Applied Neuropsychology: Adult

ISSN: 2327-9095 (Print) 2327-9109 (Online) Journal homepage: https://www.tandfonline.com/loi/hapn21

Examination of Wechsler adult Intelligence Scale-

Fourth Edition short-form IQ estimations in an
outpatient psychoeducational sample

Zachary C. Merz, John W. Lace, Alexander M. Eisenstein & Alexandra F. Grant

To cite this article: Zachary C. Merz, John W. Lace, Alexander M. Eisenstein & Alexandra F.
Grant (2019): Examination of Wechsler adult Intelligence Scale-Fourth Edition short-form IQ
estimations in an outpatient psychoeducational sample, Applied Neuropsychology: Adult, DOI:
10.1080/23279095.2019.1687480

To link to this article: https://doi.org/10.1080/23279095.2019.1687480

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APPLIED NEUROPSYCHOLOGY: ADULT
https://doi.org/10.1080/23279095.2019.1687480

Examination of Wechsler adult Intelligence Scale-Fourth Edition short-form IQ

estimations in an outpatient psychoeducational sample
Zachary C. Merza , John W. Laceb, Alexander M. Eisensteinb, and Alexandra F. Grantb
a
Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; bPsychology, Saint Louis University,
St. Louis, MO, USA

ABSTRACT KEYWORDS
Objective: The Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) is a commonly utilized cog- Psychological assessment;
nitive battery across many clinical settings. However, due to various patient variables, an abbrevi- short-form calculation; test
ated assessment of intellectual abilities, may be clinically advantageous to allow for a more selection; Wechsler Adult
Intelligence Scale
thorough assessment of other cognitive domains. The current study represents an attempt to pro-
pose additional short-form IQ estimations in an outpatient clinical sample.
Methods: We examined archival data from 318 concurrent psychological/psychoeducational evalu-
ations performed within a university clinic (Mage ¼ 28.67; 53.8% women). Thirty-six unique 4-subt-
est short-form IQ combinations were created to ensure that each WAIS-IV index score was
represented by a single subtest.
Results: Complete data for the ten core subtests and FSIQ were available for 192 cases. Stepwise
regression analyses revealed three short-form combinations that significantly accounted for unique
variance in true FSIQ scores in the final model (R2 ¼ .981, F[3, 188] ¼ 3257.597, p < .001).
Regression-based and prorated FSIQ estimates were calculated, and both methods revealed that
approximately 70–75% of participants’ FSIQ estimates fell within five Standard Score points of
true FSIQ.
Conclusion: Results suggest the utility of three derived 4-subtest short-form IQ estimations for
use within a clinical sample.

Assessing global cognitive ability (i.e., intelligence) as part of
psychological evaluation is clinically valuable (Flanagan &
McDonough, 2018). The Wechsler Adult Intelligence Scale,
4th edition (WAIS-IV; Wechsler, 2008) continues to be one
of the most widely used intelligence and general cognitive
assessment instruments across a variety of clinical settings
(Piotrowski, 2017; Rabin, Paolillo, & Barr, 2016). In addition
to the utility of the WAIS-IV as a whole, the use of one or
more subtests as stand-alone measurements of certain cogni-
tive abilities is also common, especially in settings in which a
full-scale IQ (FSIQ) calculation is not always clinically neces-
sary (e.g., neuropsychological assessments). For example,
according to a survey of practicing neuropsychologists, the
Digit Span subtest was the most frequently used assessment
of attention, concentration, and/or working memory abilities
among the responders (Rabin et al., 2016). Additional subtests
given with notable regularity include Similarities and Matrix
Reasoning to assess executive functioning (i.e., verbal and
nonverbal abstract reasoning, respectively), Arithmetic to
assess working memory, Block Design to assess visuospatial/
visuoconstructional abilities, and Vocabulary to assess lan-
guage abilities (Rabin et al., 2016).
Sattler and Ryan (2009) state that short-forms of the
WAIS-IV may be calculated “to obtain an estimate of an
individual’s intellectual status when a precise FSIQ is not
required” and “should be administered when the full battery
of 10 core subtests cannot be administered or is not needed”
(p. 72). Specific to certain diagnostic settings, the calculation
of a FSIQ is not always inherently advantageous and may be
quite misleading in some cases (Anderson, 2016; Lezak,
1988; Lezak, Howieson, Loring, & Fischer, 2004), especially
when there is high variability due to cognitive deficits. One
main disadvantage in the calculation of a FSIQ is the overall
time commitment necessary to complete all necessary subt-
ests. Time is often a necessary factor to consider as patients
experience fatigue and diminishing tolerance as testing dur-
ation increases, especially among elderly adults and patients
with medical and neurological conditions. Thus, the main
advantage of a short-form IQ calculation represents
increased efficiency in test selection and the allocation of
valuable resources (i.e., patient endurance and energy levels).
Meyers, Zellinger, Kockler, Wagner, and Miller (2013) com-
mented that while a FSIQ may take 60–90 min to be com-
pleted, a short-form can be calculated in half that time (or
less, depending on the subtests used), leaving the remaining
time to be utilized assessing other, perhaps more pressing
cognitive domains (e.g., executive functioning, learning and
memory) not addressed by FSIQ calculations. As such, the

