Halstead-Reitan battery
From Psy3241
Definition
� Fixed set of eight tests used to evaluate brain and nervous system functioning in individuals aged 15 years and older
� Children�s versions are the Halstead Neuropsychological Test Battery for Older Children (ages 9-14) and the Reitan Indiana Neuropsychological Test Battery (ages 5-8)
Purpose
� Evaluates a wide range of nervous system and brain functions including visual input, auditory input, tactual input, verbal communication, spatial perception, sequential perception, the ability to analyze information, form mental concepts, make judgements, motor output, attention, concentration, and memory
� Used to evaluate individuals with suspected brain damage
� Provides useful information regarding the cause of damage, which part of the brain was damaged, whether the damage occurred during childhood development , and if the damage is getting worse, staying the same, or getting better
� The information gathered about the severity of impairment and areas of personal strengths can be used to develop plans for patient rehabilitation and care
Precautions
� Requires administration by a professional examiner and interpretation by a trained psychologist
� Test results are affected by the examinee�s age, education level, intellectual ability, gender, and ethnicity, all of which need to be taken into account when analyzing the results
� Fixed battery of tests, which means that unnecessary information may be gathered and some important information may be missed
� Requires 5-6 hours to complete, patience, stamina, and cost
� Criticized because it does not include specific tests of memory; instead, memory is evaluated within the context of other tests
Description
� The Halstead-Reitan battery was created by Ward Halstead and Ralph Reitan
� The creation of the test was based on studies of patients with neurologic impairments at the University of Chicago
� Halstead recognized the need for an evaluation of brain functioning that was more extensive than intelligence testing
� Initially Halstead chose a set of 10 tests, all of which, except 3, are included in the current Halstead-Reitan battery
� Ralph Reitan was one of Halstead�s students who contributed to the battery by researching the tests� ability to identify neurological problems
� Reitan diagnosed 8,000 patients using only their test results, without meeting the patients or knowing anything about their background, which provided support for the effectiveness of the battery
� Reitan adapted the original battery by including additional tests
� The Halstead-Reitan has been researched more than any other neuropsychological test battery
� Research supports the ability of the battery to detect impairment accurately in a large range of neuropsychological functions
� 8 core tests
Category Test
� Total of 208 pictures consisting of geometric figures are presented
� Individuals are asked to decide whether they are reminded of the number 1, 2, 3, or 4 for each picture and press a key corresponding to their choice
� If the individual chooses correctly a chime sounds and if they choose incorrectly a buzzer sounds
� The pictures are presented in 7 subtests
� The key to the category test is that one principle or common characteristic underlies each subtest
� The numbers 1-4 represent the possible principles
� If the subject recognizes the correct principle in one picture they will respond correctly for the remaining pictures in that subtest
� The next subtest may have the same or different underlying principle and the subject must once again try to determine the principle using the feedback of the chime and buzzer
� The last subtest contains two underlying principles
� Test takes 1 hour, but individuals with severe brain damage may take up to 2 hours
� Considered to be the battery�s most effect test for detecting brain damage
� Does not help determine where the problem is occurring in the brain
� Evaluates the ability to draw specific conclusions from general information
� Also aids in detecting one�s ability to solve complex and unique problems and one�s ability to learn from experience
� The children�s versions consist of 80 items and 5 subtests for young children and 168 and 6 subtests for older children
� Scoring involves recording the number of errors
� Scores above 41 are considered indicative of brain impairment for ages 15-45
� Scores above 46 indicate impairment for ages 46 and older
� Recommended cutoffs vary depending on age and education level
Tactual Performance Test
� Board containing 10 cut-out shapes and ten wooden blocks matching those shapes are placed in front of a blindfolded individual
� Instructed to use only their dominant hand to place the blocks in their appropriate space on the board
� Same procedure repeated using the non-dominant hand only
� Same procedure repeated using both hands
� Board, blocks, and then blindfold are removed
� The individual is then asked to draw the board and the shapes in their proper locations from memory only
� Takes 15-50 minutes to complete
� Time limit of 15 minutes per trial
� Evaluates sensory ability, memory for shapes and spatial location, motor functions, and the brain�s ability to transfer information between its two hemispheres
� Detection of brain damage
� Helps to determine which side of the brain damage may have occurred
� For children under 15, only 6 shapes are used
� Scoring involves the time to complete each of the 3 blindfolded trials and the total time for all trials combined, the number of shapes recalled, and the number of shapes drawn in their correct locations
� Trial for the non-dominant hand should be 20 to 30 percent faster than the trial for the dominant hand because of practice effects
� If the non-dominant hand is slower or more than 30 percent faster, brain damage is possible
� Injuries of the arms, shoulders, or hands can also affect performance
� Scores are adjusted depending on education level and age
Trail Making Test
� Consists of 2 parts
� Part A: 25 numbered circles randomly arranged and individuals are instructed to draw lines between the circles in increasing sequential order until they reach the circle labeled �end�
� Part B: A page with circles containing the letters A through L and 13 numbered circles intermixed and randomly arranged and individuals are instructed to connect the circles by drawing lines alternating between numbers and letters in sequential order, until they reach the circle labeled �end�
� If mistakes are made, they are quickly brought to the individuals attention and they continue from the last correct circle
� Test takes 5-10 minutes to complete
� Evaluates information processing speed, visual scanning ability, integration of visual and motor functions, letter and number recognition and sequencing, and the ability to maintain two different trains of though
� A Color Trails Test is used for children and individuals of different cultures in which colors are used instead of numbers and letters
� Scoring is the time to complete each part
� Errors increase the total time
� For adults, scores above 40 seconds for Part A and 91 seconds for Part B indicate brain impairment
� However it is important to consider other variables such as age when scoring
