Aphasia Testing Using National Adult Reading Test

The assignment discusses the application of National Adult Reading Test (NART) in evaluating subjects with potential aphasia. NART is a widely used test to estimate premorbid intelligence quotient (IQ). The study highlights the test's ease of administration and its suitability for assessing cognitive functions in research studies. However, it notes limitations such as small sample sizes and lack of data on psychiatric illnesses.

Running Head: PSYCHOLOGY
Psychology
Student’s name
Name of the Institute

PSYCHOLOGY
Table of Contents
Introduction........................................................................................ 3
Administration.....................................................................................4
Scoring................................................................................................ 5
Conclusion........................................................................................... 7
References........................................................................................... 8

PSYCHOLOGY
Introduction
Aphasia is condition where a person is not able to formulate and comprehend language. It
happens when specific brain region damages. The damage can be caused by head trauma, stroke,
brain tumour or dementia. Aphasia patient is significantly impaired in one or more form of
communication modalities such as verbal expression, auditory comprehension, functional
communication and reading and writing (Haw, Gregory & Herbert, 2017). It is related to
individual’s language cognition. The signs and symbols may not be necessarily present in
patients or they may vary in severity. Some of these symptoms include inability to pronounce
words, inability to comprehend language, inability to speak, inability to form words, inability to
read, speech disorder etc.
It is necessary to check the degree of person’s prior cognitive ability (i.e. before trauma)
with the current ability in order to understand whether there is a decline. However, actual prior
ability measures of patients are seldom available. So, it is necessary to have a tool which check
persons prior cognitive ability. One of the tool is NART i.e. National Adult Reading Test. It
measures the pronunciation of 50 irregular English words. The successful word reading depends
on persons prior ability i.e. before brain damage and not on his current ability. The tool is used to
predict premorbid mental ability in mild to moderate dementia. Using appropriate equations, this
NART score can help predicting WAIS verbal, performance and full scale IQs of patient. The
estimated values are then compared with the actual IQ obtained on testing (Miller, Hudson &
Gong, 2017).

PSYCHOLOGY
Administration
The test was conducted in community health Centre for a sample of 50 old age people. It
was made sure that tester was familiar with the correct pronunciation of all the 50 irregular
English words. These words can only be pronounced if subject or respondent knows them in
written form. A well-defined NART word set was used to conduct test among the
respondents .Due to regional discrepancy in accent, slight variations were acceptable. The tester
was provided with the NART answer sheet on which he has recorded the responses or the error
made. No time limit was imposed .The respondents were unaware of the number of mistakes
they were making. The subject was given liberty to change his response if he or she wished to do
so, but he/she must decide final choice. In order to do standardization all respondent were asked
to pronounce all 50 words. It was found that the test had caused little anxiety among the
subjects .In order to tackle this issue appropriate reinforcement and reassurance was given. The
help of staff of Community Centre was taken to conduct this test properly .The NART answer
sheet was used to calculate or evaluate subjects ability to respond .But it was done after test was
conducted for all the respondents .Their demographic and previous health history was taken for
future analysis .Refreshments like juice were provided to each subject. The test was specifically
designed to estimate the premorbid intelligence level of adult patients who were suspected of
suffering from aphasia (Chan, Gallaher, Moodley, Minati, Burgess & Hartley, 2016)
Scoring
The NART error score was calculated which is equal to 50 minus number of words read
correctly. Following words were taken (McGrory, Austin, Shenkin, Starr & Deary, 2015)
 CHORD
 ACHE

