Reliability and Validity of the Naming Test from the Neuropsychological Assessment Battery (NAB) in
patients with Acquired Brain Injury
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3
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Zgaljardic, D. J. , Oden, K. E., , Lambert, M. E. , Dickson, S., , Miller, R., , Plenger, P.
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Transitional Learning Center, Galveston & Lubbock, TX; University of Texas Medical Branch, Galveston, TX
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Pate Rehabilitation, Dallas, TX
Table 1 – Neuropsychological
Tests Administered
INTRODUCTION
The NAB is a “comprehensive, modular battery of neuropsychological (NP) tests
developed for the assessment of a wide variety of cognitive skills and functions in adults
aged 18 to 97, with known or suspected disorders of the central nervous system” (Stern &
White, 2003).
RESULTS
 Each form of the NAB Naming Test maintained adequate internal consistency (form 1:
α = .79; form 2: α = .65).
NAB Naming Test - [NAB1 & NAB2]
Boston Naming Test – [BNT]
 Forms 1 and 2 of the NAB Naming Test were found to be highly equivalent (r = .75;
paired t-test [t=.50, p > .05]).
Symbol Digits Modalities Test (Oral version) – [SDMT-O]
Judgment of Line Orientation – [JLO]
The NAB consists of six modules, the first designated as the Screening Module, and five
main modules (Attention, Language, Memory, Spatial, and Executive Functions) with an
alternate form available for each module. The NAB Naming Test is a 31-item visual
confrontation naming test with good psychometric properties (based on the NAB
standardization data); however, there has not been independent validation of this
instrument in a brain injured sample.
Wechsler Abbreviated Scale of Intelligence – Matrix Reasoning – [WASI-MR]
 Neither form of the NAB Naming Test was significantly correlated with age or
education level, whereas performance on the BNT was significantly associated with
education (r = .47, P < .05).
Hopkins Verbal Learning Test – Revised – Total Recall – [HVLT-Total]
Hopkins Verbal Learning test – Revised – Delayed Recall – [HVLT-Delay]
Controlled Oral Word Association Test (FAS) – [COWA]
NAB Digit Span Forward – [Digit F]
 The NAB Naming Test correlated significantly with the BNT (form 1: r=.85; form 2:
r=.75) as well as the delayed recall trial of a word-list learning test (form 1: r=.39; form
2: r=.35).
NAB Digit Span Backward – [Digit B]
Confrontation naming is typically assessed in patients with acquired brain injury (ABI).
However, commonly used tests of confrontation naming such as the Boston Naming Test
(BNT) have been shown to be highly correlated with age and education and susceptible to
cultural factors (Yochim et al., 2009). Further, the BNT incorporates line drawings which
can impact the ecological validity of the measure.
 The BNT on the other hand was significantly correlated with NP tests that assess
visuospatial skills and verbal working memory. See Table 3.
Table 2 - NAB Naming Test
Noted differences between the NAB Naming Test and the BNT include the NAB Naming
Test’s use of a) color digital photos, b) shorter administration time, and c) fewer items (31
vs. 60).
NAB Mean (SD)
The aim of the current study was to assess the internal consistency, alternate forms
reliability, and convergent and divergent validity of the NAB Naming Test in a brain-injured
patient sample.
NAB Form 1
NAB Form 2
29.4 (2.5)
29.2 (1.9)
DISCUSSION
Raw Score Range
18-31
22-31
Cronbach’s Alpha
.79
.65
The current study provides independent validation of the NAB Naming Test in patients
with ABI.
The correlation coefficients obtained are consistent with those provided from the NAB
standardization data.
METHOD
Participants
 Thirty-six individuals (69.4% male) with a history of ABI (stoke [38.9%] or moderate to
severe traumatic brain injury [61.1%]) consecutively admitted to a residential post-acute
brain injury rehabilitation (PABIR) program participated in the study. Patients were not
included in the current study if they had prior diagnosis of a neurological or psychiatric
condition, presented with aphasia, or English was not their primary language.
 Mean age of the sample was 44.9 years (SD=14. 2) and mean educational attainment
was 13.3 years (SD=2.6).
Procedure
 The NAB Naming Test (forms 1 & 2; counterbalanced) and the BNT were administered
according to standardized procedures. Other NP tests administered included tests of
visual scanning and speed of information processing, extra-personal line orientation,
nonverbal/visual abstraction, speeded word generation, auditory concentration, verbal
working memory, and verbal learning. See Table 1 for a complete list of NP tests.
Data Analysis
 Pearson’s correlation coefficients were calculated to assess convergent and divergent
validity, as well as alternate forms reliability of the NAB Naming Test. Internal
consistency was calculated using Cronbach’s alpha. A Paired-Sample t Test was
performed to assess potential differences in performance means between forms 1 & 2 of
the NAB Naming Test.
The NAB Naming Test demonstrated good internal consistency and alternate forms
reliability.
Table 3 – Correlation Matrix
NAB1 NAB2
BNT
WASI-MR
JLO
COWA
Digits
F
Digits B
HVLTTotal
HVLTDelay
NAB1
1
NAB2
.75***
1
BNT
.85***
.75***
1
WASI-MR
.21
.29
.36*
1
JLO
.23
.26
.41*
.82***
1
COWA
.08
-.03
.18
.47**
.51**
1
Digits F
.32
.03
.29
-.16
-.18
.24
1
Digits B
.19
.26
.34*
.50**
.45**
.60***
.31
1
HVLTTotal
.28
.09
.20
.22
.21
.50
.30
.30
HVLTDelay
.39*
.35*
.30
.15
.07
.25
.15
.19
.79***
1
SDMT-O
.20
.22
.26
.46**
.45**
.38*
.05
.40*
.35*
.34*
*p<.05; **p<.01; ***p<.001
See Table 1 for test abbreviations
Convergent validity of the NAB Naming Test was established as both forms correlated
highly and significantly with a commonly used confrontation naming instrument (i.e.,
BNT).
Divergent validity was established by the lack of associations the NAB Naming Test had
with tests less related with confrontation naming such as attention and processing speed.
The BNT, but not the NAB Naming Test, correlated significantly with select measures of
visuospatial skills suggesting that the BNT may rely more heavily on visuospatial skills
than the NAB Naming Test.
REFERENCES
Stern, R. A. & White T. (2003). Neuropsychological Assessment Battery: Administration,
Scoring, and Interpretation Manual, Psychological Assessment Resources, Inc., Lutz, FL.
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Yochim, B. P., Kane, K. D., & Mueller, A. E. (2009). Naming Test of the Neuropsychological
Assessment Battery: Convergent and Discriminant Validity. Archives of Clinical
Neuropsychology, 24 (6), 575-83.