EXAMINER’S MANUAL

The only nationally-standardized Nonverbal Stroop Test for

cognitive process and neuropsychological assessment.

Chris Koch, Ph. D. and

Gale Roid, Ph. D.

NSCST Manual
CAT. NO. 30152M

STOELTING CO • 620 WHEAT LANE • WOOD DALE, IL 60191

PHONE: 800-860-9775 • WEB: WWW.STOELTINGCO.COM
EMAIL: TESTS@STOELTINGCO.COM
Table of Contents
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Chapters
1. Introduction, Theory, and Research on the Stroop Effect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2. Administration, Scoring, and Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3. Development and Standardization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
4. Reliability, Validity, and other Research Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Appendix B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Appendix C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Appendix D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Appendix E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

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 Acknowledgments

The authors especially thank Dr. Jamie Martin of Stoelting Company for his tireless supervision of the production of
materials, monitoring of the standardization, communication with examiners, and entry of data. Several educators in
the Newberg, Oregon area assisted Dr. Koch with his various pilot and validity studies, including Michelle McWilliams,
Kevin Milner, Jennifer Salamé, Mark Ross, Brandon Porter, and Amy Jackson.

The authors thank several examiners who tested many multiple cases with the NSCST, especially Loraine Alderman
and Nan Throneberry, but also Angie Blanchard, Julie Cogar, Dee Hasselhuhn, Cynthia Hutmacher, Michele Marcera,
Eva Markham, Helen Stayna, and Lucy Torres. Dr. Roid specifically thanks his wife and daughter for many hours of
assistance during the project.

Note to Clinicians and Researchers

Clinicians and researchers who use the NSCST are encouraged to send copies of their work to the authors in care
of Stoelting Company, 620 Wheat Lane, Wool Dale, Illinois 60191. The authors can also be contacted at nonverbal-
stroop@gmail.com. We will be pleased to cite appropriate and well-designed independent research in future revisions
of this test and its manual. Additional information about the NSCST is available at https://sites.google.com/site/non-
verbalstroop/.

