Halstead-reitan Neuropsychological Battery Ppt

[Libano Parkes]

Neuropsychologicalfunctioning refers to the ability of the nervous system and brain to process and interpret information received through the senses. The Halstead-Reitan evaluates a wide range of nervous system and brain functions, including visual, auditory, and tactual input; verbal communication; spatial and sequential perception; the ability to analyze information, form mental concepts, and make judgments; motor output; and attention, concentration, and memory.

The Halstead-Reitan has been researched more than any other neuropsychological test battery. Research continues to support its ability to accurately detect impairment in a large range of neuropsychological functions.

A series of 208 pictures consisting of geometric figures are presented, sorted in groups according to some underlying principle, which the test subject is asked to determine. For each picture, individuals are asked to decide which of four principles they believe is represented and to press a key that corresponds to the number of choice. If they chose correctly, a chime sounds. If they chose incorrectly, a buzzer sounds. The pictures are presented in seven subtests.

The key to this test is that one principle, or common characteristic, underlies each subtest. The numbers 1, 2, 3, and 4 represent the possible principles. If individuals are able to recognize the correct principle in one picture, they will respond correctly for the remaining pictures in that subtest. The next subtest may have the same or a different underlying principle, and individuals must again try to determine that principle using the feedback of the chime and buzzer. The last subtest contains two underlying principles. The test takes approximately one hour to complete, but individuals with severe brain damage may take as long as two hours.

Scoring involves recording the number of errors. Based on traditional scoring using cutoff values (cutoff scores are scores that indicate the borderline between normal and impaired functioning), scores above 41 are considered indicative of brain impairment for ages 15 to 45. For ages 46 and older, scores above 46 indicate impairment. Reitan has suggested a cutoff of 50 or 51 errors. Recommended cutoffs also vary depending on age and education level.

A form board containing 10 cutout shapes, and 10 wooden blocks matching those shapes are placed in front of a blindfolded individual. Individuals are then instructed to use only their dominant hand to place the blocks in their appropriate space on the form board. The same procedure is repeated using only the non-dominant hand, and then using both hands. Finally, the form board and blocks are removed, followed by the blindfold. From memory, individuals are asked to draw the form board and the shapes in their proper locations. The test usually takes anywhere from 15 to 50 minutes to complete. There is a time limit of 15 minutes for each trial, or each performance segment.

Scoring is simply the time to complete each part. Errors naturally increase the total time. Some have argued that the time taken to alert individuals of errors may vary depending on the person giving the test. For adults, scores above 40 seconds for Part A and 91 seconds for Part B have traditionally indicated brain impairment. Current research discourages the use of such traditional cutoffs, preferring ranges depending on age, education, and gender. For example, one study reported that for ages 15 to 19, the average time to complete Part A was 25.7 seconds and the time to complete Part B was 49.8 seconds. For ages 80 to 85, however, the average time to complete Part A was 60.7 seconds and the time to complete Part B was 152.2 seconds. This demonstrates the importance of considering other variables when scoring.

Individuals place their dominant hand palm down, fingers extended, with the index finger resting on a lever that is attached to a counting device. Individuals are instructed to tap their index finger as quickly as possible for ten seconds, keeping the hand and arm stationary. This trial is repeated five to 10 times, until the examiner has collected counts for five consecutive trials that are within five taps of each other. Before starting the test, individuals are given a practice session. They are also given brief rests between each 10-second trial, and one- to two-minute rests after every third trial. This entire procedure is repeated with the nondominant hand. The test takes approximately 10 minutes to complete.

Aphasia is the loss of ability to understand or use written or spoken language, due to brain damage or deterioration. In this test, individuals are presented with a variety of questions and tasks that would be easy for someone without impairment. Examples of test items include verbally naming pictures, writing the name of a picture without saying the name aloud, reading printed material of increasing length, repeating words stated by the examiner, simple arithmetic problems, drawing shapes without lifting the pencil, and placing one hand to an area on the opposite side of the body.

This test is a modification of the Halstead-Wepman Aphasia Screening Test. It evaluates language-related difficulties, right/left confusion, and nonverbal tasks. A typical scoring procedure is not used because this is a screening test; its purpose is to detect possible signs of aphasia that may require further evaluation. Subtle language deficits may not be detected.

In addition to the core tests, examiners may choose to administer other tests based on the difficulties that individuals experience. Tests commonly used in combination with the Halstead-Reitan Battery include the Grip Strength Test, the Grooved Pegboard Test, the Reitan-Klove Lateral Dominance Examination, the Wechsler Memory Scale, the California Verbal Learning Test, the Buschke Selective Reminding Test, the Rey Auditory Verbal Memory Test, the Rey Complex Figure Test, the Test of Memory and Learning, the Wide Range Achievement Test , the Minnesota Multiphasic Personality Inventory , and the Wechsler Adult Intelligence Scale or Wechsler Intelligence Scales for Children. Some of these tests expand on these measures of functioning in the latest revision of the battery.

With the above information, a psychologist can diagnose the type of condition present, predict the course of the impairment (staying the same, getting better, or getting worse), and make recommendations regarding treatment, care, or rehabilitation.

This revision includes corrections based on ethnicity in addition to age, gender, and education. The results can be adjusted to demographic components, including African American or Caucasian ethnicity. Also updated is the global deficit score, which reflects the severity and number of deficits on more test measures than previously assessed. The sample used to determine the norms for this 2004 revision also was larger, including more than 1,000 adults, ages 20 to 85, for most test endpoints. The revision also has expanded measures of psychological functioning, including Wechsler scores.

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The Halstead-Reitan neuropsychological test battery (HRNB) is a compilation of neuropsychological tests designed to evaluate the functioning of the brain and nervous system in individuals aged 15 years and older. Although the test was designed as a tool to detect brain damage, the HRNB has shown to be effective in identifying impairment associated with head trauma, tumors, cerebro-vascular accidents, infections, degenerative diseases, learning disabilities, and specific neurological disorders. The HRNB assists clinicians in the identification of a broad range of neurological variables including location, type, severity, and status of brain lesions [2, 3, 8, 10].

The Halstead-Reitan tests evaluates a wide range of nervous system and brain functions, including: visual, auditory, and tactual input; verbal communication; spatial and sequential perception; the ability to analyze information; form mental...

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