Tinkertoy Test Research Articles

Divergent thinking as a predictor of life skills in patients with schizophrenia: Evidence from the modified Tinkertoy Test.

Patients with schizophrenia often exhibit poor life skills, posing significant clinical challenges. Life skills comprise cognitive functions crucial for planning daily activities, including divergent thinking. However, the cognitive deficits contributing to these diminished skills among patients with schizophrenia are underexplored. This study introduces a modified Tinkertoy Test (m-TTT) to investigate the correlation between life skills, divergent thinking, and psychological assessment tools in patients with schizophrenia. Fifty-two patients with schizophrenia, alongside a control group, matched for sex, age, and education, were evaluated using psychological assessment tools. For the patient group, the Life Skills Profile (LSP) and Positive and Negative Syndrome Scale were administered to measure functional abilities and psychiatric symptoms, respectively. Additionally, duration of disease and antipsychotic daily dosage levels were assessed exclusively in the patient group. Both groups were evaluated with the m-TTT, Idea Fluency Test (IFT), Design Fluency Test (DFT), and Brief Assessment of Cognition in Schizophrenia (BACS) to comprehensively assess cognitive functions. A stepwise multiple regression model was conducted to identify significant correlates of LSP total score among the patient group. The schizophrenia group scored notably lower than the neurotypical controls on the m-TTT, IFT, DFT, and BACS. Our stepwise multiple regression analysis highlighted that the LSP total score was significantly correlated with the total m-TTT score and presence of negative symptoms. Divergent thinking could be a crucial factor in the life skills of individuals with schizophrenia. Rehabilitation programs based on this cognitive function might enhance their daily living capabilities.

統合失調症患者に対する修正版 The Tinkertoy Test の信頼性および妥当性の検討

統合失調症患者に対する修正版 The Tinkertoy Test の信頼性および妥当性の検討

Assessment of executive function using the Tinkertoy test.

The Tinkertoy test (TTT) has often been used to assess executive function. Despite its clinical importance, there are few published normative data for it. Thus, the primary aim of this study was to fill this gap. Moreover, as there exists a sex difference in many cognitive abilities and neuropsychological tests, a secondary aim was to examine whether sex influences TTT performance. We administered the TTT to 25 healthy men and 25 healthy women whose average age was 28 years. Performances were scored based upon Lezak's (1982) original TTT criteria. On average, our participants used 43 pieces to complete their construction (SD=8), with a range of 21-50, and their complexity scores ranged from 7 to 12, with a mean score of 9.68 (SD=1.35). Overall performance did not differ based on sex; yet, when examining individual scoring criteria, we found that men scored significantly higher on the symmetry measure. Efforts towards the development of adequate normative data for the TTT and different tests of executive functioning are crucial to neuropsychologists' and other healthcare providers' ability to reliably diagnose and treat disorders of cognition that affect executive function. The present data go some way towards enhancing the utility of the TTT.

Normative data for Lezak’s Tinkertoy test in healthy Italian adults

The Tinkertoy test is a tool for the neuropsychological assessment of executive functions and a predictor of employability. Originally a children’s toy comprising pieces to assemble freely, the TinkerToy Test examines organizational abilities, planning, and response flexibility. It allows subjects to use their own initiative and does not force them to choose from a series of predetermined alternatives. Tinkertoy test normative values were collected from 256 neurologically healthy Italian subjects. Multivariable analysis showed sex and education to have significant confounding effects. Adjusted and inferential cut-off points were determined and converted into equivalent scores, applying a distribution-free technique.

The Tinker Toy Test as a Measure of the Dysexecutive Syndrome in Those from Differing Socio-Economic Backgrounds

We investigated the impact of socio-economic status (SES) on executive functioning in a group of participants who were at least six months post Acquired Brain Injury (ABI). Challenges exist when measuring executive function in a developing country: norms developed in the country of test origin are rarely transferable to other populations and cultural differences require local test-item adaptation. Furthermore, SES has a graded impact upon cognitive functioning: those from lower socio-economic circumstances tend to produce inferior test scores to those from more affluent backgrounds. Not controlling for these effects may induce diagnostic errors. Three measures of executive functioning, the Wisconsin Card Sorting Test, the Iowa Gambling Test, and the Tinker Toy Test (TTT) were administered to 25 participants who were drawn from a South African Welfare organisation dedicated to supporting and assisting those with acquired brain injury. Sensitivity to race (as a possible measure of SES) was only elicited using the TTT. This test which is simple to administer, ecologically appropriate, and non-language based appears to be a useful adjunct as a measure of executive function in those with ABI from varying SES backgrounds.

