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The Test of Everyday Attention. Manual

Article · January 1994

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 Vol 4 No 1 October 2001

TEST
REVIEWS

THE TEST OF EVERYDAY ATTENTION (TEA)

Ian H. Robertson, Tony Ward, Valerie Ridgeway, Ian Nimmo-Smith

Thames Valley Test Company, 1994

Reviewed by Dr. Andrew W. McAnespie

Chartered Clinical Psychologist – Hull and East Riding Community Health NHS Trust
Honorary Clinical Lecturer – The University of Hull

Department of Clinical Psychology,

The University of Hull,
Cottingham Road,
Hull, HU6 7RX.

FORMAT
The TEA consists of eight sub-tests delivered and scored using a variety of mediums. The
assessment pack comes in a black portable carry-case which contains: one manual, which
covers Standardisation, Validation, Interpretation and Administration guidelines, one A4
ring-bound stimulus book covering three parallel versions, three audio tapes covering three
parallel versions for all aurally presented material, two A3 maps covering three parallel
versions of the Map Search sub-test, three A3 scoring templates for the Map Search sub-test,
three A3 fictitious Yellow Pages extracts covering three parallel versions, two clear plastic
wallets for overlaying maps and Yellow Pages while being drawn on, a set of non-permanent
markers, one stapled examiner scored answer booklet and one 30 minute Training Video.
Additional items that do not come with the TEA include: one standard cassette recorder, one
stopwatch, and of course, a quiet room with a flat surface. No computerisation of the TEA
was available as of January 2001.

COST OF MATERIALS
The complete TEA pack contains all the specified items above plus 25 scoring sheets, at a
price of £209.00 + VAT. Subsequent running costs, as of January 2001, amount to £13.00 +
VAT per pack of 25 scoring sheets.

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TEST
REVIEWS

TIMINGS
The TEA requires around 60 to 65 minutes to administer to a client who has sufficient
intelligence and language skills to enable them to comprehend test instructions on first
explanation with the support of the included trial examples. Timings for individual sub-
tests vary from approximately 5 minutes for the more straightforward visual items to around
15 minutes for the final test of sustained attention. Scoring should take little more than 15
minutes as most items are extremely straightforward, amounting to little more than simple
counting of items, much of which is done during test administration time. Interpretation and
feedback will obviously vary with the proficiency of the examiner. However, as the constructs
measured are fairly clearly discussed within the manual, even a hesitant examiner should be
able to feedback within around 15 minutes of completed scoring. If carried out continuously,
the TEA test could reasonably be completed, from commencement of administration to
delivery of feedback, within a 90 minute period.

PURPOSE OF THE TEST

The TEA, as its name suggests, is aimed at assessing various attentional subsystems, and
does so in as ecologically valid a way as possible by introducing sub-tests which closely
relate to everyday tasks, e.g. searching maps, searching telephone directories, listening to
lottery results. The TEA provides norm-referenced scores on a variety of tests which are
suggested to be sensitive to selective attention (the ability to select target items while ignoring
strongly competitive distracter items), attentional switching (the ability to switch attention
flexibly from one concept to another, e.g. shifting sets in the Wisconsin Card Sorting Test)
and sustained attention (the ability to attend to repetitive stimuli in the absence of external
motivation). The TEA additionally offers a divided attention measure and a range of tasks
which encompass both auditory and visual domains. The range of abilities are tested using
a mixture of speed and power tests.
The TEA was principally designed to offer a clinically valid assessment of individuals from
18 to 80 years of age, who have experienced some form of acquired neurological insult,
however, this would appear to be an overly restrictive use of the TEA given the mounting
evidence of attentional deficits in a wide array of developmental difficulties and physical
and mental health problems, e.g. ADHD, Asperger’s Syndrome, Schizophrenia, Myalgic
Encephalomyelitis, HIV infection etc.

WHAT OCCUPATIONS IS IT RELEVANT FOR?

While the TEA test does not provide data on occupational area of use, it would appear

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reasonable to suggest that the test is relevant to the assessment of clients who are employed
within any sphere where attentional demands of various kinds are likely to play a significant
role in their job performance (I hope the air traffic controller for my next flight has at least a
modicum of sustained attention!). Further to this, the TEA may have a role not only in the
assessment of clients with identified attention problems, but also as a tool with which to
measure aptitude.

BACKGROUND/REFERENCES
The TEA was developed as a test of mainly clinical relevance due to a number of factors:
attention difficulties are a common aftermath of neurological insults (McKinley 1981),
attention often predicts functional outcomes in cases of neurological insult (Brooks and
McKinley 1987); and more recent evidence clearly supports a multi-system model of attention
(Posner and Peterson 1990).The TEA at the time of its publication was the only non-
computerised attentional assessment which offered clinicians the ability to assess easily the
effects of differentially impaired attentional subsystems.

