NACC Uniform Data Set

Instructions
For the Neuropsychological Battery (Form C2)

Version 3.0, March 2015

Copyright© 2006, 2008, 2015 University of Washington.

Created and published by the ADC Clinical Task Force
(John C. Morris, MD, Chair) and the National Alzheimer’s
Coordinating Center (Walter A. Kukull, PhD, Director). All
rights reserved.

This publication was funded by the National Institutes

of Health through the National Institute on Aging
(Cooperative Agreement U01 AG016976).
Revisions made to this document since UDS3 implementation (March 15, 2015)

Date Test(s) Question(s)

yyyy-mm-dd Description affected affected Data element(s) affected
2018-05-01 Additional instructions added for administration Number N/A N/A
Span
Backward
2018-01-31 Additional clarification added to scoring Benson N/A N/A
instructions for Element 8 immediate,
delayed
2017-08-24 Scoring instructions for Element 8 corrected from Benson N/A N/A
>8mm to >5mm immediate,
delayed
2016-08-02 Sample worksheet updated to restore missing MINT 29 N/A
word from “anvil” definition
2016-04-08 Further instructions were provided for scoring MoCA 10 N/A
Delayed Recall.
2015-04-24 The sample worksheet was updated to reflect Benson N/A N/A
change to instructions, allowing only 4 minutes. Immediate
 Instructions for administering and scoring
the UDS v3 Neuropsychological Battery FO RM C2

General principles of assessment and testing

This section is intended to help technicians and other non-clinicians adopt appropriate test etiquette.

1. Establish rapport. This is essential to the interview in general and the assessment of cognitive function in
particular. The subjects are volunteers who will typically have little experience with cognitive assessment
procedures. Cognitive testing has the potential to be an uncomfortable or even threatening experience. The
following considerations will help to establish and maintain rapport:

a. It is important to convey appreciation for the time and effort being volunteered. Remember that the
subjects are people (not sources of data) who are donating their time. The interviewer should convey
respect for the subject, interest in the interview process, and sensitivity to the needs and concerns of
the subject.

b. The subject will respond to the interviewer’s emotional state. If the interviewer is anxious, unsure,
or uninterested, the subject will often respond in kind. Therefore, it is critical that the examiner
be thoroughly trained and confident about test administration. Subjects will be most cooperative
and at ease with an interviewer who is secure in his/her role and who has a firm command of test
administration, delivering instructions in a fluent, practiced manner with proper inflections.

c. Avoid subtle coaching or cheerleading. Your job is to administer each item as specified and obtain a
response that can be scored.

2. Ensure uniformity in data collection and scoring. This is essential for all portions of the interview. To this
end:

a. Strictly adhere to the wording of instructions and items.

b. Be sure to gain and hold the subject’s attention as items are administered.

c. Do not assume that partial answers or misstatements are correct. When in doubt about the
acceptability of a response, refer to the manual and/or your supervisor.

3. Avoid missing data. Every reasonable attempt should be made to administer all performance items and all
tests. Note that if an item is administered and the correct response is not made, the response should be
scored as an error.

Failure to complete an item or test may be the result of a subject’s physical problem (coded as 95 or 995),
cognitive/behavioral problem (96 or 996), other problem (97 or 997), or refusal (98 or 998). Select the
appropriate reason and enter the code in the space provided. If more than one reason applies, enter the
lowest numbered reason.

It is intended that the tests be administered in the order in which they appear on NACC UDS Form C2. This is
necessary in order to standardize the delay intervals for testing memory among Centers, and also to eliminate
any differences that may result from varying the order of test administration. It is therefore important that
both the current UDS and the crosswalk tests be administered in their entirety either before or after the
administration of other tests commonly used by the Center.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 3
DESCRIPTION
The Montreal Cognitive Assessment MoCA
(MoCA) is a rapid screening instrument
designed to help health professionals
detect mild cognitive dysfunction.
ADMINISTRATION
It assesses numerous cognitive Time to administer the MoCA is approximately 10 minutes. The examiner is permitted to
domains: attention and concentration, repeat each item once, if asked. Following are detailed instructions.
executive functions, memory, language,
visuoconstructional skills, conceptual 1. Alternating trail making
thinking, calculations, and orientation.
The examiner instructs the subject: “Please draw a line, going from a number to a
SOURCE letter in ascending order. Begin here (point to 1) and draw a line from 1 then to A then
All information on this test, including to 2 and so on. End here (point to E).”
publications and norms and cut-
off scores, appears on http://www. 2. Visuoconstructional skills (cube):
mocatest.org. The examiner gives the following instructions, pointing to the cube: “Copy this drawing
© Ziad Nasreddine MD 2004. MoCA® as accurately as you can, in the space below.”
is a registered trademark property of
3. Visuoconstructional skills (clock):
Neurosearch Développements Inc. and
is used under license. Form created Indicate the right third of the space and give the following instructions: “Draw a clock.
as part of the National Alzheimer’s Put in all the numbers and set the time to 10 past 11.”
Coordinating Center Uniform Data
Set, copyright 2013 University of 4. Naming
Washington. Beginning on the left, point to each figure and say, “Tell me the name of this animal.”

5. Memory
The examiner reads a list of five words at a rate of one per second, giving the following
instructions: “This is a memory test. I am going to read a list of words that you will
have to remember now and later on. Listen carefully. When I am through, tell me as
many words as you can remember. It doesn’t matter in what order you say them.”

Mark a check in the allocated space for each word the subject produces on this first
trial. When the subject indicates that he/she has finished (has recalled all words), or
can recall no more words, read the list a second time with the following instructions: “I
am going to read the same list for a second time. Try to remember and tell me as many
words as you can, including words you said the first time.” Put a check in the allocated
space for each word the subject recalls after the second trial.

At the end of the second trial, inform the subject that he/she will be asked to recall
these words again by saying, “I will ask you to recall those words again at the end of
the test.”

6. Attention
Forward digit span: Give the following instruction: “I am going to say some numbers
and when I am through, repeat them to me exactly as I said them.” Read the five-
number sequence at a rate of one digit per second.

Backward digit span: Give the following instruction: “Now I am going to say some
more numbers, but when I am through you must repeat them to me in the backwards
order.” Read the three-number sequence at a rate of one digit per second.

Vigilance: The examiner reads the list of letters at a rate of one per second, after

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 4
 giving the following instruction: “I am going to read a sequence of letters. Every time I
say the letter A, tap your hand once. If I say a different letter, do not tap your hand.”

Serial 7s: The examiner gives the following instruction: “Now I will ask you to count by
subtracting seven from 100, and then, keep subtracting seven from your answer until I
tell you to stop.” Give this instruction twice if necessary.

7. Sentence repetition
The examiner gives the following instructions: “I am going to read you a sentence.
Repeat it after me, exactly as I say it [pause]: I only know that John is the one to help
today.” Following the response, [SAY]: “Now I am going to read you another sentence.
Repeat it after me, exactly as I say it [pause]: The cat always hid under the couch
when dogs were in the room.” Space is also provided (MoCA notes page) to record
responses.

8. Verbal fluency
The examiner gives the following instruction: “Tell me as many words as you can think
of that begin with a certain letter of the alphabet that I will tell you in a moment.
You can say any kind of word you want, except for proper nouns (like Bob or Boston),
numbers, or words that begin with the same sound but have a different suffix, for
example, love, lover, loving. I will tell you to stop after one minute. Are you ready?
[Pause] Now, tell me as many words as you can think of that begin with the letter
F. [Time for 60 sec]. Stop.” Space is also provided (MoCA notes page) to record
responses.

9. Abstraction
The examiner asks the subject to explain what each pair of words has in common,
starting with the example: “Tell me how an orange and a banana are alike.” If the
subject answers in a concrete manner, then say only one additional time: “Tell
me another way in which those items are alike.” If the subject does not give the
appropriate response (fruit), say, “Yes, and they are also both fruit.” Do not give any
additional instructions or clarification. After the practice trial, [SAY]: “Now, tell me
how a train and a bicycle are alike.” Following the response, administer the second
trial, saying: “Now tell me how a ruler and a watch are alike.” Do not give any
additional instructions or prompts.

10. Delayed recall

The examiner gives the following instruction: “I read some words to you earlier, which I
asked you to remember. Tell me as many of those words as you can remember.” Make
a check mark ( ü ) for each of the words correctly recalled spontaneously without any
cues, in the allocated space. If the subject fails to freely recall one or more, proceed to
cueing, as indicated below.

Following the delayed free recall trial, prompt the subject with the semantic category
cue provided below for any word not recalled. Make a check mark ( ü ) in the allocated
space. If the subject does not recall the word after the category cue, give him/her a
multiple choice trial. For example, if the word FACE was not freely recalled with the
category cue, ask, “Which of the following words do you think it was, NOSE, FACE, or
HAND?” Use the following category and/or multiple-choice cues for each word, when
appropriate:

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 5
 Category cue Multiple choice
FACE part of the body nose, face, hand
VELVET type of fabric denim, cotton, velvet
CHURCH type of building church, school, hospital
DAISY type of flower rose, daisy, tulip
RED a color red, blue, green

11. Orientation
The examiner gives the following instructions: “Tell me the date today.” If the subject
does not give a complete answer, then prompt accordingly by saying: “Tell me the
[year, month, exact date, and day of the week].” Then [SAY]: “Now, tell me the name
of this place, and which city it is in.”

