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Token Test
Please visit this website for more information about the instrument: Token Test.
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure for language comprehension.
Supplemental: Stroke and Unruptured Cerebral Aneurysm and Subarachnoid Hemorrhage (SAH)
Short Description of Instrument
Purpose: The Token Test is used to assess auditory comprehension in persons with developmental and acquired disorders affecting language. The examinee provides a gestural response in response to a verbal command.
Comments/Special Instructions
The Token Test is excellent for detecting mild auditory comprehension deficits, but less useful for assessing other aspects of auditory comprehension (such as semantic comprehension) or functional communication. It cannot be used to directly assess expressive language, although it is sensitive to many types of aphasia.
Scoring and Psychometric Properties
Scoring: The test is scored on a scale of 0-163. The mean score for normal adults (and adolescents 14 years or older) is 161. Scores lower than 157 are virtually absent in a non-clinical adult population.
Psychometric Properties: The test shows excellent and good inter-examiner reliability, while some of the more complex sequences demonstrate lower coefficients.
Strengths: The test is very simple to administer. While it is primarily a screener for language comprehension, it is sensitive to a variety of language impairments. It has been studied across a variety of neurologic conditions and across the lifespan. It is not impacted by ethnicity, and scores tend to be stable over the lifespan.
Weaknesses: There are multiple versions of the Token Test, and some normative data are less adequate than others. Scores are highly skewed in non-aphasic samples.
De Renzi E, Vignolo LA. The token test: A sensitive test to detect receptive disturbances in aphasics. Brain 1962;85:665-678.
Additional References:
Alkhamra RA, Al-Jazi AB. Validity and reliability of the Arabic Token Test for children. Int J Lang Commun Disord. 2016 Mar;51(2):183-91.
Becker F, Reinvang I. Event-related potentials indicate bi-hemispherical changes in speech sound processing during aphasia rehabilitation. J Rehabil Med. 2007;39:658-661.
Franceschini M, Agosti M, Cantagallo A, Sale P, Mancuso M, Buccino G. Mirror neurons: action observation treatment as a tool in stroke rehabilitation. Eur J Phys Rehabil Med. 2010;46:517-523.
Hula W, Doyle PJ, McNeil MR, Mikolic JM. Rasch modeling of revised token test performance: validity and sensitivity to change. J Speech Lang Hear Res. 2006 Feb;49(1):27-46.
McNeil MR, Pratt SR, Szuminsky N, Sung JE, Fossett TR, Fassbinder W, Lim KY. Reliability and validity of the computerized Revised Token Test: comparison of reading and listening versions in persons with and without aphasia. J Speech Lang Hear Res. 2015.
Paci M, Lorenzini C, Fioravanti E, Poli C, Lombardi B. Reliability of the 36-item version of the Token Test in patients with poststroke aphasia. Top Stroke Rehabil. 2015 Oct;22(5):374-6.
Tuokko H, Woodward TS. Development and validation of a demographic correction system for neuropsychological measures used in the Canadian Study of Health and Aging. J Clin Exp Neuropsychol. 1996;18:479-616.
Vanbellingen T, Kersten B, Van de Winckel A, Bellion M, Baronti F, Muri R, Bohlhalter. A new bedside test of gestures in stroke: the apraxia screen of TULIA (AST). J Neurol Neurosurg Psych. 2011;82:389-392.
Willinger U, Schmoeger M, Deckert M, Eisenwort B, Loader B, Hofmair A, Auff E. Screening for Specific Language Impairment in Preschool Children: Evaluating a Screening Procedure Including the Token Test. J Psycholinguist Res. 2017 Oct;46(5):1237-1247.
Document last updated January 2022