Game Guide
Trail Making Test: The Science of Cognitive Flexibility & Training Guide [2026]
Learn about the Trail Making Test (TMT), the classic neuropsychological assessment for processing speed and cognitive flexibility. Understand the science behind it and train your brain flexibility with our free online version.
What is the Trail Making Test?
The Trail Making Test (TMT) is a neuropsychological assessment designed to measure processing speed, visual attention, and cognitive flexibility. Participants connect randomly placed numbers or letters on the screen as quickly and accurately as possible.
The test was originally developed in 1944 as part of the Army Individual Test Battery and was later standardized for clinical use by Reitan (1958). Today, it is one of the most widely used neuropsychological tests in the world.
Scientific Background
History of the Trail Making Test
The Trail Making Test was developed by the U.S. Army in 1944 during World War II to assess the cognitive abilities of military personnel. Following early standardization by Partington & Leiter (1949), Ralph Reitan adopted it in 1958 as part of the Halstead-Reitan Neuropsychological Battery, establishing its modern form.
For over 70 years, the TMT has been used to screen for cognitive decline, brain injury, dementia, ADHD, and other neurological and psychiatric conditions.
Latest Research Trends
Research in 2024-2025 has validated digital and VR versions of the TMT. Digital versions show high correlation with traditional paper-and-pencil methods while enabling standardized test administration and automated scoring.
The Science of Cognitive Flexibility
Cognitive flexibility is the ability to quickly switch between different tasks or rules. It is a core component of executive function, supported by networks in the prefrontal and parietal cortices.
TMT Part B specifically measures cognitive flexibility. The task of alternating between numbers and letters requires constant switching between two different categories (numerical sequence and alphabetical sequence).
Research shows:
- The B-A score (Part B time minus Part A time) is a purer measure of cognitive flexibility
- Part A time primarily reflects processing speed and visual-motor ability
- Cognitive flexibility tends to decline with age but can be improved with training
- People with ADHD or frontal lobe damage often show particular difficulty on Part B
Cognitive Abilities Measured
Processing Speed
The ability to quickly process information and respond. Measures efficiency from visual input to motor output.
Visual Search
The ability to find specific targets within the visual field. Quick identification of target numbers or letters is required.
Cognitive Flexibility
The ability to quickly switch between different rules or tasks. Particularly important for Part B.
Motor Speed
The ability to move accurately and quickly between targets. Requires hand-eye coordination.
How to Play
Select Mode
Choose Part A (numbers only) or Part B (alternating numbers and letters). Beginners should start with Part A.
Find the Target
Locate the next target among the randomly placed numbers (and letters) on the screen.
Tap in Order
For Part A, tap 1→2→3→...→25 in order. For Part B, tap 1→A→2→B→3→C→...→13 in sequence.
Complete the Trail
Connect all targets as quickly and accurately as possible. Your completion time is your score.
Score Guide
Part A (Numbers Only)
| Completion Time | Rating |
|---|---|
| Under 30 seconds | Excellent - Very fast processing speed |
| 30-45 seconds | Good - Above average performance |
| 45-60 seconds | Average - Typical adult range |
| Over 60 seconds | Room for improvement |
Part B (Alternating Numbers and Letters)
| Completion Time | Rating |
|---|---|
| Under 60 seconds | Excellent - High cognitive flexibility |
| 60-90 seconds | Good - Above average performance |
| 90-120 seconds | Average - Typical adult range |
| Over 120 seconds | Room for improvement |
Individual Differences
TMT scores are significantly influenced by age and education level. Different norms apply to older adults and those from language backgrounds that don't use the Roman alphabet daily. Focus on your own improvement rather than comparing with others.
Tips and Strategies
-
Survey the field first - Before the timer starts, get a general sense of where all targets are located. This reduces search time.
-
Anticipate the next target - While tapping the current target, use your peripheral vision to locate the next one.
-
Don't expect patterns - Targets are randomly placed. Stay flexible in your search rather than expecting specific patterns.
-
Prioritize accuracy - Focus on accuracy over speed. Wrong taps cost time.
-
Verbalize for Part B - Saying "1...A...2...B..." mentally (or quietly aloud) can help smooth your switching.
Difference Between Part A and Part B
| Feature | Part A | Part B |
|---|---|---|
| Content | Numbers 1-25 only | Numbers 1-13 + Letters A-L |
| Sequence | 1→2→3→...→25 | 1→A→2→B→...→13 |
| Measures | Processing speed, visual search | Cognitive flexibility, set-shifting |
| Average Time | ~29-39 seconds | ~61-91 seconds |
| Brain Regions | Primarily parietal | Prefrontal cortex additionally involved |
The B-A score (Part B time minus Part A time) is used as a purer measure of cognitive flexibility, removing the effects of motor speed and visual search.
Clinical Applications
The Trail Making Test is used in various clinical settings:
| Application | Description |
|---|---|
| Dementia Screening | Early detection of mild cognitive impairment and dementia |
| Brain Injury Assessment | Cognitive function evaluation after traumatic brain injury |
| ADHD Evaluation | Assessment of attention and executive function |
| Depression Assessment | Measuring cognitive impact of depression |
| Treatment Monitoring | Confirming effectiveness of rehabilitation or medication |
Combining with Other Training
The Trail Making Test combines well with other cognitive training:
| Training | Focus | Combination Benefit |
|---|---|---|
| Dual N-Back | Working memory updating | Comprehensive executive function training |
| Flanker Task | Interference inhibition | Trains both selective attention and flexibility |
| Stroop Test | Inhibitory control | Trains different types of cognitive control |
Related Articles:
FAQ
Q:
Summary
The Trail Making Test has been a standard tool for neuropsychological assessment since its development in 1944. Despite its simple "connect-the-dots" format, it measures multiple important cognitive functions, from processing speed to cognitive flexibility.
Cognitive flexibility, as measured especially by Part B, is a crucial ability in daily life. It comes into play when processing multiple tasks simultaneously, adapting to unexpected situations, and finding new problem-solving approaches—skills highly valued in modern society.
Regular practice can help maintain and even improve these cognitive abilities. Start with Part A and gradually challenge yourself with Part B.
Related Articles
Start Training Your Brain Today
Experience scientifically-proven cognitive training with our free app