Sertraline Improves Executive Function in Patients With Vascular Cognitive Impairment

The authors reviewed 35 open-label sertraline trials for executive impairment in ischemic cerebrovascular disease. Outcomes included clock-drawing, the Executive Interview (EXIT25), the Geriatric Depression Scale, and the Mini-Mental State Examination. Clinically "meaningful" improvement was defined as a >3.0 EXIT25 point decline from baseline. "Remission" was defined as the achievement of an EXIT25 score <15/50. Only EXIT25 scores improved significantly. Twenty patients (57.1%) experienced a clinically meaningful improvement in executive control function. Twelve (34.3%) achieved remission. Our findings suggest that sertraline may have both statistical and clinically meaningful effects on executive control function in ischemic cerebrovascular disease. The authors discuss the implications for future clinical trials.

Relationship between executive functions and productivity outcomes following stroke

Purpose. Stroke occurs in many individuals of working age and can considerably disrupt their capacity for employment and other productive activities. Few studies have examined the relationship between loss of productivity and cognitive impairment, particularly deficits in executive function. The present study examined whether performance on tests of executive function is related to employment and productivity at 12-months follow-up.Method. Twenty-seven individuals (mean age = 47.3 years, SD = 10.7) on average 2.1 years (SD = 1.6) post-stroke were recruited from hospital and community rehabilitation services and administered a theory-driven battery of executive function tests (i.e. Health and Safety sub-test, FAS Test, Five-Point test, Key Search Test and Tinkertoy Test). A 12-month follow-up assessment of employment outcome (‘employed’ or ‘unemployed’) and productivity (measured by the Sydney Psychosocial Reintegration Scale) was conducted.Results. A series of between-group comparisons identified that a measure of purposive behaviour and self-regulation (i.e. the Tinkertoy Test) best distinguished between the employed and unemployed groups (p < 0.01) irrespective of time since injury and neglect. Level of post-stroke productivity was significantly correlated with measures of planning (p < 0.05), self-monitoring (p < 0.01) and self-regulation (p < 0.05), as well as time since injury (p < 0.05) and functional status (p < 0.01).Conclusions. These findings highlight the importance of routinely assessing executive functions to guide cognitive rehabilitation interventions following stroke.

Assessments Validate Treatments, Enhance Care

Assessments Validate Treatments, Enhance Care

Neuropsychological deficits, syndromes, and cognitive competency in schizophrenia

Introduction. Neuropsychological functioning connects neuropathology and symptoms in schizophrenia. Previous work suggests that deficient initiation and inhibition underlie the psychomotor poverty and disorganisation syndromes, respectively. Furthermore, although the syndromes are associated with impairments in everyday functioning, cognitive competency (CC; cognitive skills for independent living) has been neglected as an outcome. This study tested a three-level model of schizophrenia pathology (Neuropsychological dysfunction → Syndromes → CC), using unstructured neuropsychological tasks to measure initiation and inhibition. Methods. Participants were 40 adults with schizophrenia. A verbal picture description and the Tinkertoy test yielded initiation and inhibition measures with good interrater reliability. Symptoms were rated using the SANS and SAPS, and an insight scale was administered. The Cognitive Competency Test utilised simulated situations to assess CC. Results. Initiation failed to predict psychomotor poverty, but affected CC directly. Only one indicator of disinhibition (intermingling of personal material into speech) predicted disorganisation, which, through mediation, led to CC deficits. Insight correlated with disorganisation and contributed to CC. Unique effects of initiation, disorganisation, and insight, combined, explained 58% of CC variance. Conclusions. Partial support for the three-level model was obtained. Specific neuropsychological abilities and symptoms explain a substantial proportion of the variance in cognitive competency.

Is Impaired Executive Function a Single or Multidimensional Disability?

This study was undertaken to determine if certain logical relations might be found in two pairs of similar executive functioning tasks: (a) Design Fluency and Word Fluency, and (b) the Tinker Toy and Story Telling Tests. Overall, the results were "inconsistent," with there being no meaningful relations found between tests with regard to similarities in task demand, theoretical hierarchical relations, or whether the tasks were verbal or nonverbal (with the exception of a very close relation between Design Fluency and Tinker Toy Test.). Despite the apparent entropy of the findings, they have substantial clinical and theoretical importance given the simultaneously rigid and weak-minded definitions and measures of disexecutive disability in current use.

