Cogscreen - If all pilots had to take it, how many would pass?

Do you think you would pass the cogscreen test on first try?

  • Yes

    Votes: 11 55.0%
  • No

    Votes: 9 45.0%

  • Total voters
    20
  • Poll closed .

Lycosaurus

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After reading how difficult and stressful (and costly) the cogscreen test is reported to be, I wonder what percent of pilots with valid medicals would pass this test if it was a requirement for everyone.

Are we holding a small segment of the pilot population (deferred/denied initial medical) to a much higher standard? Not sure I would pass the test first time around.

I'm just curious as to how others feel about this ... (Dr. Bruce and other docs are welcome to chime in as well).

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Here is a summary of the test (copied from another thread):

The Cogscreen site gives a breakdown of the various sections: http://www.cogscreen.com/Overview.aspx

Backward Digit Span (BDS): The computer will flash a series of digits (I think it starts out with 3), and when it is done, you key in the series, but in reverse. So it will flash '5', then '7', then '4', then prompt you to enter in the series in reverse. It then gradually increases the length of the series (I think it went up to 6-7 digits).

Math: This was pretty straightforward and was your basic slew of simple word problems, multiple choice answers.

Visual Sequence Comparison (VSC): This test provided 5-6 letter strings that you had to discern between. Think of it as trying to pick out N563E8 from NS63F8 and other very similar looking strings (made even more similar looking thanks to that utterly ancient old DOS font).

Symbol Digit Coding (SDC): This is just a computer version of a standard test, which is best illustrated by a picture rather than me trying to describe it: https://www.ncbi.nlm.nih.gov/projec...nt_id=phd003850&image_name=phd003850.1-g1.jpg
For the Cogscreen-AE test, I think there are only 6 symbol pairs, but the test is the same regardless. Protip: Even if you are really quick in checking the onscreen chart while keying in your responses, make sure to memorize perhaps 3 of the symbol/digit pairs. After the test, it will quiz you on how many digit/symbol pairs you recall. Sneakily, it will do this _again_ a few minutes later after you've done a completely different test!

Matching to Sample (MTS): I forget the specifics of how this was implemented in Cogscreen, but here's the wikipedia page on this type of test - note the accompanying graphic: https://en.wikipedia.org/wiki/Match-to-sample_task
Basically you're shown a pattern made on a checkerboard, then afterwards you need to pick that pattern out of several very similar looking patterns.

Manikin (MAN): You're shown a little graphic of a dude holding a semaphore flag in one hand, and you need to enter in as quickly as possible if the flag is in his left or right hand. The little guy may be facing towards you or away from you, and he'll even get rotated upside down. I think flying RC planes helped a lot with this test, as you don't have time to think through "okay, if the flag was in my right hand, and I was facing that way and upside down...."

Divided Attention (DAT): Several of the tests wind up being repeated but with the addition of an additional little graphic that you have to keep an eye on. There's a little bar that will move left and right, and you need to keep it centered. Honestly, it reminded me of tapping the rudder on a taildragger! If the bar starts moving left on its own, it will continue moving left, so the way that I did these divided attention tests was to just get the bar centered and then alternately tap left-right-left-right to keep it centered and focus on the main task. Later tests had an additional attention dividing task as well - a marker would randomly creep its way up a gauge, and once it got past a certain line, you needed to hit a key.

Auditory Sequence Comparison (ASC): Computer will go "beep barp bloop bloop". (I think it did the same pattern one more time as well). Then, the computer will go "beep barp bloop barp" and ask if it's the same tone series it just played.

Pathfinder (PF): "Visual sequencing and scanning task that requires respondents to sequence numbers, letters, and an alternating set of numbers and letters." I don't remember much about this one, but I seem to recall that it had a bunch of squares with letters around the border, and the task was to tap on them in alphabetic order. So imagine Scrabble tiles of A-M scattered around, and you have to tap A-B-C-D-E... in order as quick as possible. Numbers are also added in, and the final Pathfinder test is tapping out the series A-1-B-2-C-3-D-4-E-5...

