Ecological Assessment of Executive Functions: A New Virtual Reality Paradigm

摘要

Acquired brain injury (ABI) can lead to a constellation of higher-order executive problems, which can impact significantly on everyday behaviour. While some neu-ropsychological assessments are able to measure these impairments objectively, increasingly, clinicians are finding that a subset of their patients passes these tests while still exhibiting difficulties in day-to-day living. Calls have therefore been made to develop assessments that are more sensitive and that are more ecologically valid. In this study, in Experiment 1, a multiple errands task (MET) based around a business office was created to assess concurrently nine aspects of executive functioning (planning, prioritisation, selective-thinking, creative-thinking, adaptive-thinking, multi-tasking, action-based prospective memory (PM), event-based PM and time-based PM). This new paradigm, the Jansari assessment of Executive Functions (JEF?) showed a significant difference between six individuals with ABI and matched healthy controls; further, it showed that across the nine constructs there was a range of performance. In Experiment 2, JEF? was recreated in a virtual environment resembling a computer game, and it was found that this version significantly differentiated between 17 individuals with ABI and 30 healthy controls. These results suggest that the virtual version of JEF? could be used as a new assessment of executive function. The profile of performance across the nine constructs for each individual provides a wealth of objective information that could potentially inform targeted rehabilitation.