Construct and Criterion Validity of the Comprehensive Trail Making Test in Children and Adolescents with Traumatic Brain Injury

Abstract

The current study examined the construct and criterion validity of the Comprehensive Trail Making Test (CTMT) when used to evaluate children and adolescents with traumatic brain injury (TBI). Participants included 100 children and adolescents, 50 who had sustained TBI and 50 normal comparisons (NC). Analyses indicated that the CTMT factor scores were significantly correlated with tests of perceptual organizational ability, processing speed, and motor function and provided support for its construct validity. Additionally, correlations between the various CTMT scores suggested that a different pattern of associations was present in the TBI group compared to the NC group. Finally, the TBI group performed significantly worse (p < .001) on all of the CTMT scores, including each of the five CTMT trails as well as the factor and composite index scores. Results support the construct and criterion validity of the CTMT when used to assess children and adolescents with TBI.

Neuropsychological and Behavioral Measures of Attention Assess Different Constructs in Children With Traumatic Brain Injury

“…The Focus component was assessed using trials 4 and 5 of the Comprehensive Trail Making Test (CTMT; Reynolds, 2002), which is a modified version of the original Trail Making Test and was designed to provide an enhanced assessment of frontal lobe functioning. Trials 4 and 5 were used in the analyses because they are the most demanding of the CTMT trials, they are reported to assess a similar construct in the standardization sample, and they are sensitive to TBI and other neurological disorders (Allen, Haderlie, Kazakov, & Mayfield, 2009;Allen et al, 2011;Armstrong, Allen, Donohue, & Mayfield, 2008;Reynolds, 2002). Raw scores (time to complete each trial) were converted to age-corrected T scores based on performance of the standardization sample.…”

Executive Function Profiles in Pediatric Traumatic Brain Injury

“…Most recently, Allen and colleagues 2009 with Academic Skills on the WJ-III, Grooved Pegboard Test, findings which elucidate the discriminant validity of the CTMT (Allen, Haderlie, Kazakov, & Mayfield, 2009).…”

“…The CTMT was designed to provide an expanded assessment of the executive functions assessed by its predecessor, and is purported to assess decision-making, planning, inhibition, sequencing, development of actions, and motor outputs. Like the v TMT, initial validity evidence supports the sensitivity of the CTMT to brain injury (Allen, Haderlie, Kazakov, & Mayfield, 2009;Armstrong, Allen, Donohue, & Mayfield, 2007;Orem, Petrac, & Bedwell, 2008). In addition, the CTMT provides norms based on a large standardization sample (N = 1769) ranging in age from 8 to 89-years of age, that is stratified by age, gender, ethnicity, and geographic region.…”

Factor structure of the Comprehensive Trail Making Test in children and adolescents with brain dysfunction.

“…In a subsequent study of 121 children with TBI and 121 age- and sex-matched normal controls, the CTMT was reported to have a sensitivity of .74 and a specificity of .82, with an overall correct classification rate of 79% (Allen, Thaler, Ringdahl, Barney, & Mayfield, in press), which were comparable to rates found for other trail making test versions. A comparison of 50 children with TBI and 50 normal controls lent support for the construct validity of the CTMT factor scores by demonstrating significant correlations of factor scores with perceptual organizational ability, processing speed, and motor function (Allen, Haderlie, Kazakov, & Mayfield, 2009). However, in these studies correlations among the CTMT individual trail, factor, and composite scores were higher in the TBI group compared with the controls, suggesting that the factor structure of the CTMT may also differ between the groups (Allen et al, 2009; Armstrong et al, 2008).…”

“…A comparison of 50 children with TBI and 50 normal controls lent support for the construct validity of the CTMT factor scores by demonstrating significant correlations of factor scores with perceptual organizational ability, processing speed, and motor function (Allen, Haderlie, Kazakov, & Mayfield, 2009). However, in these studies correlations among the CTMT individual trail, factor, and composite scores were higher in the TBI group compared with the controls, suggesting that the factor structure of the CTMT may also differ between the groups (Allen et al, 2009; Armstrong et al, 2008). Consistent with this suggestion, a recent study found different factor structures for 80 children with TBI and 80 age- and sex-matched normal controls.…”