ADDITIONAL INSTRUCTIONS FOR ADMINISTERING THE MoCA

• The MoCA need not be administered by the clinician who is administering the rest of
the UDS battery, and it need not be administered in the same session as the other
tests (it can be administered one to seven days before the rest of the battery).
• In drawing the clock and cube, the subject may erase his/her work after one or two
pencil strokes and try again if they realize they didn’t leave enough room or stop for a
similar reason. The subject may not erase and try again, however, after drawing most
or all of the item.
• The clinician may not demonstrate the tapping for the vigilance item. If the subject
does not understand, the clinician may repeat the entire instruction once.
• Even though verbal fluency for F and L appear later in the battery, it is still necessary
to administer the fluency test for the letter F in the language section of the MoCA.

SCORING

If any of the individual items cannot be administered, enter the appropriate reason code
(95 / 995 – 98/998) from the key.

1. Alternating trail making

Allocate one point if the subject successfully draws the following pattern:
1− A – 2 – B – 3 – C – 4 – D – 5 – E, without drawing any lines that cross. Any error that is
not immediately self-corrected earns a score of 0. Enter the score for “Visuospatial/
executive — Trails” on NACC UDS Form C2, Question 1g.

2. Visuoconstructional skills (cube)

One point is allocated for a correctly executed drawing.

• Drawing must be three-dimensional

• All lines are drawn
• No line is added
• Lines are relatively parallel and their length is similar (rectangular prisms are
accepted)

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 6
 A point is not assigned if any of the above criteria are not met. Enter the score for
“Visuospatial/executive — Cube” on NACC UDS Form C2, Question 1h.

3. Visuoconstructional skills (clock)

One point is allocated for each of the following three criteria:

Contour (1 pt.): the clock face must be a circle with only minor distortion acceptable
(e.g., slight imperfection on closing the circle). If acceptable, enter 1; otherwise, enter
0 for “Visuospatial/executive — Clock contour” on UDS Form C2, Question 1i.

Numbers (1 pt.): all clock numbers must be present with no additional numbers;
numbers must be in the correct order and placed in the approximate quadrants on the
clock face; Roman numerals are acceptable; numbers can be placed outside the circle
contour. If all criteria are met, enter 1; otherwise, enter 0 for “Visuospatial/executive
— Clock numbers” on NACC UDS Form C2, Question 1j.

Hands (1 pt.): there must be two hands jointly indicating the correct time; the hour
hand must be clearly shorter than the minute hand; hands must be centered within
the clock face with their junction close to the clock center. If all criteria are met, enter
1; otherwise, enter 0 for “Visuospatial/executive — Clock hands” on NACC UDS Form
C2, Question 1k.

For the MoCA Total Score, a point is not assigned for a given element if any of the
above criteria are not met.

4. Naming
One point each is given for the following responses: (1) lion (2) rhinoceros or rhino (3)
camel or dromedary. Enter the score for “Language — Naming” on NACC UDS Form
C2, Question 1l.

5. Memory
For the MoCA Total Score, no points are given for Trials One and Two. Count the
number correct for both trials and enter the score for “Memory — Registration (two
trials)” on NACC UDS Form C2, Question 1m.

6. Attention
Forward digit span, backward digit span: Allocate one point for each sequence
correctly repeated. (N.B.: the correct response for the backwards trial is 2 – 4 – 7.)
Enter the score for “Attention — Digits” on NACC UDS Form C2, Question 1n.

Vigilance: Give one point if there is zero to one errors (an error is a tap on a wrong
letter or a failure to tap on letter A). Enter the score for “Attention — Letter A” on
NACC UDS Form C2, Question 1o.

Serial 7s: This item is scored out of 3 points. Give no (0) points for no correct
subtractions, 1 point for one correction subtraction, 2 points for two to three correct
subtractions, and 3 points if the subject successfully makes four or five correct
subtractions. Count each correct subtraction of 7 beginning at 100. Each subtraction
is evaluated independently; that is, if the subject responds with an incorrect number
but continues to correctly subtract 7 from it, give a point for each correct subtraction.
For example, a subject may respond “92 – 85 – 78 – 71 – 64” where the “92” is
incorrect, but all subsequent numbers are subtracted correctly. This is one error and

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 7
 the item would be given a score of 3. Enter the score for “Attention — Serial 7s” on
NACC UDS Form C2, Question 1p.

7. Sentence repetition
Allocate 1 point for each sentence correctly repeated. Repetition must be exact. Be
alert for errors that are omissions (e.g., omitting “only,” “always”) and substitutions/
additions (e.g., “John is the one who helped today;” substituting “hides” for “hid,”
altering plurals, etc.). Enter the score for “Language — Repetition” on NACC UDS
Form C2, Question 1q.

8. Verbal fluency
Allocate one point if the subject generates 11 words or more in 60 sec. Record the
subject’s response in the bottom or side margins. Enter the score for “Language —
Fluency” on NACC UDS Form C2, Question 1r.

9. Abstraction
Only the last two item pairs are scored. Give 1 point to each item pair correctly
answered.

The following responses are acceptable:

Train – bicycle means of transportation, means of traveling,
you take trips in both
Ruler – watch measuring instruments, used to measure

The following responses are not acceptable:

Train – bicycle they have wheels
Ruler – watch they have numbers

Enter the number correctly answered for “Abstraction” on NACC UDS Form C2,
Question 1s.

10. Delayed recall

Allocate 1 point for each word recalled freely without any cues.

Scoring this section for the MoCA Total Score: No points are allocated for words
recalled with a cue. A cue is used for clinical information purposes only and can give
the test interpreter additional information about the type of memory disorder. For
memory deficits due to retrieval failures, performance can be improved with a cue. For
memory deficits due to encoding failures, performance does not improve with a cue.

Enter the number of words recalled without a cue for “Delayed recall — No cue” on
NACC UDS Form C2, Question 1t.

Scoring for cued recall

If a category cue was given, enter the number of words recalled; otherwise, enter
“88=Not applicable” for “Delayed recall — Category cue” on NACC UDS Form C2,
Question 1u. If a multiple choice cue was given, enter the number of words recalled;
otherwise, enter “88=Not applicable” for NACC UDS Form C2, Question 1v.

The total possible words recalled and entered in Questions 1t, 1u, and 1v should be
5 or less. If a subject remembers all five words on the MoCA delayed recall without
cueing (i.e., uncued), enter 5 total correct for Question 1t; in this case, the number

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 8
 correct with a category cue and recognition cue (1u and 1v) should be set to “88=Not
applicable” because they were not administered.

If a subject does not remember all five words uncued, record the number correct
uncued for Question 1t, then provide the category cue for the words that were not
recalled without a cue, and enter the number correct with the category cue (if any) for
Question 1u.

If the subject did not recall all the words presented with category cue, administer
those not recalled using the recognition cue and enter the total correct with the
recognition cue (if any) for Question 1v.

11. Orientation
For the MoCA Total Score, give one point for each item correctly answered. The subject
must tell the exact date and the exact place (name of hospital, clinic, office). No
points are allocated if subject makes an error of one day for the day and date. For
each item, enter 1 if correct or 0 if incorrect for Orientation on NACC UDS Form C2,
Questions 1w – 1bb.

TOTAL SCORE

Sum all subscores listed on the right-hand side of the MoCA worksheet The maximum score
is 30 points. A final total score of 26 and above is considered normal.

Enter the uncorrected score for NACC UDS Form C2, Question 1f. If any of the scored
MoCA items (1g – 1l, 1n – 1t, and 1w – 1bb) were not administered, enter 88=Not
applicable for the total score.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 9
 Rules for single-item scoring and index score calculations for the MoCA***

INDEX SCORES
Points towards Attention/ Visuo-
ITEMS Total Score Memory ** Executive Concentration Language spatial Orientation

Trails 1 - 1 - - - -

Cube 1 - - - - 1 -

Clock — Contour 1 - 1 - - 1 -

Clock — Numbers 1 - 1 - - 1 -

Clock — Hands 1 - 1 - - 1 -

Language — Naming 3 - - - 3 3 -

Memory — Registration - Immediate - - -

(2 learning trials, total 0, not scored recall 2 trials
possible =10) total / 10

Attention — Digits 2 - 2 2 - - -

Attention — Letter A 1 - 1 1 - - -

Attention — Serial 7s 3 - 3 3 - - -

Language — Repetition 2 - - 2 2 - -

Language — Fluency 1 - 1 - 1 - -

Abstraction 2 - 2 - - - -

Delayed recall, no cue 5 =3X number

of words no cue
(max =15)

Delayed recall, category cue 0* =2X number - - - - -

of words retrieved
with category cue
(max =10)

Delayed recall, recognition 0* =1X number of - - - - -

words recognized
(max= 5)