TECHNICAL INFORMATION

NORMS
The TEA’s normative sample consisted of 154 volunteers ranging in age from 18 to 80
years, which were stratified into 4 age bands: 18 to 34; 35 to 49; 50 to 64; and 65 to 80. This
reference group contained 69 males and 85 females, all of whom were selected from a U.K.
population. In addition to this general population sample, a sample of 80 unilateral stroke
patients were assessed 2 months post injury. While each sub-group was stratified further
with regard to IQ, as measured by the National Adult Reading Test, no data was reported on
socio-economic, cultural or academic background.

RELIABILITY
Coefficients for the test-retest reliability of versions A to B of the TEA ranged from 0.59 to
0.86 utilising 118 of the normative sample. For versions B to C a sub-sample of 39 from the
normative group produced test-retest reliability coefficients ranging from 0.61 to 0.90, while
74 of the stroke sample produced a range of coefficients from 0.41 to 0.90.

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TEST
REVIEWS

VALIDITY
The TEA was subject to a principal components analysis which revealed that all subtests
loaded on four factors. The first factor, labelled visual selective attention/speed, included
the Map Search and the Telephone search which formed this factor along with other popular
visual attention speed tests such as the Stroop and Trails B. Due to the timed nature of these
tests, information processing speed is a factor that needs to be considered in the interpretation
of results, particularly where this has been highlighted as a problem, e.g. poor performance
on the Processing Speed Index from the WAIS-III. The second factor, labelled attentional
switching , included the Visual Elevator task and this factor loaded on the same function as
the number of categories from the Wisconsin Card Sorting Test. The elevator task was the
subtest which most highly correlated (0.39) with IQ, as measured by the NART, and therefore
in clients who are at the lower end of the IQ distribution, interpretation should be made
cautiously. The third factor, sustained attention, was formed by the Lottery, Elevator Counting
and the Dual Task Telephone Search. While these subtests formed a coherent factor, they
did so in the absence of any externally validated task concurrently loading on this factor and
therefore its validity cannot be ascertained from the TEA manual. The last factor involved
Auditory-Verbal Working Memory, and with regard to this the Elevator Counting with
Distraction task correlated with Backward Digit Span and the Paced Auditory Serial Addition
Task.
The ecological approach the TEA has adopted in using everyday items provides the TEA
with a feeling of high face validity, however, for those with questionable auditory and sensory
acuity, its validity may be undermined if steps are not taken to ensure that extraneous sensory
difficulties are not ruled out as a confounding factor prior to assessment.

RESTRICTIONS ON USAGE
The TEA was designed for use by Chartered Psychologists and those who are eligible to be
chartered. It can also be used by a wider number of professionals, such as psychiatrists,
neurologists, geriatricians, occupational therapists and speech and language therapists etc.,
provided that they obtain a Thames Valley Test Company endorsed licence. The TVTC
licence can be obtained by attending a one day course, currently priced just under £60,
which covers a number of TVTC tests.

HOW THE INSTRUMENT CONTRIBUTES TO EMPLOYMENT ASSESSMENT

As alluded to earlier, the TEA would form a useful adjunct to a number of areas. Two
possible applications could include aptitude testing for candidate selection where occupations

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TEST
REVIEWS

demand a certain level of attentional capacity to function at an optimal level, and as part of
a battery of assessments used in order to map a client’s cognitive profile to a task analysed
work rehabilitation programme.

ISSUES CONCERNING THE USE OF THE INSTRUMENT FOLLOWING THE

DDA AND EQUAL OPPORTUNITIES LEGISLATION
The TEA, as indeed do many tests of its kind, relies heavily on reasonably intact visual and
auditory senses and a fair degree of psycho-motor facility. Consequently, it is important
that these factors are considered in terms of the individual being assessed and that the TEA
is not used indiscriminately, and indeed some advice is given within the TEA manual on this
subject.

ACCOMMODATIONS
Because of the battery nature of the TEA, it would appear reasonable to suggest that the best
accommodation would be to use those sub-tests which fit the individual’s needs for
assessment, and to combine those sub-tests with other tests which may allow for more
appropriate assessment of an individual’s abilities

THE INSTRUMENT’S RELEVANCE AND POTENTIAL USE IN THE

EMPLOYMENT ASSESSMENT OF DISABLED PEOPLE.
The TEA is currently the only test of attention which gives an overall measure of the finer
grain aspects of attention. In breaking attention down into component parts it offers an
excellent opportunity for those involved with the assessment of disabled individuals to provide
specific and meaningful rehabilitation in conjunction with a clear analysis of how task
demands relate to varying attentional systems and their resources.

SUMMARY
The TEA is the only test of attention that gives a broad overview by breaking attention down
into theoretically distinct factors, which can then be used as the basis of a detailed analysis
of an individual’s cognitive resources. This clearly constitutes a useful assessment tool with
which to assess employee aptitude and to construct work rehabilitation programs. While the
test would be a useful adjunct, it has to be said that it will be of most use when employed
within a wider assessment setting which will allow the examiner to consider the weaknesses
alluded to earlier in context.

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