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WISCONSIN CARD SORTING TEST

Presentation · September 2023

DOI: 10.13140/RG.2.2.13517.41446

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Tooba Amouzadeh Ali Akbar Arjmandnia

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WISCONSIN CARD SORTING TEST
Can you work while helping your child do his homework? If yes, then you’re good at shifting your attention!
 WHAT IS SHIFTING ATTENTION?

 Shifting attention is an everyday life skill.

 It is the ability to flexibly shift back and forth between multiple tasks, operations, or mental sets.
 A mental flexibility that allows us to move between different cognitive activities and perform them at
the same time.
 Imagine driving your car while suddenly another car drives in front of you. You should shift your
attention immediately from driving to not crashing that car.
 SHIFTING ATTENTION ASSESSMENT

 The Wisconsin Card Sorting Test (WCST) is a neuropsychological assessment of the executive function, shifting
attention.
 WHAT IS WCST?

 There are a total of 64 cards (short form) and 128 cards (full
version), each displaying one of four shapes: a star, a circle, a
triangle, or a cross. Furthermore, these cards come in various
colors, including red, green, blue, and yellow.
 None of them are similar.
 The cards can be categorized based on shape, color, and number.
 TEST EXECUTION

o The WCST necessitates that participants match stimulus cards with one of the four category cards by matching
either the card colors, shapes, or numbers.
o Participants are expected to determine the correct card sorting rule solely through trial and error and do not
receive any information about the sorting rule in use.
o However, they receive feedback “Correct” or “Incorrect” on the screen after each attempt.
o Once the participant grasps the sorting rule, they are expected to maintain it while disregarding other irrelevant
information.
o After participants demonstrate they have learned the sorting rule by successfully sorting six consecutive trials,
the sorting rule is altered randomly and the participants have to discover the new rule to successfully sort the
cards again.
 Target card

Let’s play!

Feedback:
Correct

Examinee’s choice

Option 1 Option 2 Option 3

The Rule: The sorting is based on number.

 SCORING TERMINOLOGY

Correct

• The response matches the sorting rule

Incorrect

• The response does not match the sorting rule

Ambiguous

• The chosen card matches the response card on two or more dimensions
OUTPUT DATA

Number of Perseverative Errors

Insisting on the initial incorrect answer at the beginning
of the test, or sticking to the previously successful rule,
despite feedback indicating that the rule has changed.

Number of Categories Completed (Achieved)

The number of patterns in which the subject could

obtain 6 correct answers.
 INTERPRETATION OF THE SCORES

• A higher number of categories completed suggests better

Categories Completed cognitive flexibility, adaptability, and problem-solving skills.
• It indicates a person's ability to learn and shift strategies
effectively.

• Perseverative errors reflect difficulties in letting go of a

Perseverative Errors previously learned and now incorrect sorting principle.
• Higher numbers of perseverative errors may indicate
impairments in cognitive flexibility and response inhibition.
COMPUTERIZED WISCONSIN CARD SORTING TEST
SHAHGHOLIAN, M., AZADFALLAH, P., FATHI-ASHTIANI, A., & KHODADADI, M. (2012). DESIGN OF THE WISCONSIN CARD SORTING TEST (WCST) COMPUTERIZED VERSION: THEORETICAL
FUNDAMENTAL, DEVELOPING AND PSYCHOMETRICS CHARACTERISTICS. CLINICAL PSYCHOLOGY STUDIES, 1(4), 110-134.
 TEST EXECUTION

▪ The four main cards of the test (including a red triangle, two green stars, three yellow crosses, and four circles
blue) are displayed on the top of the monitor screen.

▪ 60 other cards in completely random order and one by one at the bottom of the page.

▪ Since in some research, the keyboard was used and in others, the mouse was used to answer the cards, in this
software the possibility of using both is built.

▪ Immediately after the subject's answer, the correct or incorrect feedback appears on the screen in the form of
"correct" and "incorrect".
 TEST DURATION

▪ The time interval between the subject's answer and the presentation of feedback is 100
milliseconds
▪ The length of feedback is 200 milliseconds.

