Paper-pencil Test Research Articles

Cerebral blood flow and cognition after 3 months tadalafil treatment in small vessel disease (ETLAS-2): study protocol for a randomized controlled trial

BackgroundTargeted treatment is highly warranted for cerebral small vessel disease, a causal factor of one in four strokes and a major contributor to vascular dementia. Patients with cerebral small vessel disease have impaired cerebral blood flow and vessel reactivity. Tadalafil is a specific phosphodiesterase 5 inhibitor shown to improve vascular reactivity in the brain.MethodsThe ETLAS-2 trial is a phase 2 double-blind, randomized placebo-controlled, parallel trial with the feasibility of tadalafil as the primary outcome. The trial aims to include 100 patients with small vessel occlusion stroke or transitory ischemic attacks and signs of cerebral small vessel disease more than 6 months before administration of study medication. Patients are treated for 3 months with tadalafil 20 mg or placebo daily and undergo magnetic resonance imaging (MRI) to evaluate changes in small vessel disease according to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE) criteria as well as cerebral blood flow, cerebrovascular reactivity, and neurovascular coupling in a functional MRI sub-study. The investigation includes comprehensive cognitive testing using paper–pencil tests and Cambridge Neuropsychological Test Automated Battery (CANTAB) tests in a cognitive sub-study.DiscussionThe ETLAS-2 trial tests the feasibility of long-term treatment with tadalafil and explores vascular and cognitive effects in cerebral small vessel disease in trial sub-studies. The study aims to propose a new treatment target and improve the understanding of small vessel disease. Currently, 64 patients have been included and the trial is estimated to be completed in the year 2024.Trial registrationClinicaltrials.gov, NCT05173896. Registered on 30 December 2021.

How to Assess Mathematics Teachers’ TPACK? A Comparison Between Self-Reports and Knowledge Tests

AbstractTeachers need technology-related knowledge to effectively use technology in the classroom. Previous studies have often used self-reports to assess such knowledge. However, it is questionable whether self-reports are valid measures for this purpose. This study investigates how mathematics teachers’ self-reports correlate with their scores in a paper–pencil knowledge test regarding TPCK (technological pedagogical content knowledge), CK (content knowledge), pedagogical content knowledge (PCK), and technological knowledge (TK). Participants were $$N = 173$$ N = 173 pre- and in-service mathematics teachers. To assess self-reports, we adapted an existing survey from the literature. We also compiled a knowledge test based on items from existing test instruments. To increase comparability between the two instruments, both the self-report and the paper–pencil knowledge test addressed the specific topic of fractions. The four subscales in both instruments had sufficient reliability. The correlations between the self-reports and the paper–pencil test scores were low or very low for all subscales $$\left(r=.00-.23\right)$$ r = . 00 - . 23 , suggesting that the two instruments captured different underlying constructs. While paper–pencil tests seem more suitable for assessing knowledge, self-reports may be influenced more strongly by participants’ personal traits such as self-efficacy. Our findings raise concerns about the validity of self-reports as measures of teachers’ professional knowledge, and the comparability of studies that use distinct assessment instruments. We recommend that researchers should be more cautious when interpreting self-reports as knowledge and rely more strongly on externally assessed tests.

Exploring Assessment Practice in Community Schools in Nepal

The assessment that reflects the praxis of students’ hands-on learning experiences motivates students to link theoretical learning to real-life situations. The existing assessment is blamed for being poor in assessing such quality. Therefore, this paper makes an in-depth study of existing practices of assessment systems and explores student-friendly, evidence-based, and goal-oriented assessment practices that lead students from the area of their interest to the designed goals. Following narrative inquiry as a research design, information was collected, coded, schematized, and generated meaning from the participants’ meaning making of the assessment system in the schools. The study found that the students have a sort of fear and detestation of the existing high stakes testing. Similarly, the practical examination has lacked trustworthiness, validity, and consistency. Although students have experienced some assessment tools as friendly, engaged, and goal oriented, they have weak decisive roles in grading. Classroom activities should be learner-engaged, performance-based, and hands-on experience-oriented. Their participation and performance in classroom activities can lead them to transcend the designed objectives. The grading scheme should be made so transparent and precise that the students by themselves can identify where their learning level is. The paper-pencil test as an assessment tool should reflect how the learning contents, classroom activities, and overall, the programs are. The study concludes that classroom activities should be designed in such a way that students’ participation in the activities can lead them to achieve the designed goals.

