CENTRAL UNIVERSITY OF ECUADOR

MEDICINE CAREER
SIXTH SEMESTER
PSYCHIATRY

Halstead-Reitan Battery

Definition

The Halstead-Reitan battery is a fixed set of eight neuropsychological tests.

used to evaluate the brain and the functioning of the nervous system in people
over 15 years old. Children's versions are the battery of neuropsychological tests
Halstead for Older Children (ages nine to 14) and the Reitan Indiana battery
neuropsychological tests (ages five to eight)

Purpose

Neuropsychological functioning refers to the capacity of the nervous system and the
brain to process and interpret the information received through the senses. The
Halstead-Reitan evaluates a wide range of functions of the nervous system and of
brain, including: visual, auditory and tactile input, verbal communication,
spatial and sequential perception, the ability to analyze information, form
mental concepts, and make judgments, and the output of the engine; and attention, the
concentration and memory.

The Halstead-Reitan is usually used to assess individuals with brain damage.

suspicion. The battery also provides useful information regarding the cause of
damage (for example, closed head injury, alcohol abuse, disorder of
Alzheimer's, stroke), which part of the brain is damaged, if the damage occurred
during childhood development, and if the damage is getting worse, it remains the same,
or increasingly better. The information about the severity of the deterioration and the areas of

personal strengths can be used to develop rehabilitation plans or

careful.

Description

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HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

Ward, Halstead Reitan, and Ralph are the developers of the Halstead battery.
Reitan. Based on studies of patients with neurological problems from the
University of Chicago, Halstead recognized the need for an evaluation of
functioning of the brain that was more extensive than the tests of
intelligence. He began to experiment with psychological tests that can help to
identify the types and severity of brain damage through observation of the
behavior of a person in the various tasks that involve skills
neuropsychological. Initially, he chose a set of ten essays; all but three
they are found in the Halstead-Reitan battery stream.

Ralph Reitan, one of the Halstead students, contributed to the battery through the
investigation of skill tests to identify neurological problems. In
a remarkable study, Reitan diagnosed 8,000 patients using only his test on
the results, without respecting the patients or knowing anything about their backgrounds. This
provided strong support for battery efficiency. Reitan adapted the battery
original through the inclusion of additional tests.

The Halstead-Reitan has been researched more than any other test battery
neuropsychological. Research continues to support its ability to detect the
deterioration of precision in a wide range of neuropsychological functions. The eight
Basic tests are described below, followed by a list of the tests.
used in combination with the base battery.

Category test

A total of 208 images consisting of geometric shapes are presented.

in each image, people are asked to decide if they remember the number 1, 2, 3, or
4. A key corresponding to their choice number is pressed. If they choose
Correctly, a bell rings. If they choose incorrectly, the buzzer.
It sounds. The images are presented in seven subtests.

ALCIVAR ZAMBRANO BLANCA ISABEL

HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

The key to this test is that a principle or a common characteristic underlies in

each subtest. The numbers 1, 2, 3, and 4 represent the possible principles. If the
Individuals are capable of recognizing the correct principle in an image, they will respond.
correctly the images that remain in that subtest. The next subtest
they can have the same or different underlying principle, and individuals more than trying
to determine that principle with the advice of the bell and the buzzer. The
The last subtest contains two fundamental principles. The test lasts
approximately an hour to complete, but people with brain damage
severe can take up to two hours.

The test category test is considered more effective than the battery for detection
brain damage, but it does not help to determine where the problem occurs.
brain. The test evaluates the ability to abstract, or the ability to extract
specific conclusions from general information. Related skills are
the solution to complex and unique problems, and learn from experience. Versions of
The children consist of 80 items and five subtests for young children, and 168
articles and 6 subtests for older children.

Scoring involves recording the number of errors. Calculations based on the use of the values.
of traditional cut (cut-off scores are the scores that indicate the limit between
normal and altered functioning), scores above 41 are considered
indicative of brain deterioration for ages 15 to 45. For ages 46 or older
However, scores above 46 indicate deterioration. Reitan has suggested a limit of
50 or 51 errors. Recommended cut-off points also vary according to age and level.
educational.

Tactile Test

A board in the shape that contains ten cut-out shapes, and ten wooden blocks.
that match those forms are placed in front of an individual they blindfolded the
eyes. The individuals are then instructions to use only their dominant hand to
BLANCA ISABEL ALCIVAR ZAMBRANO
HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE PROGRAM
SIXTH SEMESTER
PSYCHIATRY

place the blocks in their corresponding place on the shape board. The same
the procedure was repeated using only the non-dominant hand, and then with both
hands. Finally, the plate and form blocks are removed, followed by the bandage. From
memory, the person is asked to draw the board of shapes and the shapes in their
suitable places. The exam takes between 15 to 50 minutes to complete. There is a limit
a time of 15 minutes for each rehearsal, or each segment of performance.

Other names for this test are the Form Board Test and the shape board of
Seguin-Goddard. Sensory capacity, shape memory, and location are evaluated.
spatial, the motor functions and the brain's ability to transfer information
between the two hemispheres. In addition to the simple detection of brain damage, this test
it also helps to determine on which side of the brain injury there may be
Occurred. For children under 15 years old, only six forms are used.

