A-238 Psychometric Equivalence of Prorated Boston Naming Test Scores after Noose Item Removal

Abstract Objective The Boston Naming Test (BNT) noose item may offend some examinees. One solution is to omit the item, but the equivalence of prorating the BNT has not been established. This study compared prorated BNT (BNT-P) and standard administration (BNT-S) in physical medicine and rehabilitation patients. Method Participants (N = 480) completed the BNT-S in an outpatient evaluation. The sample was 34% female and 91% white with average age and education of 46 (SD = 15) and 14 (SD = 3) years, respectively. Diagnoses included traumatic brain injury (62%), mixed neurologic conditions (21%), and stroke (17%). Item level data were entered; items below the start or basal point were entered as correct. BNT-P was calculated by summing correct responses excluding item 48 and then using cross multiplication and division to estimate the 60-item score equivalent. BNT-P and BNT-S scores were compared via Spearman and concordance correlation (CC) coefficients; reflected and log transformed data were examined with paired t-tests and Westlake equivalence tests. BNT-P and BNT-S difference and scaled scores were examined descriptively. Results BNT-P (M = 52.7, SD = 7.0, Mdn = 54) and BNT-S (M = 52.6, SD = 7.1, Mdn = 54) raw scores showed very strong associations (rho = .99; CC = .99). Transformed scores were not significantly different (p = .20) and demonstrated equivalence (+/−1.5 points). Score differences (M = 0.01, SD = 0.30; range − 0.5-1) rounded to 0 in 88% of cases. Scaled scores based on prorated raw scores were the same in 96% of cases with a one-point difference observed in 15 cases and a two-point difference in 2 cases. Conclusion Findings support the utility of prorated BNT scores in rehabilitation patients.