Normative Data Collection and Comparison Of

NORMATIVE DATA COLLECTION AND COMPARISON OF PERFORMANCE ON THE POREH NAMING TEST TO THE BOSTON NAMING TEST ORION R. BIESAN Bachelor of Science in Neuroscience/Psychology Baldwin Wallace University December, 2009 Submitted in partial fulfillment of the requirements for the degree MASTER OF ARTS IN PSYCHOLOGY at the CLEVELAND STATE UNIVERSITY August, 2012 This thesis has been approved for the Department of Psychology and the College of Graduate Studies by Thesis Committee Chairperson, Dr. Amir Poreh, Ph.D. Department & Date Committee Member, Dr. Naohide Yamamoto, Ph.D. Department & Date Committee Member, Dr. Steve Slane, Ph.D. Department & Date ACKNOWLEDGEMENT To my family, friends, and the professors who supported me and provided me with guidance through my journey for knowledge, thank you! NORMATIVE DATA COLLECTION AND COMPARISON OF PERFORMANCE ON THE POREH NAMING TEST TO THE BOSTON NAMING TEST ORION R. BIESAN ABSTRACT Although word-finding difficulty is commonly self-reported by older adults, there are no clinical instruments able to reliably distinguish normal age- related effects from pathology in word-finding impairments. The purpose of this study is two-fold: (1) design and evaluate the validity of the Poreh Naming Test, a novel electronic confrontation naming test used to evaluate naming difficulties in demented populations and (2) to investigate the effect of normal aging word- finding abilities on confrontation naming tests, using both accuracy and response latency as performance indices. A community sample was used with each participant being administered the Boston Naming Test, the Poreh Naming Test, semantic verbal fluency and phonemic verbal fluency tasks. Each participant over the age of 65 or younger participants reporting health problems shown to interfere with confrontation naming test performance also received the St. Louis University Mental Status Exam. The 57-item Poreh Naming Test used in this study was analyzed and refined to a 30-item test. Items were defined as easy, medium, or hard based on latency and proportion of the sample that correctly named the item. The Poreh Naming Test was found to be a valid measure of word-finding abilities iv and was shown to better distinguish between mental status exam groups than the Boston Naming Test. However, the findings of this study do not support the hypotheses that normal aging has a negative impact on word-finding skills. Cognitive status was the best predictor for accuracy and latency on the confrontation naming tasks and no effect of age was found on accuracy or latency in either confrontation naming test. v TABLE OF CONTENTS Page ABSTRACT…………………………….……………………….…….........….iv LIST OF TABLES ……….………………………………………….…..…......viii LIST OF FIGURES……………………………………………….…….….....….ix CHAPTER I INTRODUCTION……………………...…….……………...…....…....1 II LITERATURE REVIEW……………………………………...………4 III METHOD………….……………………………………...………….20 IV RESULTS………….………………………………………....…...…28 V DISCUSSION………………………………………………….......…47 REFERENCES………………….…………………………………….............…56 APPENDICES APPENDIX A: Original Poreh Naming Test Items……………......……70 APPENDIX B: The Health and Communication Screening Questionnaire………………………..……………….....71 APPENDIX C: St. Louis University Mental Status Examination…….....72 APPENDIX D: Scoring Rules for the Verbal Fluency Tests……………75 APPENDIX E: Demographic Survey……...….........................................77 APPENDIX F: Second Phase of Test Construction – Item Order for Poreh Naming Tests………………..…..….….78 vi APPENDIX G: Procedure of Administration……………………....…..80 APPENDIX H: Correlation’s Table……………………………..….......83 APPENDIX I: IRB Approval Form…………………………..….……..85 vii LIST OF TABLES Table Page I. Demographic and background information for all subjects.….......…29 II. St. Louis University Mental Status Examination Classifications and Demographics…………………………………………...……....35 III. Frequency of Health Problems in Sample ……………...………......36 viii LIST OF FIGURES Page 1. Mean latency times for Boston Naming Test items………………….39 2. Mean latency times for the Poreh Naming Test items................…....40 3. Proportion of the sample which correctly identified each Boston Naming Test item.………………………………………..