doors & people manual
DESCRIPTION
manual del test doors & peopleTRANSCRIPT
DoorsandPeople
Manual
A test of visual and verbalrecall and recognition
MRC Applied Psychology UnitCambridgeEngland
Doorc end Peoplc
Alan BaddeleyHazel Emslielan. Nimmo-Smith
Thames ValleyTest Company
Bury St Edmunds, England, 1994 Thames Valley Test Company
Doors and People
All rights reserved
Copyright @ 1994, The authors
This test may not be reproduced, in whole or in partin any form (except by reviewers for the public press)without written permission from the publishers.
PublishedbyThames Valley Test Company7-9 The GreenFlemptonBury St EdmundsSuffolk IP28 6ELEngland
Printed by '
The Northgate Press LtdUnit D AutoparkEastgate StreetBury St EdmundsSuffolk IP33lYQEngland
ISBN 1 874261709
Alan Baddeley,Hazel Emslie, Ian Nimmo-SmithMedical Research Council, Applied Psychology Unit15 Chaucer RoadCambridge CB22EF'England'
Acknowledgrnents
§7e would like to acknowledge the help given by thelate Paul R Pearson in the selection and recruitmentof subjects at the §fedgwood Day Hospital, Bury StEdmunds.
rJü'e are particularly grateful to Julia Darling for hergood humoured efficiency in preparing the testingmaterial and designing the scoring sheet.
Contents
4 Introduction
4 I Why another test ofmernory?4 The Doors and People test
5 2 Description ofthe test5 2.1 Visual recognition: the Doors Test5 2.2 Visual recall: the Shapes Test5 2.3 Verbal recognition: the Names Test6 2.4 Verbal recall: the People Test
6 3 Collectingperforrnance norms
7 4 The validity ofthe Doors and Peoplctest
8 5 Instructions for administering andscoring the Doors and People test
8 5.1 Verbal recall: the People Test8 5.2 Visual recognition: the Doors Test9 5.3 Delayed verbal recall9 5.4 Visual recall: the Shapes Testl0 5.5 Verbal recognition: the Names Test10 5.6 Delayed visual recall
10 6 Cornpiüngarnernoryprofile10 6.1 The overall score11 6.2 Visual-verbaldiscrepancies11 6.3 Recall-recognitiondiscrepanciesI I 6.4 Forgetting scores
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NorrnsTable I Verbal recall (People)Table 2 Visual recognition (Doors)Table 3 Visual recall (Shapes)Table 4 Verbal recognition §ames)Thble 5 Overall scoreTable 6 Combined yisual scoreTable 7 Combined verbal scoreTable I VisuaVverbal discrepancyTable 9 Combined recall scoreThble 10 Combined recognition scoreThble 1 I Recall-recognitiondiscrepancyTable 12 Forgettingscore (verbal)Thble 13 Forgetting score (üsual)Thble 14 Overall forgetting scoreTable 15 Correspondence between scaled
scores and percentiles
Appendix 1: Examples of scoring in theShapes Test
References
4 Doors and People lntroduction
lntroduction
Deficits in learning and memory are among the mostcommon and disabling consequences of brain damage,whether resulting from traumatic injury or progressivedisease. Such deficits can be devastating, not only be-cause of their impact on everyday life, but also becausethey influence the patient's capacity to benefit fromtherapy, both through their impact on the comprehen-sion and retention of instructions, and through the roleof memory in the re-learning that must inevitably formthe basis for rehabilitation. Even when the task to be re-learnt does not intrinsically depend on episodic mem-ory, the process of learning and the capacity to elimin-ate erroneous responses may be heavily dependent onmemory capacity (§7ilson, Baddeleg & Cockburn,1989). It is therefore important to be able to assessmemory accurately as a precursor to adequate therapy.There are of course very many psychological tests ofmemory, so why do we need another?
I Why another test of memory?
It has become increasingly clear in recent years thathuman memory is not a unitary function. Of the verymany individual tests of memory that exist, a largenumber simply do not have adequate populationnorms. Those that do rarely offer a broad theoretically-based estimate of both visual and verbal memory, com-bined with scores of learning and forgetting, recall andrecognition. The Rioermead Behavioural Memory Test
flWilson et al., 1985), for instance, explicitly aims toprovide a screening test that will allow the clinician topredict the extent to which a patient will experienceeveryday memory problems. It does not atternpt toanalyse the nature of the underlying deficit in learningand memory. The present test was therefore designedwith the following desirable traits in mind: (l) It shouldprovide comparable measures of visual and verbal mem-ory; (2) In each case it should test borh recall and recog-nition; (3) It should provide an unstressful test that isacceptable to a wide range of subjects extending frompatients suffering from dementia or dense amnesiathrough to healthy young normal subjects; (4) It shouldprovide scores that avoid floor or ceiling effects; (5) Itshould include both learning and forgetting measures;(6) There should be a simple check that deficits are notdue to perceptual problems; (7) The visual-verbal,recall-recognition measures should each be based ontwo separate sets ofobservations to ensure that conclu-sions are reliable; (8) The test should be reasonablyshort; (9) It should have high face validity and be readilyacceptable by both patients and professionals.
The Doors and Peopletest
The test evolved as a result of a request from the Scien-tific Committee of the Amnesia Association to generatean improved measure of üsual long-term memory.It was felt that existing tests all had certain drawbacks.The Rey Osterreith figure is widely used (Osterreith,1944), but gives a single measure based on a highlycomplex pattern that makes substantial demands on theperceptual and copying skills of the patient, as well as
those of memory. The Rezlised Wechsler Memory Scalealso has visual subtests flWechsler, 1987), but some ofthese almost certainly encourage verbal coding, whileothers fail to allow for the possibility that distortionsmay be due to problems in drawing rather than memory.This could be avoided by requiring the subjects to copythe figures first, but this would then render the existingnorms invalid. rü/arrington's (1984) visual and verbalrecognition tests provide what are probably the bestavailable joint measures, but the verbal test may sufferfrom ceiling effects when used with normal subjectsor mildly impaired patients (Sunderland, Harris, &Baddeley 1983), while the face recognition tesr suffersfrom the problem of whether it assesses a specialisedface memory system, rather than a more general visualmemory. Furthermore, poor performance may be dueto either perceptual or mnemonic deficits, and whilethis may not present a problem to a neuropsychologistcarrying out a thorough examination, it could be mis-leading in the hands of a therapist whose neuropsycho-logical expertise is limited.
§7e began by designing an alternative visual recogni-tion test. §7e chose as our material pictures of doors,which have the advantage of being meaningful, visuallyrich and yet, provided the distractors are carefully cho-sen, allow little help from verbal cues. For the verbalequivalent, we chose names as again offering materialthat is ecologically meaningful, but where coding interms of meaning or visual imagery seems much lesslikely than would be the case for unrelated words. Fortesting recall and learning of visual material, we chosefour examples from the very numerous versions of thecross. Again these tend to have an obüous significance,but one which is unhelpful in remembering the detailnecessary for adequate performance. Furthermore thedegree of draughtsmanship required in reproduction isminimal. In the case of verbal learning we chose toteach the subject the names of four people, since thisoffered an ecologically plausible task which could read-ily be scored. Finally we used both of the delayed recallmeasures to give an indication of forgetting over a briefdelay.
Doors and People
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2.1 Visual recognition: the Doors Test
The stimuli are coloured photographs of doors. Thedoors are from different r],pes of buildings (e.g. houses,garages, sheds, barns, churches, public buildings),they vary in age from mediaeval to late 20th centuryand their condition ranges from pristine to dilapidated.The photographs were taken in England, France, Italyand Germany. There arc27,target, doors and gl dis_tractors. The target doors are mounted singly on agrey background. For the recognition set each target ispresented with three distractors in a 2 x 2 matrix, withthe position of the rarget door in the array counterbal_anced. Three of the target items are for practice and theremaining targets are in two sets of twelve, an easy set(A) and a harder set (B). The recognition test for theeasier set is given before the harder test is begun.
From over a thousand photographs ofdoors, thirtytwo groups offour photographs were selected, eachgroup comprising a target and three distractors fromthe same category, i.e. if the target was a church door,the three distractors were also church doors. Groupswith differing degrees of difficulty were constructedby varying the degree of similarity between target anddistractors. In the easiest groups the distractors werecompletely different from the target, e.g. when the tar_get was a plain pine door the distractors were (a) a glasspanelled door, @) a door painted green and yellow and(c) a red painted door with a stained glass window Inthe moderately difñcult groups the doors themselveswere somewhat different but with similar surroundings,e.g. plant covered walls. In the most difficult groups thefour doors in each group were of similar styles, e.g.made of pine with nail patterns on them, but differedfrom each other on at least two features, e.g. differentkinds of door handles, bell-pushes, stone surrounds,plants, etc. After a series of pilot studies in which arange of target items and distractors were tested, allitems with error rates of more than75 io were discardedand two sets of twelve targets with their attendantdistractors were selected and used to create an easy set)set A, and a harder set, set B. The targets in each set arepresented in one random order and tested in a differentorder.
