Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness

Objective: Performance on reading tests is often used as an indicator of premorbid intellectual disability in individuals with serious mental illness (SMI), but independent evidence validating their use is lacking. This study evaluated the accuracy of the Wide Range Achievement Test Word Reading Sub...

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Main Authors: Susan R. McGurk, Renata Botello, Daniel Fulford, Kim T. Mueser
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:Schizophrenia Research: Cognition
Online Access:http://www.sciencedirect.com/science/article/pii/S2215001325000393
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author Susan R. McGurk
Renata Botello
Daniel Fulford
Kim T. Mueser
author_facet Susan R. McGurk
Renata Botello
Daniel Fulford
Kim T. Mueser
author_sort Susan R. McGurk
collection DOAJ
description Objective: Performance on reading tests is often used as an indicator of premorbid intellectual disability in individuals with serious mental illness (SMI), but independent evidence validating their use is lacking. This study evaluated the accuracy of the Wide Range Achievement Test Word Reading Subtest in predicting history of intellectual disability in people with SMI. Methods: Participants were 105 people with SMI (62.8 % schizophrenia) with either a confirmed history of intellectual disability based on medical record review (Confirmed ID; n = 18) or no such history (No ID; n = 87). Participants were administered the WRAT-III Reading Subtest, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and three other cognitive tests. A receiver operator characteristics (ROC) curve was fit to identify the optimal cutoff score on the WRAT for correctly classifying the Confirmed ID and No ID groups. t-tests and effect sizes were used to compare the two groups on the WRAT and cognitive tests. Results: The ROC curve indicated that a cutoff score of 70 or below on the WRAT correctly identified 88.9 % of individuals with Confirmed ID (sensitivity) and incorrectly identified 5.6 % of individuals with No ID (Specificity) (p < .001). Performance on the cognitive battery was worse in the Confirmed ID group than No ID group, but the effect size for the WRAT was higher than any of the cognitive tests. Conclusions: A WRAT Word Reading Subtest score of ≤70 is a strong indicator of premorbid intellectual disability in people with SMI.
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spelling doaj-art-3e63de7fa5964f7cb970291b4c526f872025-08-20T03:57:58ZengElsevierSchizophrenia Research: Cognition2215-00132025-12-014210038110.1016/j.scog.2025.100381Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illnessSusan R. McGurk0Renata Botello1Daniel Fulford2Kim T. Mueser3Department of Occupational Therapy, Boston University, United States of America; Center for Psychiatric Rehabilitation, Boston University, United States of America; Sargent College of Health and Rehabilitation Sciences, Boston University, United States of America; Department of Psychological &amp; Brain Sciences, Boston University, United States of AmericaSargent College of Health and Rehabilitation Sciences, Boston University, United States of AmericaDepartment of Occupational Therapy, Boston University, United States of America; Sargent College of Health and Rehabilitation Sciences, Boston University, United States of America; Department of Psychological &amp; Brain Sciences, Boston University, United States of AmericaDepartment of Occupational Therapy, Boston University, United States of America; Center for Psychiatric Rehabilitation, Boston University, United States of America; Sargent College of Health and Rehabilitation Sciences, Boston University, United States of America; Department of Psychological &amp; Brain Sciences, Boston University, United States of America; Corresponding author at: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02215, United States of America.Objective: Performance on reading tests is often used as an indicator of premorbid intellectual disability in individuals with serious mental illness (SMI), but independent evidence validating their use is lacking. This study evaluated the accuracy of the Wide Range Achievement Test Word Reading Subtest in predicting history of intellectual disability in people with SMI. Methods: Participants were 105 people with SMI (62.8 % schizophrenia) with either a confirmed history of intellectual disability based on medical record review (Confirmed ID; n = 18) or no such history (No ID; n = 87). Participants were administered the WRAT-III Reading Subtest, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and three other cognitive tests. A receiver operator characteristics (ROC) curve was fit to identify the optimal cutoff score on the WRAT for correctly classifying the Confirmed ID and No ID groups. t-tests and effect sizes were used to compare the two groups on the WRAT and cognitive tests. Results: The ROC curve indicated that a cutoff score of 70 or below on the WRAT correctly identified 88.9 % of individuals with Confirmed ID (sensitivity) and incorrectly identified 5.6 % of individuals with No ID (Specificity) (p < .001). Performance on the cognitive battery was worse in the Confirmed ID group than No ID group, but the effect size for the WRAT was higher than any of the cognitive tests. Conclusions: A WRAT Word Reading Subtest score of ≤70 is a strong indicator of premorbid intellectual disability in people with SMI.http://www.sciencedirect.com/science/article/pii/S2215001325000393
spellingShingle Susan R. McGurk
Renata Botello
Daniel Fulford
Kim T. Mueser
Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
Schizophrenia Research: Cognition
title Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
title_full Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
title_fullStr Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
title_full_unstemmed Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
title_short Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
title_sort wide range achievement test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness
url http://www.sciencedirect.com/science/article/pii/S2215001325000393
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