NEPSY | Second Edition

In the Age 5–16 Record Form, the grid on Picture Puzzles Item 8 is missing the far right column, how do I score this item?

On the initial printing of the Record Form, a column was omitted from the right side of the grid on Item 8. There are no correct answers in this column. All correct responses on this item are in the two left-hand columns. Add a column to the right side if you need to record an incorrect response. This was corrected for the second printing of the Record Form.

I am having difficulty getting the cards out of the box. Can I get a bigger box?

The dividers in the box are actually pockets containing each set of cards. To reach the cards for each task, simply pull the divider up and out of the box and the required cards will be lifted with the divider.

I can’t find the audio files I need for Auditory Attention and Response Set.

The audio files are located on the Training CD.

If the Training CD is placed in a CD player, three tracks are available for play: Track 1 is Auditory Attention, Track 2 is Response Set, and Track 3 is Repetition of Nonsense Words.

If the Training CD is placed in a computer drive, the files can be accessed in three ways: (1) play the tracks through a media player; (2) using the file folder selection process, select the folder labeled audio and select the track you need; or (3) access the tracks through links in the Training CD. Select the Index and click on Auditory Attention and Response Set or Repetition of Nonsense Words and then click the link to the audio file.

I just got my NEPSY–II kit and am overwhelmed by the amount of administration I have to learn. What is the best way to learn the NEPSY–II?

Because NEPSY–II includes a large number of subtests, each with unique administration and recording procedures, the easiest way to learn the NEPSY–II is in small chunks. Select and practice subtests from the batteries you will be using most frequently or from the general battery. The training CD has video demonstrations of administration and animation of recording procedures. In addition, trainings are available through your regional Clinical Consultant. We are confident that you will find the clinical utility offered with the NEPSY–II will offset the time needed to master the administration.

Why did you eliminate domain scores?

The domain scores were not included in the current version to make clear that subtests within a domain are multi-factorial, and the domain itself may cover many constructs. For example, The Word Generation task is frequently used as a measure of executive functioning to assess the constructs of cognitive flexibility, sustained effort, and strategic search or long-term memory; however, this task is also a language task. Children with poorly developed language skills may score low on this subtest even though they may have adequate executive functions. The subtests within a domain may measure a component of that domain but may not be comprehensive indicators of all functions within the domain. For example, in the social cognition domain, facial affect recognition measures a very different component of the domain (e.g., understanding nonverbal communication) than does Theory of Mind (e.g., understanding the mental states of others). Both of these subtests are important indicators of the overall construct, but may not be highly correlated with one another due to their focus on specific skills within a larger domain.

How do I determine which subtests to administer?

The NEPSY–II was designed to allow examiners the maximum degree of flexibility in selecting subtests. However, such flexibility requires some forethought before administration to determine subtest selection and administration order. The scoring software contains an assessment planner that helps select subtests based on common referral questions. These groupings of subtests were based on the data collected during standardization, research on various clinical groups, and clinical experience with the previous NEPSY and standardization version of NEPSY–II. These batteries are particularly helpful to new examiners who are learning the NEPSY–II. The batteries are not intended to be rigid, and subtests may be added or removed as needed. Although a general battery is provided, examiners are free to select those subtests that are most relevant for the child being assessed.

Why was the Tower subtest dropped?

Tower was dropped for several reasons. During the revision of NEPSY, efforts were made to increase the assessment of executive functions and several new subtests were developed. The most clinically sensitive, psychometrically sound, and examiner friendly subtests were included in NEPSY–II. In terms of user friendliness, dropping Tower reduced the size of the kit by removing the multiple pieces required to administer that subtest.

You may continue to use the Tower subtest from the NEPSY along with the NEPSY–II. Utilize the norms from the NEPSY. However, keep in mind that over time, the normative data collected for the NEPSY will become outdated.

On Narrative Memory, the NM Free Recall Total Score shows a maximum of half the points available for each age. Is this right?

There are two scores available for recall on the Narrative Memory subtest. The NM Free Recall Total Score is a process score that is the total number of details recalled during the initial recall of the stories, without the cued responses. For this score, the number of details recalled during free recall is summed. Therefore, each detail has a maximum value of 1 point.

For the NM Free & Cued Recall Total Score, the main score for this subtest, the details recalled during both free and cued recall are combined. If the child recalls a detail freely, he or she is awarded 2 points for the detail and no follow-up question is asked. If the child does not recall a detail, a cued question is asked. If, after the cued question, the child recalls the information, 1 point is awarded. No points are awarded if they don't recall it at all. Then the points awarded for each detail across all age-appropriate items are summed.

