The Trail Making Test as an initial screening procedure for neuropsychological impairment in older children

This study was designed to explore the possibility of using a brief neuropsychological test for broad-band initial screening of children with academic problems who might have neuropsychological deficits that should be more completely evaluated. Part B of the Trail Making Test was selected as the instrument for investigation. Three groups of children, aged 9–14 years, were composed for this study to represent (1) children with diagnosed brain damage or disease, (2) children who were medically normal but who were of serious concern to parents and teachers because of inadequate academic progress, and (3) a normal control group. The Brain-Damaged group required more than three times the number of seconds needed by the controls to complete the test, and the group with academic difficulties required more than twice the time of the controls. Using the limits set by the distributions of the Brain-Damaged and control groups, it was possible to identify a cutoff point that may be used for preliminary identification of children with academic difficulties who might benefit from further neuropsychological evaluation. The results of this study stand in need of cross-validation and, obviously, much additional outcome research is necessary to evaluate the efficacy and validity of the findings for screening purposes.