ANALÓPEZ MINC-ATTENTION AC-2

MAIN TESTS USED FOR ATTENTION ASSESSMENT

there is no evidence of the attention...only a specific aspect can be evaluated

of human behavior with special interest in the component of attention
van Zomeren and Bower (1992)1

EVALUATION OF ATTENTION

Attention is a complex function that interrelates with various cognitive processes, assigning
resources for the task being carried out to be done effectively. Commonly, they can
differentiate three components:

• selection
• surveillance and
• control.

The normal functioning of these three aspects will allow the subject to perform and maintain a
behavior directed towards a goal.

It is evident the need to evaluate the different attentional mechanisms in a differentiated manner.
Only in this way can comparable results be obtained in research, according to the
concrete mechanism considered. Currently, it is still common to compare results of
different investigations on the impact of attention in the same type of clinical group through
the use of different attention tests that emphasize diverse components.

According to Gómez and Ostrosky-Solis (2003), to thoroughly assess attentional function, one must
It must include a set of tests that cover various attentional aspects.2According to
According to Peña-Casanova (2004), the implementation of neurocognitive tests is conditioned by multiple
factors that the examiner must know and consider appropriately in each particular case. The
Factors that can affect the performance of neuropsychological tests (Peña-Casanova, 1991).

1. Demographics: Edad
manual. Mother tongue, bilingualism, polyglotism
2. Situational: Motivation
3. Sensory: Hearing losses (hypoacusia in different degrees). Visual acuity.
Visual field defects / visuospatial neglect.
Peripheral neuropathies
4. Alterations of the peripheral systems of psychomotricity: Arthritis, arthropathies.
Traumas.
5. Attention and distractibility.
6. Sensitivity to fatigue
7. Tolerance to frustration
8. Psychological / psychiatric / personality factors: Depression. Psychosis. Behaviors.
antisocial. Somatization disorders. Anxiety disorders.
Alcohol or drug abuse.
9. Medical or general health status
10. Brain injury: Intragroup variations
11. Anatomical variables: diffuse vs. focal injury, acute vs. chronic

Demographic factors have a special importance. The most important are age,
education and sex. These factors often involve an adjustment of performance
raw scores obtained in a given test. This fact requires the availability of normative groups in the

1
ANALÓPEZ MINC-ATTENTION AC-2

that the possible impact of these variables has been defined. It could be reckless to evaluate a test that
has not been normalized for the population in question.

Situational factors such as motivation or secondary gains depending on the outcome

Exploration, or even simulation cases, constitute another special group of problems.
Various detection techniques have been developed for the simulation.

Sensory-perceptual disorders can be crucial in certain cases as certain tests

they require an important sensory component. A typical example of this problem is the difficulty of
a repetition test in a hearing-impaired patient. If word repetition is requested, they can still
good performances may appear, but if what is asked is the repetition of pseudowords, the errors
they can be patented. Logically, it should not be considered that the repetition of pseudowords
(logotomos) is altered in cases of hearing loss, especially if there are no aphasic manifestations.

Since attention plays an important role in exploration, it is very important to consider the
possible impact of distractibility as a cause of low performance and leading to falsehoods
Inferences. Fatigue can also be crucial in performance.

In this sense, and despite the great usefulness of standardized psychometric tests during the phases
initial evaluation, understanding the attentional difficulties of patients will be a
process that involves:

a) The formulation of working hypotheses based on processing models

attentional.

b) The analysis of the results and the drawing of conclusions from a perspective
functional that often exceeds the direct information provided by the
quantitative evaluation

Thus, as the capacity and professional competence, as described by Lezack:

The nature of neuropsychological evaluation requires that a competent professional must

possess interviewing and counseling skills, the appreciation of social and cultural variables,
and the training of a clinical psychologist; the statistical sophistication and familiarity with
test of a psychometer; and a broad comprehensive understanding of the human nervous system and
his pathologies, (...)."Lezack (2004).3

Currently, there are various tests that serve to carry out neuropsychological evaluations.
the attention in normal populations and with pathology in both children, adults, and the elderly.

The following is presented first schematically and then more

exhaustively, the neuropsychological tests that are most commonly used to evaluate the
attention and its different processes, according to Gómez Ostrosky-Solis (2003). Thus, like some batteries
neuropsychological that include specific sections for evaluating attention, and have
I have included some tests that I found interesting to contribute.

2
ANALÓPEZ MINC-ATTENTION AC-2

SCHEME BASED ON THE MAIN TESTS USED IN THE EVALUATION OF ATTENTION

4
according to (Feggy Ostrosky-Solis)

Neuropsychology Attention and Memory

Neuropsychological Batteries Test Barcelona TBR

Neuropsychological Battery Seville (BNS)

Digit Detection

On surveillance and continuous performance Successive Series

Digit Retention

THIS
(Test of Variable of Attention)
Sustained Attention

Conners CPT-II

Trace or stroke test

Alternate Attention
Trail Making Test
Evaluation
from Attention
Attentional Capacity Corsi cubes

Digit Symbol (WAIS-II)

Selective Attention Symbols and Digits (SDMT)

Paced Auditory Serial Addition Test

PASAT

Attentional Control Stroop test

Cancellation tasks,
Bisection of lines
Space hemiplegia
Observation, Drawing of a clock, in a house or of a
flower

AULA System - CVST (Computerized Visual Task)

Other tests the search) -GL (Global-local attention)
D2 (Attention Test) - WAIS-III 3
 ANALÓPEZ MINC-ATTENTION AC-2

Neuropsychological Batteries

NEUROPSI. (BRIEF NEUROPSYCHOLOGICAL EVALUATION IN SPANISH)

Application:Individual
Time:Variable, approximately 25 to 30 minutes
Age:Adolescents and adults (16 years - 85 years)
Material:Manual, book of springs with sheets, protocols of null schooling and
low and high middle school protocols.

Related links:The provided text is a URL and cannot be translated.

Content.Created in 1994 by Dr. Feggy Ostrosky Solís, along with Alfredo Ardila and Mónica
Rosselli, the test has contributed to the resolution of a practical problem in psychometry.
Ibero-American, which is to have a series of instruments built or adapted to the
requirements of the Spanish-speaking population. As a way to develop, standardize and
to test the reliability and validity of an instrument for the assessment of cognitive functions in
Spanish.

