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Penn State Screen of Frontal and Temporal Dysfunction Syndromes
Parts of the PSS-FTDS are copyrighted and must be obtained separately. Please contact the screen developer for details: Claire Flaherty-Craig, PhD: Alternatively, contact test publishers/authors for screen components:
Letter Fluency/Animal Naming: public domain. Norms: Gladsjo et al., 1999 and Abrahams et al., 2000.

Cognistat: The Northern California Behavioral Group. Manual for COGNISTAT (The Neurobehavioral Cognitive Status Examination). P.O. Box 460, Fairfax, CA: 94978. www/
Boston Diagnostic Aphasia Exam (BDAE)
Supplemental: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
Background: The PSS-FTDS was piloted in a large multidisciplinary ALS clinic and has been used by multiple sites in the US via collaboration with Penn State.
Construct measured: Letter fluency, judgment, attention, repetition, category fluency, similarities, reading comprehension, constructional praxis, naming, orientation, mental calculations, premorbid intelligence, and behavior.
Generic vs. disease specific: FTD specific and tailored for ALS. Administration controls for motor weakness and allows for spoken or written word responses to verbal measures.
Means of administration: By trained personnel, usually a nurse or other non- neuropsychologist trained to administer.
Administration time: 20 minutes if the FBI is completed by one examiner while a second examiner administers cognitive testing to patient. Otherwise, time required may be longer.
Intended respondent: Patient except for the FBI, which is administered to the caregiver.
# of items : Multiple sub-parts as listed below, many with several items.
# of subscales and names of sub-scales : There are 6 subscales: 1.Phonemic Fluency
  1. Category Fluency
American National Adult Reading Test (AMNART)
  1. Neurobehavior Cognitive Status Examination (COGNISAT)
5. Oral Reading via the Boston Diagnostic Aphasia Exam (BDAE) 6.The Frontal Behavior Inventory (FBI)
Strengths: 1) ALS-tailored; 2) More information than very brief (5 minute) screens; 3) FBI can be administered to caregiver while PSSFTS is being administered to patient; 4) has been used successfully in a large multidisciplinary ALS clinic.
Weaknesses: 1) At 20 minutes for administration, this is longer than some brief exams; 2) cannot be self-administered; 3) some parts (NART and BDAE) cannot be administered to subject with low intelligibility; 4) scoring requires multiple normative databases.
Letter Fluency and Category Fluency are assessed and scored as per Gladsjo et al., 1999. For those with motor weakness, a fluency ratio is used as per Abrahams et al., 2000.
NART, COGNISAT and BDAE are scored per published guidelines. A score of 27 or higher on the FBI is consistent with frontal lobe dementia (Kertesz et al., 1997).
Feasibility: Able to be administered in a large multidisciplinary ALS clinic.
Reliability: Good studies for component parts.
Validity: No published validity studies on overall instrument for use in ALS. Excellent validity studies available for component parts.
Sensitivity to Change: Not assessed for overall instrument.
Flaherty-Craig C, Eslinger P, Stephens B, Simmons Z. A rapid screening battery to identify frontal dysfunction in patients with ALS. Neuro. 2006;67:2070-2072.
Abrahams S, Leigh PN, Harvey A, Vythelingum GN, Grise D, Goldstein YH. Verbal fluency and executive dysfunction in amyotrophic lateral sclerosis. Neuropsychologia 2000;38:734-747.
Flaherty-Craig C, Brothers A, Dearman B, Eslinger P, Simmons Z. Penn State screen exam for the detection of frontal and temporal dysfunction syndromes: application to ALS. Amyotroph Lateral Scler. 2009;10(2):107-112.
Flaherty-Craig CV, Brothers A, Yang C, Svoboda R, Simmons Z. Declines in problem solving and anosognosia in amyotrophic lateral sclerosis: application of Guilford's structure of intellect theory. Cogn Behav Neurol. 2011;24(1):26-34.
Gladsjo JA, Schuman CC, Evans JD, Peavy GM, Miller SW, Heaton RK. Norms for letter and category fluency: Demographic corrections for age, education and ethnicity. Assessment. 1999;6:147-178.
Kertesz A, Davidson W and Fox H. Frontal Behavioral Inventory: Diagnostic critertia for Frontal Lobe Dementia. Can J Neurolog Sci. 1997;24(1):29-35.
Wicks P, Abrahams S, Leigh PN, Goldstein LH. A rapid screening battery to identify frontal dysfunction in patients with ALS. Neurology. 2007;69(1):118-119; author reply 119-120.


Document last updated July 2019