See page 98 of the Administration Manual for the maximum scores per age.

How do I plan administration order for my battery?

After selecting the subtests you plan to administer, determine if there are any delay times required for memory subtests. If delay times are required, place the immediate memory tasks early in administration to allow for adequate time to pass before administering the delayed tasks. Be careful about which subtests you administer during the time lag to ensure nothing you administer will interfere with the construct being assessed in the memory task. For example, do not administer Word List Interference between List Memory and List Memory Delayed because the words from Word List Interference may interfere with the delayed recall of the words from List Memory. Likewise, Affect Recognition may interfere with the delayed recall of faces in Memory for Faces. When determining subtest order, try to maintain interest and motivation by switching between tasks assessing different domains.

In addition, a suggested administration order for each referral battery.

On Theory of Mind and Geometric Puzzles, scores change from percentile ranks to scaled scores across ages. Why?

Neuropsychological tests are not designed to obtain a normal distribution of scores. They are designed to measure constructs that often are not normally distributed in the general population, particularly across age groups, but that are indicative of specific brain-behavior relationships or of atypical development. In addition, the distribution of scores varies across ages as the majority of children master a skill. The degree to which a distribution is skewed will determine if scaled scores may be generated. Measures that have a slight to moderate degree of skewing may still be converted to a scaled score metric; however, with highly skewed distributions using the scaled score metric is inappropriate. On Theory of Mind, the distribution of children begins to skew heavily toward nearly perfect scores by age 7. Therefore, at age 7 the Theory of Mind Total score switches from a scaled score, to a percentile rank, to better represent the change in the distribution of scores for that age.

The use of digital clocks has greatly increased over the years. If I am testing a child who uses digital clocks, can I give Clocks?

The use of digital clocks has increased; however, children are still taught how to read analog clocks and it is a required task in many school districts in the math curriculum around second grade. The familiarity of clocks in children of various ages is reflected in the norms. While it may be true that performance on clocks is lower now than in previous generations of children (though this has not been studied) the norms behind the Clocks subtest reflects the current ability of children between 7 and 16. If you are testing a child who has never learned analog clocks or has no access to analog clocks, you should not use the Clocks subtest. Choose an alternate subtest to measure the construct of interest.

Why is reliability higher in children with clinical diagnoses than in the normative sample?

Neuropsychological tests are note designed to obtain a normal distribution of scores. They are designed to measure constructs that often are not normally distributed in the general population, particularly across age groups, but that are indicative of specific brain-behavior relationships or indicative of atypical development. This is similar to vision assessment; most people have 20/20 vision so the distribution is skewed with some people having progressively poorer vision. Thus, in the normal population, variability is very low with the majority of cases falling into the normal range. Children with clinical diagnoses have greater variability in scores, thus increasing the reliability. See chapter 1 of the Clinical and Interpretive Manual for more information on the psychometric properties of neuropsychological assessments.

What do I do if the child rotates a design during Memory for Designs or Memory for Designs Delayed?

Count a design as correct, even when the child rotates the card. Do not track the rotation of the cards within the design. It is not an unusual or uncommon behavior for a child to rotate the cards within the grid and is not clinically indicative of an underlying disorder. A separate score was not computed for this behavior as it occurs frequently in normally developing children.

I am not sure what to record for the sorts on Animal Sorting? Is a sort only four cards, or are there 8 cards per sort?

Each sort made by the child consists of eight cards sorted into two groups of four cards each. For recording purposes, only four cards are recorded and used to assess total correct, repeated sorts, and novel sorts. Each sort by the child is recorded on a single line on the record form. To record, after each sort, find the group of four cards containing the zebras card. Turn the cards over and record the number on the back of the cards onto the Record Form (number 1 is written for you on the record form). Then turn the cards back over and place them in front of the child to begin the next sort. Demonstrations of recording and administration are included on the Training CD in the NEPSY–II kit.

Is colorblindness a factor in performance on any subtest?

Individuals who are colorblind were not included in the normative sample. However, only a few subtests require color vision. The following subtests have color sensitive responses and may show lower performance in children with colorblindness: Animal Sorting, Auditory Attention and Response Set, Comprehension of Instructions, Speeded Naming, and Memory for Designs.