by Robert A. Stern, PhD and Travis White, PhD
The NAB Provides an Efficient, Comprehensive Assessment of Attention, Language, Memory, Spatial Processing, and Executive Functions in Less Than 4 Hours...
The NAB is a comprehensive, integrated, modular battery of 33 new neuropsychological tests developed to assess a wide array of neuropsychological skills and functions in adults (ages 18-97 years) who have known or suspected disorders of the central nervous system. The individual tests are grouped into six modules: Attention, Language, Memory, Spatial, Executive Functions, and Screening (which allows the clinician to determine which of the other five domain-specific modules are appropriate to administer to an individual patient).
The NAB has excellent psychometric properties, includes extensive normative and validation data, provides clinical information that meets the needs of a broad range of modern referral sources, and offers two equivalent forms that reduce practice effects and facilitate reevaluation. The examiner can administer the entire NAB for a comprehensive evaluation of neuropsychological functioning in less than 4 hours.
The NAB was created and developed over a 7-year period and was funded, in part, through grants from the National Institute of Mental Health. Decisions pertaining to the content and format of the NAB were guided by the results of the publisher's national survey of neuropsychological assessment practices and needs, as well as by the feedback and guidance of members of the NAB Advisory Council (a group of experts recognised nationally in the field of clinical neuropsychology) and numerous other consultants and contributors.
NAB Advisory Council
- Cynthia R. Cimino, PhD, University of South Florida
- Robert K. Heaton, PhD, University of California at San Diego School of Medicine
- Nancy Helm-Estabrooks, SciD, Boston University School of Medicine (Language/Aphasia Consultant)
- Glenn J. Larrabee, PhD, Independent Practice in Clinical Neuropsychology, Sarasota, FL
- Wilfred G. van Gorp, PhD, Columbia University School of Medicine
- Kathleen A. Welsh-Bohmer, PhD, Duke University Medical Center
- David J. Williamson, PhD, Ortho-McNeil Pharmaceutical
A Closer Look at the NAB...
- The NAB offers the combined strengths of both flexible battery and fixed battery approaches to neuropsychological test selection and assessment.
- The separate Screening Module saves time and facilitates a more focused examination.
- All NAB tests were standardised on the same sample of more than 1,400 healthy adults.
- The NAB provides both demographically corrected and U.S. Census-matched norms.
- Two parallel, equivalent forms for each of the 33 NAB tests allow for reevaluation with reduced practice effects.
- The NAB has excellent psychometric properties.
- Each NAB Module includes a Daily Living test that is multifactorial in nature and relates to real-world, everyday living tasks. The NAB provides both quantitative summary scores and standardised measures of qualitative features.
- The NAB is simple to learn and easy to administer. A DVD training programme in administration and scoring is included with every NAB Kit--at no additional cost!
NAB Modules Provide the Flexibility Needed to Help You Meet the Time Constraints and the Different Areas of Clinical Focus Required for Each Individual
- The NAB Screening Module helps to generate initial hypotheses regarding differential diagnosis and treatment recommendations and provides an estimate of the examinee's functioning in a particular domain when more in-depth examination is either not warranted or not possible. It takes 45 minutes to administer.
- The NAB Attention Module provides a marker of an individual's attentional capacity, working memory, psychomotor speed, selective attention, divided attention, and information processing speed. Examination of an individual's performance on the NAB Attention Module will provide clinically useful information for patients with traumatic brain injury; disorders involving the subcortical, frontostriatal systems, and/or brainstem (e.g., Parkinson's disease, Huntington's disease, HIV-associated cognitive-motor disorders, multiple sclerosis); anxiety disorders; and adult residual attention-deficit/hyperactivity disorder. It takes 45 minutes to administer.
- The NAB Language Module provides a marker of the severity of aphasia and related disorders of language production, comprehension, and word-finding. Examination of an individual's performance on the NAB Language Module will provide clinically useful information for patients with expressive/Broca's/nonfluent aphasia, receptive/Wernicke's/fluent aphasia, or anomia. It takes 35 minutes to administer.
- The NAB Spatial Module provides a marker of the examinee's visuo perceptual skills, attention to visual detail, visuoconstruction, right-left orientation, topographical orientation, and visual scanning. Examination of an individual's performance on the NAB Spatial Module will provide clinically useful information for patients with a lesion in the right hemispheric parietal lobe, frontal systems involvement, and/or occipital lobe involvement. It takes 45 minutes to administer.
- The NAB Memory Module provides a marker of an individual's verbal explicit learning, visual explicit learning, verbal delayed free recall, visual delayed recognition memory, and verbal explicit learning and recognition of information likely to be encountered in day-to-day living. Examination of an individual's performance on the NAB Memory Module will provide clinically useful information for patients with Alzheimer's disease, frontotemporal dementia, strokes or aneurysms involving the anterior communicating artery, hypoxia/anoxia, Korsakoff's syndrome, traumatic brain injury, neurotoxic exposure, electroconvulsive therapy, major depression, mesial temporal sclerosis, herpes encephalitis, and other lesions (e.g., vascular, degenerative, epileptic, neoplastic, traumatic, metabolic, surgical) involving mesial temporal lobe structures. It takes 45 minutes to administer.
