Functional Assessment of Spatial Neglect: A Review of the Catherine Bergego Scale and an Introduction of the Kessler Foundation Neglect Assessment Process

Abstract

Spatial neglect is a debilitating post-stroke neurocognitive disorder, associated with longer hospitalization and worse rehabilitation outcomes. Prior literature suggests a high prevalence of this disorder, but in reality clinicians have difficulty reliably identifying affected survivors. This discrepancy may result from suboptimal use of validated neglect assessment procedures. In this article, we suggest a validated assessment tool, sensitive to identify neglect and its functional consequences, the Catherine Bergego Scale (CBS). We provide detailed item-by-item CBS instructions for observation and scoring: the Kessler Foundation Neglect Assessment Process (KF-NAP). We describe a unique attribute of the CBS and the KF-NAP: rehabilitation researchers may be able to use them to measure both ecological outcomes, and specific, separable perceptual-attentional and motor-exploratory spatial behaviors.

Impact of Spatial Neglect on Stroke Rehabilitation: Evidence From the Setting of an Inpatient Rehabilitation Facility

“…22,24 Each category is scored from 0 (no neglect) to 3 (severe neglect). The majority (> 94%) of the participants were scored in all KF-NAP categories.…”

“…17–19 This problem may be related to the fact that performance on tasks that are conventional methods of assessing spatial neglect is not always easily translatable to functional outcome. Assessing spatial neglect during activities of daily living (ADLs), rather than using paper-and-pencil or computerized tasks (e.g., star cancellation, figure copying, landmark judgment), 20,21 may enable clinicians to better understand the impact of spatial neglect (see previous studies 1,22,23 for further discussion on the advantage of assessing spatial neglect during ADLs). In addition to conventional assessments, previous studies almost always treated spatial neglect as a dichotomy (i.e., presence vs. absence).…”

“…22,24 We aimed to confirm the adverse impact of spatial neglect and explore whether the presence or severity of spatial neglect predicts specific outcomes. The KF-NAP is a process to measure spatial neglect using the Catherine Bergego Scale.…”

Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals With Traumatic Brain Injury

“…In particular, the fact that the Catherine Bergego Scale assesses spatial neglect in more dimensions than the Star Cancellation Test indicates that the Catherine Bergego Scale is more sensitive 31 and also suggests that the Catherine Bergego Scale is open to greater variation in how it may be administered. 34,50 This may be the reason why some patients met the criterion of spatial neglect based on the Star Cancellation Test score but not on the Catherine Bergego Scale. On the other hand, the Star Cancellation Test alone cannot identify all the patients with spatial neglect because of the complexity of the disorder, which can be manifested in various forms in different tasks (eg, line bisection, figure copying, text reading, double-simultaneous-stimulus detection).…”

Normative data for distal line bisection and baking tray task

“…For clinical purposes, tests and scales aimed to assessing ecological functions were necessary for several needs. Firstly, in a clinical setting is not infrequent to find patients that obtain a normal performance on classic tests while in everyday life they showed signs of USN [15,16]. Secondly, USN is a heterogeneous disorder and some tests fail to detect specific aspects of neglect [10,17].…”