Implementation of Early Childhood Mathematics Learning at PAUDQU Al-Anshor

The introduction of learning mathematics is an important part of early childhood. Mathematics is closely related to human daily life. So that children must be introduced from an early age so that they have adequate mathematical skills in carrying out life in the future. In the field itself, there are many activities to introduce mathematics in early childhood, dominated by calistung activities which are drills and paper pencil tests. The school environment is a place for educators to provide meaningful mathematics learning. Learning mathematics for early childhood should be introduced to various and fun methods. This study uses a type of qualitative research. The study involved 4 teachers and 15 students from groups A and B at PAUDQU Al-Anshor. The results of the study show that the application of early childhood mathematics learning in PAUDQU Al-Anshor does not only use drills and paper pencil tests, but is balanced with various other game activities that can refer to learning mathematics.

Voices from the Classroom: Exploring the Secondary School Teachers’ Perception Towards Formative Assessment Practices

The present study focuses on exploring the teacher’s perception about formative assessment practices at secondary school. For this study investigator purposively selected 39 participants for study form 23 secondary schools of Mayurbhanj district. The study employed semi-structured interviews schedule for data collection. Collected data were analysed by content analysis and presented by thick descriptions. The study revealed that most of teachers have been four categories of formative assessment strategies have been used by the teachers such as Periodic Paper-Pencil Test, Multiple Assessment Practice, Portfolio Assessment and Subject Enrichment Activities. Further study found most of the teachers were satisfy with the infrastructural facilities of the school. Most of the teachers perceive that students are benefited in their achievements, actively participating in classroom discussion, aroused their interest for better understanding of the concept, able to know their strengths and weakness, fearless for exam and get opportunity to learn again by formative assessment. However most of them not satisfy with in-service training and parent supports for conducting formative assessment practices. Most of the teachers face problems like; absence of remedial teaching, student’s absenteeism in test or classroom, managing time to complete course, language barrier, low economic background of students, and lack of in-service training to teachers. It is suggested that, short term courses, workshops, seminars and, other necessary in-service training activities should be organized by the concern authority for professional development of teachers in formative assessment strategies. Therefore teachers will effectively implement the formative assessment practices in secondary schools.

Protocol: Prospective evaluation of feasibility, added value and satisfaction of remote digital self-assessment for mild cognitive impairment in routine care with the neotivCare app

IntroductionTimely diagnosis of mild cognitive impairment (MCI) in Alzheimer’s disease is crucial for early interventions, but its implementation is often challenging due to the complexity and time burden of required...

Test–retest reliability and reliable change index of the Philips IntelliSpace Cognition digital test battery

Objective This article provides the test–retest reliability and Reliable Change Indices (RCIs) of the Philips IntelliSpace Cognition (ISC) platform, which contains digitized versions of well-established neuropsychological tests. Method 147 participants (ages 19 to 88) completed a digital cognitive test battery on the ISC platform or paper-pencil versions of the same test battery during two separate visits. Intraclass correlation coefficients (ICC) were calculated separately for the ISC and analog test versions to compare reliabilities between administration modalities. RCIs were calculated for the digital tests using the practice-adjusted RCI and standardized regression-based (SRB) method. Results Test–retest reliabilities for the ISC tests ranged from moderate to excellent and were comparable to the test-retest reliabilities for the paper-pencil tests. Baseline test performance, retest interval, age, and education predicted test performance at visit 2 with baseline test performance being the strongest predictor for all outcome measures. For most outcome measures, both methods for the calculation of RCIs show agreement on whether or not a reliable change was observed. Conclusions RCIs for the digital tests enable clinicians to determine whether a measured change between assessments is due to real improvement or decline. Together, this contributes to the growing evidence for the clinical utility of the ISC platform.