Zachary C. Merz zachary_merz@med.unc.edu Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Supplemental data for this article can be accessed here.
ß 2019 Taylor & Francis Group, LLC
2 Z. C. MERZ ET AL.
creation of validated short-form IQ estimations within clin-
ical populations appears to warrant further investigation.
The current study sought to advance the research surround-
ing this endeavor.
Creating a short-form IQ estimation is not a novel
objective. For decades, researchers have sought to create and
validate abbreviated versions of various WAIS iterations
(Britton & Savage, 1966; Chen & Hua, 2019; Dinning &
Kraft, 1983; Reid-Arndt, Allen, & Schopp, 2011; Reynolds,
Willson, & Clark, 1983; Satz & Mogel, 1962; Silverstein,
1970). Ward (1990) arguably provided the most notable
early advancement towards the creation and use of short-
form IQ estimations in clinical settings to combat time
demands of test administration and increased patient
fatigue. Ward (1990) ultimately created a 7-subtest short-
form IQ based on subtests pulled from the Wechsler Adult
Intelligence Scale, Revised (WAIS-R; Wechsler, 1981) cogni-
tive battery. Results suggested that short-form IQ estima-
tions yielded very strong correlations with WAIS-R FSIQ
calculations (r ¼ 0.98), as well as the verbal (r ¼ 0.97) and
performance (r ¼ 0.96) IQs. Overall, assessment completion
time exhibited a notable decline, short-form estimations
were seldom greater than four points off FSIQ calculations,
and these estimations outperformed previous short-form IQ
estimation efforts (see Doppelt, 1956). This 7-subtest short-
form would later be validated in traumatic brain injury
(Callahan, Schopp, & Johnstone, 1997) and psychiatric pop-
ulations (Benedict, Schretlen, & Bobholz, 1992; Bulzacka
et al., 2016). Most recently, Meyers and colleagues (2013)
assessed the validity of this 7-subtest combination in the
current WAIS-IV utilizing a multi-site clinical sample
(N ¼ 102). Results of linear regression analyses validated the
use of the 7-subtest combination short-form using the
WAIS-IV subtests, noting strong correlational data between
short-form and FSIQ calculations, as well as 50% less time
required to arrive at said results.
Continuing with the current 4th iteration of the WAIS,
several efforts have been made to create and validate various
short-form IQ estimations. This practice was perhaps most
advanced by Sattler and Ryan (2009) who, using the original
normative sample of the WAIS-IV (see Wechsler, 2008), cal-
culated FSIQ estimations based on 2, 3, 4, and 5-subtest
combinations using the Tellegen and Briggs (1967) proced-
ure, generally showing very strong correlations (Pearson rs
> 0.9) between short-form estimations and actual FSIQ cal-
culations (readers are referred to Sattler and Ryan (2009)
textbook for additional statistical information). Notably, as
reliability and validity of the short-form estimations were all
very high, select short-forms were included in the text based
upon various clinical considerations (see Sattler & Ryan,
2009, pp. 245–251).
Expanding on this work, Girard and colleagues (2015)
sought to examine all possible WAIS-IV dyads (i.e., 2-subt-
est combinations) as a way to determine viable short-forms
or rapid screening instruments for estimating FSIQ.
Participants included a clinical sample of 482 patients (mean
age ¼ 51.1 years, mean education level ¼ 12.8 years, 93.6%
male, 63.5% Caucasian) referred for a neuropsychological
evaluation from referral sources including neurology, psych-
iatry, and primary care. Using the same statistical approach
as previous analyses (Sattler & Ryan, 2009; Tellegen &
Briggs, 1967), the researchers reported reliability and validity
coefficients for all possible 45 combinations of WAIS-IV
subtest dyads. Results suggested that the Block
Design þ Vocabulary and Visual Puzzles þ Vocabulary dyads
exhibited excellent validity, consistent with previous findings
(see Sattler & Ryan, 2009). However, not all findings were
consistent. For example, dyads recommended by Sattler and
Ryan (2009), including Arithmetic þ Matrix Reasoning and
Block Design þ Matrix Reasoning, performed far worse
within this clinical sample (Girard et al., 2015), suggesting
the value of continued examination of short-form estima-
tions outside of the WAIS-IV normative sample. Additional
short-form validation efforts include identifying subtest
combinations useful in ruling out subnormal intelligence
(Ryan, Kreiner, Gontkovsky, & Glass Umfleet, 2015) and
further examinations within neurological and mixed clinical
populations (Denney, Ringe, & Lacritz, 2015; Fan et al.,
2019; van Ool et al., 2018).
All in all, there appears to be both scholarly interest and
clinical value in creating and validating various short-form
IQ estimations as a means to improve the efficiency and
efficacy of obtained cognitive data across clinical settings.
This view is shared by clinicians and test publishers alike as
evidenced by the creation of the Wechsler Abbreviated Scale
of Intelligence (WASI; Wechsler, 1991, 2011), which repre-
sented an independent and far briefer instrument aimed at
estimating FSIQ. However, the WASI, while streamlined, is
psychometrically inequivalent to the WAIS (Axelrod, 2002).
That is, the WASI emphasizes only certain aspects of intel-
lectual functioning (i.e., Verbal Comprehension and
Perceptual Reasoning) while ignoring the contributions of
both Working Memory and Processing Speed subtests.
Likewise, the usage of 2-subtest dyads is similarly limiting as
(at least) two cognitive domains are omitted within each
dyad’s calculation. Importantly, neurocognitive domains of
working memory and processing speed are particularly sen-
sitive to neurodevelopmental, neurological, and psychiatric
dysfunction (e.g., Carlozzi, Kirsch, Kisala, & Tulsky, 2015;
Moran, 2016; Ryan, Kreiner, Glass Umfleet, Gontkovsky, &
Myers-Fabian, 2018; Theiling & Petermann, 2016), and may
be important to consider when estimating global function-
ing. As such, it is important to be mindful of domain cover-
age and subtest selection when considering construct
validity of derived FSIQ estimations. To date, few studies
have attempted to maintain the breadth of domain coverage
and construct validity by utilizing a subtest from each broad
domain (i.e., Verbal Comprehension, Perceptual Reasoning,
Working Memory, and Processing Speed) in estimating
FSIQ. Empirical examples can be found within the norma-
tive (see tetrad calculations from Sattler & Ryan, 2009) and
clinical (see heptad calculation from Ward (1990)) WAIS-
IV samples.
The purpose of the current study was twofold. First, the
authors aimed to expand on the current knowledge regard-
ing short-form IQ estimations within a clinical sample.

