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QNST test represents an early screening tool that focuses on behavioral parameters associated
with learning disorders and neurological dysfunction. The QNST is an excellent way to screen
children and adults for the presence of neurological soft signs (NSS) that often indicate
difficulties in learning, motor coordination, and daily functioning. NSS are minor irregularities
that include poor motor coordination, sensory perceptual changes, and difficulty sequencing
complex motor tasks. The presence of NSS can indicate neutral trauma and are often indications
of learning difficulties (without history of trauma)

Development of Quick Neurological Screening Test

QNST a test which was developed in the California Bay Area by Margaret Mutti, Nancy
Martin, Harold Sterling, Norma Spalding Developed in 1974 and Revised in 1978 in an
attempt to provide classroom teachers with a means of identifying those children in their
classrooms who have learning disabilities caused by neurological insufficiency. QNST was
developed as a screening tool to early identify children (five years and over) who display soft
neurological signs and who are at risk for L.D. Soft signs are subtle abnormalities that emerge
in childhood with uncertain association with structural brain damage (e.g., overflow movements,
difficulty in carrying out thumb and finger circling, finger agnosia, graphesthesia).
The QNST attempts to identify three populations:
1. Children who demonstrate no failures in age-related tasks and no abnormal neurological
2. Children who have distinct, even if minor, neurological signs as clear-cut differences
from one side to the other in sensation or motor control, or disorders of control of
movement, such as tremor and ataxia
3. Children with frank organic neurological signs who, even so, are not able to perform at
the level predicted for their age often called neurologically immature but often labeled
as learning disabled.



The QNST assesses for the presence of the following behaviors that may be of clinical
Motor maturity and development.
Sensory processing.
Gross and fine muscle control.
Spatial organization.
Visual and auditory perception.
Balance and vestibular function.
Disorder of attention.

The QNST require no special equipment, just a pencil. The presence of NSS indicates impaired
motor coordination and sensory integration, both of which relate to learning as well as to general
daily functioning. The QNST provides an easy, reliable way to quantify behaviors of clinical
importance. It can be useful in:
Identifying attention and concentration difficulties.
Identifying possible learning difficulties
Screening for sports-related concussion.
Screening for neurodegenerative diseases


The Quick Neurological Screening Test is composed of fifteen subtests which measure the
integration of the child's central nervous system. This integration is manifest by "soft
neurological signs. The more signs, the more likely that abnormality is present.
The following subtests are included in the QNST (Mutti et al., 1978):
1. In the item Hand Skill the subject has to write his or her name at the page which
measures the ability of the individual to hold and use a pencil in writing his name.
2. In the item Figure Recognition and Production the subject is asked to name each one of
a series of five geometric figures, and then draw them. The figures are a circle, a square,
a diamond, a triangle, and a rectangle. This subtest assesses attention, visual


discrimination, visual perception, motor planning, fine-motor control, eye-hand skills,
and motor maturity. It also predicts computation skills and reading success or failure.
3. The item Palm Form Recognition consists of asking the subject to identify, solely by
touch, numerals drawn on the palm of his or her hands In older children, this task
corresponds with IQ and reading success.
4. The item Eye Tracking aims at determining whether the subject is able to track a moving
object with appropriate eye activity. Adequate and coordinated eye movement is essential
to learning to read.
5. In the item Sound Patterns the subject is asked to reproduce sound patterns after the test
administrator demonstrates them. Sound Patterns, screens for auditory-motor integration,
the ability to transfer an auditory pattern into a motor pattern.
6. In the item Finger to Nose, the test administrator observes motor planning, directionality,
and spatial awareness. Finger to Nose is a typical neurological test given to measure the
subject's sense of position in space. With his eyes closed, the subject is asked to touch his
nose and find the examiner's hand which he has located in space.
7. In the item Thumb and Finger Circle fine-motor development is assessed by asking
the subject to form successive circles by touching the thumb to each of the fingers (both
hands). It measures left-right discrimination, symmetry and balance in use of the hands
and fingers which is so important to visual motor coordination.
8. Double Simultaneous Stimulation of Hand and Cheek aims at determining whether
the subject is able to feel the gentle touch on the hand at the same time that he or she is
touched on the cheek. It measures the ability of the individual to discriminate touch.
9. The item Rapidly Reversing Repetitive Hand Movements consists of a series of rapid,
repetitive hand movements, in order to observe subtle motor dysfunction. Rate, rhythm,
symmetry and accuracy are all components of this subtest.
10. In the item Arm and Leg Extension the test administrator assesses muscle tone by
checking for random body, hand, or tongue movement, motor tension, unusual finger
position, tremor or twitching. Sometimes called the Monkey Test, seeks to identify
tremor and random movement in stretched muscles. Boys with this problem have more
reading and spelling difficulties. The test is particularly effective in demonstrating subtle
differences between right and left side gross- and fine-motor control.


11. In the item Tandem Walk the subject walks a straight line for at least 10 feet, placing the
heel of each shoe directly against the toe of the opposite foot. The subject then walks
backward on the 'line', heel-to-toe, and then repeats the tandem walk forward with his
eyes closed. Tandem Walk, measures balance and random body movement, and
clumsiness in gross motor movements.
12. In the item Stand on One Leg the subject is asked to balance him/herself with eyes open,
first on one foot, and then on the other foot, for a count of 10 seconds each. Stand on One
Leg measures balance and coordinated alternating movement in the feet and legs.
13. In the item Skip the subject is asked to skip across the room, while the test administrator
assesses how the subject follows directions and how he/she balances him/herself.
14. The item Left-Right Discriminations scored from parts of three other subtests, namely
'Finger to Nose Location', 'Thumb and Finger Circle' and 'Stand on One Leg'.
15. The item Behavioral Irregularities requires general observation of the subject's
behavior during the entire test, such as unusual behaviors, perseveration, excessive
talking or withdrawal tendencies, defensiveness, anxiety, excitability, distractibility, and
impulsivity, motor planning, and left-right differences.


Administration of the test is made on an individual basis and takes approximately 20 minutes to
complete. Subjective scoring is required for the tasks, which include: handwriting ability,
perceptual ability for numbers written on the palms of the hands, eye tracking, and finger to nose
coordination, tandem walk, and arm and leg extension. The test requires that the examiner be
highly observant of the childs behavior and make subjective ratings concerning the childs
performance. A total score exceeding 50 or 25 is falling in the High or Suspicious category,
and that of 25 or less is to the Normal category. The High score shows that a child is likely to
have trouble learning in the regular classroom. A Suspicious score indicates that a child does
not perform at the level predicted for his or her age. A child with a Normal score is very unlikely
to have LD. Hand scoring is quick and easy.