Handout: Halstead-Reitan Neuropsychological Test Battery for Adults (HRNTB)

	PSY 448 Clinical Neuropsychology	Last revised: 10/14/2025
Halstead-Reitan Neuropsychological Test Battery for Adults (HRNTB)

Published: Neuropsychology Press (Tucson, Arizona)

Age Range: Ages 15 and over

Administration Time: roughly 6 hours

Background

Ward Halstead (1908-1968) received his Ph.D. from Northwestern University and taught at the Medical School at the University of Chicago. During the 1930s and 1940s, he worked in conjunction with neurologists and neurosurgeons there to evaluate patients from a neuropsychological perspective. He devised and tested a great many tasks with patients on the wards there. Many of these evaluative approaches he discarded while settling upon a set of tests which eventually formed the nucleus of the Halstead-Reitan Neuropsychological Test Battery (HRNTB).

Ralph M. Reitan (1922-2014) began working with Halstead in his laboratory in the 1940s, gained his Ph.D. in 1950, and established a neuropsychology laboratory at the Indiana University Medical Center in 1951. There Reitan extended the work of Halstead in assembling a battery of tests for the comprehensive evaluation of brain-damaged individuals. Later in life, Reitan moved to Tucson, AZ where he established a training lab and examination center.

Coordinate Versions

Reitan-Indiana Neuropsychological Test Battery for Children (ages 5-8)

Halstead Neuropsychological Test Battery for Children (ages 9-14)

Summary Scores: Impairment Index = Proportion of seven test scores (CT, TPT-T, TPT-M, TPT-L, SSPT, RT, FTT) in impaired range.

Components

Tests Contributing to the Impairment Index

Category Test (CT)
Test subject is visually presented with seven sets of slides (208 in total) and must press one of four levers in response to each slide. Subject had previously been informed that there was some single principle which underlies each set of slides. It is up to the testee to figure out what that principle is.

This test is related to abstraction and reasoning abilities, particularly concept formation.

This test has been converted into both a computerized and a booklet form (against Reitan's advice). The research data suggest that these versions of the test are demonstrably equivalent to the version Reitan's work was done with, i.e., a large apparatus.

Tactual Performance Test (TPT)
The TPT employs a version of the Seguin-Goddard Form Board, a flat wooden puzzle board into which differently-shaped blocks can be placed. While blindfolded, the subject must place the blocks in the board board using the dominant, non-dominant, and both hands. The time to complete each of these tasks serves as a score and their sum gives the TPT-Total Time (TPT-T) score. Afterward, the subject is asked to recall the shape and location of the blocks. These yield TPT-Memory (TPT-M) and TPT-Localization (TPT-L) scores.

This test provides a variety of measures, particularly manual dexterity, spatial memory, tactile discrimination. Note that Lezak (1995, p. 493) argues that this test's administration procedures are particularly discomforting and distressing to individuals with brain injuries or among the elderly. She argues that it should only be given under special circumstances.

Seashore Rhythm Test (RT) Derived from a subtest in the Seashore Measures of Musical Talent, the Rhythm Test requires subjects to discriminate between 30 pairs of rhythmic beats as either different or the same. Classified as a measure of non-verbal auditory discrimination, the RT is particularly sensitive to the subject's ability to attend and concentrate, skills frequently impaired in individuals with brain damage. The test's name is derived from that of Carl Emil Seashore (1866-1949) who published the first edition of his Measures of Musical Talent in 1939.

Speech-Sounds Perception Test (SSPT)
A set of 60 "paralogs" (nonsense words based on the vowel sound 'ee') are played by a tape recorder. The subject must choose which sound is heard on each paralog from four printed alternatives.

For example:

[1] breet bleet beeft feebt
[2] sneet speet screet sbeet
[3] mleet meeb meep meef

This test is a measure of attention, verbal auditory discrimination, and auditory-visual integration. Lesions of the left temporal lobe are particularly likely to cause poor performance on this procedure.

Finger Tapping Test (FTT)
Also called Finger Oscillation Test (FOT) Subjects are given multiple 10-second trials on a manual tapping device using the index finger of the dominant and non-dominant hand. The test is a measure of motor speed and manual dexterity.

Additional Tests

Trail Making (TM)
The Trail Making test has two forms, Trails A and Trails B.

For Trails-A, subjects must connect 25 numbered circles in numeric order. The circles are distributed in a random fashion across a page. The test measures a variety of functions including motor speed, visual scanning, and visual-motor integration.

For Trails-B, subjects must perform a task similar to Trails-A, but the circles contain either numbers or letters. The subjects must connect the circles in alternating order between numbers and letters, that is, 1-A-2-B, etc. In addition to motor speed, visual scanning, and visual-motor integration, this test requires attention and cognitive flexibility.

Reitan-Indiana Aphasia Screening Test This is a diverse collection of 32 items which require the testee to demonstrate abilities such as naming, reading, writing, spelling, arithmetic, identifying body parts, identifying and copying shapes.

Reitan-Klove Sensory Perceptual Examination Similar to many neurological approaches to sensory-perceptual evaluation, this exam employs both unilateral and bilateral simultaneous stimulation across tactile, visual, and auditory channels; finger localization upon tactile stimulation, finger-tip number writing, and the tactile recognition of shapes.

Strength of Grip Test (SOGT) The SOGT employs a standard hand dynamometer to measure the strength of both dominant and non-dominant hands

Lateral Dominance Examination Right vs. left preferences are measured for tasks involving hands, arms, legs, feet, and eyes.

"Show me how you would open a door. Show me how you would kick a football. Show me how you would hop. Show me how you would unscrew a jar lid...."