Second, the authors sought to perform exploratory analyses
to identify and examine novel 4-subtest combinations for
potential clinical use in estimating intellectual ability within
clinical populations, where each WAIS-IV index score (i.e.,
Verbal Comprehension, Perceptual Reasoning, Working
Memory, and Processing Speed) is equally represented (i.e.,
one subtest per index). Thus, we aimed to provide an assess-
ment of the feasibility and utility of 4-subtest WAIS-IV short-
form estimations based on a large clinical sample readily
generalizable to many university-based mental health clinics.
Methods
Participants
Deidentified participant data were extracted from an archival
dataset of clients who presented to an outpatient, university-
based, community mental health center in the Midwestern
United States for psychological/psychoeducational assessment
between 2008 and 2016. Three hundred eighteen (318) partic-
ipants were included in the final dataset, with approximately
evenly represented men (46.2%) and women (53.8%).
Participant ages ranged from 18 to 72 (M ¼ 28.67,
SD ¼ 11.37) and education ranged from 7 to 20 years
(M ¼ 14.03, SD ¼ 2.33). Participants were mostly Caucasian
(68.2%), with 17.9% Black/African-American, 5.7% Hispanic/
Latinx, 4.1% Asian/Asian-American, and 4.1% reporting
“Other” racial/ethnic identity. All participants were proficient
in English, with most participants being native English speak-
ers (91.5%). Most participants received at least one diagnosis
(83.0%), with 43.7% receiving two or more diagnoses; the
most common diagnoses given were attention-deficit/hyper-
activity disorders (ADHD; 38.4%), anxiety disorders (29.2%),
mood disorders (25.5%), and specific learning disorders
(22.6%). Other diagnoses represented in the sample (with less
than 6.0% diagnosed with each) included traumatic brain
injury/neurologic conditions, posttraumatic stress disorders,
autism spectrum disorders, intellectual disabilities, substance
abuse, and personality disorders.
Measures
Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-
IV). The WAIS-IV is among the most widely used psycho-
logical instruments (Rabin et al., 2016). Its 10 core subtests
(Block Design, Matrix Reasoning, Visual Puzzles,
Similarities, Vocabulary, Information, Digit Span,
Arithmetic, Symbol Search, and Coding) produce index-level
(Perceptual Reasoning, Verbal Comprehension, Working
Memory, and Processing Speed) and higher-level (Full Scale
Intelligence Quotient) scores. Although demographically-
adjusted norms exist as part of Pearson’s Advanced Clinical
Solutions (ACS; Holdnack & Drozdick, 2009), age-corrected
norms were used for all clients. The WAIS-IV’s internal val-
idity and psychometric properties have been extensively
investigated and validated (Benson, Hulac, & Kranzler, 2010;
Merz, Van Patten, Hurless, Grant, & McGrath, 2019;
Reynolds, Ingram, Seeley, & Newby, 2013; Wechsler, 2008;
Weiss, Keith, Zhu, & Chen, 2013).
APPLIED NEUROPSYCHOLOGY: ADULT 3
Procedures
IRB approval was obtained before deidentified data extrac-
tion began. All participants were administered the 10-subtest
core WAIS-IV as part of the assessment process.
Assessments were performed by clinical psychology doctoral
students under supervision of licensed psychologists. The
research team extracted data from deidentified client files
obtained via secure storage. Data were reported in inconsist-
ent manners throughout the archival search wherein some
reports included data summary tables, while others included
only information in narrative form within the written
report. As some clinicians chose only to report index scores
or comment on test performances in vague terminology
(e.g., “average range”), without reported individual subtest
scores, missing data was encountered. In some instances,
standardized scores could be inferred based upon reported
percentile scores; however, only scores for which quantita-
tive data were reported were included in the current analy-
ses. That is, if scores were reported only as a range in a
narrative report (e.g., “low average range”) without a quanti-
tative representation (i.e., scaled score, standard score, or
percentile rank), these data points were unable to be
included. One hundred ninety-two (192) individuals had
data for all 10 subtests and FSIQ. Those 192 participants
with complete data did not significantly differ from those
excluded for missing data in terms of age [t(316) ¼ -1.105,
p ¼ .270], gender (Fisher’s exact test p > .999), racial/ethnic
identity [v2(10) ¼ 9.616, p ¼ .475], receipt of either any
diagnosis (Fisher’s exact test p ¼ .095) or ADHD (Fisher’s
exact test p > .999), or FSIQ scores [t(303) ¼ .436, p ¼
.663]. Excluding participants with missing data did not
appear to result in systematic bias.
Statistical analyses
Data were analyzed using SPSS 26.0. Raw scores were
unavailable for inspection and all subsequent analyses were
performed on standardized scores (i.e., scaled scores) for
WAIS-IV subtests (M ¼ 10, SD ¼ 3). Prior to conducting
analyses, data were examined for outliers and abnormal dis-
tributional characteristics. Two outlying data points were
identified (outliers were defined as ± 3.29 standard deviation
units from the mean) and replaced with values equal to 3.0
standard deviation units from the mean consistent with rec-
ommended practices (see Field, 2013). Visual inspection of
histograms suggested that all data (i.e., demographic and
WAIS variables) were normally distributed. Upon comple-
tion of archival data collection, all possible 4-subtest short-
form IQ combinations were created by the researchers,
ensuring that each WAIS-IV index score (i.e., Verbal
Comprehension, Perceptual Reasoning, Working Memory,
and Processing Speed) was represented by a single subtest
(total possible combinations ¼ 36).
In order to accomplish the aims of the study, we con-
ducted linear regression models to examine which short-
form combinations significantly predicted FSIQ calculations
while also sharing minimal overlapping variance with one
another. Given the exploratory aims of the present study, all
4 Z. C. MERZ ET AL.

