Copenhagen Cross-Linguistic Naming Test (C-CLNT)

Abstract

The Copenhagen Cross-Linguistic Naming Test (C-CLNT), developed by Nielsen et al. (2023), is a specialized Cross-Linguistic Assessment designed to evaluate Naming Impairment within diverse clinical populations. Specifically, it targets older adults in memory clinics who present with cultural, linguistic, and educational diversity, particularly those diagnosed with Dementia, Mild Cognitive Impairment, or affective disorders.

The C-CLNT is constructed using items derived from the MULTIMAP open-access database, which contains 218 standardized color drawings of objects and actions. The selection of items for the C-CLNT was based on optimal name agreement and frequency across seven tested languages (five European and two non-European). The final instrument includes a comprehensive 30-item version and an abbreviated 20-object item version. Validation studies confirmed the scale’s reliability and superior diagnostic accuracy for Dementia when compared to established tools like the Boston Naming Test (BNT).

Keywords

Naming Impairment, Cross-Linguistic Assessment, Cross-Cultural Comparison, Neuropsychological Tests, Diverse Older Adults, Multicultural Memory, Affective Disorders, Geriatric Assessment, Neurocognitive Disorders, Older Adulthood, Dementia.

Authors

Nielsen, T. Rune, Grollenberg, Bernadette Unmack, Ringkøbing, Signe Pertou, Özden, Maria, Weekes, Brendan, Waldemar, Gunhild.

Purpose

The C-CLNT serves as a crucial Cross-Linguistic Assessment tool specifically designed to evaluate Naming Impairment in patient populations characterized by significant cultural, linguistic, and educational diversity. The development of this scale was necessitated by the limitations of traditional naming tests, which often lack the cultural and linguistic standardization required for equitable assessment in multicultural memory clinics.

By utilizing a set of standardized color drawings sourced from the MULTIMAP project, the C-CLNT ensures that the stimuli possess available linguistic variable data across a broad range of languages. This robust methodological approach allows clinicians to assess lexical retrieval deficits more accurately, minimizing potential confounding factors related to language background or education level.

Construct

The primary psychological construct measured by the C-CLNT is Lexical Retrieval Ability, which is the capacity to access and produce known words in response to visual stimuli. The test is specifically tailored to detect Naming Impairment (anomia), a classic symptom of various neurocognitive disorders.

Because the test items were chosen based on cross-linguistic consistency in terms of name frequency and agreement across languages including Spanish, French, English, German, Mandarin Chinese, and Arabic, the C-CLNT provides a measure of naming that is highly standardized and less sensitive to cultural biases inherent in many older, monolingual naming instruments.

Validity

The validation of the C-CLNT provided compelling evidence for its psychometric soundness, particularly regarding its diagnostic utility in advanced cognitive decline.

Construct Validity

• The C-CLNT demonstrated robust correlations with established measures of naming ability, including the full Boston Naming Test (BNT) (r = .55, p < .001) and the BNT-15 abbreviated version (r = .54, p < .001).

• Furthermore, significant correlations were observed with related cognitive functions, specifically category fluency (r = .44, p < .001) and general cognitive function (r = .35, p < .001), supporting the scale’s measurement of lexical and general cognitive processing.

Discriminant Validity and Diagnostic Accuracy

• The C-CLNT exhibited strong discriminant validity, showing good diagnostic accuracy for Dementia. It significantly outperformed the BNT in this domain, evidenced by areas under the curve (AUC) of .80 for the C-CLNT versus .64 for the BNT (p < .001).

• Using a cutoff score of ≤ 28, the 30-item C-CLNT achieved a sensitivity of .75 and a specificity of .79. The 20-item abbreviated version was highly correlated with the full scale (r = .87, p < .001) and maintained comparable diagnostic accuracy for Dementia (AUC = .78). At a cutoff of ≤ 18, the 20-item C-CLNT yielded a sensitivity of .83 and a specificity of .70. However, the scale demonstrated poor diagnostic accuracy for Mild Cognitive Impairment (MCI).

Reliability

The internal consistency of the C-CLNT was assessed via coefficient alpha. The reported coefficient alpha for the scale was .67. This value indicates moderate internal reliability, which is generally acceptable for a brief screening instrument designed for diverse populations where variability in linguistic background might naturally lower consistency metrics.

Factor Analysis

The provided documentation does not include details regarding a formal factor analysis conducted on the C-CLNT items. Therefore, no information is available concerning the latent factor structure of the scale.

Instrument

Test Type: Original

Format: The C-CLNT is designed for rapid administration, typically requiring less than 5 minutes. Participants are given 5 seconds to name the visual stimulus. If unsuccessful, a semantic cue is provided, followed by a phonetic cue if necessary. There is no discontinuation rule to ensure all items are attempted.

The total score is derived from the number of correct responses, including those achieved after the provision of a semantic cue. Responses resulting from a phonemic cue are noted for qualitative analysis of naming performance but are not included in the final quantitative correct score.

Language Available: Spanish, Basque, Catalan, Italian, French, English, German, Mandarin Chinese, and Arabic.

Population Group: Human; Male; Female

Age Group: Adulthood (18 yrs & older); Middle Age (40-64 yrs); Aged (65 yrs & older); Very Old (85 yrs & older).

Population Details:

• Location: Denmark

• Respondents: Healthy Controls; Diverse Memory Clinic Patients diagnosed with Affective Disorder, Mild Cognitive Impairment, and Dementia.

Test Methodology: Test Validity; Construct Validity; Discriminant Validity; Test Reliability; Test Sensitivity; Test Specificity.

Keywords

Naming Assessment, Lexical Retrieval, Neuropsychology, Multicultural Testing, Cognitive Screening, Aphasia, Geriatric Neurology, Multilingual Assessment, Boston Naming Test, MULTIMAP.

Authors

Author ORCID Identifier: No data is Available

Affiliation:

• Nielsen, T. Rune: Copenhagen University Hospital–Rigshospitalet Department of Neurology, Danish Dementia Research Centre

• Grollenberg, Bernadette Unmack: Copenhagen University Hospital–Rigshospitalet Department of Neurology, Danish Dementia Research Centre

• Ringkøbing, Signe Pertou: Copenhagen University Hospital–Rigshospitalet Department of Neurology, Danish Dementia Research Centre

• Özden, Maria: Copenhagen University Hospital–Rigshospitalet Department of Neurorehabilitation and Spinal Cord Injuries, The Neuroscience Centre

• Weekes, Brendan: University of Hong Kong Faculty of Education

• Waldemar, Gunhild: Copenhagen University Hospital–Rigshospitalet Department of Neurology, Danish Dementia Research Centre

Affiliation Email addresses:

• Nielsen, T. Rune: [email protected]

Correspondence Address:

• Nielsen, T. Rune: [email protected]

Permissions & Fee and Test Year

Test Year: 2023

Permissions: Contact Corresponding Author

Fee: No

Reference’s

Nielsen, T. R., Grollenberg, B. U., Ringkøbing, S. P., Özden, M., Weekes, B., & Waldemar, G. (2023). The copenhagen cross-linguistic naming test (C-CLNT): Development and validation in a multicultural memory clinic population. Journal of the International Neuropsychological Society, 29(10), 911–921. DOI: https://doi.org/10.1017/S1355617723000437

Items of the Copenhagen Cross-Linguistic Naming Test (C-CLNT)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

This measure includes 30-item and 20-item versions. No data is Available regarding the specific items of the C-CLNT.