The test provides reliable indices that allow for early and predictive diagnosis of
cognitive alterations, such as: time, person and space orientation, attention and activation,
memory, oral language, written language, visuo-spatial and visuo-perceptual aspects, and executive functions.
It should also be mentioned that this battery was designed to be applied to subjects with and without a process.
of literacy.

The tests that make up the battery are the following:

a) Orientation,
b) Attention and concentration,
c) Encoding,
Language,
e) Verbal fluency,
f) Reading,
g) Writing,
h) Conceptual functions,
i) Motor functions, and
j)Evocation.

Obviously, the reading and writing sections are omitted for illiterate subjects. The application
The complete test allows for a maximum score of 130 points. To ensure a
degree of equivalence in the consideration of the scores, these have been grouped according to two
criteria or variables: Age and level of education. Thus, we have that the scores are
considered according to four age ranges:
from 16 to 30 years
b) 31 to 50 years old,
c) 51 to 65 years and
66 to 85 years.

For each age range, 4 levels of education have been considered:

Illiterate or uneducated (0 years of schooling);
• 1 to 4 years of schooling;
• from 5 to 9 years of schooling; and
• 10 or more years of schooling.

The performance achieved by the subject in each of the tests allows for their classification of
according to the categories: Normal, mild, moderate, or severe for this function. A total of 25 is obtained.
scores or performance of the subject, which can be organized as a profile of
4
 ANALÓPEZ MINC-ATTENTION AC-2

functioning. Among the advantageous aspects of the test, we can mention that its constitution
through simple and short items allows for a quick assessment of the functions and its system of
rating provides both quantitative and qualitative data. Additionally, since it does not rely on a model of
brain damage, allows its use in both individuals with neurological conditions and in subjects with
psychiatric pathology, making it ideal for comparative study among various clinical presentations
as well as for differential diagnostic studies and research.

Example of attention test in Neuropsi5:

II. ATTENTION AND CONCENTRATION

A. Digits in regression

Ask to repeat each series in reverse order, that is, from last to first; e.g., 2–5, answer "5–2."
If he manages to repeat the first trial, he moves on to the next series. If he fails, apply the two trials.

Integrated neuropsychological exploration program. BARCELONA TEST Revised. TBR

Significancegeneral neuropsychological evaluation and specific profile of aphasias.

Application:Individual
Time:around 3 hours
Age:adults from the age of 20
Material:CD with the normative and aphasia profiles. To facilitate the work
all profiles of normality and of aphasias are presented in a CD, exploration materials. It
they include the materials for the exploration of denomination, gestural praxis, stereognosis, and the
morfognosia (wood shapes).

Related links:Invalid input. Please provide a text passage for translation.

Content.The Barcelona Test (BT) is the first neuropsychometric instrument developed in

Spain, by Jordi Peña Casanova and collaborators (revised edition 2004), to measure
quantitatively the cognitive state. Its application does not exempt from the need to resort to other tests
when the study of the patient requires it for specific reasons.

The structure of the TB is partly similar to that of the Boston test for the diagnosis of aphasia: the
tests are grouped into functional areas, the results are expressed in percentiles and it is established
a clinical profile in which the affected and preserved capabilities can be evaluated.

The TB also includes a differentiation in 41 subtests of direct scores (correct vs. not)
correct) and scores in which the time spent by the patient is considered. The first
The scoring system (correct vs. incorrect) consists of giving one point for a correct answer.

The second form of scoring follows the Boston test scheme: 3, 2, or 1 points are given in
function of the response speed. This differentiation introduced in the TB allows for evaluating the
slowing down in cognitive performances.

The breadth of basic neuropsychological capabilities led the design of the TB to result in a
long test, with 42 sections and 106 subtests. Since in 41 cases it is also considered a

5
 ANALÓPEZ MINC-ATTENTION AC-2

scoring with time, a total of 147 variables was reached. A number of structured variables in
functional areas are fully compatible with the aim of obtaining a cognitive clinical profile but
has difficulties in a statistical and neuropsychometric approach.

ABBREVIATED BARCELONA TEST.After years of clinical experience, it was considered pragmatic and
operationally configure a shortened profile of the TB that will facilitate, for certain cases, a
more practical clinical approach (reduction of variables and administration time) and that in a
the future would allow for the establishment of global scores and their validation. It was also deemed necessary
expand the sample of normal controls. This concept includes the following

Test for cognitive domains:

1.Brief screening tests

2. Scales of activities of daily living
3. Scales of Psychopathology-Neuropsychiatry
4.Global scales of dementia
5. Quality of Life Scales
6. Integrated Batteries
7. Test of global cognitive function – intelligence
8. Test of lateralization and motor skill
9. Attention and concentration test
10. Test of oral and written language
11.Semantic test
12. Test of gestural praxis
13.Test of constructive practice
14. Test of visual and visuospatial perception
15.Memory test
16.Executive function test

Punctuation rules:specific to each subtest in percentiles. For the abbreviated version:

standardized global score with a mean of 100 and a standard deviation of 15.

The Neuropsychological Battery Sevilla (BNS)

Application:Individual

Related linkshttp://videoteca.us.es/mediateca/objeto.jsp?id=189&tipo=v

Content.Leon-Carrion, J. (1194). The Sevilla Neuropsychological Battery (BNS) is constituted by

a group of neuropsychological tests developed for the evaluation of cognitive functions and
executives associated with certain functional brain networks. The battery has been conceived as a
set of clinical instruments for assessment and neuropsychological diagnosis aimed at
the design of rehabilitation plans. Likewise, it has been very well received as a
research instrument.

The BNS allows for a broad evaluation of cognitive and executive processes in healthy subjects.
neurological subjects, in subjects with mental disorders, in subjects with developmental disorders and
of learning, both in adults and in children and adolescents:

• Evaluation of executive functioning and the associated processes and mechanisms

frontal lobe: attention, reasoning, problem solving, cognitive inhibition and
control mechanisms.
• Evaluation of memory processes and mechanisms: memory volume of
work, monthly pollution volume, monthly profit, primacy effect and
presence, learning strategy, awareness of memory deficit.
• Assessment of attention and perception associated with hemianopsia problems,
quadrantanopia, hemi-inattention or neglect.
• Child evaluation, especially in assessing learning difficulties.
• Staff selection.
• Suitable for use in neuroscience research.

