Verbal card sorting task to measure executive functions (LaCroix et al., 2023)

Purpose: The Wisconsin Card Sorting Test (WCST) is commonly used to measure nonverbal executive functions (EFs) in a variety of clinical populations. However, in some clinical populations (e.g., people with aphasia), deficits may be present in more linguistic (or verbal) domains and less pronounced in nonverbal domains. Thus, when determining possible deficits in these individuals, it is critical to assess both verbal and nonverbal cognitive abilities. The purpose of this study was to create a verbal card sorting task (VCST) to complement the WCST.

Method: We created the VCST by modifying a computerized version of the WCST, the Berg Card Sorting Task (BCST). We then compared 35 individuals with mild traumatic brain injury (mTBI) and 33 matched controls’ performance on each task. We tested the VCST in individuals with mTBI first because they demonstrate impaired EFs but unimpaired language. We therefore expected the mTBI group to perform similarly on the VCST and BCST, suggesting that the two tasks measure EFs similarly.

Results: In line with our hypothesis, the mTBI group had unimpaired inhibition and sustained attention but impaired shifting on each task. Component loadings for both tasks were also similar, and participants’ inhibition and shifting scores positively correlated across the two tasks.

Conclusions: Together, these findings suggest that the VCST is a potentially useful tool for measuring verbal EF deficits. Our results also provide important insights into the EF impairments experienced by individuals with mTBI.

Supplemental Material S1. Demographic and mild traumatic brain injury (mTBI) specific information for the mTBI group.

Supplemental Material S2. Visual depiction of the first trial of the Berg Card Sorting Task (BCST; Panel A) and verbal card sorting task (VCST; Panel B).

Supplemental Material S3. Complete list of verbal card sorting task (VCST) stimuli separated by first letter, number of letters, and semantic category.

Supplemental Material S4. Nonstandardized means and standard deviations (in parentheses) for each card sorting task measure within each task and group.

LaCroix, A. N., Greene-Winek, A., Simon, S., Groth, H., & Ratiu, I. (2023). A verbal card sorting task to measure executive functions. American Journal of Speech-Language Pathology, 32(4), 1698–1704. https://doi.org/10.1044/2023_AJSLP-23-00027