Synonyms

TOMAL-2

Definition

The Test of Memory and Learning – second edition (TOMAL-2) is an assessment of immediate verbal and nonverbal memory with a delay recall component for verbal memory.

Description

The TOMAL-2 was published in 2007 and is an individually administered assessment of memory and learning indicated for children and adults from ages 5 years 0 months through 59 years 11 months. For older adults who need a shorter battery, the assessment developers created a truncated battery to use for adults aged 55 years 0 months through 89 years 11 months [3].

Structure

Scores from the TOMAL-2 subtests provide four core index scores: Verbal Memory Index (VMI), Nonverbal Memory Index (NMI), Composite Memory Index (CMI) and Verbal Delayed Recall Index (VDRI). The indexes are derived from eight core subtests, separated into verbal and nonverbal categories. Tables 1 and 2 provide a comprehensive look at the subtests and which subtests are organized into each domain. These eight subtests will assess a wide range of memory functioning including: concrete and abstract memory functions, learning processes, and immediate and delayed recall [1].

Test of Memory and Learning. Table 1 Core and supplementary subtests of the TOMAL-2 which have a mean score of 10 and a standard deviation of 3
Full size table
Test of Memory and Learning. Table 2 Core and supplementary indexes for the TOMAL-2 which have a mean of 100 and a standard deviation of 15
Full size table

The VMI assesses memory for information presented verbally and reproduced in a sequential manner. This task is especially important in diagnosing learning disabilities with primary deficits in speech and language issues in children and adults and assessing adults with occupations which rely heavily on verbal communication. This index is comprised of Memory for Stories, Word Selective Reminding, Object Recall and Paired Recall [1].

The NMI assesses memory for information that is presented nonverbally and reproduced nonverbally. This index taps into deficits in the right hemisphere, and is particularly useful in diagnosing learning disabilities with primary deficits in perceptual-motor or related nonverbal functions or in brain injured individuals with nonverbal deficits. This index is comprised of Facial Memory, Abstract Visual Memory, Visual Sequential Memory and Memory for Location [1].

The CMI assesses the overall combination of the patient’s verbal and nonverbal memory by combining the scaled scores on the previous two measures. It is the most reliable measure of the patient’s general memory abilities and should be interpreted first before looking at the other indexes. This index is most useful when compared to the VMI and NMI to assess for specific deficits compared to global deficits [1].

The VDRI assesses memory for information presented verbally for recall after a delayed period with distraction in between [1]. This area of memory is particularly important when assessing a patient for a traumatic brain injury, as delayed recall is typically more affected than immediate recall. Additionally, dementias or progressively deteriorating mental conditions, also are often impaired more on delayed versus immediate recall which can be crucial information in the differential diagnosis.

The goal of the TOMAL-2 is to give the examiner an idea of the memory and learning functioning of the patient. Within the subtests, the patient is asked to store and then reproduce stimuli after an intermittent time delay. On certain subtests the patient is also offered corrective feedback through reminding which allows the scoring and interpretation of learning or acquisition curves.

Learning Curves

Word Selective Reminding, Object Recall, Paired Recall and Visual Selective Reminding can be combined to calculate a learning curve across the trials. Within these subtests the examiner reminds the patient of items that were performed incorrectly and there is a high repetition component built in with these subtests. This index allows the examiner to compare learning to memory in order to shed light on differentiation between memory and other factors which could impair daily functioning [1].

Standardization

Reynolds and Voress standardized the TOMAL-2 using 1,921 individuals from a population-proportionate stratified random sampling of the United States and drawn to mimic the 2002 US Bureau of Census statistics on the basis of geographic region, race, family income, educational attainment and exceptionality status. These individuals’ scores were used to derive the standard scores and norms found in the test manual. For further information on the standardization sample, see Reynolds and Voress [3].

Relevance to Childhood Development

The TOMAL-2 as an assessment to quantify deficits in memory and learning has a wide array of applications for the clinician. Primarily the test is used for diagnosing learning disabilities, traumatic brain injuries, attention deficit/hyperactivity disorder (ADHD), affective disorders and dementia and neurological/neurodevelopmental disorders [1–3]. For the pediatric population it is particularly useful in psychoeducational evaluations to diagnose learning disabilities or exceptionalities for the purpose of proper recommendations and providing appropriate accommodations [2].