test of premorbid functioning raw score conversion

doi: 10.1002/trc2.12348. Healthy adult controls (n=52) were recruited through local advertisements and selected to match participants with TBI on demographic variables of age, sex, ethnicity, and education. In practice, the clinician considers evidence from multiple sources when estimating the degree of cognitive impairment (if any), but to avoid bias and constrain subjectivity, it is crucial to employ evidence-based assessment approaches in this process (e.g., Youngstrom, Choukas-Bradley, Calhoun, & Jensen-Doss, Citation2015). Benefits. Clinicians are encouraged to administer the entire WAIS-IV, or at minimum the VCI subtests, for a more accurate measure of intelligence in those with above average intelligence and history of TBI. Test of Premorbid Functioning. Further analysis of the distribution of predicted IQ scores revealed that 25% of participants with msevTBI fell greater than 1.5 SDs below the normative mean 1 month after injury, in comparison with only 4.7% of those with mTBI and 0% of healthy controls. Results: Clipboard, Search History, and several other advanced features are temporarily unavailable. Reale-Caldwell A, Osborn KE, Soble JR, Kamper JE, Rum R, Schoenberg MR. Appl Neuropsychol Adult. In the present study, we examine the accuracy with which the NART and WTAR predict intelligence on the most recent revision of the Wechsler Adult Intelligence Scale (WAIS-IV), using a large sample of neurologically healthy participants (n=92). Linear correlation between National Adult Reading Test/Wechsler Test of Adult Reading (NART/WTAR) errors and Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) full-scale IQ (FSIQ). All participants completed the WTAR and a battery of neuropsychological measures at each visit. Comparison of methods for estimating pre . https://doi.org/10.1080/09602011.2018.1445650, https://doi.org/10.1037/0022-006X.52.5.885, http://doi.org/10.1080/09602011.2016.1231121, https://doi.org/10.1017/S1355617702860131, https://doi.org/10.1080/13854049708407050, https://doi.org/10.1017/S0033291701003634, https://doi.org/10.1016/0191-8869(90)90028-P, https://doi.org/10.1016/0191-8869(89)90043-3, https://doi.org/10.1016/S0887-6177(01)00136-6, https://doi.org/10.1080/00050060600827599, https://doi.org/10.1016/S0887-6177(02)00135-X, https://doi.org/10.1016/S0887-6177(97)00051-6, https://doi.org/10.1080/13854049708407043, https://doi.org/10.1080/09602011.2012.747968, https://doi.org/10.1037/1040-3590.8.4.404, https://doi.org/10.1016/j.cbpra.2013.12.005. (, Mathias, J. L., Bowden, S. C., Bigler, E. D., & Rosenfeld, J. V. (, McGurn, B., Starr, J. M., Topfer, J. The ToPF/demographic predicted FSIQ accounted for a significant proportion of variability in actual FSIQ, above and beyond that accounted for by education or time since injury. 2022 Sep 22;8(1):e12348. 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. Phone: +1 (800) 627-7271 Demographic and clinical characteristics of study participants. You can find STAAR raw score conversion tables listed below. Four separate indices were introduced with WAIS-IV, replacing the verbal and performance subscales included in previous versions of the test battery: Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing speed (PSI). By definition, psychometric intelligence predicts performance across all cognitive domains, but in practice such generalised inferences are likely to be problematic in many cases. Overall, the level of unexplained variance in performance across hold and no-hold tests in our neurologically healthy sample cautions against the viability of using this method for accurately predicting premorbid ability in cognitively impaired patients. These results indicate that for patients with msevTBI, word-reading tests may not be a reliable measure of premorbid intelligence during the immediate recovery period and possibly longer. Windsor: NFER-Nelson.) Moreover, the msevTBI group had a significant improvement in WTAR performance over the 1-year period. People also read lists articles that other readers of this article have read. (, Orme, D. R., Johnstone, B., Hanks, R., & Novack, T. (, Triebel, K. L., Martin, R. C., Novack, T. A., Dreer, L., Turner, C., Pritchard, P. R., et al. Definition of mild traumatic brain injury, Is performance on the Wechsler test of adult reading affected by traumatic brain injury, Pronunciation of irregular words is preserved in dementia, validating pre-morbid IQ estimation, The WRAT-3 reading subtest as a measure of premorbid intelligence among persons with brain injury, Cognitive