R M REITAN

University of Texas Southwestern Medical Center, Dallas, Texas, United States

Are you R M REITAN?

Claim your profile

Publications (84)123.02 Total impact

  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Sensation and perception, as well as motor functions, have played an important role in the history of psychology. Although tests of these abilities are sometimes included in neuropsychological assessments, comparisons of intraindividual performances on the two sides of the body (as a basis for drawing conclusions and comparisons about the functional status of the two cerebral hemispheres) are in many instances neglected or considered only casually. This study, utilizing several motor and sensory-perceptual tests, compared intraindividual differences on the two sides of the body in a group of controls and a group of persons with brain damage. The results indicated that the sensory-perceptual tests were particularly effective in differentiating the groups. More than 60% of the group with brain damage had greater differences on the two sides of the body than did any of the controls. These findings suggest that a substantial proportion of persons with cerebral disease or damage may be subject to unequivocal identification using sensory-perceptual tests that take only about 20 minutes to administer. These tests may serve a valuable role as an adjunct to comprehensive neuropsychological evaluation and should be further evaluated in this respect.
    Applied Neuropsychology 02/2008; 15(1):39-43. · 1.32 Impact Factor
  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to develop a short screening battery that would predict whether older children would show significant impairment on comprehensive neuropsychological testing. The screening battery was subdivided into two phases. Phase 1 was intended as a broad catchment effort; Phase 2 was designed to be a more detailed and selective procedure. Administration of the full set of screening tests requires about 45 minutes. Their predictive validity was assessed using the Neuropsychological Deficit Scale (NDS), which summarizes results in the entire Halstead-Reitan Neuropsychological Test Battery for Older Children. Cutoff scores and guidelines for interpretation of the screening tests were developed, and the results were substantially correct in identifying children who performed normally versus children who were impaired on the testing and therefore required comprehensive testing to evaluate their neuropsychological status and deficits.
    Applied Neuropsychology 02/2008; 15(1):11-20. · 1.32 Impact Factor
  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to develop brief neuropsychological testing procedures that would identify adults (aged 15 and older) who need comprehensive neuropsychological evaluation. The tests used for screening were selected to (1) initially provide a broad catchment procedure followed by (2) a more diversified basis for prediction. The total time required to administer the screening measures is about 45 minutes. The criterion for the need for comprehensive testing was based on the General Neuropsychological Deficit Scale (GNDS), which summarizes 42 variables derived from the complete Halstead-Reitan Battery. The results indicated that the brief testing battery permitted accurate identification of persons who showed neuropsychological impairment based on comprehensive testing. Cutoff points were determined and guidelines were provided for use of the brief testing results.
    Applied Neuropsychology 02/2008; 15(1):21-32. · 1.32 Impact Factor
  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Neuropsychological tests that produce continuous distributions routinely show some degree of overlap between groups with and without brain damage, and there is an inevitable degree of uncertainty in group differentiation when using statistical inferential methods. Recognizing these circumstances, Pliskin, Ramati, and Sweeney (2007) recently stated that neuropsychological testing alone does not address the underlying basis (or brain damage) for cognitive changes that may be inferred from test results. The present study proposed that brain-based specific deficits, evaluated on a "present" or "absent" basis, might prove to be a valuable resource in supplementing interpretation of tests based on continuous distributions by providing, in many instances, unequivocal evidence of brain damage. Comparisons of controls with a group of brain-damaged persons, as reported in this study, strongly supported this proposal.
    Applied Neuropsychology 02/2008; 15(1):33-8. · 1.32 Impact Factor
  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was designed to use a short, two-phase testing procedure to predict the outcome of a comprehensive neuropsychological examination among young children (aged 5-8 years). Phase 1, requiring less than 10 minutes to administer, predicted Phase 2 results and results of comprehensive testing with acceptable accuracy. Phase 2 testing evaluated both lower-level (sensory-motor) and higher-level functions, required about 45 minutes to administer, and also closely predicted the outcome of comprehensive testing. Cutoff scores for individual tests, areas of function, and the total score for preliminary testing were determined, and accuracy rates were identified. The results suggest that preliminary testing, as described in this article, may serve to identify young children who need a comprehensive neuropsychological examination.
    Applied Neuropsychology 02/2008; 15(1):1-10. · 1.32 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Conation, or the ability to apply one's abilities purposefully, persistently and effectively as required by the task at hand, has been considered historically to be an important element of psychology, but has been relatively neglected in clinical neuropsychology. Nevertheless, conation may well be a significant missing variable in predicting a person's success in practical situations based on neuropsychological test scores. This study listed 19 tests from the Halstead-Reitan battery in order of their predicted dependence on conation. Differences between a brain-damaged group and a control group were determined through computation of t-ratios. The rank-ordering of the 19 tests according to their requirement of conation and the magnitude of the t-ratios were closely correlated, yielding a rank-difference coefficient of 0.84. These results suggest that conation is a strong factor in determining differential performances on neuropsychological tests. Further research is required to identify the role of conation in determining the ecological validity of neuropsychological test results.
