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The Targeted Box and Blocks Test (tBBT)

In this instructional video, you will learn how to administer the targeted Box and Blocks Test, or tBBT, to 

a patient or participant. The targeted Box and Blocks Test is a performance-based clinical outcome 

assessment tool that elicits ecologically representative actions, including movement initiation, grasp, 

transport, and controlled release of objects during an upper limb task.

To administer this test to a patient or participant, you will need the following: a Stopwatch; the targeted 

Box and Blocks Test inserts; the Box and Blocks Test box, which is a wooden box with dimensions 53.7 x 

25.4 x 8.5 centimeters with 15.2 centimeter tall partition placed in the middle of the box; nine wooden 

blocks numbered 1 through 9; two pieces of white paper; a table of standard height; and a chair with or 

without arm rests.

To start, place the box and blocks test box on the table so that the edge of the box closest to the patient 

or participant is 5 centimeters from the edge of the table. Then place the partition in the middle of the 

box.

Next, place one sheet of white paper within each side of the box and place the targeted box and blocks 

inserts on top of the paper. Using a black permanent marker, write the numbers 1 through 9 inside the 

target spaces, starting with the bottom row, inner-most block and working your way across the row. The 

inner-most block should always be the first block transported within each row and numbered as such.

Now, repeat this for the other side of the box, again, starting your numbering with the bottom row, 

inner-most block. Next, take your numbered blocks and place them in the corresponding numbered 

target space on the side of the patient or participant’s testing hand. For ease of task explanation, each 

row can consist of a single-color block. However, this is not a requirement.

You are now ready to invite your patient or participant to sit or stand in a comfortable position at the 

table with the box in front of them. Be sure the center of the test box is aligned with the midline of the 

person’s body. To ensure consistency in administration of the targeted box and blocks test, we 

encourage test administrators to use the detailed script provided in the instruction manual.

The patient or participant will be instructed to place their hands on the sides of the box before testing 

begins. Patients or participants will be instructed to transport one block at a time, placing the blocks in 

the mirrored position on the opposite side of the partition. The blocks on the testing side are numbered 

in the order they should be picked up, and the location of the mirrored position for each block is 

numbered on the other side. The test administrator will say “Ready...Go” to prompt the patient or 

participant to start the test. Once the test administrator says “Go”, the stopwatch should also be 

started.

When the patient or participant releases the 9th block on the non-testing side of the partition, stop the 

timer and record the time. In addition to the time it takes to transport all 9 blocks, the number of 

unsuccessful block transports will be tracked. An unsuccessful transport is any block that is not within 

the target space, leaning against the target grid, or any block that was dropped during the task. A 

transport is deemed successful if the block is placed within the designated space in the target grid. 

The block must be placed flat in the target space. If the patient or participant consistently drops the 

block over the partition and/or nudges it into the target hole or forgets the order of transport and does 
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not place the blocks in their mirrored position, stop and reset the test, explain the instructions again, 

and restart the test.

Thank you for tuning into this instructional video. Please consult the instruction manual at the link on 

your screen for more detailed information about test set-up, administration, and the administrator 

script. Thank you.

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