2.2 Visual recall: the Shapes Test
The stimuli for this test are four line drawings of crosses.Each drawing is in black ink on a rectangular white card.The four cross shapes that were chosen, potenr, pom_mee, quadrate and Celtic, came from a larger pool ofcrosses which had been judged as easy to copy by ninesubjects who had rated themselves as bad at drawing.Items were selected that varied sysrematically on three
dimensions, overall shape (elongated or square), pres-ence of features at the end of the arms, and presence ofa feature at the intersection of the arms.
2.3 Verbal recognition: the Names Test
The test stimuli are forename/surname pairs. Thesurnames were taken from the Cambridge telephonedirectory. The forenames were taken from a list of themost f¡equently generated names in a semantic categ_ories test of male and female English and Scottish sub_jects (Logie, 1930). There arc 27 ,target, names and g1distractors. The target names are mounted singly onwhite card. For the recognition test the targets are eachpresented with three disuactors (all of which shared thesame forename) in a vertical list with the position of thetarget in the list counterbalanced. Three of the targetitems are for practice and have male forenames. Theremaining targets comprised two sets of twelve, an easi_er set (A) which has female forenames, and a harder set(B) which has male forenames. The recognirion tesr forthe easier set is given before the harder set is begun-
Groups of names with differing degrees of difficultywere constructed by varying the similarity between thetarget surname and its distractors. In the easiest groupsthe target and distractors were either low-frequencynames with the same initial letter (e.g. DIANENAB_NEY, DIANE NEESON, DIANE NORFAR, DIANENUSSEY) or the target was a low-frequency name andthe distractors were high-frequency names (e.g. SARAH§rRIGHT, SARAH BOGGIS, SARAH HARRIS, SARAHTAYLOR). In the intermediate groups the target anddistractors were high-frequency names with the sameinitial letter (e.g. MARTIN, MILLER, MITCHET L,MARSHALL). The most difficult sets were those in
ó Doors and People
which all the surnames were low frequency with identi-cal first or second syllables (e.9. BROWNHIL¿, BROSIN-LO§7, BRO§(rNELL, BRO§(TNLEE). In all groups targetand distractors had the same number of syllables and,as far as possible, the same number of letters.
Several pilot studies using subjects from a widevariety ofbackgrounds and age groups were neededto eliminate all names which were associated with a
well-known person or company, to eliminate nameswith error rates of more than 75%o and to ensure thatthere was no overlap between targets and distractorsin different groups in the resulting final sets of names.Presentation order of targets was randomised and adifferent random order was used in the recognition test.
2.4Yerbalrecall: the People Test
The stimuli comprise three high-frequency and onelow-frequency forename/surname pairs of differingsyllabic length. Each name is paired with an occupationand presented to the subject as a caption to a colouredphotograph, thus a clean-shaven, bespectacled forty-year-old has the label [M GREEN - DOCTO& a beard-ed and bespectacled fifty-year-old has the label CUTH-BERT CATTERMOLE - MINISTE& a smiling twenry-year-old is TOM§íEBSTER-POSTMAN and a cheerfulthirteen-year-old is PHILIP ARI4STRONG - PAPERBOY-
The four occupations that are used were selectedbecause they would seem to be relevant to most sub-jects. None of the forenames or surnames is used in theverbal recognition test (Names Test).
Collecting performance norms
3 Collecting performance norms
§7e tested a stratified sample of 238 subjects compris-ing approximately equal numbers of subjects from eachof the six social class categories (I, II, [I(N), III(M), IV,and V) as defined in the Office of Population Censusesand Surveys'Classification of Occupations 1 980' (pp.x-xi) and balanced so as to have approximately equalnumbers of men and women in each category fromeach of the four age bands, 16-31, 32-47, 48-63,64-79, plus a fifth similarly balanced group, 80-97year olds, which contained about two-thirds of theaverage number of subjects. As in our preüous studiesinvolving the collection of population norms (Baddeley,Emslie, & Nimmo-Smith, 1992), we chose to have anapproximately equal number of subjects in each sub-category, rather than sample categories on the basis oftheir frequency of occurrence in the population, sincethis would have led to very small and unreliable sam-ples for some of the more extreme categories, given theoverall size of the sample that was feasible ro test. Aswe have noted elsewhere (e.g., Baddeley, Emslie, &Nimmo-Smith, 1993) recruiting a balanced sampleis far from easy given the reluctance of some elderlypeople to have their memory tesred and a generalreluctance on the part of people from the lower socio-economic groups to participate in anything involüngtests of language. There is a danger under such circum-stances that those who agree to be tested are atypical.rJTe went to great lengths to avoid volunteer bias byselecting subjects purely on the grounds of age andoccupation and then approaching each one personallyand arranging to test them in their own homes at what-ever time was convenient to them.
In addition to the Doors and People test, subjectswere tested on a four-choice version of Spot-the-lYord(Baddeley et al., 1993) and the NaúonalAdult ReadingTZsr §ART) (Nelson, 1982).
Figure 1 shows the distribution of scores across agebands for the four subtests. A principal axis factoranalysis of these data yielded three factors. The first ofthese was a general memory factor which accounted for62.1% of the variance, and showed a systematic declinewith age. The second appeared to be a verbal/visualfactor accounting for a further 16.0% of the variance,and was not related to age in any simple way. The thirdfactor, accounting for a further L2.6% of the variance isharder to interpret since it loads positively on the Doorsand People subtests and negatively on the Names andShapes subtests. It is marginally influenced by age(0.05 < p < 0.1). The major conclusion to be drawnfrom this analysis is the importance within the normalpopulation of the general memory factor, together witha much smaller contribution of the üsual/verbal dis-tinction.
Doors and People Validity of the test
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7
Figure 1
Mean and +/- standard deviation by age group for each test
Doors Testscore
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Shapes Testscore
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Names Testscore
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People Testscore
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In the process of developing the test, we have used itto study a wide range of subject groups, from elderlypatients with Alzheimer's disease to healthy younggraduate students. The relevant studies will be reportedelsewhere, but indicate that the test does indeed have awide range of applicability and is sensitive to effects ofAlzheimer's disease, stroke, normal ageing and schizo-phrenia. The capacity of the test to measure visual andverbal memoryhas been verified in a study comparingpatients who have undergone left and right temporallobe surgery as a treaünent for temporal lobe epilepsy.
It is already clear from these studies that the testgives a robust and sensitive overall memory score, andthat the detailed pattern ofperformance varies fromone patient group to another in ways that suggest thatdifferent aetiologies result in different pafterns of mem_ory deficit. However, until such patterns have beenreplicated we prefer to emphasise üe overall score as
being the most robust feature of üe test. In using sub_test scores, it is important to bear in mind that they arelikely to have a narrower range than the overall score,and to ensure that any differences in the detailed pat_tern of memory deficit are not unduly influenced byany truncation in range ofscores for the age group con_cerned. As with any test, the true clinical and researchvalue of the Doors and Peopletestwillonly emerge fromits use in practice.
8 Doors and People
5 lnstructions for administering and scor¡ngthe Doors and People test
When the full battery of tests is used the followingorder should be followed:1 The People Test
immediate verbal recall with a maximum of threelearning trials.
2 The Doors Testvisual recognition - sets A and B.
3 The People Testdelayed verbal recall.
4 TheShapesTestimmediate üsual recall with a maximum of threelearning trials.
5 The Names Testverbal recognition - sets A and B.
6 TheShapesTestdelayed visual recall.
§(rhen only a subset of the tests is used it is importantto ensure that there is at least one intervening task be-tween the immediate and delayed trials in the recalltests. The intervening task(s) should not be of a similarnature and the delay should be not less üan 10 and notmore than l5 minutes.
It is important to note that although there is asummary of the procedure on the scoring sheet, thisis simply a reminder. Testers must consult the relevantpages of this manual for the exact procedure to befollowed.
The tester should introduce the test battery to thesubject with a general preamble to the effect that all thetests are to do with memory, saying something like,
'There are sez.teral kinds of memory but the ones wewill be concerned with now are oisual memory, that ismemory for uthat we have seen, qnd oerbql memory, thatis memory for words. We are going to start with memory
for names'.
5.1 Verbal recall: the People Test
Say:'I am going to ask you to learn the names of four people:a doctor, a minister, a postma,n and a paper boy, I haoea photograph of each of thefour people with their nameand theirjob written underneath on these cards here.The photograph is just to help you remember the names.I am not going to test your memory for the photograph.I just want you to concenta,te on remembering the fore-name and the s'urname.'
'I will show the cards to you one at a time and after youhazte seen allfour pictures and names I will say:'Tell methe doctor's name) tell me the minister'srtarr,e' andso on. Do you understand what you ha,zLe to do? Don'tworry if you can't remember them all staight away.The test is designed so that no one can remember thefournames first time. lX/hat we are interested in is how people
lnstructions
leartt names so I will show you the cards for a second imeand ask foi all the names again and then I'll shoza youthemfor the third tirue and see how you do. OK?'
The tester turns over the first page of the People Testitems and says:
'This is the docnr. His name is Jim Green'.
§üait for 3 seconds (long enough for the sub¡'ects torepeat it if they wish) and then turn over the second cardand say:
'This is the minister. His name is Cuthbert Cattermole'.
Repeat for the other two cards. After the fourth removethe cards and say:
'Now let's see'if you can remember them. tYlhat was thedoctor's name? ... the minister's name? .. . ' and so on.
