The impact of language on the equivalence of trail making tests: Findings from three pediatric cohorts with different language dominance

The effect of different language backgrounds on performance and the functional equivalence of trail making tests were examined. The children's version of the Trail Making Test A and B (TMT) and the Children's Color Trails Test 1 and 2 (CCTT) were employed with right-handed (n=79) participants. Children were classified into three groups according to language proficiency: Chinese dominant (CDL), Chinese-English bilinguals (CEB), and English dominant (EDL). In general, the CDL group exhibited the best performance on Children's Color Trails 1 and 2 and Trail Making Test A and B. In examining the functional equivalence of TMT and CCTT, both tests were influenced by language background and intelligence but not gender. The results suggest that language backgrounds do exert a modest effect on trail making tests and that diverging executive demands on CCTT 2 versus TMT B may impact their functional equivalence with different groups of participants. Therefore, caution should be exercised when comparing or replacing CCTT with TMT in children from different and diverging language backgrounds.