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PSYCHOLOGICAL and NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID Final Version: January, 2016 * Published Administration Time

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PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID AGE RANGE APPROPRIATE PUBLISHED TEST TEST NAME FOR TEST ADMINISTRATION TARGET AREAS/PURPOSE ACRONYM ADMINISTRA- TIME * TION Abel and Becker Cognition Scale ABCS Adults Adult and Self-report assessment of minimization and other Intellectually cognitive distortions related to sexually assaultive Disabled Offender behavior (29 items) versions: Estimate 20 mins Abel Assessment for Sexual AASI-2 12+ 10-20 mins Assessment of sexual interests in children and sexual Interest – 2 behavior problems. Abel Assessment for Sexual AASI-3 18+ 10-20 mins Assessment of sexual interests in children and sexual Interest – 3 behavior problems. Abel-Blasingame Assessment ABID 18 – 65 1 hr 20 mins Assessment of sexual interests in children and sexual System for Individuals With behavior problems. Measure orally administered. Intellectual Disabilities Achenbach Behavior Checklist: ABCL 18 -- 59 20 mins estimate Behavior rating scale: adult ADHD assessment Adult Behavior Checklist Achenbach Behavior Checklist: OABCL 60 -- 90+ 20 mins estimate Behavior rating scale: older adult to geriatric adult Adult Behavior Checklist - OLDER attentional processing assessment ADULT Achenbach Behavior Checklist: ASR/18-59 18 – 59 20 mins estimate Behavior rating scale: adult ADHD assessment Adult Behavior Checklist - Self- Report Achenbach Behavior Checklist: OASR 60 -- 90+ 20 mins Behavior rating scale: older adult to geriatric adult Adult Behavior Checklist - Self- attentional processing assessment Report Achenbach Behavior Checklist: CBCL/6-18 6 -- 18 20 mins estimate Behavior rating scale: child and adolescent ADHD Child Behavior Checklist - School- assessment Age Achenbach Behavior Checklist: CBCL/1.5-5 1.5 -- 5 20 mins estimate Behavior rating scale: early childhood ADHD assessment Child Behavior Checklist - Pre- School * Published Administration Time refers to the time required to administer the measure as listed by the test publisher, with this time having been estimated for cases where no formal published administration time is available. Optum/OHBS-CA Psych Testing Guideline criteria specify that authorization is to be based on the total published administration times for the measures able to be authorized by Optum/ OHBS-CA, and will not exceed 150% of published test administration time. Final Version: January, 2016 PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID AGE RANGE APPROPRIATE PUBLISHED TEST TEST NAME FOR TEST ADMINISTRATION TARGET AREAS/PURPOSE ACRONYM ADMINISTRA- TIME * TION Achenbach Behavior Checklist: C-TRF 1.5 -- 5 20 mins estimate Behavior rating scale: early childhood ADHD assessment Child Behavior Checklist - Pre- School Caregiver/Teacher Report Form Achenbach Behavior Checklist: TRF/6-18 6 -- 18 20 mins estimate Behavior rating scale: child and adolescent ADHD Child Behavior Checklist – assessment School-Age Teacher Report Form Achenbach Behavior Checklist: YSR/11-18 11 -- 18 20 mins estimate Behavior rating scale: late childhood and adolescent Child Behavior Checklist - School- ADHD assessment Age Youth Self Report Form Achenbach Semi-Structured SCICA 6 – 18 60 – 90 mins Assessment of aggressive, rule-breaking, anxious, Clinical Interview for Children and depressed, attention, language, motor, self-control, Adolescents somatic problems Achenbach System of Empirically ASEBA 1.5 – 90+ Estimate 20 mins Assessment of adaptive and maladaptive behavioral- Based Assessment Modules: per rating scale emotional functioning Preschool 1.5- 5 School-Age 6 – 18 Adult 18 – 59 Older Adult 60 – 90+ Adaptive Behavior Scale- ABS-RC:2 18 – 79 15 - 30 mins To determine an individual's strengths and weaknesses Residential and Community: 2nd among adaptive domains and factors. Edition (by AAMR) Adaptive Behavior Scales: 2nd ABSS:2 3 -- 21 60 -- 120 mins Measure retardation, emotional maladjustment, Edition (by AAMR) developmental disadvantages. Assess adaptive behavior Adaptive Behavior Assessment ABAS-3 5 -- 89 20 mins each Adaptive behavior measure System parent/teacher/adult forms Published Administration Time refers to the time required to administer the measure as listed by the test publisher, with this time having been estimated for cases where no formal published administration time is available. OptumHealth/OHBS-CA Psych Testing Guideline criteria specify that authorization is to be based on the total published administration times for the measures able to be authorized by OptumHealth/ OHBS-CA, and will typically not exceed 150% of published test administration time. Final Version: 2 January, 2016 PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID AGE RANGE