SPANS-X: Extended norms, extra modality, and exceptional utility

By Dr Gerald H. Burgess

SPANS (Short Parallel Assessments of Neuropsychological Status) was first developed and published in 2014 as a tool to test the cognitive, perceptual and language of people with acquired brain injuries (ABI). In his work as a clinical neuropsychologist, the author, Dr Gerald Burgess, became aware of ways to improve the standard tests and so put that insight and experience to use and created SPANS-A as the initial test, and SPANS-B as the retest.

Over the years and particularly during the COVID-19 pandemic it became clear there was a growing need to adapt SPANS so it could be administered remotely. Empirical evidence from a validity/equivalency study, which compared demographically matched samples performances administering remote SPANS-X against traditional in-person administration, shows favourable outcomes.

The other insight was the potential utility of SPANS for use with older adults, and dementia assessment, given its existing characteristics. The ‘X’ in ‘SPANS-X’ therefore stands for its ‘extended’ norms up to age 90, and the addition of an ‘extra’ administration modality, as well as a few smaller extras to make the experience better and more accurate for you, the SPANS-X user.

SPANS-X has nearly doubled the size of the original SPANS norm standardisation sample. It has been subject to a new and innovative statistical norming and standardisation procedure. Each age now has associated individual percentile and critical cut-off scores at a 95% confidence interval. SPANS-X now provides unsurpassed accuracy compared to other short battery neuropsychological tests.

An extra score and an extra interpretative metric have been added to the existing SPANS to create a SPANS-X total score, which is the sum of five core index scores, and a norm-referenced, ‘moving’ critical cut-off score which accounts for natural and expected decline in cognitive performances with age, not a single cut-off score ‘for all’.

SPANS-X has been streamlined to make it easier and simpler to administer. SPANS-X is also more process-orientated, offering more accurate scoring and interpretation. The SPANS-X administrator can use the interpretations provided as a guide to make better clinical conclusions based on scores and percentiles obtained.

New validation studies have also been added, including the use of SPANS-X as a screening measure for the detection of dementia in adults aged 75 and above.

More is understood now about the exceptional equivalency between SPANS-X A and SPANS-X B, two parallel yet alternate versions. The SPANS-X administrator can now have greater trust and precision in determining whether change occurred in a patient’s presentation between time points 1 and 2 when administering either SPANS-X A or SPANS-X B. 

Find out more

To find out more visit the SPANS-X page on our website, contact us for more information, and sign up to our ‘Introduction to the SPANS-X’ webinar at 12pm on 10th February here.