Adaptation of a neurobehavioral test battery for Thai children

Exposure to neurotoxicants is a world wide problem with significant health implications for child development. In spite of higher neurotoxicant exposures, many developing countries do not have established neuropsychological instruments. This study evaluated the adaptation and reliability of a computer and examiner administered Behavioral Assessment and Research System (BARS) that includes tests of motor speed and dexterity, attention, memory, and visuospatial coordination for use in Thailand. To assess test-retest and alternate form reliability, BARS was administered to 24 healthy, 6-8 year old urban Thai children during two testing sessions two weeks apart. A comparison group of 29 healthy, rural Thai children of similar age and sex completed the BARS as part of another study and comprised a comparison group. Test-retest reliabilities for tests without alternate forms ranged from 0.41 to 0.77, but reliabilities were lower for tests with alternate forms (0.11 to 0.83). Paired t-tests revealed few significant differences in group performance between test administrations. Performance of urban Thai participants was compared to 29 rural Thai participants of similar age and sex. Parental education was significantly greater for urban vs. rural participants, resulting in significant differences in performance on tests of motor speed. This study supports the use of BARS for epidemiologic studies of neurotoxicants in Thailand, but highlights the sensitivity of these tests to differences in parental education and the need for improved alternate test forms.