136 ESSENTIALS OF NEPSY-II ASSESSMENT

Some subtests have combined scores only, some have contrast scores only, and some subtests have both combined and contrast scores.

Step 5: Behavioral Observations

Behavioral Observations are scored by tallying Behavioral Observations or checking presence or absence as required. For example, every time the child was inattentive/off-task during the Auditory Attention and Response Set subtest, you recorded a tally mark in the Behavioral Observation Box at the bottom of the page. Those marks are now counted up and the total raw score written in the appropriate bubble on the Behavioral Observation page inside the front cover of the Record Form. After you have recorded totals or presence/absence by checking “yes/no” boxes for all pertinent Behavioral Observations, this qualitative data can be converted to quantitative information by looking up cumulative percentages in Table D.1 or D.4 and the percent in the standardization population in Table D.2 or D.5 in the NEPSY-II Clinical and Administrative Manual. An example of a quantified Behavioral Observation would be the frequency with which motor overflow (that is, involuntary movements that accompany, and are similar to, a required motor response) is observed in a child of a particular age. Some motor behaviors are observed more often in younger children than in older children in the normative group, as is indicated in the norms.

TESTS WITH COMPLEX RECORDING AND/OR SCORING

Subtests with Complex Recording and/or Scoring will be addressed individually in this chapter. They include:

•Auditory Attention

•Clocks

•Design Copying

•Inhibition

•Memory for Designs

•Visuomotor Precision

Auditory Attention and Response Set Subtest

The Auditory Attention and Response Set (AA/RS) subtest is made up of two sections, Auditory Attention (AA) and Response Set (RS). Recording and scoring this test may seem complex at first, but with practice, recording and scoring will fall into place. Note that while you record the child’s performance you need to keep following the child’s performance. This demands divided attention and a certain level of training. Score as outlined in subsequent steps.

HOW TO SCORE THE NEPSY-II 137

Auditory Attention and Response Set Subtest

The Auditory Attention and Response Set (AA/RS) subtest is made up of two sections, Auditory Attention (AA) and Response Set (RS). Recording and scoring this test may seem complex at first, but with practice, recording and scoring will fall into place. Note that while you record the child’s performance you need to keep following the child’s performance. This demands divided attention and a certain level of training. Score as outlined in subsequent steps.

Step 1: Total Correct Scores and Percentile Ranks

Total Correct Scores are Primary Scores on the AA/RS Tests. In the Auditory Attention (AA) section, look for all of the Rs that occurred within the two shaded spaces (2 sec.) for each target word RED. Circle 1 if you have written R next to the target word or the word that follows it in the shaded area. When added, the numbers you have circled will be the AA Total Correct score that you will enter in the appropriate box at the bottom of the AA Record Form page. Use this to find the AA Total Correct Scaled Score and Percentile Rank in Table A.1 and enter in the correct box at the bottom of the page.

The RS Total Correct score is derived in the same manner. If the target word is YELLOW, to which the child is to respond Red, and you have written R next to it or next to the word in the space immediately following the target word, circle 1. If the target word is RED, and the child correctly points at the yellow circle, a Y should be written next to the word RED on the Record Form or in the space immediately following. For the word BLUE, the child should simply point at the blue circle. If the child responds correctly a B should be written beside the target word or in the space immediately following. For any of these correct responses within the 2-second window, the 1 should be circled. When added, the numeral ones that you have circled will be the RS Total Correct raw score that you will enter in the appropriate box and will use to find the RS Total Correct Scaled Score and Percentile Rank in Table A.1. Enter these values in the correct box at the bottom of the page on the RS Record Form. Figure 3.3 illustrates recording correct scores.

Step 2: Error Scores

In order to derive the AA and RS error scores, which are Process Scores, one must understand the types of errors and how to record them. This process was discussed in Chapter 2 in the individual subtest instructions for the Auditory Attention and Response Tests, but will be repeated here to give continuity to the scoring process (Figure 3.4 illustrates the recording and scoring of errors on the AA/RS subtest.)