- The NAB Executive Functions Module provides a marker of planning, engaging with others effectively, problem solving, successfully interacting with the environment to get one's needs met, judgment, conceptualisation, cognitive response set, mental flexibility, verbal fluency, and generativity. Examination of an individual's performance on theNAB Executive Functions Module will provide clinically useful information for patients with traumatic brain injury, stroke, tumor, hypoxia/anoxia, degenerative disease (e.g., Parkinson's disease, Pick's disease, frontotemporal dementia, Huntington's disease, advanced Alzheimer's disease), attention-deficit/hyperactivity disorder, depression, schizophrenia, obsessive-compulsive disorder, metabolic disorders (e.g., Graves' hyper thyroidism, hypothyroidism), and other lesions (including vascular, degenerative, epileptic, neoplastic, traumatic, metabolic, surgical). It takes 30 minutes to administer.
Depending on which modules are administered, the NAB yields a variety of differenT scores. Each NAB test (with the exception of the Screening and Attention Modules Orientation test and the Language Module Reading Comprehension test) results in one or more primary tesT scores and, in some cases, additional secondary and/or descriptive tesT scores. For the Screening Module, selected primary test T scores are summed to obtain each of the Screening Domain scores (e.g., the two Screening Language tesT scores compose the Screening Language Domain score). The five Screening Domain scores are summed to obtain the Total Screening Index score.
For each main module, a module Index score is calculated from the sum of selected primary T scores from that module; this score summarizes the examinee's performance on that module. The Total NAB Index is based on the sum of the five main module Index scores, representing the examinee's overall performance on the NAB. The Neuropsychological Assessment Battery® Software Portfolio (NAB®-SP) provides unlimited scoring and report generation after hand-entry of an individual's NAB tesT scores.
NAB Reliability and Validity Studies
In addition to the standardisation study of more than 1,400 adults, the NAB has undergone extensive reliability studies, including equivalent form, interrater, 6-month test-retest, and internal consistency.
The two forms of the NAB were found to be highly equivalent in an equivalent-form reliability study (n = 50). Interrater reliability studies conducted on those NAB tests that require more subjective scoring indicated excellent agreement. A 6-month test-retest study (n = 95) resulted in very good temporal stability and provides important practice-effect information. Internal consistency analyses also indicate excellent reliability. The reliability estimates for the NAB Index scores are excellent. For example, the reliability coefficient for the Total NAB Index score is .96.
Extensive validation evidence has been established through both exploratory and confirmatory factor analyses, criterion validity investigations, and several clinical validation studies (including separate studies involving groups of patients with dementia, aphasia, traumatic brain injury, attention-deficit/hyperactivity disorder, multiple sclerosis, and HIV/AIDS). Additional validity studies included a comparison of the NAB with measures of functional independence in an inpatient rehabilitation hospital and an investigation involving a group of simulated malingerers who received the NAB, along with several existing measures of symptom validity.
Using the NAB in Your Practice
As a comprehensive neuropsychological test battery, the NAB is appropriate for outpatient evaluation, forensic examination, large-scale research studies, and many other clinical and research applications. Because of its modular flexibility, its potential for focused and shorter examination times, and the ability to use the Screening Module on its own, the NAB also is appropriate for inpatient bedside consultations, interdisciplinary team evaluations, memory disorder clinic examinations, and focused research investigations, among other purposes.
The NAB allows for both flexible battery and fixed battery approaches to assessment. You can administer the entire NAB, selected modules, or individual NAB tests based on specific needs, examination focus, and referral question(s). Standardised administration and scoring procedures across all tests enhance the consistency and interpretability of tesT scores. The NAB is unique among modern neuropsychological test batteries in that all of the tests in all of the modules have been co-normed on the same individuals.
NAB Software Portfolio (NAB-SP)
The NAB-SP automates many of the steps involved in calculating raw scores as well as obtaining normative scores (e.g., z scores, Tscores, percentiles) and generating profiles, all in a fraction of the time required by hand scoring. It includes built-in, easy-to-use report editing features, and it generates profile graphs with the ability to overlay profiles from prior NAB administrations for a specific client. Reports can be exported to common word processing programmes, and client data can be exported to many spreadsheet and database programmes. The NAB-SP now includes the NAB Main Modules Primary Score Report. Click here to download a patch for your existing NAB-SP to enable it to produce this report.
NAB Training Programme on DVD
The Training Programme on the Administration and Scoring of the NAB Module Kit is designed to facilitate learning the correct administration and scoring procedures for the NAB Module you have purchased. The specific module DVD contains an overview of the module you ordered; it is organised into chapter titles that correspond to the individual tests within the module, thus facilitating easy navigation to information about a specific test. Each chapter includes an overview of the specific test followed by a demonstration of a standard administration. Procedures for recording and scoring responses also are described. A set of completed NAB Record Forms and Response Booklets for the specific module you ordered, corresponding to the actual administration shown in the video clips, is included with the DVD set. In addition, the Screening Module DVD is included as a complimentary bonus because it includes an overview of the entire NAB. Together, these materials facilitate learning the correct administration, recording, and scoring procedures.
Note: If you are purchasing a NAB module kit--with the exception of the Screening Module--we strongly recommend that you also purchase the NAB Administration, Scoring, and Interpretation Manual (Item #WW-5088-TM) and the NAB Demographically Corrected Norms Manual (Item #WW-5091-TM). All kits include the NAB Video Training Program DVD and the NAB-SP.