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Clinical and Interpretive Manual, it does not appear that strict research criteria were employed for many of the special group studies, such as use of state Department of Education criteria and use of the Diagnostic and Statistical Manual-IV- TR (American Psychiatric Association, 2000) without acknowledgement of any reliability checks. This type of ascertainment can contribute to the potential for significant heterogeneity in the samples, and is magnified by the small sample size. Third, the comorbidity apparent in many of these clinical samples is not mentioned or examined in the data presentations, thus leading to additional variables that could contribute to group differences. Finally, it is unclear why the different clinical groups were not compared in some fashion. While the differences from typical performance are important to document, this clinical differentiation, if present, might have provided more useful information with respect to its clinical utility and uncovering neuropsychological profiles for specific clinical populations.

ADMINISTRATION AND SCORING

For the NEPSY-II, there is a separate Administration Manual that provides detailed, manualized procedures for administration and scoring of each subtest. The domain, description, materials, starting points, discontinue rule, timing, recording, general guidelines, and specific administration and scoring details are provided for each subtest. These details are particularly important for several subtests, such as Clocks, Design Copying, Visuomotor Precision, and Word Generation, where increased attention to detail in administration and scoring is required. In fact, the Administration Manual provides specific appendices for scoring procedures for the Clocks Subtest (Appendix A) and Design Copying Subtest (Appendix B), for which inter-rater reliability probably should be obtained for any new examiner. Additional positive administration features and potential improvements over the 1998 NEPSY include: (a) the alphabetical arrangement of the subtests, which should facilitate administration efficiency; (b) the inclusion of eight different assessment batteries suggested by the referral question, which should assist new examiners in their use of the NEPSY-II; and

(c) an increased age range for the NEPSY-II, which extends its clinical use into the adolescent years. As such, the manual is clear and user friendly, and should assist in learning the procedures in a standardized fashion for both clinical and research settings.

The materials provided in the NEPSY-II kit are easy to use, colorful, and attractive, and appear to be relatively durable. Separate test forms are provided for the preschool battery (ages 3 to 4) and the school-age battery (ages 5 to 18). The

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NEPSY-II test forms are clear, providing additional guidance to the examiner without the need for referring to the manual and include key information such as materials needed, starting and stopping points, time limits, and specific administration rules (e.g., reversal rules). Space is provided on the cover sheet for profile presentations of the subtests by domain so that normative findings can be viewed immediately, and on the second page for the specific behavioral observations. Other specific scores (e.g., Contrast scores) are provided space associated with their specific subtest.

The innovative addition of teaching items for selected subtests, and the modifications to the Auditory Attention and Response Set Subtest also are noteworthy in that they should improve the chances of obtaining a reliable administration on these tasks. With respect to the Auditory Attention and Response Set Subtest, the administration “gymnastics” that were needed to administer this subtest were significant and likely contributed, in part, to its low correlation to other subtests in the 1998 version of the NEPSY. For the NEPSY-II, specific changes included: (a) when each of the components of this task are administered (i.e., ages 5 to 6 years are no longer given the Response Set component); (b) the method of response has been changed from selecting colored foam squares to a simple pointing response to a stimulus book within 2 seconds of the target word presentation; (c) elimination of partial credit for a slower response. These changes purportedly have minimized the effects of motor speed and finger dexterity in this attention task.

Scoring procedures for the NEPSY-II subtests are clearly presented in the Administration Manual. While most of these can be calculated by hand, the efficiency of their use likely will increase with use of the NEPSY-II computer scoring program. To obtain the various scores on the NEPSY-II, however, the Clinical and Inter pretive Manual also will be needed as this is where the normative tables are located. If the computer scoring program is utilized, it will be important for the examiner to consult the Clinical and Inter pretive Manual to determine how to use these scores, especially when employing the various contrast scores and behavioral observations that are calculated. The deletion of the NEPSY domain scores should facilitate the scoring process, but it will require additional knowledge with respect to how various subtests interrelate for a selected clinical population of interest. Perhaps the only concern at this time for the administration and scoring of the NEPSY-II will be to determine the clinical utility of the various combined scores and contrast scores, as limited evidence was provided for their use. See Rapid Reference 5.5 on the following page for a summary of strengths and weaknesses of administration and scoring of the NEPSY-II.

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Rapid Reference 5.5

Strengths and Weaknesses of NEPSY-II Administration

and Scoring

INTERPRETATION

Just like other neuropsychological assessment approaches, the interpretation of the NEPSY-II requires a certain amount of examiner knowledge with respect to brain functioning and, at a minimum, a knowledge base in the underlying neurocognitive functions of selected conditions. So, while this battery is available