Testing to detect brain damage: an alternative to what may no longer be useful

Kane, Parsons, and Goldstein (1985) recently demonstrated that the Halstead-Reitan Battery, the Luria-Nebraska Neuropsychological Battery, and the Wechsler Adult Intelligence Scale are all equally effective when used to detect brain damage. This commentary raises the question of whether this type of testing and test development is still useful. Several arguments are made suggesting that it is not. First, it is shown that detecting brain damage alone is usually not clinically useful. Instead, it is argued that neuropsychological instruments more effectively contribute to clinical diagnosis and treatment when used to delineate cognitive function. Additionally, it is demonstrated that brain-damage detection has a number of pitfalls. A method to develop instruments to delineate cognitive function is proposed, and a recent example of such an approach is provided.