Activities Explained: Trail Making

The Trail Making Test challenges planning, focus, and coordination, helping predict how well you'll handle complex tasks.

1. Navigate to https://activity.neurofit.ca/
2. Select "Trail Making"

3. Click "Start" to begin activity.

4. Begin with 1 and alternate between number and letter sequences.

5. Once correctly selected the target will turn green.

6. As you progress through the sequence, a line will connect the correct sequence to each other.

7. If you need support, you can right click on your mouse to bring up the Assist Function to provide some guidance in each activity.

8. When you complete the activity, you will be able to see some general metrics on how you performed as well as the option to restart or continue to the main menu.

After each session, the Activity Stats screen displays four key metrics: Accuracy (percentage of correct target selections), Time (total seconds to complete the full sequence), Experience (a star rating reflecting overall performance), and Clears (number of full sequences completed).

Track these across sessions rather than relying on a single result. A client who is slow but accurate presents very differently from one who is fast with errors. Document whether the Assist Function was used and when in the sequence — this reflects cue-level dependency and is worth noting in your session documentation.

Stroke / Acquired Brain Injury Trail Making is highly sensitive to the executive and attentional deficits common after stroke. Use performance trends to guide progression to higher-complexity IADL training. TMT results correlate with driving readiness and complex home management tasks — useful data when planning discharge or home support recommendations.

Autism Spectrum Disorder (ASD) Cognitive flexibility is a core challenge in ASD. This task provides a structured, low-social-demand measure of set-shifting that can track progress across a therapy program. Pair with caregiver observations of flexibility in daily routines for a complete functional picture.

Healthy Aging / Cognitive Screening Processing speed and executive function decline naturally with age. Repeated administrations serve as a functional baseline — flag significant performance drops for further assessment or referral.

Orient before starting. Briefly explain the alternating rule (1, then A, then 2, then B) before the session begins. Clients who misunderstand the instruction generate misleading error patterns that don't reflect their true cognitive ability.

Track trends, not single sessions. Four to six sessions gives a meaningful picture of trajectory. A single score in isolation has limited clinical utility.

Document prompt use. Note when in the sequence the Assist Function was used: early use suggests comprehension or working memory difficulty; late use suggests attention fatigue. Track whether frequency decreases over time as a marker of progress.

Consider motor confounds. Post-stroke hemiplegia or fine motor impairment may affect results independently of cognition. Document any observed motor difficulty separately from your cognitive interpretation.

Keep timing consistent. For neurological populations, administer at a consistent time of day across sessions to minimize fatigue-related variability in results.