The Development of a Trial Making Test in Young Children: The TRAILS-P

Abstract

Preschool children have a more limited verbal repertoire, less proficient manual skills, and more variable attention spans relative to those of school age, with comparatively few neuropsychological tasks available for use in this age range. A prototypic neuropsychological test, the Trail Making Test, was adapted for use with young children, the TRAILS-P, using a developmentally salient storybook format with colorful stimuli in differing conditions with varying executive demands. The TRAILS-P was administered to 103 normally developing preschoolers between 2 and 6 years of age; 30 of these children were retested within one month to determine test reliability. Correlations among latencies to complete each condition and condition errors generally were moderate to high, suggesting coherence in test content. There also was evidence for good test–retest reliability. Latency to complete the TRAILS-P conditions differed as a function of the interaction of condition type and age group. Although the youngest children generally took more time to complete all TRAILS-P conditions, 3-year-old children were disproportionately slow to complete the condition that required shifting between stamping stimuli of two classes, with distraction by the additional presence of irrelevant stimuli. In contrast, the number of errors differed only in the 5-year-olds relative to younger children. These findings suggest that executive abilities can be assessed adequately in young children when tasks are designed to take advantage of the developmentally unique features of the preschool period.

Acknowledgments

This research was supported in part by grant R01 MH065668 from the National Institute of Mental Health, the Pediatric Neuropsychology/Developmental Cognitive Neuroscience Award from the Rita Rudel Foundation, and the Special Research Program Award from the Southern Illinois University Office of Research Development and Administration to the first author. The authors thank the participating families and undergraduate staff who assisted in various laboratory tasks associated with this study.

Notes

Note. Diagonal elements represent test–retest reliabilities using Spearman correlations in the top section of the table.

*p < .05, **p < .01, ***p < .001, ****p < .0001.

Note. (s) = seconds.