Shifting Attention (SAT): This was just Cogscreen's version of the Wisconsin Card Sorting Task. Rather than me trying to describe this test, this page has a description and sample test that you can run in your browser: https://www.psytoolkit.org/experiment-library/wcst.html

Dual Task (DTT): This is the one I mentioned previously - the side task of keeping a rudder centered, hitting a key if a needle goes above a line on a gauge, all while doing the main task, which was to respond with the previous digit shown in a series. That's not a great description, so let me give an example... The computer shows '2', then '1'. Then it prompts you for "what was the previous digit in the series? You respond with '2', the computer then displays '3', then asks again for the previous digit in the series, so you respond with '1'. The computer then shows '2', you respond with '3', etc... Basically you just have to keep responding in that fashion. For some reason this core task by itself gave me fits (especially if there are repeating digits - computer says '2', I respond with '2', and then lose my place). Oddly enough, it was when the additional side tasks of keeping the rudder centered and keeping an eye on the creeping vertical gauge were added that I fell into a solid rhythm and absolutely nailed this test better than without the side distractions...
 
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I did. Delta gives it during the initial interview….

If you’re test adverse, it’s likely gonna get you.

I can see where it is useful for SOME cases, like strokes, head injuries, long term meth usage… but how it’s generally used is a farce.
 
After reading how difficult and stressful (and costly) the cogscreen test is reported to be, I wonder what percent of pilots with valid medicals would pass this test if it was a requirement for everyone.

Are we holding a small segment of the pilot population (deferred/denied initial medical) to a much higher standard? Not sure I would pass the test first time around.

I'm just curious as to how others feel about this ... (Dr. Bruce and other docs are welcome to chime in as well).
I've never seen it, so have no idea if I would pass. But it's standardized, and if I recall correctly, Dr Chen has said that 15%ile, or something around there, is passing. So statistically, only about 85% of pilots would pass.
 
I didn’t do an FAA one, but did do a full neuropsych eval after a head injury years ago. It was actually really interesting to see what they asked and how they performed it.

Without a baseline for before the incident that need to fall back on how your results compare to someone with a similar background. I’m not sure whether I was compared to other engineers, other folks with masters degrees, or what the categories were.

My results came back with “has some verbal deficiencies, believed to be preexisting”. Sounds about right. What can I say? I are an engineer.

Not sure what that would mean for an FAA evaluation. But I’m glad basic med came out after that and that I qualify for it based on my last medical. I wouldn’t want to jump through the FAA’s hoops.
 
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I took the full exam last September. Very costly ($3800). My medical was issued the following month so obviously my score was acceptable to the FAA. It was a two day exam. Some parts were silly, however some parts were quite difficult. One test had so many things going on with pictures and sounds I remember thinking how in the hell could anyone keep up with this. Maybe it was designed to be completely overwhelming to see how Long it would take you to fail. I do believe that if you have a few years on you, and you are required to take the test, you will struggle with some
Parts. Just my opinion based my my experience.
 
My results came back with “has some verbal deficiencies, believed to be preexisting”. Sounds about right. What can I say? I are an engineer.

BWAHAHAHA! Hilarious! Mine said I had an EXCELLENT vocabulary, but limited to only 4 letters….

Ok, no it didn’t….
 
I didn't pass it the 1st time. I felt that it was impossible to do well on all of it. Then I found out I had severe sleep apnea. Retook it 1.5 years later after the sleep apnea treatment and passed it the 2nd time around. I told some smart people about this test and most said "I'm not sure I'd pass it". I'll leave it at that.
 
I did the full eval, which the cog screen was a small part of that. It’s all very daunting because you don’t know what you’re walking into. In my opinion, that is why it is extremely important to go somewhere that has deep experience administering these tests.

Having a doctor that frequently administers these can clearly explain the process which will alleviate the nervousness.

The cog screen really wasn’t bad. The technology used is a little dated, but it’s pretty simplistic. Like most tests, it’s going to find your weakness areas. Don’t let that get in your head. Just keep relaxed and plug away with the tasks.

Just a helpful hint: there is nothing that prohibits you from talking to yourself during the test. Remember that.
 
I did the full eval, which the cog screen was a small part of that. It’s all very daunting because you don’t know what you’re walking into. In my opinion, that is why it is extremely important to go somewhere that has deep experience administering these tests.

Having a doctor that frequently administers these can clearly explain the process which will alleviate the nervousness.

The cog screen really wasn’t bad. The technology used is a little dated, but it’s pretty simplistic. Like most tests, it’s going to find your weakness areas. Don’t let that get in your head. Just keep relaxed and plug away with the tasks.

Just a helpful hint: there is nothing that prohibits you from talking to yourself during the test. Remember that.

