Neuropsychological Rehabilitation

An International Journal

ISSN: 0960-2011 (Print) 1464-0694 (Online) Journal homepage: http://www.tandfonline.com/loi/pnrh20

Special issue on ecological validity and cognitive

assessment

Deirdre R. Dawson & Thomas D. Marcotte

To cite this article: Deirdre R. Dawson & Thomas D. Marcotte (2017) Special issue on ecological
validity and cognitive assessment, Neuropsychological Rehabilitation, 27:5, 599-602, DOI:
10.1080/09602011.2017.1313379

To link to this article: https://doi.org/10.1080/09602011.2017.1313379

Published online: 07 May 2017.

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NEUROPSYCHOLOGICAL REHABILITATION, 2017
VOL. 27, NO. 5, 599–602
http://dx.doi.org/10.1080/09602011.2017.1313379

EDITORIAL

Special issue on ecological validity and cognitive

assessment

Introduction
While each passing year brings new discoveries aimed at more efficiently, and accu-
rately, diagnosing neurological conditions and a growing appreciation of the value of
early initiation of treatments for such conditions, a fundamental question for patients,
families, and caregivers, remains – is this person able independently to perform daily
activities and, if not, can anything be done to improve his/her functioning?
The goal of this special issue is to highlight current research, from multi-disciplinary
perspectives, regarding methods and approaches for assessing everyday functioning.
The articles in this volume address ecological validity, various methodological
approaches to ecologically valid assessment and the application of these to various
populations. The issue of ecological validity is highly relevant to researchers, clinicians,
funders and consumers, as virtually every form of brain damage or disease affects every-
day life. A core goal of all neuropsychological rehabilitation is to positively benefit
quality of life.
The term ecological validity is used here to refer to generalisability (veridicality, or the
extent to which assessment results relate to and/or predict behaviours outside the test
environment) and representativeness (verisimilitude, or the degree to which assess-
ments resemble everyday life contexts in which the behaviours will be needed).
While not the original meaning of the term (see Burgess et al., 2006 for discussion
and Baum et al., 2017), it is the meaning that is now in general use.
Traditional cognitive assessments typically require discrete responses to single
events, and are conducted in carefully controlled environments. Performance in the
real world, however, often involves a serial, or occasionally parallel, stream of tasks, fre-
quently in disordered environs. This juxtaposition of how/when we assess patients,
versus the real-world context, may significantly limit the ecological validity of our
measures. This problem gives rise to the question of whether “better” assessments
are possible. We hope to address this through the series of papers in the current
volume. These papers represent a variety of theoretical and disciplinary perspectives
and in aggregate provide a comprehensive picture of the current state of research on
ecologically valid assessment.
The papers in this issue extend our knowledge of assessments that use everyday life
tasks and activities to understand the effect of cognitive impairments, particularly
executive dysfunction, on real-world functioning. One group of papers focuses on per-
formance-based measures.
The scoping review by Poncet, Swaine, Dutil, Chevignard, and Pradat-Diehl (2017),
via their in-depth comparison of 12 performance-based measures, provides an excellent

© 2017 Informa UK Limited, trading as Taylor & Francis Group

600 EDITORIAL

overview for readers. Additional content on two of the measures cited by Poncet et al. is
provided in three papers in this volume. Baum et al. (2017) show data on the validity and
clinical utility of Executive Function Performance Test in a large sample of adults with
traumatic brain injury. Clark, Anderson, Nalder, Arshad and Dawson (2017) and
Nalder, Clark, Anderson and Dawson (2017) add to a growing literature on the psycho-
metric characteristics and clinical utility data of the Multiple Errands Test (MET). Lastly,
the first psychometric data for the Complex Task Performance Assessment, a newer test
modelled on the MET, but using library tasks, are provided by Wolf, Dahl, Auen, and
Doherty (2017).
McFadyen, Gagné, Cossette, and Ouellet (2017) broaden our perspective regarding
performance-based measures in their comprehensive review on the value of para-
digms combining walking and cognitive tasks (dual-task walking, DTW) in the assess-
ment of executive dysfunction. Finally, Cavuoto, Ong, Pike, Nicholas and Kinsella
(2017) and Sanders and Schmitter-Edgecombe (2017) use performance-based tasks
in real-world environments to further understand specific aspects of cognitive pro-
cessing. Cavuoto et al. explore predictors of successful prospective memory for habit-
ual tasks in older adults and Sanders and Schmitter-Edgecombe investigate how the
use of a formal planning phase prior alters task execution, in this instance using the
Amap task.
There are two primary approaches to developing everyday functioning assessments:
function-led perspectives, which focus on the everyday task at hand (e.g., medication
management), and construct-led, which focus on the underlying constructs needed
for successful completion of task (e.g., habitual prospective memory). The distinction
between these perspectives, in the context of virtual environments, is discussed in
the review paper by Parsons, Carlew, Magtoto, and Stonecipher (2017), with the
authors suggesting that virtual assessments designed from a function-led perspective
align more closely with the aim of achieving a set of ecologically valid assessments.
We encourage the reader to keep this idea in mind while reviewing the papers by
Nir-Hadad, Weiss, Waizman, Schwartz, and Kizony (2017) and Canty, Neumann,
Fleming, and Shum (2017). Nir-Hadad and colleagues provide data on the validity of
a function-led virtual assessment, an adapted version of the Four-Item Shopping
Task. In contrast, Canty et al. have developed a theory of mind assessment that
occurs in a virtual environment, the Virtual Assessment of Mentalising Ability (VAMA).
Their data suggest that the VAMA is more representative of social functioning in the
real world than more traditional measures of theory of mind.
In the final paper in this special issue, Bottari, Gosselin, Chen, and Ptito (2017) illus-
trate that imaging paradigms may enhance our understanding of performance on eco-
logically valid tasks (in this instance, the Instrumental Activities of Daily Living Profile):
adults with post-concussion syndrome performing poorly on this everyday life task
also showed abnormalities on functional magnetic resonance imaging and evoked
response potentials.
An underexplored issue, and an area of continuing importance, is the examination of
the ecological validity of assessments between differing diagnostic and socio-demo-
graphic populations. Three recent papers addressing this issue include Chaytor et al.
(2017), Goverover et al. (2017), and Thomas and Marsiske (2017).
Together, these studies provide a wealth of information not only with regards to
specific ecologically valid assessments but also in relation to methodologies that will
 NEUROPSYCHOLOGICAL REHABILITATION 601

inform ongoing work in this area. It is our hope that these papers will serve as a catalyst
for discussion of the best way to evaluate everyday functioning, in an ecologically valid
approach, and inspire new and creative approaches to addressing the critical issue of
how to assess, and help, patients in their everyday life.

References
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Validation and clinical utility of the executive function performance test in persons with traumatic
brain injury. Neuropsychological Rehabilitation, 27(5), 603–617.
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injury on complex everyday activities and the link with alterations in cerebral functioning:
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602 EDITORIAL

Deirdre R. Dawson
Department of Occupational Science & Occupational Therapy, & Rehabilitation Sciences
Institute, University of Toronto, Toronto, Canada
Rotman Research Institute, Baycrest
ddawson@research.baycrest.org

Thomas D. Marcotte
Department of Psychiatry, University of California, San Diego