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Halstead-Reitan Neuropsychological Test Battery for Adults (HRNTB)

Published: Neuropsychology Press ( Tucson , Arizona )

Age Range : Ages 15 and over

Administration Time: roughly 6 hours

Background

Ward Halstead (1908-1968) received his Ph.D. from Northwestern University and taught at the Medical School at the University of Chicago . During the 1930s and 1940s, he worked in conjuction with neurologists and neurosurgeons there to evaluate patients from a neuropsychological persepctive. He devised and tested a great many tasks with patients on the wards there. Many of these evaluative approaches he discarded while settling upon a set of tests which eventually formed the nucleus of the Halstead-Reitan Neuropsychological Test Battery (HRNTB). Ralph Reitan began working with Halstead in his laboratory in the 1940s, gained his Ph.D. in 1950, and established a neuropsychology laboratory at the Indiana University Medical Center in 1951. There Reitan extended the work of Halstead in assembling a battery of tests for the comprehensive evaluation of brain-damaged individuals.

Coordinate Versions

Reitan-Indiana Neuropsychological Test Battery for Children (ages 5-8)
Halstead Neuropsychological Test Battery for Children (ages 9-14)

Summary Scores: Impairment Index = Proportion of seven test scores (CT, TPT-T, TPT-M, TPT-L, SSPT, RT, FTT) in impaired range.

Components:

Tests Contributing to the Impairment Index

Description

Category Test (CT)

Test subject is visually presented with seven sets of slides and must press one of four levers in response to each slide. Subject had previously been informed that there was some single principle which underlies each set of slides. It is up to the testee to figure out what that principle is.

This test is related to abstraction and reasoning abilities, particularly concept formation.

Tactual Performance Test (TPT)

The TPT employs a version of the Seguin-Goddard Form Board, a flat wooden puzzle board into which differently-shaped blocks can be placed. Without using vision the subject must place the blocks in the board board using the dominant, non-dominant, and both hands. The time to complete each of these tasks serves as a score and their sum gives the TPT-Total Time (TPT-T) score. Afterward, the sbuject is asked to recall the shape and location of the blocks. These yield TPT-Memory (TPT-M) and TPT-Localization (TPT-L) scores.

This test provides a variety of measures, particularly manual dexterity, spatial memory, tactile discrimination. Note that Lezak (1995, p. 493) argues that this test's administration procedures are particularly discomforting and distressing to individuals with brain injuries or among the elderly. She argues that it should only be given under special circumstances.

Seashore Rhythm Test (RT)

Derived from a subtest in the Seashore Measures of Musical Talent, the Rhythm Test requires subjects to discriminate between 30 pairs of rhythmic beats as either different or the same. Classified as a measure of non-verbal auditory discrimination, the RT is particularly sensitive to the subject's ability to attend and concentrate, skills frequently impaired in individuals with brain damage. The test's name is derived from that of Carl Emil Seashore (1866-1949) who published the first edition of his Measures of Musical Talent in 1939.

Speech-sounds Perception Test (SSPT)

A set of 60 "paralogs" (nonsense words based on the vowel sound 'ee') are played by a tape recorder. The subject must choose which sound is heard on each paralog from four printed alternatives.

This test is a measure of attention, verbal auditory discrimination, and auditory-visual integration. Lesions of the left temporal lobe are particularly likely to cause poor performance on this procedure.

Finger Tapping Test (FTT)
Also called Finger Oscillation Test (FOT)

Subjects are given multiple 10-second trials on a manual tapping device using the index finger of the dominant and non-dominant hand. The test is a measure of motor speed and manual dexerity.

 

Additional Tests

Description

Trail Making (TM)

The Trail Making test has two forms, Trails A and Trails B.

For Trails-A, subjects must connect 25 numbered circles in numeric order. The circles are distributed in a random fashion across a page. The test measures a variety of functions including motor speed, visual scanning, and visual-motor integration.

For Trails-B, subjects must perform a task similar to Trails-A, but the circles contain either numbers or letters. The subjects must connect the circles in alternating order between numbers and letters, that is, 1-A-2-B, etc. In addition to motor speed, viscual scanning, and visual-motor integration, this test requires attention and cognitive flexibility.

Reitan-Indiana Aphasia Screening Test

This is a diverse collection of 32 items which require the testee to demonstrate abilities such as naming, reading, writing, spelling, arithmetic, identifying body parts, identifying and copying shapes.

 Reitan-Klove Sensory Perceptual Examination

Similar to many neurological approaches to sensory-perceptual evaluation, this exam employs both unilateral and bilateral simultaneous stimulation across tactile, visual, and auditory channels; finger localication upon tactile stimulation, finger-tip number writing, and the tactile recognition of shapes.

Strength of Grip Test (SOGT)

The SOGT employs a standard hand dynamometer to measure the strength of both dominant and non-dominant hands

Lateral Dominance Examination

Right vs. left peferences are measured for tasks involving hands, arms, legs, feet, and eyes.

Notes

The HRNTB also regularly employs

Wechsler Adult Intelligence Scale (WAIS)
Minnesota Multiphasic Personality Inventory (MMPI)

Reitan pioneered a four-fold approach to inferential decisionmaking using the HRNTB. These include

Level of Performance: Comparison of individual with normative groups of impaired and non-impaired persons
Pattern of Performance: Examination of intra-test performance and subtest scores
Specific Behavioral Deficits (Pathognomonic Signs): Sensitivity to deviant or deficient performance which, of itself, points to impairment
Comparison of Two Sides to the Body (Right-Left Comparisons): Looking for discrepancies in test performance which may reveal weakness or lateralized impairment

References

Boll, T. J. (1981). The Halstead-Reitan neuropsychological battery. In S. B. Filskov, & T. J. Boll (Eds.), Handbook of clinical neuropsychology (pp. 577-607). New York : Wiley-Interscience.

Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New York : Oxford University Press.

Reflections on Ward Halstead, Ph.D.: An interview with Ralph M. Reitan, Ph.D. (1996, Summer/Fall) Newsletter 40 (Division of Clinical Neuropsychology), 14(2), 1-2, 12-13. [pdf version; Google html version]

Reitan, R. M. (1994). Ward Halstead's contributions to neuropsychology and the Halstead-Reitan Neuropsychological Test Battery. Journal of Clinical Psychology, 50(1), 47-70.

Reitan, R. M., & Wolfson, D. (1993). The Halstead-Reitan neuropsychological test battery: Theory and clinical interpretation (2nd ed.). South Tucson , AZ : Neuropsychology Press.

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