Sage advice, I must've said, "DON'T HIT THE X!" to myself about a hundred times during one particular test. I did very well on the initial test battery so it must've helped lol
 
I'd fail the BDS for sure. I remember items from a sequence but not exact order. IRL, the exact order of things is rather unimportant in my experiences.
 
After looking through these boards for a little bit, i’d say it’d be about 25/75 pass/fail based on what i’ve seen. Although that may not be representative of the whole pilot community.
 
After looking through these boards for a little bit, i’d say it’d be about 25/75 pass/fail based on what i’ve seen. Although that may not be representative of the whole pilot community.

This may be extreme but not out of the realm of possibility. The cogscreen was tough enough, the full battery Neuropsych exam was intense.
 
After looking through these boards for a little bit, i’d say it’d be about 25/75 pass/fail based on what i’ve seen. Although that may not be representative of the whole pilot community.

The standard is SUPPOSED to be 15th percentile of similar-aged pilots, but this is peverted in the way the FAA deals with the test. They just use 15th percentile of the entire sample set.
 
Do I have this right? In order to determine if you are mentally fit to fly, you have pass a test that 15% of normal, healthy pilots would fail?
 
Do I have this right? In order to determine if you are mentally fit to fly, you have pass a test that 15% of normal, healthy pilots would fail?

yes.

I had to go through this test because of an ADHD diagnosis. I can easily name 10 people I personally know who could never pass that test. Because they have no mental health diagnosis on their records they would have sailed through getting a 3rd class medical.

On the other hand, because I have always done well, am very driven, and wanted to do even better and sought help to increase focus and concentration resulting in a mild ADHD diagnosis— I get to spend $3.5K out of pocket and deal with 18 months of nonsense..

the system is broken.
 
I did. Delta gives it during the initial interview….

If you’re test adverse, it’s likely gonna get you.

I can see where it is useful for SOME cases, like strokes, head injuries, long term meth usage… but how it’s generally used is a farce.

Actually had to take a Cognitive assessment, the Montreal Cognitive Assessment to be exact (preferred by the FAA), due to a TIA (mini stroke) I had nearly 10 years ago. Passed it with full marks (30 out of 30 possible points). It wasn't to bad in my opinion, but thankfully my prognosis was much better than it could have been for my situation. Currently waiting for the FAA to finish reviewing my application to see if my get my medical.
 
I had to do the FAA one two years ago and passed first try, got a non-SI class 3, after reporting some ADHD meds years ago.

it was super stressful. At one point, I had to press enter every time I saw a dot above a line, but not below a line. The doctor tapped on the glass accidentally and I looked over. I missed a second or two, and I had a feeling I was screwed.

He got the results back and said it didn’t look good. I stated he tapped on the glass at the start and I thought he was trying to get my attention, so I may have missed one in the first 3 minutes.

If I hadn’t said that, he said it would have probably been a fail.

The whole test is tough, for sure. It’s completely doable. I personally think it has an opposite effect. If you’re trying ti prove I don’t have ADHD, what’s to say my temporary hyper focus tunnel vision superpower didn’t help me out here? Other than the fact that it took 8 hours to complete. I was exhausted.
 
I had to do the full neuropsych battery (the bulk of which was the WAIS-IV) for a history of OCD but not the Cogscreen - looks like the only similarities are the digit span and symbol coding portions. I found most parts of WAIS-IV fairly easy, but I am 100% certain I would fail the Cogscreen. Looks terrifying.
 
I went through the neuropsychological evaluation (cog screen) back in December and the buildup was stressful to say the least. The doctor told me not to be discouraged if I have to stay all day as only about 30% pass the initial battery. After 5 hours of running the gauntlet, the neuropsychologist said I did very well, making the supplemental battery unnecessary. She also said to be very careful driving home and to expect mental fatigue into the next day and she wasn't kidding. I was mentally exhausted but so proud of what I had just accomplished. Now I'm waiting for a decision from the FAA but that's a topic for another thread..
 
Unless the final score is adjusted for age, I'd probably have trouble passing. I admit I'm not as quick as I was when I was 60ish.
 
I did the full eval, which the cog screen was a small part of that. It’s all very daunting because you don’t know what you’re walking into. In my opinion, that is why it is extremely important to go somewhere that has deep experience administering these tests.

Having a doctor that frequently administers these can clearly explain the process which will alleviate the nervousness.

The cog screen really wasn’t bad. The technology used is a little dated, but it’s pretty simplistic. Like most tests, it’s going to find your weakness areas. Don’t let that get in your head. Just keep relaxed and plug away with the tasks.