6
 ANALÓPEZ MINC-ATTENTION AC-2

The BNS consists of six subtests:

• Hanoi Tower Seville (executive functions, planning, and problem-solving)

• Assessment of Attention (tonic alertness, phasic alertness, and hemi-neglect)
• Assessment of neurocognitive interferences: Stroop effect and Quasi-Stroop (control
mental and divided attention
• Evaluation of memory and learning (Expanded Luria memory curve)
• Evaluation of emotional and personality disorders (NECHAPI)
• Assessment of functional memory disorders (CUPOM)

Neurobirds has developed this new version of the BNS with a revolutionary system of
application, since it is the first neuropsychological evaluation test that is accessible
entirely on the Web and offers the clinician and the researcher the possibility of being able to manipulate,
according to their work needs, the parameters of the different subtests that make it up
batería: tiempo de duración interestimular, tiempo de exposición, targets, tamaño de la fuente, color
from the source and the background,...

And it also offers the possibility of combining the BNS with neuroimaging tests such as
the electroencephalogram or the near-infrared spectroscopy techniques. The BNS can be
applied anywhere in the world by an expert evaluator. The only thing the professional needs
A qualified computer and an internet connection are required to manage the BNS. Once the
tests have been correctly applied, the program offers a detailed results table with the
list of measures that the evaluator needs to interpret the data from a perspective
qualitative and quantitative. The results sheets are designed in such a way that it can be
print and attach to the corresponding report.

SURVEILLANCE AND CONTINUOUS PERFORMANCE TESTS

The watchkeeping tasks - monitoring tasks - constitute the paradigm

basic experimental study of surveillance in laboratory context (Jerison, 1977)6The tests
in wakefulness, they examine the ability to sustain and focus attention on a task. Successful execution
any test of attention, concentration or tracking requires the ability to sustain the
attention.

In general, surveillance tasks consist of keeping attention towards a source of

stimulation for a prolonged and uninterrupted period of time, in which is presented a
series of stimuli (e.g., flashes of light, letters, figures, etc.), some of them signals and others not-
signals or noise, to which the subject must remain alert and respond to the appearance of the
signals. The results obtained in this type of tasks are measured in terms of

• precision (correct and commission errors) and

• speed (reaction time of hits and reaction time of errors of
commission).

These dependent variables are analyzed in the following performance indices:

a) level of surveillance, which indicates the overall performance achieved in a surveillance task;
b) surveillance decrement function (or vigilance decrement), which shows a
decrease in the percentage of signals correctly detected over time.

Performance degradation appears after the first 10-15 minutes of task execution.
this total between 20 and 35 minutes of its duration.

These tasks during the vigil are easily carried out by those individuals whose ability to
sustained attention is intact and not affected by age. In the case of
alterations, one or two parts of these tests may reflect attention problems (Lezak, 2004)
Ostrosky–Solis, et al., 2003, 2007.
7
 ANALOPES MINC-ATTENTION AC-2

Some of these tasks are:

nDigit Detection.It consists of reading a series of digits and the task to be performed by the subject.
is to detect when I hear the target stimulus, which in this case consists of striking.
on the table every time a 2 followed by a 5 is heard in a block of digits. It
they record successes, errors, and omissions.

nSuccessive Series.It consists of the subject counting from 1 in groups of 3.

until reaching number 40. The time is recorded and the score depends on the mistakes
committed7.

Digit Retention.The digit span retention test in progressive order involves

different mental activities that may be affected by different types of damage
cerebral. This type of test is used in patients who have problems with
attention and they do not learn. Additionally, this test depends on the ability of
short-term retention. The task consists of sequences commonly of 9 numbers with two
trials in each sequence and the subject's task is to repeat the numbers they heard
exactly as the examiner mentioned, for example, it reads “2, 5” and the subject must
repeat the same digits (Lezak, Howieson & Loring, 2004).

Related links:The provided link appears to be a document reference and cannot be translated as it is not in a textual format. Please provide the text you would like to have translated.

SUSTAINED ATTENTION TESTS

These tests examine the ability to maintain and focus attention, and consist of the
sequential presentation of stimuli over a certain period of time in which the patient
indicate in some way (with a tap, with the hand, etc.) when the stimulus is perceived.

The items or stimuli are presented in a list of 60 or more, and can be read or heard.
The simplest form of this task presents a single white stimulus, but two or more can be used.
more. These surveillance tasks are easily carried out by people whose ability to sustain the
attention is intact and is not largely affected by age. Therefore, one or two failures in
These tests may reflect an attention problem (Lezak, Howieson & Loring, 2004).

Additionally, the most common forms of evaluation that provide interesting information are
the computerized systems.

These surveillance tests are known as continuous performance tests and also as
CPT (Continuous Performance Test) by its English acronym, and several versions have been developed.
of them. They usually last between 10 and 20 minutes, which is the minimum time needed to observe if
Is there any alteration in the maintenance of attention throughout a monotonous test?

The white stimulus/non-white stimulus ratio as well as the presentation speed of the
stimuli vary throughout the test, which allows us to see if there is a difference in the responses
according to the different presentation modalities.

The two most widely distributed and internationally accepted versions are the T.O.V.A and the CPT.

8
ANALÓPEZ MINC-ATTENTION AC-2

nTOVA (Test of Variable of Attention)

The TOVA (Test of Variables of Attention) provides one of the most objective measures of deficit.
of attention (Greenberg, 1996)8which, in version 7.0 for PC, is presented in two versions:

• TOVA (visual) and

• TOVA-A (auditory).
9
consists of the continuous appearance,
This test, according to Gratch (2000)
for 22.5 minutes, from two rectangular graphs on the screen of the
computer. One of them, referred to as 'target', has
a square near the top edge, while the 'non-target' or
no-white has a square near the bottom edge.

The subject, when evaluated, will hold a 'microswitch' in their hand that they must press after the
appearance of the target. The microswitch must be used with the same hand that the
the subject uses to write and the pressure must be very small since it is an element of
high precision and sensitivity.

