How to Diagnose ADHD With a Trail Making Test

Children with the inattentive subtype of attention deficit hyperactivity disorder often cannot complete their schoolwork or chores without becoming distracted. Also, they have a difficult time following instructions from beginning to end. A child's lack of attention results in failures to accomplish what they want. A psychologist's Trail Making Test tests a child's ability to focus on a task by using her visual-motor speed and skill in switching tasks to follow a continuous order, without an interruption in attention.

Things You'll Need

• Number sequences
• Combined number and letter sequences

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Instructions

Trail Making Test Steps

• 1

  Take patient history to determine if the inattentive subtype of ADHD may be diagnosed. For a diagnosis, a psychologist needs much more than occasional inability to hold a sustained attention. He will take the patient's history to find if they have experienced regular symptoms for at least six months. If the patient tells the psychologist she has a persistent problem, the Trail Making Test can be used to test her basic attention skills.

• 2

  Instruct the child to follow a number sequence. For Test A, the tester asks the child to read a sequence of numbers. While the psychologist watches, the child reads the numbers in the sequence order. The tester notes any pauses, back steps, jumps forward in the sequence or changes in order. The most important interruptions are any stops during the test or distractions by the surroundings.

• 3

  Instruct the child to follow a combined number and letter sequence. For Test B, the psychologist gives a combined sequence of numbers and letters to the child for them to read. The numbers and letters each have a continuous order. As the psychologist watches, the child reads through the sequences. In addition to the noted interruptions in Test A, the psychologist notes any ability to switch between numbers and letters.

• 4

  Assess the demonstrated skills. Three basic skills are involved: visual scanning, number sequencing and letter sequencing. The tester uses their observations and the child's misses and errors during the test to assess each basic skill. Upon review, the tester can determine if there are specific skill deficiencies with vision, numbers or letters, or attention dips and failures.

• 5

  Diagnose whether the child has an inattention problem that can be classed as the inattentive subtype in ADHD. The psychologist determines the child's attention abilities: selecting the right number or letter to attend to, sustaining attention throughout the sequence order, switching between sequences and attending to more than one sequence. For the diagnoses, he decides whether any attention deficits found in testing show that the inattentive subtype of ADHD causes the inattention reported in the patient history.