Notes

The HRNTB also regularly employs

Wechsler Adult Intelligence Scale (WAIS)

Minnesota Multiphasic Personality Inventory (MMPI)

Reitan pioneered a four-fold approach to inferential decision-making using the HRNTB. These include

Level of Performance: Comparison of individual with normative groups of impaired and non-impaired persons

Pattern of Performance: Examination of intra-test performance and subtest scores

Specific Behavioral Deficits ("Pathognomonic Signs"): Sensitivity to deviant or deficient performance which, of itself, points to impairment

Comparison of Two Sides of the Body (Right-Left Comparisons): Looking for discrepancies in test performance which may reveal weakness or lateralized impairment

References & Sources

After Reitan died in 2014, the journal, Archives of Clinical Neuropsychology, published a special issue (Vol. 30, no. 8) in Reitan's memory in 2015. All the articles in the issue are open-sources and available to download.

Boll, T. J. (1981). The Halstead-Reitan neuropsychological battery. In S. B. Filskov, & T. J. Boll (Eds.), Handbook of clinical neuropsychology (pp. 577-607). New York: Wiley-Interscience.

Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.

Reflections on Ward Halstead, Ph.D.: An interview with Ralph M. Reitan, Ph.D. (1996, Summer/Fall) Newsletter 40 (Division of Clinical Neuropsychology), 14(2), 1-2, 12-13.

Reitan, R. M. (1994). Ward Halstead's contributions to neuropsychology and the Halstead-Reitan Neuropsychological Test Battery. Journal of Clinical Psychology, 50(1), 47-70.

Reitan, R. M., & Wolfson, D. (1993). The Halstead-Reitan neuropsychological test battery: Theory and clinical interpretation (2nd ed.). South Tucson, AZ: Neuropsychology Press.

Tests Contributing to the Impairment Index
Category Test (CT)	Test subject is visually presented with seven sets of slides (208 in total) and must press one of four levers in response to each slide. Subject had previously been informed that there was some single principle which underlies each set of slides. It is up to the testee to figure out what that principle is. This test is related to abstraction and reasoning abilities, particularly concept formation. This test has been converted into both a computerized and a booklet form (against Reitan's advice). The research data suggest that these versions of the test are demonstrably equivalent to the version Reitan's work was done with, i.e., a large apparatus.
Tactual Performance Test (TPT)	The TPT employs a version of the Seguin-Goddard Form Board, a flat wooden puzzle board into which differently-shaped blocks can be placed. While blindfolded, the subject must place the blocks in the board board using the dominant, non-dominant, and both hands. The time to complete each of these tasks serves as a score and their sum gives the TPT-Total Time (TPT-T) score. Afterward, the subject is asked to recall the shape and location of the blocks. These yield TPT-Memory (TPT-M) and TPT-Localization (TPT-L) scores. This test provides a variety of measures, particularly manual dexterity, spatial memory, tactile discrimination. Note that Lezak (1995, p. 493) argues that this test's administration procedures are particularly discomforting and distressing to individuals with brain injuries or among the elderly. She argues that it should only be given under special circumstances.
Seashore Rhythm Test (RT)	Derived from a subtest in the Seashore Measures of Musical Talent, the Rhythm Test requires subjects to discriminate between 30 pairs of rhythmic beats as either different or the same. Classified as a measure of non-verbal auditory discrimination, the RT is particularly sensitive to the subject's ability to attend and concentrate, skills frequently impaired in individuals with brain damage. The test's name is derived from that of Carl Emil Seashore (1866-1949) who published the first edition of his Measures of Musical Talent in 1939.
Speech-Sounds Perception Test (SSPT)	A set of 60 "paralogs" (nonsense words based on the vowel sound 'ee') are played by a tape recorder. The subject must choose which sound is heard on each paralog from four printed alternatives. For example: [1] breet bleet beeft feebt [2] sneet speet screet sbeet [3] mleet meeb meep meef This test is a measure of attention, verbal auditory discrimination, and auditory-visual integration. Lesions of the left temporal lobe are particularly likely to cause poor performance on this procedure.
Finger Tapping Test (FTT) Also called Finger Oscillation Test (FOT)	Subjects are given multiple 10-second trials on a manual tapping device using the index finger of the dominant and non-dominant hand. The test is a measure of motor speed and manual dexterity.

Additional Tests
Trail Making (TM)	The Trail Making test has two forms, Trails A and Trails B. For Trails-A, subjects must connect 25 numbered circles in numeric order. The circles are distributed in a random fashion across a page. The test measures a variety of functions including motor speed, visual scanning, and visual-motor integration. For Trails-B, subjects must perform a task similar to Trails-A, but the circles contain either numbers or letters. The subjects must connect the circles in alternating order between numbers and letters, that is, 1-A-2-B, etc. In addition to motor speed, visual scanning, and visual-motor integration, this test requires attention and cognitive flexibility.

Reitan-Indiana Aphasia Screening Test	This is a diverse collection of 32 items which require the testee to demonstrate abilities such as naming, reading, writing, spelling, arithmetic, identifying body parts, identifying and copying shapes.
Reitan-Klove Sensory Perceptual Examination	Similar to many neurological approaches to sensory-perceptual evaluation, this exam employs both unilateral and bilateral simultaneous stimulation across tactile, visual, and auditory channels; finger localization upon tactile stimulation, finger-tip number writing, and the tactile recognition of shapes.
Strength of Grip Test (SOGT)	The SOGT employs a standard hand dynamometer to measure the strength of both dominant and non-dominant hands
Lateral Dominance Examination	Right vs. left preferences are measured for tasks involving hands, arms, legs, feet, and eyes. "Show me how you would open a door. Show me how you would kick a football. Show me how you would hop. Show me how you would unscrew a jar lid...."