140 ESSENTIALS OF NEPSY-II ASSESSMENT

(continued )

target word RED, assume that the R response you have recorded is the child’s response to the fi rst target word YELLOW and not to the second, RED.

Therefore, it is a Commission Error. If you have recorded a Y next to the red or in the next space by the word square, it would be scored as the child’s response to the RED and would, therefore, receive 1 point.

Commission Errors (c) in Overlapping Sets:

In Auditory Attention, if the fi rst R response is outside the shaded area for the fi rst RED, or if it is another color within or without the shaded area, a “c” is circled. If it is another color within the shaded area, it is also an Inhibitory Error, so the “i” is also circled. The second response to the second RED is also outside the shaded area for the second target word, so it is a commission error, as well.

Omission Errors (o) in Overlapping Sets:

In the above Auditory Attention example, if there is no response to the second RED, circle “o” to designate an Omission Error. Remember that the R beside the second RED is the response to the fi rst Red.

(marked “c”), all of the Omission Errors (“o”), and all of the Inhibitory Errors (“i”), and enter the totals for each type of error in the appropriate box on the bottom of the Record Form. The percentile ranks for these raw scores are looked up in Table A.1, and then entered in the appropriate boxes on the bottom of the Record Forms.

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Step 3: Combined Scores

The Combined Scores are Primary Scores on the AA/RS Test. The AA Combined Score integrates the AA Total Correct Scaled Score and the AA Total Commission Errors Percentile Rank for ages 5–12 (Table B.2) and the AA Total Correct Percentile Rank and the AA Total Commission Errors Percentile Rank for ages 13–16 (Table B.3). Caution: These AA Combined Scores are derived in two different ways. For ages 5–12, the AA Total Correct Score is integrated with the Total Commission Errors Percentile Rank. For ages 13–16, the two percentile ranks (Total Correct SS Percentile Rank and Total Commission Errors Percentile Rank) are integrated. See Caution box. The RS Combined Scores are derived in the same way, integrating the RS Total Correct Scaled Score and the RS Total Commission Errors Percentile Rank for ages 7–12 (Table B.4) and the RS Total Correct Percentile Rank and the RS Total Commission Errors Percentile Rank for ages 13–16 (Table B.5). Note that there is pale shading on the Record Form for both AA and RS that guides you in deriving the AA Combined Score and the RS Combined Scores.

Step 4: Contrast Score

The AA vs. RS Contrast Scaled Score compares the child’s performance on AA (AA Combined Scaled Score) with the child’s performance on RS (RS Combined Scaled Score). When you have completed both tests, the AA Combined Score and the RS Combined Score are entered into the appropriate boxes shaded in a pale color at the bottom of the RS Record Form page. Using these scores, the Contrast Score is then looked up in Table C.1 as indicated in white on the colored

C A U T I O N

Deriving AA and RS Combined Scores

AACombined Scores are derived in two different ways:

•For ages 5–12, the AA Total Correct Score is integrated with the Total Commission Errors Percentile Rank.

•For ages 13–16, the two percentile ranks (Total Correct SS Percentile Rank and Total Commission Errors Percentile Rank) are integrated.

The RS Combined Scores are derived in the same way:

•For ages 7–12, the RS Total Correct Scaled Score and the RS Total Commission Errors Percentile Rank are integrated. (Table B.4)

•For ages 13–16, the RS Total Correct Percentile Rank and the RS Total Commission Errors Percentile Rank are integrated.

142 ESSENTIALS OF NEPSY-II ASSESSMENT

arrow that points to the AA vs. RS Contrast Scaled Score box at the bottom of the RS page of the Record Form. The value resulting from this table is entered into the final appropriate box.

This contrast allows one to compare the child’s performance on a simple selective auditory attention task (AA) to performance on a complex auditory attention task (RS), during which one must sustain selective attention on one target, while using executive functions to shift set between two other targets.

