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Modulation of executive function in acquired brain injury
FISH, J., MANLY, T. and WILSON, B.A.
Journal of the International Neuropsychological Society 12, S2:42
Year of publication:
A principal aim in the assessment of executive functioning is the prediction of problems in everyday life. The assumption that tests predict everyday performance is by no means unequivocally supported by research findings (Burgess et al, 1998), though the development of ecologically valid tests is helping to improve the situation. Most assessment procedures share one major drawback: they tell us very little about variability in performance. We have used methods that attempt to gauge this variability, with reference to prospective memory rehabilitation. We used a naturalistic task, in which patients are asked to make four daily telephone calls to a voicemail service, and found significant facilitation of performance when a text-message based alerting strategy was used. A second study investigated how different aspects of executive functioning are influenced by motivational salience, employing traditional experimental research methodology. We would argue that measuring variability in, rather than absolute level of, performance, provides a better reflection of everyday function than standard “snapshot” assessment procedures, as well as providing theoretical insight into the cognitive processes involved in these complex behaviours, and clinical insight regarding the implementation of rehabilitation strategies.