Test of Everyday Attention for Children, Second Edition

What does the complete TEA-Ch2 kit include?

The complete kit comes with instructions to install the latest version of the computerised subtests and scoring from the Pearson Assessment Support site, the Administration, Scoring & Technical Manual, TEA-Ch2 J comics, TEA-Ch2 A comics, star stickers, scoring acetates, red pen, powered external speakers, and a stopwatch. To use the TEA-Ch2 you will also need a computer (PC, Mac or laptop) with keyboard and mouse, a blank sheet of paper and a ruler. Instructions included with the kit show you how to download an .exe file onto your PC or Mac. Running this file will extract the program onto the PC and initiate the password and log-in processes. It will open when selected from the program list or if the icon is clicked.

What are the TEA-Ch2 technical requirements?

The computerised subtests of the TEA-Ch2 will run well on devices that meet minimum specification as follows:

Hardware:

• a minimum of 500mb of free disk space
• a minimum of 2GB of physical memory (RAM)
• must support Hardware-accelerated OpenGL or OpenGL ES.

Software:

• Windows operating system (OS) Vista, Windows 7, Windows 8
• Product Support/TEA-Ch2 5/4/2016
• Windows 8.1, Windows 10 or later
• Mac operating system (OS) 10.8 or later.

The TEA-Ch2 is 32bit application and will run on both 32bit and 64bit operating systems.

Please note that the TEA-Ch2 program is not supported on tablet or mobile devices.

Can the TEA-Ch2 be administered on an IPad? Can I use TEA-Ch2 on my smartphone?

At the moment, the TEA-Ch2 will not work on an IPad.It will work on a Mac and PC, but not on smaller (tablet or mobile) devices.

Storage of information by the TEA-Ch2 program - where is it?

After entering an Examination ID, while this is 'live' on the test-user's system and until it is deleted (e.g., in the course of finalising a PDF output report), the results are stored in a file called "exams.json" in the TEA-Ch2 local app folder on the user's C drive. The file cannot be opened using other programs and attempting to open, modify or move the file may result in loss of test-takers’ data.

What new subtests are included?

The TEA-Ch2 has all new subtests: some cover the same tasks and functions as subtests in the original TEACh and some address new and different abilities.

Please see the table below for what each subtest measures and how these compare with the original TEACh.Brand new subtests include:

Sustained Attention to Response task (SART), a measure of sustained attention, where children respond with a key press to shapes, but withhold their response when presented with a triangle;

Reds & Blues, Bags & Shoes (RBBS), a measure of switching attention in the TEA-Ch2 A, that requires children to switch between two rules while responding to simple images;These subtest before now were not available to clinicians in accessible formats.

TABLE 1: TEACh2 Subtests and TEACh equivalents. TEA-Ch2 subtests and TEA-Ch equivalents

What are the main changes between TEACh and TEA-Ch2?

The TEA-Ch2 is a comprehensive update of the original TEACh, with important innovations, including:

• a colourful, ‘comic’ format for the paper based subtests, that gives the assessment a game-like and engaging feel, and is especially useful for younger children;
• computer-based subtests, that allow for trial-by-trial recording of responses, including reaction time and accuracy, scored by the computer rather than by the examiner;
• a shorter, simplified age-appropriate version for the youngest children (TEA-Ch2 J);
• incorporation of modern tasks from the literature on attention (e.g., simple reaction time, SART, and attentional switching) that cannot be given easily in paper-based formats;
• a large normative sample from the UK;
• modern, regression based norms, provided by scoring program, that can take a child’s age, gender and family education level into account when providing scaled scores.

Can you obtain any scores from just using the paper based parts?

The TEA-Ch2 is designed to be administered as a whole, using both computer-based and comic (paper-based) parts. Some of the subtests can be administered without using the program:

• TEA-Ch2 J Balloon Hunt, Balloons 5 and Hide & Seek Visual
• TEA-Ch2 A Hector Cancellation, Hector-B Cancellation and Hecuba Visual Searchand so it is possible to obtain scores for these subtests.

However, even for these subtests

• it is best to use the timers provided in the computer program for administration
• it is only possible at present to derive scaled scores using the scorer in the program
• and it is not possible to derive any of the composite indices using just these subtests,so it is best to use both the computer and paper-based components together.

