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Rehab Measures: Behavioral Inattention Test

Link to instrument

Available for purchase from the publisher's website (other languages below) 

Title of Assessment

Behavioral Inattention Test 

Acronym

BIT

Instrument Reviewer(s)

Summary Date

 

Purpose

A comprehensive battery designed to screen for unilateral visual neglect and provide information relevant to it’s treatment

Description

  • Divided into two subtests:
    • Conventional
    • Behavioral
  • BIT Conventional subtest (BITC) consists of 6 items:
    • Line crossing
    • Letter cancellation
    • Star cancellation
    • Figure and shape copying
    • Line bisection
    • Representational drawing
  • BIT Behavioral subtest (BITB) consists of 9 items:
    • Pre-scanning
    • Phone dialing
    • Menu reading
    • Article reading
    • Telling and setting the time
    • Coin sorting
    • Address and sentence copying
    • Map navigation
    • Card sorting
  • Total and subscores are obtained by adding the subtests scores together
  • Maximum scores:
    • BIT = 227
    • BITC = 146
    • BITB = 81
  • Higher scores are indicative of more severe visual impairment

Area of Assessment

Vision & Perception 

Body Part

Not Applicable 

ICF Domain

Body Function 

Domain

Sensory 

Assessment Type

Observer 

Length of Test

60 Minutes or More 

Time to Administer

40 minutes

Number of Items

6 on the BITC and 9 on the BITB 

Equipment Required

  • BITC and BTIB Forms
  • Photographs of:
    • A meal
    • A wash-basin and toiletries
    • A large room with pieces of furniture and hospital aids
    • Different settings of a digital clock
  • Open-out menu
  • Analogue clock
  • Six different types of coins
  • Playing cards
  • Paper and pencil

Training Required

None necessary

Type of training required

No Training 

Cost

Not Free 

Actual Cost

$280.00 in 2010

Age Range

Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Stroke 

Populations Tested

Stroke
Healthy Adult Normals

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Cut-Off Scores: (Halligan et al, 1991; Menon & Korner-Bitensky, 2004)
Indicating the presence of spatial neglect:
    • BITC < than 129
    • BITB < than 67
    • BIT < than 196

Normative Data

Not Established

Test-retest Reliability

Stroke & Healthy Normals: (Wilson et al, 1987, n = 28 stroke and 14 non stroke patients; mean age (patients) = 54.29 (8.82) years; time since stroke = 12.25 (20.06) days)
  • Excellent test-retest reliability (r = 0.83)
Acute Stroke: (Halligan et al, 1991, n = 80; mean age = 56.2 (10.5) years; average time since stroke = 2 months)
  • Excellent test-retest reliability (r = 0.89 BITC; r = 0.97 BITB)

Interrater/Intrarater Reliability

Acute Stroke: (Halligan et al, 1991):
  • Excellent inter-rater reliability (r = 0.99 BITC; r = 0.99 BITB)

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Acute Stroke: (Jehkonen et al, 2000, n = 57, mean age = 63.23 (10.21) years, examined within 10 days of stroke)
  • Excellent predictor of poor functional outcomes
    • Results accounted for 73%, 64% and 61% of the total variance of the Frenchay Activity Index at 3, 6 and 12 months respectively 

Construct Validity (Convergent/Discriminant)

Acute Stroke: (Halligan et al, 1991; Cassidy et al, 1999)
  • Excellent to adequate convergent validity with:
    • Occupational Therapist Checklist (r = -0.65)
    • Rivermead Activities of Daily Living Assessment (r = 0.55)
    • Barthel Index (r = 0.64)

Content Validity

Test development: (Wilson et al, 1987)

  • Interviewed clients with stroke about everyday difficulties
  • Retrieved information from published cases, behavioral observation of patients with neglect, as well as from discussions with occupational therapists, physiotherapists, clinical psychologists, and neurologists, all of whom had worked with patients with visual neglect.
  • Final selection of items was determined based on results of a pilot study

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

Considerations

Cost of the test is approximately $280 dollars

Behavioral Inattention Test translation:

Spanish:
http://www.funveca.org/revista/PDFespanol/1998/art04.3.06.pdf

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Bibliography

Cassidy, T., Bruce, D., et al. (1999). "The association of visual field deficits and visuo-spatial neglect in acute right-hemisphere stroke patients." Age and Ageing 28(3): 257. Find it on PubMed

Halligan, P., Cockburn, J., et al. (1991). "The behavioural assessment of visual neglect." Neuropsychological Rehabilitation 1(1): 5-32.

Jehkonen, M., Ahonen, J. P., et al. (2000). "Visual neglect as a predictor of functional outcome one year after stroke." Acta Neurol Scand 101: 195-201. Find it on PubMed

Menon, A. and Korner-Bitensky, N. (2004). "Evaluating unilateral spatial neglect post stroke: working your way through the maze of assessment choices." Top Stroke Rehabil 11: 41-66. Find it on PubMed

Wilson, B., Cockburn, J., et al. (1987). "Development of a behavioral test of visuospatial neglect." Arch Phys Med Rehabil 68: 98-9102. Find it on PubMed

Year published

1987 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 10/30/2010 11:36 AM  by Dawood Ali 
Last modified at 8/8/2014 2:17 PM  by Jason Raad