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About the CTMT

Why should I trust the results?

  • Neuropsychological Test
  • Descriptive and evaluative
  • Based on the highly popular Trail Making Test or TMT -1948 (Partington and Leiter)

Validity

Reliability

Internal Consistency : Excellent

  • Chronbach's reliability coefficient 0.90 Smith et.al 2008)
  • Guilford's Formula 0.92 (Reynolds 2002)

Test-Retest

  • Correlation: Adequate 0.74-0.78 (Reynolds 2004)
  • Content Validity: Excellent

- Statistical Methods used

  • Construct Validity: Adequate

-Compared to other standardized test which measure, Processing speed (r= 0.7) and Perceptual Organization (r=0.58)

-Correlation values supported construct validity (p = 0.004)

  • Criterion Validity: Not compared to a gold standard

Who is it for?

What does it assess?

  • 11- 74 year old's
  • Traumatic Brain Injury
  • Central Nervous System Injuries

Who is it NOT for?

Brain Compromise

  • Visual Search/Perception
  • Sequencing
  • Set-Shifting
  • Visual Motor Speed
  • Focused Attention
  • Higher Level Cognitive Processing
  • Visual problems
  • Severe Visual Perception issues
  • Fine motor issues in dominate hand

Administering the Test

Environment

How to administer

  • Quite
  • No distraction/Other people
  • Lighting overhead

Clinical Utility

- 5 search and sequence tasks or "trails" + 3 Sample trails

- Increase in difficulty

- First 3 measure Simple sequencing

- Last 2 measure Complex Sequencing

  • 1st sample test - can be repeated
  • Trail 1, 2, 3
  • 2nd sample test
  • Trail 4
  • 3rd sample
  • Trail 5
  • Sample test may be repeated, if unable to do sample -> stop test

Comprehensive Trail Making Test

(CTMT)

Scoring

  • Short
  • Simple instructions
  • Little set-up/Few tools
  • Large age range
  • Relatively inexpensive
  • No specialized training
  • Supported by research

Raw score = time in seconds

Time in seconds converted to t-scores

T-scores converted to percentiles

"Profile of scores" = graph depicting results

Calculation of significance - is the time for each trial significantly different from that of other trials.

By Ashley Lockyer

Percentiles

T- Score

Qualitative

Description

Severely Impaired

Mild/Mod Impaired

Below Average

Average

High Average

Superior

Very Superior

2.34

6.87

16.12

49.61

16.12

6.87

2.34

<30

30-35

36-42

43-57

58-64

65-70

>70

Lets give it a try

Discussion

  • The Kristen is 12 months post car accident. Moderately severe head trauma + fractured pelvis.
  • Referred OT to determine suitability to return to former work as a pipe-fitter.
  • The client denies any difficulties
  • Family reports that there are behavioural and cognitive difficulties – short bursts of temper, lack of concentration and attentiveness, difficulty following directions.
  • No obvious motor problems.
  • How could CTMT be useful clinically?
  • Limitations of the CTMT ?
  • Cultural issues?
  • Would you use the tool? Would you pair it with others?
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