Reliability, validity, and clinical utility of a nonverbal cognitive test

People who struggle to provide verbal responses may be underserved by neuropsychology. A nonverbal cognitive test (NCT) was developed to fill this need. Reliability, concurrent validity, criterion-related validity, and clinical utility are presented.

The NCT and neuropsychological tests were administered to 122 adults aged 19-91, including 87 healthy adults (CN) and 35 adults with cognitive impairment (CI) meeting diagnostic criteria for a neurocognitive disorder. The overall sample was used to determine internal consistency and concurrent validity of the NCT (Experiment 1). The criterion-related validity and clinical utility of the NCT were assessed among the above 35 older adults with CI and 49 older adult CN participants with similar age and education (Experiment 2).

The NCT (alpha = .84) is internally consistent. Seven NCT subtests assessing learning, recall, attention, and working memory demonstrated concurrent validity (r's > .6) with neuropsychological tests. CN outperformed people with CI on the NCT and all subtests. Receiver Operating Characteristic shows a large area under the curve (.98). A cut-score of 75.5 differentiated people with CI from CN (true positive rate = .91; false positive rate = .04).

The NCT demonstrates acceptable psychometric properties and clinical utility for use as a cognitive test.