Results indicate that word-reading tests may underestimate premorbid intelligence during the immediate recovery period for patients with msevTBI. Typically, Vocabulary and Information are employed as hold tests because they are considered disproportionately resistant to neurological and psychological impairment (e.g., Groth-Marnat & Wright, Citation2016; Lezak et al., Citation2012). Two of these measures were chosen for analyses as they assess areas of cognition known to be sensitive to the effects of head injury (Rabinowitz & Levin, 2014): Trail Making Test (TMT), Part A and B (Reitan & Wolfson, 1993), and the California Verbal Learning Test-II (CVLT-II) Trials 15 Total (Delis, Kramer, Kaplan, & Ober, 2000). Mean performance across the subtests was generally similar, with only four significant differences, following Bonferroni correction for multiple comparisons. Future studies including a higher number of severity groups will help to elucidate at what point on the TBI severity spectrum reading ability tests begin underestimating premorbid intelligence. Premorbid intellect is either from Wechsler Test of Adult Reading or Test of Premorbid Functioning. The Test of Premorbid Functioning (TOPF; Pearson, Citation2009; Wechsler, Citation2011), proposed as a replacement for the WTAR, has been standardised against WAIS-IV, but has not been widely adopted to date (at least for research purposes). Premorbid intelligence has commonly been estimated using hold tests, which are neuropsychological measures that are relatively unaffected by most forms of neuropathological change, therefore able to hold an individual's level of functioning (Russell, 1980). The Wechsler Test of Adult Reading (WTAR) is a neuropsychological assessment tool used to provide a measure of premorbid intelligence, the degree of Intellectual function prior to the onset of illness or disease. The authors report no conflicts of interest. In this study, we compare the precision of a range of approaches for estimating WAIS-IV full-scale IQ (FSIQ) and constituent indices and offer new combined methods that clinicians and researchers may wish to consider adopting in their work. Additionally, WTAR-estimated intelligence was similar to that predicted by the Crawford and Allan (1997) demographic equation. The ToPF frequently underestimated post-injury intelligence and is therefore not accurately measuring premorbid intelligence in our sample, particularly in those with above average to superior intelligence. Number of academic publications in which NART-R (solid line), WTAR (dashed line) and Advanced Clinical Solutions/Test of Premorbid Functioning (ACS/TOPF) (dotted line) neuropsychological tests were cited for each year from 2011 to October 2017. . Purpose. Although this mean change did not meet criteria for a clinically significant difference in testretest scores according to the Wechsler (2001) manual (>10.8 point difference), it should be noted that 23% individuals with msevTBI did meet this cutoff. The benefit of including the sum of NART and WTAR errors on estimation accuracy was negligible. Similarly, a comparison of participants mean lowest subtest scaled score (7.85) against their highest subtest scaled score (14.77) revealed a mean difference of 6.92 scaled points. Anecdotally, and in clinical practice, two tests are commonly selected to provide a comparator against hold performance (Block Design and Digit Span). sharing sensitive information, make sure youre on a federal Arch Clin Neuropsychol. To request a reprint or commercial or derivative permissions for this article, please click on the relevant link below. of premorbid Statistically, the tests provided equally precise predictions of WAIS-IV performance, with the strongest effects observed for FSIQ, GAI and VCI. NFER-Nelson] for NART-R; [Wechsler (Citation2001). Occupation information unavailable for 14 participants; education data lists maximum qualification obtained (or in progress). While those with mTBI performed approximately 1 SD below the controls on all measures at baseline, those with msevTBI had severely impaired performance at least 2.5 SDs below the mean of healthy controls. Although the relative utility and accuracy of these tests for many neurological conditions is unknown, Bright et al. MeSH The WAIS-IV supplementary tests were administered to all participants at the end of the session but will not be reported here. The FSIQ range was 80 to 150, with an arithmetic mean of 108.52 and standard deviation of 12.71. Clinicians and researchers have at their disposal a range of methods for the estimation of premorbid cognitive ability, and their choice of method will be informed by the characteristics of the presenting patient and their own expertise and experience. Bold values indicate significant single predictor models and stepwise multivariate models in which the fit is significantly improved. Entering Test of Premorbid Functioning Scores Our findings suggest that tests of word reading/vocabulary knowledge provide the most reliable and precise estimates of WAIS-IV performance, and previous work indicates that their utility for predicting premorbid IQ holds in a range of neurological conditions (Bright et al., Citation2002). Advanced Clinical Solutions for WAIS

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