Absence Within the Neurological Community of Executive Essay

Excerpt from Essay :

absence within the neurological community of executive function performance testing for various real-world activities (that include multi-tasking) on subjects who have suffered brain damage (Baum & al, 2008). By testing real-world functioning via the EFPT, the researchers, as occupational therapists, hoped to provide more accurate information on the ability of subjects to function independently in their day-to-day existence and to perform functions within society (Baum & al, 2008). This study served as a test of the validity and reliability of the EFPT model on patients with mild to moderate stroke, as a follow-up to previous studies of EFTP validity and reliability on subjects with multiple sclerosis and schizophrenia (Baum & al, 2008). Hypothesis: Stroke will have a negative effect on executive functioning in real-world tasks.

Research study design and characteristics

This was an empirical, quantitative, conclusion-oriented, lab/simulation research study using the EFTP. The EFTP measures executive cognitive functions (initiation, organization, sequencing safety, judgment, and task completion) via a "structured cueing and scoring system" (Baum & al, 2008. p.446). The five specific cognitive functions are assessed as participants complete four separate tasks: "cooking, using the telephone, managing medications, and paying bills" (Baum & al, 2008, p. 446). These activities were structured based on the existing "Kitchen Task Assessment," using simple instructions and materials in a simulated lab environment (Baum & al, 2008). The EFTP was administered to 73 subjects who had previously suffered a mild to moderate stroke, and 22 healthy control-group volunteers matched for age and education level and tested for physical and cognitive health (Baum & al, 2008). The experimental group was participants in a research program at a nearby hospital, and verified by a neurologist for the diagnosis of stroke (Baum & al, 2008). Testing was conducted six months after stroke onset, while none of the patients were undergoing rehabilitative care (Baum & al, 2008). Dependent variables were measured using a "standardized cueing system," based on "the progressive need for assistance associated with increasing levels of cognitive impairment," and analyzed statistically using ANOVA and chi-square analyses, resulting in a concise table of data/results (Baum & al, 2008).

Distinguishing characteristics of the EFPT compared to current/existing performance based assessments?

The EFTP differs from existing performance assessments in several ways. First, it is easy for occupational therapists to learn, conduct, and score (Baum & al, 2008). Second, it measures the amount of support the subject will need in order to successfully carry out four daily activities which are essential to "daily community life" (Baum & al, 2008). Third, during the four activities, the study measures key executive functions in terms of cognitive components, allowing for the development of effective treatment plans (Baum & al, 2008). Finally, the EFTP "uses a top-down approach that allows the practitioner to objectively assess the client during the performance of a task, and unlike many other instruments assessing instrumental activities of daily living (IADLs), it assesses actual performance rather than rely on proxy or self-report" (Baum & al, 2008, p. 447)

Variables: How classified and operationalized

The independent variable in this study was stroke, classified as either mild or moderate based on the NIHSS, and controlled with a group of healthy individuals, also tested for cognitive and physical health functions (Baum & al, 2008). These variables were further classified based on age, gender, race, and education level (Baum & al, 2008).

The dependent variables studied were classified under five categories: "initiation, organization, sequencing safety, judgment, and task completion" (Baum & al, 2008, p. 446). These variables were operationalized in terms of their role in the successful completion of four daily tasks: "cooking, using the telephone, managing medications, and paying bills," and measured via a "standardized cueing system" (Baum & al, 2008, p. 446). The cueing system rates the…

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References

Baum, C., & al, e. (2008). Reliability, Validity, and Clinical Utility of the Executive Function Performance Test. American Journal of Occupational Therapy, 62 (4), 446-454.

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