36 possible short-form combinations were chosen as possible Table 1. WAIS-IV full-scale IQ, index score, and subtest descriptive data.
predictor variables, while FSIQ was the outcome variable. N Mean SD
Given the excellent psychometric properties of the WAIS- FSIQ 305 99.72 14.97
VCI 303 103.77 16.46
IV, it appeared likely that a majority of, if not all, short- Similarities 218 10.35 3.05
form combinations would correlate strongly and subse- Vocabulary 217 10.71 3.45
quently significantly predict FSIQ calculations. Moreover, it Information 211 10.97 3.37
PRI 304 100.06 15.42
appeared likely that a majority of short-form combinations Block design 220 9.35 3.17
would correlate strongly with each other. As such, due to Matrix reasoning 217 10.52 3.35
Visual puzzles 215 10.27 3.12
the anticipated multicollinearity given that many short-form WMI 307 97.02 15.10
combinations utilize similar subtests, we chose the stepwise Digit span 218 9.39 3.10
regression input criterion of tolerance to preemptively Arithmetic 212 9.58 3.18
PSI 305 94.73 13.06
address this concern (Tabachnik & Fidell, 2013). We chose Symbol search 217 9.17 2.80
the appropriate input criterion of tolerance > .10 (Daoud, Coding 217 9.24 2.88
2017; Mertler & Reinhart, 2016). That is, short-form com- FSIQ: Full Scale IQ; VCI: Verbal Comprehension Index; PRI: Perceptual
bination predictor variables that demonstrated overtly prob- Reasoning Index; WMI: Working Memory Index; PSI: Processing Speed Index.
lematic multicollinearity (i.e., tolerance values  .10) were
precluded from inclusion in the regression models. While Results
this study methodology appears unique across current litera- Descriptive results
ture assessing the viability of short-form IQ estimations, the
authors felt it important to exclude tetrads with problematic Overall, performance across WAIS-IV subtests approximated
rates of multicollinearity, particularly so that revealed tetrads that of age-matched peers from the original normative sam-
would provide a maximum amount of clinically interpret- ple. Slight decreases in mean scores were observed across
able data, maximizing overall testing efficiency and limit tests assessing working memory and processing speed.
data redundancy. Given the large percentage of individuals A description of WAIS-IV FSIQ, index, and subtest scores
receiving clinical diagnoses and those specifically diagnosed can be seen in Table 1. Pearson correlations for FSIQ and
with ADHD within the current sample, this procedure was individual subtest scores are shown in Table 2. Consistent
repeated separately controlling for these diagnostic factors. with the excellent psychometric properties espoused with the
Following the completion of stepwise regression analyses, WAIS-IV technical manual (Wechsler, 2008), all correlations
omega total coefficients, which estimate proportion of vari- were significant at the 0.01 level.
ance in a score representing a multidimensional construct
attributable to all sources of common variance, were calcu- Identifying 4-subtest short-forms
lated (using JASP v0.10.2; JASP Team, 2019) to assess each
short-form’s reliability (see Watkins, 2017 for a description In the overall sample, stepwise regression results yielded three
of omega’s application to multidimensional, neuropsycho- short-form combinations that significantly accounted for
logical tests) and Pearson correlation coefficients were per- unique variance in the final model (R2 ¼ .981, F[3,
188] ¼ 3257.597, p < .001). The short-form combinations (all
formed to ensure strong correlations between obtain subtest
ps < .001) entered in order were: Vocabulary þ Block
combinations and actual FSIQ scores. Finally, using regres-
Design þ Arithmetic þ Coding (SF1), followed by
sion equations extracted from linear regression models for
Information þ Matrix Reasoning þ Digit Span þ Symbol Search
each subtest combination examined, short-form FSIQ esti-
(SF2) and Similarities þ Visual Puzzles þ Arithmetic þ Coding
mations in the form of standard scores (M ¼ 100, SD ¼ 15)
(SF3). Table 3 displays these results.
were calculated. Additionally, prorated sums of scaled scores
Given the high prevalence of participants receiving one
for each short-form combination were calculated by multi- or more clinical diagnoses (83.0%), this regression procedure
plying each short-form combination’s sum of scaled scores was repeated to control for this effect. The presence of any
by 10/4, consistent with arithmetic methods used in the diagnosis was entered in the first block (No ¼ 1, Yes ¼ 2)
WAIS-IV manual for deriving prorated sums of scaled and significantly accounted for 2.1% of the variance in FSIQ
scores for index-level and FSIQ scores. These prorated sums scores (F[1, 190] ¼ 4.044, p ¼ .046). The stepwise regressions
of scaled scores were converted to FSIQ estimates according then revealed the same three short-form combinations as
to the WAIS-IV scoring manual (see Table A.7, Wechsler, reported above in the combined sample as significantly indi-
2008). Paired-samples t-tests (with Bonferroni-corrected p vidually contributory (ps < .001) to FSIQ scores in the final
values as necessary) and effect sizes were calculated to deter- model (R2 ¼ .981, F[4, 187] ¼ 2459.606, p < .001). Notably,
mine if the short-form FSIQ estimates for both the regres- these same three short-form combinations (i.e., SF1, SF2,
sion-based and prorated methods differed significantly from and SF3) were entered in the same order as above even after
the true FSIQ scores for participants and if regression-based controlling for presence of diagnosis. In the final model,
and prorated FSIQ estimated differed from each other. presence of diagnosis was not individually predictive
Frequencies of discrepancies between estimated and true (p ¼ .138).
FSIQ were calculated for each short-form for both regres- Moreover, given the high prevalence of individuals diag-
sion-based and prorated estimates. nosed with ADHD within the present sample (38.4%), this
 APPLIED NEUROPSYCHOLOGY: ADULT 5

Table 2. WAIS-IV full scale IQ and subtest pearson correlations.

