Reinterpreting the Token Test as a Visual Immediate Memory Task: A Proposal for Assessing Retention and Manipulation Involving Auditory–Visual Matching

The Token Test has long been used to assess auditory comprehension in aphasia, yet non-linguistic factors are known to contribute to performance on it. This paper reframes this component, usually treated as a confound, as a target of measurement. It proposes the hypothesis that the Token Test can be reinterpreted as an immediate memory task involving retention and manipulation under auditory–visual matching, together with a protocol for testing it. The Token Test increases the number of attributes to be retained in graded steps, and every item requires spoken symbols to be matched to visual objects. The New Japanese Version of the Token Test first verifies comprehension of each word in a single-attribute part (Part A) and then probes the same words in higher-load parts, allowing word comprehension and retention to be distinguished within the same examinee. We hypothesize that part of the decline in Token Test performance reflects components other than the phonological loop, and discuss a brief assessment combining the Token Test with the Reading Span Test. This paper presents a hypothesis and a validation protocol without data. Researchers with access to clinical Token Test data, including existing records, are warmly invited to test these predictions, and the author welcomes contact and collaboration.