Louis F. E-Elia, PhD, Paul Satz, PhD, Craig Lyons Uchiyama, PhD, Travis white, PhD
The CTT was developed to meet the need for a test with the sensitivity and specificity of the original Trail Making Test (TMT), but one that was as free as possible from the influences of language and cultural bias. The CTT retains the psychometric properties of the TMT, but it substitutes the use of colour for the use of English alphabet letters, making it more suitable in cross-cultural and other special needs contexts. Instructions may be presented either verbally or with visual cues. Respondents must be able to recognize Arabic numerals from 1-25 and to distinguish between the colours pink and yellow. Research has shown the CTT to be comparable to the TMT.
Validity of the CTT has been documented in a variety of clinical and neuropsychological populations. The CTT uses numbered, colored circles and universal sign language symbols. The circles are printed with vivid pink or yellow backgrounds that are perceptible to colourblind individuals. For the Color Trails 1 trial, the respondent uses a pencil to rapidly connect circles numbered 1-25 in sequence. For the Color Trails 2 trial, the respondent rapidly connects numbered circles in sequence, but alternates between pink and yellow colors. The examiner uses a stopwatch to record the length of time to complete each trial along with qualitative features of performance indicative of brain dysfunction, such as near-misses, prompts, number sequence errors, and colour sequence errors on the CTT Record Form.
Administration and Scoring
Administration and Scoring may be accomplished by individuals without formal training in psychology. The CTT Professional Manual presents age- and education-corrected normative data derived from a sample of 1,528 participants. Interpretation of CTT scores in patient care settings requires professional training in clinical psychology, school psychology, neuropsychology or related fields. Form A is the standard test form on which normative data was collected. Therefore, Form A is the only form that should be used for clinical evaluation. Forms B, C and D of the CTT are considered experimental versions at this time, and should be used only in research settings.
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