Trail Making Test

History

The test was created by Ralph Reitan, an American neuropsychologist considered one of the fathers of clinical neuropsychology. The test was used in 1944 for assessing general intelligence, and was part of the Army Individual Test of General Ability.{{cite journal

Method and interpretation

The task requires the subject to connect 25 consecutive targets on a sheet of paper or a computer screen, in a manner to like that employed in connect-the-dots exercises. There are two parts to the test. In the first, the targets are all the whole numbers from 1 to 25, and the subject must connect them in numerical order. In the second part, thirteen of the dots are numbered from 1 to 13 and twelve are given the letters from A to L; the subject must connect the dots in order while alternating letters and numbers (1–A–2–B–3–C ...) as fast as possible without lifting the pen from the paper.{{cite journal

The goal of the test is for the subject to finish both parts as quickly as possible, with the time taken to complete the test being used as the primary performance metric. The error rate is not recorded in the paper version of the test; instead, time spent correcting errors extends the completion time. The second part of the test, in which the subject alternates between numbers and letters, is used to examine executive functioning. The first part is used primarily to examine cognitive processing speed.

Score

Scoring is based on time taken to complete the test (e.g. 35 seconds yielding a score of 35) with lower scores being better. Different norms are available that allow comparison with age-matched groups.

Time to complete

The entire test usually takes between 5 and 30 minutes. The average times to complete part A and B are 29 and 75 seconds, respectively. It is not necessary to continue the test if a patient cannot complete parts A and B within 5 minutes.

Population and usefulness

The population to be assessed includes adolescents, adults and the elderly.

The usefulness of this test in 1944 was to assess general intelligence, but in the 1950s researchers began to use it to assess cognitive dysfunction resulting from brain damage. It is now used as a diagnostic tool in clinical settings. It can also detect cognitive impairment associated with dementia.

References

References

1. Arnett, James A.. (1995). "Effect of physical layout in performance of the Trail Making Test". Psychological Assessment.
2. (1995). "Detection of dementia of the Alzheimer type in a population-based sample: Neuropsychological test performance". Journal of the International Neuropsychological Society.
3. R. M. Reitan, R. M. (1955). The relation of the trail making test to organic brain damage. Journal of Consulting Psychology
4. (1958). "Validity of the Trail Making test as an indicator of organic brain damage". Perceptual and Motor Skills.
5. Lezak, Muriel Deutsch. (2012). "Neuropsychological assessment".