Potential Impact of Age- and Education-Corrected Scores on HRNB Score Patterns in Participants With Focal Brain Injury

Abstract

Heaton, Grant, and Matthews (1991) presented an alternate scoring system for the Halstead-Reitan Neuropsychological Battery (HRNB) using age-, education-, and gender-corrected T scores to replace the raw score system traditionally employed with the test. This study addressed the impact of using this system on the score patterns generated by the HRNB in 64 clients with localized injuries to one of four quadrants of the brain. Results showed that the raw scores show more overall impairment than do the T scores, but overall the systems are statistically equal in their ability to separate the localized groups. The patterns of differences among the systems also differ. Although these findings suggest overall equivalence of the systems, they also show that each may have strengths that will show up in different analyses. A process of using both scoring systems for their own unique information is advocated as most appropriate at the current time until additional research addresses the questions raised in this study and elsewhere.

Prediction of driving ability with neuropsychological tests: Demographic adjustments diminish accuracy

“…Findings are also consistent with the observation of Reitan and Wolfson (2005) that corrections for age are less useful for accurate interpretation of neuropsychological performances of a wide range of brain-damaged patients, for whom scores have diminished associations with age and education. Similarly, Golden and van den Broek (1998) reported that, among brain-damaged subjects, neuropsychological scores undergoing age-, education-, and gender-corrections were less sensitive to impairment than were raw scores. They noted that by correcting for cognitive changes arising from aging, we may also be inadvertently adjusting for the effect of brain changes, “corrections” which make the individual appear normal when there may actually be subtle impairment.…”

Editorial

“…From a clinical viewpoint, it is obviously of greater interest to recognize the effects of brain damage and to classify brain-damaged subjects correctly than to recognize normal scores and classify control subjects correctly. Golden and van den Brock (1998) performed separate statistical analyses of Heaton, Grant, and Matthews T-scores and raw scores from the Halstead-Reitan Battery obtained in examination of 64 persons with focal cerebral lesions. They concluded that the "results certainly suggest that the patterns of scores in focal injuries generated by these [scoring] systems are indeed different," and that "one approach may not be appropriate for the other" (p. 163).…”