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Boston Naming Test with Latencies (Bnt-L) BOSTON NAMING TEST WITH LATENCIES (BNT-L) Margaret Anne Budd, MEd, MPH Dissertation Prepared for the Degree of DOCTOR OF PHILOSOPHY UNIVERSITY OF NORTH TEXAS May 2007 APPROVED: Susan F. Franks, Major Professor Richard Herrington, Committee Member James Hall, Committee Member Jose Toledo, Committee Member Linda Marshall, Chair of the Department of Psychology Sandra L. Terrell, Dean of the Robert B. Toulouse School of Graduate Studies Budd, Margaret Anne. Boston Naming Test with Latencies (BNT-L). Doctor of Philosophy (Health Psychology and Behavioral Medicine), May 2007, 168 pp., 15 tables, 9 figures, references, 129 titles. Although most people have experienced word-finding difficulty at one time or another, there are no clinical instruments able to reliably distinguish normal age-related effects from pathology in word-finding impairment. Two experiments were conducted to establish a modified version of the Boston Naming Test (BNT) that includes latency times, the Boston Naming Test of Latencies (BNT-L), in order to improve the instrument's sensitivity to mild to moderate word- finding impairment. Experiment 1: Latency times on the 60-item BNT (Goodglass et al., 2001) for 235 healthy adults’ ages 18-89 years were collected on a representative sample. Qualitative features of the BNT items, statistical analyses, IRT, and demographic considerations of age, gender, education, vocabulary, race and culture, helped create a reduced BNT-L version with 15 of the most discriminating items. Statistically sound and sophisticated normative tables are provided that adjust for unseen covariates. Response latencies did not indicate earlier age-related decline in an optimally healthy sample. Experiment 2: Twenty-three patients referred for neuropsychological testing were administered the BNT-L. Patients referred for evaluation of mild cognitive impairment or possible dementia produced significantly different response BNT- L latencies from the healthy sample whereas patients referred for mild brain injury evaluation did not. Normal word-finding problems were discussed in terms of serial stage models of lexical access, as well as in terms of automatic and controlled cognitive processes in younger and older adults. Statistical process for creating a psychometric instrument using latencies is illustrated. Copyright 2007 by Margaret Anne Budd ii TABLE OF CONTENTS Page LIST OF TABLES.....................................................................................................................viii LIST OF FIGURES .....................................................................................................................ix Chapter 1. INTRODUCTION ................................................................................................ 1 2. WORD-FINDING, ANOMIA & TOT ................................................................. 6 Word Finding and Anomia ....................................................................... 6 TOT........................................................................................................... 7 3. FACTORS AFFECTING NAMING ABILITY ................................................... 9 Individual Varibles.................................................................................... 9 Age.............................................................................................. 10 Gender......................................................................................... 11 Education, IQ and Verbal Ability ........................................................... 11 Age of Acquisition...................................................................... 13 Memory....................................................................................... 14 Health.......................................................................................... 16 Stress........................................................................................... 17 Environmental Variables that may Affect Naming ................................ 17 Exposure Time of Stimulus ........................................................ 17 Priming........................................................................................ 19 Properties of Target Word .......................................................... 20 Summary................................................................................................. 20 4. COGNITIVE MODELS OF NAMING.............................................................. 21 Background............................................................................................. 21 What's in a Name? .................................................................................. 21 Lexical Access ........................................................................................ 24 Other Tasks Involved with Naming........................................................ 26 Processing Models .................................................................................. 27 iii Conclusion .............................................................................................. 29 5. RESPONSE LATENCIES.................................................................................. 30 Properties of Object Names .................................................................... 30 Age of Acquisition...................................................................... 31 Word Length ............................................................................... 32 Name Agreement ........................................................................ 33 Word Frequency.......................................................................... 34 Object Familiarity ....................................................................... 36 Conclusion .............................................................................................. 36 6. LANGUAGE AND AGING............................................................................... 38 Comprehension and Semantic Meaning ................................................. 38 Word Production..................................................................................... 38 Possible Contradictory Findings............................................................. 39 Summary................................................................................................. 40 7. MEASURING WORD FINDING ...................................................................... 41 Picture Naming Tests.............................................................................. 42 Verbal Fluency Tests .............................................................................. 43 Discourse Tests ....................................................................................... 44 Conclusion .............................................................................................. 44 8. BOSTON NAMING TEST (BNT)..................................................................... 48 Caution with BNT Research ................................................................... 48 History of BNT Versions........................................................................ 50 Existing Normative Data......................................................................... 51 Shortened Versions ................................................................................. 52 Conclusion .............................................................................................. 52 9. INDIVIDUAL VARIABLES AND BNT PERFORMANCES.......................... 53 Demographic Factors and BNT .............................................................. 53 Age.............................................................................................. 53 Education and Intelligence...................................................................... 56 Vocabulary.................................................................................. 57 Education vs. Verbal IQ for BNT-L Norm Stratification........... 58 iv Explanation for Mixed Findings on Education and Vocabulary ......................................................................................... 58 Gender......................................................................................... 60 Race and Culture......................................................................... 61 Conclusion .............................................................................................. 62 10. BNT RESEARCH AND FACTORS TO CONSIDER WHEN SELECTING ITEMS FOR BNT-L........................................................................................... 64 BNT Administration and Scoring ........................................................... 64 Item Analysis and Item Selection ........................................................... 64 Alternative Responses................................................................. 64 Name Agreement ........................................................................ 65 Speed-Accuracy Tradeoff ........................................................... 66 Summary..................................................................................... 67 Error Types on BNT with Age................................................................ 68 Conclusion on BNT Research................................................................. 68 11. TEST CONSTRUCTION: BNT LATENCY TEST (BNT-L) ........................... 70 New Normative Data .............................................................................
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