The task presented to the subject is as follows:

Now you are going to see a sequence of figures and you should press the button as quickly as possible.
that you can when you see the rectangle with the small square near the top part; no
you press it when the figure has the little square close to the bottom edge. What is important is
do it as quickly as possible but also as safely as you can. Try not to
to make a mistake

Before starting the test, a practice session is conducted for 3 minutes so that the subject can...
familiarize yourself with the test.

From this moment on, the evaluation begins with which we can obtain the following
indicators:

• Errors of omission:They measure inattention and occur when the subject does not press the button each time.
once the white appears.

• Errors of commission: They measure impulsivity and occur when the subject presses the button when
I shouldn't have done it.

• Correct response time: Measures in milliseconds the time it takes to respond.

correctly to the target. The response time tends to be longer in people with
attention deficit, as they tend to process information more slowly.

• Anticipatory responses: They measure the attempts to 'guess' what kind of stimulus is
will present (white or non-white). An anticipatory response is considered to be the one that occurs
before the 200 milliseconds of stimulus appearance (this is the time required
to differentiate between white and non-white). Therefore, the responses that occur before
from this period are "riddles" and cannot be counted as mistakes or correct answers. If
an excessive number of them appears, it affects the validity of the test and it is recommended to return
to have a good time.

• Post-commission response time: Measures the response time that follows immediately after
a commission error. Most of the subjects evaluated will realize that they have
made a mistake by commission and will act more cautiously next time
response. Now, when individuals exhibit behavioral disorders, they often do not
delay the response that follows a commission error and, in some cases, even respond
more quickly. This might allow for distinguishing subjects with attention deficits from subjects
with behavioral problems.
9
ANALÓPEZ MINC-ATTENTION AC-2

• Multiple responses: They can indicate the presence of neurological disorders. In this regard,
It is important to emphasize that the frequency of occurrence of the targets varies throughout the test.
(22.5 minutes). In the first two quarters, the white appears once every three times and
media that presents the non-white. Therefore, the first two quarters are of
"infrequent" presentation of white. In that situation, boredom is usually a factor.
important in the occurrence of errors of omission, especially in those who suffer from deficits
of attention.

In the second half of the test, the white is presented three and a half times for each presentation of the
no-white. This more intense presentation makes it so that approximately every two seconds the
the subject has to press the button. A rhythm then develops that needs to be controlled.
so that it does not unnecessarily press by committing an excessive number of errors of commission.
In this way, the main indicators of inattention (errors of omission) and impulsivity
(errors of commission) will provide us with data that are not definitive in themselves, but that along with
other assessments (observation questionnaires, N-EEG, GSR, etc.) will lead us to a
much more objective assessment of attention.

Based on the evaluation, we can better adjust the training.10since we know

where is the deficit concentrated and what is its intensity.11

Related links:http://www.tovatest.com/media/av/

nConners CPT-II

The CPT II V.5 of Conners (1995) is an evaluation

task-oriented computerized disorders of
attention and neurological functioning. The results
they indicate the likelihood that a person has a
attention disorder. CPT II is useful outside of ADHD,
pointing out the potential problems related to the
executive functions such as time perception,
internal orders, working memory, and motor control.
This exam can also be used to investigate the
neurological performance of people with attention,
impulsivity or controlling the problems of activity.

Scales and Forms

• Response Times
• Change in reaction time, speed, and consistency
• Statistical Signal Detection Theory
• General Statistics (Confidence Index and General Index)
• The omission of errors
• Commission of errors

In the normalized computerized version of Conners' CPT-II (1995), the subject must
respond by pressing a key each time a letter appears on the black background screen
white, except for the letter X (that is, there are multiple white stimuli) and the stimulus
no-white in the letter X (unique). The test lasts 14 minutes and the presentation time of
each stimulus lasts 250 ms, with a variable interstimulus interval between 1000 and 4000 ms. In
in this version, the ratio of white stimulus/non-white stimulus does not vary. As can be
it can be observed, the paradigm is considerably different from that of the TOVA (for example: Length
from the test, invariability of the proportion of white vs. non-white stimulus, variability
interstimulus)
Once the administration is finished, the program produces a series of scores that
reflect the patient's performance. The parameters taken into account are the amount of
correct answers in response to a target stimulus, omission errors (no response to
10
 ANALÓPEZ MINC-ATTENTION AC-2

a white stimulus), reaction time, standard deviation of reaction time, and an index
of global performance.

In order to conclude that an individual has some attention disorder, there must be performance
atypical in at least 2 of the considered parameters. A single altered parameter cannot
to be considered evidence of deficit. The greater the number of outlier parameters, the greater the evidence.
of attentional problem.

The performance analysis also yields an index that reflects the response style of
subject. Some subjects are cautious and prefer not to respond rather than make mistakes and
others are more reckless or impulsive and respond more frequently. The level of
activation (arousal), is reflected in the existing coherence between response speed and the
speed of stimulus presentation. People tend to adjust their response speed.
according to how quickly the stimulus occurs.

When stimuli are presented quickly, high activation occurs and the responses
They tend to be quick. When the stimuli are slow, there is less activation and the
responses tend to be slower and less consistent.

A performance profile that does not respond to this trend would indicate some failure in
the activation.

Example of CPT-II report:

Related links:
http://www.psychcorp.co.uk/Psychology/ChildMentalHealth/ChildADDADHDBehaviour/ConnersContinuousPerforman
ceTestIIVersion5forWindows(CPTIIV5)/PDFReports/Profile.pdf

TESTS TO EVALUATE ALTERNATE ATTENTION

nTrail Making Test (TMT)

It is one of the most widely used neuropsychological tests. It is a pencil-and-paper test created by
Partington in 1938, and later the Halsted-Reitan Neuropsychological Battery was added to it.
The effectiveness of this test to discriminate individuals with brain damage from the rest of the population has
has been reported in several studies, becoming one of the most widely used tools by the
neuropsychologists. There are two forms: Form A and Form B. Both tests involve the combination of 25
circles that the subject has to connect.

• Part AIt consists of a letter-sized sheet on which are distributed at

Randomize the numbers from 1 to 25. The subject must connect the numbers with a straight line in order.
consecutive ascending (from smallest to largest) as quickly as possible.