If the subject correctly recalls all four forename/sur-name pairs terminate the test. If there are any errorsmake encouraging noises like:
'That's oery goodfor afirst attempt. You might be
surprised to know that the aaerage first time is onlyone name and perhaps a bit of another'.
Then repeat the procedure as before showing all fourcards and asking for all four names. If there are anyerrors repeat for the third and final time showing allfour cards and asking for all four forename/surnamepairs.
Scoring: 1 mark for each forename or surname cor-rectly recalled plus an extra mark for a correct pairing,making a maximum score of 12 per trial - e.g.: Cuth-bert Catchpole or Colin Cattermole score 1, CuthbertCattermole scores 3.
Scores for the three trials should be combined andThble 1 (p. l1) used to derive an age-scaled score. (All '
the scaled scores in ihis manual are a number between 1
and 1 9, each scale point representing 1/z of a standarddeüation. The correspondence between scaled scoresand percentiles is shown in Tábte 15, p. 19.) Note thatsubjects should be credited with a score of 12 for anyof the three trials remaining after reaching criterion.Flence a subject who scored 8 on Trial I and 12 on Trial2 would be credited with 12 for Trial 3, even though athird trial is not given, making a total score of 32.
5.2 Visual recognition: the Doors Test
Say:
'We are now going to see hout good you are at recognisingthings you haoe seen before)
'I am going m show you pictures of üfferent kinds ofdoors. There are front doors, back doors, stable doors,shed doors, new doors, old doors, English doors, infactmarry kinds of doors. After I haae shown you the picruresI want to see if you can recognise those doors again.'
'Let me show you what I mean with these firstfew pho-tographs which are just for practice. I am going to showyou a photograph of a door and ask you to look at it for
Doors and People lnstructions
3 seconds- A little while later I zlill show you a page withphotographs of four dffirent doors on it, one door thatI showed you earlier and three that you haz¿e neaer seenbefore. I want you to point out the one I showed youearlier. Let's do these practice ones together.'
The tester turns to the first practice target and says:'This is a workshop door'.
After 3 seconds the tester turns over the page and says:'Now can you find a photograph of that door on this
page?'.
§(¡hen this has been successfully completed say:'In the actual memory test you will do in a moment thereare 12 doors for you to look at before you are asked, to pickthem ou6 but to make sure I haae explained the test prop_erly I haae two more doors for gou to practice on'.
Show the second and third targets for 3 seconds eachsaying:
'afront door' and'a barn door',
then turn the page and say:'lVhich one of these doors did I show you?'.
Ask the same of the next page.
\X/hen the subject has understood the procedure,explain again that there are l2 photographs in the setand that they will see all l2 doors before they are askedto recognise them.
Present the targets at 3-second intervals giving averbal label with each. The labels for the practice itemsare workshop, front and barn, andsuggested labels forthe twelve test targets atefront, churchrfront, stable,front, garage, city hall, English cottage, shed, English pub,stable and garage. These labels are printed on the scor_ing sheet. The important point here is to provide thesubject with a plausible label that will noiin fact allowthe target to be discriminated from the three distrac_tors, hence forcing the subject to rely on visual ratherthan verbal memory.
The second set of doors is more difñcult than thefirst and can, if necessary be omitted if a subject hasscored less than 9 on set A. It is however, preferable togive both sets, since this will proüde a more reliablemeasure of performance. Explain that you have a sec_ond set of twelve doors which are a bit more difEcultthan the first in that the four doors that subiects have tochoose from are more similar than they were in the firstset so the subject will have to look quite carefully ateach photograph. The procedure is exactly the same asfor set A: Thrgets are presented at 3-second intervalsand given a label. Suggested labels arey'o nt, Frenchb arn, front, old wooden, front, Italian, garage, Spanish, oldEnglish,front, German, another old English.
Scoring: I mark for each correct response) giving amaximum score of l2 per set.
Scores on sets A and B shou'ld be combined andan age-scaled score derived from Thble 2a (p. 12).Separate scores for sets A and B are provided in Table2b and 2c for those cases in which only one set has beenused.
5.3 Delayed verbal recall
Say:
'A little while ago I asked you to learn the names of fourpeople, a doctor, a minister, a postman and a paper boy.Do you remember? ... Well now I would like you to tell methose names again. What was the doctor's name? ,..' etc.
Scoring: Score as for verbal recall. The use ofa forget_ting score is described on page I1.
5.4 Visual recall: the Shapes lbstIt is important to note that for the copying stage only,each drawing is left in front of the subject for as long asit takes him/her to copy it. The reason for telling sub_jects to look at each drawing for 5 seconds befoie theystart copying, is to ensure they have looked carefully atthe whole picture. For the recall trials the drawings are,of course, removed before recall begins.
Explain that you would now like to see how good thesubject is at remembering things they have seen. Say:
'I hazte herefour simple drawings. I will show each draw_ing to you in turn and ask you to look at hfor 5 secondsand then copy it. tilhen you hazte drawn alt four I rtill askyou to draw them again from memory. Don,t worry ifyou can't remember them all thefirst time because youzpill be allowed three attempts at remembering them, justas you did with thefour names earlier.'
Put copying page (a sheet of plain paper) A4 or US let_ter) in front of subject with a pencil and eraser and say:
'I am going to shozl you thefirst one.'
Open the People and Shapes Test booklet at the firstshape, place in front of the subject and say:
'Look at itfor 5 seconds and then draw it here'[point to top left quadrant].
Leave the picture of the shape there until subject hasdrawn it. Repeat for the other three shapes. After all fourshapes have been copied, conceal the pictures and thecopy, give the subject a second sheet ofpaper and askthem to draw the four shapes again from memory.Explain they can do them in any order and it doesn,tmatter which space they put them in. If a subject doesnot recall all four drawings the trial ends either whenthey say they can not remember any more or after theyhave not drawn anything for 15 seconds. Then saysomething like:
'Don't worry, that\ goodfor afirst attempt, you can haaetwo more goes'.
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I0 Doors and People Compiling a memory profile
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Then femove their first attempt. IJnless performanceis perfect, a second learning trial is given in which thefour drawings are presented again, this time for only 3seconds each. All four are shown before the subject isasked to draw all four shapes again from memory. Ifnecessary repeat for a third time. Note (a) that subjectsare not allowed to copy the drawings when they areshown them for the second and third times and (b) theword 'cross' is neoertsed.
Scoring: 3 marks per drawing, maximum to¡al= 12Details of how to mark the drawings are given in
Appendix 1 (p. 1 9). Scores for the three trials shouldbe combined as for the verbal recall subtest, and age-scaled scores derivedfromThble 3 (p. 13).
The range of copying scores is typically 10-12.In our sample the only subject to score less than thisscored 9. There was no evidence for an associationbetween a less than accurate copy and low learningscores. A copying score ofless than 9, therefore, couldindicate perceptual or motor problems and should beinterpreted with caution.
5.5 Verbal recognition: the Narnes Test
say:'Now I haoe got some rnore names for you, but th,is timeI am not asking you to remember them all, I am goingto ask you ro recognise them when you see them againlater. I am going to show you & name and ask you to readthat name out loud just to help you remember it. Later Iwill show you a group of four names and ask you to pointto the name that you were shown earlier. Let's do these
first few togéther for practice.'
Show Martin Chapman and ask the subject ro say thename. (This ensures that (a) there is no üsual/percep-tual problem, (b) the subject is literate and (c) guaran-tees verbal encoding.)
Then turn the page and say:
'Can you show me the name you hazse just seen?'
Repeat the trial if necessary. Then say:'This time I will shou: you two names and see if you canrecognise them'.
Show Geor§e Dou;son andJames Fitzjohn andthen theJamespage and say:
'You willfind one of those names there') wait for aresponse and turn to the next page: 'and the otherna.me there'.
§(/hen subjects have understood what is required ofthem explain that you are now going to show them 12names. This time the first names are female names andsubjects are shown all 12 names before they are askedto recognise them. The tester presents the female fore-name/surname pairs at 3-second intervals, having thesubject read each one as it is presented.
The second set of (male) names is more diffrcultthan the first and can be omitted if patients score lessthan 9 on the female set. Ffowever, it is preferable togive both sets as this will proüde a more robust andreliable measure. The procedure for presentation andtesting of the second set is exactly the same as for thefirst set.
\Vhile it is preferable for the subject to read our thenames, it is acceptable for the tester to read the nameswhen the patient is illiterate or has visual problems thatseriously interfere with reading.
Scoring: 1 mark for each correct response) giving amaximum score of 12 per set.
Scores on sets A and B should be combined and anage-scaled score derived from Thble 4a (p. I 3). Tábles4b and 4c provide separate scaled scores for sets A andB for cases where only one set has been presented.
5.6 Delayed Visual Recall
say:'A little while ago you didfour drawings for me. I'd likenow to see how well you remember them. Can you drawas malty of them as you can remember?'
Put another sheet of paper down in front of the subjectwith a pencil and eraser and terminate the test eitherwhen all four shapes have been attempted, when thesubject says he/she can not remember any more, orwhen nothing has been drawn for 30 seconds.
Scoring: Score as for visual recall. The use of a forget-ting score is described on page I 1.