sequelae of traumatic brain injury, How robust is performance on the National Adult Reading Test following traumatic brain injury, Fluid and crystallized intelligence: Effects of diffuse brain damage on the WAIS, A compendium of neuropsychological tests: administration, norms, and commentary, Treatment consent capacity in patients with traumatic brain injury across a range of injury severity, WAIS-III Wechsler Adult Intelligence Scale. Participant demographics and WAIS-IV performance are shown in Table 1. Joseph AC, Lippa SM, McNally SM, Garcia KM, Leary JB, Dsurney J, Chan L. Appl Neuropsychol Adult. Effective for predicting intellectual and memory performance. Their group reported stable performance on the WTAR despite consistent improvement on other cognitive measures known to be sensitive to the effects of head injury. Knowledge of intelligence is essential for interpreting cognitive performance following traumatic brain injury (TBI). All participants were recruited and tested between 2013 and 2016, in a UK university setting. HHS Vulnerability Disclosure, Help Clipboard, Search History, and several other advanced features are temporarily unavailable. government site. WebThe TOPF[6] involves reading up to 70 irregular English words. Figure 1 provides an indication of comparative popularity of NART, WTAR and TOPF in research year-by-year. In this cross-sectional study, post-9/11 veterans (N = 233, 84.12% male) completed the TOPF, the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), and performance validity measures. Ninety-two neurologically healthy adult participants were assessed on the full Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV; Wechsler, D. (2008). Moreover, the msevTBI group's performance improved from baseline (M=23.4; SD=13.20) to 12 months post-injury (M=26.88; SD=12.05), t(39)=2.19, p<.05, d=.35. All patients were administered the RBANS-Update and the Advanced Clinical SolutionsTest of Premorbid Functioning (TOPF) according to standardized instructions. Development of methods for estimation of premorbid functioning in cognitive domains other than IQ may also be beneficial in supporting clinical judgement by providing more direct comparison against presenting symptoms (whether memory loss, deterioration in conceptual knowledge, executive dysfunction, or other reported deficits). Chronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium. However, the weight of evidence is not consistent with this view. (Citation2003) provide evidence that the Oklahoma Premorbid Intelligence Estimate (OPIE; Scott, Krull, Williamson, Adams, & Iverson, Citation1997), based on combined hold WAIS subtest and demographic information, produces estimates in cognitively impaired patients which may be closer to their current than premorbid IQ (i.e., the method underestimates patient deficit). (, Delis, D., Kramer, J., Kaplan, E., & Ober, B. In contrast, those participants with mTBI did not significantly differ from healthy controls and both the mTBI and control groups demonstrated stability on the WTAR over time. Categories based on occupational status and education, for example, are arguably too coarse to provide an accurate premorbid IQ for a specific individual. Several approaches have been devised to estimate premorbid cognitive ability in neurological patients. Bookshelf These analyses were followed with Dunnett's comparisons using healthy controls as the reference group. National Adult Reading Test (NART). Epub 2019 Nov 13. NART, National Adult Reading Test; WTAR, Wechsler Test of Adult Reading; WAIS-IV Wechsler Adult Intelligence Scale Fourth Edition. Causes of TBI for the patient sample included: 65% motor vehicle collision (n=54), 13% falls (n=17), 2% assaults (n=3), and 11% other (n=9). The https:// ensures that you are connecting to the Predictor equations, such as the Crawford and Allan (1997) equation, integrate demographic information such as age, race, years of education, and occupational status into a regression formula in order to predict an individual's IQ and may provide better estimates for those on the severe spectrum of head injury. 