Psychometric Equivalence of the Computerized and Original Halstead Category Test Using a Matched Archival Sample

Objective: Investigate the equivalence of several psychometric measures between the traditional Halstead Category Test (HCT–Original Version [OV]) and the computer-based Halstead Category Test (HCT–Computerized Version [CV]). Method: Data were from a diagnostically heterogeneous, archival sample of 211 adults administered either the HCT by computer ( n = 105) or cabinet ( n = 106) as part of a neuropsychological evaluation. Groups were matched on gender, race, education, Full Scale Intelligence Quotient, and Global Neuropsychological Deficit Score. Confirmatory factor analysis was used to examine structural equivalence. Score, variability, and reliability equivalency were also examined. Differential item and test functioning under a Rasch model were examined. Results: An identified factor structure from research of the HCT-OV fit the HCT-CV scores adequately: χ2(4) = 8.83, p = .07; root mean square error of approximation = 0.10 [0.00, 0.20]; standardized root mean residual = 0.03; comparative fit index = 0.99. Total scores and variability of subtest scores were not consistently equivalent between the two administration groups. Reliability estimates were, however, similar and adequate for clinical practice: 0.96 for HCT-OV and 0.97 for HCT-CV. About 17% of items showed possible differential item functioning, though just three of these items were statistically significant. Differential test functioning revealed expected total score differences of <1% between versions. Conclusion: The results of this study suggest that the HCT-CV functions similar to the HCT-OV with there being negligible differences in expected total scores between these versions. The HCT-CV demonstrated good psychometric properties, particularly reliability and construct validity consistent with previous literature. Further study is needed to generalize these findings and to further examine the equivalency of validity evidence between versions.

Normative Data for the Halstead Category Test in a Spanish-Speaking Adult Population Living in the U.S./México Border Region

Objective To provide norms applicable to Spanish-speakers living in the US- Mexico border region for the Halstead Category Test, a test of executive function. Participants and Method Healthy Spanish-speakers (n = 252) were recruited from the US–Mexico border regions (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.3, range 0-20; 58% female). Participants completed the Category Test as part of a larger neuropsychological test battery. Relationships between demographic variables and raw error scores were assessed using Spearman and Wilcoxon Rank-sum tests. Demographically corrected T-scores for the Category Test were normed using fractional polynomial equations accounting for age, education, and sex. For comparison, T-scores were also computed for the Spanish-speaking normative sample using published norms for English-speaking non-Hispanic Whites and African Americans, which were also adjusted for age, education and sex. Impairment rates based on -1SD (T &lt; 40) were calculated using both, published and current, norms. Results Older age was significantly associated with higher number of errors (Spearman ρ = 0.32, p &lt; .001) and higher education was associated with lower number of errors (Spearman ρ = -0.52, p &lt; .001), with no other significant demographic effects. Applying non-Hispanic norms resulted in overestimation of impairment rates in the Spanish-speaking sample (impairment rate: 48% with White norms and 27% with African American norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using African American norms were comparable to those based on the newly developed norms. Conclusions The present study is the first to develop norms for the Category test in a sample of Spanish-speakers in the US-Mexico border region. These norms will provide tools for the assessment of executive function in this population. Research concerning generalizability of norms to other Spanish-speaking populations is needed.

A-15 Examining the Construct Validity of the Halstead Category Test - Computer Version: A Confirmatory Factor Analysis

Objective To examine evidence of construct validity for the Halstead Category Test – Computer Version (HCT-CV). Previous factor analyses on the HCT generally found the following structure: a Counting factor comprised of Subtests I and II; a Spatial Reasoning factor of Subtests III, IV, and VII; and a Proportional Reasoning factor of Subtests V and VI. Method Data were collected from a diagnostically heterogeneous sample of 105 adults (56 males, 49 females) referred for neuropsychological evaluation who completed the HCT-CV. The sample had an average educational attainment of 14.37 years (SD = 2.98 years) and an average age of 62.30 years (SD = 17.53). The total number of errors made on each of the seven HCT subtests were computed for each participant, and these data were used to complete a regularized confirmatory factor analysis based on the identified factor structure of the HCT. Results The confirmatory factor analysis converged normally. The model fitting the HCT factor structure demonstrated excellent overall fit to the HCT-CV data: χ2(11) = 12.20, p = .35; RMSEA = 0.03 (95% CI: 0.00 to 0.11); SRMR = 0.03; CFI = 1.00; TLI = 0.99. Analysis of the residuals and modification indexes further confirmed the excellent model fit. Conclusions The HCT-CV demonstrates what appears to be an unchanged factor structure to the HCT. This finding supports the computerized version construct validity as being seemingly unchanged from that of the slide projector version. This model fit may be viewed as promising for the comparability between the original version and the computerized version.

A-14 An Updated Item Response Analysis of the Halstead Category Test

Objective To identify item parameter estimates for the Halstead Category Test (HCT). Previous item response analyses have been conducted on the HCT but without implementing item response theory methods. Method Data were collected from a diagnostically heterogenous sample of 211 adults (110 males, 101 females) referred for neuropsychological evaluation. The sample had an average educational attainment of 14.18 years (SD = 3.05 years) and an average age of 59.75 years (SD = 18.28). Responses from items on Subtests III-VII were dichotomously coded (0 = incorrect, 1 = correct). A two-parameter, hierarchical, logistic item response model was fit to the data using code in Stan, which uses an adaptive variant of Hamiltonian Monte Carlo. Results The model converged appropriately with posterior estimates of item parameters all demonstrating adequate effective sample sizes (min. = 3485.74) and Rhat (max. = 1.002). The range of posterior difficulty estimates follows: -1.06-2.07 (III), -1.67-1.92 (IV), -3.80-2.62 (V), -2.35-4.38 (VI), and -2.28-1.80 (VII). The range of posterior discrimination estimates follows: 0.20-5.41 (III), 0.35-8.17 (IV), 0.11-4.14 (V), 0.69-5.88 (VI), and 0.53-2.83 (VII). Conclusions The HCT demonstrates a wide range of item difficulties with few items being excessively difficult, though some in this range were identified in Subtest VI. Ranges for item discriminations are also wide with some estimates returning high estimates, which may be related to the smaller sample size for a two-parameter model or may be due to less-than-ideal item functioning. These findings support the longstanding sensitivity of the HCT to a variety of neurological conditions and across the severity spectrum.