ó Compiling a memory prof¡le
6.1 The overall score
This is likely to be the most reliable and sensitive indexof episodic memory performance, based on virtually allthe available data from the test. It is derived by simplyadding the scaled scores from the four subtests andderiving an overall scaled score from Thble 5 (p. 14).
The overall score can be broken down so as to con-trast verbal and visual scores or recall and recognition.In each case, subscores are based on two sources ofevidence, so as to reduce the chance that a lapse ofattention at some point during testing could be falselyinterpreted as a specific deficit. It is however, importantto bear in mind that subscores and scores based ondifferences between subscores will inevitably be lessreliable than the overall score. Furthermore, clearmodality-specific deficits, or differences between recalland recognition memory are rare compared to occur-rences of a more general memory deficit. Consequently,observation ofsuch deficits should be taken as indicat-ing the need for more extensive exploration, rather thansimply taken at face value.
Doors and People
6.2 Visual-verbal discrepancies
Visual memory scores are obtained by adding thescaled scores for the Doors Test and Shapes Test. Thble6 (p. t5) gives a combined scaled visual score.
Verbal memory performance may be assessed sepa_rately by combining the scaled scores from the NamesTest and People Test. Ifrequired, a scaled verbal scorecan be derived from Thble 7 (p. 15).
A üsual-verbal discrepancy score is obtained by sub_tracting the scaled score derived from the two scaledverbal scores from that based on the two scaled yisualscores. Thble 8 (p. l6) gives the relevant scaled score.
6.3 Recall-recognition discrepancies
Recall performance may be assessed by combining theage-scaled scores for the Shapes Test and the peopleTest. A combined scaled score is given in Thble 9(p. 16).
Recognition may be assessed by adding scaled scoresfrom the Doors Test and Names Test and using Thble10 (p. l7).
Any recall-recognition discrepancy can be evaluatedby taking üe difference between the scaled scoresderived from these two combined scores and consultingTáble ll (p. 17).
6.4 Forgetting scores
This requires returning to the raw data and calculatingthe difference between performance on the final learn_ing trial on each of the two recall subtests, and the twodelayed recall scores.
As a general rule of thumb, a loss of up to 3 pointson the People Test and ofup to 2 points on the ShapesTest is broadly within the normal range. A more precisescaled score can be estimated as follows: an age_scaledforgetting score for the people Test can be obtainedfrom Thble l2 (p. l8), and an equivalent scaled forget_ting score for the Shapes Test from Thble 13 (p. I g).These should be added and the sum entered into Thblela fu. 19) to obtain an overall scaled forgetting score.
Note that subjects occasionally score slightly moreon the delayed than on the immediare resr.
7 J,lorms
Thble l: Verbalrecall (people)Norms for recall of people Test, scores of trials1-3 combined
Raw scoreScaled scores by age groupl6-3 t 3247 48-64 65_79 80+
7
8
9
IO
IIt2l3t4t5
t6t7t8t9
20
2t22
23
24
25
26
27
28
29
30
3t37
33
34
35
36
3
3
3
3
4
4
4
4
4
5
5
5
5
6
6
7
7
I8
9
9
t0IIIt2l3t4t5
t5
t6
2
2
2
2
2
3
3
3
3
3
4
4
4
5
5
6
6
6
7
8
I9
9
t0ill2t3
t3
t4l5
4
4
4
4
4
4
4
5
5
5
5
6
6
6
7
7
8
8
9
9
t0ililt2t3
t3
l4I5
t6
t7
575757576768686868787979898 t08 t09 tl9|l0 t2t0 t2I t3il t3t2 14
t3 t513 t514 t6t5 t7t6 t8t7 t8t8
t9
o//o
Percentiles by age groupl6-3 t 3247 48-44 65_79 80+
I
5
t025
50
75
9o
95
99
t82t25
28
3t33
34
t5
2t23
27
30
32
34
36
l6t924
27
30
32
34
36
t4
20
25
28
3t
32
34
t42t25
28
30
32
12 Doors and People
Table 2a: Visual recognition (Doors)Norrns for cornbined recognition ofDoors Test,sets A and B
Thble 2b: Visual recognition (Doors)Norms for recognition of Doors Test, set A
Scaled scores by age groupRawscore 16-31 3247 48-64 65-79 80+
Scaled scores by age groupRawscore 16-3 I 3247 48-64 65-79 80+
9
t3
2
2
3
3
5
6
9
t2
7
7
7
8
9
ilt3
t7
354545566789t0 llt3 t5
3
3
3
4
5
7
689987t0 t0 9 8
t0ill0l0Ill il ll l0 9
t2 t2 12 ll l0t2 t2 12 12 llt2 - 12 12 ll
-12
13522357445795 5 6 8 l07 7 8 l0 12
8 8 9 ll 13
t0 t0 | t3 15
|ill21416t2 .12 t3 15 17
t4 t4 t5 17 19
15 t5 t6 t8
2
3
4
5
6
7
I9
t0llt2
4432s5432665427765488865roro986il lt l0 9 7
l2t2|t08ill0
I
5
t025
50
75
90
95
99
5
6
7
8
246l-247223572245833468445795 4 6 I l06 5 7 I ll6689127 7 I l0 13
8 8 9 ll 14
g 9 ll 12 15
llt0121316t2il131517t3 t3 14 16 18
t4 14 15 t7
t6 t5 t7 19
8
9
t0lll2r3
t4t5
t6t7t8l920
2l22
23
24
I
5
t025
50
75
90
95
99
II
I
I
I
I
i¡
I
I
I
rl
L[
9
t0ilt2
Percentiles by age groupt6-3 t 3247 48-44 65-79 80+
I
5
t025
50
75
90
95
99
.Percentiles by age groupt6-3 t 3247 48-$4 65-79 80+
Table 2c: Visual recognition (Doors)Norrns for recognition of Doors Test, set B
il12815 llt7 t4t9 t620 t82t t923 2t
t2 t2 t0t4 t5 t3
t6 t6 t418 18 17
t9 20 18
2l 2t 20
23 23 27
23 24 23Scaled scores by age group
Rawscore 16-31 3247 48-64 65-79 80+
Percentiles by age groupt6-3t 32--47 48-.64 65-79 80+
Doors and People
Ihble 3: Visual recall (Shapes)Norms for recall of Shapes Test, scores oftrials1-3 combined
Table 4a; Verbal recognition sames)Norms for cornbined recognition ofNames Test,sets A and B
Scaled scores by age groupRawscore 16-3 I 3247 48-64 65-79 gO+
Scaled scores by age groupRawscore 16-3 I 3247 4A-44 65-19 gO+
5
6
7
8
_;t223344556677889t0 t0It t213 t3t4 t516 t6
20
2t22
23
I
5
t025
50
75
90
95
99
7
7
7
7
7
7
7
7
8
8
8
8
8
8
9
9
242424242424242525353535353646464657
I
I
2
2
2
2
3
3
4
4
5
5
6
6
7
8
8
9
t0ilt2
9
t0ltt2l3t4l5t6t7t8t9
2453454565675789
l0It2t3
t4t5
t6t7t8
t9
20
2t22
23
24
25
26
27
28
29
30
3t32
I
I
I
7
2
2
2
3
3
4
4
4
5
5
6
7
7
I9
t0t0ilt2
9
IO
6897 9 t0I t0 ill0ilt2il t2 t312 t3 t413 t5 t6t5 t6 t7t6 t8 t9t8
Percentiles by age groupl6-3 t 3247 48-64 65_79 80+5 7 t0
5 8 t06 I It69il79127 t0 t3I t0 t39|t49 t2 t5t0 t2 t5il t3 t612 t4 t7t3 t5 t814 t6 t9
t3 t2 t0t5 t4 t3 l| tot6t6t4t2ilt8 t7 t6 t4 t3t9 t9 t7 t6 ts2t 20 t9 t8 t722 22 20 t9 t923 22 2t 20 ts
22 22 2t
33
34
35
36
Percentiles by age groupf 6-3 t 3247 48-44 65_79 80+
I
5
l025
50
75
9o
95
99
23 22 t627 26 23 t629 28 26 203t 3t 29 2s tt34 33 32 29 2336 36 34 3t a7
36 34 30
-3532 \*
I
14 Doors and People Norms
Table 5: Overall scoreNorrns for overall score, based on sum ofage-scaled scores for the four subtestsTable 4b: Verbal recognition §arnes)
Norrns for recognition ofNames Test, set A
Scaled scores by age groupRawscore 16-3 I 3247 48-{.4 65-79 80+
