1999 NormativeDataStratifiedbyAgeand
- (Tombaugh et al., 1999) ⇒ Tom N Tombaugh, Jean Kozak, and Laura Rees. (1999). “Normative Data Stratified by Age and Education for Two Measures of Verbal Fluency: FAS and Animal Naming.” In: Archives of Clinical Neuropsychology, 14(2).
Subject Headings: Verbal Fluency.
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Abstract
Normative data stratified by three levels of age (16–59, 60–79, and 80–95 years) and three levels of education (0–8, 9–12, and 13–21 years) are presented for phonemic verbal fluency (FAS) and categorical verbal fluency (Animal Naming). The normative sample, aged 16 to 95 years, consisted of 1, 300 cognitively intact individuals who resided in the community. Years of education ranged from 0 to 21. The total number of words in 1 minute for each of the letters F, A, and S was correlated r =. 52 with the number of animal names generated in 1 minute. Regression analyses showed that FAS was more sensitive to the effects of education (18.6% of the variance) than age (11.0% of the variance). The opposite relationship occurred for Animal Naming, where age accounted for 23.4% of the variance and education accounted only for 13.6%. Gender accounted for1% of variance for FAS and Animal Naming. The clinical utility of these norms is discussed.
Phonemic and semantic verbal fluency, as measured by an individual's ability to generate words beginning with a specific letter (e.g., FAS and CFL) and semantic category (e.g., animals), have played a prominent role in neuropsychological research. Verbal fluency has been demonstrated to be sensitive to lesions in the frontal lobe, temporal lobe, and caudate nucleus Benton 1968, Butters et al. 1987, Miceli, Caltagirone, Gainotti, Masullo, & Silveri 1981, Milner 1964, Perret 1974 and Ramier & Hecaen 1970; Alzheimer's disease Appell, Kertesz, & Fisman 1982, Bayles & Tomoeda 1983, Butters et al. 1987, Chertkow & Bub 1990, Cummings, Benson, Hill, & Read 1985, Hodges et al. 1992, Martin & Fedio 1983, Ober, Dronkers, Koss, Delis, & Friedland 1986, Pachana, Boone, Miller, Cummings, & Berman 1996 and Rosen 1980; Huntington's disease Butters, Sax, Montgomery, & Tarlow 1978 and Butters et al. 1987; amnesia Butters et al. 1987 and Weingartner, Grafman, Boutelle, Kaye, & Martin 1983, and traumatic brain injury (Raskin & Rearick, 1996).
Current time-limited, verbal fluency tests can be traced to the Thurstone’s Word Fluency Test, which formed part of the Primary Mental Abilities Test Thurstone 1938 and Thurstone & Thurstone 1949. This test required individuals to write words beginning with a specific letter over a relatively long period of time (e.g., 5 minutes to write all possible words that began with the letter S). Benton and colleagues are generally credited with developing a verbal counterpart for Thurstone’s procedure Bechtoldt, Benton, & Fogel 1962, Benton 1968 and Fogel 1962. The letters FAS were used in these experiments with 1 minute of responding allowed for each letter. The first attempt to develop norms for letter fluency was by Borkowski, Benton, and Spreen (1967). All letters of the alphabet except X and Z were normed using 1-minute test intervals with 66 maternity patients. The letters were divided into three difficulty levels: hard (Q, J, V, Y, K, U); moderate (I, O, N, E, G, L, R); and easy (H, D, M, W, A, B F, P, T, C, S). Eventually, this lead to the verbal fluency test used in the Multilingual Aphasia Examination (MAE; Benton & Hamsher 1976 and Benton, Hamsher, & Sivan 1994). Two parallel sets of letter triads (CFL and PRW) were used rather than FAS. However, according to Ruff, Light, Parker, and Levin (1996), the name of the test was changed to Controlled Oral Word Association Test (COWA or COWAT) to avoid confusing the phrase “word fluency” with the “fluent/nonfluent” dimension of aphasia. The letters FAS have continued to be used as a measure of verbal fluency in the Neurosensory Center Comprehensive Examination for Aphasia (NCCEA; Benton 1967, Spreen & Benton 1969 and Spreen & Benton 1977).
The other popular procedure for assessing verbal fluency is semantic fluency, where individuals are asked to generate names from a specified category (e.g., animals, fruits, cities). For example, the Western Aphasia Battery (WAB; Kertesz, 1982) and Boston Diagnostic Aphasia Examination (BDAE; Goodglass & Kaplan, 1983) uses Animal Naming as its word fluency test, the Mattis Dementia Rating Scale (Mattis, 1988) uses the Supermarket Test, where the person names items found in a supermarket, and the Set Test (Issacs & Kennie, 1973) uses color, animals, towns, and fruits. A review of the literature shows that the category of “animals” is most frequently employed. Recently, comparison of performance on phonemic and semantic measures of verbal fluency has been used to investigate language deficits in Alzheimer’s patients, with mixed results (for reviews see Hart 1988, Lezak 1995 and Zec 1993).
In spite of the widespread use and clinical utility of verbal fluency tests, few norms are available across the entire adult age range. Those that are available are for the COWAT. This is largely because two recent studies have produced a reasonably comprehensive set of norms Ivnik et al. 1996 and Ruff et al. 1996. Unfortunately, a similar state of affairs does not exist for FAS. The original normative data for FAS in NCCEA were from a rural sample that was poorly educated with lower levels of intelligence (Spreen & Strauss, 1991). The normative data produced subsequently suffer from restricted age samples or limited number of individuals Bolla et al. 1990, Cauthen 1978, Geiser & Vanderploeg 1993, Kozora & Cullum 1995, Read 1987 and Yeudall et al. 1986. Norms for animal naming with an adequate range for age and education are lacking also. Consequently, the purpose of the present study is to provide age (16–95 years) and education (0–21 years) appropriate normative data for FAS and Animal Naming.
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| Author | volume | Date Value | title | type | journal | titleUrl | doi | note | year | |
|---|---|---|---|---|---|---|---|---|---|---|
| 1999 NormativeDataStratifiedbyAgeand | Tom N Tombaugh Jean Kozak Laura Rees | Normative Data Stratified by Age and Education for Two Measures of Verbal Fluency: FAS and Animal Naming | 1999 |