Just a helpful hint: there is nothing that prohibits you from talking to yourself during the test. Remember that.
Can you suggest a way to prepare for the tests?
Not all Neuropyschs on the list specialize in aviation evaluations..
How can you find a Neuropsych that specializes in aviation evaluations?
 
I have absolutely no idea but I know I can fly the plane and unless there’s some debilitating thing going on my life I’m not going to poke the bear and risk failing something that will hose me.

If it were up to me we’d do away with third class medical, at least for the typical private pilot or just get rid of the “pass once” part of basic med. I don’t think there are enough truly medically unfit people who can pass the tests for a ppl, have the means to afford to fly, and lack the judgement to know when they’re not fit to justify it.

The stats on basic med and sport pilots would tend to support that opinion as well.
 
Well, well, well. Looks like someone at the FAA has been following this thread :)

The FAA is recruiting pilots attending EAA AirVenture Oshkosh 2023 to participate in a PAID FAA research study. For this study, the FAA needs pilots (18-plus years of age) who have flown at least once in the last 6 months (including training simulator time), and who hold a current medical certification Class I, II, or III (not BasicMed). The study session takes about 4 hours and pays $300, $400, or $500 (dependent on medical certification class), and payment is dispersed immediately following participation!

Participation involves completing two computerized cognitive tests related to tasks such as working memory, attention, mental rotation, and multitasking performance. This study has received FAA IRB approval. The purpose of this study is to obtain pilot normative data for these computerized tests. The FAA uses these tests to help recertify pilots for flying following a medical event (e.g., stroke, head injury, certain medication). The results of this study will help ensure that aeromedical decision-making is based on the most current scientific data, and will contribute to the safety of the national airspace system. FAA Cognitive Test PAID Study (Cogstudy) FAQs.

https://www.eaa.org/airventure/eaa-...cruiting-pilots-for-airventure-research-study
 
Well, well, well. Looks like someone at the FAA has been following this thread :)

The FAA is recruiting pilots attending EAA AirVenture Oshkosh 2023 to participate in a PAID FAA research study. ...

If you volunteer, what happens if you score really low on the test? I hope that there is a clause that says no enforcement action will be taken based on the results of the test. Hmmm, inquiring mind wants to know.
 
After reading how difficult and stressful (and costly) the cogscreen test is reported to be, I wonder what percent of pilots with valid medicals would pass this test if it was a requirement for everyone.

I used to watch that show, ''Are You Smarter Than A Third Grader'', and I wasn't....
 
Passed it at my Delta interview. I did lots of prep. It still wasn’t easy but I was familiar and got some practice beforehand.
 
Well, well, well. Looks like someone at the FAA has been following this thread :)

The FAA is recruiting pilots attending EAA AirVenture Oshkosh 2023 to participate in a PAID FAA research study. For this study, the FAA needs pilots (18-plus years of age) who have flown at least once in the last 6 months (including training simulator time), and who hold a current medical certification Class I, II, or III (not BasicMed). The study session takes about 4 hours and pays $300, $400, or $500 (dependent on medical certification class), and payment is dispersed immediately following participation!

Participation involves completing two computerized cognitive tests related to tasks such as working memory, attention, mental rotation, and multitasking performance. This study has received FAA IRB approval. The purpose of this study is to obtain pilot normative data for these computerized tests. The FAA uses these tests to help recertify pilots for flying following a medical event (e.g., stroke, head injury, certain medication). The results of this study will help ensure that aeromedical decision-making is based on the most current scientific data, and will contribute to the safety of the national airspace system. FAA Cognitive Test PAID Study (Cogstudy) FAQs.

https://www.eaa.org/airventure/eaa-...cruiting-pilots-for-airventure-research-study

This is interesting and I wonder what the real point is. The FAQ says:

"This FAA research study about the use of computerized cognitive tests as a non-invasive way to measure cognitive function in pilot populations. The purposes of this research are to: 1) evaluate computerized cognitive tests to determine if they are acceptable for use as a cognitive screening tool; and 2) obtain pilot normative datasets for each cognitive test. The FAA uses computerized cognitive tests only for those pilots who may have a medical condition associated with aeromedically significant cognitive impairment (e.g., stroke, head injury, certain medications) and who wish to return to flight or duty status. Normative datasets are a collection of test scores that represent what is usual or expected in a representative sample of pilots. The outcome of this research will ensure that FAA processes for aeromedical decision-making are consistent with best clinical practices for aerospace medicine and current scientific knowledge."

