Lessons learned-15 years of the WHO-NCTB: A review

Based on expert recommendations, the World Health Organization (WHO) recomm ended the Neurobehavioral Core Test Battery (NCTB) in 1983 to detect neurot oxicity in world-wide populations. The NCTB consists of 7 neurobehavioral t ests (Digit Symbol, Digit Span, Benton visual memory test/recognition form, Santa Ana dexterity test, Simple Reaction Time, Pursuit Aiming II, and Pro file of Mood States). Research with the NCTB provides the context for the r esults of a mini-symposium held in 1999 to discuss the lessons learned abou t using the NCTB in working populations. Speakers from Africa, Asia, Europe , and North America reviewed data from 94 studies using the NCTB, including 63 from China, 13 from Korea, Il from Poland, three from South Africa, thr ee from the USA, and one form Ecuador. Although a consensus was not sought in the symposium, the key lessons learned that emerged from the various pre sentations, were: The NCTB is effective in testing adults with 12 or more years of formal edu cation, bur can not reliably test persons with less than 9 years of educati on. People ii-om cultures very different from those in Europe and North America (eg, aboriginal and African cultures) may not be tested effectively by the NCTB, although others such as at least some Asian populations, can be. To address this problem, the construct validity of the NCTB should be establis hed in a wide range of countries. The POMS measures of emotion proved to be very sensitive to neurotoxic expo sures in several countries, but the POMS was the NCTB test most affected by cultural differences. The Digit Symbol or the Milan modification of that t est was also highly sensitive to neurotoxic exposures. Examiner drift following training to administer the NCTB is a significant p roblem in technically trained Examiners. Pursuit Aiming II is very difficul t to score reliably. (C) 2000 Intox Press, Inc.