PSYCHOLOGY
 DEPOT
 AISLE
 BOUQUET
 PSALM
 CAPON
 DENY
 NAUSEA
 DEBT
 COURTEOUS
 RAREFY
 EQUIVOCAL
 NAÏVE
 CATACOMB
 GAOLED
 THYME
 HEIR
 RADIX
 ASSIGNATE
 HIATUS
 SUBTLE
 PROCREATE
 GIST
 GOUGE
 SUPERFLUOUS
 SIMILE
 BANAL
 QUADRUPED
 CELLIST
 FAÇADE
 ZEALOT
 DRACHM
 AEON
 PLACEBO
 ABSTEMIOUS
 DÉTENTE
 IDYLL
 PUERPERAL
 AVER
 GAUCHE
 TOPIARY
 LEVIATHAN
 BEATIFY
 PRELATE
 SIDEREAL
 DEMESNE
 SYNCOPE

PSYCHOLOGY
 LABILE
 CAMPANILE
This NART error score was calculated for each respondent .These scores were used to predict
verbal and performance prior ability of all the respondents.
Estimated WAIS Full Scale IQ = 127.7 – 0.826 × NART error score
Estimated WAIS Verbal IQ = 129.0 – 0.919 × NART error score
Estimated WAIS Performance IQ = 123.5 – 0.645 × NART error score
It justifies that the respondents has scored low because of their demographic profile like
education, age etc. Those who have scored good will have good predicted score. This forms the
basis of aphasia testing .The predicted scores were then matched with their actual scores of the
verbal and performance test which were conducted by the community health center after NART
test. These actual scores were taken directly from the authority .They matched with NART
calculated predicted scores. So it was found that for 25 respondents, actual and estimated scores
are approximately same. So these patients were fine. For 5 patients, their predicted score is much
less than actual score, this indicates that these patients have higher chances of aphasia.
Conclusion
NART test was combined with other verbal and performance test to evaluate the
condition of subject .After further analysis it was found that these 5 respondents have some
history of damage to brain. However there were certain limitations with the test like it was used
to predict IQs of respondents between 55 and 70 years of age.

PSYCHOLOGY
NART does not require much concentration from respondents. It is easy and can be used
in evaluating the effect of drugs .It is pleasant test for the respondents .It is easy to administer by
the tester. Because of good correlation with WAIS test, it has good scope in analyzing the impact
of psychological disorders in research studies. There are studies which show that NART can be
used to retest the individual under different conditions. It significantly estimates predicted
premorbid IQ level among the respondents.
The test makes allowance that effect of aging on cognitive thinking is not much i.e. IQ
remains stable. There were 50 words which could increase the anxiety among the
respondents .Instead, short NART test could have been conducted to manage the anxiety
(Mackinnon & Wooden, 2015). Due to certain limitations, the actual test of verbal and
performance ability was conducted by the Community Centre only, so the actual test was not
monitored by the tester. Also the samples taken were very small, so it was difficult to generalize
this study. NART data was not available on any psychiatric illnesses so firm conclusion cannot
be drawn from this.

PSYCHOLOGY
References
Miller, B., Hudson, C., & Gong, G. (2017). Depression is associated with lower American
National Adult Reading Test scores among rural dwellers aged between 50 and 64 years
in Texas: A Project FRONTIER Study. The Southwest Respiratory and Critical Care
Chronicles, 5(21), 16-20.
McGrory, S., Austin, E. J., Shenkin, S. D., Starr, J. M., & Deary, I. J. (2015). From “aisle” to
“labile”: A hierarchical National Adult Reading Test scale revealed by Mokken
scaling. Psychological assessment, 27(3), 932.
Mackinnon, A., & Wooden, M. (2015). A short form of the National Adult Reading Test for use
in epidemiological surveys. Personality and Individual Differences, 86, 101-107.
Haw, C., Gregory, E., & Herbert, R. (2017, September). Developing an evidence-based template
for health information with people with aphasia: principles, findings, and implications for
practice. In BAS Therapy Symposium 13-14th September 2017 (p. 18).
Chan, D., Gallaher, L. M., Moodley, K., Minati, L., Burgess, N., & Hartley, T. (2016). The 4
Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis
of Pre-dementia Alzheimer's Disease. Journal of visualized experiments: JoVE, (116).