Can you give me some information about the standardisation?What is the normative data for this test?

The TEA-Ch2 at present has normative data based on a sample of UK children ages 5-16 years.

• for TEA-Ch2 J, 394 children ranging in age from 5-8 years
• for TEA-Ch2 A, 621 children ranging in age from 8-16 years of age
• For mathematical reasons, children slightly older than the test format were included in the norms for each age-group, to ensure that the ‘shape’ of the regression curve was correct at the upper end of the age range.

The sample was matched to UK demographic variables for gender and family educational level, and the UK regions and ethnic groups are represented. The sample were typically-developing children attending mainstreams schools, who were primary speakers of English. Children with significant medical, psychiatric or neurological illnesses, with a learning disability, sensory impairment, or a diagnosis of specific learning disability, were not included.

The normative data were collected by trained examiners, either Pearson Clinical development staff or qualified and specialist psychologists (clinical, forensic, neuro- or educational psychologists) who were experience users of child cognitive and neuropsychological tests.

What scores will I get from the TEA-Ch2?

Subtest raw scores are converted to scaled scores, taking into account the child’s age, gender and (if provided by the examiner) family education level. The scaled scores have a Mean = 10 and SD = 3 (range 1 to 19). In addition, the program provides a percentile rank that corresponds to the number of persons achieving either that scaled score or less in the standardisation sample. If all of the required subtests have been administered, the scoring program will provide composite index scores corresponding to the key attentional domains, and performance overall:

• Selective Attention Index
• Sustained Attention Index
• Everyday Attention Index.

The index scores have a Mean = 100 and SD = 15. Percentile ranks are provided to correspond to the standard scores. Confidence Intervals (95%) are provided around all scores.

Who can administer the tests?

The TEA-Ch2 is designed for use by clinical, educational and child psychologists who are asked to undertake assessment of attentional functions in children.

As with all psychometric instruments, examiners using the TEA-Ch2 should have training and experience in the administration and interpretation of standardised tests. Examiners should also have experience in testing children and young people from linguistic, clinical, cultural or educational backgrounds similar to those they will be evaluating.

Although a trained technician or a research assistant may administer the subtests, results should always be interpreted only by those who have appropriate graduate or professional training in assessment. The test may also be used by academic researchers and other health and care professionals who have appropriate training in test administration and interpretation.

How long does the TEA-Ch2 take to administer?

The TEA-Ch2 A takes on average 48 minutes to administer in full; the TEA-Ch2 J takes on average 35 minutes. The individual subtests range from just 2 minutes for short cancellation tasks, to around 10 minutes for tests of sustained attention in the older age group. The battery should ideally be administered in its entirety and in the subtest order set out in the manual.

What clinical populations can I use the TEA-Ch2 with?

The TEA-Ch2 is designed for the assessment of attentional functions in children: the diverse subtests and factor structure allows examiners to identify strengths and weaknesses in attention, and so use results to design interventions and monitor outcomes.

The TEA-Ch2 will be particularly useful with children who have known or suspected problems with attention, including:

• children referred for difficulties in attention and/or executive functions;
• children referred for difficulties with behaviour, hyperactivity and/or impulsivity;
• children with cognitive difficulties due to neurological disorders.

The TEA-Ch2 is for children aged from 5 years 0 months to 15 years 11 months, who are primary speakers of English.

There a gap in age of administration between the TEA-Ch2 (up to age 15) and the TEA (from age 18). What should we use for young people aged 16 and 17 years?

Yes, there is a gap in the age ranges for the TEA and the TEA-Ch2 (as there was for the TEA and original TEACh). Really, the TEA-Ch2 is now a very different test to the TEA, not simply a downward extension in terms of age.

The materials and program are new, and are designed to appeal to children and young people. The norms have been collected on this group (to age 15 years) to reflect that ambition.For young people aged 16-17 years, the clinical picture will determine the choice of suitable tests.

However, usually the clinician will want to address the broad range of attentional functions. We recommend using relevant parts of the WAIS/WISC and DKEFS, for example:

• WAIS/WISC Coding and Symbol Search for processing speed,
• WAIS/WISC Digit Spans for short term stores and working memory,
• DKEFS Colour-Word, Verbal Fluency and Trail-making tests for the executive functions (inhibition and switching).

