Impaired National Adult Reading Test (NART) performance in traumatic brain injury

Abstract

Some research suggests the National Adult Reading Test (NART) may be impaired by traumatic brain injury (TBI). To investigate this, a prospective, longitudinal study included 214 Australian TBI participants given the NART within 1 month post-injury, and at 6 and 12 months. TBI severity, age, education, sex, and mood (HADS) were examined, and significant improvement in NART- estimated full-scale IQ (FSIQ) was noted over time (p < .001). A three-way interaction of time, severity, and age showed younger and middle-aged mild TBI sub-groups improved significantly between 1 and 6 months post-injury, and the older sub-group between 6 and 12 months. In severe TBI, significant NART-estimated FSIQ improvement was noted only for the middle-aged and only between 6 and 12 months post-TBI. NART administration soon after TBI underestimated premorbid IQ, with a complex relationship between time post-injury, severity, and age. Participants with a longer education had higher NART FSIQs, although those with less education gained more IQ points between initial and 6 months assessments suggesting higher initial NART impairment. Regression equations predicted NART FSIQ at 6 (R = 0.813) and 12 months post-trauma (R = 0.792-0.845), their effectiveness being confirmed via cross-validation. No significant relationships were noted between NART-estimated FSIQ and mood variables, or evidence of significant gains in estimated FSIQ between 12 and 24 months post-injury.

Comparison of methods for estimating premorbid intelligence

“…These include best performance (Lezak, 1995), "hold/no-hold" (Wechsler, 1958), demographics (e.g., Barona, Reynolds, & Chastain, 1984;Crawford & Allan, 1997), reading ability (e.g., Nelson, 1982;Nelson & Willison, 1991;Wechsler, 2001), and combinations thereof (e.g., Crawford, Nelson, Blackmore, Cochrane, & Allan, 1990;Vanderploeg, Schinka, & Axelrod, 1996). The appropriateness of a given approach is likely to depend on the patient under investigation, but those based on reading ability/word knowledge are among the most widely employed, particularly in North America, UK and Australia (e.g., Crawford, Stewart, Cochrane, Parker, & Besson, 1989;Mathias, Bowden, & Barrett-Woodbridge, 2007;Skilbeck, Dean, Thomas, & Slatyer, 2013). However, there are few published methods currently available that have been standardised against the most recent revision of the Wechsler Adult Intelligence Scale (WAIS-IV; Wechsler, 2008).…”

Prevalence of anxiety following adult traumatic brain injury: A meta-analysis comparing measures, samples and postinjury intervals.

“…Also important is the way in which self-report measures are administered (e.g., mailed, by phone), with a variety of methods having been used, including completion at a research center or at home, over the phone, or via a combination of methods (Alfano, Neilson, & Fink, 1993; Hawthorne, Kaye, Gruen, Houseman, & Bauer, 2011; Kit, Mateer, & Graves, 2007; Skilbeck, Dean, Thomas, & Slatyer, 2013). Each of these situations may be affected by different variables, such as the desire to respond in a socially acceptable way (research center, phone), limited time to consider a response (phone), potential influence of others (at home), and/or degree of anonymity; all of which may impact prevalence rates (Fairweather-Schmidt & Anstey, 2012; Richman, Kiesler, Weisband, & Drasgow, 1999).…”

Stability of Estimated Premorbid Cognitive Ability over Time after Minor Stroke and Its Relationship with Post-Stroke Cognitive Ability

“…Although, the NART has been shown to be a stable estimate of premorbid IQ in healthy individuals [19] and patients with schizophrenia (mean age 35 years) [11] over one and 7.5 years respectively, small but significant decreases have been shown in healthy older individuals [20] and those with dementia [21]. Furthermore, improvements in NART performance has also been shown in traumatic brain injury (TBI) [22,23] demonstrating the complex interaction of disease variables, age, education and time post-injury affecting NART performance.…”