Studies from the Center for Stroke Rehabilitation Research at Kessler Foundation
2026 Updated Guidance for Assessing Hidden Spatial Neglect Expanded KF-NAP® Plus 2026 Manual helps clinicians observe and score spatial neglect in more daily activities
The Key Takeaway: KF-NAP Plus 2026 Manual builds on the Kessler Foundation Neglect Assessment Process by helping clinicians assess spatial neglect as well as anosognosia for spatial neglect more fully in real-life settings. It includes an expanded 13-item Catherine Bergego Scale (CBS+), Self-Rating Forms, and standardized guidance to support observation, scoring, and treatment planning.
Terms to Know: Spatial Neglect: Difficulty noticing or responding to information on one side of space after a stroke or other brain injury. Anosognosia for Spatial Neglect (ASN): Impaired self-awareness of spatial neglect in individuals with the condition.
Kessler Foundation has released the KF-NAP® Plus 2026 Manual, an updated resource that expands the assessment of spatial neglect with new clinical measures, self-rating tools, and standardized guidance for clinicians. Spatial neglect is a neuropsychological syndrome that can follow stroke or another type of brain injury. A person with spatial neglect may have trouble noticing, turning toward, or responding to things on the side of the body or space opposite the affected area of their brain. For example, a person with brain damage in the right side of the brain may have difficulties on the left side of the body or space. Because symptoms may not be obvious without a comprehensive assessment, clinicians need practical tools that help them observe how spatial neglect affects everyday activities.
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Catherine Bergego Scale Plus (CBS+): The expanded 13-item version of the Catherine Bergego Scale included in the KF-NAP Plus 2026 Manual. Clinicians use this functional assessment to observe signs of spatial neglect. KF-NAP Plus 2026: An updated manual that builds on the Kessler Foundation Neglect Assessment Process, or KF-NAP, by expanding assessment of spatial neglect and ASN in real-life settings.
(Continued, from first page) Since its introduction in 2012, Kessler Foundation Neglect Assessment Process (KF-NAP) has helped clinicians use the Catherine Bergego Scale, or CBS. This scale is used to assess spatial neglect or ASN, which is reduced self-awareness or underestimation of the condition’s impact on daily activities. The new KF-NAP Plus 2026 Manual builds on that foundation with updated tools and guidance to help clinicians detect and measure spatial neglect and anosognosia for spatial neglect including: • Expanding the original CBS 10-item scale with three new items: Reading, Small Object Organization, and Way Finding. The extended version is called CBS+ • The original 10 items include Gaze Orientation, Limb Awareness, Auditory Attention, Personal Belongings, Dressing, Grooming, Navigation, Collisions, Meals, Cleaning After Meals • Two Self-Rating Forms with step-by-step instructions to help individuals with left or right spatial neglect evaluate their own deficits
• Standardized examiner instructions for administering and scoring CBS+ and Self-Rating Forms • Practical tips for inpatient, outpatient, and home settings, consistent with the KF-NAP 2023 Manual Why this update matters Why this update matters The 2026 update reflects the changing needs of people with spatial neglect or ASN in rehabilitation. As individuals move from inpatient facilities to home and community settings, difficulties with reading, organizing objects, and navigating unfamiliar environments may become more apparent, even as basic self-care skills improve.
Learn more: The lead researcher was Peii Chen, PhD, assistant director, Center for Stroke Rehabilitation Research at Kessler Foundation. Visit our website to learn more about the clinical tools that support spatial neglect recovery developed by our scientists. This Real-Life Science summary is part of our series that translates peer-reviewed research into practical, real-world understanding. You can download the free KF-NAP Plus 2026 Manual or scan the QR code below. There are also 2023 versions available in Greek, Japanese, or Croatian.
The added CBS+ items broaden the assessment to better reflect challenges people may face in everyday life, while preserving the scale’s reliability. By evaluating both spatial neglect and ASN, KF-NAP Plus gives clinicians a more complete understanding of an individual’s clinical presentation. This information can support treatment planning, guide family caregiver education, and help monitor rehabilitation outcomes over time.
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