Total of all Overallfour scaled scaled
Percentilesfor all age groups
i
l
7t26
29
34
40
46
5t54
59
I
5
t025
50
75
90
95
99
t5
l6t7t8
t9
20
7l22
23
-)3345
3356655788779t0t099ilt2t2il il t3 t4 t5
13 t3 t5 t6 t7
5
6
7
I9
t0ltt2
443-6s443665547766598876t0 9 9 8 8
ll l0 t0 9 9
ililr0t09
22334566789tiltt3 r
t5 I
3
4
5
6
7
8
9
t0il
2442s5
Percentiles by age gr.oupt6-3 t 3247 48-44 65-79 80+
776658877699877r0 r0 9 8 8
il lll099t2t2llt0t0l2t2t2ilil
12 il lt-t2t2
Table 4c: Verbal recognition §arnes)Norrns for recognition ofNarnes Test, set B
Scaled scores by age groupRaw score l&-31 3247 48-64 65-79 80+
5
5
6
6
6
7
7
7
8
I9
9
9
t0r0
26
27
28
79
30
3t32
33
34
35
36
37
38
I
5
t025
50
75
90
95
99
0
2
3
5
46
47
48
49
50
5t
52
53
54
55
r0
ilililt2t7l3t3
t3
t4t4t4l5t5
l5t6l6t7t7l7t8t8t8t9
39
40
4t42
43
44
45
3455566788 8 9.9t0iltf t2 t3
13 t3 t415 t5 t6t7 t7 18
Percentiles by age group16-31 3247 48-{.4 65-79 80+
56
57
58
5e60
6t
62
63
64
I
5
t025
50
75
90
95
99
Doors and People
Table 6: Combined visual score Table 7: Combined verbal scoreNor:rns for cornbined üsual subtest scaled scores Norrns for combined verbal subtest scaled scores(Doors Test and Shapes Test) (people Test and Narnes Test)
Total of Yisual percentilesscaled visual scaled for all age gnoups
Total of all Overall percentilesscaledverbal scaled forallagegroupsscores score %
§cores score
9
t2t4t720
23
26
28
3t
I
5
t025
50
75
90
95
99
3
3
4
4
5
6
6
7
7
I9
9
t0ltilt2t2t3
t4t4l5t6t6l7t7t8
I9
t0ilt2t3
t4l5t6t7t8t9
20
2t22
23
24
25
26
27
28
29
30
3l32
33
8
t2t3
t720
23
27
28
32
I
5
t025
50
75
90
95
99
3
4
4
5
5
6
7
7
8
8
9
9
t0ililt2t2t3t4l4t5t5t6l6t7t8
8
9
t0ilt2t3
t4t5
t6t7t8
l920
2t22
23
24
25
26
27
28
29
30
3I32
33
16 Doors and People
Table 8: VisuaUverbal discrepancy Table 9: Cornbined recall scoreNorrns forvisual/verbaldiscrepancyin cornbined Norrns forcombinedscaledrecall scoresscaled scores (People Test and Shapes Test)
Visual-verbal
Scaled Percentilesvisual-verbal for all age groups
discrepancy score %
Total ofrecallscores
Scaledrecallscorle
Percentilesfor all age grloups
-t3-t2-il-t0-9-€-7-6-5
3
4
4
5
5
6
6
7
7
I8
9
t0t0llilt2
t2t3
t3
t4t4t5
t6t6t7t7
I
5
t025
50
75
90
95
99
-t3-9-7-30
3
7
9
t2
8
9
t0It2t3
t4t5
t6l7t8t9
20
7t22
23
24
25
26
27
28
29
30
3t32
33
3
3
4
4
5
6
6
7
I8
9
9
t0ltilt2t2t3
t4l4l5t5
t6t7t7t8
I
5
t025
50
75
90
95
99
9
t2t4t720
23
26
28
3t4-3)-l0
I
2
3
4
5
6
7
8
9
t0ilt2t3
Doors and People
Table 10: Cornbined recognition scoreNorms for cornbined scaled recognition scores(Doors Test and Names Test)
Thble I I : Recall-recognition discrepancyNorrrs for recall-recognition discrepancy inscaled scores
Total of Scaled Percentilesrecognition recognition for all age groupsscores score %
Recall- Scaled recall- . Percentilesrecognition recognition for all age groupsdiscrepancy score o/o
-12-8-640
4
6
8
t2
I
5
t025
50
75
90
95
99
-t4 2
-r3 2
-t2 3
-il4-r0 4
-95+5-76-66-5748-38-29-t 9
0 t0|il2|3t24t25 t36 t.4
7t48 t59t6t0 t6
I9
t0ilt2I3
t4l5l6t7t8t920
2t22
23
24
25
26
27
28
29
30
3t32
3
3
4
4
5
.6
6
7
7
8
99
t0ililt2t3
t3
t4t4t5t6t6t7t8
I
5
t025
50
75
90
95
99
9
t2t4t720
23
26
28
3r
ilt2t3t4
t7t7t8t9
d'll,1:
18 Doors and People
Table 12: Forgetting score (verbal)Norrns for forgetting between trial 3 and delayedrecall on the People Test
Norms
Table 13: Forgetting score (visual)Norrns for forgetting between trial 3 and delayedrecall on üre Shapes Test
Trial 3minusdelayed Scaled scores byage group*recall 16-31 3247 48-44 65-79 80+
Trial 3minusdelayedrecall
Scaled scores by age group*t6-3 t 3247 48-64 65-79 80+
)-l0
I
2
3
4
5
6
7
8
9
t7 t7t4 t4t2il
t8 t8t4 t5
t7 t3
t8 t9
t6 t7t3 t4ilt2
l6t4t2t09
I7
6
5
4
3
t8l6t4lt9
6
4
2
il9
6
4
I
il9
7
4
2
9
6
4
I
t07
5
2
-3)-l0
I
2
3
4
i,l
il
I
l
ltl
ill
99
95
90
75
50
25
t05
I
99
95
90
75
50
25
t05
I
l0l0t0ll9
I7
6
5
4
3
2
889777666545434333272l-7
Percentiles by age groupt6-3 t 3247 48-44 65-79 80+
Percentiles by age groupl6-3t 3247 4H4 65-79 80+
-2 -3 -2 -3 -2-2-2-2)-l
0
0
I
2
3
3
-l0
I
I
2
3
3
0
0
I
2
2
3
0
I
2
2
3
4*Note that a large forgetting score leads to a low scaled score.
-2-2)-Z-l-t-t-t-t-l-l-l-t-t00
I
2
4
5
7
0
I
2
3
4
6
0
I
3
4
5
7
0
2
3
5
6
8
I
2
4
6
7
9
*Note that a large forgetting score leads to a low scaled score.
Doors and People Appendix t9
Combined Overallscaled forgettingforgetting scaledscore score
Percentilesfor all age groups/o
Table 14: Overall forgetting scoreNorms for overall forgetting, based on cornbinedage-norrned scores
Appendix l:Examples of scoring in the Shapes Test
A maximum of 3 marks is given for each drawing,making a possible total of l2 for each of the trials.
One mark is given for the presence/absence of thefeatures at the end of the'arms', thus shape I musthave foür knobs, shape 3 must have four bars andshapes 2 and4 must have nothing.
The second mark is given for the presence/absenceof a central feature, thus shapes 1 and 3 must havenothing, shape 2 must have a box with the intersectionof the vertical and horizontal lines showing, and shape4 must have a circle with no intersection showing.
The third mark is given for preservation of the over-all shape, thus shapes I and 4 must be long and thinand shapes 2 and 3 must be square. §7ith practice it ispossible to award this mark'by eye'but of course it isessential to specifiz the criteria for judging'squareness'and 'long and thinness'.
'Square'in shapes 2 and3 means that (a) when thevertical and horizontal lines are measured the shorterline must be equal to, or greater than, 7 5%o of thelonger line, and (b) the shorter part of the vertical linemust be at least 40% of the total length.
'Long and thin'in shape I means that the'body'(the vertical line) should be at least one and a half timesas long as the 'arms' (the horizontal line) and the ,tail,(the lower part of the vertical line) must be at least twiceas long as the 'head'.
'Long and thin' in shape 4 means the 'tail'must beat least twice as long as the 'head' or'arms'.
fn sum, for each shape one mark is awarded for eachof the three items listed below.
Shape 1
4 knobsNo central feature
I-ong and thin(body> l xarms¡ail- 2 x head)
Shape 3
4 barsNo central featureSquare
(shorter line>75%olonger line, smallerbody part > 40oA
total body)
Shape 2No feature at end of armsBox with intersection
showingSquare
(shorter line>75oAlonger line, smaller bodypat> 4OoA total length)
Shape 4No feature at end of armsEmpty circleLong and thin
(tail>2xheadand both arrns)
Using these instructions, agreement betw€en two inde-pendent markers of the 237 subj ects in the normativesample was 0.98.