2021 Sep-Oct;28(5):564-572. doi: 10.1080/23279095.2019.1664547. Register to receive personalised research and resources by email. PMC Mean performance across the subtests was generally similar, with only four significant differences, following Bonferroni correction for multiple comparisons. The current study sought to determine whether the Wechsler Test of Adult Reading (WTAR) provides a stable estimate of premorbid intellectual ability in acutely injured patients recovering from traumatic brain injury (TBI). San Antonio, TX: Pearson Assessment.) doi: 10.1093/arclin/acaa025. The two variable equations are as follows: NART: estimated FSIQ=141.126 (1.26 NART error) (.236 age)WTAR: estimated FSIQ=111.553 (1.087 WTAR error)+(2.976 education)NART+WTAR: estimated FSIQ=136.839 (.720 (NART+WTAR error)) (.212 age). The significance level for all analyses was p<.05. Clinicians should therefore consider alternative measures to assess premorbid functioning in this TBI subpopulation. (Citation2002) provided evidence that the use of the NART is justified in patients with frontal lobe damage, Korsakoff syndrome, and mild or moderate stages of Alzheimers disease, and that this test outperforms demographic-derived estimates, with no additional benefit to be gained from a combination of the two methods. Participants self-declared that they had no history of neurological or psychiatric disorder. [1] Additionally, scores on the VCI and PRI subtests contribute to a General Ability Index (GAI), typically employed in cases in which disproportionate working memory and/or processing speed difficulties complicate the interpretation of FSIQ (Wechsler, Citation2008). It was hypothesized that performance on these measures would improve over time whereas the WTAR remained stable. FOIA Future studies should aim to identify methods optimally adapted to specific conditions, so that, to the greatest extent possible, like is compared with like. Consistent with these findings were the large correlations between test performance and age, indicating that both the NART and WTAR tap crystallised knowledge (which typically improves across our sample age range) rather than fluid ability (which typically peaks in early adulthood and subsequently declines; Cattell, Citation1971). 5 Howick Place | London | SW1P 1WG. WebTest of Premorbid Functioning (TOPF)-Raw Score : FITBIR : Federal Interagency Traumatic Brain Injury Research Informatics System Start of main content Unique Data Element: Test of Premorbid Functioning (TOPF)-Raw Score General Details Basic Attributes Classifications Keywords and Labels Specific Details Change History 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. The benefit of including the sum of NART and WTAR errors on estimation accuracy was negligible. (1991). Note: p values not corrected for multiple comparisons. The published NART/NART-R manual provides estimates of WAIS or WAIS-R performance, and the WTAR presents WAIS-III estimates, all of which are now obsolete. Scatterplots showing linear correlations relating number of the National Adult Reading Test (NART) and Wechsler Test of Adult Reading (WTAR) errors to (A) General Ability Index (GAI); (B) Verbal Comprehension (VCI); (C) Perceptual Reasoning (PRI); and (D) Working Memory (WMI). It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. 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). Before Ideal for clinicians wishing to develop appropriate treatment plans. Definition: The raw score that the subject earned, as part of the Test of Premorbid Functioning. This was the case for equations incorporating NART, WTAR, and the sum of these test scores (Table 5). Although the NART and WTAR are among the most popular instruments for estimating premorbid WAIS IQ, only the former has been standardised against the most recent (fourth revision) of the WAIS battery (Bright et al., Citation2016). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Potential differences in demographic characteristics between control and TBI groups were analyzed using one-way analysis of variance (ANOVA; age, years of education) or Pearson's chi-square tests (gender, race). Please visit our International Contacts Page to find where you can order from. Riley and Simmonds (2003) administered the NART to individuals with severe head injury while they were within the first year of recovery and again after a year. