Front Desk Duty Multitasking Test After Mild Stroke: Preliminary Reliability and Validity

Abstract

Background. Performance-based multitasking assessments may be more sensitive than cognitive screens to detect executive dysfunction after a mild stroke. Purpose. This cross-sectional study examined inter-rater reliability and preliminary convergent and discriminant validity of the Front Desk Duty Test (FDDT). Method. Adults with mild stroke ( n = 35) and community controls ( n = 33) were administered the FDDT and other measures of executive functions. Findings. Inter-rater reliability of the FDDT subscores were high (ICC 0.971–0.999). There were weak but statistically significant correlations between participants’ scores on some of the executive function tests and some FDDT subscores. Participants with mild stroke and community controls had statistically significant different FDDT scores (performance accuracy p = .006; performance time, p = .033), with rank order FDDT score patterns across community controls, participants with mild stroke who passed the executive function screen, and participants with mild stroke who failed the executive function screen. Implications. Preliminary validation results suggest that the FDDT warrants further study.

Executive Function Poststroke: Concepts, Recovery, and Interventions

“…Administering standardized measures in structured testing environments can obscure executive function impairments that might be apparent in conditions requiring the expression of novel adaptive behavior (eg, real time monitoring and updating within everyday activities). 48,49 To address this problem, self-report questionnaires (eg, Behavioral Rating Inventory of Executive Function and Dysexecutive Questionnaire, Executive Interview-25) 50 and activities of daily living performance measures that are sensitive to impairments in adaptive behavior during complex, cognitively challenging and real world activities may be more reflective of problems experienced in everyday living (eg, Behavioral Assessment of Dysexecutive Syndrome, 51 Hotel Task, 52 Front Desk Duty Task, 53,54 Menu Task, 55 and Multiple Errands Test). 49,56 While these more complex measures may be more sensitive to executive dysfunction in everyday life, this sensitivity may come at the cost of loss of precision (ie, observed impairment and recovery may be difficult to localize to specific executive, motivational, or related cognitive processes) In addition, given the complexity of underlying cognitive processes, apparent change as measured in repeated testing may not necessarily reflect recovery of executive function per se, but rather recovery of these underlying cognitive processes.…”

Measurement properties of performance-based instruments for assessing mental function during activity and participation in persons with stroke: A systematic review

“…Kettle test [41] and the Short Behavioural Scale (SBS) [42], assessed attention, memory and executive functions, both through instrumental activities. Six instruments assessed executive functions only: Complex Task Performance Assessment (CTPA/CTPA-alt) [43,44], Executive Function Performance Test (EFPT) [26,[45][46][47][48][49][50], Four Item Shopping Task (Adapted) [27], Front Desk Duty Test (FDDT) [51], Multiple Errands Test (MET/ MET-R/VMET) [52][53][54][55][56] and Virtual Action Planning-Supermarket (VAPS) [57]. Executive functions were assessed through instrumental activities.…”