A single error in part A (such as the omission of a number in the sequence this
yes, 1, 2, 3, 5 for example) even using low time, it is already an important indicator
of some failure in the service.

It is often considered that part A measures motor and visuo-spatial skills.

of visual search and sustained attention.

11
ANALÓPEZ MINC-ATTENTION AC-2

Example of execution of TMT-A:

• Part Bit resembles form A, but with greater cognitive demand. In this
second part, there are randomly distributed numbers (from 1 to 13) and letters (from A to L) and the subject
You must combine the stimuli alternating between numbers and letters, respecting the numerical order.
ascending and alphabetical. The sequence that must be followed is 1-A-2-B-3-C, etc., which
requires flexibility for continuous alternation.

Form B is more complex than Form A because it requires the connection of numbers and
alternating letters. In terms of the validity of the TMT, there are a number of factors that
they make this form more complicated:

1.The distances between the numbers are greater in Form B, which

spend more time on orderly connecting the circles.

2.The arrangement of the circles in shape B can cause a

visual interference.

3.The difference in times to complete Form B can be attributed to the

more complex cognitive processes necessary to take into account the
alternation of letters and numbers.

In part B, although an error may be found among normal performances, the presence of
more than one of them can also be revealing. In this case, there can be two types of
mistakes, the most common one, is the type of error called "perseverative", in
where the subject fails to alternate between a number and a letter and remains in the same one
sequence, this is for example, number, letter, number, number, (1-A-2-3); the second type
It is the error not 'perseverative', when although it maintains the alternation of the series, it is mistaken.
the order (e.g., 1-A-2-B-4-C). The persistence in the commission of errors, even after the
correction by the examiner has a significant value.

This form can be a good indicator of general frontal lobe dysfunctions.

12
 ANALÓPEZ MINC-ATTENTION AC-2

general, it can indicate the subject's inability to execute and modify a plan of action.
Similarly, it can be useful as an indicator of focal frontal lesions; however, it is
It is important to note that the test, in itself, is not ordinarily an indicator of the
frontal dysfunction.
Subjects with lesions in the left hemisphere show worse outcomes in this.
test.

Part B is associated with the following processes: distinguishing between numbers and letters, the
integration of two independent series, the ability to learn a principle of
organization and applying it systematically, the retention and serial integration, solve the
verbal problem, and planning.

Example of TMT-B execution:

Both parties have a practice sheet. Timing starts immediately after

complete the instruction. If the subject makes any mistake, they are interrupted by pointing out the error, and they are
it should continue from the last correctly completed element. It should not stop
stopwatch during the correction.

Once the test is finished, the time taken is recorded in seconds. The number of errors is
Note that only the time used is considered for the score (which will obviously be greater if the
subject has made mistakes, due to the time required for correction). It is usually taken into account
also the errors made, considering both the quantity and the type of them.

Each of the parts must be scored separately by measuring the time required.
to complete each test. The execution is evaluated using normative data, taking into account
the correlation between TMT and factors such as age, education, and IQ. Generally, time
Necessary to complete both forms ranges between 5 and 10 minutes.

The TMT has demonstrated great sensitivity to cognitive decline in dementias and the
attentional commitments in head trauma, multiple sclerosis and epilepsy, among
other neurological diseases.

13
ANALÓPEZ MINC-ATTENTION AC-2

TESTS TO ASSESS ATTENTIONAL CAPACITY

Some attention capacity tests consist of a task that has eight levels.
progressive, increasing in complexity, with two or three trials at each level and trials of
practice preceding each group of tests.

The first level simply requires the repetition of the subject of the heard digits and so on.
successively until completing all levels (Lezak, Howieson &
Loring, 2004).

nThe task of Corsi Cubes.consists of 9 cubes placed

on a board. On each occasion, the examiner touches or
point to the cubes in a sequence and the patient must pay attention
to copy the same pattern as the examiner. Each
the sequence consists of two trials and if the subject does not fail in the
two essays, it moves on to the next sequence and so on
successively.

Related links:The provided text is a URL and does not contain translatable content.

TESTS TO MEASURE SELECTIVE ATTENTION

Cancellation tests represent a classic assessment of selective attention. They are tests
of pencil and paper that requires visual selectivity and speed. The visual exploration, activation and
inhibition of quick responses is also necessary for the successful execution of this type of
tasks. Low scores on these tasks may reflect the overall decreased response.

The basic format of these tests follows the patterns of vigil tests. These consist of
lines of letters, figures or randomly interspersed numbers with a letter, figure or number
designated objective. The subject is instructed to mark all the target figures, letters, or numbers. The
execution is qualified by the errors and the time it takes to complete the task; if it is within a time
limit, the rating is based on errors and the number of objectives marked within the time.

The possibilities for variations in the basic format are unlimited. Many similar tasks
They can be presented on a page. The task can become more difficult by increasing the space.
among the types of objectives or by the number of non-objectives (Lezak, Howieson & Loring, 2004).

nDigit Symbol Test.This test, which is part of the WAIS-II battery, consists of
a sheet that has printed at the top a model that contains a series of 9
small squares numbered from 1 to 9, each of which has a symbol underneath
different for each number. It contains a row that has a series of small squares,
each with a randomly assigned number from 1 to 9, below which the subject must complete
the symbol that corresponds to it according to the model. After executing a series of
in practice, the subject must complete as many symbols as possible in a time of
120 seconds. The score is the number of correctly completed frames.
It is traditionally considered a test of learning, processing speed of
the information and sustained attention, but as happens with many other tests, a
Poor performance can be due to several factors. The great importance that speed
motor plays in the score, and particularly the written component, gives them a scarce
validity for many manual workers, who obtain low qualifications, and for anyone
whose motor responses tend to be slow. It is particularly difficult for the subjects
aged, whose vision or visomotor coordination is altered or who have difficulty in
understand the instructions. Several studies have suggested that much of the decrease
of age-related performance, it would be a product of motor skill and not so much
a reflection of attentional difficulty.

