NEPSY is a series of neuropsychological tests authored by Marit Korkman, Ursula Kirk and Sally Kemp, that are used in various combinations to assess neuropsychological development in children ages 3–16 years in six functional domains. NEPSY was designed to assess both basic and complex aspects of cognition critical to children’s ability to learn and be productive, in and outside of, school settings. It is designed to test cognitive functions not typically covered by general ability or achievement batteries. The original NEPSY was published in 1998 by Pearson Assessment, and was superseded by the NEPSY-II in 2007.
History
Pediatric neuropsychological assessments evolved from knowledge and experience from the assessment of adults with brain damage. Consequently, early tests were not specifically designed with children in mind and were often normed on small samples of children. The development of the NEPSY was revolutionary as it was specifically designed for the purpose of testing children. The NEPSY is grounded in developmental and neuropsychological theory and practice. The diagnostic approach originated in the Lurian approach to assessment. The original NEPSY test battery was published in Finnish in 1980. It was not until 1998 that the English version was published. When first published in English, the age range for testing was 3 to 12 years old. The original version of the NEPSY consisted of five theoretically derived domains: Attention and Executive Functioning, Language, Memory and Learning, Sensorimotor, and Visuospacial Processing. These domains were made up of a total of 25 subtests that would either provide an individual score or be part of the overall domain score. The NEPSY-II was published in 2007. One of the first changes of note was the increased age range, allowing for testing of children and adolescents from 3 to 16 years 11 months of age. The NEPSY-II test battery also added a new domain, Social Perception, and eleven new subtests, and removed four of the old subtests. The test battery thus consists of six domains comprising 32 subtests. The NEPSY-II also exists in two forms: one for ages 3 through 4 and one for ages 5 through 16. The creators also removed the option for domain scoring, a choice which is still hotly debated today. The largest change is the elimination of a core battery; instead, the authors suggest eight different referral batteries depending on the child's presentation. The subtests are no longer aggregated into overall domain scores like the previous version or the WISC, but rather each subtest produces a score including process scores, contrast scores and additional cumulative percentages for behavioural observations.
Test format
The six functional domains below are made up of 32 subtests and four delayed tasks. These domains are theoretically, not statistically, derived. The subtests were designed to assess cognitive abilities related to disorders that are typically diagnosed in childhood and that are required for success in an academic environment.
Attention and Executive Functions – inhibition, self-regulation, monitoring, vigilance, selective and sustained attention, maintenance of response set, planning, flexibility in thinking and figural fluency. Subtests: Animal Sorting, Auditory Attention, Response Set, Clocks, Design Fluency, Inhibition & Statue.
Language and Communication – phonological processing, receptive language, expressive naming, verbal fluency and rhythmic oral motor sequences. Subtests: Body Part Naming and Identification, Comprehension of Instructions, Oromotor Sequences, Phonological Processing, Repetition of Nonsense Words, Speeded Naming & Word Generation.
Sensorimotor Functions – tactile sensory input, fine motor speed, imitative hand functions, rhythmic and sequential movements and visuomotor precision. Subtests: Fingertip Tapping, Imitating Hand Positions, Manual Motor Sequences & Visuomotor Precision.
Visuospatial Functions – the ability to judge position and directionality, copying of 2-dimensional and the reconstruction of 3-dimensional designs. Subtests: Arrows, Block Construction, Design Copying, Geometric Puzzles, Picture Puzzles & Route Finding.
Learning and Memory – memory for words, sentences and faces, immediate and delayed list learning, memory for names and narrative memory under free- and cued-recall conditions. Subtests: List Memory, Memory for Designs, Memory for Faces, Memory for Names, Narrative Memory, Sentence Repetition & Word List Interference.
Social Perception – the ability to recognize emotions, to guess what another person is thinking and feeling, empathy. Subtests: Affect Recognition & Theory of Mind.
These tests supposedly help detect any underlying deficiencies that may impede a child's learning. Each NEPSY-II test is freestanding, though the results of all of the tests of the original NEPSY could be normed together to provide an overall standardized score for each of the domains. The overall score for each domain was dropped in NEPSY-II, because the diagnostic information is strongest at the subtest level and discrepancies can be washed out in computing a global score. This was especially true if the examiner reported only global scores. A comprehensive neuropsychological evaluation can be completed using the full assessment but there is no required set of subtests that must be administered to every child. NEPSY can provide a brief evaluation across all six domains and in-depth assessment based on referral problems/questions or diagnostic concerns. NEPSY allows for selective assessment enabling the selection of certain subtests based on clinical need which helps reduce testing time.
Psychometric properties
Up-to-date psychometric norms are based on the standardization of over 1,000 children tested throughout the United States, which enables the comparison of a child's performance to others in the appropriate age group. Several special group studies are included in the NEPSY-II. These groups consisted of 260 children with a variety of conditions including: ADHD, reading disorders, language disorder, autistic disorder, Asperger’s disorder, traumatic brain disorder, mathematics disorder, emotionally disturbed, mild intellectual disability. The children in these groups met the DSM-IV diagnostic criteria for that particular disorder. Validity Studies were carried out with NEPSY, WISC-IV, DAS—II, WNV, WIAT—III, CMS, DKEFS, BBCS:3R, DSMD, ABAS—II, Brown ADD Scales and CCC-2.
Translations
NEPSY has been translated or adapted into a number of languages including: Dutch/Flemish, Finnish, French, Norwegian, Portuguese, Romanian, Swedish and Italian.