FSIQ Similarities Vocabulary Information Block design Matrix reasoning Visual puzzles Digit span Arithmetic Symbol search Coding
FSIQ – .744 .726 .704 .750 .742 .744 .686 .784 .576 .618
Similarities – .683 .610 .514 .562 .551 .516 .577 .237 .361
Vocabulary – .710 .407 .490 .529 .451 .513 .207 .322
Information – .496 .457 .559 .375 .518 .217 .250
Block design – .545 .667 .478 .601 .445 .378
Matrix reasoning – .564 .509 .560 .389 .449
Visual puzzles – .486 .623 .333 .248
Digit span – .653 .394 .409
Arithmetic – .352 .391
Symbol search – .599
FSIQ: Full Scale IQ.
Note. All correlations are significant at the p < .01 level.

procedure was additionally performed with an attempt to Table 3. Stepwise regression data for WAIS-IV 4-subtest short-form calcula-
control for the effect of this particular diagnosis. Presence of tions in the combined sample.
ADHD diagnosis (Yes ¼ 1, No ¼ 2) entered in the first Model B Std. Error b t p
block was not significant (R2 ¼ .004, F[1, 190] ¼ .781, p ¼ 1
(Constant) 37.644 1.377
.378). Results again revealed the same three short-form com- SF1 – VO þ BD þ AR þ CD 1.596 .034 .959 46.594 <.001
binations as reported above as significantly individually con- 2
(Constant) 31.717 .890
tributory (ps < .001) to FSIQ scores in the final model (R2 SF1 – VO þ BD þ AR þ CD .955 .041 .574 23.511 <.001
¼ .982, F[4, 187] ¼ 2572.348, p < .001). Notably, these same SF2 – IN þ MR þ DS þ SS .773 .042 .447 18.296 <.001
three short-form combinations (i.e., SF1, SF2, and SF3) were 3
(Constant) 30.567 .729
entered in the same order as above even after controlling for SF1 – VO þ BD þ AR þ CD .552 .052 .331 10.641 <.001
ADHD diagnosis. In the final model, ADHD diagnosis was SF2 – IN þ MR þ DS þ SS .704 .035 .407 20.221 <.001
individually predictive (p ¼ .001). Tables displaying results SF3 – SI þ VP þ AR þ CD .498 .049 .295 10.063 <.001
from the regressions controlling for any diagnosis and AR: Arithmetic; BD: Block Design; CD: Coding; DS: Digit Span; IN: Information;
MR: Matrix Reasoning; SI: Similarities; SS: Symbol Search; VO: Vocabulary; VP:
ADHD can be found within Supplementary Materials. Visual Puzzles.
Overall, the same three short-form combinations emerged as
significant individual predictors in the combined sample and
after controlling for both any diagnosis and ADHD. Omega Comparing short-form estimations to true FSIQ
total coefficients were .762, .736, and .786 for SF1, SF2, and
SF3, respectively, suggesting adequate reliability for each Regarding regression-based FSIQ estimates, paired-samples
multidimensional, short-form combination. While lower t-tests (dfs ¼ 191) revealed no significant differences
than omega total coefficients for the 10-subtest WAIS-IV between true FSIQ and estimated FSIQ for each of the three
FSIQ in the standardization sample, these values nonetheless short-form combinations (tSF1 ¼ .013, p ¼ .990; tSF2 ¼
represent acceptable reliability for each as short-forms .03, p ¼ .976; tSF3 ¼ .04, p ¼ .968); these p values were
(Watkins, 2017). not Bonferroni-corrected as none of them were significant.
Regarding prorated FSIQ estimates, paired-samples t-tests
(dfs ¼ 191) revealed a statistically significant difference
Estimating FSIQ from 4-subtest short-forms between true FSIQ and prorated SF1 FSIQ (t ¼ 4.636,
pcorrected < .001), although the effect size was negligible
Individual linear regression models performed for the three
(Cohen’s d ¼ .098; Lenhard & Lenhard, 2016). No signifi-
significant short-form combinations were significant at the
cant differences were found between true FSIQ and prorated
< .001 level. Using these models, regression equations were FSIQ estimates for either SF2 (t ¼ .253, pcorrected > .999)
calculated, allowing for the sum of scaled scores for each or SF3 (t ¼ 2.154, pcorrected ¼ .096).
combination to predict a standard score synonymous with Furthermore, paired-samples t-tests (dfs ¼ 191) were also
the traditional FSIQ calculation. Pearson correlations conducted between the regression-based FSIQ estimates and
between the regression-based estimated and true FSIQ scores prorated FSIQ estimates for each short-form combination,
were strong between FSIQ and SF1 (.959), SF2 (.943), and with significant differences emerging for SF1 (t ¼ 15.715,
SF3 (.944). A method for translating scaled score perform- pcorrected < .001) and SF3 (t ¼ 8.586, pcorrected < .001), but
ance into standard scores based on these regression-based not for SF2 (t ¼ 1.401, pcorrected ¼ .489). Again, despite
results can be found in Table 4. Additionally, sums of scaled statistically significant t-tests, effect sizes for the SF1 and
scores for each short-form combination were prorated; that SF3 differences remained negligible (Cohen’s ds ¼ .051 and
is, the sum of scaled scores for each short-form was multi- .028, respectively). The statistically significant results may be
plied by 10/4. These prorated values were then used to esti- artifacts of sample size (n ¼ 192). As such, the authors inter-
mate FSIQ for each participant according to normative data preted these results, particularly the negligible effect sizes, to
from the WAIS-IV manual. Similarly, Pearson correlations indicate non-meaningful differences between estimated and
between true FSIQ and prorated FSIQ estimates were strong true FSIQs and between regression-based and prorated FSIQ
for SF1 (.957), SF2 (.940), and SF3 (.948). estimates for each short-form combination.
6 Z. C. MERZ ET AL.

