A new approach for assessing executive functions in everyday life, among adolescents with Genetic Generalised Epilepsies

Zlotnik, Sharon; Schiff, Aharon; Ravid, Sarit; Shahar, Eli; Toglia, Joan

doi:10.1080/09602011.2018.1468272

Cited by 14 publications

(13 citation statements)

References 30 publications

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“…The task of entering appointments into a weekly schedule is easily recognized as relevant to functional abilities in everyday life and appears easy on the surface; however, appointment conflicts, rule constraints and unexpected obstacles create significant cognitive challenges that require a strategic approach. The standard 17-item version of the WCPA differentiates between healthy controls and a wide range of populations with executive dysfunction including those with multiple sclerosis ( 19 ), mild cognitive impairment ( 20 ), attention-deficit hyperactivity disorder ( 21 ), pediatric acquired brain injury ( 22 ), and epilepsy ( 23 ). Accuracy on the WCPA correlates with inhibitory control and set-shifting as assessed by the Delis-Kaplan Executive Functioning System ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation

et al. 2021

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Performance-based, functionally relevant, and standardized measures of cognitive-instrumental activities of daily living (C-IADL) can complement neuropsychological tests of cognitive impairment and provide valuable clinical information to inform rehabilitation planning. Existing measures have been validated in the outpatient setting. Here, we sought to evaluate a 10-item, short-form of a C-IADL measure, Weekly Calendar Planning Activity (WCPA-10), in inpatients with stroke undergoing acute rehabilitation. The specific goal was to determine if the WCPA-10 could differentiate between stroke patients undergoing acute inpatient rehabilitation and healthy control individuals. We also explored whether the WCPA-10 would identify C-IADL limitations in stroke patients screened as having intact cognition. Seventy-seven stroke inpatients undergoing rehabilitation and 77 healthy control participants completed the WCPA-10, which involves entering a list of simulated, fictional appointments into a weekly schedule while keeping track of and adhering to multiple task rules and ignoring built-in obstacles and distractions. Compared to the control group, stroke patients had significantly worse accuracy, made more errors, used fewer cognitive strategies, followed fewer rules, took more time to complete the task, and were less efficient. 83% of stroke patients were less accurate than predicted by their age, and 64% used less strategies than their age prediction. Among 28 participants who screened as having “normal” cognitive function on the Montreal Cognitive Assessment, the majority had deficits on the WCPA-10. Our results provide initial support for use of a brief C-IADL assessment, WCPA-10, for individuals with stroke undergoing inpatient rehabilitation. They indicate that stroke patients have deficits in C-IADL accuracy, efficiency, and strategy use at this stage of stroke recovery. Results highlight the need to use performance based, functional cognitive assessments, even for those who perform well on cognitive screening tools.

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Section: Introductionmentioning

confidence: 99%

Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation

et al. 2021

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“…Adolescents with acquired brain injury performed more poorly on the WCPA than typically developing controls (e.g., lower accuracy, more errors; Doherty et al., 2022 ). Adolescents with genetic generalized epilepsies demonstrated significantly lower accuracy, lower efficiency, and fewer strategies used on the WCPA, compared with their typical peers ( Zlotnik et al., 2020 ). Additionally, adolescents with ADHD tend to overestimate their performance on the WCPA, compared with typically developing controls ( Fisher, Berger, Grossman, & Maeir, 2022 ).…”

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confidence: 92%

“…Additionally, adolescents with ADHD tend to overestimate their performance on the WCPA, compared with typically developing controls ( Fisher, Berger, Grossman, & Maeir, 2022 ). It is important to note that performance on the WCPA has been associated with caregiver-rated EF ( Doherty et al., 2022 ; Zlotnik et al., 2020 ) and performance on other neuropsychological assessments ( Doherty et al., 2022 ). The WCPA has also been used to document EF deficits and as an outcome measure for a time management intervention for adults with neurodevelopmental disorders, including ASD and ADHD ( Wingren et al., 2022 ).…”

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confidence: 99%

Use of the Weekly Calendar Planning Activity to Assess Executive Function in Adolescents With Autism Spectrum Disorder

