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Margaret L. Stivers, Ph.D.
Clinical Psychologist

Margaret is a clinical and social psychologist trained at the University of Kansas and the University of Miami. She has taught psychology at four major universities and directed mental health, residential, and nonpublic school programs for children and adolescents. Her experience includes 30 years of consultation and collaboration with educational programs throughout the country, including schools in urban and rural areas and on Indian reservation.

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  • Assessing executive functioning with the NEPSY-II

Question:

Hi,

I'm assessing a six-year-old girl that presents ADHD-like behavior. I'm using the NEPSY-II for the first time, I'm wondering what your favorite five most telling NEPSY-II sub-tests are when assessing for ADHD.

Thanks!

Liam Early
Masters Candidate, Class of 2014
MS in Counseling, School Psychology Option
California State University, East Bay


Answer:

Hi Liam,

I enjoyed meeting you when you came to see our program. Thank you for your question.

The following subtests of the NEPSY II are my favorite among those designed specifically to assess attention and other aspects of executive functioning. Several are normed only for students seven years of age and older; three have norms for students starting at five years of age; and one, Statue (holding still), is for ages three to six years.

Subtest

Age Range

Skills Assessed

Animal Sorting (AS)   

7-16

cognitive flexibility (sorting and resorting stimuli by differing criteria)

Auditory Attention (AA)

5-16

auditory vigilance

Response Set (RS)

7-16

adds shifting and inhibition of a previously learned response (AA)

Clocks (CL)

7-16

visual planning and organization

Design Fluency (DF)

5-12

generation of novel designs under both structured and random conditions

Inhibition (IN)  

5-16

inhibition of automatic responses to replace with novel responses; switching response sets

Statue (ST)

3-6

motor control and inhibition

For a six-year-old student, AA, DF, IN, and ST are within the age-range to generate standard scores. However, you can try out-of-age-range subtests to generate observational information. Your observations may be useful. For instance, if you administer AS or RS, you would not report standard scores, but might report a relevant observation, such as “She was observed to demonstrate cognitive flexibility by shifting her response set in response to a change in task instructions (RS) and ability to sort the same stimuli by differing criteria.”

Other subtests on the NEPSY-II can yield valuable information relevant to ADHD/Executive Functioning.

  • For general information on cognitive efficiency, the Speeded Naming subtest (age range 3-16) generates useful information on the student’s ability to rapidly name colors, shapes, size, numbers, and letters. This information is particularly important for students having trouble learning to read.
  • If there is no speech and language assessment, consider administering Comprehension of Instructions to check whether ADHD-like behavior may result from the student feeling “lost’ due to poor language comprehension.
  • List Learning (age range 7-16 years), in the Memory and Learning domain, assesses spontaneous generation of strategies to improve recall of list items over repeated trials. There is also a delayed learning task available to assess retention of items following a Word List Interference subtest, consisting of an alternate word list that can be used for further assessment of mental control.
  • Route Finding (age range 5-12 years), in the visual spatial processing domain, can be used to assess visual-motor planning.

Thanks again for writing. I hope this information is helpful.

Best wishes,
Marji Stivers