Albert's Test

Purpose of the measure
Albert’s Test is a screening tool used to detect the presence of unilateral spatial neglect (USN) in patients with stroke. In this test, patients must cross out lines that are placed in random orientations on a piece of paper. USN is indicated when lines are left uncrossed on the same side of the page as the patients motor deficit or brain lesion is located.
Available versions
The original Albert’s Test was published by Albert in 1973.
Features of the measure
Items: The modified Albert’s Test is the preferred version of the test and varies only slightly from the original description in which 41 lines were placed on slightly smaller sheet of paper. In the modified version, a series of 40 black lines, each about 2 cm long, are randomly oriented on a sheet of white 11 x 8.6-inch size paper in 6 rows. The test sheet is presented to the patient at their midline. Some of the lines are pointed out to him/her, including those to the extreme right and extreme left. The examiner asks the patient to cross out all of the lines, and demonstrates what is required by crossing out the 5 central lines him/herself. The patient is encouraged to cross out all the lines until he/she is satisfied that they have all been crossed.

Scoring: The presence or absence of USN is based on the number of lines left uncrossed on each side of the test sheet. If any lines are left uncrossed, and more than 70% of uncrossed lines are on the same side as motor deficit, USN is indicated. This may be quantified in terms of the percentage of lines left uncrossed (Fullerton, McSherry, & Stout, 1986).

Time: Less than 5 minutes.

Training: None typically reported.

Subscales: None.

Equipment:

  • 11x 8.5-inch page of paper with 41 lines 2 cm in length each.
  • Pencil

A computer program has been developed to interpret results of patient responses but is not necessary for the scoring of the test or diagnosis of USN (McSherry & Fullerton, 1985).

Alternative forms of the Albert's Test
Modified version of Albert’s Test. This version varies only slightly from the original version and consists of 40 black lines (25 mm long, 0.5 or 1.2 mm thick) of various orientations dispersed randomly on a 297 x 210 mm sheet of white paper. Each side of the stimulus sheet contains 18 lines divided into 3 columns of 6 lines. The columns are numbered as 1 to 6 from left to right.
Client suitability

Can be used with: Patients with stroke.

  • Patients must be able to hold a pencil to complete the test (the presence of apraxia may impair this ability).

Should not be used with:

  • Albert’s Test should be used with caution in the clinical diagnosis of spatial neglect. Performance on Albert’s Test may be influenced by or may be indicative of other syndromes besides spatial neglect, such as hemianopia (damage of optic pathways that result in loss of vision in half of the visual field) (Ferber & Karnath, 2001). The use of a clinical expert system for assessment of perceptual disorders may be useful for interpreting results and forming a diagnosis (e.g. McSherry & Fullerton, 1985).
In what languages is the measure available?
Not applicable.