Apples Cancellation Test

Script Author: Katja Borchert, Ph.D. (katjab@millisecond.com), Millisecond

Created: January 21, 2013

Last Modified: January 19, 2025 by K. Borchert (katjab@millisecond.com), Millisecond

Script Copyright © Millisecond Software, LLC

Background

This script implements Millisecond's computerized version of the Apples test (Bickerton et al, 2011), a test for visual neglect and search strategy.

Mancuso et al (2015) discuss four measures (ExecutionTime in seconds, Accuracy Score, left-right Asymmetry Score for targets, and Commission Asymmetry Score for left-open vs. right-open apples) that depend on age and level of schooling to varying degrees.

This script provides the functionality to present the 'apples page' in roughly the same absolute size as the original paper&pencil version of the Apples Test. Default settings default back to proportional sizing. Go to 'defaults' setting for more info.

Data Files will contain the suggested measures by Bickerton et al (2011)/Mancuso et al (2015) as well as additional information about the 'response path' (search path) taken to find the Apple targets. Screenshots of the taken path/numbered targets can be taken (optional setting) for further analyses.

DISCLAIMER Millisecond advises caution in comparing results obtained with this computerized version of the Apples Test to results obtained with the original paper&pencil version.

References

Bickerton WL, Samson D et al (2011) Separating forms of neglect using the Apples test: validation and functional prediction in chronic and acute stroke. Neuropsychology 25(5):567 https://doi.org/10.1037/a0023501

Mancuso, M., Rosadoni, S., Capitani, D., Bickerton, W. L., Humphreys, G. W., De Tanti, A., Zampolini, M., Galardi, G., Caputo, M., De Pellegrin, S., Angelini, A., Bartalini, B., Bartolo, M., Carboncini, M. C., Gemignani, P., Spaccavento, S., Cantagallo, A., Zoccolotti, P., & Antonucci, G. (2015). Italian standardization of the Apples Cancellation Test. Neurological Sciences, 36(7), 1233+1240. https://doi.org/10.1007/s10072-015-2088-2

Duration

7 minutes

Description

Participants are asked to select as many full apples as they can find on a page of 150 items that displays 50 full apples, 50 apples that have a piece missing on the left side, and 50 apples that have a piece missing on the right side. By default, participants have 5 minutes to complete the task.

Procedure

(1) Demographic Information (Optional, see section Editable Parameters)
- script collects age and education information about the participant
( Since Mancuso et al (2015) reported that age and education can have an impact on participants' execution time,
this information can be collected when running the script)

(2) Practice:
Participants practice to cross out the full apples while leaving the open apples alone.
7 example apples are provided on the vertical center line.
Practice can be repeated once.
If practice is failed twice in a row, the script terminates prematurely.

(3) Test: Max allotted time = 5minutes (editable parameter)
- participants are presented the 'stimuli page' and a submit button
(the 'stimuli page' is presented with 95% of the width of the active canvas to allow for some
room to provide the submit button)
- participants use the mouse/finger to select the apples scattered around the page
- When they are done, they click the submit button
- The test is over if the allotted time is up, or if participants submit their responses
- the apples page contains 150 apple images total and is divided into 5 columns
with 2 rows each. Each column contains the same number of foils and targets.

(4) Path Feedback with screencapture (optional)
Once done with the test, the script can show participants the 'stimuli page' with all apples
circled in blue and with all responses made numbered in sequence (starting with '1').
Numbers in Green show correctly selected apples, numbers in red show responses that were
made outside of the apples response circles. The taken path is marked by a turquoise dotted line.
A screenshot of this feedback page (with subject ID) can be taken for further analyses
(optional)

Stimuli

The original paper Apples Test (sized on DinA4) was re-created by Millisecond for this script
as a W:H=4:3 image to reduce pixelation of the apples.
Placement and size of the apples as well as apple appearance was attempted to be kept as similar as possible
to the original. The resulting image is stored under 'stimulipage.png'. This image could be replaced with
an image of the original apples test.
To check if the coded responsecircles that lie under the stimuli, still align with the stimuli,
set parameters.showResponseCirclePlacements to true.


The 'stimuli page' run by the script is sized to be 95% of the width of the active canvas
to allow for response buttons to be placed on the screen.

The script can be run with an absolutely sized stimuli page that approaches the actual size of the paper version
of the task (provided the screen is large enough). See section 'defaults' for more information.

Instructions

provided by Millisecond - can be edited in script applesttest_instructions_inc.iqjs
Practice instructions modelled after Mancuso et al (2015)

Summary Data

File Name: applestest_summary*.iqdat

Data Fields

Raw Data

File Name: applestest_raw*.iqdat

Data Fields

Parameters

The procedure can be adjusted by setting the following parameters.