What is the Boston Naming Test?

The Boston Naming Test (BNT) is a clinical test of word retrieval in which a person looks at 60 black-and-white line drawings, one at a time, and tries to name each object from memory. Neuropsychologists and speech-language pathologists use it to detect naming problems in people with aphasia, dementia, and brain injury. The test was created by Edith Kaplan, Harold Goodglass, and Sandra Weintraub, with the standard 60-item version published in 1983. This article explains what the test looks like, what "confrontation naming" actually measures, how the cue system works, who takes the test, and how a naming test differs from a vocabulary test or an IQ test.

The format is deliberately simple. Researchers who use the test describe it as 60 black-and-white line drawings of various items, roughly ordered by increasing difficulty. Early pictures show objects that almost every adult can name without effort, while later pictures show less familiar items such as a protractor or a palette. The examinee does not read, write, or define anything. They look at a drawing and say what it is.

The BNT belongs to the Boston aphasia battery family. According to the publisher PAR, the current second edition of the naming test is packaged with the Boston Diagnostic Aphasia Examination, Third Edition (BDAE-3), a comprehensive aphasia battery authored by Harold Goodglass, Edith Kaplan, and Barbara Barresi for adults ages 18 to 79. The naming test can also be administered on its own, and in practice it appears in many neuropsychological batteries far outside formal aphasia workups.

"Confrontation naming" means producing the correct word when you are confronted with a picture or object. It is a direct test of "lexical access," the brain's ability to retrieve a specific stored word on demand. Most adults have experienced the mild version of this failure: the tip-of-the-tongue state, where you know the thing and can describe it but cannot pull up its name. When word retrieval breaks down persistently, clinicians call it "anomia," and it is one of the most common symptoms across nearly all forms of aphasia.

A naming failure can happen for two quite different reasons, and the distinction matters clinically. In a 2024 study in the Journal of the International Neuropsychological Society, researchers led by Carling Robinson framed the question as whether a missed item reflects loss of word knowledge itself or a retrieval-based difficulty, where the knowledge is intact but cannot be accessed. Degenerative conditions that erode semantic knowledge tend to produce the first pattern. Retrieval problems, in which cues restore the word, tend to point elsewhere. The BNT's cue system exists precisely to help separate these patterns.

Administration follows a structured sequence, and examiners record much more than a simple right-or-wrong tally. Research protocols describe the standard procedure this way.

• Spontaneous responses: The examinee first attempts each picture with no help. A correct name earns full credit for that item.

• Semantic (stimulus) cues: If the person misperceives the drawing, the examiner gives a brief cue about meaning or context to correct the misperception. A correct response after a stimulus cue still counts toward the total score in standard research scoring.

• Phonemic cues: If the person clearly recognizes the object but cannot produce the word, the examiner gives the first sound of the target word. Correct responses after a phonemic cue are recorded separately and do not add to the main score. They are still diagnostically informative because they show the word is stored and merely hard to retrieve.

• The overall pattern: Examiners also track "I don't know" responses and error types. A person who benefits greatly from phonemic cues looks different, clinically, from a person whom no cue can help.

This is why the BNT yields more than a number. Two people with identical totals can show very different profiles once the cue data are considered, which is part of the reason the test has remained a fixture of neuropsychological testing for four decades.

The BNT shows up in three broad clinical contexts.

• Aphasia evaluations: As part of the BDAE family, the test helps characterize language loss after stroke or other focal brain injury. The publisher describes the parent battery as an assessment of aphasia and related disorders in adults.

• Dementia and memory clinic workups: Naming declines early in Alzheimer's disease and is a hallmark of semantic variants of primary progressive aphasia, so naming tasks appear throughout dementia assessment. Brief cognitive screeners such as the MoCA include a few naming items; the BNT examines the same ability in far greater depth.

• Traumatic brain injury: Word-retrieval disruptions are commonly reported after TBI across severity levels, and the BNT has been one of the most widely used measures in that literature, according to a 2024 study in the American Journal of Speech-Language Pathology by McCurdy, Covington, and Duff.

Because 60 items can be taxing for impaired patients, several abbreviated versions exist. The best known is the 15-item form built into the CERAD battery, a standardized set of tasks developed for Alzheimer's disease research. Other researchers, including Mack and colleagues, constructed additional 15-item and 30-item forms. A 2015 study in Dementia and Geriatric Cognitive Disorders by Katsumata and colleagues compared these versions in an Alzheimer's disease center cohort and found that all of the short forms could still separate cognitively normal older adults from those with dementia, although the CERAD version tracked the full test less closely than the alternatives and was weaker at detecting milder impairment.

