Wechsler Test Of Adult Reading
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The Wechsler Test of Adult Reading (WTAR) is a neuropsychological assessment tool used to provide a measure of
premorbid Premorbidity refers to the state of functionality prior to the onset of a disease or illness. It is most often used in relation to psychological function (e.g. premorbid personality or premorbid intelligence), but can also be used in relation to ot ...
intelligence Intelligence has been defined in many ways: the capacity for abstraction, logic, understanding, self-awareness, learning, emotional knowledge, reasoning, planning, creativity, critical thinking, and problem-solving. More generally, it can b ...
, the degree of Intellectual function prior to the onset of illness or disease.Holdnack, H.A. (2001). Wechsler Test of Adult Reading: WTAR. San Antonio. The Psychological Corporation


Test Design

Developed for use with English-speaking patients aged 16 to 89 years, WTAR is a “hold” test, a type of neuropsychological test that relies on abilities thought to be unaffected by cognitive decline associated with neurological damage. In the design of WTAR, the demographic prediction tables were co-normed with the widely used Wechsler Adult Intelligence Scale (WAIS) and
Wechsler Memory Scale The Wechsler Memory Scale (WMS) is a neuropsychological test designed to measure different memory functions in a person. Anyone ages 16 to 90 is eligible to take this test. The current version is the fourth edition (WMS-IV) which was published in ...
(WMS). This gives it an advantage for comparative analyses on predicted and actual general intellectual and memory function over similar reading tests such as the
National Adult Reading Test The National Adult Reading Test (NART) is a widely accepted and commonly used method in clinical settings for estimating premorbid intelligence levels of English-speaking patients with dementia in neuropsychological research and practice. Such te ...
(NART), which do not share normative data sets with the other widely used Wechsler assessments.Spreen, O., & Strauss, E. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary. Oxford University Press, USA. Using vocabulary level as a correlate to IQ, the test relies on reading recognition’s resistance to the cognitive impacts of brain damage to estimate premorbid function. The patient is presented with irregularly spelled words and prompted to pronounce each; the irregular
grapheme In linguistics, a grapheme is the smallest functional unit of a writing system. The word ''grapheme'' is derived and the suffix ''-eme'' by analogy with ''phoneme'' and other names of emic units. The study of graphemes is called ''graphemics' ...
-to-
phoneme In phonology and linguistics, a phoneme () is a unit of sound that can distinguish one word from another in a particular language. For example, in most dialects of English, with the notable exception of the West Midlands and the north-west o ...
translations (such as the “gh” in the word ''tough'') in the prompts make it difficult pronounce without having previously learned the word. Since the patient cannot apply standard pronunciation rules to complete the task, the examiner can assess their vocabulary by their ability to pronounce the irregularly spelled words, and by extension, estimate their premorbid IQ. WTAR was published in 2001 by
Pearson Pearson may refer to: Organizations Education *Lester B. Pearson College, Victoria, British Columbia, Canada *Pearson College (UK), London, owned by Pearson PLC *Lester B. Pearson High School (disambiguation) Companies *Pearson PLC, a UK-based int ...
.


Instructions for administration and scoring

The WTAR is composed of 50 irregularly spelled words and takes approximately 10 minutes to complete. The examiner begins by presenting the first word card and prompting the patient for a single pronunciation of the word. This procedure continues through all 50 word cards and is discontinued if the patient provides 12 consecutive incorrect pronunciations. Lists of acceptable pronunciations and tape recordings are provided by the publisher to account for words with multiple pronunciation variants. Each correct pronunciation is given a score of 1, with 50 as the maximum raw score. The raw score is then standardized by age and compared to the scores predicted for the patient’s demographic classification.


Validity

In standardized samples, WTAR scores were shown to correlate highly with measures of verbal IQ (r = .75), verbal comprehension (r = .74), and full scale IQ (r = .73). Patients recovering from traumatic brain injury (on average measuring in severely impaired ranged on the
Glasgow Coma Scale The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These thre ...
) showed high stability in WTAR scores during their recovery period while performing highly similar to demographic estimates, suggesting the test is a reliable estimate of premorbid intelligence in individuals with TBI. Presented in an inpatient neuropsychologic battery for TBI, WTAR scores have been shown to be significant predictors of 1-year outcome, suggesting score stability over time and predictive validity. WTAR performance also appears to remain stable in patients exerting suboptimal effort. Evaluation of WTAR scores across the degree of sustained TBI (mild, moderate, severe) suggests that the assessment may underestimate premorbid IQ in patients with more severe damage. In patients with
Alzheimer's disease Alzheimer's disease (AD) is a neurodegeneration, neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in short-term me ...
, WTAR scores declined as the degree of cognitive impairment increased in more affected individuals.McFarlane, J, Welch, J, Rodgers, J. (2006). Severity of Alzheimer's disease and effect on premorbid measures of intelligence. British Journal of Clinical Psychology, 45(4) 453-63. Individuals with preexisting
learning disorders Learning disability, learning disorder, or learning difficulty (British English) is a condition in the brain that causes difficulties comprehending or processing information and can be caused by several different factors. Given the "difficult ...
were found to perform poorly relative to those without learning disorders. Reading-disabled individuals scored lower on WTAR than on WAIS test measures; WTAR is not recommended for use with such individuals.


References


Further reading

* * {{Neuropsychology tests Neuropsychological tests