POINTING SYSTEM INTERVENTION FOR NON-PARTICIPATIVE STUDENTS IN TECHNOLOGY AND LIVELIHOOD EDUCATION (TLE) CLASS: A CLASSROOM-BASED ACTION RESEARCH

Non-participative students in classes have a detrimental effect on the social learning environment. Low student participation is a common problem. This classroom-based action research aims to increase students' active participation in Technology and Livelihood Education (TLE) classes. The researcher used a quantitative-descriptive approach in gathering data. Descriptive analysis is employed to interpret the quantitative data utilizing frequency, mean, percentage, and standard deviation to conclude. To increase classroom participation, the researcher integrated a "Pointing System" intervention strategy as an extrinsic motivation. A paper-pencil test examination was used as pre-test to gather pre-data while conducting this action research. The researcher collected post-data using another set of paper-pencil test as post-test after a month of intervention. Pre- and post-data are used in the descriptive analysis to conclude its association with class participation. The data revealed that there are 42 out of 60 students who have undergone the intervention. Students who passed the pre-test took part in the intervention without using the strategy applied. The post-intervention statistics showed significantly more active participants—51 in total—than before the intervention. The "Pointing System" would encourage the students to engage in more active learning throughout the teaching and learning session. The researcher concluded that students actively participate in class and perform well academically if "Pointing System" is integrated as one of the external sources of incentive.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu/0758/a.php" alt="Hit counter" /></p>

Perceived Effectiveness of Computer-Based Test in Curbing Examination Malpractices and Revitalizing Quality Control by Undergraduates of Federal Universities in Southwestern Nigeria

The study investigated the perceived effectiveness of computer-based test in curbing examination malpractices and revitalizing quality at the Federal Universities in Southwestern Nigeria. A descriptive survey research design was adopted. The population for the study consisted of all undergraduates at the Federal universities in Southwestern Nigeria. Multistage sampling technique was used to select 1,200 samples for the study. A questionnaire titled “Perceived Effectiveness of Computer-based Test in Curbing Examination Malpractices and Revitalizing Quality (PECBTCEMRQ) was used to gather data. Data collected were analyzed using frequency count, mean and standard deviation. The results showed that the paper pencil test is highly susceptible to different kinds of malpractices (81.3%). The result also showed the CBT effectiveness in curbing examination malpractices is very high (87.5%). Again, the result showed the CBT effectiveness in revitalizing quality is also attested to be high (73.6%). The study concludes that Computer-based test is more effective and preferred to Paper-pencil Test at ensuring reduction in examination malpractices and revitalizing quality of graduates in Southwestern Nigeria. Nevertheless, inadequate facilities, poor network failure among many were identified to have impede the effectiveness of CBT at controlling examination malpractices and revitalizing quality control. The study recommends that the management of education at all level should endeavor to improve on identified deficient facilities and infrastructures for the full potentials of CBT to materialize.

Clinical Manifestations.

Tools for web-based testing to detect cognitive impairment are still underdeveloped in Thailand. Our aim was to generate a web-based instrument to assess cognitive and functional abilities and to explore its ability for diagnosis of dementia and MCI. We have developed a web application for cognitive and functional assessment to detect cognitive impairment. We hoped that subjects or family members could use this web-based tests at home as self-screening. These web-based tests included an electronic version of the Thai Mental State Examination (e-TMSE), a clock drawing test, a category verbal fluency test, a short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and Thai activities of daily living scale (Thai ADL). Correlations, receiver operator curves (ROCs), sensitivity, and specificity were analyzed using SPSS (version 18). A total of 198 participants (69% female, mean age 66.7 ± 10 years). 57.1% had education of more than 6 years. Forty-four were Major Neurocognitive Disorder, fifty-eight were Mild Neurocognitive Disorder (MCI), and ninety-six were normal controls. The e-TMSE correlated with both paper-pencil based TMSE(r = 0.80,p<0.001) as well as clock drawing test (r = 0.470 p<0.001). There were also statistically significant high correlations between digital and paper & pencil tests (e.g, category verbal fluency test, A short form of the IQCODE, and ADL). For diagnosis of dementia, e-TMSE achieved an AUC of 0.84 (95% bootstrapped CI [0.78, 0.90]. The cut-off score ≤23 offered sensitivity and specificity of 88.6% and 70.1% respectively. For diagnosis of dementia with the combination of 5 e-tests, the AUC was 0.832 (p<0.001), while for MCI diagnosis, the AUC was 0.615 (p = 0.013). The area under the ROC of the IQCODE combined with ADL scale test was 0.907 (p<0.001). We demonstrated that our web application that included: e-TMSE, clock drawing test, category verbal fluency test, IQCODE and Thai-ADL scale showed good correlation between digital vs paper-pencil tests. Individual e-test and combination of them can offer self screening for MCI and dementia.

