The validity of the Color Trail Test in the pre-driver assessment of individuals with acquired brain injury

Maeir, Adina; Erez, Asnat Bar-Haim; Ratzon, Navah Z.; Mattatia, Tatiana; Weiss, Penina

doi:10.1080/02699050802491305

Cited by 14 publications

(7 citation statements)

References 17 publications

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“…The CTT is a language-free analogue of the Trails test designed to be applicable across various cultural contexts. Two studies (23,24) (Table 2) looked at the CTT and its association with ability to predict fitness-to-drive. CTT 2 is similar to Trails B.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive

Roy

Molnar

2013

Can Geri J

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BackgroundFitness-to-drive guidelines recommend employing the Trail Making B Test (a.k.a. Trails B), but do not provide guidance regarding cut-off scores. There is ongoing debate regarding the optimal cut-off score on the Trails B test.The objective of this study was to address this controversy by systematically reviewing the evidence for specific Trails B cut-off scores (e.g., cut-offs in both time to completion and number of errors) with respect to fitness-to-drive.MethodsSystematic review of all prospective cohort, retrospective cohort, case-control, correlation, and cross-sectional studies reporting the ability of the Trails B to predict driving safety that were published in English-language, peer-reviewed journals.ResultsForty-seven articles were reviewed. None of the articles justified sample sizes via formal calculations. Cut-off scores reported based on research include: 90 seconds, 133 seconds, 147 seconds, 180 seconds, and < 3 errors.ConclusionsThere is support for the previously published Trails B cut-offs of 3 minutes or 3 errors (the ‘3 or 3 rule’). Major methodological limitations of this body of research were uncovered including (1) lack of justification of sample size leaving studies open to Type II error (i.e., false negative findings), and (2) excessive focus on associations rather than clinically useful cut-off scores.

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Section: Discussionmentioning

confidence: 99%

Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive

Roy

Molnar

2013

Can Geri J

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“…Regarding the evaluation of individuals with acquired brain damage who sought to obtain a driver’s license, Hartman-Maeir, Erez, Ratzon, Mattatia and Weiss(2008) tested 30 subjects using the CTT 1 and CTT 2. The subjects also underwent traffic evaluation with a driving rehabilitation specialist and an instructor.…”

Section: Introductionmentioning

confidence: 99%

Color Trails Test: A Brazilian normative sample.

Rabelo¹,

Pacanaro²,

Rossetti³

et al. 2010

Psychology & Neuroscience

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“…The second subtest, CTT-2, consists of double the stimuli as the CTT-1, with two sets of the 25 numbers in each color (pink and yellow). For this study, similar to previous studies ( 28 , 29 ), only raw completion time of CCT-1 was analyzed, since the time component is considered essential for driving performance, regardless of age. Additionally, the CTT-2 had not been administrated to some participants in the unfit group because of its increased cognitive demands on frontal systems functioning (flexibility, increased information processing) ( 29 , 30 ).…”

Section: Methodsmentioning

confidence: 99%

“…For this study, similar to previous studies ( 28 , 29 ), only raw completion time of CCT-1 was analyzed, since the time component is considered essential for driving performance, regardless of age. Additionally, the CTT-2 had not been administrated to some participants in the unfit group because of its increased cognitive demands on frontal systems functioning (flexibility, increased information processing) ( 29 , 30 ). Nonetheless, previous research indicates the validity of CTT-1 as a brief screening test in driving evaluation processes that could identify participants most at risk for unsafe driving behaviors ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, the CTT-2 had not been administrated to some participants in the unfit group because of its increased cognitive demands on frontal systems functioning (flexibility, increased information processing) ( 29 , 30 ). Nonetheless, previous research indicates the validity of CTT-1 as a brief screening test in driving evaluation processes that could identify participants most at risk for unsafe driving behaviors ( 29 ). In this current study, we refer to the CTT1 as cognitive processing speed.…”

Section: Methodsmentioning

confidence: 99%

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Self-awareness predicts fitness to drive among adults referred to occupational therapy evaluation

Rosenfeld

Goverover

Weiss

2022

Front. Rehabilit. Sci.

Self Cite

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BackgroundDriving is associated with independence, well-being, quality of life, and an active lifestyle. Driving requires cognitive, motor, and visual skills, including self-awareness and processing speed. This study examines whether driver self-awareness, motor processing speed, and cognitive processing speed can predict fitness to drive among individuals referred to occupational therapy evaluation due to concerns about their driving ability.MethodIn this cross-sectional study, 39 participants were referred to off- and on-road driving evaluation to determine their fitness to drive due to changes in health status, advanced age, license renewal requirement, or prior automobile accidents. A registered occupational therapist (OT) classified 23 of the participants as fit to drive and 16 as unfit to drive. Motor and cognitive processing speed were assessed by the Stationary Perception-Reaction Timer and the Color Trails Test, respectively. Driving self-awareness was assessed by comparing the DI and OT evaluations to the participants' estimation of their own on-road driving performance.ResultsThe fit-to-drive participants had a better motor and cognitive processing speed than those unfit-to-drive. The unfit-to-drive group overestimated their driving ability, whereas the fit-to-drive group accurately or almost accurately estimated their driving ability. Driving self-awareness was a significant predictor of participants' fitness to drive.ConclusionsThis study demonstrates the importance of self-awareness for predicting fitness to drive among people at risk for compromised driving skills. Thus, driving self-awareness should be addressed as part of fitness-to-drive evaluations and interventions.

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The validity of the Color Trail Test in the pre-driver assessment of individuals with acquired brain injury

Abstract: The CTT1 may contribute to the pre-driving screening by rapidly identifying those individuals who are most at risk for unsafe driving behaviors. Further studies are required with a larger representative sample.

Cited by 14 publications

References 17 publications

Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive

Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive

Color Trails Test: A Brazilian normative sample.

Self-awareness predicts fitness to drive among adults referred to occupational therapy evaluation

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