What is the Trail Making Test?

A trail making test is a neuropsychological test administered to determine an individual's task-switching and visual attention capabilities. A trail-making test requires an individual to connect the dots of a series of targets. In its earliest incarnations, trail making tests were utilized to determine intelligence levels, but it has since become a benchmark testing method for neurology patients; it is an especially beneficial diagnostic means to determine the extent of various types of brain injury.

The standard trail making test began in the 1930s as the Taylor Number Series, which required test takers to link a series of numbers between one and 50. The test was subsequently revised and became the Partington Pathways Test, named after the doctor who modified it. In 1944, the test was adopted for use as part of the Army Individual Test Battery, and its name was changed to the trail making test. It then became a standard part of the Halstad-Reitan Neuropsychological Test Battery. Though they have been traditionally been taken on paper, trail making tests are also administered via computers.

A typical trail making test is comprised of two parts. The test is first and foremost an assessment of speed, so individuals are encouraged to take the examination in as little time as is feasible. In the first section of the test, the numbers one through 25 are laid out randomly across a single piece of paper. The tester connects the numbers in order as quickly and efficiently as possible. In the second part of the testing process, series of letters and numbers — such as A-B-C and 1-2-3 — are presented, and the test subject must connect the patterns in sequential order.

The second part of the trail making test generally takes longer than the first section of the battery. It is common for those taking the test to grow frustrated during the second part of the process if they focus on it for more than a few minutes. The entire trail making test should take just five to 10 minutes.

Trail making test scoring involves adding up the time it takes to complete each section of the examination. The testing process is meticulously monitored. If the test taker makes a mistake in linking the patterns, the test administrator will point it out immediately and instruct the individual to correct the error. The individual will then continue with the test. All of this is accomplished while the timer is ticking away and helps in determining the test taker's ability to switch tasks effectively and remain visually attentive.