Symbol Match

About the Symbol Match exercise

Reading a bus timetable, checking a receipt against a bank statement, or matching the code on a parking meter to the one on the ticket all mean looking something up in a key and answering quickly, over and over. After a stroke or a brain injury, or with changes in attention and processing speed, each look-up can take longer and the pace can fade before the task is done.

Symbol Match is that look-up on screen, in the style of the digit symbol substitution test. A key pairs each symbol with a number. Symbols then appear one at a time and the person taps the matching number as fast as they can. Every response is timed, so a round reports correct items per minute, accuracy, typical speed, and whether the pace held from the first half of the run to the second.

What Symbol Match practices

Processing speed

The rule is simple, so the result mostly reflects how quickly the person can look at a symbol, find it in the key, and press the number, measured in milliseconds on every item.

Sustained attention

A timed run keeps the same demand going for 30 to 120 seconds. The pace check compares the second half with the first, so a fading effort shows rather than hiding in the total.

Visual discrimination

The ten symbols include pairs that look alike, two triangles and two arrows, which only join the key at the larger sizes. Misses are listed by symbol at the end of the round.

Working memory

In from-memory mode the key is studied for 10 to 30 seconds and then hidden, so each symbol has to be matched from what was held in mind rather than looked up.

How the tool works and what it records

The key holds 4 to 10 symbols: circle, square, triangle, diamond, asterisk, cross, heart, right arrow, downward triangle, left arrow. A practice run is a set number of items, 10 to 60, at the person's own pace; a timed run is as many items as possible in 30 to 120 seconds. The key can stay visible or be studied for 10 to 30 seconds and then hidden. Free presets: practice with 4 symbols, and 60-second runs with 6 or 9 symbols. Pro unlocks the dials; large-print mode is free.

Answers are taps on large numbered buttons or the number keys on a keyboard. The results panel shows correct per minute, accuracy as correct of items, median speed, and pace: the second half's mean time against the first, which needs at least ten items. Misses are listed by symbol. Free accounts get 5 rounds per tool per day; Pro adds unlimited rounds and a PDF worksheet with an answer key, and accounts with the session log feature have each round saved.

Screen or paper?

The screen suits this task especially well: it times every response, works out correct per minute, and shows whether the pace held, none of which a pencil can do. Paper suits sessions where writing the number is part of the practice, where a therapist wants to watch the pencil move along the row, or where there is no device or wifi to hand.

The printable version is the Symbol Digit Modalities worksheet set on rehabworksheets.com, and there is a free symbol digit worksheet to try first, with no email required.

Using it well

• Begin with the practice preset. Four symbols, 20 items, no clock. It settles the rule and the button layout before speed matters. Move to the 60-second run with 6 symbols when accuracy is close to all correct.
• Read pace before correct per minute. Correct per minute is the headline, but pace tells you what happened late in the run. A second half that is noticeably slower at the same accuracy is worth noting; a steadier pace across sessions is stamina you can see.
• Add symbols before adding time. Going from 6 to 9 symbols makes each look-up harder; a longer run makes the same look-up last longer. Change one at a time so the results say which one moved.
• Try from-memory mode as a step up. Once a visible-key run is quick and accurate, set the key to hide after a 15-second study and expect speed to drop at first. The misses-by-symbol line shows which pairings did not hold.
• Adapt for hand use. The number keys on a keyboard work as well as the on-screen buttons, and large-print mode enlarges the symbol and the buttons. A partner can press the key the person calls out; the timing still counts from when the symbol appeared.

Common questions