Using Virtual Reality to Assess Spatial Cognition in Subjective Cognitive Decline and Mild Cognitive Impairment due to Alzheimer’s Disease

AbstractBackgroundSpatial navigation impairment (SNI) is prevalent in people with Alzheimer’s disease (AD) continuum and may appear in the initial clinical stage. To detect this deficit in people at risk may not only help to prevent getting lost or missing incidents, but also provide a useful clinical feature for diagnosis. Traditional assessments for SNI include questionnaires, paper pencil and maze tests, or video games. Although a real‐world setting is more valid, direct, and accurate, it has many unexpected conditions such as weather, obstacles, or accidents. Thanks to technology, virtual reality (VR) is a new way to assess SNI.MethodWe used PJVR to test spatial navigation ability in cognitively unimpaired (CU), subjective cognitive decline (SCD) and mild cognitive impairment due to AD (MCI‐AD). The PJVR is the VR version (Vive Pro Eye Head‐mounted Display, HTC) of the PJ device, which was developed by Pai and Jan and has been successfully verified its power to discriminate each other among CU, MCI, and mild AD. With a map provided and using joysticks or handles, participants were requested to reach five points in a 660‐meter path on our university campus. Linear deviation in meters in each point was treated as the variable for comparison. A pre‐test training course was given to facilitate the procedure.Result118 subjects signed informed consent and 87 (73.7%) completed the trials, including 18 CU, 41 SCD and 28 MCI‐AD. Fourteen, or 11.9%, of all participants failed the trials due to cybersickness. The averaged linear deviations of the CU, SCD and MCI‐AD were 36.1 (38.2), mean (S.D.), 40.8 (44.4), and 93.7 (46.8) meters respectively (p&lt;0.000). The linear deviation of the PJVR of the participants was correlated with the Questionnaire on Everyday Navigation Abilities (p&lt;0.001), indicating a good real‐world validity.ConclusionAlthough the rate of cybersickness is higher as compared with the reports from Western countries, most of the participants completed the trials. The PJVR is feasible to assess spatial cognition and able to discriminate CU/SCD from MCI‐AD. To simplify PJVR to be practical is important to welcome the era of digital cognitive assessment.

Practice of Alternative Assessment at Tribhuvan University

Alternative assessment is a recent trend in the field of education. It helps the teachers and students to be more self reflective and responsible towards their tasks and activities. In this light, the present study aimed to explore the practice of alternative assessment system at Tribhuvan University. To accomplish the objective, the researcher adopted interpretivism as philosophical approach and narrative inquiry as research design. This research was based on the experience of university level teachers teaching at semester level. The total population of this study comprised all the teachers teaching at Tribhuvan University. However, the researcher selected only seven English language teachers from Tribhuvan Multiple Campus, Palpa using purposive sampling procedure. Similarly, the researcher made an interview guide, and interviewed with the sampled teachers using recording devices to obtain in-depth information. The results revealed that most of the teachers prefer to use traditional paper pencil test rather than using alternative assessment tools for student evaluation. They had their reluctance to use alternative assessment tools because of the time, resource and investment constraints. They were not properly updated and trained towards alternative assessment. However, they highlighted the importance of such tools for their students’ evaluation. The present study can be useful to the teachers of university level for gaining insights of the alternative assessment tools for student evaluation.

