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

Abstract

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.