    Archives of Clinical Neuropsychology 01/2006; 20(8):957-66. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Heaton, Grant, and Matthews (1991) published procedures for adjusting raw scores on various neuropsychological tests according to the individual's age and education. Despite rather widespread use of these score conversions in both clinical work and research publications, there have been very few investigations to evaluate the accuracy or limitations of these score transformations. This study was based on 52 persons with brain damage who had a range of verified brain injuries or disease. Raw scores were transformed according to the Heaton, Grant, and Matthews (HGM) procedure and also according to Reitan and Wolfson's Neuropsychological Deficit Scale (RW NDS) score procedure. The latter method is a straightforward transformation of raw scores and does not adjust for age or education. The number of normal (vs. impaired) scores was 1.74 times greater using the Heaton, Grant, and Matthews method than when using the Reitan and Wolfson method, yielding a chi2 value of 32.66 (p < .001). These results suggest that impairment in this brain-damaged group was identified less often when using the Heaton, Grant, and Matthews procedure than when using a method that represented the raw scores directly. The clinical and forensic implications of these findings are discussed. More research on this issue is needed.
    Applied Neuropsychology 02/2005; 12(4):181-9. · 1.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper presents a review and critique of the Houston Conference on Specialty Education and Training in Clinical Neuropsychology, together with an informal summary of opinions of a number of neuropsychologists. Issues regarding the role of the Clinical Neuropsychology Synarchy (CNS) and the applicability of the conference policies are offered. Several deficiencies and limitations of the policy statement are discussed. An informal survey of neuropsychologists interested in the Houston Conference indicates rather different opinions concerning the training and education of neuropsychologists. It is our contention that the results of the Houston Conference can only be considered controversial at best and that there is still much diversity of opinion in the field regarding the proper training of neuropsychologists. We hope to stimulate further discussion and greater involvement of the profession before final criteria for education and training are developed and adopted.
    Archives of Clinical Neuropsychology 05/2004; 19(3):375-90. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was designed to explore the possibility of using a brief neuropsychological test for broad-band initial screening of children with academic problems who might have neuropsychological deficits that should be more completely evaluated. Part B of the Trail Making Test was selected as the instrument for investigation. Three groups of children, aged 9-14 years, were composed for this study to represent (1) children with diagnosed brain damage or disease, (2) children who were medically normal but who were of serious concern to parents and teachers because of inadequate academic progress, and (3) a normal control group. The Brain-Damaged group required more than three times the number of seconds needed by the controls to complete the test, and the group with academic difficulties required more than twice the time of the controls. Using the limits set by the distributions of the Brain-Damaged and control groups, it was possible to identify a cutoff point that may be used for preliminary identification of children with academic difficulties who might benefit from further neuropsychological evaluation. The results of this study stand in need of cross-validation and, obviously, much additional outcome research is necessary to evaluate the efficacy and validity of the findings for screening purposes.
    Archives of Clinical Neuropsychology 04/2004; 19(2):281-8. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This study explores the use of the Progressive Figures Test as an instrument for broad initial screening of children in the 6- through 8-year age range with respect to the possible need for more definitive neuropsychological evaluation. Considering earlier results obtained in comparison of brain-damaged and control children [Clinical Neuropsychology: Current Applications, Hemisphere Publishing Corp., Washington, DC, 1974, p. 53; Proceedings of the Conference on Minimal Brain Dysfunction, New York Academy of Sciences, New York, 1973, p. 65], the Progressive Figures Test seemed potentially useful as a first step in determining whether a comprehensive neuropsychological evaluation is indicated. In this investigation, three groups were studied: (1) children with definitive evidence of brain damage or disease who, when compared with normal controls, help to establish the limits of neuropsychological functioning, (2) a group of children who had normal neurological examinations but also had academic problems of significant concern to both parents and teachers, and (3) a normal control group. Statistically significant differences were present in comparing each pair of groups, with the brain-damaged children performing most poorly and the controls performing best. Score distributions for the three groups make it possible to identify a score-range that represented a borderline or "gray" area and to suggest a cutting score that identified children whose academic problems might have a neurological basis and for whom additional neuropsychological evaluation appeared to be indicated.