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. To evaluate impact of neurological injury on cognitive performance it is typically necessary to derive a baseline (or premorbid) estimate of a patients general cognitive ability prior to the onset of impairment. This approval level enables you to buy all our assessments. UK: Pearson Corporation] for ACS/TOPF. The Psychological Corporation, San Antonio] and [Wechsler (Citation2011). The TOPF Actual and Predicted scores were related to FSIQ. These potential problems can be avoided by eschewing estimates based on current test performance, i.e., by using demographic data only, but demographic-based approaches raise other concerns. These include best performance (Lezak, Citation1995), hold/no-hold (Wechsler, Citation1958), demographics (e.g., Barona, Reynolds, & Chastain, Citation1984; Crawford & Allan, Citation1997), reading ability (e.g., Nelson, Citation1982; Nelson & Willison, Citation1991; Wechsler, Citation2001), and combinations thereof (e.g., Crawford, Nelson, Blackmore, Cochrane, & Allan, Citation1990; Vanderploeg, Schinka, & Axelrod, Citation1996). Nevertheless, we question the ambition of the tools developed to date and encourage the development of novel approaches to improving premorbid estimates. In addition, paired sample t-tests were used to assess for within-group effect of time for each group. Orme and colleagues (2004) compared WRAT Reading subtest performance in individuals with mild, moderate, and severe TBI during the acute rehabilitation hospitalization and again 1 year later. 2020 Jan;34(1):43-52. doi: 10.1037/neu0000569. 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). One such word pronunciation task is the Wechsler Test of Adult Reading (WTAR; Wechsler, 2001). Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. Premorbid, or pre-injury functioning is the estimate of an individuals' level of functioning prior to injury/disease onset, and provides a baseline against which their current performance is compared. Specifically, they found that the estimated IQs of 42% of their participants improved by five or more points, providing evidence that the NART may underestimate IQ in patients with severe TBI still within the first year of recovery. All TOPF scores were significantly correlated with WAIS-IV FSIQ scores (range r = 0.56-.73). This study aimed to compare 3 common measures and assess their accuracy: the Test of Premorbid Functioning (TOPF), Oklahoma Premorbid Intelligence Estimate (OPIE-3), and what is commonly referred to as the Barona equation. We discuss and encourage the development of new methods for improving premorbid estimates of cognitive abilities in neurological patients. Significant mixed ANOVA interactions were followed with univariate ANOVA at both baseline and 12 months to test between-group effects. We use cookies to improve your website experience. Earn money by contributing to product development, Booklets, record forms, answer sheets, report usages & subscriptions, Manuals, stimulus books, replacement items & other materials, Includes Manual (Print), 25 Report forms (Print) with pre-paid Q-global score reports (Digital), TOPF laminated Word List card (Print). Participants with mTBI did not significantly differ from healthy controls at any time during the 1-year period, and both the mTBI and control groups demonstrated stability on the WTAR over time. As expected, comparison of groups over time on TMT and CVLT-II Trials 15 revealed that both mTBI and msevTBI had lower baseline performance than controls. Participants were initially assessed at 36 months post-injury and again 6 months later. They may also identify redundant test items that possess little, if any, predictive power. Results Individuals with a prior mTBI were included if their previous injury occurred at least 1 year before enrollment. . Kirton JW, Soble JR, Marceaux JC, Messerly J, Bain KM, Webber TA, Fullen C, Alverson WA, McCoy KJM. Can be given in addition to WAIS-IV / WMS-IV assessment to provide an estimate of change in abilities. Webpremorbid: [ pre-morbid ] occurring before the development of disease. The .gov means its official. government site. Such scaling techniques may provide the basis for dramatic and highly significant increases in predictive power in our data, for example, we observed a 46% increase in the variance shared between rescaled NART values and WAIS-IV FSIQ. 2021 Sep-Oct;28(5):564-572. doi: 10.1080/23279095.2019.1664547. WAIS-IV, Wechsler Adult Intelligence Scale Fourth Edition. 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. For example, both the NART and the WTAR use equal weightings for each of the 50-test items comprising each test. Please note that the item can still be purchased. In contrast, participants with msevTBI performed significantly worse than controls on the WTAR both at baseline (p<.001, d=.99) and at 12 months post-injury (p<.01; d=.75), with a 11.25 and 8.15 raw point mean difference, respectively. The https:// ensures that you are connecting to the Can be used in forensic evaluations to evaluate suspected loss of cognitive functioning. Top mental health tools all in one place. Published by Oxford University Press. Despite the considerable limitations associated with all currently available methods, even the most experienced clinician would be constraining his or her ability to deliver optimal clinical management of a presenting neurological patient if estimation of premorbid ability was not attempted. However, given that all three groups had similar demographic profiles and that those with msevTBI experienced improvement over time, there is no reason to suspect that the msevTBI group was less intelligent than other groups prior to injury. 