What validity studies have been carried out?

The TEA-Ch2 has great validity, which we have looked at in three main ways: using special group studies (criterion validity), looking at relationships with other measures (concurrent validity) and looking at the test’s internal structure (construct validity).

Special Group Studies

TEA-Ch2 subtests were administered to children who had been referred to a UK clinic for children with problems in attention and behaviour. Compared to a matched group of children without problems, the children referred for attention/behaviour problems showed weaknesses affecting several subtests:

• for TEA-Ch2 J, their scores were significantly lower for Balloon Hunt, Barking and Simple RT;
• for TEA-Ch2 A, their scores were significantly lower for Vigil, Simple RT and RBBS subtests.

Relationship with other variables

For some of the normative sample, the TEA-Ch2 was administered alongside the Strengths & Difficulties Questionnaire (SDQ) a measure of emotional and behavioural problems in children and young people. The results show that

• TEA-Ch2 subtests and indices were correlated with a number of SDQ scores, particularly the Hyperactivity/Inattention, Conduct Problems and Peer Problems subscales;
• accordingly, TEA-Ch2 subtests and indices were correlated with the SDQ External Problems dimension.

Internal Structure

Structural Equation Modelling (SEM) of the TEA-Ch2 data confirmed that

• the individual subtests contributed unique variance, and so each address different abilities;
• two common underlying factors emerged, supporting the construct validity of the Selective Attention and Sustained Attention indexes; and
• the two attention factors were correlated, endorsing the overall Everyday Attention Index.

Have you conducted clinical or special group validity studies?

Yes, special group studies (clinical validity studies) are an important way to establish that a test measures functions of interest. We administered the TEA-Ch2 to children in three clinical groups:

• children with difficulties in attention and behaviour;
• children who have had a stroke; and
• children treated for Acute Lymphoblastic Leukaemia.

These studies showed that:

• children referred for attention or behaviour problems showed significant weaknesses, affecting several TEA-Ch2 subtests (though not on simple cancellation tasks in older children);
• children with a previous stroke were disadvantaged only on subtests measuring selective attention;
• in contrast, children who had been treated for leukaemia (who had been medically ill, and experienced an adverse life event) obtained good scores on TEA-Ch2 subtests.

Further studies with children who have had a head injury, and children referred and treated for behavioural problems, are currently underway.

How is the TEA-Ch2 different to other test batteries such as the WISC or BAS?

The TEA-Ch2 measures some of the same abilities as other test sets, but is intended to specifically address attention, and - uniquely - measures separable aspects of attention: selective attention, sustained attention and switching attention. For part of the normative sample, the TEA-Ch2 was administered alongside subtests of the Wechsler Intelligence Scales for Children (WISC-IV), a measure of general cognitive and intellectual abilities.

These results show that

• generally, TEA-Ch2 subtests have low correlations with WISC subtests, which suggests that they measure different abilities, and that the TEA-Ch2 is not unduly influenced by verbal comprehension or visual/perceptual abilities.

The TEA-Ch2 indices were correlated with the WISC general ability index, reflecting the typical observation that composite measures of cognitive abilities tend to be inter-correlated.

Can you tell me about the test reliability?

The TEA-Ch2 has good reliability, which we have looked at in two main ways: consistency within the scores on a subtest (internal consistency); and consistency between scores obtained on two testing occasions (test-retest stability).

Internal Consistency coefficients for the TEA-Ch2 J range from moderate (>.5) to good (>.8), with most subtests being good. For the TEA-Ch2 A, Internal Consistency coefficients ranged from moderate (>.5) to excellent (>.9) with most subtests being good or excellent.

Test-retest stability coefficients for the TEA-Ch2 J range from lower (>.3) to acceptable (>.7), with most subtests being adequate (>.6). For the TEA-Ch2 A, stability coefficients ranged from lower (>.4) to good (>.8) with most subtests being acceptable.Please note that for some subtests, such as Barking and Vigil, reliability is difficult to establish:

• the subtests are easy for typically-developed children without attention problems;
• the subtest trials are short and/or contain just one or very few responses;
• the subtests measure inherently variable/fluctuating aspects of sustained attention.For these subtests, it is important to consider the reliability in clinical samples: our clinical studies confirm that - for children who have problems in these areas - the subtests are reliable.