Rehabilitation of Executive Function Impairments after Stroke

Recent advances in neuropsychological research reveal the importance of cognitive function in stroke rehabilitation. Executive function is the highest function of the cognitive process, however, studies focused on rehabilitation outcomes are rare. Three ACoA aneurysm rupture survivors are trained with self-instructional training, a problem-solving procedure, and physical-set changing exercises for 6 months. Two subjects improved their scores on a neuropsychological test (Tinker-Toy Test) after problem-solving training. Patients revealed improvement in all activities in their everyday lives, including ADLs, instrumental ADLs, leisure activities, etc. These results suggest that a remedy for executive function impairments must be a fruitful area for future research in stroke rehabilitation.

Reliability and Validity of the Tinkertoy Test in Evaluating Individuals with Alzheimer's Disease

The Tinkertoy Test is a self-structured task used to evaluate executive functioning. We examined its psychometric properties and its clinical sensitivity in 84 patients with Alzheimer's disease and 32 control participants. Interrater reliability was high, and subscores were relatively independent of one another. Tinkertoy Test scores differentiated between patients and controls and between patients with mild and moderate dementia. Test performance did not distinguish patients with respect to their results on a measure of ADL functioning. Modifications in the scoring system are suggested to enhance the clinical utility of the Tinkertoy Test.

A developmental study of the Tinker Toy®test: normative and clinical observations

Tinker Toy test performance is presented for a normative group of 5- to 12-year-old children. Contrary to reported findings for some executive function tasks, developmental trends in Tinker Toy Test performance were not found. Results from a large group (N=55) of children who had sustained traumatic brain injury demonstrated that Tinker Toy Test performance was sensitive to the effects of traumatic brain injury and significantly associated with separate clinical ratings of functional or executive impairment. Present findings support the utility of the Tinker Toy Test as one component of the pediatric neuropsychological evaluation following traumatic brain injury.

Differences Between Multi-Infarct Dementia and Alzheimer's Disease on Unstructured Neuropsychological Tasks

Although patients with multi-infarct dementia (MID) may have greater spontaneity than those with dementia of the Alzheimer's type (DAT), conventional neuropsychological tests often fail to distinguish between these two dementias. We studied 18 patients with MID and compared them to 18 comparably demented patients with DAT and 18 normal elderly controls on conventional structured tests and two unstructured tasks, a 3-minute verbal description of the Cookie Theft Picture and the Lezak Tinker Toy Test. On the structured tests, the only significant difference between the two dementia groups was worse performance by the DAT patients on several memory measures. On the unstructured tasks, the MID group had significantly fewer words/minute and constructional assemblages. These results suggest that unstructured tasks help distinguish patients with MID from those with DAT, and that MID patients have decreased spontaneous behavior and initiation, possibly reflecting frontal-subcortical pathology and compromised executive abilities.

Executive functions in the head-injured: Some observations on Lezak's Tinkertoy Test

Executive functions in the head-injured: Some observations on Lezak's Tinkertoy Test

Executive functions in the head-injured: Some observations on Lezak's Tinkertoy Test : Tupper, D.E., Wiggs, E.A., and Cicerone, K.D. New Medico Rehabilitation Center of Troy, Georgetown University, and Johnson Rehabilitation Institute

Executive functions in the head-injured: Some observations on Lezak's Tinkertoy Test : Tupper, D.E., Wiggs, E.A., and Cicerone, K.D. New Medico Rehabilitation Center of Troy, Georgetown University, and Johnson Rehabilitation Institute

Tinker toy test performance and vocational outcome in patients with closed-head injuries.

Fifty patients who had suffered closed-head injury with no resultant physical disabilities and 25 normal controls were administered a modified version of Lezak's Tinker Toy Test. All head-injured patients were examined at least 24 months following medical clearance to return to work. Twenty-five of the head injured had been unable to return to work or sustain normal competitive employment as a result of their head injuries. The remaining 25 had returned to their previous jobs successfully or had been employed for at least 6 months prior to assessment. Whereas all but one of the head injured who returned to work scored normally on the Tinker Toy Test, nearly half of the nonreturnees performed below the level of the worst control.

The Problem of Assessing Executive Functions

Abstract The capacities for formulating goals, planning, and carrying out plans effectively - the executive functions - are essential for independent, creative, and socially constructive behavior. Although they tend to be vulnerable to brain impairment, they are often overlooked in neuropsychological and neurological examinations. Reasons why there are few formalized examination procedures for evaluating executive functions are suggested. Prefrontal contributions and the importance of other brain areas (e.g., subcortical, right hemisphere) to executive functions are discussed. Assessment techniques are presented for evaluating four categories of executive capacities: (1) goal formulation, (2) planning, (3) carrying out goal-directed plans, and (4) effective performance. The Tinkertoy Test, which can provide information about these capacities, is described in some detail. Need for further exploration in this area is emphasized.