8
9
t0ltt2t3
t4
t5
t6t7t8
t9
20
2t
22
23
24
25
26
27
28
29
30
3t
I
2
2
3
4
5
5
6
7
8
9o
r0
llt2t2I3
t4t5
t6t6t7r8
t9
I
5
t025
50
75
90
95
99
llt3
t5
t7z0
22
25
26
29
Table 15: Correspondence between scaled scoresderived frorn any table in this manual, andpercentiles
Scaledscore '
M¡d.percentile Percentilerange
I
2
3
4
5
6
7
8
9
IO
llt2t3
t4t5 -
t6t7t8
t9
0.t%0.4%
1.0%
2.3%
4.8%
9.1%
15.9%
25.3%
36.9%
s0.0%
63.1%
74.8%
84.1%
90.9%
95.2%
97.7%
99.0"A
99.6%
99.9%
<0.2
0.2- 0.6
0.6- t.5
t.5- 3.3
3.3- 6_7
6.7-12.2
12.2-20.2
20.2-30.9
30.943.443.4-56.6
56.6-69.2
69.2-79.8
79.8-87.8
87.8-93.3
93.3-96.7
96.7-98.5
98.5-99.4
99.4-99.8>99.8
I20 Doors and People References
Shape I
4 knobsNo central featureLong and thinTotal scores
+_]*+IIIx
)
x
.,x23
xxI
Shape 2
x
2
x
.,
x
2x23
No features at arm ends ,/Box with visible intersection /Square
Total scores
Shape 3
4 barsNo central featureSquare
Total scores
+T-F+tx,/x1
x/,/2
{x
2
,/
x)3
x
)
x
x1
x2
x
23
i
Shape 4
No features at arm ends
Empty circleLong and thinTotal scores
t t++tReferences
Baddeley, A.D., Emslie, H., and Nimmo-Smith, I.(1992) The Speed and Capacity of Language Processing
Test (SCOLP). Bury St Edmunds: Thames ValleyTest Company
Baddeley,4.D., Emslie, H., and Nimmo-Smiü, I.(1993) 'The Spot-the-§7ord test: A robust estimateof verbal intelligence based on lexical decision.'British Journal of Clinical Psycholng3t, 32, 55-65
I-ogie, R.H. (1980) 'The information in categorynorms: Cultural and structural aspects.'Unpublished report
Nelson, H.E. (1982) The NationalAdult Reading Test
@ARD . §Tindsor: NFER-NelsonOfEce ofpopulation censuses and surveys (1980)
Clas sifi cation of occup ations, x-xi
Osterreith, P.A. (1944) 'k test de copie d'une figurecomplexe' I rchioes de Psychologie, 30, 206-256
Sunderland, A., Flarris, J.E., and Baddeley, A.D.(1983) 'Do laboratory tests predict everydaymemory?'Journal of Verbal Learning and Verbal
Behaaiour,22,34L-357rJ7arrington, E. K. (1984) The Recognition Memory Test.
§Tindsor: NFER-Nelson§?'echsler, D. (1987) The Wechsler Memory Scale -
Revised. San Antonio: The PsychologicalCorporation
§7ilson, B.4., Baddeley, A.D., & Cockburn,J.M.(19S9) 'How do old dogs learn new tricks: Teachinga technological skill to brain injured people.' Cortex,25, Lt5-tt9
'§7'ilson, B.A., Cockburn, J., & Baddeley, A.D. (1985)The Rioermead Behavioural Memory Test (RBMT).Bury St Edmunds: Thames Valley Test Company
lsBN r 874261 70 9
r" ..:l{r=q
A test of visual and verbalrecall and recognition
Modifications to sub-scales ofthe Doors & People Test
The use of scaled scores is relatively straight forward inmost components of üe test, but in one or two of themore detailed sub-scales the original format has occa-sionally caused some confusion, and has consequentlybeen modified. The tables involved are as follows:-
Table 8: Visualfuerbal discrepancy
Normal performance, involving minimal discrepancyreceives a scaled score of 10. A negative discrepancy,implying a bias in the direction of verbal memory, or a
positive score, indicating an advantage to visual memo-ry, are boü given scaled scores that are less than 10.
Table 11 : Recall-recognition discrepancy
An advantage to recognition over recall is not uncom-mon, and is usually taken to signiS a memory retrievaldefrcit. Differences in the opposite direction are how-ever less common and should be further investigated.
Tables 12 & 13: Forgetting scores(verbal and visual)
Occasionally subjects will recall more after a delay üanthey did on immediate test. Typically this simply reflectsthe fact that retrieval variabiliry may lead to a greaterdegree of flucruation in recall scores. The original tablegave scaled scores greater üan l0 for these occasionalanomolies, which implies that such behaviour is 'supernormal'. To avoid this false impression, it is now sug-gested üat the rare occasions in which delayed recall isbetter than immediate should simply be scored as zeroforgetting.
Thames Valley Test CompanyBury St Ednundr England, 1996
trrmTIItrIIITDoors and People ffffirfrModiflcations to sub-scales
April 1996
l
ti
i
_l
u ' 16 Dorits and People Norms
(\'[]{
I
{
Ij
Table 8: Visua.lJverbal discrepancy Table 9: Combined recall score
Norms for visuaUverbal discrepancy in combined Norms for combined scaled recdl scores
scaled scores * (People Testand Shapes Test)
Visual- Scaled Pe¡rcentlles
verbal visua!-ve¡óal for all age grcupe
disoepancy ccore %
Total ofrecal!§cores
Scaledrecallscore
Perrentilesfor all age gioupsu
-13-t2-lt-10-9J-74-54-3-2-l0I
2
3
45
6
7
I9
l0ill2l3
3
4
4
5
5
6
6
7
7
8
I9
l0t09
9
II7
7
6
6
5
44
3
3
I
5
t025
50
25
t05
I
-t3-9-7-30
3
7
9
l2
8
9
t0ilt2t3t4
t5t6
l7t8t9
20
2l22
23
24
25
26
27
28
29
30
3r
32
33
3
3
4
4
5
6
6
7
8
8
9
9
r0illlt2t2t3t4l4l5t5t6l7l7t8
I
5
t025
50
75
90
95
99
9
t7l4l720
23
76
28
3l
t Since üsual and verbal scores are normally equivalent, a discrep-
ancy in either direction is abnormal and is reflected in a low scaled
scone.
L
Doors and People Norms t7
Table 10: Combined recognitio¡ scoreNorms forcombined scaled recognition scores(Doors Test and Names Test)
Table 11: Recall-recogniüon discrepancyNorms for recall-recognition discrepancy inscaled scores
Totalof Scaled
recognition recognitionscoñes Score
Perncentiles
for all age grcuPs
Recall-
recognitiondiscrepancy
Scaledrccall- Pe¡centilesrccognition for all age grcups
3core %
8
9
l0ilt2l3t4t5l6t7t8l920
2l22
23
24
25
26
27
28
29
30
3l32
3
3
4
4
5
6
6
7
7
8
9
9
t0ililt2l3t3l4l4r5
l6t6l7t8
I
5
l025
50
75
90
95
99
9
t2
l4t720
23
26
28
3l
2
2
3
4
4
5
5
6
6
7
I8
9
9
t0
I
5
t025
50*
-12-8-640
-t4-t3-12-il-t0-9-8-7-6-54-3-2-t0to +3
* lt is not unusual fcr patjents to perform bener on recognition
than recall. The reverse Pattern is less common. lf observed it
should be funher investigated, esablishing firstthatthe discrep-
ancy is reliably obtained.
" 18 'Doorc and People Norms
Table 12: Forgetting score (verbal)Norms for forgetting between trial 3 and delayedrecall on the People Test
Table 13: Forgetting score (visual)Norms for forgetting between trial3 and delayedrecall on the Shapes Test
Trial3mlnusdelayed Scaled scones by age group Irecall 16-31 3247 48-++ 65-79 80+
Trial 3
minusdelayed Scaled scones by age group 'recall le3l 3247 48-44 65-79 80+
0tI
2
3
4
5
6
7
8
9
t2t0I7
6
5
43
2I
ilt0I7
6
4
3
3
2
t2t09
7
6
5
4
3
2
2
0tI
2
3
4
lt9
6
4
2
ll9
6
4
I
il9
7
4
2.
13 14
il1291089786756453423
ilt29106745t2
Percentiles by age group16-31 3?47 48-44 65-79 80+
Percentiles by age groupt6-3t 3247 48.ó4 65-79 80+
99
95
90
75
50
25
t05
I
I
2
3
3
-3_)
-l0
0
I
2
3
3
* Note that a large forgetting score leads to a low scaled score.
t Occasionally a delayed score may be higher ttnn úre immediate.
This should be scored as 0.
-2-2-l0
I
-2 -3 -2-2 -2 -l-t-t-l000tortt2222323334
99
95
90
75
50
25
t05
I
-2-l-l0I
24
5
7
-2 -2 -7 -l-t-t-t-l-l*t-t0000tlt222334345645676789
I Note that a large forgetting score leads to a low scaled score.
t Occasionally a delayed score may be higher than the immediate.
This should be scored as 0.
Doorc and People Appendix l9
Combined Overallscaled forgettingforgetting scaledscoñe score
Percentilesfor all age groups
Table 14: Overall forgetting scoreNorms for overall forgetting, based on combinedage-norrned scores
iñ;;;il'¡;""""""Examples of scoring in the Shapes Test
A maximum of 3 marks is given for each drawing,making a possible total of 12 for each of the trials.
One mark is given for the presence/absence of thefeatures at the end of the 'arms', thus shape I musthave four knobs, shape 3 must have four bars andshapes 2 and 4 must have noüing.
The second mark is given for the presence/absence
of a central feature, thus shapes I and 3 must have
nothing, shape 2 must have a box with the intersectionof the vertical and horizontal lines showing, and shape
4 must have a circle with no intersection showing.The üird mark is given for preservation of the over-
all shape, thus shapes I and 4 must be long and üinand shapes 2 and3 must be square. '§(/ith pracrice it ispossible to award this mark'by eye'but of course it isessential to specify üe criteria for judging 'squareness'and 'long and üinness'.
'Square'in shapes 2 and 3 means that (a) when thevertical and horizontal lines are measured üe shorterline must be equal tor or greater üan, 75% of thelonger line, and (b) the shorter part of the vertical linemust be at least 40% of üe total length.
