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AMFAST
The Attention, Memory, and Frontal Abilities Screening Test
A novel, 10-minute, paper-and-pencil measure developed to identify attention, processing speed, memory, and executive functioning deficits in children and adults with various conditions characterized by frontal-subcortical dysfunction.
About the AMFAST
Cognitive impairment complicates multiple conditions that occur across the lifespan. Indeed, cognitive deficits are routinely seen in neurologic conditions such as traumatic brain injury (TBI), multiple sclerosis (MS), and Parkinson’s disease (PD), psychiatric illness such as schizophrenia, unipolar and bipolar depression, and attention-deficit/hyperactivity disorder (ADHD), and systemic diseases such as systemic lupus erythematosus (SLE), sickle cell disease (SCD), and human immunodeficiency virus (HIV).
Although different underlying neuroanatomic mechanisms are thought to be at play in these discrete disorders, they all have been associated with disturbances that either directly or indirectly impact the functional integrity of frontal-subcortical brain circuits. Moreover, multiple medications and treatments, including certain chemotherapies and focused brain radiation, are also known to impact these frontal-subcortical circuits.
Oftentimes, the cognitive dysfunction associated with these conditions is characterized by a distinct pattern of deficits; namely, deficits are typically found in the areas of attention, processing speed, memory, and/or executive functioning (EF).
Multiple tests have been developed to screen for cognitive impairment. In general, these measures are brief (i.e., 20 minutes or less) and contain items sampling a wide range of cognitive domains. Many of these measures were originally developed to screen specifically for dementia and consequently place a high emphasis on memory and less of an emphasis on other areas of cognitive functioning such as processing speed and executive functioning.
Furthermore, most screening tests were created to assess functioning in adults only. Given that many of the aforementioned conditions characterized by frontal-subcortical dysfunction (e.g., SLE, SCD, ADHD, and leukemia) are present in children and adolescents as well as adults, there are clinical indications for a cognitive screener that specifically evaluates for deficits in attention, processing speed, memory, and executive functioning and can be administered to individuals across the life span.
Enter the Attention, Memory, and Frontal Abilities Screening Test (AMFAST). The AMFAST is a novel, paper-and-pencil screening test that was specifically designed to assess for the presence of attention, processing speed, memory, and/or executive functioning deficits in individuals across the lifespan (ages 8+).
The AMFAST takes only 10 minutes to administer and it is easy to score. It is comprised of six subtests (see table below): three attention/executive functioning tasks and three memory tasks. The total score is calculated by summing up the scores of the six subtests, with a maximum of 100 points.
AMFAST Subtests
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Number Cancelation Test |
A timed divided attention/cancellation task in which examinees are instructed to draw a slash through all the 2s and 4s in a series of written numbers as fast and as accurately as possible. |
20 |
|
List Memory Test |
A word-list learning and recall task involving the presentation of five words over two trials. |
15 |
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Number Letter Switching Test |
A timed set-shifting/mental flexibility task in which examinees are required to alternate between saying numbers and letters aloud in numerical and alphabetical order. |
20 |
|
Spatial Memory Test |
A figure reproduction and recall task in which examinees are required to copy and later reproduce (free recall) a figure that has five details/elements. |
15 |
|
Number Inhibition Test |
An auditory attention/response inhibition task in which examinees are provided a sheet of paper with four numbered circles and are instructed to tap the number 4 when the examiner says 2, tap 2 when the examiner says 4, and do not tap when the examiner says 1 or 3. |
15 |
|
Story Memory Test |
A story/prose learning and recall task involving the presentation of a short story (read aloud once) that is comprised of seven main details. |
15 |
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TOTAL |
100 |
AMFAST Download & Instructions
Print out AMFAST Response Page (for examinees). Fold along dotted line, and place in front of examinee (top half facing up).
Print out AMFAST Scoring and Instructions (for examiners). Please note that there are separate Scoring and Instructions for 8-10 year-old examinees.
Administer and score the AMFAST according to instructions provided in the AMFAST Scoring and Instructions.
Print out AMFAST Scoring Template on transparency film (optional) to assist in scoring.
Interpret the AMFAST according to guidelines outlined below.
AMFAST Interpretation/Scoring
The total score is calculated by summing up the scores of the six subtests, with a maximum of 100 points.
Total Score = Sum of Subtest Scores - Interference Score
Score of <70 suggests significant neurocognitive dysfunction
Score of 71-83 suggests mild neurocognitive dysfunction
Mean total AMFAST score for healthy control subjects = 88.38 (SD = 6.93)
2 Yaffe B, Feirsen N, & Freilich BM (2020). The Attention, Memory, and Frontal Abilities Test (AMFAST): A Clinical Efficacy Study in a Sample of Children, Adolescents, and Young Adults with Complex Medical Conditions. Poster presented at the International Neuropsychological Society 48th Annual Meeting, Denver, CO.
