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The cross-cultural utility of foreign- and locally-derived normative data for three WHO-endorsed neuropsychological tests for South African adolescents

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Abstract

Interpretation of neuropsychological tests may be hampered by confounding sociodemographic factors and by using inappropriate normative data. We investigated these factors in three tests endorsed by the World Health Organization: the Grooved Pegboard Test (GPT), the Children’s Color Trails Test (CCTT), and the WHO/UCLA version of the Auditory Verbal Learning Test (AVLT). In a sample of 12-15-year-old, Afrikaans- and English-speaking adolescents from the Cape Town region of South Africa, analyses of covariance (ANCOVAs) demonstrated that quality of education was the sociodemographic factor with the biggest influence on test performance, and that age also significantly influenced GPT and CCTT performance. Based on those findings, we provide appropriately stratified normative data for the age group in question. Comparisons between diagnostic interpretations made using foreign normative data versus those using the current local data demonstrate that it is imperative to use appropriately stratified normative data to guard against misinterpreting performance.

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Notes

  1. For instance, chicken replaced turkey, and herdboy replaced ranger.

  2. But note the typographical error for the 5th item of list A, which should read plane, not place

  3. These three problematic items were: (1) boot/stewel- the Afrikaans word is used rarely (and only in more formal language contexts), and so the semantically compatible words shoe/skoen weresubstituted; (2) plate/bakkie—the Afrikaans word bakkie is ambiguous in that it could take the meaning of either bowl or truck, and so the semantically compatible words plate/bord were substituted; (3) bee/by—the Afrikaans word by is a homophone, and could be heard as taking the meaning of the English words at, bee, or mood; hence, and to ensure that the word was understood in its original semantic category (i.e., insects), we used the Afrikaans word gogga, as a generic description of a bug.

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Acknowledgement

This study was supported by the National Institutes of Health (NIH Grant Number 5RO1AA016303-04). The authors do not have any conflicts of interest that might be interpreted as influencing the research.

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Authors and Affiliations

  1. Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, J2, Anzio Road, Groote Schuur Hospital, Observatory, 7925, Cape Town, South Africa

    Helen L. Ferrett, Natalie L. Cuzen & Dan J. Stein

  2. ACSENT Laboratory, Department of Psychology, Faculty of Humanities, University of Cape Town, Cape Town, South Africa

    Kevin G. F. Thomas

  3. University of California at San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA

    Susan F. Tapert

  4. Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, Stellenbosch, South Africa

    Paul D. Carey

  5. Department of General Linguistics, Faculty of Arts and Social Sciences, University of Stellenbosch, Stellenbosch, South Africa

    Simone Conradie

  6. Neurobehavioral Research Inc, 1585 Kapiolani Blvd., Suite 1030, Honolulu, HI, 90814, USA

    George Fein

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  1. Helen L. Ferrett
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Correspondence to Natalie L. Cuzen.

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Ferrett, H.L., Thomas, K.G.F., Tapert, S.F. et al. The cross-cultural utility of foreign- and locally-derived normative data for three WHO-endorsed neuropsychological tests for South African adolescents. Metab Brain Dis 29, 395–408 (2014). https://doi.org/10.1007/s11011-014-9495-6

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