Comprehensive Trail-Making Test (CTMT)

For the purpose of assessing and diagnosis brain injury, the Comprehensive Trail-Making Test is composed of five visual search and sequencing task sets.  The CTMT can detect problems with the frontal lobe, psychomotor speed, focus, visual search, and sequencing.

Participants are asked to complete five items or “trails” which include connect sets of numbers or letters with lines.  Approximately 5 to 12 minutes is required for completion.

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Cecil Reynolds, 2002

Reliability and Validity

The Comprehensive Trail-Making Test is a popular and established instrument.  Alpha coefficients for internal consistency were above 0.70 for all five of the subtests and 0.92 for the Composite Index (Reynolds, 2002).  Reynolds also reported the test-retest score above 0.70, generally ranging from 0.70 to 0.78, and the inter-rater reliabilities from 0.96 to 0.98.  For validity, the CTMT was compared with the Developmental Test of Visual-Perception-Adolescents and Adults (Reynolds, Pearson, & Voress, 2002) and the Draw-A-Person Intelligence Scoring (Reynolds & Hickman, 2002).  All these test contained common visual perception and visual-motor skill traits.

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Administration, Analysis and Reporting

Statistics Solutions consists of a team of professional methodologists and statisticians that can assist the student or professional researcher in administering the survey instrument, collecting the data, conducting the analyses and explaining the results.

For additional information on these services, click here.


Halstead, W. C. (1947). Brain and intelligence: A quantitative study of the frontal lobes. Chicago: University of Chicago Press. View

Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). Oxford: Oxford University Press. View

Partington, J. E., & Leiter, R. G. (1949). Partington’s Pathway Test. The Psychological Service Center Bulletin, 1, 9-20.

Reitan, R. M., & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation (2nd ed.). Tucson, AZ: Neuropsychological Press.

Reynolds, C. R. (2002). Comprehensive Trail Making Test: Examiner’s manual. Austin, Texas: PRO-E.

Reynolds, C. R., Pearson, N. A., & Voress, J. K. (2002). Developmental Test of Visual Perception-Adolescent and Adult. Austin, TX: PRO-ED.

Spreen, O., & Strauss, E. (1998).  A compendium of neuropsychological tests (2nd ed.). Oxford: Oxford University Press. View

Stuss, D., Bisschop, S. M., Alexander, M., Levine, B., Katz, D., & Izukawa, D. (2001). The Trail Making Test: A study in focal lesion patients. Psychological Assessment, 13, 230-239.

Dissertations and Journals

Armstrong, C.M., Allen, D.N., Donohue, B. & Mayfield, J. (2007). Sensitivity of the comprehensive trail making test to traumatic brain injury in adolescents. Archives of Clinical Neuropsychology, 23(3), 351 – 358.

Cole, C.S., Richards, K.C. (2005). Sleep and cognition in people with alzheimer’s disease. Issues in Mental Health Nursing, 26(7), 687 – 698.