INTRODUCTION

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child development, and related neuroscience fields; customer feedback; author experiences with the NEPSY; and pilot data in the early phases of revision. In addition, there were four specific goals for the NEPSY-II: (1) to improve domain coverage across a wider age range; (2) to improve clinical and diagnostic utility; (3) to improve psychometric properties; and (4) to improve its ease of administration and, ultimately, its usability. The developers have addressed each of these issues in the Clinical and Interpretive Manual and, in general, have been successful in addressing each of these goals. Additionally, the developers are commended for engaging in an iterative process of subtest inclusion and elimination via pilot and tryout phases prior to their national standardization. It was during the tryout phase that the extension of the NEPSY-II into the adolescent years was examined, with the data suggesting additional subtest modifications (e.g., lowering test floors and raising ceilings), although only 45 adolescents were included in the tryout phase. They also followed test construction guidelines espoused by the Standards for Educational and Psychological Testing (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 1999). (See Rapid Reference 5.1 on the following page.)

Similar to its predecessor, the NEPSY-II continues to be based on the theoretical foundation of Luria (1966), wherein designated brain functions correspond with selected assessment tasks. While other concepts from Lurian Theory, such as functional systems and zones of proximal development, are not clear with respect to their integration into the NEPSY-II, the domains provided are clearly multidimensional and representative of the broad range of neurocognitive functions espoused by most neuropsychological models. Consistent with the NEPSY, the NEPSY-II includes the domains of Attention and Executive Functioning, Language, Memory and Learning, Sensorimotor, and Visuospatial Processing. The NEPSY-II also includes the new domain of Social Perception. Although the manual mentions a range of neuropsychological studies documenting the inclusion of selected dimensions within each domain, there is not a clear model underlying any of the domains that may have strengthened its theoretical underpinnings. Also, it is important to note that the neuropsychological domains are not empirically derived, or even statistically independent. Although this is clearly noted in the manual and, indeed, noted that the intent was not to create empirically derived domains, the user is left to determine how specific subtests relate within and across domains—and, importantly, how these relationships may change over the age range proposed by the NEPSY-II. Based on available research on the NEPSY, including information provided in the original NEPSY Manual, the NEPSY-II does not provide individual domain

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Rapid Reference 5.1

Strengths and Weaknesses of NEPSY-II Test

Development

or composite scores. Although a variety of different types of scores can be generated from the NEPSY-II, the use of subtests to guide interpretation of results is emphasized.

Further, the NEPSY-II not only modified and expanded subtests within the domains to be more representative of different dimensions of a neurocognitive domain, they extended the number of domains to include subtests measuring social cognition (i.e., Affect Recognition, Theory of Mind). This latter addition is innovative with respect to its inclusion in such assessment batteries, will assess an important brain function to a certain degree, be applicable to certain clinical groups (e.g., Autism Spectrum Disorders), and provide an additional avenue for assessment from the neuroscience literature that has not

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Rapid Reference 5.2

Strengths and Weaknesses of NEPSY-II Standardization

figures. The normative sample was well-matched on race, parent education, and geographic region of the country, with the minority representation being particularly noteworthy across nearly all of the stratification cells. The NEPSY-II also was stratified by chronological age and evenly divided by gender. (See Rapid Reference 5.2.)

The NEPSY-II was standardized on 1,200 children across the ages of 3 through 16 years. Of the 29 possible subtests included in the standardization, 17 were administered to children ages 3 to 4 years; children 5 to 6 years of age were administered 22 subtests and 2 delay tasks; children ages 6 to 12 years were given 23 subtests and 2 delay tasks; and the adolescent children, ages 13 to 16 years, received 24 subtests and 3 delay tasks. Final adjustments to the final composition of subtests were made following the standardization process (e.g., deletion of several subtests due to low clinical sensitivity and/or administration challenges), and scoring nuances were determined. Of note with respect to the scoring nuances, the NEPSY-II provides new scores for selected subtests, Contrast Scores, which are a quantification of the difference between one

232 ESSENTIALS OF NEPSY-II ASSESSMENT

measure and a comparison measure. In addition to being new to the NEPSY-II when compared to the 1998 NEPSY, the development of these scores utilized a normed contrast/comparison variable wherein normative data on the specific variable are produced by controlling for the ability of the children on the control variable. As such, this score does not assume equal base rates across different ages and ability levels, and the variances can be different across the range of the control variable.

One modification asserted for the NEPSY-II was to provide increased flexibility in the order of subtest administration. Although this was present in the 1998 version of the NEPSY, it was not clear how different orders of subtest administration would affect scores in a larger test profile. For the NEPSY-II, the test developers examined the flexibility systematically via four different administration orders during the standardization process. By not showing any order effects, they were successful in being able to document that the subtests in the NEPSY-II could be administered in a variety of orders without affecting results. This should facilitate subtest administration, particularly in difficult-to-test samples of children (e.g., child psychiatric disorders, ADHD-Hyperactive Type), and this benefit will extend into both the clinical and research realms. While it is recognized that all possible test orders could not be assessed given the possible number of permutations and combinations, this is one of the first times that a test developer has examined the evidence for order effects to such an extent, and it was critical to the NEPSY-II given the expressed option of a flexible subtest administration order.

Throughout the standardization process, the developers of the NEPSY-II made significant efforts in addressing the quality of the data being obtained. Specifically, they ensured that the examiners had testing experience with children, with the majority of the examiners having professional credentials to conduct psychological testing. Examiners were then trained using a videotape of NEPSYII administration and scoring procedures, and needed to pass a quiz with 90% accuracy on these procedures. Ongoing follow-up also was provided via monthly Internet meetings. Prior to engaging in the standardization phase, examiners were required to provide a practice case, with direct feedback being provided by the test publisher within 48 hours of submission. Once standardization testing ensued, cases were reviewed within 72 hours of receipt in the event of errors in administration and/or scoring, and a periodic newsletter was provided to all examiners indicating where commonly occurring errors appeared on the protocols. Once data were obtained, information was double-entered into the database, and all data were checked routinely for ranges, extreme values, and derivation of the