Orientation — Date 1 - - - - - 1

Orientation — Month 1 - - - - - 1

Orientation — Year 1 - - - - - 1

Orientation — Day 1 - - - - - 1

Orientation — Place (name) 1 - - - - - 1

Orientation — City 1 - - - - - 1

TOTALS 30 15 13 18 6 7 6

* The standard administration of the MoCA does not score category and recognition responses, even if administered.
** If all five words are freely recalled, cued and category recall are not administered and the total score would be 15 (3 points for
each word recalled freely). After free recall, category cues are given only for items not recalled. Each word correct with category cue is
awarded 2 points. After category cues, only words not correct are then tested with recognition. Award 1 point for each word correct on
recognition (max=5). Here is an example: Subject gets two free recall, two cued, and recognizes the fifth word. Memory index score:
(2X3) + (2X2) + (1X1) = 11/15
*** © Ziad Nasreddine MD 2004. MoCA® is a registered trademark property of Neurosearch Développements Inc. and is used under license. Form created as part of
the National Alzheimer’s Coordinating Center Uniform Data Set, copyright 2013 University of Washington.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 10
 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 11
 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 12
Description
This test assesses the ability to recall Craft Story 21 Recall (Immediate)
a short story. The examiner reads the
story to the subject in a clear voice. Administration
Immediately after hearing the story,
the subject is asked to retell the story Making sure you have the subject’s attention, read the following instructions aloud. Then
from memory. The story should be read the story slowly, articulating clearly and with normal inflection.
read with adequate volume and clarity
[SAY]: “I am going to read you a story. Listen carefully, and when I am through, I want you
for the subject to understand during
the presentation. No repetitions are to tell me everything you can remember. Try to use the same words I use but you may also
permitted. use your own words. The story is …”
It is important for the examiner to As soon as the story is over, give the recall instruction:
get a sense of the subject’s hearing
[SAY]: “Now tell me the story I just told you. Try to remember as much as you can.”
acuity and modulate her/his voice
accordingly. Please note that for the Record the subject’s recall, writing between the lines of the story. For rapid and accurate
hard of hearing, it is not necessarily transcribing of the story, use abbreviations as needed, omit filler words and irrelevant
helpful merely to increase the volume.
verbiage, and if absolutely necessary, say “A little slower, please,” rather than miss story
A change in pitch tends to be effective,
elements. Make sure your transcription of the story is legible before proceeding.
with a lower-pitched voice more
audible than a loud, high-pitched Your transcriptions should be an exact replica of the subject’s verbal responses. Write
voice. As with all neuropsychological legibly, in ink, and leave room between each line for scoring. If it is difficult to write the
testing, it is best if the examiner subject’s response, the examiner may prefer to tape-record the subject’s response and then
projects his/her voice at the subject,
transcribe the results after the session; this is acceptable if appropriate consent has been
rather than down toward a clipboard.
obtained.
Source
After the subject tells the story, you must give the delayed recall cue.
Craft S, Newcomer J, Kanne S,
Dagogo-Jack S, Cryer P, Sheline Y, [SAY]: “Later on, I will ask you to tell me this story again, so try not to forget it.” Note
Luby J, Dagogo-Jack A, Alderson the time so that later you can calculate the time that has elapsed between Craft Story 21
A. Memory improvement following Recall (Immediate) test and the Craft Story 21 Recall (Delayed) test.
induced hyperinsulinemia in
Alzheimer’s disease. Neurobiol Aging.
1996 Jan-Feb;17(1):123-30. Scoring
Reproduced by permission of the
author, Suzanne Craft, PhD. Do not A. General instructions
copy or distribute without author’s
Scoring can be deferred until after the entire battery is administered but should be
permission. Form created as part of
the Uniform Data Set of the National performed close to the completion time. Use the score sheets to score the transcription.
Alzheimer’s Coordinating Center, One sheet is for verbatim scoring and the second is for paraphrase scoring.
copyright ©2013 University of The verbatim score is independent of the paraphrase score. Treat each scoring effort
Washington.
separately: they are not additive. Score the story first for verbatim recall and then score it
for paraphrase recall.

For verbatim scoring, the story is divided into 44 “bits.” All bits contain one “content”
word, which is scored. Some bits also contain “non-content” words, which are not
considered in scoring. Each bit is demarcated by a slash (/ ) at the beginning and at the
end of the bit (e.g., /Barry/) on the score form.

For the paraphrase scoring, there are 25 bits of information to score.

Separately sum verbatim and paraphrase points earned for each story, for both the
immediate and delayed recall conditions. Record all sums, in the appropriate boxes, on the
summary scoring sheet.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 13
 Remember with verbatim and paraphrase scoring to consider each bit individually. The
order that the bits were given does not matter in the scoring system.

B. Definitions
1. CONTENT WORDS: nouns, adjectives, adverbs, verbs, pronouns, prepositions with
semantic load. These are considered during the scoring process.

2. NON-CONTENT WORDS: conjunctions, articles, helping verbs, prepositions without

semantic load. These are not considered during the scoring process.

VERBATIM SCORING
PERFECT VERBATIM RESPONSE (1.0 POINT): Give the subject 1 point for every bit for which
content words are recalled exactly and completely. Allowances can be made for variations
of verbs (e.g., “likes” for “liked,” “join” for “joining”) and minor omissions (e.g.,
“neighbor” for “neighbor’s”) or changes in number (e.g., “games” for “game”). The content
words do not need to be recalled by the subject in the same order they were read to receive
credit. The words can appear anywhere in the recall.

Enter the verbatim score on NACC UDS Form C2, Question 8a. If the test was not
completed, enter the appropriate reason code, 95 – 98, and leave the paraphrase score
blank.

PARAPHRASE SCORING
PARAPHRASE RESPONSE (1.0 POINT): Give a point for a response that captures the elements
of the story although not necessarily with the exact words (see table on page 16). If the
subject provides a bit verbatim (e.g., the name), you should give a point for that bit.

Enter the paraphrase score on NACC UDS Form C2, Question 8b.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 14
 CRAFT STORY 21 RECALL (IMMEDIATE): VERBATIM SCORING

Maria’s so

child hard

Ricky it

played went

soccer over

every neighbor’s

Monday fence

three thirty three

he large

liked dogs

going lived

field dogs’

behind owner

their heard

house loud

joining barking

game came

one out

day helped

he them

kicked retrieve

ball ball

TOTAL

Number of items recalled for verbatim scoring:

Immediate Recall Score: /44 maximum

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 15
 GUIDELINES FOR PARAPHRASE SCORING, CRAFT STORY 21

Item General rule Alternative 1-point responses 0-point responses Points

“Maria” or a variant of the
Maria’s Mary, Marie Martha, Anna
name
“child” or a phrase denoting
child son, kid, boy, teenager, young man guy, children, daughter
it was a young person
“Ricky” or a variant of the Rick, Rich, Richie, Richard,
Ricky Randy, Rusty, Robert
name Ricardo

played “played” is required to play, plays did (soccer)

baseball, volleyball, other

soccer “soccer” is required futbol
sport
“Monday” or an indication every day, another day of
every Monday —
that it occurred on a weekday the week
an indication that the activity after dinner, at night, in
at 3:30 after school, every afternoon
took place in the afternoon the morning
He liked going to an indication that he went to went outside, went to the yard,
went to the school, gym
the field an outdoor area going to the backyard
behind their “house” or word denoting a
home, residence, where they lived any other building
house house
an indication that he played w/ other kids, became part watching, played in the
and joining
participated in a game of the team, playing w/ the team park

the game. “game” in any context — —

One day “One day” is required — —

indication that he performed threw, hit (with no

he kicked booted, punted
the activity with his foot mention of the foot)

the ball “Ball” is required football, soccer ball baseball, volleyball

an indication that force was so much force, so strongly, (kicked

so hard —
used it) so far

that it went over “Over” is required — —

an indication that the person

the neighbor’s nearby resident friend’s
lived in the same area
“fence” or a word denoting a
fence garden wall, wall property line, street
fence of some kind

where three “Three” is required three (boys) —

an indication that there were puppies, cats, kittens,

large dogs lived. hounds, doggies
dogs present other animals
an indication that the person neighbor (if owner implied and
The dogs’ owner a bystander, the police
was responsible for the dogs “neighbor” mentioned twice)
heard loud an indication that the dogs yelping, baying, yapping, heard the saw the dogs running
barking were making noise dogs around
a word or phrase indicating his mother came out, the
came out (owner) saw the ball
that the owner was present dogs came out
a word or phrase indicating
and helped them assisted, aided, had to help —
that help was provided
an indication that they got gave him the ball, return the ball,
retrieve the ball.
the ball back (helped him) get the ball —

Number of items recalled for paraphrase scoring: Immediate Recall Score: /25 maximum

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 16
 SAMPLE WORKSHEET

SAMPLE WORKSHEET

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 19
Description
This test is a simplified form of the Benson Complex Figure Copy (Immediate)
Rey-Osterrieth Complex Figure. The
purpose of the test is to assess a
subject’s visuoconstructional and Administration
visual memory functions. Give subject a pen, place sheet with figure in front of the subject, and say, “Please copy
this design as best you can.” Please do not use colored pencils for each element because
Source
Reproduced by permission of the this can be disruptive and will not be consistent with other ADCs. Instead, please write
author, Joel Kramer, PsyD; do not notes to track progress. Have the subject make his or her copy in the lower half of the
copy or distribute without author’s page below the figure. When design is completed, leave the figure in front of the subject
permission. Form created as part for 5 seconds and say “Be sure to remember this design, because I’ll ask you to draw it
of the FTLD Module to the Uniform again later from memory.” A maximum of 4 minutes should be allowed for completing the
Data Set of the National Alzheimer’s
drawing. Do not administer other figure-copy tests during the delay, and do not administer
Coordinating Center, copyright 2013
the Rey-Osterrieth before the Benson on the same day.
University of Washington.
Possin, KL, Laluz VR, Alcantar The subject may start over once. Since a pen must be used, the subject cannot erase. They
OZ, Miller BL, Kramer JH. Distinct may, however, cross out or write over their first attempt. If the subject produces more than
neuroanatomical substrates and one figure, ask them which drawing is the final figure for scoring.
cognitive mechanisms of figure copy
performance in Alzheimer’s disease
and behavioral variant frontotemporal Scoring
dementia. Neuropsychologia. 2011 Follow the scoring instructions as closely as possible and use your best judgment when
Jan; 49(1):43-8.
scoring the Benson Complex Figure Copy.