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 CHAPTER 1
INTRODUCTION
DESCRIPTION
The Nonverbal Stroop Card Sorting Test (NSCST) assesses
cognitive interference in children and adults, ages 3 to 75+. The
approximate testing time is 5 to 10 minutes, including directions.
Nationally standardized on 1,450 individuals and co-normed
with the Leiter-3 (Stoelting Cat. #34100), the NSCST uses
pantomime, non-vocal test administration to identify deficits in
executive functioning and attention processes. The test uses pro-
cedures proven effective in many years of computerized Stroop
research, adapted for individual assessment.
The NSCST can be used alone or in combination with other
Stroop measures (e.g., the Nonverbal Stroop Subtest of Leiter-3
or Golden’s Color-Word Stroop Test, (Stoelting Cat. #30150)) or
within a larger battery of cognitive or neuropsychological tests.
Also, an Examiner’s Rating Scale, covering behaviors such as
attention, impulse control, activity level, and anxiety, provides
an optional measure of test-taking behavior. The Scale was
developed as part of the Leiter-3 battery (Roid, Miller, Koch, &
Pomplun, 2013, in press) and, originally, the Leiter-R (Roid &
Miller, 1997). The rating scale adds observational information on
individuals’ test-taking behaviors and aids in the identification of
attention or learning difficulties.
Two sets of cards—one with matching (congruent) color bars
and one with non-matching (incongruent) color bars—are used
to contrast the speed (cards per second ratios) with which the
individual sorts the cards onto a large, laminated panel showing
locations for each color. The difference between the congru-
ent and incongruent trials reveals the degree of interference
commonly referred to as the “Stroop effect.” The sorting times,
ratios, and interference score can be converted to normalized
standard T-scores (with a mean of 50 and a standard deviation
of 10) for profile “strengths and weaknesses” assessment. The
profile scores allow the examiner to assess the magnitude of
any unusually large difference in sorting speed, particularly for
the incongruent trial, showing evidence of processing deficits and
cognitive interference.
The kit includes two sets of Cards, Laminate Sorting-Sheet,
Stopwatch, and Manual. The Manual summarizes the theory and
research on Stroop effect, administration and scoring methods,
interpretation and case studies, development and standardiza-
tion, and reliability and validity of the instrument.
BACKGROUND
Attention is an important aspect of executive functioning (cf.,
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Baddeley, 1996). Researchers and theorists since William
James (1890) have postulated that attention is essential to the
selection of important information for further processing from a
myriad of other competing information. Selective attention in-
volves two complementary processes. First, as the term implies,
there is the selection of a particular stimulus, or signal, for ad-
ditional processing. Once selection has taken place, competing
signals must be ignored or inhibited. Thus, selective attention is
involved with both the selection of relevant information and inhibi-
tion of irrelevant information. Similarly, attention is also important
for selecting a response. By implication, response selection and
response inhibition are related functions (Mostofsky & Sim-
monds, 2008). Consequently, tests of inhibition have become
important measures in cognitive assessment.
STROOP’S ORIGINAL TASK
The Stroop task is one of the most commonly-used experimen-
tal and clinical measures of inhibition. Three experiments were
reported in Stroop’s (1935) seminal paper. In the first experiment,
participants read color-words that were presented in incongru-
ent color ink. The time to complete the task was compared to a
control condition in which the same color-words were presented
in black ink. No difference was found between the two conditions.
The same color-word stimuli were used in Experiment 2 but
participants named the color of the ink. Color blocks were used
in the control condition. Naming the ink color of incongruent
color words took significantly longer than naming the color
of blocks. This difference in naming time has been referred
to as Stroop Interference; although, the term Stroop Effect is
often used synonymously. Finally, in Experiment 3, participants
practiced the color naming task for eight days. Color naming
times in the incongruent condition decreased with practice.
Participants also read the words after the eight days of practice.
Their word naming (i.e., reading) times were longer the first time
they named the color words. This finding has been referred to as
the reverse Stroop Effect.
Stroop Interference is robust and highly replicable (cf.,
MacLeod, 1991). In fact, it has been called the gold standard
of attentional measures (MacLeod, 1992). The Color-Word
stimuli presented in the Stroop task are obviously composed of
two components: color and word. Therefore, it is not surprising
that theoretical explanations of Stroop Interference have focused
on how these two dimensions are processed. One explanation
is the relative speed of processing hypothesis (Morton & Cham-
bers, 1973; Posner & Snyder, 1975). This account assumes that
both the color and the word are processed at the same time but
at different rates. It also assumes that there is a limited capacity
response channel which the color and word information must
travel. Since words are processed faster than colors (Cattell,
5
1886), the word information passes along the limited capacity re-
sponse channel first thereby causing interference when the color
and the word do not match. A related explanation is based on
the amount of attentional resources required to process the two
dimensions instead of the speed at which they are processed.
The automaticity explanation assumes that more automatic
processes can interfere with less automatic processes (LaBerge
& Samuels, 1974; Shiffrin & Schneider, 1977). Since reading is
more automatic than color naming, word information interferes
with color naming when the word and color are incongruent.
The parallel distributed processing model proposed by Cohen,
Dunbar, and McClelland (1990) suggests that the color and word
are processed along two pathways that differ in strength. Despite
differences between these three explanations of Stroop Interfer-
ence, they primarily focus on the speed, attentional demand, or