Evaluating Educators: A Comprehensive Study of Teachers' Assessment Skills and Practices

The study delved into the evaluation of teachers' assessment proficiency and classroom assessment methodologies within the context of five distinct academic programs. The research findings unveiled the commendable abilities of teachers in various aspects, including their adeptness in paper-pencil tests, performance assessments, authentic assessments, item analysis, and effectively communicating assessment results to their students. Remarkably, both teachers and students held positive perceptions of these assessment skills across these different domains. The study's results further illuminated that there was no discernible relationship between the gender of teachers and their assessment skills. However, a substantial correlation emerged between the teaching experience of educators and their assessment practices. This indicated that more seasoned teachers tended to exhibit superior assessment skills, underscoring the role of experience in this regard. Significantly, there were no substantial disparities in classroom assessment practices and the proficiency of teachers in assessment skills among the various academic programs under scrutiny. These findings underscore the critical significance of continuous professional development as a means to augment assessment competencies among educators. Such development initiatives are pivotal in contributing to enhanced student learning outcomes across diverse educational settings.

Observing effective classroom management in early instruction in primary school: rating instrument construction and its link to teacher knowledge

This study presents a novel standardized rating instrument for observing and measuring effective classroom management (ECM) as part of the teaching and learning environments in primary school. The instrument comprises eight high-inferent items on organizational aspects (lack of disruptions/discipline problems, withitness, effective time use, clear rules, clear routines, appreciation) and instructional aspects (structuring, goal clarity). It was applied in second grade classrooms of German primary school teachers (n = 35) providing early reading and writing instruction. Pairs of trained raters (student teachers) observed one to three lessons in each classroom over 3–4 months, reaching acceptable interrater agreement. The instrument showed acceptable internal consistency. Factor analyses revealed structures with good to acceptable fit indices, with confirming the differentiation into organizational and instructional ECM aspects. Correlations between observed ECM and facets of teacher knowledge (that were directly assessed by using paper–pencil tests) provide divergent and convergent validity evidence: Whereas no significant correlations could be found between pedagogical content knowledge for early reading and writing instruction and ECM, findings show significant correlations between general pedagogical knowledge and the ECM. The added value of the study is therefore to provide a novel instrument that can be applied in future empirical research on primary school classroom management.

Comparison of the response time-based effort-moderated IRT model and three-parameter logistic model according to computerized adaptive test performances: a simulation study

Depending on the developments in technology and information, paper-pencil tests leave their place for computerized adaptive tests (CATs). CAT is widely used in the field of health, mainly in psychiatry. Many item response theory models have been proposed in the literature regarding the use of response time focusing on item difficulty and personal characteristics by ignoring the multidimensional interactions, therefore these results may cause bias in estimates of individual ability levels. The present simulation study was conducted to compare the performance of CAT applications of the effort-moderated item response theory (EM-IRT) model, which is based on response time, and the three-parameter logistic (3PL) model. While simulating CAT with the EM-IRT model and the 3PL model, the hybrid method was used for ability estimation and maximum Fisher information (MFI) was used for item selection. The CAT process proceeded until the standard error of the estimation was <0.3 and <0.5, or all items in the item bank were used. The number of individuals was specified as 1000, while the number of items was changed to 50, 100, and 250. All six scenarios were repeated 1000 times. With the increase in the number of items and the decrease in the standard error as a stopping criterion, consistent results were obtained with true ability levels in both methods. The CAT with the EM-IRT model estimated true ability level slightly lower than CAT with the 3PL model. The EM-IRT model enables measuring the response time that could yield additional data to the physician about the mental and cognitive condition of the patient. The CAT method can be a promising method of telemedicine in the era of the pandemic.