The scoring system for the Benson Figure is modeled after Taylor’s widely used scoring
system for the Rey-Osterrieth Figure. Eight major figural elements have been identified.
Each figural element is scored as 2 points if the element is drawn accurately and placed
correctly in the figure (1 point for accuracy, 1 point for placement). Score 1 point if the
element is poorly drawn but placed correctly or is correctly drawn but misplaced, and 0
points if the element is neither accurately drawn nor correctly placed. Detailed scoring
rules are on the following page.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 20
 Enter the total score on NACC UDS2 Form C2, Question 4a. If the test could not be administered, enter the appropriate
reason code, 95 – 98, from the key.

1. Four-sided, 90° angles, width > height, any gaps or overlaps < 8mm
0 1 2

2. Reasonably straight lines; any gaps or overlaps < 8mm

0 1 2

3. Connects at middle third, no overlap with diagonals

0 1 2

4. Reasonably round, doesn’t touch sides

0 1 2

5. Vertical lines > 1/2 distance to diagonals, width > height, 90° angles
0 1 2

6. Connects below #3, top of square above bottom

0 1 2

7. Vertex corresponds to middle third; any gaps or overlaps < 8mm

0 1 2

8. Gap between #8 and #7 < 5mm, angle at end of stem = 90°

0 1 2

BONUS
0 1

Time of day design completed: : AM PM

Total score (circle one): 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Always score leniently for borderline responses. If a response is borderline for accuracy and borderline for placement,
give 1 point. Self-corrected responses are acceptable. Multiple attempts are acceptable at the subject’s request either
on an empty area of the page or, if more room is needed, on a fresh page. Ask the subject which drawing he or she would
like you to score. If the subject copies directly on top of the stimulus instead of drawing below, the subject should be
directed one more time to draw below the figure. If a subject draws close to the edge of the paper, that subject can start
again. Instances may occur where test administrators should consider the test invalid (e.g., if the subject did not bring
his or her glasses and can’t see well enough to take the test). In these instances, enter the appropriate code listed on
NACC UDS Form C2. If a subject has motor problems and cannot complete the Benson Figure Complex Copy, a code of
95 (Physical problem) should be entered for the score on NACC UDS Form C2, Question 4a.

For accuracy (A), element drawn must be recognizable as the target element and meet the additional criteria listed
below. Leniency is given for wavy lines or rounded angles (e.g., due to tremor). A protractor and ruler should be used for
making angle and distance judgments. Extraneous lines do not impact scoring.

For placement (P), element need not be accurate, it must only bear some slight resemblance to the target element (with
leniency), be placed correctly, and meet the additional placement criteria below. Major rotation of an element is not
acceptable for placement credit.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 21
 ELEMENT 1

Accuracy: Four reasonably straight sides must be present with 90º angles (±10º); width > height;
corners do not have to touch and lines can be broken, but gaps or overlaps cannot exceed 8mm.

Placement: Any square-like or rectangular figure is present with at least 3 sides but no more than
four sides. Less precise angles are acceptable. Rotation of the entire figure should not exceed 30°.
If height is greater than width, this is considered an accuracy failure rather than a rotation-related
placement failure.

2-point examples:

Figure is not rotated more than 30°, and gaps at Leniency is given for wavy lines.
corners and at broken lines do not exceed 8mm.

1-point examples:

Accuracy: 0 Placement: 1 Accuracy: 0 Placement: 1

Bottom left angle is not precise.

Accuracy: 0 Placement: 1 Accuracy: 1 Placement: 0

Three sides of the rectangle are present, and Placement credit is lost due to rotation.
element bears enough of a resemblance to the
target element to receive placement credit.

0-point examples: pentagon, circle, triangle

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 22
 ELEMENT 2

Accuracy: Two reasonably straight intersecting lines are recognizable as the target figure. Rotation is
acceptable for accuracy, and lines need not be diagonal.

Placement: Gap or overlap at the corners of the large rectangle must not exceed 8mm. If only one
line is present but placement is correct, credit is given.

2-point examples:

1-point examples:

Accuracy: 1 Placement: 0 Accuracy: 0 Placement: 1

These lines are recognizable as the target figure Element loses accuracy point because one line
(A), but the gaps at corners exceed 8mm (P). is missing, but it is placed correctly.

Accuracy: 1 Placement: 0 Accuracy: 1 Placement: 0

Lines are recognizable (A) but rotated (P). Lines are recognizable but not correctly placed.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 23
 ELEMENT 3

Accuracy: Figure is correctly shaped.

Placement: Figure is connected at the middle third of the large rectangle but does not need to be
above element 6. Any gap with the large rectangle does not exceed 8mm. Lines may cross the large
rectangle but not the diagonal lines.

2-point examples:

Placement credit is given because it connects at Do not deduct accuracy because of the extra-
the middle third. neous line.

1-point examples:

Accuracy: 1 Placement: 0 Accuracy: 1 Placement: 0

Connects at upper third. Element is correctly shaped (A), but the gap
between the element and large rectangle
exceeds 8mm (P).

Accuracy: 0 Placement: 1 Accuracy: 1 Placement: 0

Element bears some slight resemblance to the Placement credit is lost due to overlap with
target element (with leniency) and is placed diagonals. This element barely receives
correctly, at the middle third (P). This is an accuracy credit.
example of the least resemblance an element
might have to receive credit for placement.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 24
 ELEMENT 4

Accuracy: Reasonably round (longest diameter to shortest ratio < 2:1).

Placement: The circle is inside the right quadrant of the rectangle, which is defined by the diagonal
lines. If the diagonal lines are not present or are misplaced, score based on their correct placement,
with leniency. The circle cannot touch the large rectangle.

2-point examples:

The ratio for this circle is 1.8:1, and so it barely Placement is scored based on where the
receives accuracy credit. diagonal lines should have been placed.

1-point example:

Accuracy: 1 Placement: 0

0-point example:

Exceeds ratio requirement (A). Circle touches the

rectangle (P).

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 25
 ELEMENT 5

Accuracy: The width must be > the height, and the angles are 90º (±10º). The vertical sides of the
rectangle are > ½ of the vertical measurement between the bottom of the large rectangle and the
closest part of diagonal lines. If the diagonal lines are not present, calculate based on where the
lines should be placed (see first 2-point example). Extraneous lines are acceptable.

Placement: Figure is located in bottom quadrant of the large rectangle as defined by the diagonal
lines. The gap or overlap with the bottom of the large rectangle does not exceed 8mm, and any
overlap with the diagonal lines does not exceed 8mm.

2-point examples:

Extraneous lines are acceptable.

1-point examples:

Accuracy: 0 Placement: 1 Accuracy: 0 Placement: 1

Vertical sides are < ½ vertical measurement. Top left angle is not precise.
Dotted lines were added to illustrate vertical
measurement.

0-point example:

This response would have received placement

credit if the overlap with the diagonal lines did not
exceed 8mm.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 26
 ELEMENT 6

Accuracy: Flag points in the correct direction and shares a side with its staff. Flag may resemble a
rectangle or a square.

Placement: Element must be outside the large rectangle and below the left internal element (#3). If
left internal element is not present, score placement leniently based on where left internal element
should have been placed. The top of the flag must be above the bottom of the large rectangle.

2-point examples:

Extraneous lines are acceptable.

1-point examples:

Accuracy: 0 Placement: 1 Accuracy: 0 Placement: 1

Flag does not point in the correct direction (A). Element is just below element 3 (P), but flag
Placement is scored based on where element 3 does not share a side with the staff (A).
should have been placed.

Accuracy: 0 Placement: 1 Accuracy: 1 Placement: 0

In this example, the element bears some slight Top of the flag is below the bottom of the large
resemblance to the target element and is placed rectangle (P).
correctly.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 27
 ELEMENT 7

Accuracy: Element is composed of two lines that form a triangle that is roughly the correct size,
relative to element 1. The vertex of the angle must correspond to the middle third of the rectangle.

Placement: External lines must be outside the large rectangle on the right. Gap or overlap with the
large rectangle should not exceed 8mm. Lines do not need to connect at corners for accuracy or
placement credit.

