Construct and Criterion Validity of the Rey Auditory Verbal Learning Test-Spanish Version in Adults with Traumatic Brain Injury
Creators: name: Neblina, Cristobal 
Publisher: name: University of Nevada, Las Vegas
Year: 2012

description: The Rey Auditory Verbal Learning Test (RAVLT) is among the most commonly used English-language neuropsychological tests of verbal learning and memory. Previous research supports the validity and clinical utility of adaptations of the RAVLT into many diverse languages. In the United States, Hispanics represent the largest and fastest-growing ethnic minority group. As the Hispanic populace continues to grow, so does the need for empirically validated Spanish-language neuropsychological measures. In 2002, a Spanish adaptation of the RAVLT was developed in Puerto Rico (Acevedo-Vargas, 2002). However, validation studies have not been undertaken with clinical samples, and little is known regarding its psychometric properties when used to evaluate Hispanic individuals with traumatic brain injury (TBI). 
Using archival data, this study examined the construct and criterion validity of the Rey Auditory Verbal Learning Test-Spanish (RAVLT-S) when used to evaluate Spanish-speaking adults with TBI. Participants included 106 Spanish-language dominant adults (Mean age = 39.3 years, SD = 17.9; 50.0% male) selected from a consecutive series of cases referred to a neuropsychology consultation service at the Neurology Section of the University of Puerto Rico Medical School. Measures included the RAVLT-S and Spanish adaptations of the Wechsler Adult Intelligence Scale-third edition (WMS-III), Wechsler Memory Scale (WMS), Controlled Oral Word Association Test (COWAT), and Trail Making Test parts A and B (TMT A & B). A split-half procedure was used to examine internal consistency. To examine criterion validity, TBI group performance was compared to the English-language standardization sample (NS; Schmidt, 1996) and to the DEP group. Sensitivity, specificity, positive predictive power and negative predictive power were calculated. Confirmatory factor analyses were conducted to evaluate the underlying structure of the RAVLT-S. Construct validity was further evaluated by examining correlations between RAVLT-S scores and age and education, while convergent and discriminant validity were examined by correlations with the other tests of cognitive abilities. It was hypothesized that (a) the RAVLT-S would demonstrate acceptable reliability; (b) mean RAVLT-S scores for the TBI group would be selectively reduced as compared to the standardization sample; (c) sensitivity, specificity, and positive and negative predictive power would exceed chance; (d) the RAVLT-S would be composed of two factors; (e) raw RAVLT-S scores would yield expected patterns of associations with demographic variables; and (6) standardized RAVLT-S scores would be strongly correlated with other measures of verbal learning and memory, less so with verbal measures that lack an explicit memory component, and insignificantly to measures of perceptual and motor abilities. 
Split-half correlations yielded excellent reliability (r = 0.95). MANCOVA comparing age-corrected z scores for the DEP and TBI groups while covarying education indicated a significant overall effect, F (8, 96) = 7.01, p < .001, <em>f</em>Øp2 = .37, as well as a significant effect for education, F (8,96) = 3.08, p = .004, <em>f</em>Øp2 = .20, and diagnosis, F (8,96) = 2.22, p = .032, <em>f</em>Øp2 = .16. Repeated measures MANCOVA indicated a significant effect for trial, F (7, 721) = 3.03, p = .004, <em>f</em>Øp2 = .029, a significant effect for group, F (1, 103) = 4.10, p = .046, <em>f</em>Øp2 = .038, and a significant trial by group interaction effect, F (7, 721) = 3.61, p = .001, <em>f</em>Øp2 = .034. Single sample t tests indicated that the TBI group performed significantly worse (p < .001) than the NS group on all RAVLT-S trials. Classification statistics were modest. Confirmatory factor analyses indicated that a two-factor model provided improved fit and parsimony over a one-factor model. Only Trial 1 was significantly correlated with age (r = -.195, p < .05), while all RAVLT-S trials were significantly positively correlated with education (p < .01). RAVLT-S factor scores correlated significantly with nearly all other measures. 
In light of the growing need for linguistically diverse neuropsychological measures, these analyses examined the construct and criterion validity of the RAVLT-S when used to evaluate Hispanic adults with TBI. With some exceptions, the RAVLT-S yielded results consistent with our hypotheses, providing initial support for its validity and clinical utility. Limitations of our study include sample size, use of archival data, potential selection bias, and the use of English language norms. A major strength of this study is its empirical approach to evaluating the validity of the RAVLT-S, which was carried out in accordance with numerous recommendations outlined in the Standards for Educational and Psychological Testing (AERA et al., 1999). Further analyses with normal and clinical populations of children and adults are needed, as are factor analytic studies with larger sample sizes. The effects of bilingualism on RAVLT-S performance should also be explored.