▪ The interval between the end of feedback and the presentation of the next card is
considered to be 700 milliseconds.
 NORMATIVE DATA FOR WCST
A REVIEW OF ARTICLES

✓ KHALAFI, A., KUCHACK ENTEZAR, R., HASANI, F., ASTAKI, M. (2016). PSYCHOMETRIC FEATURES AND STANDARDIZATION OF THE SOFTWARE VERSION OF THE CARD SORTING TEST
WISCONSIN IN 9-12 YEAR OLD STUDENTS OF QAZVIN CITY. THE 2ND NATIONAL CONFERENCE ON SCHOOL PSYCHOLOGY (HTTPS://REPOSITORY.UMA.AC.IR/ID/EPRINT/10251/)

✓ CIANCHETTI, C., CORONA, S., FOSCOLIANO, M., CONTU, D., & SANNIO-FANCELLO, G. (2007). MODIFIED WISCONSIN CARD SORTING TEST (MCST, MWCST): NORMATIVE DATA IN CHILDREN 4-13
YEARS OLD, ACCORDING TO CLASSICAL AND NEW TYPES OF SCORING. THE CLINICAL NEUROPSYCHOLOGIST, 21(3), 456–478. HTTPS://DOI.ORG/10.1080/13854040600629766
✓ MARQUINE, M. J., YASSAI-GONZALEZ, D., PEREZ-TEJADA, A., UMLAUF, A., KAMALYAN, L., MORLETT PAREDES, A., … HEATON, R. K.
(2020). DEMOGRAPHICALLY ADJUSTED NORMATIVE DATA FOR THE WISCONSIN CARD SORTING TEST-64 ITEM: RESULTS FROM THE NEUROPSYCHOLOGICAL NORMS
FOR THE U.S.–MEXICO BORDER REGION IN SPANISH (NP-NUMBRS) PROJECT. THE CLINICAL NEUROPSYCHOLOGIST, 1–
17. DOI:10.1080/13854046.2019.1703042

✓ NORMAN, M. A., MOORE, D. J., TAYLOR, M., FRANKLIN, D., JR, CYSIQUE, L., AKE, C., LAZARRETTO, D., VAIDA, F., HEATON, R. K., & HNRC GROUP (2011). DEMOGRAPHICALLY CORRECTED
NORMS FOR AFRICAN AMERICANS AND CAUCASIANS ON THE HOPKINS VERBAL LEARNING TEST-REVISED, BRIEF VISUOSPATIAL MEMORY TEST-REVISED, STROOP COLOR AND WORD TEST,
AND WISCONSIN CARD SORTING TEST 64-CARD VERSION. JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 33(7), 793–804.
HTTPS://DOI.ORG/10.1080/13803395.2011.559157
 NORMATIVE DATA FOR SPANISH-SPEAKING PEOPLE IN AMERICA, 2020
MARQUINE, M. J., YASSAI-GONZALEZ, D., PEREZ-TEJADA, A., UMLAUF, A., KAMALYAN, L., MORLETT PAREDES, A., … HEATON, R. K. (2020). DEMOGRAPHICALLY ADJUSTED
NORMATIVE DATA FOR THE WISCONSIN CARD SORTING TEST-64 ITEM: RESULTS FROM THE NEUROPSYCHOLOGICAL NORMS FOR THE U.S.–MEXICO BORDER REGION IN SPANISH (NP-NUMBRS)
PROJECT. THE CLINICAL NEUROPSYCHOLOGIST, 1–17. DOI:10.1080/13854046.2019.1703042

 Population: aged 19-60

 The test version: 64 cards
 T-score cut point: T<40 is impaired (Heaton, et al, 2004 )
 Sample size: 189 native Spanish speakers
 Rule changing point: 6 consecutive correct sorts
 Basic parameters:
1. Perseverative responses
2. Perseverative errors
3. Conceptual level responses
4. Number of categories completed
5. Failure to maintain set
 IRANIAN NORMATIVE DATA, 2016
KHALAFI, A., KUCHACK ENTEZAR, R., HASANI, F., ASTAKI, M. (2016). PSYCHOMETRIC FEATURES AND STANDARDIZATION OF THE SOFTWARE VERSION OF THE CARD SORTING TEST
WISCONSIN IN 9-12 YEAR OLD STUDENTS OF QAZVIN CITY. THE 2ND NATIONAL CONFERENCE ON SCHOOL PSYCHOLOGY.

 Population: aged 9-12, girls and boys

 Software: The software designed by Shahgholian, et al, 2012
 Sample size: 320
 T mean: 50
 Basic parameters:
1. Number of Perseverative Errors
2. Number of Categories Completed
3. General errors
▪ Rule changing point: 10 consecutive correct sorts
Iranian normative data table
https://repository.uma.ac.ir/id/eprint/
10251/
 NORMATIVE DATA: AFRICAN-AMERICAN POPULATION, 2014
NORMAN, M. A., MOORE, D. J., TAYLOR, M., FRANKLIN, D., JR, CYSIQUE, L., AKE, C., LAZARRETTO, D., VAIDA, F., HEATON, R. K., & HNRC GROUP (2011). DEMOGRAPHICALLY CORRECTED NORMS FOR AFRICAN
AMERICANS AND CAUCASIANS ON THE HOPKINS VERBAL LEARNING TEST-REVISED, BRIEF VISUOSPATIAL MEMORY TEST-REVISED, STROOP COLOR AND WORD TEST, AND WISCONSIN CARD SORTING TEST 64-
CARD VERSION. JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 33(7), 793–804. HTTPS://DOI.ORG/10.1080/13803395.2011.559157