'Long and thin'in shape I means üat üe 'body'(the vertical line) should be at least one and a half timesas long as üe 'arms' (the horizontal line) and the 'tail'(the lower part of the vertical line) must be at least twiceas long as üe 'head1
'Long and thin' in shape 4 means the 'tail' must beat least twice as long as the 'head' or'arms'.
In sum, for each shape one mark is au'arded for eachof üe three items listed below.
Shape I4 knobsNo central feature
Long and üin(body)lxarmstatl> 2 x head)
Shape 3
4 barsNo central featureSquare
(shorter line> 7 5o/o
longer line, smallerbody part > 40%total body)
Shape 2
No feature at end of armsBox with intersection
showingSquare
(shorter line> 7 5Yo
longer line, smaller bodypart> 40oA total lengü)
Shape 4
No feature at end of armsEmpty circleLong and thin
(tail22xheadand both arms)
Using these instructions, agreement between nrro inde-pendent markers of ¡*ie 237 subjects in the normativesample was 0.98.
I9
l0ilt2t3
l4t5l6l7t8t920
2l72
23
24
25
26
I
2
2
3
4
5
5
6
7
I9
9
t0ilt2t2l3t4t5
I
5
t025
50
75
90
95
ilt3
t5
t7
z0
22
25
26
Table 15: Correspondence between scaled scoresderived from any table in this manual, andpercentiles
Scaled M¡d-scone percentile Percentile range
I
2
3
4
5
6
7
8
9
t0ltt2t3
l4t5t6t7t8
l9
0.t%0.4%
l.o%2.3%
4.8%
9.1%
15.9%
75.3%
36.9%
50.0%
63.1%
74.8%
84.t%90.9%
95.2%
97.7%
99.O%
99.6%
99.9%
<0.2
0.2- 0.6
0.6- t.5
t.5- 3.3
3.3- 6.7
6.7-12.2t2.2-20.220.2-30.9
30.9-43.4
43.4-56_6
56.6-69.2
69.2-79.8
79.8-87.8
87.8-93.3
93.3-96.7
96.7-98.5
98.5-99.4
99.+99.8>99.9
E-rEruur-¡,EilE=lnfI*,HJ;'"B Feoplc scoring sheer
sub¡ect and test detarls
Name
Age
Date of rest
Score summaq/ and scaled-scoresAge-scaled scores
Raw scores -t
Age-scaled scores--'
Percentiles-(olwoysshownos
o u tl i n e d co n n e cti n g bo x e s)
People Doorsab
I table I .[ table 2a
¡+ i+I I [- Irr[]
Shapes Namescd
] table 3 | table 4a
k- l-I -1 r-' rt I I t,ll
+-Total age-scaled scores
.1, table 5
+-Overall age-scaled score
Yisual-verbal memory profile ,+ = *Total age-scaled visual scores
{ table 6
m.-Combined visual memory testage-scaled score
. Visual memoryto obtain an age-scaled score forthe combined visual memory tasks(Doors Test and Shapes Test)
. Verbal memoryto obtain an age-scaled score forthe combined verbal memory tasks(People Test and NamesTest)
. Visual-verbal discrepancyto obtain an age-scaled score fordiscrepancy between visual and
verbal age-scaled scores
t- +Tot¿l age-scaled verbalscores
I table 7
¡ +Combined verbal memorytest age-scaled score
table 8
umn
Visual-verbal discrepancy-*age-scaled score
Recall-recognition memory profile. Recall
to obtain an age-scaled score forthe combined recall tasks
(People Test and Shapes Test)
+ <-Total age-scaled recall scores
+ table 9
q <-Combined recall test. age-scaled score
. Recognitionto obtain an age-scaled score forthe combined recognition task(Doors Test and NamesTest)
l= <-Total age-scaled
recognition scores{ uble l0
p +Combined recognitiontest age-scaled score
. Recall-recognition discrepancyto obtain an age-scaled score fordiscrepancy between recall and
recognit¡on age-scaled scores
P-J table I I
Recall-recognition discrepancy +age-scaled score
Forgetting scores. Verbal
to obtain an age-scaled verbal
forgetting score (People Test)
.[Trial
e3 raw scores {Delayed recall raw scores
f-
I table 12
q <-Verbal forgetting age-scaled score
. Visualto obtain an age-scaled visual
forgett¡ng score (Shapás Test) ,j, table 13
¡ <-Visual forgetting age-scaled
scoreOverallto obta¡n an overall age-scaled score .
for combined verbal and visual forgetting
9¡
Overall forgetting--+age-scaled score
{ table 14
¡Il
Section l¡The People Test> Immediate verba! recalt
For full text and procedure see Manual p. g
.' I' m going to osk you to leorn the nomes of four people...,
. 'l will show the cords to you one ot o time...'. Turn to the first page of the People Test items and say'Ihis is tJre doctor. His nome is Jim Green.'Wait for 3 seconds.
. 'Ihis is the rnrnister...' etc., for oll four items.. Close the test items book.
. 'Now lett see if you con remember them.'
. Trial I
.'Whot wos the doctor's nome?'
ScoreFirst name = I
Second name = I
Correct pair = I
t-3Jim Green. 'Whotwos the ministert norne?'
Cuthbert Cattermole l-3. 'Whatwos the postmon's nome?'
Tom Webster l-3. 'Whatwos the poperboy's nome?'
Phillip Armstrong l-3
Trial I total scoret_12
. lfsubjectscores 12, inserrascore of l2fortrials 2and 3,and move directly on to Section 2.
. 'Thot's very good for o firstottempt...'. Repeat the procedure for showing all four cards.
. Trial 2. 'Whotwos the doctor's nome?'
Jim Green l-3. 'Whotwos the minister's nome?'
Cuthbert Cattermole l-3. 'Whotwos the postmon's nome?'
Tom Webster l-3. 'Whot wos the poperboy's nome?'
Phillip Armstrong l-3
Trial 2 total scoret_t2
. lf subject scores I 2, insert a score of I 2 for trial 3,and move directly on to Section 2.
. 'You're getting better ot this...'
. Repeat the procedure for showing all four cards.
. Trial 3
. 'Whotwos the doctor's name?'
Jim Green l-3
. 'Whotwos the min¡ster's nome?'
Cuthbert Cattermole. 'Whotwos the postnon's name?'
Tom Webster. 'Whatwosthe poperboy's nome?'
Phillip Armstrong
Trial 3 total score
Total People Test, immediateverbal recall raw score(totaltr¡als I +2+3)
l-3
t-3
t-3e
l-t 2
[---laI -3ó
Section 2: The Doors Test> Visualrecogn¡t¡on
For full texr and procedure see Manual p. 8. 'We ore now goingto see how good you ore ot recognrsing things
you hove seen before.'. 'l om going to show you pictures of different kinds of doors. . .'. 'Let me show you whot I meon.'. Turn to first practice target of the Doors Test items and say
'Ihis is o workhop door'Wait 3 seconds.'Now, con you find o photogroph ofthot door on this poge?'
. 'lnthe octuol memorytest..l2 doors..,2 moreforyouto proctice on:. Turn to second and third practice targe*'Ihis is o front door.''Ihis is o barn door.'Turn to second and third ptactice recognition items:'Which one oftlrese doorc did I showyou?'
. Explain thar there are I 2 photographs, and that the subiectwill see all l2 before being asked to recognise them.. Present targets at 3-second intervals -a
. TestA
. Turn to first page of recognition items:'Which one ofthese doors did I show you?'
Tick or circle the subject's response.Correct targets are indicated by a fullstop (period).
la'b 5 a.ib 9.. ld .ld
2a]b 6alb l0. id. ¿ ld.
31_b 7 a'b ll.ld .. Id
4rib. 8a b. 12.ld .l¿
Test A score
Score I for each correct ¡tem l-¡ 2
It is preferable to give Test B whatever scoreis achieved in Test Alf subject scores less than 9, you can considermoving directly on to Section 3.
a lb.c ida.,bc ld
a'b¿ i¿.
a lbc. id
Presentationlabels
. front
. church
. front
. stable
. front
. garage
. city hall
. English cotrage
. shed
. English pub
. stable
. garage
labels
. French barn
. old wooden
. front
. ltalian
. garaSe
'SPanish. old English. front. German. another
old English
. 'l have o second set of l2 doors which ore o bitmore dfficult ..'
. Present targets at 3-second intervals -) I Presentation
. TestB
. Turn to first page of recognition items:'Which one ofthese doors did I show you?'
5 a. lb 9 a !
Trial I
Give subiect a second Piece ofpaper and ask them to draw thefour shapes from memory.Stop when subiect says they can
not remember any more, or when
nothing drawn for l5 seconds.
Score I for each correct'feature'according to the preceding table and
Manual Appendix P.00.
Trial I total score
t-3
t-3
Shape I
Shape 2
Shape 3
Shape 4
t-3
lbl¿.I
iblalb.l¿lbl¿
ll
t2
¿ i¿a. lb.ld" lb..id
" lb.ld.
¿ i¿
'lbc ld.
