Supplement 2

Recommendations for domain-specific cognitive tests and for assessment toolsrelated to key clinical variables in the psychological domain

Recommendations for domain-specific cognitive tests

With the following Table S2, we provide recommendations for a set of domain-specific neuropsychological tests that may be used for research purposes (e.g. in a prospective institutional/multinational study) or in clinical practice. For a comprehensive description and appropriate referencing of the neuropsychological tests see Strauss et al1 and GoldsteinNaglieri2. Please note that characteristics oftest versions other than those specified in Table S2 may differ in same aspects.Language and visuospatial abilities are expected to be generally unimpaired in craniopharyngioma patients but due to their upmost importance for other tests in the verbal and visual domain, a short testing is recommended.Although tests were selected according to pre-defined criteria,we would like to emphasize the subjective aspect of selection.In addition, tests which may be of high value for specific hypotheses testing (e.g. California Verbal Learning Testor further subtests of the Wechsler Memory Scales for the episodic memory domain) are not included in Table S2.

Following criteria were applied for test selection:

1)Adequate psychometric characteristics:For a comprehensive overview onpsychometric properties of the tests selected seeStrauss et al1and GoldsteinNaglieri2.

2)Accessibility:Where reasonable, tests were selected out of the most commonly used neuropsychological tests which are thus widely available.

3)Administration time:Where reasonable, we selected tests with a short administration time.

4)Age range: For each cognitive domain, tests were selected to cover age ranges from childhood to late adulthood.

5)Primacy of tests limited to the auditory domain:As far as possible, we selected tests which may also be performed with visually impaired and blind subjects,butfor special issues related to the testing of this groupplease refer toHill-Briggs et al3.

Table S2. Cognitive domains to be tested in childhood craniopharyngioma patients and domain-specific neuropsychological tests to consider in future investigations. [A] = Tests limited to the auditory domain.

Test (Age Range) / Administration Time / Further Comments
General Cognitive Functioning / Intelligence
Kaufmann Assessment Battery for Children (K-ABC; 2;5-12;5 yrs.) and The Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV; 6 to 16 yrs., 11 month) and Wechsler Adult Intelligence Scale (WAIS IV; 16 to 90 yrs.)
or Wechsler Abbreviated Scale of Intelligence (WASI, 2-subtest and 4-subtest forms;6-89 yrs.)
orRaven’s Progressive Matrices (PM): Colour Progressive Matrices (CPM; 5-11yrs.); Standard PM (SPM; 6.5+ yrs.) / 60-95 min. s
15 min. (2 subtests form)
30 min. (4 subtests form)
CPM: 25-30 min. SPM: 30-45min. / The Wechsler Intelligence Scales (Full Scales): a) The verbal scales may be used with visually impaired or blind subjects without any procedural or structural adaptations[A]. For further issues related to the testing of visually impaired subjects see3; b) Several subtests of the Wechsler Intelligence Scales are valuable to indicate domain specific performance (see below).
Raven’s Progressive Matrices: Non-verbal and culture fair testing; suitable for group testing; parallel forms available for repeated testing.
Short-term/Working memory
Memory Span:Digit Span (digits forward; 6-16 and 16-90 yrs.[A])
or Spatial Span (4-90 yrs)
Working Memory: Digit Span (digits backward; 6-16 and 16 to 90 yrs.; [A]) or Letter-Number Sequencing(6-16 and 16 to 90 yrs.; [A])
or Spatial Working Memory (4-90 yrs.) / 5 min.
6 min.
5 min.each
8 min. / Subtest of the WISC-IV and WAIS-IV (see above)
Subtest of the Cambridge NeuropsychologicalTest Automated Battery (CANTAB)
Subtests of the WISC-IV and WAIS-IV
Subtest of the CANTAB
Long-term episodic memory
Immediate recall, delayed recall and recognition: Rey Auditory Verbal Learning Test (RAVLT; 7-89 yrs.[A])
or Stories I and II (Children’s Memory Scale [CMS]; 5-16 yrs. [A]) and (Logical Memory I and II (Wechsler Memory Scale III [WMS-III]; 16-90 yrs. [A])
orRey-Osterrieth Complex Figure Test and Recognition Trial (RCFT; 6-89 yrs.) / 10-15min.administration time plus 20 min. delay
10-15 min. administration time plus 20-30 min. delay
15 min. administration time plus 30 min. delay / RAVLT: Alternate lists are available for repeated testing.
CMS subtests are similar in format and use comparable stimuli, to those from the WMS-III.
In the RAVLT,the CMS, and the RCFT, the delay between immediate and delayed recall is usually filled with other tests.
Long-term semantic memory
Information or Vocabulary (both:6-16 and 16-90 yrs. [A]); / 5 min. each / Subtests of the WISC-IV, WAIS-IV. Vocabulary is also included in theWASI.
Sustained Attention:Connors Continuous Performance Test III (CPT-III; 8+ years)
or Rapid Visual Information Processing(4-90 yrs) / 14 min.
10 min. / Subtest of the CANTAB
Processing Speed
Coding orSymbol search(6-16 and 16-90 yrs.) / 5 min. each / Subtests of the WISC-IV and WAIS-IV. A processing speed index may be calculated by additionally using results of a further subtest (Cancellation).
Executive Function
Set Shifting:Wisconsin Card Sorting Test (WCST; 6.5-89 yrs.)
orModifiedWisconsin Card Sorting Test (M-WCST; 18-90 yrs.)
or Classification (8-89 yrs.[A])
or Intradimensional/Extradimensional Shift (IED; 4-90 yrs)
Fluency: Verbal fluency tests (semantic or phonemic), e.g. Category Fluency or Letter Naming (8-89 yrs.[A])
Planning, Problem Solving: Stockings of Cambridge (SOC; 4-90 yrs) / 20-30 min.
7-10 min.
7-10 min.
7 min.
5 min. each
10 min / Classification: Language-based analog to the Wisconsin Card Sorting Test.Subtest of the Test of Verbal Conceptualization and Fluency (TVCF).
Subtest of the CANTAB
Subtests of the Test of Verbal Conceptualization and Fluency (TVCF).
Subtest of the CANTAB
Vocabulary (both:6-16 and 16-90 yrs. [A]) / 5 min. / Subtest of the WISC-IV and WAIS-IV. Additionally a Verbal Comprehension Index can be calculated from several subtests of the WISC-IV and WAIS-IV.
Visuospatial Abilities
Rey-Osterrieth Complex Figure Test(Copy Condition; 6-89 yrs.) / 5 min.

