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Related Experiment Video

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Olfactory Behavioral Testing in the Adult Mouse
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Boston Naming Test: Lose the Noose.

Janelle M Eloi1, Jennifer Lee1, Erica N Pollock1

  • 1Neuropsychology Program, Department of Psychiatry, Geisel School of Medicine at Dartmouth/DHMC, Lebanon, NH, USA.

Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists
|April 6, 2021
PubMed
Summary

Modifying the Boston Naming Test (BNT) by skipping the noose item impacts clinical interpretation, especially for patients with lower overall BNT performance. Failure rates were higher in specific demographic and clinical groups.

Keywords:
AssessmentCross-cultural/minorityLanguage and language disorders

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Area of Science:

  • Neuropsychology
  • Cognitive Assessment
  • Psychometrics

Background:

  • The noose item on the Boston Naming Test (BNT) presents cultural and emotional challenges.
  • Modifications, like skipping the item, have been proposed but their clinical impact is unknown.

Purpose of the Study:

  • Examine the prevalence of noose item failure in the BNT.
  • Identify demographic and clinical factors associated with noose item failure.
  • Determine if altering scoring by awarding a point for failure affects clinical interpretation.

Main Methods:

  • A mixed clinical sample of 762 adults (ages 18-88) undergoing neuropsychological evaluation was studied.
  • Prevalence of noose item failure was calculated.
  • Demographic and clinical characteristics of those who failed versus passed were compared.
  • The effect of awarding a point for failure on score interpretation was analyzed.

Main Results:

  • 13.78% of participants failed the noose item.
  • Failure was more common in females, non-White individuals, and those with diagnoses of major neurocognitive disorder, epilepsy, or neurodevelopmental disorder.
  • Noose item failure correlated with lower BNT total scores, less education, and poorer cognitive function.
  • Awarding a point for failure changed score interpretation for 17.1% of individuals, particularly those with overall poor BNT performance.

Conclusions:

  • While few patients fail the noose item, adjusting the score impacts interpretation.
  • Poorer overall BNT performance, not necessarily specific difficulty with the noose item, likely explains the observed results.
  • Standardized administration and scoring of the BNT should be carefully considered in clinical practice.