8600 Rockville Pike Would you like email updates of new search results? WebThe most common methods of premorbid function estimation include demographic based approaches (e.g., Barona, Reynolds, & Chastin, 1984), best current performance (e.g., Lezak et al., 2004), reading ability (Willshire, Kinsella, & Prior, 1991), achievement measures (e.g., Baade & Schoenberg, 2004), or a combination of these approaches to create 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). FOIA Unauthorized use of these marks is strictly prohibited. Performance across the WAIS-IV measures also differed significantly [F(3, 272.59Footnote1)=3.12, p=.026], although pairwise comparisons revealed that only one effect remained significant following Bonferroni correction, with FSIQ higher than PSI (p=.043). WebThe Test of Premorbid Functioning (TOPF) (Delis, Kaplan, & Kramer, 2009) was administered to assess individuals premorbid verbal intelligence. Anecdotally, and in clinical practice, two tests are commonly selected to provide a comparator against hold performance (Block Design and Digit Span). Extensive training in the administration and scoring of all tests was provided to three research assistants over several days by the lead author, and the testing sessions were closely monitored and supervised to ensure full compliance with the standardised administration and scoring procedures. Data were retrospectively analyzed on persons with TBI (n=83) who were enrolled from the University of Alabama at Birmingham (UAB) hospital system between 2007 and 2011 as part of a larger NIH-funded longitudinal study investigating medical decision making in TBI (Triebel et al., 2012). This is a clinically significant issue as estimates of premorbid intellectual functioning are often compared with current neuropsychological performance to determine the amount of discrepancy between observed and expected scores. Comparison of models of premorbid IQ estimation using the TOPF, OPIE-3, and Barona equation, with corrections for the Flynn effect. A., Pattie, A., Whiteman, M. C., Lemmon, H. A., et al. Correlation coefficients, although significant, were relatively small, even though statistical power (1 - ) in all cases exceeded .8 (two-tailed). National Adult Reading Test (NART): For the assessment of premorbid intelligence in patients with dementia: Test manual. The raw score can be transformed to an age-adjusted standard score, which is used to predict IQ (M=100; SD=15). For permissions, please e-mail: journals.permissions@oup.com. 1R01HD053074]. WebThe Test of Premorbid Functioning (TOPF) is a revised and updated version of the Wechsler Test of Adult Reading clinicians to estimate an individual's level of intellectual National Adult Reading Test (NART). Despite the modest disparity among the subtest and index means, marked within-subject variability in performance was found. National Library of Medicine Purpose. The control, mTBI, and msevTBI groups did not differ with regard to age, education, or race. Estimating premorbid intelligence in persons with traumatic brain injury: an examination of the Test of Premorbid Functioning. Unauthorized use of these marks is strictly prohibited. Results indicated a main effect of group, F(2, 132)=10.23, p<.001, partial eta2=.134, but not of time, F(1, 132)=1.49, p=.23, partial eta2=.011, on raw WTAR score. Figure 1. They concluded that the WRAT Reading subtest underestimates premorbid functioning in those with more severe head injuries during the acute recovery period. In the WAIS batteries, Vocabulary, Matrix Reasoning, Information and Picture Completion subtests are those least likely to be affected by brain damage (e.g., Donders, Tulsky, & Zhu, Citation2001; Wechsler, Citation1997), and are therefore considered to be embedded hold tests, against which those subtests more sensitive to damage (the no-hold tests) can be compared. An official website of the United States government. measure of premorbid intelligence. Includes scoring and reporting digital-only when used separately from WMS-IV. Windsor: NFER-Nelson. Wechsler Test of Adult Reading: WTAR. sharing sensitive information, make sure youre on a federal In addition to the WTAR, all participants were administered a standardized battery of neuropsychological tests. Accessibility Best performance and embedded hold/no-hold methods are also problematic. WebWechsler Test of Adult Reading. With large samples, however, reliable stimulus-specific coefficients can be computed in which the predictive value of each stimulus is individually weighted. A proposed method to estimate premorbid intelligence utilizing group achievement measures from school records. Table 2 presents linear correlations between hold and no-hold tests, along with combined measures. 