Flexible vs. fixed batteries in forensic neuropsychological assessment: Reply to Bigler and Hom

The present commentary addresses issues raised by Bigler [Bigler, E. D. (2007). A motion to exclude and the ‘fixed’ vs. ‘flexible’ battery in ‘forensic’ neuropsychology: Challenges to the practice of clinical neuropsychology. Archives of Clinical Neuropsychology, 22, 45–51] and Hom [Hom, J. (2008). Commentary. Response to Bigler (2007): The sky is not falling. Archives of Clinical Neuropsychology, 23, 125–128] relative to the acceptability of flexible vs. fixed batteries (i.e. Halstead–Reitan Battery or HRB) in forensic neuropsychology. The Frye and Daubert rulings are reviewed, followed by comparisons of the sensitivity to brain dysfunction of the HRB and Wechsler Scales of Intelligence, and measures of verbal supraspan learning. Specific comparisons of the sensitivity to brain dysfunction of two flexible batteries [Rohling, M. L., Meyers, J. E., & Millis, S. R. (2003). Neuropsychological impairment following traumatic brain injury: A dose–response analysis. The Clinical Neuropsychologist, 17, 289–302; Larrabee, G. J., Millis, S. R., & Meyers, J. E. (2008). Sensitivity to brain dysfunction of the Halstead–Reitan vs. an ability-focused neuropsychological battery. The Clinical Neuropsychologist, 22, 813–825] and the HRB are discussed. Issues related to determination of error rates are reviewed, as well as the sensitivity of the HRB to location and etiology of brain dysfunction, in comparison to similar data recently published employing a flexible battery [Fargo, J. D., Schefft, B. K., Szaflarski, J. P., Howe, S. R., Yeh, H.-S., & Privatera, M. D. (2008). Accuracy of clinical neuropsychological vs. statistical prediction in the classification of seizure types. The Clinical Neuropsychologist, 22, 181–194]. It is concluded that flexible batteries covering the core domains of neuropsychological functioning including language, perceptual and spatial functions, sensorimotor skills, attention, information processing and working memory, verbal and visual learning and memory, and intellectual and problem solving skills, including executive functioning, are as valid as approaches relying on the HRB augmented by measures of language function, memory, and intellectual skills, and that both approaches most likely meet Frye and Daubert standards for admissibility into evidence in legal proceedings.