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Five-Point Test (5-PT)
Availability
Please visit this website for more information about the instrument: Five-Point Test
Classification
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure for executive functioning (generativity/set-shifting).
 
Exploratory: Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage (SAH)
Short Description of Instrument
Description: The paper-and-pencil form of the 5-Point Test (5-PT) is a widely used test of brain functioning. The test makes demands on different neuropsychological domains - generativity, planning, cognitive flexibility and divergent thinking. The 5-PT's usefulness as a clinical test has been demonstrated for both neurological and psychiatric disorders. The influence of different demographic variables has been discussed in the literature. In particular, age and education level appear to affect performance on the 5-PT. The present test is based on proven experimental paradigms for measuring divergent thinking as an aspect of the executive functions. It can be used to assess neuropsychological deficits and prepare for therapeutic intervention.
Another commonly used alternate is DKEFS Design Fluency, which aims to evaluate the same cognitive constructs.
Comments/Special Instructions
In the 5-PT the participant is given sheets of paper on which 40 squares, each consisting of a fixed pattern of five symmetrically arranged dots, are printed. The participant is asked to produce as many different designs as possible by connecting the dots in each square with one or more straight lines within two minutes. The participant is given the following instructions:
 
"There are a number of squares, each containing five dots, on the sheet of paper in front of you. I want you to draw as many designs as possible within the next two minutes by connecting two or more dots with straight lines. Not all dots per square have to be used. Please do not repeat any designs or draw lines that do not connect dots."
 
After the demonstration of two possible designs by the examiner, the participant is asked to begin with the task. Repetitions of designs (perseverative errors) and production of designs with lines that failed to connect dots (rule violations) are regarded as errors. The number of unique designs and the number of both perseverative errors and rule violations are scored for each minute.
 
NeuroRehab Specific: For figural fluency tests, DKEFS Design Fluency is most accepted and has more data supporting its utility; Five-Point Test (5-PT) is acceptable.
 
 
Scoring

The main variables describe the total number of patterns produced, the number of correct patterns and perseveration errors. The number of strategies used, the error rate and the percentage of correctly worked items are also reported.
Scoring and Psychometric Properties
Scoring: The main variables describe the total number of patterns produced, the number of correct patterns and perseveration errors. The number of strategies used, the error rate and the percentage of correctly worked items are also reported.
 
Psychometric Properties:
1) 20-30 day test-retest r=0.65 to 0.78 (unique designs) is acceptable.
2) Minimal ceiling/floor effects and generally normally distributed
3) Medium (d=0.5) practice effects and no alternate forms available. However, practice effects lessen with age and other brain risk factors (e.g., vascular disease)
Rationale/Justification
Strengths:
The 5-PT and especially DKEFS Design Fluency, are widely used, easy/quick to administer, sensitive to frontal lobe injury (particularly R>L injury), and have good psychometric properties. It tests a number of neuropsychological domains that are regarded at risk in patients following SAH. Tucha et al., 2012 describes normative data for 5-PT available in n=635 healthy adults up until the age of 69 years, thus covering the age range of SAH patients. For these reasons, the Swiss national standard of neuropsychological assessment after SAH includes the 5-PT.
Weaknesses: Not appropriate for patients with motor impairment.
 
 
References
Fernandez AL, Moroni MA, Carranza JM, Fabbro N, Lebowitz BK. Reliability of the Five-Point Test. Clin Neuropsychol. 2009;23(3):501-509.
 
Possin KL, Chester SK, Laluz V, Bostrom A, Rosen HJ, Miller BL, Kramer JH. The frontal-anatomic specificity of design fluency repetitions and their diagnostic relevance for behavioral variant frontotemporal dementia. J Int Neuropsychol Soc. 2012 Sep;18(5):834-44.
 
Regard M, Strauss E, Knapp P. Children's production on verbal and non-verbal fluency tasks. Percept Mot Skills. 1982;55(3 Pt 1):839-844.
 
Stienen MN, Zweifel-Zehnder AE, Chicherio M, Studerus-Germann A, Bl?si S, Rossi S, Gutbrod K, Schmid N, Beaud V, Mondadori C, Brugger P, Sacco L, Müri R, Hildebrandt G, Keller E, Regli L, Fandino J, Mariani L, Raabe A, Daniel RT, Reinert M, Robert R, Schatlo B, Bijlenga P, Schaller K, Monsch AU, on behalf of the Swiss SOS study group. Neuropsychological testing after aneurysmal subarachnoid hemorrhage. Swiss Medical Forum. 2015;15(48):1122-1127.
 
Tucha L, Aschenbrenner S, Koerts J, Lange KW. The Five-Point Test: Reliability, Validity and Normative Data for Children and Adults. PLoS ONE. 2012;7(9): e46080.
 
Zweifel-Zehnder AE, Stienen MN, Chicherio C, Studerus-Germann A, Bl?si S, Rossi S, Gutbrod K, Schmid N, Beaud V, Mondadori C, Brugger P, Sacco L, Müri R, Hildebrandt G, Fournier JY, Keller E, Regli L, Fandino J, Mariani L, Raabe A, Daniel RT, Reinert M, Robert T, Schatlo B, Bijlenga P, Schaller K, Monsch AU; Swiss SOS study group. Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations. Acta Neurochir (Wien). 2015;157(9):1449-1458.
 
Document last updated January 2022