    Archives of Clinical Neuropsychology 04/2004; 19(2):305-12. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Conation, or the ability to apply effective effort in completing a task over time, has been shown to be impaired in brain-damaged subjects. Various intelligence tests differ in the apparent extent to which they require conative ability. In this study we compared results earned by brain-damaged and control groups on three measures of intelligence: Wechsler Verbal IQ (VIQ), Wechsler Performance IQ (PIQ), and the Henmon-Nelson Test (HNT) of Mental Ability. Test scores were converted to T-score distributions for the combined groups in order to delete possible effects of differences in standardization procedures and the normative samples on which IQ scores were generated. The degree of impairment shown by the brain-damaged subjects was in direct relationship to the extent to which the three intelligence measures appear to require conation. The results support a generalization that intelligence tests that require a greater conative ability tend to produce lower scores for brain-damaged persons, as compared to controls, than do intelligence tests that are less demanding of conation.
    Archives of Clinical Neuropsychology 02/2004; 19(1):29-35. · 2.00 Impact Factor
  • Source
    Ralph M. Reitan PhD, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper reviews procedures and reports of adjustments of raw scores from the Halstead-Reitan Neuropsychological Test Battery for Adults using the method proposed by Heaton, Grant, and Matthews (1991). Arguments and findings both supporting and criticizing the HGM transformations are reviewed. From a psychometric viewpoint, the conclusion is reached that the HGM method, which is based only on a neurologically-normal group, transforms raw scores into scaled scores that tend to fall in the normal range, especially for braindamaged persons. Although this question is not yet adequately researched, the effect may stem principally from adjustments made for persons with less education and older age. The consequent result of the adjustments, in this case, would be to produce normal scores for tests that were designed, developed, and validated as measures of brain impairment-defeating the very purpose of the tests as neuropsychological measures. If the transformation process, based on age and education, is faulty for any reason (including inadequacies of the normative sample), and the transformations skew the raw scores either in the direction of normalcy or brain impairment, a serious problem exists in clinical interpretation or in a forensic setting. Thus, the questions raised in this paper are of theoretical, clinical, and forensic importance, and are urgently in need of resolution through further empirical research.
    Journal of Forensic Neuropsychology 01/2004; 4(1):1-32.
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Sensory-perceptual and motor functions are closely dependent on the integrity of the brain and nervous system. Standardized tests have been developed to assess these functions, but such tests are not routinely used to evaluate children who are suspected of having a neuropsychological basis for their difficulties. Higher-level functions (such as verbal and academic abilities, executive functioning, etc.) are obviously important in producing successful performances, but the brain and nervous system correlates of these abilities are less well defined than the correlates for sensory-motor abilities. Our contention is that tests from these two general areas (higher-level and lower-level aspects of brain functioning) can be used effectively in a complementary manner to evaluate individual children. The first step in this process is to evaluate formal sensory-motor tests and to assess their validity as a brief preliminary examination used to differentiate between brain-damaged and control children. The results of this study demonstrated striking differences between the groups and indicated that sensory-motor testing might serve very effectively, when used in conjunction with higher-level tests, to identify those children whose higher-level impairment is due to brain impairment rather than a lack of environmental opportunities or advantages.
    Archives of Clinical Neuropsychology 02/2003; 18(1):11-8. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: The Tactile Form Recognition (TFR) Test, which evaluates stereognosis in each hand and requires less than 15 min for administration, was given individually to 50 persons with brain damage and 50 controls who were essentially equivalent in age and education. Scores for the two groups yielded mean values that were different at a statistically significant level. Evaluation of the two distributions of scores yielded a cutoff score that had an accuracy rate of 82% for the controls and 84% for the persons with brain damage. The results suggest that the TFR Test is a valid and useful procedure for differentiating persons with brain damage from controls and, thus, can serve effectively, in conjunction with tests of higher-level brain functions, in neuropsychological evaluation of individual persons.
    Archives of Clinical Neuropsychology 03/2002; 17(2):117-21. · 2.00 Impact Factor
  • Source
    R M Reitan, D Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This article presents a critical evaluation of a Special Article, provided as an "educational service" and prepared by an Expert Panel under the direction of the Technology and Therapeutic Assessment Subcommittee of the American Academy of Neurology. The chief author of the Special Article was Jeffrey L. Cummings, M.D.
    Archives of Clinical Neuropsychology 05/2001; 16(3):215-26. · 2.00 Impact Factor
  • Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: This article presents a critical evaluation of a Special Article, provided as an ”educational service” and prepared by an Expert Panel under the direction of the Technology and Therapeutic Assessment Subcommittee of the American Academy of Neurology. The chief author of the Special Article was Jeffrey L. Cummings, M.D.