Table 4. Prorated sum of scaled scores and regression-based FSIQ estimates.

Estimated FSIQ Estimated FSIQ
Sum of short-form Prorated sum of Sum of short-form Prorated sum of
scaled scores scaled scoresa SF1b SF2b SF3b scaled scores scaled scoresa SF1b SF2b SF3b
4 10 44 41 43 41 103 103 102 102
5 13 46 43 45 42 105 105 103 104
6 15 47 45 46 43 108 106 105 106
7 18 49 46 48 44 110 108 106 107
8 20 51 48 50 45 113 109 108 109
9 23 52 50 51 46 115 111 110 110
10 25 54 51 53 47 118 113 111 112
11 28 55 53 54 48 120 114 113 114
12 30 57 54 56 49 123 116 115 115
13 33 59 56 58 50 125 117 116 117
14 35 60 58 59 51 128 119 118 118
15 38 62 59 61 52 130 121 119 120
16 40 63 61 62 53 133 122 121 122
17 43 65 63 64 54 135 124 123 123
18 45 66 64 66 55 138 125 124 125
19 48 68 66 67 56 140 127 126 126
20 50 70 67 69 57 143 129 128 128
21 53 71 69 70 58 145 130 129 129
22 55 73 71 72 59 148 132 131 131
23 58 74 72 74 60 150 133 132 133
24 60 76 74 75 61 153 135 134 134
25 63 78 76 77 62 155 136 136 136
26 65 79 77 78 63 158 138 137 137
27 68 81 79 80 64 160 140 139 139
28 70 82 80 82 65 163 141 141 141
29 73 84 82 83 66 165 143 142 142
30 75 86 84 85 67 168 144 144 144
31 78 87 85 86 68 170 146 145 145
32 80 89 87 88 69 173 148 147 147
33 83 90 89 90 70 175 149 149 149
34 85 92 90 91 71 178 151 150 150
35 88 94 92 93 72 180 152 152 152
36 90 95 93 94 73 183 154 154 153
37 93 97 95 96 74 185 156 155 155
38 95 98 97 98 75 188 157 157 157
39 98 100 98 99 76 190 159 158 158
40 100 101 100 101
a
This prorated sum of scaled scores was calculated by multiplying the sum of scaled scores for each short-form combination by 10/4. The prorated sum of scaled
scores may be converted to an FSIQ estimate according to WAIS-IV manual Table A.7. bThese columns display the regression-based FSIQ estimates specific to
the sample in the present study according to each short-form combination.
Bolded values represent distinctly different values relative to their neighboring numbers.

Regarding accuracy of regression-based and prorated Table 5. Percentage of regression-based and prorated FSIQ estimates within
FSIQ estimate, for each participant and short-form, concor- 5, 10, and 15 standard score points of true FSIQ.
dances between the FSIQ and estimated FSIQ were calcu- D±5 D ± 10 D ± 15
lated and these results are displayed in Table 5. For each Regression-based FSIQ estimates
SF1 70.3 97.9 100
short-form combination, most participants’ regression-based SF2 69.3 94.8 99.5
FSIQ estimates fell within 5 (69.3–71.9%) or 10 SF3 71.9 93.8 99.5
(93.8–97.9%) Standard Score points of true FSIQ. Nearly Prorated FSIQ estimates
SF1 74.5 96.4 100
every participants’ regression-based FSIQ estimates fell SF2 70.3 93.8 99.5
within one standard deviation (i.e., 15 Standard Score SF3 75.5 94.3 99.5
points; 99.5–100%) of true FSIQ. Regarding prorated FSIQ
estimates, most participants’ also fell within 5 (70.3–75.5%)
or 10 (93.8–96.4%) Standard Score points of true FSIQ. processing speed indices are consistent with the high preva-
Similarly, nearly every participants’ prorated FSIQ estimates lence of participants with clinical diagnoses, the most prom-
fell within one standard deviation (99.5–100%) of true FSIQ. inent of which was ADHD, in the current sample
(Theiling & Petermann, 2016). These neurocognitive
domains have also been shown to be sensitive to the pres-
Discussion
ence of psychiatric conditions as well (Albert, Potter,
The present study sought to investigate the WAIS-IV in a McQuoid, & Taylor, 2018; Moran, 2016; Rose & Ebmeier,
sample of clinically-referred clients who presented for an 2006). As such, the overall performance on WAIS-IV scores
outpatient psychological/psychoeducational assessment and appears commensurate with a mixed, outpatient clinical
revealed several noteworthy findings. First, the relative sample with high base rates of attention-related and psychi-
decreases in mean scores on the working memory and atric presentations.