2021 Sep-Oct;28(5):535-543. doi: 10.1080/23279095.2019.1661247. Data were collected from all participants in one session. Published by Oxford University Press 2020. Registered in England & Wales No. By closing this message, you are consenting to our use of cookies. All rights reserved. Best performance approaches to estimating premorbid ability are based upon the assumption that the tests in which patients accrue the highest score are likely to reflect relatively intact function, and therefore provide a baseline ability level against which current functioning can be compared. Scaled scores were higher for Information in comparison with Digit Span (p=.046), Coding (p=.041) and Similarities (p<.01), and for Block Design in comparison to Similarities (p=.038). Bold values indicate significant single predictor models and stepwise multivariate models in which the fit is significantly improved. Accurate prediction of premorbid functioning is important in neuropsychological assessment. Bold values indicate significance at p < .05. The site is secure. WebMCCB scores were presented in four 2-year age cohorts as T-scores for each test and cognitive domain, and analyzed for effects of age and sex. Alzheimers Dement (N Y). The Test of Premorbid Functioning enables clinicians to estimate an individuals level of cognitive and memory functioning before the onset of injury or illness. Given the limited and mixed findings of previous studies, additional studies are critical to determine the utility of word-reading tasks as hold tests in an acutely injured TBI population. No differences were observed among the index scores (p>.05 in all cases). WebTest of Premorbid Functioning estimates an individual's pre-morbid cognitive and memory functioning. Controls were excluded if they had been diagnosed with psychiatric disorders (except mild depression), substance abuse, or neurologic diseases. The raw score (total number correct) can be converted into two estimates of premorbid IQ. No potential conflict of interest was reported by the author(s). Table 1 presents demographic variables for all participants and injury severity data for participants with TBI. Would you like email updates of new search results? For full access to this pdf, sign in to an existing account, or purchase an annual subscription. By comparing estimated pre-injury intelligence to measures of current cognitive functioning, clinicians can approximate the level of decline that a patient has experienced. The authors thank the following contributors: Sandra Caldwell, MA (UAB Department of Physical Medicine and Rehabilitation, data collection); UAB Neuropsychology Laboratory Staff (data collection); Pat R. Pritchard, MD (UAB Department of Surgery, referring study participants), and Sarah Nafziger, MD (UAB Department of Emergency Medicine, referring study participants). Results: Multiple correlations between demographic variables and individual Learn about a patient referred for neuropsychological testing when a neurological evaluation and brain imaging were inconclusive. However, Mathias, Bowden, Bigler, and Rosenfeld (2007) found contradictory results in their longitudinal study of patients with mild, moderate, and severe TBI and demographically matched orthopedic injury controls. Table 4 provides correlations of these test scores with WAIS-IV FSIQ, constituent indices and core subtest scaled scores. Use of the TOPF as was designed is recommended. To determine the viability of using a straightforward best performance approach to estimating premorbid IQ, we assessed variability in performance across WAIS-IV subtests and indices in our neurologically healthy sample. The authors report no conflicts of interest. The WTAR (Wechsler, 2001)comprises 50 words with irregular pronunciations that participants read aloud. ToPF and WAIS-IV scores did not differ by injury severity.

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