14
ANALÓPEZ MINC-ATTENTION AC-2

nSymbol and Digit Test (SDMT).It is used to evaluate exploration and tracking.
visual, sustained and selective visual attention and speed of information processing.
This test is very similar to the Digit-Symbol subtest of the WAIS, as it requires
substitution under time constraints, but alters the format of the latter, since when
The subject is presented with symbols and he must complete the corresponding number. This
the format makes it suitable for oral administration as well, thereby eliminating
the graph-motor component that can cloud the results. The oral format can be
particularly useful with patients whose attention disorder tends to affect activities
in progress, since these patients tend to skip or repeat items or lines (given
that there is no pencil mark indicating where to go) unless they help with
the finger. These failures to maintain control over what is done provide evidence of the
types of problems that these patients encounter when trying to carry out their activities
daily. Another virtue of the SDMT is that there are three pairs of mirror figures, which highlights
problems with inattention to details or failures to notice changes in orientation. In
patients with multiple sclerosis (a population in which alterations are often observed in
the attention and the speed of information processing) the difficulties in this test
they are a consistent finding, even in the oral version that avoids the motor demand.

nPASAT.The Paced Auditory Serial Addition Test (PASAT) consists of auditory presentation.
in a recording of a series of 60 digits from 1 to 9 arranged randomly and the subject must go
adding the numbers in pairs, so that each number is added to the
immediately prior, without accumulating the sums. That is, the second number is
added to the first, the third to the second, and so on. It is considered a test
that evaluates the capacity and speed of information processing and sustained attention
and divided. When the interstimulus time is low (for example, four seconds) the task
It tends to be easy for cognitively normal subjects. When the speed is increased
at one digit every two seconds, the subjects start making errors because their limits are exceeded
processing capacity. There are various versions of this test, varying series of
digits and the speed of presentation, that is, the interstimulus time that can range from 3 to 12
seconds.

Computerized adaptation in English in:

• Just like the original version presented on cassette

from audio, this computerized adaptation offers a
series of 61 pseudo-random numbers from 1 to 9. The
participant receives instructions to add the
even numbers, so that each number is added
immediately preceding it. In other
words, the second number is added to the first,
the third to the second, the fourth to the third, and so on
successively. The same 61 numbers are presented
in four essays that differ only in the
rhythm. The PASAT lasts about 15-20 minutes of
manage if the four tests are given.

related_linksThe provided text is a URL and cannot be translated.

15
 ANALÓPEZ MINC-ATTENTION AC-2

TESTS FOR MEASURING ATTENTIONAL CONTROL

Ostrosky-Solís et al. (2003, 2007) mention that tests of the frontal lobe include the
skills that allow:

a. Start and maintain a series of directed partnerships

b. Maintain a series against interference
c. Change from one conceptual structure to another
d. Maintain a series of alternating motor activities

The following are some examples of tests that examine these skills:

nStroop Test

Application:Individual
Time:5 approx.
Age:7-80 years
Material:Manual and application booklet.

Related links: Stroop Effect - Interactive test

http://ezyang.com/stroop/

Content.The Stroop effect is named after its discoverer John Ridley Stroop (1935), and consists of
basically in the existence of a reflected interference in the reaction time for execution
of a specific task. Specifically known as semantic interference, it would obey the
automaticity of the reading process, for example when the meaning of the word interferes in the
naming task.

As early as 1886, J. M. Cattell had verified a time difference between the task of reading words and the
recognition of basic colors, but it is not until the publication of Stroop's work on
“Interference studies in the reaction to verbal series” in which this phenomenon is systematized.
considerably, later Edith Kaplan would continue Stroop's work, separating the
tasks in four phases: identification of color fields, words with congruent color, words
with incongruent color, and combined.

In general terms, the test is based on the notion that the difficulty in reading words could
originate from noxas in the right hemisphere, while problems in identification of
colors would relate to the right hemisphere.

It consists of asking the subject to respond by naming a series of colors written in

different shades of colors arranged on stimulus cards presented in the following
order:
• Sheet 1) A series of words that denote colors, written in black ink and
repeated at random in the columns;

• Sheet 2) It is a series of the same stimulus reproduced 100 times printed in colors
blue, green and red;

• sheet 3) corresponds to words that denote colors, printed in a different color

to which they refer.

The task consists of going down the columns reading the words or mentioning the ink colors.
as quickly as possible, within a specified timeframe. The assessment is carried out by obtaining
three main scores and then it is possible to perform a factor analysis to determine what
punctuation can provide more significant or meaningful information; the formulas and procedures

16
 ANALOPES MINC-ATTENTION AC-2

The scoring calculations are found in the appendices that come with the manual.

Mistakes are not counted but they affect performance since the subject must repeat the element.
when it makes a mistake, and among the scores obtained, the interference score results from
utility to determine cognitive flexibility, creativity, and reaction to cognitive stress.
The reliability of the test has shown a high degree of consistency for the different modalities.
Applied and in all opportunities, researchers have relied on the test-retest method.

The simplicity of the stimuli and the speed of their administration contributes to this instrument
may be useful in the assessment of diverse cases such as brain damage or dysfunction,
drug addiction, senile dementia, stress, ADHD or psychopathology, since they minimize the cultural variable.

Related links:
Invalid input. Please provide text to be translated.
http://www.youtube.com/user/cim0rales

EVALUATION OF SPATIAL HEMINEGLECT

Cancellation Tests arise as a measure of Attention in Negligence. Negligence is

refers to a characteristic of selective attention that is characterized by errors in orientation,
in the performance or in response to a stimulus that is presented in a contralateral manner in the injuries
from one cerebral hemisphere, without this error being due to sensory or motor dysfunction.

Mesulam, 198512, generated a series of tests, which along with the line bisection test, the
analysis of the copy of drawings or the execution of drawings by indication, allow to quantify and/or
detect this alteration. Cancellation tasks have been applied in a variety of base studies
neuropsychological as a measure of: difficulties in visual attention; response control and
motor perseverations.

A Cancellation test represents a sheet of paper with letters, numbers, geometric shapes or
drawings placed in a more or less masked way among other similar elements but not
keys. The subject must mark (cross out or enclose in a circle) the elements that are indicated.

In the Cancellation Tests, effectiveness (degree of has been evaluated so far

correction of the homework or number of errors/correct answers), the starting site, the route address and the
location of the omitted stimuli. Also the latency time to give the response, the total time
employee in performing the task, the types of errors (omissions and/or failures in identification due to confusion
or bad perceptual discrimination), the type of strategy that is employed.

