Test of Everyday Attention (TEA)

I. H. Robertson, I. Nimmo-Smith, T. Ward, V. Ridgeway

The TEA has three parallel versions, is ecologically plausible and acceptable to patients. It is sensitive enough also to show normal age effects in the normal population.

The test gives a broad-based measure of the most important clinical and theoretical aspects of attention: no other test of attention exists which does this.

It can be used analytically to identify different patterns of attentional breakdown.

The TEA has a wide range of applications, from patients with Alzheimer’s disease to young normal subjects.

It is the only test of attention based largely on everyday materials: the real-life scenario means that patients enjoy the test and find it relevant to the problems faced in life.

There are eight subtests of the TEA:

Map search - Subjects have to search for symbols on a coloured map. The score is the number out of 80 found in 2 minutes. This subtest is age-sensitive and usable with almost all brain-damaged patients, including those with Alzheimer’s disease. It measures selective attention and loads on the same factor as the Stroop Test and the d2 cancellation test.

Elevator counting - Subjects are asked to pretend they are in an elevator whose door-indicator is not functioning. They therefore have to establish which ‘door’ they have arrived at by counting a series of tape-presented tones. This is an established measure of sustained attention sensitive to right frontal lesions.

Elevator counting with distraction - Subjects have to count the low tones in the pretend elevator while ignoring the high tones. This was designed as a subtest of auditory selective attention.

Visual elevator - Here, subjects have to count up and down as they follow a series of visually presented ‘doors’ in the elevator. This reversal task is a measure of attentional switching, and hence of cognitive flexibility. It is self-paced and loads on the same factor as the number of categories on the Wisconsin Card Sorting Test.

Auditory elevator with reversal - The same as the visual elevator subtest except that it is presented at fixed speed on tape.

Telephone search - Subjects must look for key symbols while searching entries in a simulated classified telephone directory.

Telephone search dual task - Subject must again search in the directory while simultaneously counting strings of tones presented by a tape recorder. The combined performance on sub-tests 6 and 7 gives a measure of divided attention - a ‘dual task decrement’.