Second, results of the current study suggest utility of
three unique 4-subtest combinations as short-forms for the
WAIS-IV within a clinical sample readily generalizable to
psychoeducational settings commonplace in university clin-
ics across the United States. The current findings expand on
the work performed by Sattler and Ryan (2009) who con-
structed 2, 3, 4, and 5-subtest short-form FSIQ estimations.
However, it is important to highlight that these previous cal-
culations were derived using the WAIS-IV normative sam-
ple. From a clinical perspective, it could be viewed as
inappropriate to assume that cognitive assessments normed
on an otherwise healthy group of individuals would perform
the same as clinical patients with a variety of conditions
and/or comorbidities. This notion is seemingly supported by
the current study as only one out of the three combinations
(SF1) derived from the current study was previously identi-
fied by Sattler and Ryan (2009, p. 249; termed C11). As
such, SF2 and SF3, which were similarly identified via
regressions in both the overall sample and after controlling
for the presence of any diagnosis and ADHD specifically,
may represent unique short-form combinations identified
by the present study as appropriate estimations of FSIQ
within an outpatient, psychoeducational clinical sample.
Additionally, approximately 70–75% of participants’ esti-
mated scores fell within ± 5 points of true FSIQ across com-
binations (using both regression-based and prorated FSIQ
estimation methods), commensurate with mean concordance
values reported in previous short-form validation studies on
earlier WAIS iterations (57.5–83.3% ± 5 points; Donnell,
Pliskin, Holdnack, Axelrod, & Randolph, 2007; Reid-Arndt
et al., 2011). Moreover, these concordance rates are generally
comparable to a recent study validating a four-subtest
WAIS-IV short-form (including Block Design, Information,
Arithmetic, and Coding) in Chinese samples (Fan et al.,
2019) which indicated approximately 66% of estimated
scores fell within 4–5 Standard Score points and approxi-
mately 95% fell within 9–10 points. These comparisons to
previous literature suggested the favorable accuracy of these
three short-form combinations.
Regarding the FSIQ estimation methods used, results
indicated some statistically significant, though ultimately
non-meaningful, differences between estimated and true
FSIQ and between regression-based and prorated estimates.
While it may be that the prorated method provides margin-
ally better accuracy under a stringent criterion (mean % of
scores ± 5 points of true FSIQ ¼ 70.5% for regression-based
and 73.4% for prorated methods), these accuracies broadly
became equivalent when considering more lenient ranges
(mean % of scores ±10 points of true FSIQ ¼ 95.5% for
regression-based and 94.8% for prorated methods).
Although prorated FSIQ estimate may provide greater gen-
eralizability outside of the present sample, these results sug-
gested that both methods produced fairly accurate estimates
of true FSIQ; nonetheless, future research to this end and
replication of these findings are needed.
Of note, each short-form described in the present study
may provide various levels of pragmatic clinical utility given
the combinations of subtests included in each. For example,
APPLIED NEUROPSYCHOLOGY: ADULT 7
SF1, which contains subtests requiring psychomotor control
and processing speed, may be generally appropriate in many
clinical cases where these concerns are not markedly influ-
ential. On the other hand, SF2 provided subtests that are
likely to be least influenced by processing speed and psycho-
motor control deficits. For example, Digit Span is untimed
(in contrast to Arithmetic), Matrix Reasoning both is
untimed (in contrast to Block Design and Visual Puzzles)
and does not contain manipulatable objects (in contrast to
Block Design), and Symbol Search (which demands examin-
ees make single marks) may require less fine-motor dexterity
than Coding (which asks examinees to produce accurate rec-
reations of symbols). Moreover, the inclusion of the Matrix
Reasoning within SF2 is noteworthy as this subtest is rarely
included within Sattler and Ryan (2009) published tetrads,
despite being a non-processing speed-based assessment of
visuospatial relationships and nonverbal abstract reasoning.
Thus, given SF2’s limited reliance on processing speed and
psychomotor control in general (outside of Symbol Search,
which has relatively lower psychomotor demand than
Coding), this combination may represent an estimation less
influenced by deficits in these cognitive domains.
Additionally, SF3’s inclusion of Similarities over Vocabulary
may allow for a verbal comprehension contribution less con-
strained by available educational resources or cultural con-
founds (Kaufman, McLean, & Reynolds, 1988; Weiss,
Saklofske, Coalson, & Raiford, 2010). Overall, the authors
believe these combinations may be readily applied by clini-
cians currently performing psychological/psychoeducational
assessments and by researchers hoping to efficiently charac-
terize a sample’s global cognitive ability. While the current
study does not recommend the usage of one particular
short-form combination over another (as clinicians are
encouraged to choose measures most appropriate to their
clinical cases), current results do provide additional combi-
nations which could be utilized given examiner preference
and assessment goals unique to each client/patient. Readers
are encouraged to investigate these short-forms in unique
clinical populations for whom each combination may pro-
vide psychometric utility and pragmatic applicability.
As noted in earlier sections of this manuscript, the major
benefit of utilizing a short-form IQ estimation is the allow-
ance for the clinician to be more efficient with test selection,
therefore requiring less time to complete a comprehensive
cognitive assessment. While obtaining a FSIQ by administer-
ing the complete WAIS-IV may take 60–90 min to complete,
the derived short-form estimations likely decrease time spent
on intellectual measures by clinically meaningful amounts,
consistent with previous research endeavors (Axelrod &
Ryan, 2000); unfortunately, the authors cannot provide a
quantitative time-saving estimate of these short-forms’, as
data regarding duration of each subtest’s or short-form’s
administration was not available. Future research investigat-
ing the efficiency of these short-forms compared to the full
WAIS-IV administration and to each other is warranted.
Nonetheless, it is likely that clinicians who opt to use a
