Analysis of an Oral Paradigm for the Trail Making Test

Performance on the Trail Making Test is dependent upon multiple factors (e.g., motor speed, visual search, symbolic set shifting, capacity to sustain effort), many of which are difficult to assess differentially using the test's traditional administration, or with certain clinical populations (e.g., blind or grossly motor-impaired individuals). The present study investigated a motor-free, vision-free, oral version of the Trail Making Test in two groups of younger adults and one group of elderly adults. The results demonstrated that although there were age-associated differences in raw performance times, the comparability of oral and written performances, as assessed by oral-to-written ratios, was consistent across age groups. These results suggest that the oral version of the Trail Making Test yields results consistent with an individual's written performance in normal subjects, regardless of age. Findings are discussed with regard to the potential clinical application of this measure as an alternative for specific populations, and as a useful way of interpreting written Trail Making performances.