The New MULES: A Sideline-Friendly Test of Rapid Picture Naming for Concussion

Measures of rapid automatic naming (RAN) have been used for over 50 years to capture vision-based aspects of cognition. The Mobile Universal Lexicon Evaluation System (MULES) is a test of rapid picture naming under investigation. MULES was designed as a series of 54 grouped color photographs (fruits, random objects, animals) that integrates saccades, color perception and contextual object identification. Recent changes to the MULES test have been made to improve ease of use on the sidelines. Originally an 11x17-inch single-sided paper, the test has been reduced to a laminated 8.5x11-inch double-sided version. We identified performance changes associated with transition to the new, more sideline-friendly MULES. We also examined MULES on the sideline for sports-related concussion.