short-form estimation identified in the current study may
either reduce the overall testing burden or gain meaningful
8 Z. C. MERZ ET AL.
additional face-to-face time with patients. The conservation
of time is clinically valuable as factors such as patient fatigue
and tolerance are extremely important variables to consider,
especially when working with older adult patients or patients
with medical and neurological conditions for whom these fac-
tors are extremely common and debilitating (e.g., Parkinson’s
disease, multiple sclerosis). As intellectual assessments like the
WAIS-IV are limited in their assessment of other specific nar-
rowband domains (e.g., executive functioning, visual working
memory, learning and memory, confrontation naming), the
calculation of a FSIQ often yields far less value than a thor-
ough assessment of the aforementioned, more diverse neuro-
cognitive abilities. The utilization of a valid short-form
estimation therefore allows clinicians to estimate and com-
ment on intellectual abilities (i.e., to assess for generalized
cognitive decline), but also allocate patient resources (e.g.,
stamina and tolerance) and clinical resources (e.g., testing
time, measures across cognitive domains) appropriately to
better answer potentially specific referral questions.
Given the existence of the Wechsler Abbreviated Scale of
Intelligence (WASI; Wechsler, 1991, 2011), some may critique
the presumed incremental utility gained by the utilization of
WAIS-IV short-form estimations rather than scores derived
from the former measure. While the end goal of both meth-
ods (i.e., providing a valid estimation of current intellectual
abilities using a 4-subtest combination) is the same, the
approaches of each are vastly different. The WASI chooses to
focus only on Verbal Comprehension and Perceptual
Reasoning while outright ignoring aspects of working mem-
ory and processing speed. As such, the argument could be
made that the WASI best estimates the General Abilities
Index (GAI) as seen within the WAIS-IV (Wechsler, 2008).
In fact, Axelrod (2002) noted that the WASI did not consist-
ently predict WAIS-III FSIQ scores accurately, perhaps due to
this distinction. In contrast, the 4-subtest short-form estima-
tions identified in the present study account for performance
across all four neurocognitive domains assessed by the WAIS-
IV, ensuring a more well-rounded, thorough, and likely psy-
chometrically representative estimation of FSIQ scores.
Representing each of these domains in deriving FSIQ esti-
mates is particularly important in clinical samples, given the
sensitivity of the domains of working memory and processing
speed to neurological and psychiatric conditions (Moran,
2016; Ryan et al., 2018; Theiling & Petermann, 2016).
Moreover, in looking at common test selection among prac-
ticing clinicians who commonly administer cognitive assess-
ments, individual WAIS-IV subtests are given with very high
frequencies, while the WASI is far more rarely utilized (Rabin
et al., 2016), lending additional credence to the clinical viabil-
ity and preference of the approach used within the current
study. That is, if psychologists routinely give several individ-
ual WAIS-IV subtests in the absence of a complete WAIS-IV,
their data may allow for the simultaneous interpretation of
specific narrowband neuropsychological constructs and the
easy identification of FSIQ estimates, thereby yielding more
clinical “bang for your buck.”
The current study is not without its limitations. Due to
constraints in archival data collection, missing data among
subtest performance was frequent (see Table 1 for differen-
ces in ns across variables) and raw scores were unavailable
for review or analysis. Second, while generalizable to psy-
choeducational settings and university clinics, our sample
contained relatively few participants presenting with trau-
matic brain injury/neurological conditions, limiting its gen-
eralizability to settings specializing in the assessment of
neuropsychological populations. Third, assessments were
completed by clinical psychology doctoral students with
varying levels of assessment experience, creating the possibil-
ity for increased random measurement error. Relatedly,
from a statistical perspective, the reported bivariate correla-
tions between true and estimated FSIQ scores were uncor-
rected for redundant error and are likely inflated
overestimates of true correlations. While reporting uncor-
rected correlation coefficients is consistent with some (but
not all) previous literature (e.g., Reid-Arndt et al., 2011),
readers are nonetheless discouraged from over-interpreting
the magnitudes of these correlations, and future research
may seek to utilize sophisticated statistical corrections,
including those outlined by Levy (1967) and/or Girard and
Christensen (2008), in providing adjusted correlation coeffi-
cients between estimated and true FSIQ. Fourth, as stated
earlier in the manuscript, current efforts aimed at elucidat-
ing short-form combinations with minimal overlapping vari-
ance. However, it should be noted that the potential remains
for certain viable tetrads to be eliminated from consideration
given these efforts, and future research may consider exam-
ining the validity of other predetermined tetrads of interest.
Fifth, short-form combinations derived from the current
study stem from age-based normative scoring and may or
may not perform similarly when taking demographically
corrected scoring into account. Finally, the authors were
unable to assess performance validity for WAIS profiles.
To address these limitations, future researchers (and
clinicians in university-based outpatient clinics) should seek
to collect assessment data prospectively to ensure that miss-
ing data are minimized and that data on rigorously validated
standalone and/or embedded validity indicators (e.g., reliable
digit span; Schroeder, Twumasi-Ankrah, Baade, & Marshall,
2012) are represented. Additionally, future studies should
seek to explore short-form estimations in more traditional
neurological settings and in relationship to other measures
of cognitive/psychological functioning. Finally, future
research should seek to validate and critique these WAIS-IV
short-form combinations in demographically diverse or spe-
cialized samples, for example, in settings where particular
racial/ethnic minorities are over-represented or for those of
non-English-speaking background.
Disclosure statement
No conflicts of interest are declared by any authors.
ORCID
Zachary C. Merz http://orcid.org/0000-0001-7268-6265

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