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Early Trials: Newly Developed Moss Attention Scale Appears to have Potential

Categories: Cognitive Assessments - Thinking and Emotional Skills

The Question

Is the Moss Attention Rating Scale a useful tool for measuring attention skills for individuals with traumatic brain injury?

Past Studies

Past Studies recognize that it is common for individuals with traumatic brain injury to experience shorter attention spans than they did before their injuries. Individuals with attention difficulties experience problems when they try to keep their focus on a specific issue, object, or activity. They may be distracted easily and need cues from another person to complete a task. The causes of attention difficulties after traumatic brain injury are very complex and not clearly understood. Researchers have not identified the best way to accurately measure the attention skills of individuals with traumatic brain injury. 

This Study

This Study focused on the creation and trial of the Moss Attention Rating Scale (MARS). The researchers consulted past studies, experts, and clinicians for input when they made the 53-test items for the MARS. Items on the MARS are scored on a 5-point scale based on the healthcare provider’s observations of an individual’s attention-related behaviors. The researchers ran two small studies and adjusted the test before using it with 228 individuals with traumatic brain injury at eight Traumatic Brain Injury Model Systems inpatient rehabilitation facilities. The researchers statistically analyzed the results from all of the items on the Moss Attention Rating Scale to find out how well the test seems to “cover” different kinds of attention problems, and how closely two different therapists working with the same patient would agree on the type and severity of the problems. Agreement between scores given by different people is one way of measuring a scale’s reliability, or general stability and soundness. The researchers found the degree of agreement to be promising, meaning that the scale might give a true score even when different people fill it out, based on different observations of the patient’s behavior. . In terms of how completely the scale covered different kinds of attention problems, it appeared to be a good tool to measure the attention span of individuals who were in inpatient rehabilitation, but looked like it might miss subtle attention problems, such as not being able to think about two things at once. More research is needed on the MARS to determine if it is an appropriate tool for individuals beyond the inpatient rehabilitation setting and to show that it is valid—that is, that it really measures different types of attention problems. The researchers state that they are continuing to work on “fine tuning” the MARS so that it will produce even more specific information.

Who May Be Affected By These Findings

Researchers, healthcare providers, individuals with traumatic brain injuries


The researchers found that occupational therapists tended to score individuals as slightly less attentive than did physical therapists. The researchers state this may be because the therapists observe an individual doing different types of tasks, which require different amounts of attention skills. The researchers plan to examine this occurrence further and make changes to the MARS as necessary.

Bottom Line

The first studies indicate that the Moss Attention Rating Scale (MARS) for individuals with traumatic brain injury appears to be a good tool to use in inpatient rehabilitation settings. The MARS’s designers and researchers are conducting further studies to “fine tune” the scale and determine its full potential for use.

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Find This Study

Whyte, J., Hart, T., Bode, R.K., & Malec, J.F. (2003). The Moss Attention Rating Scale for traumatic brain injury: Initialpsychometric assessment. Archives of Physical Medicine and Rehabilitation, 84, 268-276.

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