2-point examples:

The lines to the right form a triangle-like shape,

but if they were more rounded than this (i.e., if
they formed a semi-circle), accuracy credit would
be lost.

1-point examples:

Accuracy: 1 Placement: 0 Accuracy: 0 Placement: 1

The vertex of the angle corresponds to the middle The vertex corresponds to the bottom third of
third of the large rectangle (A) but is on the wrong the large rectangle (A).
side (P).

Accuracy: 0 Placement: 1 Accuracy: 0 Placement: 1

This element is considered to bear enough Element is too small to receive accuracy credit
slight resemblance to target element to receive
placement credit, although it is a borderline
response.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 28
 ELEMENT 8

Accuracy: There must be a triangle and a stem. The angle of the triangle at the farthest end of the
stem must approximate 90° (± 15°). The flag and stem are in correct relationship to each other.

Placement: Either a stem or flag must be present and placed to the right of the rectangle. The
flag need not be a triangle. The element must connect directly to element 7 or be within 5mm of
element 7. No credit is lost for an additional stem of any length, provided one of the stems meets
the placement criteria (see examples). The top of the flag must be above the bottom of the large
rectangle. Rotation > 45° is not allowed.

2-point examples:

1-point examples:

Accuracy: 0 Placement: 1 Accuracy: 1 Placement: 0

Stem is present and placed correctly (P). This is The entire element is rotated > 45º (P), but the
an example of the minimal amount of resemblance relationship between the triangle and stem is
required to be eligible for placement credit. preserved (A).

Accuracy: 0 Placement: 1 Accuracy: 0 Placement: 1

The angle does not approximate 90º (A). No stem.

Accuracy: 0 Placement: 1 Accuracy: 1 Placement: 0

Element bears resemblance and is placed Accurate but not placed correctly.
correctly.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 29
 BONUS POINT

Each element must be accurately drawn, all elements must be properly placed, all elements must
be drawn in proper proportions, all connections between elements must be clean, and no extraneous
lines may be present.

1-point examples:

0-point example:

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 31
Description
This is a test of working memory, and
it taps two different working memory
Number Span Test (Forward and Backward)
constructs. The first, Forward Number
Span, measures the capacity for ADMINISTRATION — Forward Number span
holding information very briefly for
[SAY]: “I am going to ask you to repeat some numbers for me. Wait until I finish saying the
the purpose of repeating it exactly.
numbers and then repeat them in the same order. For example, if I say 1 – 8 – 7, you would
The second, Backward Number Span,
measures the ability not only to hold say 1– 8 – 7. If I say 2 – 9 – 8, what would you say?” If the subject gives the wrong answer,
the information but also to manipulate say, “Actually, you would say 2 – 9 – 8.”
the numbers and reverse the sequence. [SAY]: “Repeat only the numbers I say each time.” Then start with the test items. Before
This test is also referred to as Digit each item, say, “Ready?”
Span.
Administer the items in the order indicated on the test form. Write the subject’s response
Numbers for both forward and
on the answer sheet. Continue testing until two number strings at the same length are
backward span tests are presented,
with sequences ranging from 2 to 9 failed. Record total number of trials correct and longest number sequence repeated
numbers. Two trials are administered correctly prior to the two failed trials.
at each sequence length. There are two
scores: total number of correct trials; SCORING — Forward Number span
longest sequence repeated correctly
Enter the total forward trials correct on NACC UDS Form C2, Question 5a. If the test
prior to failing two consecutive trials of
the same length. was not completed, enter the appropriate reason code, 95 – 98, from the key, and leave
Question 5b blank. If the test was completed, enter the longest span forward that was
SOURCE correct for Question 5b.
Reproduced by permission of the
author, Joel Kramer, PsyD; do not
ADMINISTRATION AND SCORING — Backward Number span
copy or distribute without author’s
permission. Form created as part of [SAY]: “I am now going to ask you to repeat some numbers for me but to reverse them from
the Uniform Data Set of the National the way I say them. Wait until I finish saying the numbers and then repeat them in reverse
Alzheimer’s Coordinating Center, order, or backward. For example, if I say 3 – 7 – 4, you would say 4 –7 – 3. If I say 7 – 3 – 6,
copyright ©2013 University of what would you say?” If the subject gives the wrong answer, say, “Actually, you would say
Washington. 6 – 3 – 7.”
[SAY]: “Repeat only the numbers I say each time, backward, in reverse order.” Then start
with the test items. Before each item, say, “Ready?”
If the participant repeats the numbers in the forward order on either of the first two test
items, you may remind them to say the numbers in reverse order by saying, “Remember,
after I say the number sequence, repeat the sequence backwards. Ready?” Do not give
them the number sequence again. Score correct if the participant is able to give the correct
reverse order after the prompt. This unrequested reminder of the instructions can only
be given once. For all future test items, if the participant repeats the numbers in forward
order, score as errors.
Stop testing after two consecutive failures of the same span length. Administer the items
in the order indicated on the test form. Write the subject’s response on the answer sheet.
Continue testing until two number strings at the same length are failed. Record total
number of trials correct and longest number sequence repeated correctly prior to the two
failed trials.

SCORING — Backward Number span

Enter the total backward trials correct on NACC UDS Form C2, Question 6a. If the test
was not completed, enter the appropriate reason code, 95 – 98, from the key, and leave
Question 6b blank. If the test was completed, enter the longest span forward that was
correct for Question 6b.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 32
 SAMPLE WORKSHEET

SAMPLE WORKSHEET

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 34
Description:
This is a widely used measure of Category Fluency
semantic memory (verbal fluency,
language). The subject is asked to Administration
name different exemplars of a given
semantic category, and the number of Read the initial instruction:
unique exemplars named is scored. [SAY]: “I am going to give you a category and I want you to name, as fast as you can, all of
the things that belong in that category. For example, if I say ‘articles of clothing’, you could
Source:
The procedure is adapted from CERAD say ‘shirt’, ‘tie’, or ‘hat’. Can you think of other articles of clothing?”
administration and scoring procedures Allow up to 20 seconds for the subject to produce two responses. Circle the number
for Verbal Fluency (Morris et al.,
corresponding to the subject’s responses, and read the associated instruction.
1989).

Response Code Instruction

0 (No response) “You could have said ‘shoes’ or ‘coat’ since they
are articles of clothing.”
1 (One or more incorrect “No, ____is (are) not an article(s) of clothing. You
responses, no correct response) could have said ‘shoes’ or ‘coat’ since they are
articles of clothing.”
2 (One or more correct response, “That’s right. You also could have said ‘shoes’ or
no incorrect responses) ‘coat’.”
3 (One or more correct responses, “______is (are) correct, but _______ is (are) not
one or more incorrect responses) an article of clothing. You also could have said
‘shoes’ or ‘coat’.”
4 (Two or more correct responses) “That’s right.”

Next, read the instructions for the Animals category:

[SAY]: “Now I want you to name things that belong to another category: Animals. You will
have one minute. I want you to tell me all the animals you can think of in one minute.
Ready? Begin.”

Start timer as you say “Begin.” Write actual responses as legibly as possible on the
Worksheet for Category Fluency — Animals. Stop the procedure at 60 seconds. One prompt
(“Tell me all the animals you can think of”) is permitted if the subject makes no response
for 15 seconds or expresses incapacity (e.g., “I can’t think of any more.”). It is also
permissible to repeat the instruction or category if the subject specifically requests it. Do
not cue the subject about including more than mammals. However, if the subject inquires
prior to initiating the response or asks during the test, the examiner is permitted to say
“yes.”

Next, read the instructions for the Vegetables category:

[SAY]: “Now I want you to name things that belong to another category: Vegetables. You will
have one minute. I want you to tell me all the vegetables you can think of in one minute.
Ready? Begin.”

Start timer as you say “Begin”. Write actual responses as legibly as possible on the
Worksheet for Category Fluency — Vegetables. Stop the procedure at 60 seconds. One
prompt (“Tell me all the vegetables you can think of”) is permitted if the subject makes no
response for 15 seconds or expresses incapacity (e.g., “I can’t think of any more.”).
It is also permissible to repeat the instruction or category if the subject specifically
requests it.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 35
 Scoring
Defer scoring until after all test administration is finished.

The Animal Total score on the Worksheet for Category Fluency — Animals is the number of
correct unique animal names produced within the one-minute time limit.

• CREDIT: Breeds (e.g., terriers); male, female, and infant names of a species (e.g.,
bull, cow, calf); both superordinate and subordinate examples of a species (e.g.,
both dog and terrier are credited); birds; fish; reptiles, insects.

• DO NOT CREDIT: Repetitions, mythical animals.

The Animal Total score (0–77) should be entered on NACC UDS Form C2, Question 7a. If
the test was not completed, enter the appropriate reason code, 95 – 98, from the key.

The Vegetable Total score on the Worksheet for Category Fluency — Vegetables is the total
number of correct unique names of vegetables produced within the 1-minute time limit.

• CREDIT: Both superordinate and subordinate responses (e.g., peppers and

jalapeños are credited); less specific names (e.g., greens); nuts (e.g., peanuts,
acorns); and grains such as corn or rice.

