Evaluating the Modified-Shortened Token Test as a Working Memory and Language Assessment Tool

Abstract

Purpose: Working memory and linguistic knowledge are highly intertwined in language tasks. Verbal working memory in particular has been studied as a potential constraint on language performance. This, in turn, highlights the need for a clinical assessment tool that will assist clinicians in understanding individual children's performance in relation to working memory and language. In this study, we investigated whether performance on the Token Test could capture differences in verbal working memory and linguistic knowledge given its manipulation of length and syntactic complexity. Method: In Experiment 1, 257 children ages 4–7 years completed our Modified-Shortened Token Test, in which they carried out commands of increasing length and complexity. Experiment 2 was an exploratory study that included a separate group of 24 kindergarten-age children who completed our Modified-Shortened Token Test as well as other memory and language measures. Results: The factor analysis in Experiment 1 revealed a three-factor solution with factors corresponding to verbal working memory, linguistic, and basic attention constructs. In Experiment 2, we conducted exploratory correlations between composite scores formed based on identified factors (from Experiment 1) and related measures. Recalling sentences and formulating sentences correlated with the working memory demands of the Token Test, whereas following directions and word structure correlated with Token Test linguistic factor. Conclusions: A modified Token Test has the potential to be used clinically to understand language performance. In particular, differential performance across sentences could reveal relative verbal working memory and linguistic knowledge abilities. Supplemental Material: https://doi.org/10.23641/asha.19178474