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Using, reproducing and adapting the 4AT

The 4AT is free to use. It may be copied, shared and adapted under the Creative Commons Attribution 4.0 International licence (CC BY 4.0). No permission, payment or registration is required.

The official current instrument is version 1.2. The original version was published in September 2011; version 1.2 was released in October 2014. The 4AT was designed by Alasdair MacLullich with Tracy Ryan and Helen Cash. See authorship information and the revision history.

Clinical safety when making changes

Use the official wording, items, instructions, scoring and interpretation wherever possible. The validation evidence on this website applies to the official 4AT versions that were studied.

If you change the wording, item content, instructions, response options, scoring thresholds or interpretation, the result is a modified version. Make this clear wherever the material is displayed or distributed, describe the changes, and do not imply that the modified version is the official 4AT or that the published validation evidence automatically applies to it.

A translation is also an adaptation for licensing purposes. Name the translator or translation team, link to the source version and describe any further changes.

Copy-and-paste attribution

For an unchanged copy

4AT © 2011–2014 Alasdair MacLullich, Tracy Ryan and Helen Cash.
Licensed under CC BY 4.0: https://creativecommons.org/licenses/by/4.0/.
Official and current version: https://www.the4at.com/.
No changes have been made.
No warranty is given as to accuracy or fitness for purpose.

For an adaptation or translation

Adapted from the 4AT © 2011–2014 Alasdair MacLullich, Tracy Ryan and Helen Cash.
Licensed under CC BY 4.0: https://creativecommons.org/licenses/by/4.0/.
Official and current version: https://www.the4at.com/.
This version has been modified. Changes: [briefly describe the changes, including translation where relevant].
The published validation evidence for the official 4AT should not be assumed to apply to this modified version.
No warranty is given as to accuracy or fitness for purpose.

What CC BY 4.0 requires

  • Give appropriate credit and retain the supplied copyright, licence and disclaimer notices.
  • Link to the CC BY 4.0 licence and to the official source material.
  • State whether changes were made and retain any earlier indication of changes.
  • Do not suggest that the 4AT developers endorse your use or your modified version.

CC BY 4.0 permits sharing and adaptation, including commercial use, when its terms are followed. The licence does not itself grant rights in logos or trademarks. Separately credited third-party material, or material marked as excluded, may have different terms.

For administration, scoring and interpretation, use the 4AT user guide. For other questions, please contact us.

Last reviewed 26 July 2026.