In the Cancellation Tests, lateral dominance usually determines the starting point of the task. It is
check that as the years of schooling progress, due to the influence of reading, the
The starting point is unified. It is scored based on the number of errors, which are the sum of the omissions.
and false identifications. A high score may be due to a distorted sharpness.
visual, difficulties in visual perception, anxiety, vulnerability to distractibility, fatigue, lack
of motivation or poor consolidation in work habits.

These tests have been used to evaluate focused attention, the ability to maintain
attention to a certain environmental stimulus. In reality, it shares many of the profiles of a
sustained attention test, especially in the symbol tests, along with other tests, by
for example, the Digit Span subtest of WISC-R, the Stroop Test, or the classic measures of
attention: Identical Forms, Faces, Letter Squares, or the Toulouse-Pieron (in TEA).

The factors that affect its execution are: the speed of visual search and discrimination.
speed of mental processing, short-term visual memory, spatial visualization and the
visuomotor coordination.
An example of a Cancellation Test could be the following:

A simple way to exhibit this condition is to ask the subject to point to or take objects.
placed on a surface, like a table. Commonly, the response of the subjects is to ignore the
objects that are placed on the left side.
17
 ANALÓPEZ MINC-ATTENTION AC-2

The cancellation tests consist of a sheet of paper with letters or key signs placed on it.
random among others that are not keys. The subject's task is to mark those signs that are
keys.

nLine bisection test.

In this test, the patient is presented with a sheet containing horizontal lines.
it must be marked exactly in the middle of each one. The common execution of the patient is that the mark is made by
move to the right of the line.

nTest of 'cancellation' or strikethroughYou are asked to cross out the lines drawn on a paper.
placed before him.

The test can be made more sensitive if there are stimuli on the page that must be crossed out, and distractors.
other drawings that should not be crossed out

nCopy of a drawing

18
ANALOPES MINC-ATTENTION AC-2

nCVST (Computerized Visual Search Task)

This test was described by Goldstein et al. in 1973

as an effective tool for discriminating brain damage
of normal and psychiatric populations. DeMita and Johnson
they have developed a computerized version of it
task for the LSI team 11/03. The task consists of
find in a pattern of 24 squares, the one that matches with
one that is located in the center of the screen. The
patterned squares are shown like on a board of
chess and are numbered from 1 to 24. The target pattern
is marked by an arrow on the right side and is
select when typing the correct number from the keyboard.

There is a second version with 10 plaid patterns. This version is intended for younger children.
children and elderly people who have difficulties with the extended version.

Related links:http://www.fepsy.com/tests/cvst/

nD2, ATTENTION TEST

Application: Individual and collective.

Time: Variable, between 8 and 10 minutes.
Age: Children (from 8 years old), teenagers and adults

This test provides a concise measure of processing speed, selective attention and
mental concentration, through a task consisting of performing a selective search of
relevant stimuli. The d2 has been particularly useful in basic research, as well as in the
clinical, neuropsychological, educational, human resources, and sports psychology fields
becoming one of the most relevant and important tests of the evaluation of the
attention in Europe.

Related links:http://www.teaediciones.com/teaasp/search.asp?idGama=40

nWAIS-III WECHSLER ADULT INTELLIGENCE SCALE III

Application: Individual.
Time: Variable, around two hours.
Age: From 16 to 94 years old.

New version, completely revised and updated, of the most important evaluation test of
intelligence, with new elements and broad benchmarks. WAIS-III includes the 11 tests of the WAIS and
three new: Matrices, Symbol Search and Letters and numbers.

It allows obtaining the classic IQs (verbal, manipulative, and total) and four specific indices:
Verbal comprehension, Perceptual organization, Working memory, and Processing speed. The WAIS-
It was classified in Spain between 1997 and 1998, being the first adaptation published after
the United States. The sample consisted of 1,369 subjects aged between 16 and 94 years.
coming from all Spanish regions. WAIS-III has been designed to facilitate use
transcultural, reducing the "ground" of tests so that they are applicable to people with
deficient cognitive functioning, maintaining continuity with the WAIS but introducing
important improvements in the elements and in the new tests, especially focusing on the development
of the materials.
19
 ANALÓPEZ MINC-ATTENTION AC-2

Example of the output of the profile created by the correction disk in:

Related links:URL provided does not contain translatable text.

nGL, Global-Local Attention

Application: Individual and Collective

Time: Approximately 10 minutes
Age From 1st year of Secondary Education to 2nd year of Baccalaureate

The objective of this test is to evaluate perceptual speed and accuracy in a task that demands
distribution of attention at two levels of a visual stimulus: global and local. The AGL can result in
of great utility for detecting issues related to attention and perception, such as in the
Attention Deficit Hyperactivity Disorder, or those attentional difficulties and
perceptual associations related to other disorders, such as schizophrenia, anxiety, depression, etc.

It can be especially useful for detecting difficulties in paying sufficient attention to

the details of a stimulus, to maintain attention on a prolonged task over time,
process two or more sources of information and distribute attention between them or ease of
distraction caused by irrelevant stimuli. For all this, it is an excellent choice for
evaluate attentional and perceptual processes in clinical and educational settings.

Related links:http://www.teaediciones.com/teaasp/buscador.asp?idGama=277

nAULA System. Assessment of ADHD through Virtual Reality technology

The AULA system developed by Virtualware for Nesplora is a continuous performance test (CPT).
that takes place in a virtual reality environment, displayed through special glasses equipped
of motion sensors and headphones. The setting is similar to a school class or
institute, and the perspective is situated at one of the desks, looking towards the blackboard, where appear
the task stimuli.

AULA is the only assessment tool that evaluates visual, auditory, mixed attention, the tendency to
distraction, sterile movements, and processing speed in a test that lasts
only 18 minutes.

In AULA, attention deficit problems in children can be evaluated by replicating an environment and
conditions as close as possible to reality: the ecological validity of AULA is very high.
It also measures data related to hits, omissions, response speed (impulsivity), and deviation.
with attention at a temporal precision of milliseconds, it is a simple tool to use and
very quick in the assessment. Its appearance similar to a next-generation video game enhances the
cooperation of the child reduces the typical dropout rate in other tests.

