246 ESSENTIALS OF NEPSY-II ASSESSMENT
(continued)
Strengths |
Weaknesses |
Provides a variety of scores, including base rates. Lateralizing signs may be difficult Provides rich hypotheses by domain. to extract and may require
additional measures.
Each section has purpose, subtest use, and primary and secondary factors influencing performances.
Provides level, pattern, pathognomonic signs, and some left-right differences.
OVERVIEW OF STRENGTHS AND WEAKNESSES
The NEPSY-II is the second iteration of the American version of the NEPSY. The 1998 version of the NEPSY likely represented one of the first well-normed, well-standardized neuropsychological batteries that was available to child neuropsychologists and other child practitioners, and its revision continues in the same tradition. This revision was able to capitalize on the available information from the 1998 NEPSY, and provide a nicely packaged update to both clinicians and researchers alike. From an initial review of the strengths and weaknesses apparent in the NEPSY-II, suffice it to say that the test authors and test developers have done an exceptional job in producing a quality tool.
The NEPSY-II maintains a wealth of strengths that have been described in this chapter but, like most assessment tools, also presents some weaknesses of which users should be aware. Specific weaknesses include the limited availability of data on the preschool tasks and their application; the use of 1998 normative data for certain subtests; the relatively low ceilings on many of the subtests, particularly as children get older; the heterogeneity of their clinical groups and the likely presence of comorbid conditions; the lack of subtest specificity estimates, especially given the subtest approach espoused; and the relative lack of coverage to examine left-right differences in the sensorimotor domain, which will be critical for determining the presence of lateralizing signs. While none of these specific weaknesses or the few others that were mentioned in this chapter are significant enough to offset the wide array of strengths of this assessment tool, recognizing these limitations should facilitate intelligent use of this NEPSY-II in both clinical and research settings.
STRENGTHS AND WEAKNESSES OF NEPSY-II 247
Of importance here is that the NEPSY-II manuals certainly provide the information from which to evaluate the NEPSY-II. So, as in all tests, there are relative strengths and weaknesses, but this test can be evaluated from data presented in the manual, and additional evaluative aspects of this test will appear with its usage over the next decade. Of course, while this initial review is positive, it remains for the field to determine its ultimate use and utility across different venues.
S
TEST YOURSELF
S
Fill in the blanks.
1. Chapter 5 highlights strengths and weakness for: Test Development,
Standardization, |
|
|
|
|
|
, Test |
|
|
|
. |
|||
Administration and Scoring, and |
|
|
|
|||
|
|
|
||||
2.Name four specific goals for the Revision of NEPSY when developing NEPSY-II:
(a)
(b)
(c)
(d)
3.The NEPSY-II developers are commended for engaging in an iterative
process of subtest inclusion and elimination via
and phases prior to their national standardization.
4.A strength for NEPSY-II Test Development, according to Hooper, was the following of construction test guidelines espoused by the
.
5.Name three weaknesses of NEPSY-II Reliability:
(a)
(b)
(c)
6.Name three strengths of NEPSY-II Reliability:
(a)
(b)
(c)
7.Strengths and weaknesses of NEPSY-II Standardization, according to Hooper, show that the normative sample is an excellent match
with 2003 census figures in the United States, particularly for
|
representation and |
|
parent |
education. |
|
|
|
248ESSENTIALS OF NEPSY-II ASSESSMENT
8.The standardization sample for NEPSY-II was stratified by age, race,
parent education, and |
|
|
|
|
|
, |
|
|
|
. |
|||
with a sample evenly divided between |
|
|
|
|||
|
|
|
||||
9. The summary of Strengths and Weaknesses of NEPSY-II Validity
shows that the following types of validity were adequately |
|
|||||
addressed: (a) |
|
|
, (b) |
|
, |
|
|
. |
|
||||
(c) |
|
|
|
|
|
|
|
|
|
|
|
||
10.On NEPSY-II, the development of Contrast 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 |
|
|
variable. As such, this score does not assume |
|||||
|
|
|||||||
equal |
|
|
|
|
|
across different |
||
|
|
|
|
|
||||
ages and ability levels, and the |
|
|
can be different |
|||||
across the range of the control variable. |
|
|
||||||
11.The ability to infer left-right differences probably represents a strength in the full battery.
True or False?
12.Of 29 possible subtests in the standardization, 17 were administered at ages 3–4.
True or False?
13.The NEPSY-II Clinical and Interpretation Manual provides steps for interpretation, including a verification step.
True or False?
14.Correlations with specific neurocognitive batteries (e.g., DKEFS, CMS, BBCS) are weak to moderate.
True or False?
15.No subtest specificity estimates were provided to reinforce interpretation strength of the NEPSY-II.
True or False?
16.Correlations with Devereux Scales of Mental Disorder show specific relationships with Autism (Comprehension of Instructions) and Conduct Disorder (Affect Recognition).
True or False?
17.Hooper sees a strength in the fact that no domain scores are derived for NEPSY-II.
True or False?
18.Several subtests are not renormed and continue to employ 1998 norms.
True or False?
19.Subtests are arranged in order of administration in the Administration Manual.
True or False?
STRENGTHS AND WEAKNESSES OF NEPSY-II 249
20.The use of 50 children for each six-month age band between 3.0–4.11 (making 100 children for age 3 and 100 for age 4) is a relative weakness, especially for preschool years, according to Hooper.
True or False?
Answers:
1. Psychometric Properties, Interpretation; 2. (a) to improve domain coverage across a wider age range; (b) improve clinical and diagnostic utility; (c) to improve psychometric properties; and (d) to improve its ease of administration and, ultimately, its usability; 3. pilot, tryout; 4.
Standards for Educational and Psychological Testing or APA guidelines; 5. and 6. See Rapid Reference 5.3; 7. minority, education; 8. geographic region, gender; 9. content, concurrent, and construct validity; 10. control; base rates, variances; 11. False; 12. True; 13. True; 14. False; 15. False; 16. True; 17. True; 18. True; 19. False; 20. True
Six
CLINICAL APPLICATIONS
OF THE NEPSY-II
APPLICATIONS OF NEPSY-II DERIVED
FROM STUDIES OF DISORDERS
Children with virtually all types of developmental problems may be assessed with NEPSY-II. Because the brain organizes all behavior, an evaluation that assesses the various brain processes underlying complex behavior is, in principle, applicable to all situations where disordered development is of concern. The problem often lies in time constraints: how can the clinician, with a restricted amount of time, direct his or her efforts in the most efficient way and choose among the wide variety of NEPSY-II subtests as well as other instruments? How can he or she understand and organize the various results? The best way to answer these questions is for the clinician to review the types of findings he or she may expect in various disorders as well as research findings that may provide explanations and theories concerning the disorders. Along with a thorough grounding in child neuropsychology, one must gain experience in assessment and how it is used diagnostically. Experience naturally comes with assessing children with many types of disorders. However, one should also build on the experience of others and the findings in current research.
This chapter focuses first on the use of the NEPSY-II Referral Batteries as a guide for subtest selection and parsimonious assessment when constraints preclude a full NEPSY-II assessment. In addition to the subtests of the General Referral Battery, the subtests for the specific Diagnostic Referral Batteries will be presented as pertinent cases are discussed later in the chapter. These Referral Batteries serve to guide the clinician to subtests that address hypotheses relevant to the referral question.
After the general discussion of the Referral Batteries, the discourse turns to the clinical applications of the NEPSY-II (Korkman, Kirk, & Kemp, 2007) in various developmental and acquired disorders. The focus is on test results that are
250