Concordance between the Noose and Boomerang Items of the Boston Naming Test in an Adult Clinical Sample

A publisher of the Boston Naming Test recently provided a boomerang item to replace the noose item. We examined response accuracy and speed for these items.

Participants were 300 patients seen for clinical neuropsychological evaluation. Noose and boomerang items were administered consecutively, in counterbalanced order.

Spontaneous response was correct for the noose in 91% and boomerang in 76.7%. Both responses were correct for 72.7% and incorrect for 5% (overall concordance of 77.7%), 18.3% had correct noose/incorrect boomerang, and 4% correct boomerang/incorrect noose. Time to spontaneous response was faster for the noose. Phonemic cues were more helpful in naming the boomerang.

Spontaneous response to the noose and boomerang items showed lack of concordance in 22.3% of patients, and the items showed differences in time to response and benefit from phonemic cuing. These findings raise concern about using the boomerang as a replacement for the noose item.