An Investigation of the Relationship of Student Performance on the Wisconsin Card Sorting Test with Other Clinical Measures

Abstract

The Wisconsin Card Sorting Test (WCST) is widely used for neuropsychological assessment of executive functions. Although the literature notes that the WCST is a measure of abstract reasoning and cognitive flexibility, there has been little data relative to the constructs that are assessed when the test is used with children or to the relationship between WCST performance and performance on other child assessment tools. This study of 94 children and adolescents referred for psychological evaluations investigated the relationship between scores obtained on the WCST and scores from child and adult versions of the Wechsler intelligence scales and the Delis-Kaplan Executive Function System, and selected Scale scores from the Behavior Rating Inventory of Executive Functions and the Behavior Assessment System for Children, based on ratings obtained from parents and teachers. The results suggest a modest relationship between WCST scores and the scores from other cognitive tests and rating scales, although students generally received higher Wechsler Matrix Reasoning scores than WCST Conceptual Level Response scores. In reviewing the performance of these 94 students, results also suggest differences in performance, based on test administration format (computer or manual) and by age groupings, with older students outperforming younger in spite of age-corrected scores. Analysis of response patterns, particularly the number of trials to complete the second set, and of performance observations suggest that use of a process approach may be helpful in identifying set-shifting and sustained attention difficulties of students not otherwise identified, using the existing WCST scoring procedures. This study suggests that the WCST may offer unique and important insights into the executive function capacities of children and adolescents.

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