Abstract

Abstract Objective: There are few neuropsychological measures available for valid assessment of hospital inpatients who are intubated or otherwise unable to communicate verbally. The Nonverbal Test of Cognition in Hospitals (NoTCH) was developed to provide a brief inpatient assessment that does not require verbal responses. The objective of this study was to describe the NoTCH and determine its tolerability and practicality among hospitalized patients, to justify normative data collection. Method: The NoTCH contains 10 subsections and was designed to assess domains of attention, working memory, learning and memory, receptive language, orientation, and suboptimal engagement. The test was developed and then administered to a small cohort of four neuropsychologists and health psychologists to pilot the measure and refine the test. Thirteen participants with epilepsy undergoing monitoring on the epilepsy monitoring unit then completed the NoTCH. Participants answered a series of prompts by holding up fingers, tapping, and pointing to objects in their room. Means and standard deviations of test performance were examined to identify ceiling effects. Results: The NoTCH took an average of 16 minutes to administer and was well tolerated by all patients. The overall measure was reasonably difficult on average (56/96; SD = 6.76) and four sections had notable ceiling effects. No tests had floor effects that would preclude detection of low scores. Conclusions: The NoTCH was well-tolerated in the inpatient setting, quick to administer, and demonstrated preliminary indication of sensitivity to cognitive functioning across domains. Future research will develop normative data for the measure and a companion outpatient form.

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