strength of word processing compared to color naming.
DISORDERS AND THE COLOR-WORD STROOP TASK
The Color-Word Stroop task has been used to examine attention-
al processing in a number of disorders. Three disorders, Attention
Deficit Hyperactivity Disorder (ADHD), Learning Disability, and
Autism, are summarized in this section as examples.
Attention Deficit Hyperactivity Disorder (ADHD) Research
consistently shows that children with ADHD have greater dif-
ficulty naming the color print of incongruent color-word pairs
than control children (Barkley, Grodzinsky, & Paul, 1992; Frazier,
Demaree, & Youngstrom, 2004; Nigg, Willcutt, Doyle, & Sonuga-
Barke, 2005; Pennington & Ozonoff, 1996). This finding has
frequently been interpreted as a deficit in interference control for
ADHD children (e.g., Barkley, 1997). However, other researchers
have suggested that differences between ADHD and control chil-
dren are due to a slowing in word and color naming for the ADHD
children rather than a deficit in interference control (Homack &
Riccio, 2004; Nigg, 2001). This issue is revisited in the Criterion
Validity section of the Manual.
Learning Disability (LD) Deficits in executive functioning have
been found for both boys (Seidman, Biederman, Monuteaux,
Doyle, & Faraone, 2001) and girls (Seidman, Biederman, Valera,
Monuteaux, Doyle, & Faraone, 2006) with learning disabilities. In
particular, attention deficits can accompany learning disabilities
(Benezra & Douglas, 1988; Willcut et al., 2001; Whyte, 1994).
The Stroop Color and Word Test (Cat. No. 30150) (SCWT,
Golden, 1978) has been used to distinguish children with an LD
from children without an LD. Golden and Golden (2002), for in-
stance, were able to differentiate a learning disability group from
a non-LD group using the scores obtained from the SCWT with
89 percent accuracy. Lazarus, Ludwig, and Aberson (1984) were
also able to use the Stroop task to distinguish between children
with learning disabilities and controls. Further, they recommend-
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ed using the Stroop task as a screening tool for assessing LD.
Autism Spectrum Disorder (ASD) Impaired executive function-
ing is characteristic of a number of developmental disorders in-
cluding the spectrum of autistic conditions (Hill, 2004a, b). These
impairments can be seen among children (Robinson, Goddard,
Dritschel, Wisely, & Howlin, 2009) and adults (Hill & Bird, 2006).
Level of impairment may be related to level of functioning. For
example, inhibitory deficits have been found among high-func-
tioning autistic children (Rinehart et al., 2002; also Crane et al.,
2011). However, Bryson (1983), among others, found no differ-
ence in Stroop Interference between children with ASD and typi-
cally developing children. Adams and Jarrold (2009) concluded
that the lower reading comprehension of children with autism
affects Stroop Interference which could lead to misleading Stroop
results despite the failure to find impairment on the task (Hill &
Bird, 2006; Ozonoff & Jensen, 1999). This issue is also revisited
in the Criterion Validity section of the manual.
DISORDERS AND MODIFIED COLOR-WORD STROOP TASKS
There have been a number of variations to the original Stroop
task. Several researchers, for instance, presented a picture with
an embedded word (e.g., the word “chair” embedded in a picture
of a table). Incongruent picture-word pairings produced longer
picture naming times than congruent pairings (Rosinski, 1977;
Rosinski, Golinkoff, & Kukish, 1975; Posnansky & Rayner, 1977;
Rayner & Posnansky, 1978; Underwood, 1976). While these
studies changed the type of object paired with a word, Klein
(1964) changed the word meaning. He found that color associ-
ated words, such as grass and sky, produce interference when
presented in incongruent color print. These task variations have
led others to modify the Stroop task for clinical purposes. For
example, a number of researchers have replaced color-words
with threat words and asked participants to name the color of
the print. Controls were found to complete the task faster than
patients with generalized anxiety disorder (Bradley, Mogg, Millar,
& White, 1995; Mathews & MacLeaod, 1985; Mathews, Mogg,
Kentish, & Eysenck, 1995), phobias (Kindt & Brosschot, 1997;
Martin, Horder, & Jones, 1992; Becker, Rinck, Margraf, & Roth,
2001), obsessive compulsive disorder (Lavy, van Oppen, & van
den Hout, 1994; McNeil, Tucker, Miranda, Lewin, & Nordgren,
1999), panic disorder (Buckley, Blanchard, & Hickling, 2002;
Ehlers, Margrat, Davies, & Roth, 1988), and posttraumatic stress
disorder (Beck, Freeman, Shipherd, Hamblen, & Lackner, 2001;
McNally, Amir, & Lipke, 1996). Food- and body-related words
have also been shown to produce interference among individu-
als with eating disorders (Ben-Tovim & Walker, 1991; Fairburn,
Cooper, Cooper, McKenna, & Anastasiades, 1991; Johansson,
Ghaderi, & Andersson, 2005). Thus, modifying the original
color-word Stroop task to include words associated with
a particular disorder has proven to be an effective tool for
examining attentional bias associated with those disorders.
DEVELOPMENT, LANGUAGE, AND STROOP INTERFERENCE
Research has clearly shown that the Color-Word Stroop task is
a reliable measure with clinical utility. However, obtaining scores
that reflect the true ability of individuals who do not communi-
cate effectively in the published language of a test has been a
long-standing concern in testing. According to the U.S. Census,
a language other than English is the primary language spoken in
approximately 20 percent of the homes across the United States.
Although Spanish is spoken in the majority (62.3%) of these
homes, there are a significant number of homes in which other
Indo-European languages (18.6%) and Asian and Pacific Island
languages (15.0%) are spoken (Shin & Kominski, 2010). The
number of different languages spoken can be staggering. For
instance, Pasko (1994) estimated that 200 different languages
were spoken in Chicago Public Schools. However, the number
of different languages spoken within a school district is
not a problem limited to the largest school districts. For
example, there are 92 different languages spoken in the Los
Angeles Unified School District (Master Plan Institute, 2010), the
second largest school district in the United States with nearly
700,000 students (Snyder, Dillow, & Hoffman, 2009), and 94 dif-
