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Summary/Overview of Instrument: The test is an adaptation of the Thurstone's Word Fluency Test (Thurstone and Thurstone, 1962) which together with other spoken word fluency tests has been shown to be sensitive to frontal lobe lesions. This test was adapted to control for motor speed for use with patients with upper limb disability with the incorporation of a copy condition. The test has been shown to be independent of physical disability.

 

The participant is required to verbally generate items from a given semantic category. The most frequently used category is animals; however, other categories used include: fruits and vegetables, items of clothing, things found in a supermarket.

 

Construct measured: Generation, executive function, semantic knowledge.

Generic vs. disease specific: Generic.

Intended use of instrument/purpose of tool (cross-sectional, longitudinal, diagnostic, etc): The category fluency task is a measure of fluency in verbal generation of semantic category members. It may be used as a longitudinal marker of disease severity in manifest/premanifest HD or as a cross-sectional measure of cognitive impairment across disease stages or between manifest/premanifest HD and healthy controls.

 

Means of administration (paper and pencil, computerized): Verbal (responses recorded on paper verbatim for later scoring if needed).

 

Location of administration (clinic, home, telephone, etc): Clinic.

Intended respondent (patient, caregiver, etc.): Patient.

# of items: N/A.

# of subscales and names of sub-scales: N/A.

Strengths: The adaptation to control for motor speed was designed for patients with ALS. The test has also been shown to be sensitive to frontal lobe dysfunction in ALS through functional and structural MRI studies.

Weaknesses: Requires further validation of properties and production of normative data. The full test is not suitable for patients with marked writing difficulties.

Feasibility: The test requires that the patient can write. Spoken versions of this test can be employed in patients with severe upper limb dysfunction.

Reliability: Has not been assessed.

Validity: The Written Verbal Fluency Index has been shown to be sensitive to frontal lobe dysfunction in ALS in functional imaging and structural imaging (Abrahams et al. 2004, 2005a. ). The index has also be found to correlate with ocular fixation abnormalities in ALS (Donaghy et al. 2009).

Sensitivity to Change: No change was reported over a 6 month period (Abrahams et al. 2005b).

Relationships to other variables: This measure was shown not to correlate with measures of emotional lability (Palmieri et al. 2009) or measures of disease duration or disability (Abrahams et al. 2000).

 

Language is one of the functions most frequently affected after SAH, with a highly variable prevalence of language impairment ranging from 0 – 76% (Al-Khindi et al., 2010). Most previous studies on language function after SAH have included the verbal fluency test in the battery of tests and assessments. In longitudinal studies, a further advantage of the verbal fluency test is that it is not subject to practice effects. For these reasons, the Swiss national standard of neuropsychological assessment after SAH includes the verbal fluency test (Zweifel-Zehnder et al., 2015; Stienen et al., 2015).