Differential sensitivity of TOMAL subtests and index scores to pediatric traumatic brain injury

The objective of the present study was to examine and compare the subtest, index, and factor scores of the Test of Memory and Learning (TOMAL), using receiver-operating characteristic curves, to investigate their sensitivity and specificity to traumatic brain injury (TBI) in children and adolescents. One hundred and fifty participants who had sustained TBI were compared to 150 controls matched on age and gender from the TOMAL's standardization sample. Results indicated that the greatest area under the curve (AUC) was for the Object Recall (OR) subtest score, the Composite Memory Index (CMI), and the attention factor score. The optimal CMI cutoff score for a TBI diagnosis was 83. When factor scores were compared, the attention factor and two verbal factors had significantly larger AUCs than the three nonverbal factors. These findings suggest that the OR subtest and CMI are most sensitive to TBI, and that when components were broken into factors with no overlapping subtests, attention and verbal memory were optimal for classifying TBI.