Skip to main content

The Modified Five-Point Test: normative data for a sample of Italian healthy adults aged 16–60

Abstract

The Five-Point Test is one of the various measures of figural fluency functions that have been developed as nonverbal analogues to word fluency tasks, and used in neuropsychological assessment to evaluate the ability to initiate and sustain mental productivity, and to self-monitor and regulate responding in the visual–spatial domain. The aim of the current study was to collect normative data for a version of the Five-Point Test (M-FPT) administered to a sample of Italian healthy adults aged 16–60 (n = 332). Performance on the M-FPT was scored by computing the cumulative number of unique designs (UDs) performed on a 3-min administration time. Two supplemental scores were also computed: (a) the cumulative strategies (CSs) consisting with the number of UDs incorporated into enumerative or rotational strategies; (b) the error index (ErrI), consisting with the percentage between the number of perseverative or rule-breaking errors and the number of designs overall. Multiple regression analyses revealed a significant effect of age and education, but not gender, for both UDs and CSs. Equivalent scores and cut-off scores were then determined for UDs and CSs. Descriptive statistical analyses and cut-off scores were reported for ErrI. The availability of normative data for the M-FPT will be valuable in clinical settings for assessing of executive dysfunctions on the visual-spatial subdomain of subjects with brain injury. However, in order to increase the usefulness of the test, the upper limits of the age range of the normative sample should be widened. Moreover, further analyses should be required for determining the inter-rater and test–retest reliability for M-FPT performances, and providing evidence of the sensitivity of this measure to brain disturbances generally and to frontal lobe dysfunction specifically.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Benton AL, Hamsher K, Sivan AB (1994) Multilingual aphasia examination. AJA Associates, Iowa City

    Google Scholar 

  2. Lezak M (1995) Neuropsychological assessment. Oxford University Press, Oxford

    Google Scholar 

  3. Jones-Gotman M, Milner B (1977) Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 15:653–674

    PubMed  Article  CAS  Google Scholar 

  4. Regard M, Strauss E, Knapp P (1982) Children’s production of verbal and non-verbal fluency tasks. Percept Mot Skills 55:839–844

    PubMed  CAS  Google Scholar 

  5. Ruff RM, Light RH, Evans RW (1987) The Ruff Figural Fluency Test: a normative study with adults. Dev Neuropsychol 3:37–51

    Article  Google Scholar 

  6. Glosser G, Goodglass H (1990) Disorders in executive control functions among aphasic and other brain-damaged patients. J Clin Exper Neuropsychol 12:485–501

    Article  CAS  Google Scholar 

  7. Delis DC, Kaplan E, Kramer JH (2001) Delis–Kaplan executive function system: manual. Psychological Corporation, San Antonio

  8. Ruff RM, Allen CC, Farrow CE et al (1994) Differential impairment in patients with left versus right frontal lobe lesions. Arch Clin Neuropsychol 9:41–55

    PubMed  CAS  Google Scholar 

  9. Baldo JV, Shimamura AP, Delis DC et al (2001) Verbal and design fluency in patients with frontal lobe lesions. J Int Neuropsychol Soc 5:586–596

    Article  Google Scholar 

  10. McDonald CR, Delis DC, Norman MA et al (2005) Discriminating patients with frontal-lobe epilepsy and temporal-lobe epilepsy: utility of a multilevel design fluency test. Neuropsychol 19(6):806–813

    Article  Google Scholar 

  11. Varney NR, Roberts RJ, Struchen MA et al (1996) Design fluency among normals and patients with close-head injury. Arch Clin Neuropsychol 11:345–353

    PubMed  CAS  Google Scholar 

  12. Taylor AE, Saint-Cyr JA, Lang AE (1986) Frontal lobe dysfunction in Parkinson’s disease: the cortical focus of neostriatal outflow. Brain 109:845–883

    PubMed  Article  Google Scholar 

  13. Bigler ED (1995) Design fluency in dementia of Alzheimer’s type, multi-infarct dementia and dementia associated with alcoholism. Appl Neuropsychol 2:7–14

    PubMed  Article  CAS  Google Scholar 

  14. Fama R, Sullivan EV, Lim KO et al (2000) Structural brain correlates of verbal and nonverbal fluency measures in Alzheimer’s disease. Neuropsychology 14(1):29–40