Validity of the SKILLCOURT® technology for agility and cognitive performance assessment in healthy active adults

Background/ObjectivesAgility and cognitive abilities are typically assessed separately by different motor and cognitive tests. While many agility tests lack a reactive decision-making component, cognitive assessments are still mainly based on computer-based or paper-pencil tests with low ecological validity. This study is the first to validate the novel SKILLCOURT technology as an integrated assessment tool for agility and cognitive-motor performance. MethodsThirty-two healthy adults performed agility (Star Run), reactive agility (Random Star Run) and cognitive-motor (executive function test, 1-back decision making) performance assessments on the SKILLCOURT. Cognitive-motor tests included lower limb responses in a standing position to increase the ecological validity when compared to computer-based tests. Test results were compared to established motor and agility tests (countermovement jump, 10 m linear sprint, T-agility tests) as well as computer-based cognitive assessments (choice-reaction, Go-NoGo, task switching, memory span). Correlation and multiple regression analyses quantified the relation between SKILLCOURT performance and motor and cognitive outcomes. ResultsStar Run and Random Star Run tests were best predicted by linear sprint (r = 0.68, p < 0.001) and T-agility performance (r = 0.77, p < 0.001), respectively. The executive function test performance was well explained by computer-based assessments on choice reaction speed and cognitive flexibility (r = 0.64, p < 0.001). The 1-back test on the SKILLCOURT revealed moderate but significant correlations with the computer-based assessments (r = 0.47, p = 0.007). ConclusionThe results support the validity of the SKILLCOURT technology for agility and cognitive assessments in more ecologically valid cognitive-motor tasks. This technology provides a promising alternative to existing performance assessment tools.

Do classical and computerized cognitive tests have equal intrarater reliability in myotonic dystrophy type 1?

Myotonic dystrophy type 1 (DM1) is a multisystemic inherited neuromuscular disease leading to central nervous system symptoms, including cognitive impairments, among multiple other symptoms. However, information is presently lacking regarding the psychometric properties of neuropsychological tests and promising computerized cognitive tests, such as the Cambridge Neuropsychological Test Automated Battery (CANTABⓇ). This type of information is critical to improve clinical trial readiness and provide knowledge of DM1 natural history. The aims of the present study were (1) to document the intrarater reliability of classic paper-pencil tests assessing visuospatial working memory, cognitive flexibility, attention, episodic memory and apathy, and (2) to compare these findings with their equivalent computerized automated tests from the CANTABⓇ. Thirty participants were seen twice at four-week intervals. Results showed that the Stroop Color and Word Test (ICC = 0.741–0.869) and the Ruff 2 & 7 (ICC = 0.703–0.871) appear to be reliable paper-and-pencil tests in the DM1 population. For the CANTABⓇ, a similar observation was made for the Multitasking test (ICC = 0.588–0.792). Further studies should explore the applicability and concurrent validity of the CANTAB® and classic neuropsychological assessments in additional cohorts of DM1 patients.

Employing a Force and Motion Learning Progression to Investigate the Relationship between Task Characteristics and Students’ Conceptions at Different Levels of Sophistication

Research has demonstrated that when learning mechanics, students’ conceptions (SCs) improve gradually (1) and are often activated depending on problem features (2). The aim of this study is to combine these two research lines to investigate how different task characteristics affect the activation of SCs at different levels of sophistication. Data were collected from N = 356 students using a paper–pencil test in which conceptual and contextual task characteristics (CCTCs) are varied systematically across ordered multiple-choice items. Answer options were constructed according to the four levels of a force and motion learning progression. Results, obtained using quantitative methods (e.g., Rasch analysis and regression), demonstrate that the effects of CCTCs may differ at different levels of SCs. For the direction of problem, for example, activating the correct conception, assuming force proportional to acceleration, seems to be easier in tasks asking for the resulting motion. However, activating more appropriate conceptions regarding lower levels, e.g., assuming force proportional to velocity, compared to a rather undifferentiated understanding of force and motion, seems to be easier in tasks asking for the forces. Results of our study can be used for choosing tasks with specific CCTCs to support conceptual change along specific steps of a learning path.

