output: Review and comparison of several scoring methods. Assessment, 8, 323-336] each demonstrated excellent interrater reliability (all indices at or above r(icc)=.9). Consistent with previous research [e.g., Ross, T. P. (2003). The reliability of cluster and switch scores for the COWAT. Archives of Clinical Psychology, 18, 153-164), test-retest reliability coefficients (N=53; M interval 44.6 days) for the qualitative scores were modest to poor (r(icc)=.6 to .4 range). Correlations among COWAT scores, measures of executive functioning, verbal learning, working memory, and vocabulary were examined. The idea that qualitative scores represent distinct executive functions such as cognitive flexibility or strategy utilization was not supported. We offer the interpretation that COWAT performance may require the ability to retrieve words in a non-routine manner while suppressing habitual responses and associated processing interference, presumably due to a spread of activation across semantic or lexical networks. This interpretation, though speculative at present, implies that clustering and switching on the COWAT may not be entirely deliberate, but rather an artifact of a passive (i.e., state-dependent) process. Ideas for future research, most noticeably experimental studies using cognitive methods (e.g., priming), are discussed.