Trail Making Test (TMT)

Evaluation Summary

What does the tool measure? Executive function in patients with stroke.
What types of clients can the tool be used for? The TMT can be used with, but is not limited to, patients with stroke.
Is this a screening or assessment tool? Assessment tool
Time to administer The TMT takes approximately 5 to 10 minutes to administer.
  • Color Trails
  • Comprehensive Trail Making Test
  • Delis-Kaplan Executive Function Scale (D-KEFS)
  • Oral TMT
  • Repeat testing – alternate forms have been developed for repeat testing purposes
  • Symbol Trail Making Test
Other Languages Arabic, Chinese and Hebrew
Measurement Properties
Reliability Test-retest reliability
– Two studies examined the test-retest reliability.

Validity Predictive validity
– Several studies have examined the predictive validity of the TMT and have found Part B to be predictive of fitness to drive following stroke.

Content validity
– One study examined the content validity of the TMT and found it to be a complex test that involves aspects of abstraction, visual scanning and attention.

Convergent validity
– One study examined the convergent validity of the TMT and found poor to adequate correlations with the Category Test, Wisconsin Card Sort Test, Paced Auditory Serial Addition Task and the Visual Search and Attention Test.

Known groups validity
– Three studies have examined the known groups validity of the TMT and found that the TMT was able to differentiate between patients with and without brain damage however, it was not sensitive to differentiating between front and non-frontal brain damage.

Floor/Ceiling Effects One study found Part A of the TMT to have significant ceiling effects.
Does the tool detect change in patients? The responsiveness of the TMT has not formally been studied, however the TMT has been used to detect changes in a clinical trial with patients with stroke.
Acceptability The TMT is simple and easy to administer.
Feasibility The TMT is relatively inexpensive and highly portable. The TMT is public domain and can be reproduced without permission. It can be administered by individuals with minimal training in cognitive assessment.
How to obtain the tool? The Trail Making Test (TMT) can be purchased from: