Investigating a classical neuropsychological test in a real world context

This study was performed to investigate the validity of a real world version of the Trail Making Test (TMT) across age strata, compared to the current standard TMT which is delivered using a pen-paper protocol. We developed a real world version of the TMT, the Can-TMT, that involves the retrieval of food cans, with numeric or alphanumerical labels, from a shelf in ascending order. Eye tracking data was acquired during the Can-TMT to calculate task completion time and compared to that of the Paper-TMT. Results indicated a strong significant correlation between the real world and paper tasks for both TMTA and TMTB versions of the tasks, indicative of the validity of the real world task. Moreover, the two age groups exhibited significant differences on the TMTA and TMTB versions of both task modalities (paper and can), further supporting the validity of the real world task. This work will have a significant impact on our ability to infer skill or impairment with visual search, spatial reasoning, working memory, and motor proficiency during complex real-world tasks. Thus, we hope to fill a critical need for an exam with the resolution capable of determining deficits which subjective or reductionist assessments may otherwise miss.