The alphabet backwards is not always a component of the FST, but its relationship to neurological function is interesting. There is a cognitive aspect to remembering how the alphabet goes and how to recite it backwards. That is actually a variation of the mental status subtest of repeating the months backwards. However, the cerebellum is important because speech production is a coordinated activity. The speech rapid alternating movement subtest is specifically using the consonant changes of “lah-kah-pah” to assess coordinated movements of the lips, tongue, pharynx, and palate. But the entire alphabet, especially in the no rehearsed backwards order, pushes this type of coordinated movement quite far. It is related to the reason that speech becomes slurred when a person is intoxicated. The cerebellum is an important part of motor function in the nervous system. It apparently plays a role in procedural learning, which would include motor skills such as riding a bike or throwing a football. The basis for these roles is likely to be tied into the role the cerebellum plays as a comparator for voluntary movement. The motor commands from the cerebral hemispheres travel along the corticospinal pathway, which passes through the puns. Collateral branches of these fibers synapse on neurons in the puns, which then project into the cerebella cortex through the middle cerebella peduncles. Ascending sensory feedback, entering through the inferior cerebella peduncles, provides information about motor performance.

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