MICK (Mobile Integrated Cognitive Kit) App: Feasibility of an Accessible Tablet-Based Rapid Picture and Number Naming Task for Concussion Assessment in a Youth Ice Hockey League (P2-9.005)

<h3>Objective:</h3> We evaluated the capacity of the Mobile Universal Lexicon Evaluation System (MULES, rapid picture naming) and Staggered Uneven Number (SUN) testing to be effective during pre-season baseline testing in a cohort of youth athletes using a novel and freely-available app (Mobile Integrated Cognitive Kit, MICK) and paper-pencil testing. <h3>Background:</h3> Visual symptoms are common following concussion. Rapid automatized naming (RAN) tasks are effective for identifying individuals with concussion and with other neurological disorders, such as multiple sclerosis, Parkinson’s disease and mild cognitive impairment (MCI) due to Alzheimer’s disease. The MULES test of picture naming and the SUN test of number naming demonstrate increased time scores (worse performance) after concussion. <h3>Design/Methods:</h3> Participants from a youth hockey league (n=59, median age 13 years, range 6–17) underwent pre-season testing. Each participant completed two trials of MULES and SUN. Children &lt;10 years of age completed paper versions, while children aged 10 or greater used the MICK app. The app records completion times for each trial and is semi-automated for use while supervised by research staff. <h3>Results:</h3> As noted in prior studies, learning effects were noted between the two baseline trials for both the MULES (median improvement=11.3 sec, range=−32.3–92.0 sec, <i>p</i>&lt;0.001, Wilcoxon sign-rank test) and SUN (median improvement=0.78 sec, range=−8.0–15.1 sec, <i>p</i>=0.002). Median best baseline for the MULES was 50.4 sec (range=34.2–141.0 sec) and for SUN 71.1 sec (range=36.6–200.0 sec). Age was a predictor of best baseline times for both tests, with longer times for younger participants for MULES (<i>p</i>&lt;0.001, <i>r</i>_<i>s</i>=−0.67, Spearman rank correlation) and SUN (<i>p</i>&lt;0.001, <i>r</i>_<i>s</i>=−0.54). Degrees of learning effect did not vary across age groups in this cohort (<i>p</i>=0.14, <i>r</i>_<i>s</i>=−0.20). <h3>Conclusions:</h3> Vision-based RAN tasks, such as the MULES and SUN, can be feasibly administered using the MICK app during pre-season baseline testing in youth sports teams. These data provide a foundation for post-injury sideline testing among youth athletes. <b>Disclosure:</b> Ms. Hyman has nothing to disclose. Mr. Blacker has nothing to disclose. Mr. Bell has nothing to disclose. Marc Balcer has nothing to disclose. Binu Joseph has nothing to disclose. Dr. Galetta has nothing to disclose. An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children’s Hospital of Philadelphia. Dr. Balcer has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for North American Neuro-Ophthalmology Society. Dr. Grossman has nothing to disclose.

"Look straight ahead"-A new test to diagnose spatial neglect by computed tomography.

Spatial neglect is the dominant behavioral disorder after right hemisphere brain lesions. Reliabel diagnosis by formal neuropsychological testing is often achieved only later during hospitalization, leading to delays in targeted therapies. We propose a way to diagnose spatial neglect right at admission. We measured the conjugated eye deviation (CED) on the initial computed tomography (CT) scans, in combination with the verbal instruction "Please look straight ahead" during the scan. The command was implemented in the scanner program and automatically played before a cranial CT started. This prospective study included a total 46 consecutive subjects (16 patients with first ever right brain damage and no spatial neglect, 12 patients with first ever right brain damage and spatial neglect, and 18 healthy controls). The right brain damaged groups were submitted to paper pencil tests to access the diagnosis of a spatial neglect after radiological confirmation of the brain damage during the initial phase of their hospitalisation. This procedure allowed us to define a cut-off value of 14.1 degrees of CED to the ipsilesional side to differentiate right hemispheric stroke patients with versus without spatial neglect with a confidence interval of 99%. This simple addition to a radiological routine procedure provides a new tool to help diagnose spatial neglect at the earliest stage possible and thus offers the possibility of providing patients with optimized rehabilitative therapy from a very early stage on.