Performance on the test is also shaped by factors that have nothing to do with brain disease, and honest interpretation has to account for them. In a study of 670 cognitively normal older adults published in the Journal of the International Neuropsychological Society, Otto Pedraza and colleagues found that 12 of the 60 items functioned differently for African American and Caucasian test takers even after matching people on overall naming ability, with items such as dominoes, escalator, muzzle, latch, tripod, and palette showing the strongest evidence of bias. The authors cautioned that demographically corrected norms can mask problems that exist at the item level. Related work reviewed by McCurdy and colleagues notes that BNT scores correlate with age, sex, education, and ethnicity, and that the test's familiar, high-frequency stimuli may underestimate subtle deficits in some patients. In plain terms: a low score in a person with limited schooling, or from a cultural background where some depicted objects are uncommon, needs careful interpretation before anyone calls it impairment.

It is tempting to read a naming score as a vocabulary score or even an intelligence score, and neither reading is quite right. A receptive vocabulary measure such as the Peabody Picture Vocabulary Test asks you to recognize a word someone else supplies, which is a test of what you know. The BNT asks you to generate the word yourself, which tests whether you can retrieve what you know on demand. A person with a rich vocabulary and a retrieval deficit can fail items for words they understood perfectly well before their injury.

An IQ test is different again. General intelligence reflects performance sampled across many distinct abilities, and no single narrow task can stand in for that breadth. The BNT was never designed to estimate IQ, has no full-scale composite, and says nothing about reasoning, spatial ability, or processing speed. For readers interested in a broad cognitive measure rather than a clinical language instrument, the RIOT IQ test (the Reasoning and Intelligence Online Test) was developed by RIOT IQ with psychometrician Dr. Russell T. Warne for adults 18 and older. It includes 15 subtests across six cognitive indices (verbal reasoning, fluid reasoning, spatial ability, working memory, processing speed, and reaction time), takes about 52 minutes, and reports scores on the familiar mean-100, standard-deviation-15 scale. It is not a diagnostic tool, and it does not replace an individually administered evaluation for someone with suspected aphasia or dementia. If you want a well-built measure of overall cognitive ability, you can take the RIOT IQ test at riotiq.com.

Edith Kaplan, Harold Goodglass, and Sandra Weintraub developed it, with the standard 60-item version published in 1983. The second edition is distributed with the Boston Diagnostic Aphasia Examination, Third Edition.

No. It measures one narrow ability, retrieving object names from pictures. It produces no IQ score and does not assess reasoning, memory, or spatial ability.

A semantic cue tells the person something about the object's meaning and is used when the drawing was misperceived. A phonemic cue gives the first sound of the word and tests whether the word is stored but hard to retrieve.

Yes. Several 15-item and 30-item forms exist, including the 15-item version used in the CERAD battery. Research shows the short forms still distinguish dementia from normal aging, though less precisely than the full test.

No. Education, cultural familiarity with the pictured objects, age, and language background all influence scores. A low score is a signal for a qualified clinician to investigate, never a diagnosis by itself.

The test is a controlled clinical instrument administered by trained examiners, and its value depends on standardized administration and cueing. Informal online versions cannot replicate that and can spoil the items for future clinical use.

1. Robinson, C. G., Goodrich, A. W., Weigand, S. D., Pham, N. T. T., Carlos, A. F., Buciuc, M., Murray, M. E., Nguyen, A. T., et al. (2024). Determinants of confrontation naming deficits on the Boston Naming Test associated with transactive response DNA-binding protein 43 pathology. Journal of the International Neuropsychological Society. pmc.ncbi.nlm.nih.gov

2. PAR, Inc. (n.d.). Boston Diagnostic Aphasia Examination, Third Edition (BDAE-3). parinc.com

3. Katsumata, Y., Mathews, M., Abner, E. L., Jicha, G. A., Caban-Holt, A., Smith, C. D., Nelson, P. T., Kryscio, R. J., et al. (2015). Assessing the discriminant ability, reliability, and comparability of multiple short forms of the Boston Naming Test in an Alzheimer's disease center cohort. Dementia and Geriatric Cognitive Disorders, 39, 215-227. pmc.ncbi.nlm.nih.gov

4. Pedraza, O., Graff-Radford, N. R., Smith, G. E., Ivnik, R. J., Willis, F. B., Petersen, R. C., & Lucas, J. A. (2009). Differential item functioning of the Boston Naming Test in cognitively normal African American and Caucasian older adults. Journal of the International Neuropsychological Society, 15(5), 758-768. pmc.ncbi.nlm.nih.gov

5. McCurdy, M., Covington, N. V., & Duff, M. C. (2024). Naming ability in the chronic phase of moderate-severe traumatic brain injury. American Journal of Speech-Language Pathology. pmc.ncbi.nlm.nih.gov

Deck of playing cards featuring New Zealand native birds, ca. 1950, Alexander Turnbull Library, via Wikimedia Commons (public domain)