Effects of Stimulus Number and Target-to-Distractor Ratio on the Performance of Random Array Letter Cancellation Tasks

Cancellation tests are commonly used in the clinical assessment of visuospatial function, but there has been little study of task characteristics influencing performance. This study was designed to assess factors which affect cancellation performance. Sixteen healthy subjects sequentially performed four random-array letter cancellation tasks. The forms contained 50 and 100 stimuli and target:distractor (T/D) ratios of 1:4 and 1:9 with target letter “A” and randomly selected letter distractors. The primary performance measure was calculated as the number of correctly cancelled targets divided by the time to complete the task, corrected for accuracy. This measure revealed a strong effect of T/D ratio (p< .0001), with performance adversely affected by higher proportion of distractors. There was no effect of stimulus number. This suggests that T/D ratio should be considered in cancellation test design and interpretation.