– Names of vegetables found in other cultures but perhaps unfamiliar to you

(e.g., jicama) are acceptable only if they can be verified in the dictionary. After
completion of the task, ask the subject to spell the word if you are unsure of
the correct spelling.
– Grains (e.g., rice, wheat, oats, etc.), gourds, sugarcane, herbs, and seaweed are
counted as acceptable vegetable responses.
– Tomato, avocado, and pumpkin are acceptable responses.
– Legumes are acceptable responses.
– Nuts are acceptable responses.

• DO NOT CREDIT:
– Repetitions.
– Prepared vegetable products (e.g., pickles, tomato sauce, ketchup, etc.) are not
acceptable responses.
– Spices are not acceptable responses.

The Vegetable Total score (0–77) should be entered on NACC UDS Form C2, Question 7b.
If the test was not completed, enter the appropriate reason code, 95 – 98, from the key.

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

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 SAMPLE WORKSHEET

SAMPLE WORKSHEET

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 39
Description
This is a test of processing speed and Trail Making Test
executive function. Although both
Parts A and B depend on visuomotor Administration
and perceptual-scanning skills, Part
B also requires considerable cognitive PART A
flexibility in shifting from number to
Place the form for Sample A in front of the subject. Read aloud the instructions:
letter sets under time pressure.
[SAY]: “There are numbers in circles on this page. Please take the pencil and draw a
Part A consists of 25 circles numbered
1 through 25 distributed over a white line from one number to the next, in order. Start at 1 (point to the number), then go to
sheet of 8½² x 11² paper. The subject 2 (point to the number), then go to 3 (point to the number) and so on. Please try not
is instructed to connect the circles to lift the pencil as you move from one number to the next. Work as quickly as you can.
with a drawn line as quickly as possible Begin here (point to “Begin” number) and end here (point to “End” number).”
in ascending numerical order.
If the subject makes an error, mark through the line and go back to the point at which
Part B also consists of 25 circles, but
the error was made and say, for example, “You were at number 2. What is the next
these circles contain either numbers
number?” Wait for the subject’s response. If the subject indicates 3, say “Please start
(1 through 13) or letters (A through L).
The subject must connect the circles here (pointing to 2) and continue.” If the subject indicates any other number, say “The
while alternating between numbers and next number would be 3.” Then point to 2 and say “Please start here and continue.” If
letters in an ascending order (e.g., A to the subject cannot complete the sample and clearly does not comprehend the task, do
1; 1 to B; B to 2; 2 to C). not administer Test A. In that event, on the recording form enter the appropriate code
The subject’s performance is judged (996=cognitive/ behavioral problem).
in terms of the time, in seconds, If the subject completes the sample, go to Test A.
required to complete each Trail. The
time to complete Part A (150-second [SAY]: “On this page there are more numbers in circles. Please take the pencil and draw
maximum) and Part B (300-second a line from one circle to the next, in order. Start at 1 (point to the “Begin” number) and
maximum) will be the primary measure end here (point to “End” number). Please try not to lift the pencil as you move from one
of interest (testing is stopped if the circle to the next. Work as quickly as you can.” Start timing as soon as the instruction is
maximum time is reached).
given to begin.
Source NOTE: In giving the instructions for the test form (as opposed to the sample), the
This test, originally called Partington’s examiner tells the subject to move from one circle to the next and does not used the
Pathways1, was a component of the
word “number.”
Army Individual Test Battery2. It was
popularized by Reitan and colleagues If the subject makes an error, mark through the line and say “That one was not correct.”
and subsequently became part of the Point to the last correct number and say “Please start here and continue.” This is
Halstead-Reitan Neuropsychological done for each error. The examiner should attempt to provide corrections as quickly as
Battery3. The instructions for
possible. Stop timing when the Trail is completed, or stop subject when the maximum
administration are adapted from
time is reached. Allow a maximum of 150 seconds for the test.
Spreen and Strauss4.
PART B
Place the form for Sample B in front of the subject. Present the sample for Part B even if
the subject failed the sample for Part A. Read aloud the instructions:

[SAY]: “There are numbers and letters in circles on this page. Please take the pencil
and draw a line, alternating in order between the numbers and letters. Start at number
1 (point to the number), then go to the first letter, A (point to the letter), then go to the
next number, 2 (point to the number), and then the next letter, B (point to the letter),
and so on. Please try not to lift the pencil as you move from one number or letter to the
next. Work as quickly as you can.”

If the subject makes an error, mark through the line and go back to the point at which
the error was made and say, for example, “You were at number 2. What is the next

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 40
 letter?” Wait for the subject’s response. If it is correct, say “Please start here (point to
the 2) and continue.” If the subject picks the wrong item, say, “The next letter would be
B (point to the B).” Then point to the 2 and say “Please start here and continue.” If the
subject cannot complete the sample and clearly does not comprehend the task, do not
administer the test. Enter the appropriate code (996=cognitive/behavioral problem.)

If the subject completes the sample correctly, go to Test B.

[SAY]: “On this page, there are more numbers and letters in circles. Please take the pencil
and draw a line from one circle to the next, alternating in order between the numbers and
letters. Start at 1 (point to the “Begin” number) and end here (point to the “End” number).
Please try not to lift the pencil as you move from one circle to the next. Work as quickly as
you can.” Start timing as soon as the instruction is given to begin.

Note: In giving the instructions for the test form (as opposed to the sample), the examiner
tells the subject to move from one circle to the next and does not use the words “number”
or “letter.”

If the subject makes an error, mark through the line and say, “That one was not correct.”
Point to the last correct item and say, “Please start here and continue.” This is done for
each error. Do not indicate if the next item has to be a number or a letter. The examiner
should attempt to provide corrections as quickly as possible. Stop timing when the Trail is
completed, or stop subject when the maximum time is reached. Allow a maximum of 300
seconds for the test.

Scoring
Record the total number of seconds to complete Part A, up to a maximum of 150 seconds.
If the subject is not finished by 150 seconds, the score is 150. Enter the score for Part A
on NACC UDS Form C2, Question 8a. If the test was not completed, enter the appropriate
reason code, 995 – 998, from the key, and leave Questions 8a1 and 8a2 blank.

Record the total number of seconds to complete Part B, up to a maximum of 300 seconds.
If the subject is not finished by 300 seconds, the score is 300. Enter the score for Part B
on NACC UDS Form C2, Question 8b. If the test was not completed, enter the appropriate
reason code, 995 – 998, from the key, and leave Questions 8b1 and 8b2 blank.

For both Part A and Part B, record errors of commission and number of correct lines as
described below:

“Errors of commission” are defined as errors occurring when the subject connects two
circles in the incorrect sequence. Each time this occurs, one error of commission is
scored. Essentially, any connecting line drawn by the subject that elicits a correction
from the examiner is an error of commission. For example, on Part B, if the subject
draws a line from C to D (instead of C to 3), the examiner would point out the error
and have the subject go back to C. This would count as an error of commission.

“Number of correct lines” is defined as the total number of correct connections

between circles. The maximum number of correct lines on each condition of Trail
Making is 24, so whenever a subject completes the task within the time limit, the total
number of correct lines will always equal 24. Scores less than 24 will occur when the
subject is slow and does not complete the task in the time allotted. For example, a
subject who gets as far as the number 6 on Part B when the allotted time elapses has

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 41
 only completed 10 correct connecting lines (1-A, A-2, 2-B, B-3, 3-C, C-4, 4-D, D-5,
5-E, E-6).

Number of correct lines and commission errors are theoretically orthogonal. Impulsive
subjects who make several failure-to-shift errors on Part B but who eventually finish will
have several commission errors but have 24 correct lines. Conversely, subjects who work
slowly but accurately might have fewer than 24 correct lines because they did not finish in
time but have zero commission errors.

If the subject draws a line through another circle while clearly on the way to the next
circle in the sequence, caution the subject to avoid touching circles other than the ones
intended, and make a note of what occurred on the raw data form, but do not count as an
error of commission.

Recording number of correct lines and errors of commission significantly increases the
amount of information gleaned from the Trail Making test. Under the current scoring
system, a subject who gets as far as “C” within the time limit on Part B would receive
the same score as a subject who gets as far as “K,” yet clearly the second subject’s
performance is better. Recoding the number of correct lines allows researchers to measure
these performance differences. Recording errors of commission provides an index of
impaired rule monitoring, and preliminary data (Kramer, personal communication) suggest
that this index may have a more specific relationship with frontal lobe neuroanatomical
volumes.

