Validity of the dynamic Wisconsin Card Sorting Test for assessing learning potential in brain injury rehabilitation.
The dynamic Wisconsin Card Sorting Test (dWCST) examines the effects of brief training on test performance where pre- to post-test change reflects learning potential. The objective was to examine the validity of the dWCST as a measure of learning potential in patients with acquired brain injury (ABI). A total of 104 patients with ABI completed the dWCST at rehabilitation admission. Performance of a subgroup (n=63) was compared to patients (n=28) who completed a repeated administration of the conventional WCST (rWCST). Furthermore, dWCST performance was compared between patients with ABI (n=63) and healthy controls (n=30) matched on gender, age, and education. Three learning potential indices were used: post-test score, gain score, and a group classification (decliners, poor learners, strong learners, high achievers). The median dWCST administration time was 30 min. The dWCST showed no floor or ceiling effects and the post-test and gain score were significantly intercorrelated. The pre-test score showed no significant associations with other neuropsychological tests. The learning potential indices were significantly associated with language and/or memory. In contrast to the dWCST group, the rWCST group showed no significant pre- to post-test improvement. There were significantly more poor learners in the rWCST group. Compared to controls, patients obtained similar gains, but significantly lower pre- and post-test scores for the dWCST. The ratio of poor learners between-groups was not significantly different. The results support the validity of the dWCST for assessing learning potential in patients with ABI. Further research is needed to investigate the predictive validity of the dWCST.
1Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine,University Medical Center Utrecht and De Hoogstraat Rehabilitation,Utrecht,The Netherlands.
Hileen
H
Boosman
1Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine,University Medical Center Utrecht and De Hoogstraat Rehabilitation,Utrecht,The Netherlands.
Johanna M A
JM
Visser-Meily
2School of Applied Psychology and Griffith Health Institute,Griffith University,Australia.
Tamara
T
Ownsworth
3Maastricht University,Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience,Maastricht,the Netherlands.
Ieke
I
Winkens
3Maastricht University,Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience,Maastricht,the Netherlands.
Caroline M
CM
Van Heugten
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001245:Association Learning; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D055815:Young Adult