    PubMed  Article  CAS  Google Scholar 

  15. Lee GP, Strauss E, Loring DW et al (1997) Sensitivity of figural fluency on the Five-Point Test to focal neurological dysfunction. Clin Neuropsychol 11:59–68

    Article  CAS  Google Scholar 

  16. Elfgren CI, Risberg J (1998) Lateralized frontal blood flow increases during fluency tasks: influence of cognitive strategy. Neuropsychologia 36(6):505–512

    PubMed  Article  CAS  Google Scholar 

  17. Foster PS, Williamson JB, Harrison DW (2005) The Ruff Figural Fluency Test: heightened right frontal lobe delta activity as a function of performance. Arch Clin Neuropsychol 20:427–434

    PubMed  Article  Google Scholar 

  18. Ruff RM (1996) Ruff Figural Fluency Test Manual. Psychological Assessment Resources, Lutz

    Google Scholar 

  19. Carter SL, Shore D, Harnadek MCS et al (1998) Normative data and interrater reliability of the Design Fluency Test. Clin Neuropsychol 12(4):531–534

    Google Scholar 

  20. Santa Maria MP, Martin JA, Morrow CM et al (2001) On the duration of spatial fluency measures. Int J Neurosci 106:125–130

    PubMed  Article  CAS  Google Scholar 

  21. Delis DC, Kramer JH, Kaplan E et al (2004) Reliability and validity of the Delis–Kaplan executive function system: an update. J Int Neuropsychol Soc 10:301–303

    PubMed  Article  Google Scholar 

  22. Ross TP, Foard EL, Hiott FB et al (2003) The reliability of production strategy scores for the Ruff Figural Fluency Test. Arch Clin Neuropsychol 18:879–891

    PubMed  Google Scholar 

  23. Goebel S, Fisher R, Ferstl R et al (2009) Normative data and psychometric properties for qualitative and quantitative scoring criteria of the Five-Point Test. Clin Neuropsychol 23:675–690

    PubMed  Article  Google Scholar 

  24. Fernandez AL, Moroni MA, Carranza M et al (2009) Reliability of the Five-Point Test. Clin Neuropsychol 23:501–509

    PubMed  Article  Google Scholar 

  25. Lee GP, Strauss E, McCloskey L et al (1994) Figural fluency on the Five-Point Test: preliminary normative and validity data. Int Neuropsychol Soc Bull 1:51

    Google Scholar 

  26. Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Ital J Neurol Sci 6(8):1–120

    Google Scholar 

  27. Capitani E (1997) Normative values and neuropsychological assessment. Common problems in clinical practice and research. Neuropsychol Rehab 7:295–309

    Article  Google Scholar 

  28. Gibbons Natrella M (1966) Experimental statistic. National Bureau of Standard, Wiley, New York

    Google Scholar 

  29. Risser AH, Andrikopoulos J (1996) Regard’s Five-Point Test: adolescent cohort stability. J Int Neuropsychol Soc 2:3–4

    Google Scholar 

  30. Folstein MF, Folstein SE, McHugh PR (1975) Mini-Mental State (a practical method for grading the state of patients for the clinician). J Psychiat Res 12:189–198

    PubMed  Article  CAS  Google Scholar 

  31. Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment. Oxford University Press, New York

    Google Scholar 

  32. Harter SL, Hart CC, Harter GW (1999) Expanded scoring criteria for the Design Fluency Test: reliability and validity in neuropsychological and college samples. Arch Clin Neuropsychol 14:419–432

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Patrizia Felice for her helpful support with data collection.

Conflict of interest

The authors state no conflicts of interest. The research was not funded by any corporation or by any external party directly interested in the results.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raffaella Cattelani.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cattelani, R., Dal Sasso, F., Corsini, D. et al. The Modified Five-Point Test: normative data for a sample of Italian healthy adults aged 16–60. Neurol Sci 32, 595–601 (2011). https://doi.org/10.1007/s10072-011-0489-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-011-0489-4

Keywords

  • Modified Five-Point Test
  • Spatial fluency
  • Assessment
  • Executive functions
  • Normative data