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Description
This is a test of delayed recall (episodic Craft Story 21 Recall (Delayed)
memory) of the story read to the
subject at the beginning of the testing
session, during Craft Story 21 Recall Administration
(Immediate).
Administer this test approximately 20 minutes after Craft Story 21 Recall (Immediate).
Source NOTE: If 20 minutes have not elapsed, do not add other tests to fill the interval. Some of
Craft S, Newcomer J, Kanne S, the time can be used to obtain blood pressure, weight, etc., if need be. Administer Craft
Dagogo-Jack S, Cryer P, Sheline Y, Story 21 Recall (Delayed) and record the actual time elapsed.
Luby J, Dagogo-Jack A, Alderson A.
[SAY]: “I read you a story a few minutes ago. Can you tell me what you remember about
Memory improvement following induced
hyperinsulinemia in Alzheimer’s that story now?”
disease. Neurobiol Aging. 1996 Jan- If the subject does not recall the story or having been told a story, make a note as indicated
Feb;17(1):123-30.
below and
Reproduced by permission of the
[SAY]: “It was a story about a boy. Can you tell it to me now?”
author, Suzanne Craft, PhD; do not
copy or distribute without author’s Record the subject’s response on the Worksheet for Craft Story 21 Recall (Delayed). Make
permission. Form created as part of sure that your written record is legible before proceeding. If the subject asks a question
the Uniform Data Set of the National
about the story or for repetition of some or all of it, say, “Please tell me as much as you
Alzheimer’s Coordinating Center,
remember about the story.”
copyright ©2013 University of
Washington.
SCORING
Score according to instructions for Craft Story 21 Recall (Immediate) in this instruction
book. The examiner may prefer to tape-record the subject’s response and then transcribe
the results after the session; this is acceptable, if appropriate consent has been obtained.

VERBATIM SCORING
PERFECT VERBATIM RESPONSE (1.0 POINT): Give the subject 1 point for every bit for
which content words are recalled exactly and completely. Allowances can be made for
variations of verbs (e.g., “likes” for “liked,” “join” for “joining”) and minor omissions (e.g.,
“neighbor” for “neighbor’s”) or changes in number (e.g., “games” for “game”). The content
words do not need to be recalled by the subject in the same order they were read to receive
credit. The words can appear anywhere in the recall.

Enter the verbatim score on NACC UDS Form C2, Question 9a. If the test was not
completed, enter the reason code, 95 – 98, from the key and leave the paraphrase score,
Question 9b, blank.

PARAPHRASE SCORING
PARAPHRASE RESPONSE (1.0 POINT): Give a point for a response that captures the
elements of the story although not necessarily with the exact words (see table on page
51).

Enter the paraphrase score on NACC UDS Form C2, Question 9b. Enter the delay time,
in minutes, on NACC UDS Form C2, Question 9c. If the delay time is unknown or mis-
recorded, enter 99=Unknown. If the cue (“boy”) was needed, select 1=Yes for Question
9d; otherwise, select 0=No.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 49
 CRAFT STORY 21 RECALL (DELAYED): VERBATIM SCORING

Maria’s so
child hard
Ricky it
played went
soccer over
every neighbor’s
Monday fence
three thirty three
he large
liked dogs
going lived
field dogs’
behind owner
their heard
house loud
joining barking
game came
one out
day helped
he them
kicked retrieve
ball ball
TOTAL

Number of items recalled for verbatim scoring:

Delayed Recall Score: /44 maximum

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 50
 GUIDELINES FOR PARAPHRASE SCORING, CRAFT STORY 21

Item General rule Alternative 1-point responses 0-point responses Points

“Maria” or a variant of the
Maria’s Mary, Marie Martha, Anna
name
“child” or a phrase denoting
child son, kid, boy, teenager, young man guy, children, daughter
it was a young person
“Ricky” or a variant of the Rick, Rich, Richie, Richard,
Ricky Randy, Rusty, Robert
name Ricardo

played “played” is required to play, plays did (soccer)

baseball, volleyball, other

soccer “soccer” is required futbol
sport
“Monday” or an indication every day, another day of
every Monday —
that it occurred on a weekday the week
an indication that the activity after dinner, at night, in
at 3:30 after school, every afternoon
took place in the afternoon the morning
He liked going to an indication that he went to went outside, went to the yard,
went to the school, gym
the field an outdoor area going to the backyard
behind their “house” or word denoting a
home, residence, where they lived any other building
house house
an indication that he played w/ other kids, became part watching, played in the
and joining
participated in a game of the team, playing w/ the team park

the game. “game” in any context — —

One day “One day” is required — —

indication that he performed threw, hit (with no

he kicked booted, punted
the activity with his foot mention of the foot)

the ball “Ball” is required football, soccer ball baseball, volleyball

an indication that force was so much force, so strongly, (kicked

so hard —
used it) so far

that it went over “Over” is required — —

an indication that the person

the neighbor’s nearby resident friend’s
lived in the same area
“fence” or a word denoting a
fence garden wall, wall property line, street
fence of some kind

where three “Three” is required three (boys) —

an indication that there were puppies, cats, kittens,

large dogs lived. hounds, doggies
dogs present other animals
an indication that the person neighbor (if owner implied and
The dogs’ owner a bystander, the police
was responsible for the dogs “neighbor” mentioned twice)
heard loud an indication that the dogs yelping, baying, yapping, heard the saw the dogs running
barking were making noise dogs around
a word or phrase indicating his mother came out, the
came out (owner) saw the ball
that the owner was present dogs came out
a word or phrase indicating
and helped them assisted, aided, had to help —
that help was provided
an indication that they got gave him the ball, return the ball,
retrieve the ball.
the ball back (helped him) get the ball —

Number of items recalled for paraphrase scoring: Immediate Recall Score: /25 maximum
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DESCRIPTION
Reproduced by permission of the Benson Complex Figure Copy (Delayed)
author, Joel Kramer, PsyD; do not
copy or distribute without author’s
permission. Form created as part Administration
of the FTLD Module to the Uniform 10 –15 minutes after completion of the copy trial, subjects should be given a blank piece
Data Set of the National Alzheimer’s
of paper and pen and asked:
Coordinating Center, copyright 2013
University of Washington. [SAY]: “Remember that figure that I asked you to copy a while ago? I want you to draw as
much of it as you can remember.”
Source
Possin, KL, Laluz VR, Alcantar A maximum of 4 minutes should be allowed for completing the drawing. The same scoring
OZ, Miller BL, Kramer JH. Distinct guidelines as used for Benson Complex Figure Copy (Immediate) should be used to score
neuroanatomical substrates and recall performance.
cognitive mechanisms of figure copy
performance in Alzheimer’s disease
and behavioral variant frontotemporal Recognition
dementia. Neuropsychologia. 2011
After the completion of figure recall, place the recognition page in front of the subject and
Jan; 49(1):43-8.
ask:

[SAY]: “Which of these figures was the one you copied before?”

Scoring
Enter the total score on NACC UDS2 Form C2, Question 10a. If the test could not be
administered, enter the appropriate reason code, 95 – 98, from the key. If the subject
recognized the stimulus from among four options, select 1=Yes for Question 10b;
otherwise, select 0=No.

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Description
The Multilingual Naming Test (MINT) is a
test of visual object naming designed to
MINT
contain items that have similar levels of ADMINISTRATION
usage and familiarity across four different
languages: English, Spanish, Hebrew and [SAY]: “I am going to show you some pictures of objects, one at a time. Please tell me the
Mandarin. Other naming tests designed for name of each object, that is, tell me what it is called. If you cannot think of the name try
English speakers have items that either do to make your best guess. If you don’t know what the object is, I will try to help you. Do you
not exist in another language or that occur have any questions?”
in different frequencies in other languages,
making the MINT appropriate for use Allow up to 20 seconds for a response, particularly if the subject is struggling.
in diverse populations. Line drawings If the answer is correct, put a check mark in the column “Uncued-correct.”
are presented to the subject with the
instruction to say the name of the object. For items 30 and 31 (mortar, pestle), there is only one picture.

SOURCE
[Say]: “On this page there are two things I would like you to name.” Point to the mortar
Tamar H. Gollan, PhD, Department of and say “What is this called?” and record the response. Then point to the pestle and say
Psychiatry, University of California, San “What is this called?” and record the response. Be sure to ask for both items.
Diego
Continue until the subject fails to name six consecutive items, either spontaneously or after
Ivanova I, Salmon DP, Gollan TH. The receiving semantic cues.
Multilingual Naming Test in Alzheimer’s
Disease: Clues to the Origin of Naming Alternative responses
Impairments. J Int Neuropsychol Soc.
2013; 19:272-283. Item no. MINT item Alternative correct response(s)

Gollan TH, Weissburger G, Runnqvist

3 lightbulb electric bulb, bulb
E, Montoya RI, Cera CM. Self-ratings 10 seesaw teeter-totter
of spoken language dominance: A
27 gauge manometer, barometer
Multilingual Naming Test (MINT) and
preliminary norms for young and aging
Spanish–English bilinguals. Bilingualism:
Language and Cognition. 2011;13:215-8. CUEING
From A Multilingual Naming Test, Tamar If the initial response is incorrect, there are several procedures to follow. Responses to cues
H. Gollan, PhD; reproduced by permission. are not timed, and if they do not occur immediately, the examiner should move on. When
Do not copy or distribute without author’s the subject indicates knowledge of the object but cannot name it, it is appropriate to give
permission. Form created as part of a phonemic cue (the first few sounds of the word). Knowledge of the word can be assumed
the Uniform Data Set of the National
if the subject makes a phonemic paraphasia, such as “ankle” for “anvil” (substituting a
Alzheimer’s Coordinating Center, copyright
sound within the word, retaining most of its original sounds) or correctly describes the use
©2013 University of Washington.
of the object (e.g., “You use it to mash things up,” for “pestle”).