Scoring involves recording the time taken to complete each of the three trials with the
blindfolded and the total time for all combined trials (result all the
time), the number of ways to remember (memory score), and the number of the
shapes drawn in their correct positions (punctuation location). In general, the
practice for the non-dominant hand should be 20 to 30 percent faster than the
test for the dominant hand, due to the advantage of practice. If the hand does not
dominant is slower than the dominant hand or faster more than 30 percent of
the dominant hand, brain damage is possible. However, some people who do not
they have brain damage do not show this type of typical improvement. The injuries of the
arms, shoulders, or hands can also affect performance.
Scores should be adjusted depending on the level of education and can vary.
depending on the age.

Trail Making Test

This test consists of two parts. Part A is a page with 25 numbered circles.
randomly arranged. The individuals are instructed to draw lines between
ALCIVAR ZAMBRANO BLANCA ISABEL
HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

the circles in ascending sequential order until reaching the circle labeled "End". The
Part B is a page with circles labeled A to L and 13 numbered circles.
mixed and arranged at random. The individuals are instructed to connect the
circles with drawing lines alternating between numbers and letters in sequential order,
until they reach the labeled circle 'End'. If people make mistakes, the mistakes
they are quickly brought to your attention, and will continue from the last circle
Correct. The test takes about five to 10 minutes to complete.

This essay was originally known as Pathways Partingon, or the test of

divided attention, which was part of the Individual Army test battery. The
test evaluates the speed of information processing, the ability to
visual exploration, the integration of visual and motor functions, recognition of
letters and numbers and the sequence, and the ability to maintain two trains of
thought. The essay can be administered orally if an individual is incapable
to write. The Trails color test, designed for children and people of different
cultures, use colors instead of numbers and letters.

The score is simply the time it takes to complete each part. The errors,
naturally, increase the total time. Some have argued that the time
necessary to alert individuals of errors may vary depending on the
person who administers the test. For adults, scores above 40
seconds for Part A and 91 seconds for Part B have traditionally indicated
cerebral deterioration. Current research does not recommend the use of such cuts
traditional, preferring ranges depending on age, education, and gender. By
For example, a study reported that for ages 15 to 19, the average time for
complete Part A. It took 25.7 seconds and the time to complete Part B was
49.8 seconds For ages 80 to 85, however, the average time for
the time to complete Part B was
152.2 seconds. This demonstrates the importance of considering other variables when scoring.

Finger Tapping test

ALCIVAR ZAMBRANO BLANCA ISABEL
HCAM - PSYCHIATRY
Central University of Ecuador
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

The individuals place their dominant hand palm down, the fingers
extended, with the index finger resting on a lever that is connected to a
counting device. Individuals are instructed to use their index finger.
as fast as possible for ten seconds, keeping the hand and arm
motionless. This test is repeated five to 10 times, until the examiner has collected the
counts for five consecutive trials that are within the five taps of one
to the other. Before starting the test, individuals are given a session of
practice. They are also given brief breaks of 10 seconds between each test, and of
one to two minutes breaks after every third trial. This procedure
complete repeats with the non-dominant hand. The test lasts approximately ten
minutes.

This test is also known as the Finger Tapping Test. The version of
The children use an electronic collector instead of a manual one, which was difficult.
for the children to operate. The test measures motor speed and helps determine
particular areas of the brain that may be damaged. Noting involves the use of the
five essays accepted to calculate an average number of taps per essay for
each hand. In general, the dominant hand should perform ten percent better than
the non-dominant hand. However, this is not always the case, especially in
left-handed individuals. Men and young people tend to perform better than the
women and older people. The interpretation must also consider the level of
education, intelligence,fatigueofgeneral clumsiness or lack of coordination,
depression and injuries to the shoulders, arms or hands. This test should only be
to be interpreted in conjunction with other tests in the battery.

Test rhythm

Thirty pairs of engravings, non-verbal sounds are presented. For each pair, the
people decide if the two sounds are the same or different, marking 'S' or 'D'
respectively, on their answer sheets. The pairs are grouped into three
subtests. This test is also known as the Seashore Rhythm Test, and it
ALCIVAR ZAMBRANO BLANCA ISABEL
HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

based on the Seashore musical skill tests. Auditory attention and the evaluation are assessed.
concentration, and the ability to discriminate between non-verbal sounds. The exam
helps detect brain damage, but not the location of the damage. Appropriate audience and
Visual skills are necessary to take this test. The score is based on
the number of correct items, with higher scores indicate less damage or
good recovery. Scores should be interpreted along with information from
other tests. Some researchers consider this test unreliable and
simple. The children's version does not include this test.

Speech Sounds Perception Test

Sixty recorded meaningless syllables that contain the sound 'i' (for example, 'meer' and
"Weem") are presented. After each syllable, people who underline,
set of four written syllables, the spelling that represents the syllable that
They listened. This test evaluates auditory attention, concentration, and ability.
to discriminate between verbal sounds. Information is provided about areas
specific brain damage, and it can also indicate attention deficit or loss of
the audition. Scoring and interpretation are similar to those used for the test of
Rhythm. The children's version contains fewer syllable options.