" io¿laa lb..ld
c
l0 a.
c
t-3
t-t 2
Test A score
Score I for each correct item
Total Doors Test, visualrecognition raw score(totalTestA +TestB)
Section 3: The PeoPle Test> Delayed verba! recall
For full textand procedure see Manual p.9
. 'A littte while ogo I osked you to leorn the nomes of four people...
. 'Whotwos the doctor's nome?'
Jim Green. 'Whatwas the minister's nome?'
Cuthbert Catterrnole'Whotwas the Postmon's nome?'
Tom Webster. 'Whot wosthe poperboy'snome?'
Phillip Armstrong l-3
Total People Test, delaYed [--_1 fverbal recatl rawscore I I
l-12
Section 4: The Shapes Test) lmmediate visual recall
For full text and procedure see Manual p. 9
r Explain that you would now like to see how good the subiect
is at remembering things they have seen.. 'l hove here four simple drowings.. [do not say trosses]
...1will show eoch drowingto you...'. Put plain paper in front of subject with pencil and eraser.. Turn tofirstshape:
'Look ot this for 5 seconds and then drow it here.'. After the subiect has drawn it, turn the page and repeat for
the other three shapes. Then close the test items book.
. lf subiect scores I 2, insert a score of I 2 for trials 2 and 3.
and move directly on to Section 5.
. 'Don'tworry, thot's good for o first ottempt...'
. Remove first attempt.
. Show all the drawings again, for 3 seconds each, but do not let
the subiect copy them again.
. Trial 2
. Give subiect a third piece ofpaper and ask them to draw the
four shapes from memorY.. Stop when subject says theY can
not remember any more, or when
nothing drawn for l5 seconds.
Shape I
Shape 2
Shape 3
Shape 4
Trial 2 total score
t-3
¡-r 2
. lf subiect scores I 2, insert a score of I 2 for trial 3,
and move directly on to Section 5.
.'You' re getüng better...'
. Remove second attempt-
. Show all the drawings again, for 3 seconds each, but do not let
the subiect copy them again.
Trial3. Give subiect a fourth piece of
paper and ask them to draw the
four shapes from memorY.. Stop when subiect says theY can
not remember any more, or when
nothing drawn for l5 seconds.
Trial 3 total score
Total ShaPes Test, immediatevisual recall raw score(totaltrials I +2+3)
t-3
Shape 4
l-3c
t-12
l--lbt-74
t-3
t-3
t-3
t-3
t-3
t-3
Shape I
Shape 2
Shape 3
. Scoring the shape features (see also Manual Appendix p. l9)End features Central features Overall shape
2 none box with square
| -3ó
Section 5: The Names Test> Verbalrecognition
For full text and procedure see Manual p. l0. 'Now I hove got some more names for you...'. Turn to first practice target of the Names Test items
[Ma:'tin Chapman] and ask- the subject to say the name.. Turn the page: 'Con you show me the nome you hove just seen?'. Repeat if necessary., 'This üme l'm going to show you two nomes... '. Turn to second and third practice targets
[George Dowson and James F¡tzjohn].. Turn to second and third practice recognition items: 'you
will find one ofthose nomes tfiere...o nd the other nome there...'. Explain that there are l2 names, rhat they are female,and that the subject will see all l2 before being asked torecognize them.
. Present targeB at 3-second intervals.
. TestA
. Turn to first page of recognition items:'Which of these nomes did I show you?'
Tick or circle the subject's response.Correct targets are indicared by a full stop (period).
I qeryI,ul,.lDiane Neeson
D¡i,r" Nofai.Diáne Nussey
2 Julie Manin
5 Helen Murray 9 Susan Burnage
Helen Philips Susan Burnell
Helenluller 'Susan Burnirill.
Helen Edwards. Susan Burnside
6 Chr¡stine Kebbell I 0 Ruth Layfield.
Órhristine Lovick Ry6 CamfieldJulie Mitchell
¡yl¿l¡,*__julie Marshall.
3 Margaret Giblin. 7
Nirg.'*ó-áado,ñá.etcarrn;--Margaret Gosnell -
SarahTaylor
Sarah Wright
Christine Oldford
ehi¡st¡né Siwk¡ns
Jane Watkinson ltJaneWilkinson
JaneWaterson
Jant\¡/¡ll¡-mso,r
Ruth Morefield
iuth Sandfield
l4ary Didcock
Mary Diddel.
M3,r,D!1"tt -_Mary Didham
l2 1!r1ryg!.,¿s.4,fll.ll''dr1 _Ann Farbridge
en; Lethbi¡dCe
Test A score
I-t 2
4 Sarah Boggis. 8 JrlLs¡t!Sarah Harris JillAshman
jiiÁr,rál
JlllÁihton
Score I for each correct item
It is preferable to give Test B whatever scoreis achieved in Test A.
lf subject scores less than 9, you can considermoYing directly on to Section 6.
. 'l have o second set of l2 nomes, t}is time they are oll molenomes...'
. Present targets at 3-second intervals
o Test B. Turn to first page of recognition items:
'Which ofthese nomes did I show you?'
2 Mark Easterbrook 6 Gnham Camish l0 lain Buckley
Mark Easterling Graham Cammann lain Euckler
M¡rk Easterfield. Graham Cammiss. lain Bucklow.
Mark Easterhope Graham Cammell lain Buckner
I David Robinson 5 Simon Fairhall
David Roberuon. Simon Fairhurst.
David Richardson Simon Fairhead
David Rogerson Simon tairholm
3 Neil Pennel
Neil Herrett.
Né¡t G¡uuará
NeilWhktall
4 Andrew Beardsall 8 Alan Dunsden
Andrew Beardsmore Alan Dunstone
Andrew Beardsell. Alan Dunster
Andrew Beardshaw Alan Dunton
Score I for each correct item
9 ¡ames Broadbridge.
James Broadribb
James Broadhead
james Broadrick
7 ManhewBrownhill ll ThomasBebbington
MatthewBrownlow ThomasBoddington
MatthewBrownell Th;a;Bennington.
MatthewBrownlee. ÍhomitBillington
I 2 ¡ohn Blackborn
John Blacklaws
John BlacKord
John Blackmore
Test B score
Tota! Names Test,verbal recogn¡t¡on raw score(total Test A score + Test B score)
t-12
f---l¿t-24
Section ó: The Shapes Test> Delayed visualrecal¡
For full text and procedure see Manual p. l0. 'A little while ogo you did four drowings for me.lU /ike to see how
well you remember them. Can you drow as mony of them'os youcon remember?'
. Give subject a fifth piece ofpaper and ask them to draw thefour shapes from memory.
. Stop when subject says they cannot remember any more, or whennothing drawn for 30 secónds.
Shape I
t-3
Shape 2t-3
Shape 3t-3
Shape 4t-3
[-_lrrTotal Shapes Test, delayedvisual recall raw score
t-t 2
No part of this publication may be reproduced, in whole orin part in any form (except by reviewers for the public press)without written permission from the publishers.
Copyright@ 1994The authors
Thames Valley Test Company7-9 The Green, FlemptonBury St EdmundsSuffolk lP28 6EL England
rsBN t87426t 709
DOORS AND PEOPLEPACIENTE:
Sección {. Test de las Personas. Recuerdo verbal inmediatoSección 3. Test de las
pesonas, Recuerdoverbal demoradoPreguntas Correcta
Ensayo 1 Ensayo 2 Ensayo 3
o-1-3 0-1-3 0-1-3 o-1-3
¡Cuál es el nombrelel doclor? Juan González
¿Cuál es el nombredel ministro? Roberto Fioueroa
¿Cuál es el nombredel cartero? Tomás Huertas
¿Cuál es el nombredel repartidor deperiódico? José Trillos
rOTAL TOTAL= l(f)
Total Test de las Personas, puntaje bruto de recuerdo verbal
inmediato (Total ensayo§ 1+2+3) la)
Sección 2. Test de las Puertas. Reconocimiento visualPrueba A Prueba B
Item Correcta Respuesta Puntaie {1/0) Item Correcta Respuosta Puntaie (1/O)
C 1 B
2 D 2 D
3 A 3 c4 B 4 B
5 A 5 A
6 D b A7 c 7 c8 B I D
I B I D
10 A 10 A11 D 11 B
12 C 12 crOTAL TOTALfotal Test de las Puertas, puntaje bruto de reconocimiento visual'Total Prueba A + Prueba B) tb)
secclon *. Iesr oe tas rof1[a§.Recuerdo visual inmediato.
Forma=nsavo
1 insavo 2 nsavo 3
1-2-3 1 -2-3 1-2-31
234
rOTAl
lotal Test de las Formas, puntaieorulo de recuerdo v¡sual ¡nmediatolTotal ensavos l+2+3) c)
§ecclon o. lGsI oe las rorfflas.Recuerdo visual demorado
Forma o-1-2-31
2
3
4rOTAL 'h)
Sección 5. Test de los Nombres. Reconocimiento verbal.Prueba A Prueba B
Item Correcta Respuesta Puntaie (1/O) Item Correcta Respuesta Puntaie (1/O)
1 B 1 C
2 D 2 B
3 A 3 A4 A 4 D
5 D 5 B
6 B 6 B
7 D 7 c8 C 8 AI C 9 C
10 A 10 D
't1 B 11 A12 B 12 D
rOTAL TOTAL