How does the TOLDX differ
from other tower systems, including that developed by Shallice
The TOLDX incorporates 6- to 7-move problems;
permits only one trial per test item; provides standardized
instructions for administration, scoring, and interpretation;
and presents extensive norm data for ages 7-through 60+ years
How does the TOLDX
differ from the TOH?
The TOLDX structure employs three pegs of
descending height, and beads or rings of similar size and different colors, whereas the TOH structure is
comprised of three pegs of equal height and rings or disks of
descending size. Both
the TOH and TOLDX prohibit the examinee from
removing more than one ring/bead at a time from the pegs in
solving test items. While
the instructions for performing the TOH prohibit the placement
of a larger ring on top of a smaller ring, the instructions
for the TOLDX do not permit the placement of more
beads on a peg than it is designed to hold. Finally, there is
increasing evidence that the TOLDX and TOH measure
different psychological constructs.
Do females and males differ
in their TOLDX performance?
In analyzing the TOLDX normative data, there was
minimal evidence of a difference in TOLDX
performance as a function of gender.
What clinical groups have
been compared to normal children/adults with the TOLDX?
Our initial efforts focused on developing normative data for
the TOLDX with healthy children and adults.
We have now turned our attention to different clinical
example, we have draw normative data for children (n =
200+) with attention-deficit/hyperactivity disorder (ADHD). Additionally, Dr. Carrie Kennedy studied a group of mentally
retarded adults (n = 64) who were assessed with a
battery of neuropsychological measures, including the TOLDX,
to determine their competency in rendering sexual consent.
This latter data is included in the TOLDX
Which TOLDX scores
have been found most clinically useful?
Although all seven scores provide valuable information
concerning executive planning and problem solving, the three
that have been found to be most clinically useful are Total
Move Score, Rule Violations, and Execution Time.
Who should use the TOLDX?
Any professional who is interested in assessing executive
planning and problem solving can potentially use the TOLDX.
However, it is important that the user have an
understanding of brain-behavior relationships (particularly
the complexities of the developmental trajectory of executive
functions) and possess the necessary clinical skills to
carry out a competent assessment.
Should the appraisal of an
individual’s executive functions be based solely on the TOLDX?
No, an adequate assessment of executive functions requires a
comprehensive evaluation involving multiple measures of
executive and non-executive functions.
The TOLDX provides but one sample of
executive functioning, specifically planning and
problem-solving, that can be integrated with other data to
draw pertinent conclusions.
How much time is allotted for
each TOLDX test item, and when is a time violation
The time limit for each TOLDX test item is 2-minutes.
If the examinee fails to solve a given test item within 1-minute, a
time violation is scored, but the individual’s performance
is not interrupted until the 2-minute limit is reached.
If the examinee has not solved a test item at the
expiration of the 2-minute time limit, a score of 20 is assigned regardless
of the number of moves that have been executed.
For example, if a child/adult, at 2-minutes, has made
16 unsuccessful moves on test item 10 (a 7-move problem), (s)he is asked to suspend performance, and the item move
score is calculated as follows: 20 - 7 = 13.
The perceptive reader will note that a time violation
is also scored at 1-minute for this item.
What is the rationale for
assigning a time violation at 1-minute?
In our preliminary research with the TOLDX we found
that the majority of children/adults solved the individual
test items within 1-minute. Thus, solving TOLDX
items in a minimum number of moves within 1-minute suggested
relatively effective planning and problem solving.
The extra 1-minute (time limit per test item is 2-minutes) was added to enable the clinician to differentiate
between the slow-accurate and slow-inaccurate planner and
Do children and adults find
the TOLDX to be “user friendly?”
Without a doubt! Most
children and adults report that they find the measure
game-like appearance is appealing to both children and adults. The hands-on nature of the measure, coupled with its limited
demands for verbal or academic skills, is attractive to many
individuals, particularly those with impaired or limited