By excluding people without medicals (i.e. BasicMed/SP/balloon/Gliders) they are showing a strong selection bias and skewing the results. By paying different rates for class of medical they are skewing it even more (towards the C1 folks).

Peer reviewed normative data sets for cognitive tests are available and in wide use already.

And the statement

"FAA uses computerized cognitive tests only for those pilots who may have a medical condition associated with aeromedically significant cognitive impairment (e.g., stroke, head injury, certain medications) and who wish to return to flight or duty status."

Is a bold face lie. They are commonly used in HIMS cases.


This would fail any high school statistics class.
 
This is interesting and I wonder what the real point is. The FAQ says:

"This FAA research study about the use of computerized cognitive tests as a non-invasive way to measure cognitive function in pilot populations. The purposes of this research are to: 1) evaluate computerized cognitive tests to determine if they are acceptable for use as a cognitive screening tool; and 2) obtain pilot normative datasets for each cognitive test. The FAA uses computerized cognitive tests only for those pilots who may have a medical condition associated with aeromedically significant cognitive impairment (e.g., stroke, head injury, certain medications) and who wish to return to flight or duty status. Normative datasets are a collection of test scores that represent what is usual or expected in a representative sample of pilots. The outcome of this research will ensure that FAA processes for aeromedical decision-making are consistent with best clinical practices for aerospace medicine and current scientific knowledge."

By excluding people without medicals (i.e. BasicMed/SP/balloon/Gliders) they are showing a strong selection bias and skewing the results. By paying different rates for class of medical they are skewing it even more (towards the C1 folks).
Of course! This is proportionate to the abiltiy of the classes of aircraft's abilty to do damage.
Peer reviewed normative data sets for cognitive tests are available and in wide use already.

And the statement

"FAA uses computerized cognitive tests only for those pilots who may have a medical condition associated with aeromedically significant cognitive impairment (e.g., stroke, head injury, certain medications) and who wish to return to flight or duty status."

Is a bold face lie. They are commonly used in HIMS cases.


This would fail any high school statistics class.
Chronic alcoholics....have a medical condition associated with aeromedically significant cognitive impairment, John. This is NOT high school. Why don't you cite the statistics?
 
I'd love to cite the actual statistics. But the FAA treats them like state secrets for some reason. If they are available somewhere, please point me to them.

All they really need to do for credibility is to publish the results in a peer reviewed professional journal. Anybody think that's likely? Not me.
 
On the other hand, because I have always done well, am very driven, and wanted to do even better and sought help to increase focus and concentration resulting in a mild ADHD diagnosis— I get to spend $3.5K out of pocket and deal with 18 months of nonsense..

the system is broken.

Five or more of the symptoms in DSM-5 that "have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities" and you think that's not a problem?

Thank God for the system.
 
After reading how difficult and stressful (and costly) the cogscreen test is reported to be, I wonder what percent of pilots with valid medicals would pass this test if it was a requirement for everyone.

Are we holding a small segment of the pilot population (deferred/denied initial medical) to a much higher standard? Not sure I would pass the test first time around.

I'm just curious as to how others feel about this ... (Dr. Bruce and other docs are welcome to chime in as well).

------------------------------------------------------------------------------------------
Here is a summary of the test (copied from another thread):

The Cogscreen site gives a breakdown of the various sections: http://www.cogscreen.com/Overview.aspx

Backward Digit Span (BDS): The computer will flash a series of digits (I think it starts out with 3), and when it is done, you key in the series, but in reverse. So it will flash '5', then '7', then '4', then prompt you to enter in the series in reverse. It then gradually increases the length of the series (I think it went up to 6-7 digits).

Math: This was pretty straightforward and was your basic slew of simple word problems, multiple choice answers.

Visual Sequence Comparison (VSC): This test provided 5-6 letter strings that you had to discern between. Think of it as trying to pick out N563E8 from NS63F8 and other very similar looking strings (made even more similar looking thanks to that utterly ancient old DOS font).

Symbol Digit Coding (SDC): This is just a computer version of a standard test, which is best illustrated by a picture rather than me trying to describe it: https://www.ncbi.nlm.nih.gov/projec...nt_id=phd003850&image_name=phd003850.1-g1.jpg
For the Cogscreen-AE test, I think there are only 6 symbol pairs, but the test is the same regardless. Protip: Even if you are really quick in checking the onscreen chart while keying in your responses, make sure to memorize perhaps 3 of the symbol/digit pairs. After the test, it will quiz you on how many digit/symbol pairs you recall. Sneakily, it will do this _again_ a few minutes later after you've done a completely different test!