ferent languages spoken in the Portland School District, the 94th
largest school district with more than 43,000 students (Portland
School District, 2012). These statistics highlight the diversity of
the population and the potential for language-related difficulties
regardless of location.
Concern about language is especially important for tests that are
language-based. Attempts to develop nonverbal assessments
can be traced back to the Army Beta test (Thorndike & Lohman,
1990). More recently, the Joint Committee on the Standards
for Educational and Psychological Testing developed several
standards (e.g., Standard 7.3 and Standard 9.3) addressing
language-related issues (American Educational Research As-
sociation, 1999). Since the Color-Word Stroop task uses words,
reading ability is critical to the task (e.g., Cox et al., 1997). Two
areas of research are particularly relevant to this issue. Develop-
mental research regarding the Stroop task has shown that
interference increases, as children learn, from seven to nine
years of age. Interference begins to taper off through adult-
hood until approximately 60 years of age when it increases
once again (cf., MacLeod, 1991). Schiller (1966), for example,
examined 40 subjects each in six grades ranging from first
grade to the freshman year in college. He found minimal Stroop
Interference in first grade. However, interference was maximal
by second and third grade and consistently declined thereafter.
Subjects also responded faster with age.
Comalli, Wapner, and Werner (1962) tested a wider age range.
They administered the Stroop task to 235 subjects between the
ages of seven and 80 years of age. Interference was greatest in
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young children. It is important to note that the young children ex-
amined by Comalli, Wapner, and Werner (1962) were the same
age as the second graders tested by Schiller (1966). Therefore,
the findings from these two studies are consistent. However,
Schiller’s oldest subjects were college freshmen while Comalli et
al. examined individuals as old as 80 years of age. This wider
age range contributed to an additional finding. Stroop Inter-
ference decreased slightly throughout adulthood but then
increased in old age. Other researchers have found similar
patterns. For instance, Wise, Sutton, and Gibbons (1975) found
less interference among college students than elementary school
students. Additionally, Cohn, Dustman, and Bradford (1984), us-
ing a sample between the ages of 21 and 90, found that individu-
als older than 60 years of age were slower, and exhibited greater
interference than younger adults.
One factor that changes with age is reading ability. Consequently,
the developmental findings are frequently explained in terms of
reading ability. For instance, age seven is generally when chil-
dren develop reading fluency (Chall, 1983). This is also the
age at which Schiller (1966) found that Stroop Interference
peaks and begins to decline. Similarly, reading ability tends to
decline in the elderly (Kirsch et al., 1993) which is when Camalli,
Wapner, and Werner (1962) found that Stroop Interference began
to increase. Fournier et al. (1975) directly examined reading lev-
el and found the better readers exhibited more interference than
poor readers (also Protopapas, Archonti, & Skaloumbaka, 2007).
In a longitudinal study of first graders, Stanovich, Cunningham,
and West (1981) also found that greater interference was linked
with greater reading ability. In addition, they argued that the
automaticity associated with reading began to level off at the end
of first grade. As mentioned previously, the speed with which
reading occurs is an important theoretical concept often
used in several explanations of Stroop Interference.
Another area of research important to the Stroop task and
language ability is bilingualism. If the Stroop task is related
to reading ability and the speed with which words are pro-
cessed, then individuals who process one language faster
than another should also show more interference with that
language than with the other. This is precisely what happens.
Preston and Wallace (1969) were the first to demonstrate this
finding. They had participants who were bilingual in English
and French, English and Hungarian, and German and English.
Participants engaged in the Color-Word Stroop task in both lan-
guages. Preston and Wallace found that the differences across
languages were about the same as the interference found within
a language with the primary language producing more interfer-
ence. English speaking monolinguals and Spanish-English bilin-
guals were tested by Dyer (1971b) using the Color-Word Stroop
task in five different languages. Interference was maximal when
7
the words appeared in the participant’s primary language and
decreased as the languages became less familiar (also Rosselli
et al., 2002). Mägiste (1984, 1985) obtained a complementary
finding by examining trends in language development. Initially,
more interference was found in participants’ primary language.
However, as they became more proficient in the second lan-
guage (i.e., balanced bilinguals) the amount of interference found
for each language was equivalent (cf., Vega & Fernandez, 2011;
Gerhand, Deregowski, & McAllister, 1995). Chen and Ho (1986)
attempted to extend this finding to Chinese-English bilinguals.
Although interference with English color-words increased as
participants became more proficient with English, Chinese stimuli
continued to produce greater interference. This particular finding
may suggest that certain languages are more susceptible to
Stroop Interference (Biederman & Tsao, 1979). Together, these
findings indicate that language development and proficiency
influence Stroop processing. More recent research suggests that
Stroop Interference among bilinguals may also be mediated by
age (Kousaie & Phillips, 2012; Gathercole et al., 2010).

PURPOSE
Despite the robustness of the Stroop Effect, research shows
that the task is tied to reading and language ability. The
purpose of the NSCST is to provide a nonverbal assessment
of inhibition processing using a modified version of the
Stroop task. In particular, by removing words from the task and
their associated developmental and language effects, the NSCST
is designed to provide an unbiased measure of basic attentional
processing (cf., Taylor & Clive, 1983).

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