Box Clicking Test
Background
The brief Box Clicking Test (BCT) introduced by Raymond Hernandez and colleagues in 2024 is a cognitive and physical assessment designed to measure visual-motor integration (VMI) in adults, specifically adult's functional capability to interact with modern technologies like computers, smartphones, and tablets. The task is very simple and quick and can be run in the lab or remotely. It only asks participants to click four response boxes as fast as possible.
Hernandez and colleagues argue that just like the speed of gait is used to assess functional mobility, the speed of clicking boxes can be used to assess VMI ability. The researchers validated the test as part of a larger internet panel study with over 10,000 adult participants that assessed a range of cognitive abilities with a variety of tasks. They found that slower completion times directly correlated with lower scores on most cognitive measures that required visual-perceptual speed as well as with greater functional difficulties in daily life.
Task Procedure
The Millisecond BCT presents participants with the simple task instructions, the four response boxes and an inactive next button and tracks participants responses from page onset until the last box is pressed. Stimuli sizing depends on the size of the device. For devices classified as 'phones' based on their screen dimensions, the response boxes and the empty distance between the response boxes is adjusted proportionally. For any other devices, the size of the response boxes is set to 4cm and the empty distance between them is set to 2cm.
What it Measures
The Box Clicking Test (BCT) assesses visual-motor integration in adults
Psychological domains
- Visual Processing: Before a participant can move their hand, their brain must process visual stimuli
- Reading Speed & Reading Comprehension: Ability to quickly understand written instructions
- Fine Motor Control & Dexterity: Ability to coordinate micro-movements, e.g. guiding a mouse cursor across a screen
Main Performance Metrics
- Task Duration: The time from onset of the task page until all four boxes are clicked in ms (also log transformed)
Psychiatric Conditions
The Box Clicking Test (BCT) has not yet been tested with any clinical populations.
Brief assessment of visual–motor integration (VMI) developed by Hernandez et al (2024)
References
Search Google Scholar for peer-reviewed, published research using the Inquisit Box Clicking Test.
Hernandez, R., Gatz, M., Schneider, S., Finkel, D., Darling, J. E., Orriens, B., Liu, Y., & Kapteyn, A. (2024). Visual–motor integration (VMI) is also relevant for computer, smartphone, and tablet use by adults: Introducing the brief box clicking test. American Journal of Occupational Therapy, 78, 7805205010. https://doi.org/10.5014/ajot.2024.050680