Matching to Sample (MTS): I forget the specifics of how this was implemented in Cogscreen, but here's the wikipedia page on this type of test - note the accompanying graphic: https://en.wikipedia.org/wiki/Match-to-sample_task
Basically you're shown a pattern made on a checkerboard, then afterwards you need to pick that pattern out of several very similar looking patterns.

Manikin (MAN): You're shown a little graphic of a dude holding a semaphore flag in one hand, and you need to enter in as quickly as possible if the flag is in his left or right hand. The little guy may be facing towards you or away from you, and he'll even get rotated upside down. I think flying RC planes helped a lot with this test, as you don't have time to think through "okay, if the flag was in my right hand, and I was facing that way and upside down...."

Divided Attention (DAT): Several of the tests wind up being repeated but with the addition of an additional little graphic that you have to keep an eye on. There's a little bar that will move left and right, and you need to keep it centered. Honestly, it reminded me of tapping the rudder on a taildragger! If the bar starts moving left on its own, it will continue moving left, so the way that I did these divided attention tests was to just get the bar centered and then alternately tap left-right-left-right to keep it centered and focus on the main task. Later tests had an additional attention dividing task as well - a marker would randomly creep its way up a gauge, and once it got past a certain line, you needed to hit a key.

Auditory Sequence Comparison (ASC): Computer will go "beep barp bloop bloop". (I think it did the same pattern one more time as well). Then, the computer will go "beep barp bloop barp" and ask if it's the same tone series it just played.

Pathfinder (PF): "Visual sequencing and scanning task that requires respondents to sequence numbers, letters, and an alternating set of numbers and letters." I don't remember much about this one, but I seem to recall that it had a bunch of squares with letters around the border, and the task was to tap on them in alphabetic order. So imagine Scrabble tiles of A-M scattered around, and you have to tap A-B-C-D-E... in order as quick as possible. Numbers are also added in, and the final Pathfinder test is tapping out the series A-1-B-2-C-3-D-4-E-5...

Shifting Attention (SAT): This was just Cogscreen's version of the Wisconsin Card Sorting Task. Rather than me trying to describe this test, this page has a description and sample test that you can run in your browser: https://www.psytoolkit.org/experiment-library/wcst.html

Dual Task (DTT): This is the one I mentioned previously - the side task of keeping a rudder centered, hitting a key if a needle goes above a line on a gauge, all while doing the main task, which was to respond with the previous digit shown in a series. That's not a great description, so let me give an example... The computer shows '2', then '1'. Then it prompts you for "what was the previous digit in the series? You respond with '2', the computer then displays '3', then asks again for the previous digit in the series, so you respond with '1'. The computer then shows '2', you respond with '3', etc... Basically you just have to keep responding in that fashion. For some reason this core task by itself gave me fits (especially if there are repeating digits - computer says '2', I respond with '2', and then lose my place). Oddly enough, it was when the additional side tasks of keeping the rudder centered and keeping an eye on the creeping vertical gauge were added that I fell into a solid rhythm and absolutely nailed this test better than without the side distractions...
This is an accurate description of the actual cogscreen - which is just 1.5 hours of the 8 hour testing and interviewing process. I just took the tests last month- and passed. It was hard, but totally doable unless you really do have an impairment (I'd had a concussion the year before the test, and was also required to take the test due to my long term sobriety in AA). I'd been dreading the process - but realized afterward that there was no way to study for the test, and I was glad to learn I had no cognitive damage. I did a free trial of one of the online brain game sites, and then got a good night of sleep before the test. I also chose a HIMS Psychologist in San Francisco from the FAA website who splits the testing into two half days. I actually used FF miles to fly down there to test with her instead of doing it all in one 8-hour session. So grateful she offered that - it allowed me to destress and relax before the second half of testing. Dr. Alison Waterworth at the Presidio. She made the process as compassionate as possible and she was patient - made sure I understood all the instructions before I did the tests. Choose someone who puts you at ease! She is married to a pilot and gets how important this test is. I think that helped a lot too - I wasn't nervous with her.
 
Dr Waterworth has done some nice work for a few of my applicants.....

Quoting for posterity.

Most likely the highest praise right there. If I needed a cogscreen that’s the Doc I’d be going to on Brice’s recommendation alone.
 
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