….41 4. Proportion of the sample which correctly identified each Poreh Naming Test item……………………………………………..42 5. Latency times for St. Louis University Mental Status Examination derived groups for the Boston Naming Test…………..43 6. Latency times for St. Louis University Mental Status Examination derived groups for the Poreh Naming Test……………44 7. Latency times for refined 30-item Poreh Naming Test……………...45 8. Proportion of the sample which correctly identified each item on the refined 30-item Poreh Naming Test………………………….46 ix CHAPTER 1 INTRODUCTION Although word-finding difficulty is commonly self-reported by older adults, there are no clinical instruments able to reliably distinguish normal age- related effects from pathology in word-finding impairment. Currently, the gold standard for evaluating word-finding abilities is the Boston Naming Test (also known as the BNT), which was developed 40 years ago and has not been improved upon since. Some of the criticisms of the current BNT include (a) some of the items are lower frequency words which results in a clear bias in favor of better educated people with a wider vocabulary (Hawkins & Bender, 2002), (b) the test is indirectly biased towards people of a higher socioeconomic status who can afford better education (Jefferson et al., 2007), (c) the pictures used in the BNT are simple black and white images, which can make recognition of the items more difficult due to ambiguity (Adlington, Laws, & Gale, 2009), and (d) latency is often not precisely measured or reported in the literature (Tsang & Lee, 2003). An examinee has 20 seconds to respond to the item, but this is not recorded and is done with a stopwatch. Time is not recorded because the examinee merely has to 1 finish in the time allowed, and there is no benefit to finishing an item quickly, nor is there any penalty for taking longer. The Poreh Naming Test (referred to as the PNT) was created to address each of these concerns. The PNT is a computerized confrontation naming test where items are presented to participants on a computer screen. The benefits of a computerized version are primarily that administration of the test is more standardized between administrators, and that the software automatically measures latency, responses, and errors. In this study, 27 new items were added based on the methods of Miotto, Lucia, Camargo, and Scaff, (2010) and Tsang and Lee (2003). New items were included that had high word-frequency, perceived high familiarity, cultural relevance, and perceived to have high difficulty independent of word-frequency to make the PNT a test of actual naming abilities, as opposed to a test of vocabulary. The goals of this study were two-fold: to evaluate the validity of the PNT and evaluate the effects of normal aging on word-finding abilities. Community populations were sampled and given a battery containing the BNT, the PNT, a semantic verbal fluency task, and phonemic verbal fluency tasks. Any participant over age 65 or younger participants reporting health problems known to interfere with word-finding abilities were also given a mental status exam to screen for mild neurocognitive impairment disorder-like performance or dementia-like performance. Participants were grouped based on mental status examination score 2 ranges to investigate the validity of the PNT and compare group differences on the battery, particularly differences between BNT and PNT performances. In addition, participants were grouped into three age groups: less than 65 years old, between 65 and 80 years old, and greater than 80 years old. Performances on the battery were compared to investigate the effects of normal aging. 3 CHAPTER II LITERATURE REVIEW Measuring Word-Finding Abilities. Confrontation naming tasks, particularly the Boston Naming Test (BNT), are the most common method to assess word-finding skills in clinical and normative populations (Nicholas, Barth, Obler, Au, & Albert, 1997; Schmitter-Edgecombe, Vesneski, & Jones, 2000; Strauss, Sherman, & Spreen, 2006). The BNT consists of presenting a person with a line-drawing of an object and asking the person to name each object presented. Originally designed for the detection of aphasia in clinical populations, the BNT is a well-researched confrontation naming test used to assess word-finding abilities in normal aging populations and clinical populations with neurodegenerative diseases (Goodglass, Kaplan, & Barresi, 2001; Thompson & Heaton, 1989). The items on the BNT range from high-frequency, high familiarity objects (e.g. harmonica) to those that occur less frequently in word-frequency and are considered less familiar (e.g. trellis). If the subject does not know what the picture is (e.g. a harmonica), the test administrator can give them a stimulus cue 4 (e.g. “it is a musical instrument you play by blowing”) with an additional 20 seconds following the cue (Kaplan, Goodglass, & Weintraub, 1983; Strauss et al., 2006). If the person is still unable to correctly name the object, a phonemic cue is provided (e.g. “it begins with H”) (Kaplan et al., 1983; Strauss et al., 2006). If the participant fails to provide the correct response in an additional 20 second period, the item is marked as incorrect and the test is continued until all items are completed or the participant fails to name six consecutive items (Strauss et

Load more