Psychology RootsTrail Making Test
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About Trail Making Test
Scale Name
Trail Making Test
Author Details
Ralph M. Reitan
Translation Availability
English
Background/Description
The Trail Making Test (TMT), developed by Ralph M. Reitan (1986), is a neuropsychological assessment designed to evaluate executive functioning, including attention, visual scanning, processing speed, and cognitive flexibility in individuals aged 15–89 years. Published through the Reitan Neuropsychological Laboratory, the TMT consists of two parts: Part A (connecting numbered circles in sequence, e.g., 1-2-3) and Part B (alternating between numbered and lettered circles, e.g., 1-A-2-B). Part A assesses visuomotor speed and attention, while Part B evaluates cognitive flexibility and task-switching, sensitive to frontal lobe dysfunction.
Participants complete both parts using a pencil to connect circles as quickly and accurately as possible. Performance is scored by time taken (seconds) for each part, with errors noted but not scored. Normative data (adjusted for age and education) indicate completion times of approximately 29 seconds (Part A) and 75 seconds (Part B) for healthy adults. The TMT was validated with diverse clinical samples (e.g., 150–200 patients with brain injuries, mean age ≈ 30–50 years, U.S.-based), showing slower times in neurological conditions (e.g., traumatic brain injury, dementia). It correlates with the Wechsler Adult Intelligence Scale (r ≈ 0.40–0.60) and Stroop Test (r ≈ 0.50–0.70). The TMT is used in clinical neuropsychology, psychiatry, and research to assess cognitive impairment, diagnose neurological disorders, and monitor treatment outcomes.
Administration, Scoring and Interpretation
- Obtain the TMT from Reitan (1986) or authorized sources (e.g., Reitan Neuropsychological Laboratory), ensuring ethical permissions.
- Explain to participants (ages 15–89) that the test involves connecting circles in order, emphasizing speed, accuracy, and voluntary participation.
- Administer Part A and Part B in a quiet, clinical setting using standardized paper forms, with a practice trial for each part to ensure understanding.
- Record time to completion (seconds) for each part; note errors but do not penalize in scoring.
- Estimated completion time is 2–5 minutes (Part A: ~1–2 minutes; Part B: ~2–3 minutes).
- Ensure a distraction-free environment; provide accommodations (e.g., larger print) if needed.
Reliability and Validity
The TMT demonstrates robust psychometric properties (Reitan, 1986; Strauss et al., 2006). Test-retest reliability is high (Part A: r ≈ 0.75–0.90; Part B: r ≈ 0.65–0.85 over 2–4 weeks), based on samples of 50–100 healthy and clinical participants. Inter-rater reliability is near perfect (r > 0.95) due to objective timing.
Convergent validity is supported by correlations with the Stroop Test (r ≈ 0.50–0.70), Digit Span (r ≈ 0.40–0.60), and Wisconsin Card Sorting Test (r ≈ 0.45–0.65). Discriminant validity is evidenced by weak correlations with unrelated constructs like verbal fluency (r < 0.20). Criterion validity is shown by its ability to differentiate healthy controls from patients with traumatic brain injury, stroke, or dementia (sensitivity ≈ 0.80–0.90). Part B is particularly sensitive to executive dysfunction. Pairing with tests like the Montreal Cognitive Assessment or Stroop Test enhances comprehensive cognitive assessment.
Available Versions
Multiple-Items
Reference
Reitan, R. M. (1986). Trail Making Test manual for scoring and administration. Tucson, AZ: Reitan Neuropsychological Laboratory.
Strauss, E., Sherman, E., & Spreen, O. (2002). A compendium of neuropsychological tests: Administration, norms, and commentary. (No Title).
Important Link
Scale File:
Frequently Asked Questions
What does the Trail Making Test measure?
It measures executive functioning, including attention, processing speed, and cognitive flexibility.
Who is the target population?
Individuals aged 15–89, typically in clinical or research settings.
How long does it take to administer?
Approximately 2–5 minutes.
Can it inform interventions?
Yes, it identifies cognitive impairments to guide diagnosis and treatment planning.
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