Step 5: Behavioral Observations

After all quantitative scores have been looked up and recorded, one should tally the frequency of designated AA/RS Behavioral Observations: Inattentive/Distracted Off-task Behaviors during AA and during RS separately and Out of Seat/Physical Movement in Seat Off-Task Behaviors during AA and during RS separately. Enter each of these totals in the appropriate bubble on the left side of the Record Form at the bottom of each page. These raw score totals are then transferred to the Behavioral Observation summary page on the inside front cover of the Record Form. For ages 5–6, Table D.1 is used to obtain Cumulative Percentages for these raw scores, and for ages 7–16 Table D.4 is used. Enter the Cumulative Percentages in the appropriate rectangular box under Auditory Attention and Response Set. Scoring is complete at this point.

Clocks Subtest

The Clocks (CL) subtest, along with the Design Copying Test that follows it in this chapter, both require clinical judgment in scoring. Therefore, it is important to be familiar with the scoring criteria before you begin administering and scoring these tests.

Step 1: Score the Criteria for Items 1–4 and Items 9–10 and Sum the Item Scores

On pp. 127–133 of Appendix A in the Administration Manual are found the Scoring Procedures for the Clock Subtest. The criteria are illustrated with examples of children’s performances. Study these carefully and keep them present as you score.

On Drawing to Command Items 1 and 2, as well as Clock Copy Items 9 and 10, a child’s Clock subtest performance is evaluated according to the criteria for:

•Numbers

■Presence

■Location

■Sequence

HOW TO SCORE THE NEPSY-II 143

See the Caution box on the following page: Scoring the Numbers–Sequence

■Presence

■Location

After these criteria have been evaluated for each of these four items (Items l–2; 9–10) and scored 0 or 1, add the scores across the row from left to right for each item and place the sum of the scores in the shaded item scoring box on the far right hand side of the page under Item Score.

On the Digital–Analog task, Items 3 and 4, the child’s performance is only scored for the criteria for:

•Hands

■Presence

■Connection

■Proportion

■Correct Target

•Center

■Presence

■Location

Again, after the items have been carefully evaluated for the aforementioned criteria and scored 0 or 1, add the scores across the appropriate row and place the sum in the shaded box at the end of the row.

Step 2: Score Correct/Incorrect on Items 5–8

On the Clock Reading without Numbers and the Clock Reading with Numbers tasks (Items 5–8), the child’s answer is either correct or incorrect, so the score for each of these items is circled as 1 or 0.

144 ESSENTIALS OF NEPSY-II ASSESSMENT

Step 3: Derive the CL Total Score (Raw Score) and CL Scaled Score

Sum the Item Scores in the far right-hand column of the Clocks Record Form, including those in shaded boxes and the Item 5–8 scores of 0 or 1. Place the resulting total in the CL Total Score box. The colored arrow shows you that Table A.1 should be used to obtain the CL Scaled Score.

Design Copying Subtest

The Design Copying (DC) subtest has two scoring methods:

•The quick scoring method provides the DC General score. This method is a quick and simple way of scoring.

•DC Process scoring system provides more diagnostic information as it assesses three skills associated with paper/pencil copying:

■Motor—the ability to use fine motor control in manipulating a pencil.

■Global—the ability to reproduce the general gestalt of a design.

■Local—the ability to reproduce details, shapes, and sizes of a design, as well as the correct relationship between design elements.

DON’T FORGET

Interpretation of Regulatory Factors on DCP

Spatial, detail, or fi ne motor processing impairments are scored.

Planning and execution are not scored, but your interpretation should always take into account whether or not errors are due to

•Regulatory factors (e.g., executive functioning). Executive functions needed for accurate design copying include:

■ Employing ordering and sequencing necessary to see that the design will fi t in the allotted space and fi gure-ground errors are not made.

Be sure that you digest the Scoring Procedures for both types of scoring for the Design Copying Test on pp. 135–182 in the Administration Manual. Also become familiar with the use of the Scoring Template that came with your NEP- SY-II kit. At first, you should score each item in a child’s DC subtest while referring to this guide. There you will find General Scoring Considerations as