    Archives of Clinical Neuropsychology - ARCH CLIN NEUROPSYCH. 01/2001; 16(3):215-226.
  • Source
    R M Reitan, D Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Reports in the literature have suggested that the neuropsychological effects of mild head injury are selective, represented by impairment of attention, information processing, and memory, and that evaluations with comprehensive and standard test batteries are likely to miss such deficits. The present study compared groups of individuals with mild head injuries, more severe head injuries, and non-brain-damaged controls using 19 tests from the Halstead-Reitan Battery. The results indicated that the group with mild head injuries performed significantly poorer than the controls, and that the group with more severe head injuries scored significantly more poorly than either of the other groups. Comparisons of the pattern of test scores for the two head-injured groups were remarkably similar across the 19 tests, yielding a rank difference correlation of 0.87. The findings yielded no evidence of selective or delimited impairment in the group with mild head injuries, but instead, showed them to have test results that were very similar, though showing less neuropsychological impairment, to the group of subjects with more severe head injuries. These findings suggest that a comprehensive neuropsychological test battery is necessary to detect the broad range of deficits that may result from mild head injury.
    Archives of Clinical Neuropsychology 08/2000; 15(5):433-42. · 2.00 Impact Factor
  • Source
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Conation, which involves the ability to apply oneself diligently and productively to the completion of a task over time, was compared in groups with and without evidence of brain damage. Both groups were administered tests that ranged from tasks that were presented by an examiner one item at a time (minimal conation), to a task that required the subject to work independently for 30 minutes, with instructions to work as quickly and as accurately as possible. In this study it was not possible to control test content perfectly, but all tasks were primarily verbal in nature. The subjects with brain damage, compared to the controls, showed progressive impairment in accordance with the degree to which the tasks were judged to require conative ability. Conation, which has been a neglected dimension of behavior in neuropsychological assessment, may be the missing link between cognitive ability and prediction of performance capabilities in everyday life. Additional research is needed to investigate further this apparently significant aspect of neuropsychological functioning.
    Archives of Clinical Neuropsychology 08/2000; · 2.00 Impact Factor
  • Article: Conation
    Ralph M Reitan, Deborah Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: Conation, which involves the ability to apply oneself diligently and productively to the completion of a task over time, was compared in groups with and without evidence of brain damage. Both groups were administered tests that ranged from tasks that were presented by an examiner one item at a time (minimal conation), to a task that required the subject to work independently for 30 minutes, with instructions to work as quickly and as accurately as possible. In this study it was not possible to control test content perfectly, but all tasks were primarily verbal in nature. The subjects with brain damage, compared to the controls, showed progressive impairment in accordance with the degree to which the tasks were judged to require conative ability. Conation, which has been a neglected dimension of behavior in neuropsychological assessment, may be the missing link between cognitive ability and prediction of performance capabilities in everyday life. Additional research is needed to investigate further this apparently significant aspect of neuropsychological functioning.
    Archives of Clinical Neuropsychology - ARCH CLIN NEUROPSYCH. 01/2000; 15(5):443-453.
  • Source
    R M Reitan, D Wolfson
    [Show abstract] [Hide abstract]
    ABSTRACT: The research literature indicates that the great majority of persons who sustain any initial neuropsychological impairment from a mild head injury recover in 1 to 3 months. Nevertheless, clinicians report that some persons with a mild head injury demonstrate signs and report symptoms suggesting that they have sustained permanent brain damage. Although this latter group contains the participants of principal clinical interest, our literature review did not identify any research that provided a comprehensive description of the neuropsychological characteristics of this important subgroup of mild head-injured persons. The present investigation compared four groups: (1) controls, (2) persons with definite traumatic brain tissue damage, (3) persons with mild head injuries routinely accessed into a research study, and (4) persons with mild head injuries who had persisting clinical signs and symptoms. The same comprehensive neuropsychological test battery was used to evaluate all four groups. All pairs of groups differed significantly in neuropsychological status, with Group 3 showing only mild impairment (approaching the level of the controls) and Group 4 showing significant impairment (approaching the level of the group with definite brain tissue damage). The results emphasize the need for a comprehensive neuropsychological examination of persons with mild head injuries who have persisting clinical problems.
    Archives of Clinical Neuropsychology 03/1999; 14(2):191-202. · 2.00 Impact Factor

Publication Stats

1k Citations
123.02 Total Impact Points

Institutions

  • 1990
    • University of Texas Southwestern Medical Center
      Dallas, Texas, United States
  • 1980–1986
    • The University of Arizona
      • Department of Psychology
      Tucson, Arizona, United States
  • 1976
    • University of Washington Seattle
      • Department of Neurological Surgery
      Seattle, WA, United States