Tamm,

Hamik,

Zoromski

et al. 2024

The American Journal of Occupational Therapy

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Importance: Youths with autism spectrum disorder (ASD) have challenges with executive function (EF). However, there are few measures to objectively assess EF, such as time management and prioritization. The Weekly Calendar Planning Activity (WCPA) is a promising performance-based EF measure that has rarely been used with youths with ASD. Objective: To characterize the performance of youths with ASD on the WCPA and the association of WCPA performance with caregiver-rated EF. Design: Observational and summary data obtained during a baseline evaluation for a research study. Setting: Middle school. Participants: Thirty-nine adolescents with ASD and without an intellectual disability. Method: Youth were administered the WCPA; caregivers completed EF ratings. Descriptive statistics characterized WCPA performance. Correlations between WCPA scores and age, IQ, and EF ratings were computed. Results: The majority of youth performed poorly on the WCPA and lacked insight into their poor performance. Many struggled to enter appointments. Appointment accuracy was <30%. The most common errors were location errors. Appointment accuracy and planning time were moderately associated with IQ but not with caregiver-rated EF or age. Conclusions and Relevance: Overall, the WCPA was cognitively demanding for youths with ASD without an intellectual disability. These results have implications for using evidence-based strategies to teach adolescents with ASD how to manage their time and plan and prioritize homework assignments, upcoming tests or quizzes, and extracurricular activities. Plain-Language Summary: Youths with autism spectrum disorder have significant problems with executive function, particularly organization, prioritization, time management, and planning. There are few objective, performance-based measures of executive function, especially those that can be used with autistic youths. To our knowledge, this study is the first to use the Weekly Calendar Planning Activity (WCPA) with autistic adolescents who do not have an intellectual disability. The WCPA captured their deficits related to executive function and could be a useful tool for assessment and treatment planning.

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“…The standard 17-item version of the WCPA distinguishes between healthy controls and people with executive dysfunction including those with attention-deficit hyperactivity disorder (Lahav et al, 2018), epilepsy (Zlotnik et al, 2020), and multiple sclerosis (Goverover et al, 2020). The WCPA allows measurement of awareness in multiple ways (Toglia, 2015).…”

Section: Introductionmentioning

confidence: 99%

Awareness of Performance on a Functional Cognitive Performance-Based Assessment Across the Adult Lifespan

2021

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As people age, their cognitive skills and ability to complete complex instrumental activities of daily living often decline in subtle ways. Older adults who are aware of these slight cognitive and functional changes spontaneously adapt and implement strategies to maximize performance. On the other hand, older adults with limited self-awareness are less likely to adjust performance or initiate compensatory strategies as they may not recognize the need to do so. This places them at higher risk of functional decline and loss of independence. Research on awareness of functional performance in healthy adults is, however, limited, and there is a paucity of assessment tools available to address questions of awareness and strategy use in functional tasks. We used the Weekly Calendar Planning Activity (WCPA) – a performance-based assessment of functional cognition including measures of awareness and strategy use – to investigate differences in performance, awareness, and strategy use across the adult lifespan. The WCPA requires examinees to schedule appointments into a weekly calendar while following rules designed to increase task demands. Healthy adults (n=342) from ages 18–92 were observed for strategy use and error recognition, while a post-test interview probed participants’ reported strategy use and estimation of accuracy. The discrepancy between participant estimation and actual accuracy provided a measure of online awareness of performance where a larger estimation discrepancy indicated over-estimation of performance. Performance on the WCPA declined across the adult lifespan. Older adults were less likely to use self-monitoring strategies and used less effective strategies overall. Overestimation was associated with use of fewer strategies and lower accuracy in all age groups. Importantly, twice as many older adults overestimated compared to younger adults. Furthermore, the subset of older adults who had good awareness of performance was more likely to use effective strategies, to recognize errors, and achieved accuracy on par with their younger counterparts. Our results emphasize the importance of examining self-awareness of performance and analyzing the strategies used to perform a complex functional task. This information can provide a foundation for early detection of functional decline in aging and for designing interventions to maximize functional independence in aging.

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A new approach for assessing executive functions in everyday life, among adolescents with Genetic Generalised Epilepsies

Cited by 14 publications

References 30 publications

Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation

Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation

Use of the Weekly Calendar Planning Activity to Assess Executive Function in Adolescents With Autism Spectrum Disorder

Awareness of Performance on a Functional Cognitive Performance-Based Assessment Across the Adult Lifespan

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