Key clinical variables to consider in future investigations that include psychology outcomes and examples for related validated assessment tools

Neurobehavioral outcome

  • Behavior Rating Inventory of Executive Function (BRIEF). Age 5-18. Parent/teacher report of executive functioning. Key variables: Behavioral regulation, emotional regulation, metacognition. Administration time: 10-15 minutes
  • Child Behavior Checklist (CBCL) and Adult Behavior Checklist (ABCL, OABCL).Versions for different age ranges available, covering a range from 1.5 up to 90+ yrs. Administration time: 10-15 minutes.

Social outcome

  • Child Behavior Checklist (CBCL, see above).Includes social competencies scales.
  • Personality Inventory Scale for Children (PIC-2).Age 5-19 yrs. Designed to evaluate emotional, behavioral, cognitive, and interpersonal adjustment.Includes scales for Social Withdrawal andSocial Skills Deficit and a composite score for Social Adjustment. Administration time for the short form: 15 minutes.

Emotional/affective outcome

  • Beck Depression Inventory(BDI-II). Age 13-86. Self-report of depression. Key variables: Somatic-affective and cognitive aspects. Administration time: 5-10 minutes
  • State-Trait-Anxiety Inventory (STAI). Age >15 yrs.Self-report of anxiety, differentiating between the temporary condition of state anxiety and the more general and long-standing quality of trait anxiety.Administration time: 10 minutes.
  • Child Behavior Checklist (CBCL, see above)

Quality of Life

  • Pediatric Quality of Life Inventory (PedQL). Ages 2-18; Child Self-Report: ages 5-7, 8-12, 13-18; Parent Proxy-Report: ages 2-4, 5-7, 8-12, 13-18). The Generic Core Scales include 23 items; administration time: < 4 minutes.
  • The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).Age > 18 yrs. Self-administered questionnaire that consists of 30 items. Administration time: 10 minutes

School performance

  • Interviews with parents and/or teachers(unstandardized) or school achievement tests.

Zada et al.4provide a first comprehensive overview on neurobehavioral, social, and emotional dysfunction in childhood craniopharyngioma patients.

1.Strauss E, Sherman EMS, Spreen O. A compendium of neuropsychological tests. Oxford, New York: Oxford University Press; 2006.

2.Goldstein S, Naglieri JA, editors. Handbook of Executive Functioning. New York, Heidelberg: Springer; 2014.

3.Hill-Briggs F, Dial JG, Morere DA, Joyce A. Neuropsychological assessment of persons with physical disability, visual impairment or blindness, and hearing impairment or deafness. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists. 2007;22(3):389-404.

4.Zada G, Kintz N, Pulido M, Amezcua L. Prevalence of neurobehavioral, social, and emotional dysfunction in patients treated for childhood craniopharyngioma: a systematic literature review. PLoS One. 2013;8(11):e76562.