Caution warranted in extrapolating from Boston Naming Test item gradation construct

Abstract

The Boston Naming Test (BNT) was designed to present items in order of difficulty based on word frequency. Changes in word frequencies over time, however, would frustrate extrapolation in clinical and research settings based on the theoretical construct because performance on the BNT might reflect changes in ecological frequency of the test items, rather than performance across items of increasing difficulty. This study identifies the ecological frequency of BNT items at the time of publication using the American Heritage Word Frequency Book and determines changes in frequency over time based on the frequency distribution of BNT items across a current corpus, the Corpus of Contemporary American English. Findings reveal an uneven distribution of BNT items across 2 corpora and instances of negligible differentiation in relative word frequency across test items. As BNT items are not presented in order from least to most frequent, clinicians and researchers should exercise caution in relying on the BNT as presenting items in increasing order of difficulty. A method is proposed for distributing confrontation-naming items to be explicitly measured against test items that are normally distributed across the corpus of a given language.

Item-Level Scores on the Boston Naming Test as an Independent Predictor of Perirhinal Volume in Individuals with Mild Cognitive Impairment

“…Although BNT items are roughly sorted in order of difficulty (in this study, from Item 1: "BED" to Item 59: "PROTRACTOR"), item-level scores assessing words' "frequency of use" indicate that the difficulty levels of individual items fluctuate throughout task administration [62]. This legitimises a more in-depth focus on individual items, as different items are associated with different semantic difficulties, and two performances that are quantitatively equal may be qualitatively different.…”

Mayo normative studies: regression-based normative data for ages 30–91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency

“…For example, item-level error analysis by Martielli and colleagues revealed error rates from 20–49% on 11 items and 50–91% on 5 items, suggesting that limited item familiarity confounds object naming performance in older adolescents falling within the same generation as the lower age bracket of this sample (Martielli & Blackburn, 2016). The popularity of specific words changes over time and is quantifiable through examination of word corpuses or a cursory search through Google ngrams (Beattey et al, 2017). Similarly, there are total performance and item-level differences cross-culturally (Li et al, 2022).…”

“…These datasets remain gold standard clinical tools despite several limitations that may reduce sensitivity of normative data, including the influence of population-level changes in cognitive performance (e.g., Flynn effect on IQ) and improved methodological approaches (Bilder & Reise, 2019; Heaton et al, 2004; Hiscock, 2007). In addition, intergenerational sociopolitical, linguistic, and cultural differences influence the salience of test and item construction (Beattey et al, 2017). Factors that also limit the applicability of normative data include recruitment of convenience samples that are not representative of local demographics, ill-defined exclusion criteria, and lack of or limited demographic corrections (Mitrushina et al, 2005; Tombaugh et al, 1999; Tombaugh, 2004).…”

Constraint-induced aphasia therapy for patients with aphasia: A systematic review

“…Moreover, the BNT relied on word frequency at its first published time, i.e. 1983, and its items were not listed in order from least to most frequent [ 39 ]. Furthermore, monolinguals or bilinguals may respond differently to the BNT [ 40 ], but these trials did not report whether the enrolled participants were bilingual speakers or not.…”