Related links: Evaluation of ADHD through technology

virtual-reality.aspx

To finish, two fun tests:

nConcentration test (Spanish subtitled) HQ

Invalid input. Please provide text for translation.

nPsychological experiment and attention

No translatable text provided.

20
 ANALÓPEZ MINC-ATTENTION AC-2

BIBLIOGRAPHY

Ardila, A.; Ortrosky-Solis, F.; Rosselli, M. (1999) Neuropsi: A brief neuropsychological test battery in Spanish with
norms by age and educational level. (e-Texts). IAEU: Barcelona. URL:
<The provided text is a URL and does not contain translatable content.[query: May 25, 2010]

García, M.J. (2001). Attentional mechanisms and neuropsychological syndromes. Neurology Review. (Vol. 32). pp463-
467.URL:<Unable to access external content, including URLs.[query: May 25, 2010]

Gómez, C.; Chóliz, M.; Carbonell, E. (2000). Experimental analysis of monitoring capacity: Effect of the
partial sleep deprivation and task difficulty. Annals of Psychology. (V:16-1). (pp49-59).
Invalid input. Please provide text for translation.>[query: May 25, 2010].

Gratch, L. (2000). Attention Deficit Disorder (ADD-ADHD). Buenos Aires: Panamericana.

Greenberg, M.(1996) Test of Variables of Attention (TOVA-TOVA-A). Los Alamitos, CA: U.A.D.

León-Carrión, J. (1994). "Sevilla Battery for computerized neuropsychological assessment (Multilingual)", IV

Congress of Psychological Evaluation, Santiago de Compostela, pp.514-515.

Lezak, M. (2004). Neuropsychological Assessment. (pp 349-374.) Oxford University Press.

Lubar, J.F. (1995). Neurofeedback for the Management of Attention-Deficit / Hyperactivity Disorders, pp. 493-522;
Schwartz, M.S. (Ed.). Biofeedback. A Practitioner's Guide, 2nd ed. New York: The Guilford Press.

Mesulam, M. (1985). Neglect syndrome and the spatial attention network - e-Texts, IAEU: Barcelona. URL:
<Unable to access external content or URLs for translation.>[consultation: May 25, 2010].

Ostrosky-Solis, F. (2010). Neuropsychology of Attention. International Master's Module in Neuropsychology.

Barcelona: IAEU.

Peña-Casanova, J. (1991). Integrated Neuropsychological Exploration Program "Barcelona Test". Normality,

semiology and neuropsychological pathology. Masson: Barcelona.

1
There are no test attention...one can only assess a certain aspect of human behavior with special interest for it.
attentional component.Lezak, M.(2004): 'Neuropsychological Assessment'. (p 349). Oxford University Press.
2
In various neuropsychological assessments, the evaluation of attention is conducted in a casual manner. On the other hand,
It ignores the fact that no memory assessment can be made without a systematic evaluation of function.
attention. In some cases, a problem that initially manifests as a learning or memory deficit may be
secondary and may be the result of a person not having the ability to effectively respond to a stimulus
relevant and ignore that irrelevant information (Mapou & Spector, 1995). Attention is often evaluated
informally, it is even assessed as a whole without analyzing that there are different types of attention (Mirsky, 1995).
Ostrosky-Solis, F. (2010). Neuropsychology of Attention. International Master Module in Neuropsychology. Barcelona: IAEU.
3
Lezak, M.(2004): "Neuropsychological Assessment". (p 349). Oxford University Press. P.4
4
Ostrosky-Solis, F. (2010). Neuropsychology of Attention. International Master Module in Neuropsychology. Barcelona: IAEU.
5
Ardila A, Ortrosky-Solis F, Rosselli M. (1999) Neuropsi: A brief neuropsychological test battery in Spanish with norms by age
and educational level. e-Texts, IAEU: Barcelona.
6
At the beginning of the 20th century, neurologist Head introduced the term vigilance to describe the functioning of the system.
central nervous system, which he defined as 'a state of high efficiency of the central nervous system' (Head, 1923; p.361).
This concept of surveillance is related to the concept of activation, which refers to the efficiency of the system.
nervous to process the information from the environment that, in turn, allows the organism to remain in a state of alertness or vigilance.
As a consequence, both concepts were considered synonymous. Subsequently, based on a research
systematic study conducted by Mackworth (1948) with tasks that simulated the functioning of a radar (e.g., Clock Test) in
In a laboratory context, it defined the concept of surveillance emphasizing the attentional process; specifically, attention.
sustaining or maintaining attention, although not overlooking the activation process -originating in the concept of vigilance of
Head-. For this author, vigilance was considered a state of readiness of the nervous system, which is characterized
by the ability of the observer to maintain attention on a source of stimulation for an extended period and
uninterrupted time. Consequently, the terms of surveillance and sustained attention were considered as
synonyms. Therefore, an optimal level of alertness or activation is one of the necessary factors for the execution of any
cognitive activity, such as maintaining attention or sustained attention during the execution of a task
surveillance. Gómez, C.; Chóliz, M.; Carbonell, E. (2000). Experimental analysis of the capacity for surveillance: Effect of the
partial sleep deprivation and task difficulty.
7
Taken from Neuropsi Attention and Memory (Ostrosky-Solís, et al, 2003, 2007).
8
Greenberg, M.L. (1996) Test of Variables of Attention (TOVA-TOVA-A). Los Alamitos, CA: U.A.D.] which, in version 7.0 for
PC is available in two versions: TOVA (visual) and TOVA-A (auditory). Los Alamitos, CA: U.A.D.
9
Gratch, L.O. (2000). Attention Deficit Disorder (ADD-ADHD). Buenos Aires: Panamericana.
10
Lubar, J.F. (1995). Neurofeedback for the Management of Attention-Deficit / Hyperactivity Disorders. p.498.

21
 ANALÓPEZ MINC-ATTENTION AC-2

11
Once the TOVA has been applied, if the errors of omission and commission are evident, it is necessary to contrast these profiles through
from the measurement of cortical activation (Adapted EEG Systems) and peripheral (GSR Systems).
12
Mesulam, M (1985). Neglect syndrome and the spatial attention network - e-Texts, IAEU: Barcelona.

22