Reitan-Indiana Aphasia Screening Test

Aphasia is the loss of the ability to understand or use spoken language.

written, due to brain damage or deterioration. In this test, people are
they present with a variety of questions and tasks that would be easy for a person without
disability. Examples of evidence elements include verbally naming
photos, write the name of an image without saying the name aloud, reading of
increasing length printed material, repeating the words expressed by the
examiner, simple arithmetic problems, drawing shapes without lifting the pencil, and
placing one hand on an area on the opposite side of the body.

ALCIVAR ZAMBRANO BLANCA ISABEL

HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

This test is a modification of the Halstead-Wepman screening test.

aphasia. The language is evaluated regarding difficulties, right confusion/
left and non-verbal tasks. A typical scoring procedure is not used.
because it is a screening test, the purpose of which is to detect possible signs
the aphasia that may require a new evaluation. Subtle deficits of the language may
not to be detected.

Reitan-sensory-perceptual Klove exam

This test detects if individuals are unable to perceive stimulation in a

side of the body when both parts are stimulated simultaneously. It has tactile,
auditory, visual and components that involve the ability to (a) specify whether the
movement of touch, sound, or is being produced visible on the right, on the left,
or on both sides of the body; (b) retrieve assigned numbers to particular fingers
The examiner assigns numbers by touching each finger, indicating the number of eyes of the
closed person), (c) identify the numbers "written" on the tips of the fingers
while the eyes close, and (d) determine the shape of a block of wood
placed in one hand by pointing to its shape on a plate-shaped object with the hand
opposite.

Complementary tests

In addition to the basic tests, the examiners may choose to apply others.
tests based on the difficulties that a person is experiencing. The tests
commonly used in combination with the Halstead-Reitan battery include the test of
the grip strength, the Grooved Pegboard Test, the Reitan-Klove Dominance Test
lateral, the Wechsler Memory Scale, the California verbal learning test, the
Buschke Selective Remembering Test, the Rey Auditory Verbal Memory Test,
Test of the Rey Complex Figure, the memory and learning test, the Test
of Broad Scope Utilization, the Multifaceted Personality Inventory of

ALCIVAR ZAMBRANO BLANCA ISABEL

HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICAL DEGREE
SIXTH SEMESTER
PSYCHIATRY

Minnesota and the Wechsler Adult Intelligence Scale

for Children.

Results

Interpretation of the Halstead-Reitan involves the analysis of several factors:

The overall performance of the battery. The Halstead Deterioration Index (HII) and the
General Neuropsychological Deficit Scale (GNDS) is used to obtain a
global score. The HII is calculated by counting the total number of tests in the
deterioration range, and dividing that number by the total tests
, which results in a decimal number between zero and one (0.0 to
normal functioning
deterioration; 0.8-1.0: severe deterioration). The GNDS is calculated by the assignment
from a value between zero and four to 42 variables contained in the tests, and then
adding the values (0-25: Normal functioning; 26-40: Mild deterioration, 41-
67: Moderate insufficiency, 68+: severe deterioration.
The performance in the individual tests. Each test must be interpreted in
relationship with other tests in the battery. Significantly poor performance
in a test it may be due to several factors. However, if a pattern of
low performance occurs in three or more tests, or if they occur
significant discrepancies in two or more tests, deterioration is likely.
Indications of lateralization and localization. This refers to the particular region
of the damaged brain. Performance in motor and sensory tasks
provide the necessary keys.

With the above information, a psychologist can diagnose the type of illness.
present, predict the course of the disability (it stays the same, it is improving or
worsening) and make recommendations on treatment, care and
rehabilitation.

ALCIVAR ZAMBRANO BLANCA ISABEL

HCAM - PSYCHIATRY
CENTRAL UNIVERSITY OF ECUADOR
MEDICINE DEGREE
SIXTH SEMESTER
PSYCHIATRY

Broshek, Donna K. Barth and Jeffrey T. Halstead-Reitan test battery

neuropsychological.
The interpretation of tests and integration, edited by Gary Groth-Marnat. New York:
John Wiley and Sons, 2000.

Evans, Jovier D., Walden S. Miller, Desiree A. Byrd, and Robert K. Heaton. "Cross-cultural
applications of Halstead-Reitan batteries. In Cross-Cultural Manual
Neuropsychology: Critical Issues in Neuropsychology, edited by Elaine Fletcher-Janzen,
Tony L. Stickland, et al. New York: Kluwer Academic / Plenum Publishers, 2000.

Horton, Arthur MacNeill, ed. "The Halstead-Reitan battery of neuropsychological tests:"

problems and perspectives". In the Manual of Neuropsychology. New York: Springer
Publishing Company, 1997.

Spreen, Otfried, Strauss and Esther. A compendium of neuropsychological tests.

Administration, rules, and Commentary 2nd ed. New York: Oxford University Press, 1998.

Vanderploeg, Rodney D., ed. Guide for Clinicians for the Evaluation
neuropsychological Mahwah, New Jersey: Lawrence Erlbaum Associates, 2000.

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HCAM - PSYCHIATRY