An improved diagrammatic procedure for interpreting and scoring the Wisconsin Card Sorting Test: An update to Steve...

The Wisconsin Card Sorting Test (WCST) is a popular neuropsychological test that is complicated to score and interpret. In an attempt to make scoring of the WCST simpler, Berry (The Clinical Neuropsychologist 10, 117-121, 1996) developed a diagrammatic scoring procedure, particularly to aid scoring of perseverative responses. We identified key limitations of Berry's diagram, including its unnecessary ambiguity and complexity, use of terminology different from that used in the standardized WCST manual, and lack of distinction between perseverative errors and perseverative responses. Our new diagrammatic scoring procedure scores each response one-by-one; we strongly suggest that the diagram is used in conjunction with the 1993 WCST manual. Our new diagrammatic scoring procedure aims to assist novice users in learning how to accurately score the task, prevent scoring errors when using the manual version of the task, and help scorers verify whether other existing computerized versions of the task (apart from the PAR version) conform to the Heaton et al. (1993) scoring method. Our diagrammatic scoring procedure holds promise to be incorporated into any future versions of the WCST manual.