Please take care to provide only the sound of the letter(s) underlined on the response form.
Only three-syllable words have the first two letters underlined. The examiner can practice
cuing by starting to say each word and suddenly stopping after the first sound.

Sometimes a subject will give a response that indicates lack of visual recognition of the
object, that is, misperception (e.g., focusing only on the flame at the top of the candle and
saying “fire” or misperceiving the twigs in the nest and saying “hair”). In that instance,
a semantic cue should be given since it helps lead the subject to more accurate visual
perception of the object. If the response is correct with the semantic cue, it is marked
correct in the appropriate column under “Semantic cue.”If it is incorrect it is marked as
wrong and the examiner should then move to the phonemic cue. Note, the semantic cue is
only given if the subject does not recognize the object.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 57
 PROMPTS ALLOWED FOLLOWING SPONTANEOUS RESPONSE ONLY
Subjects will often say non-target/alternative names. If that happens there are three
prompts you can give to try to elicit the target name as follows:

Prompt 1: “Can you think of a more specific name?” (code = S)

Prompt 2: “Can you think of a more general name?” (code = G)
Prompt 3: “Can you think of a different or another name?” (code = A)

If you use one of these three prompts, indicate this on the coding sheet by writing the
relevant code in the Spontaneous Response column.

Examples:
1) If the subject gives a circumlocutory or more general response (e.g., for “saw” says
“it cuts wood” or “it’s a tool”), use Prompt 1 and write (S) on the coding sheet.

2) If the subject gives a more specific name (e.g., for “volcano” says “It’s Mt.
Vesuvius”), use Prompt 2 and write (G) on the coding sheet.

3) If subject gives an alternative, but not incorrect response (e.g., “dromedary” for
‘camel’), use Prompt 3 and write (A) on the coding sheet.

Other useful prompts

Sometimes subjects might tell you other things that they remember about using the object,
etc. For example, “My dad had one of those!” If that happens [SAY]:

Prompt 4: “Can you tell me the name?”

If the subject gives a correct name, but says it is not that object (e.g., “Well, it’s not a
canoe”), cueing proceeds as if the response was incorrect, [SAY]:

Prompt 5: “Do you know the name?” or “Do you know what it is?”

If the subject is focusing on the wrong part of the picture (e.g., “needle” for “barometer”
or “sky” for “rainbow”), point to what they should be focusing on and [SAY]:

Prompt 6: “What is the whole thing called?” or “What is this part called?”

Scoring
The total MINT score should be calculated using items up to the point where the subject
stopped the test. Items are counted as correct only if spontaneously named or named
with a semantic cue if needed (see below). If the subject gives the correct name with a
phonemic cue, this is not counted towards the total correct. The reason for this is that this
test assesses word retrieval under conditions of full recognition of the object. If the subject
is cued to the object’s identity after an initially faulty recognition and names the item
correctly, it is not a word retrieval problem.

Enter the total score on NACC UDS Form C2, Question 11a. If the test was not completed,
enter the appropriate reason code, 95 – 98, from the key and leave Questions 11b – 11f
blank.

For Question 11b, enter the total correct without a semantic cue. For Question 11c, enter
the number of semantic cues given. For 11d, enter the number of items correct with a
semantic cue. If no semantic cues were given, enter 88=Not applicable for Question 11d.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 58
 For Question 11e, enter the number of phonemic cues given. For 11f, enter the number
of items correct with a phonemic cue. If no phonemic cues were given, enter 88=Not
applicable for Question 11f.

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Description
This is a widely used measure of word
Verbal Fluency: Phonemic Test
generation that may be sensitive to
dysfunction in the dominant frontal ADMINISTRATION
lobe. In this version, the subject is
asked to say as many words as possible
that begin with the letter “F” in 60 Letter F
seconds, and then as many words that
begin with the letter “L” in 60 seconds. MATERIALS: 1-minute timer

Source [SAY]: “I’m going to say a letter of the alphabet. When I ask you to start, tell me as many
Reproduced by permission of the words as you can that begin with that letter. You will have 1 minute before I tell you to
author, Argye E. Hillis, MD; do not stop. None of the words can be numbers or names of people, or places.
copy or distribute without author’s
permission. Form created as part
“For example, if I gave you the letter B, you could say brown, bottle or bake, but you
of the FTLD Module to the Uniform wouldn’t say Barbara, Boston or billion. Also, please try not to give me the same word with
Data Set of the National Alzheimer’s different endings, so if you said bake, you wouldn’t also say baked or bakes, and if you said
Coordinating Center, copyright 2013 big, you wouldn’t also say bigger and biggest.
University of Washington.
“Let’s begin. Tell me all the words you can, as quickly as you can, that begin with the letter
‘F’. Ready? Begin.”

Start timer after completing instructions. Write actual responses as legibly as possible.
Stop the procedure at 60 seconds.

PROMPTS:
If the subject pauses for 15 seconds:
• “Keep going.”
• “What other words beginning with “F” can you think of?”

If the subject gives three consecutive words that do not start with the designated letter
(provide this prompt only once during this condition):

• “We are now using the letter F.”

Letter L

MATERIALS: 1-minute timer

[SAY]: “Now I want you to do the same for another letter. The next letter is L. Ready?
Begin.”

Start timer after completing instructions. Write actual responses as legibly as possible.
Stop the procedure at 60 seconds.

PROMPTS:
If the subject pauses for 15 seconds:
• “Keep going.”
• “What other words beginning with “L” can you think of?”

If the subject gives three consecutive words that do not start with the designated letter
(provide this prompt only once during this condition):

• “We are now using the letter L.”

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 62
 Guidelines
Record all responses, including repeated words and rule violations. When a rule violation
(e.g., proper nouns, words beginning with the wrong letter) occurs on three consecutive
responses, examiners should remind the subject of the correct rule. Each rule can be
repeated only once per trial.

Scoring

Correct responses
Any word that begins with the specified letter, can be found in a dictionary, is not a proper
noun or a number, and is not a repetition within that trial, should be scored as a correct
response.

Although scoring of most responses is straightforward, many responses are ambiguous.

For example, “frank” can refer to a man’s name, a food item, or an adjective. The scoring
principle with these sorts of responses is to give the benefit of the doubt and score the item
as correct for the first instance of the response in a trial. In some instances, the context in
which the response is given can provide clues as to the subject’s meaning. For example,
the sound “fôr” is ambiguous, and could be a preposition (for), golf term (fore), or number
(four). If the word is given along with other numbers (e.g., “four, five”), the response can
be interpreted as a number and be scored as a rule violation. If the response is at all
ambiguous, however, apply the general principle of giving the benefit of the doubt. If a
person self-corrects a rule violation or repetition during the trial, the response should not
be counted as an error.

Other types of responses that should be scored as correct include:

• Contractions
• Compound words or conjoined words that convey a single meaning (e.g., ferris wheel)
• Slang words if they can be found in a dictionary
• Proper nouns that are not the names of people or places (e.g., days of the week, months
of the year, brand names)

Repetitions
Any response that is repeated verbatim within the 60-second trial should be scored as a
repetition.

If a repeated word has more than one meaning (e.g., “still” can be an adjective and
a noun) or is a homophone (e.g., “flue” and “flew”), score the second response as a
repetition error unless the subject explicitly or implicitly (e.g., with intonation or gesture)
indicates that the second response has a different meaning or spelling, or if the context
strongly suggests that it is a different word. For example, for the string of responses “felt,
feeling, fresh, fabric, felt,” the second occurrence of “felt” can be scored as correct since
the context implies a different meaning than the first occurrence of “felt.”

Grammatical variants should be scored as rule violations, not repetitions (see below).

Rule violations
Any response that reflects a deviation from the rules provided to the subject should be
scored as a rule violation.

NACC UDS Neuropsychological Battery Instructions (Form C2), version 3.0, March 2015 Page 63
 Several types of responses are potentially rule violations and include:

• Words beginning with letters other than the designated letter. This includes words that
have the same initial sound but begin with a different letter (e.g., “phone” for F-words).
• Non-words
• Proper nouns that are names of people or places
• Numbers
• Grammatical variants of a previous response. These include words that are exactly
the same as a previous response but with a different ending that represents a plural,
altered tense, or other grammatical variant (e.g., present participle; comparatives). It is
important to note that the examples in the instructions only explicitly prohibit plurals
(e.g., bake, bakes), alteration in tense (bake, baking), and comparatives (big, bigger),
and thus only these types of variants should be scored as rule violations.

Responses that are at all ambiguous should not be scored as rule violations. This
particularly applies to responses that use the same root word as a previous response, but
the addition is not a plural or change in tense. For example, give credit for “bakery,” even
if “bake” was a previous response.

Repeated rule violations count as repetitions, not rule violations.

On NACC UDS Form C2, Question 12a, enter the number of correct F-words generated in
1 minute. If the test was not completed, enter the appropriate reason code, 95 – 98, and
leave Questions 12b and 12c blank. Enter scores for 12b and 12c, if applicable.

On NACC UDS Form C2, Question 12d, enter the number of correct L-words generated
in 1 minute. If the test was not completed, enter the appropriate reason code, 95 – 98,
and leave Questions 12e – 12i blank. Enter scores for 12e and 12f, if applicable. Enter
corresponding total scores for 12g – 12i, if applicable.

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