The validity of the Brain Injury Cognitive Screen (BICS) as a neuropsychological screening assessment for traumatic and non-traumatic brain injury

Abstract

Objective: The Brain Injury Cognitive Screen (BICS) was developed as an in-service cognitive assessment battery for acquired brain injury patients entering community rehabilitation. The BICS focuses on domains that are particularly compromised following TBI, and provides a broader and more detailed assessment of executive function, attention and information processing than comparable screening assessments. The BICS also includes brief assessments of perception, naming, and construction, which were predicted to be more sensitive to impairments following non-traumatic brain injury. The studies reported here examine preliminary evidence for its validity in post-acute rehabilitation. Method: In Study 1, TBI patients completed the BICS and were compared with matched controls. Patients with focal lesions and matched controls were compared in Study 2. Study 3 examined demographic effects in a sample of normative data. Results: TBI and focal lesion patients obtained significantly lower composite memory, executive function and attention and information processing BICS scores than healthy controls. Injury severity effects were also obtained. Logistic regression analyses indicated that each group of BICS memory, executive function and attention measures reliably differentiated TBI and focal lesion participants from controls. Design Recall, Prospective Memory, Verbal Fluency, and Visual Search test scores showed significant independent regression effects. Other subtest measures showed evidence of sensitivity to brain injury. Conclusions: The study provides preliminary evidence of the BICS’ sensitivity to cognitive impairment caused by acquired brain injury, and its potential clinical utility as a cognitive screen. Further validation based on a revised version of the BICS and more normative data are required.

Keywords:

• Traumatic brain injury
• acquired brain injury
• focal cerebral lesion
• cognitive screen assessment
• cognitive screen normative data

Acknowledgments

We are grateful for the contribution to this project made by Amrat Singh, Bob Rafal, Becca Henderson, Caroline Roffey, Christian Ashford, Christos Chrysomalis, Elaine Fowler, Elizabeth Pritchard-Sleath, Nick Fleck, Lauren Thompson, Paloma Mari-Beffa, Priya Pattni, Naomi Wood, Ross Roberts, and Shanti Shanker.