Susan R. McGurk , Renata Botello , Daniel Fulford , Kim T. Mueser
{"title":"Wide Range Achievement Test word reading subtest score as an indicator of premorbid intellectual disability in serious mental illness","authors":"Susan R. McGurk , Renata Botello , Daniel Fulford , Kim T. Mueser","doi":"10.1016/j.scog.2025.100381","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>Participants were 105 people with SMI (62.8 % schizophrenia) with either a confirmed history of intellectual disability based on medical record review (Confirmed ID; <em>n</em> = 18) or no such history (No ID; <em>n</em> = 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. <em>t</em>-tests and effect sizes were used to compare the two groups on the WRAT and cognitive tests.</div></div><div><h3>Results</h3><div>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) (<em>p</em> < .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.</div></div><div><h3>Conclusions</h3><div>A WRAT Word Reading Subtest score of ≤70 is a strong indicator of premorbid intellectual disability in people with SMI.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100381"},"PeriodicalIF":3.0000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Schizophrenia Research-Cognition","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2215001325000393","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
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.