The MICK (Mobile integrated cognitive kit) app: Digital rapid automatized naming for visual assessment across the spectrum of neurological disorders

George Park, Marc J. Balcer, Lisena Hasanaj, Binu Joseph, Rachel Kenney, Todd Hudson, John Ross Rizzo, Janet C. Rucker, Steven L. Galetta, Laura J. Balcer, Scott N. Grossman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: Rapid automatized naming (RAN) tasks have been utilized for decades to evaluate neurological conditions. Time scores for the Mobile Universal Lexicon Evaluation System (MULES, rapid picture naming) and Staggered Uneven Number (SUN, rapid number naming) are prolonged (worse) with concussion, mild cognitive impairment, multiple sclerosis and Parkinson's disease. The purpose of this investigation was to compare paper/pencil versions of MULES and SUN with a new digitized format, the MICK app. Methods: Participants (healthy office-based volunteers, professional women's hockey players), completed two trials of the MULES and SUN tests on both platforms (tablet, paper/pencil). The order of presentation of the testing platforms was randomized. Between-platform variability was calculated using the two-way random-effects intraclass correlation coefficient (ICC). Results: Among 59 participants (median age 32, range 22–83), no significant differences were observed for comparisons of mean best scores for the paper/pencil versus MICK app platforms, counterbalanced for order of administration (P = 0.45 for MULES, P = 0.50 for SUN, linear regression). ICCs for agreement between the MICK and paper/pencil tests were 0.92 (95% CI 0.86, 0.95) for MULES and 0.94 (95% CI 0.89, 0.96) for SUN, representing excellent levels of agreement. Inter-platform differences did not vary systematically across the range of average best time score for either test. Conclusion: The MICK app for digital administration of MULES and SUN demonstrates excellent agreement of time scores with paper/pencil testing. The computerized app allows for greater accessibility and scalability in neurological diseases, inclusive of remote monitoring. Sideline testing for sports-related concussion may also benefit from this technology.

Original languageEnglish
Article number120150
JournalJournal of the Neurological Sciences
StatePublished - 15 Mar 2022
Externally publishedYes


  • Mobile integrated cognitive kit (MICK)
  • Mobile universal lexicon evaluation system (MULES)
  • Rapid automatized naming (RAN) tasks vision
  • Staggered uneven number (SUN)


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