 Population: aged 20-65

 The test version: 64 cards
 T-score cut point: T<40 is impaired (Heaton, et al, 2004 )
 Sample size: 246 healthy individuals
 Rule changing point: 6 consecutive correct sorts
 Basic parameters:
1. Total errors
2. Perseverative errors
3. Conceptual level responses
African-American normative
data table
 ITALIAN NORMATIVE DATA, 2006
CIANCHETTI, C., CORONA, S., FOSCOLIANO, M., CONTU, D., & SANNIO-FANCELLO, G. (2007). MODIFIED WISCONSIN CARD SORTING TEST (MCST, MWCST): NORMATIVE DATA IN CHILDREN 4-13 YEARS OLD,
ACCORDING TO CLASSICAL AND NEW TYPES OF SCORING. THE CLINICAL NEUROPSYCHOLOGIST, 21(3), 456–478. HTTPS://DOI.ORG/10.1080/13854040600629766

 Population: aged 4-13, girls and boys

 The test version: 48 cards (Nelson, 1976)
 Sample size: 1126 normal children
 Rule changing point: 6 consecutive correct sorts Italian normative data table
(next page)
 Basic parameters:
1. Percent perseverative errors
2. Categories completed
3. Perseverative errors, to name but a few
 REFERENCES
▪ Giandomenico, K.; Baron, L.S.; Gul, A.; Arbel, Y. Between Shifting and Feedback Processing in the Wisconsin Card Sorting Test in Children with
Developmental Language Disorder. Brain Sci. 2023, 13, 1128.
▪ Bishara, A. J., Kruschke, J. K., Stout, J. C., Bechara, A., McCabe, D. P., & Busemeyer, J. R. (2010). Sequential Learning Models for the Wisconsin Card Sort Task:
Assessing Processes in Substance Dependent Individuals. Journal of mathematical psychology, 54(1), 5–13.
▪ Miles, S., Howlett, C. A., Berryman, C., Nedeljkovic, M., Moseley, G. L., & Phillipou, A. (2021). Considerations for using the Wisconsin Card Sorting Test to
assess cognitive flexibility. Behavior research methods, 53(5), 2083–2091.
▪ Shahgholian, M., azadfallah, P., Fathi-Ashtiani, A., & khodadadi, M. (2012). Design of the Wisconsin Card Sorting Test (WCST) computerized version:
Theoretical Fundamental, Developing and Psychometrics Characteristics. Clinical Psychology Studies, 1(4), 110-134.
▪ khalafi, A., KUchack entezar, R., Hasani, F., Astaki, M. (2016). Psychometric features and standardization of the software version of the card sorting test
Wisconsin in 9-12 year old students of Qazvin city. The 2nd National Conference on School Psychology (https://repository.uma.ac.ir/id/eprint/10251/)
▪ Cianchetti, C., Corona, S., Foscoliano, M., Contu, D., & Sannio-Fancello, G. (2007). Modified Wisconsin Card Sorting Test (MCST, MWCST): normative data
in children 4-13 years old, according to classical and new types of scoring. The Clinical neuropsychologist, 21(3), 456–478.
https://doi.org/10.1080/13854040600629766
▪ Marquine, M. J., Yassai-Gonzalez, D., Perez-Tejada, A., Umlauf, A., Kamalyan, L., Morlett Paredes, A., … Heaton, R. K. (2020). Demographically adjusted
normative data for the Wisconsin Card Sorting Test-64 item: Results from the Neuropsychological Norms for the U.S.–Mexico Border Region in Spanish (NP-
NUMBRS) project.The Clinical Neuropsychologist, 1–17. doi:10.1080/13854046.2019.1703042
▪ Norman, M. A., Moore, D. J., Taylor, M., Franklin, D., Jr, Cysique, L., Ake, C., Lazarretto, D., Vaida, F., Heaton, R. K., & HNRC Group (2011). Demographically
corrected norms for African Americans and Caucasians on the Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Stroop
Color and Word Test, and Wisconsin Card Sorting Test 64-Card Version. Journal of clinical and experimental neuropsychology, 33(7), 793–804.
https://doi.org/10.1080/13803395.2011.559157

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