APPROPRIATE PUBLISHED TEST TEST NAME FOR TEST ADMINISTRATION TARGET AREAS/PURPOSE ACRONYM ADMINISTRA- TIME * TION Adaptive Behavior Inventory ABI 6 -- 18.11 20 -- 25 mins Evaluate functional daily living scales, communication with others, and social interaction of school age children who are Mental retarded, have emotional difficulties or are normal with no difficulties. Adaptive Behavior Street Survival SSSQ 9.5 & up 60 mins Assess fundamental community living and prevocational Skills Questionnaire skills of mentally disabled adolescents and adults ADD-H: Comprehensive ACTeRS Grades K -- 8th 15 mins Behavior rating scale: child ADHD assessment Teacher's Rating Scales, 2 Ed ADD-H: Comprehensive Parent ACTeRS Grades K -- 8th 15 mins Behavior rating scale: child ADHD assessment Form ADHD Self-Report Scale ASRS Adults 5 mins Self-report adult ADHD screening measure. Adolescent Apperception Test 12 -- 19 45 -- 60 mins Projective tests attempts to elicit internal conflicts and interpersonal interactions Adolescent Co-Pathology Adolescent 60 mins Self-report inventory: general adolescent diagnostic Inventory screening measure Adolescent Drinking Index ADI 12 -- 17 5 mins Quickly assess alcohol abuse; assess self-medicating vs. rebellious types; physical, social, psycho indicators Adolescent Psychopathology APS 12 -- 19 45 -- 60 mins 325 items: Clinical disorder, personality, psychosocial Scale problem content response style. Adolescent Psychopathology APS-SF 12 -- 19 15 -- 20 mins Brief self-report measure of psychopathology & Scale-Short Form problem behaviors in adolescents; cross section of psychopathology and psychological problems relevant to adolescent adjustment Adolescent Symptom Inventory-4 ASI-4 12 -- 18 Not listed, estimate Behavior rating scale: assessment of 15 emotional and 20 mins; self, behavioral disorders parent, teacher versions Published Administration Time refers to the time required to administer the measure as listed by the test publisher, with this time having been estimated for cases where no formal published administration time is available. OptumHealth/OHBS-CA Psych Testing Guideline criteria specify that authorization is to be based on the total published administration times for the measures able to be authorized by OptumHealth/ OHBS-CA, and will typically not exceed 150% of published test administration time. Final Version: 3 January, 2016 PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID AGE RANGE APPROPRIATE PUBLISHED TEST TEST NAME FOR TEST ADMINISTRATION TARGET AREAS/PURPOSE ACRONY ADMINISTRA- TIME * M TION Adult ADD Symptom Checklist (by Adult Estimate 20 mins 78-item self-report measure to assist in the diagnosis of Amen) adult ADHD. Adult Manifest Anxiety Scale AMAS 18 -- 59 10 mins Self-report inventory: adult anxiety assessment Adult Suicide Ideation ASIQ 18 & up 10 mins Self-report inventory: adolescent suicidality assessment Questionnaire Aggregate Neurobehavioral ANSER Child Estimate 20 mins Set of questionnaires designed to collect background Student Health & Educational per questionnaire information from parents, teachers, students helpful to the Review evaluation of learning and behavior problems Alcohol Use Inventory AUI 16 & up 35 -- 60 mins Identify patterns of behavior, attitudes, symptoms associated with abuse of alcohol Alloway Working Memory AWMA-2 5 – 79 Screener: 5-10 Measure of working memory. Assessment – 2 mins; Short Form: 10-15 mins; Long Form: 30 mins Ammons Quick Test Adults Estimate 10-20 Brief IQ test and picture vocabulary test mins Anger Disorders Scale ADS 18 & up Short form: 10 mins Anger assessment over 5 domains, 18 sub-scales Long form: 20 mins Animal Naming Test Child Not listed (compare Test of verbal abilities and deficits; downward extension to 15-20 mins for of the Boston Naming Test Boston Naming Test) Anxiety Disorders Interview ADIS-IV Adult version; Not listed; Estimate Structured diagnostic assessment interview to assess Schedule – IV child version 20-40 mins anxiety disorders and differential diagnosis per DSM-IV; adult and child versions Published Administration Time refers to the time required to administer the measure as listed by the test publisher, with this time having been estimated for cases where no formal published administration time is available. OptumHealth/OHBS-CA Psych Testing Guideline criteria specify that authorization is to be based on the total published administration times for the measures able to be authorized by OptumHealth/ OHBS-CA, and will typically not exceed 150% of published test administration time. Final Version: 4 January, 2016 PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING STANDARDIZED TIME GRID AGE RANGE APPROPRIATE PUBLISHED TEST TEST NAME FOR TEST ADMINISTRATION TARGET AREAS/PURPOSE ACRONY ADMINISTRA- TIME * M TION Aphasia Screening Tests (e.g., Ages range from Times
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