Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T08:05:56.951Z Has data issue: false hasContentIssue false
  • English
  • Français

Ecological Assessment of Executive Functions: A New Virtual Reality Paradigm

Published online by Cambridge University Press:  02 September 2014

Ashok S. Jansari ,
Alex Devlin ,
Rob Agnew ,
Katarina Akesson ,
Lesley Murphy  and
Tony Leadbetter
Ashok S. Jansari*
Affiliation:
Department of Psychology, Goldsmiths, University of London, Lewisham Way, New Cross, London SE14 6NW, United Kingdom
Alex Devlin
Affiliation:
School of Psychology, University of East London, Water Lane, London E15 4LZ, United Kingdom
Rob Agnew
Affiliation:
School of Psychology, University of East London, Water Lane, London E15 4LZ, United Kingdom
Katarina Akesson
Affiliation:
School of Psychology, University of East London, Water Lane, London E15 4LZ, United Kingdom
Lesley Murphy
Affiliation:
School of Psychology, University of East London, Water Lane, London E15 4LZ, United Kingdom
Tony Leadbetter
Affiliation:
School of Psychology, University of East London, Water Lane, London E15 4LZ, United Kingdom
*
Address for correspondence: Ashok S. Jansari, Department of Psychology, Goldsmiths, University of London, Lewisham Way, New Cross, London SE 14 6NW, UK. E-mail: [email protected]
Get access

Abstract

Acquired brain injury (ABI) can lead to a constellation of higher-order executive problems, which can impact significantly on everyday behaviour. While some neuropsychological 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.

Keywords

executive functionsecological validityvirtual realityassessmentmultiple errand task
Type
Articles
Information
Brain Impairment , Volume 15 , Issue 2 , September 2014 , pp. 71 - 87
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alderman, N., Burgess, P.W., Knight, C., & Herman, S. (2003). Ecological validity of a simplified version of the multiple errands shopping test. Journal of the International Neuropsychological Society, 9 (1), 31–44.CrossRefGoogle ScholarPubMed
Baddeley, A., Della Sala, S., Papagno, C., & Spinnler, H. (1997). Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. Neuropsychology, 11 (2), 187–194.Google Scholar
Bennett, P.C., Ong, B., & Ponsford, J. (2005). Assessment of executive dysfunction following traumatic brain injury: Comparison of the BADS with other clinical neuropsychological measures. Journal of the International Neuropsychological Society, 11, 606–613.Google Scholar
Bottari, C., Swaine, B., & Dutil, E. (2007). Interpreting activity of daily living errors for treatment and discharge planning: The perception of occupational therapists. Journal of Head Trauma Rehabilitation, 1, 26–30.CrossRefGoogle Scholar
Brooks, B.M., & Rose, F.D. (2003). The use of virtual reality in memory rehabilitation: current findings and future directions. Neurorehabilitation, 18, 147–157.CrossRefGoogle ScholarPubMed
Burgess, P., & Shallice, T. (1997). The Hayling and Brixton tests. Test manual. Bury St Edmunds, UK: Thames Valley Test Company.Google Scholar
Burgess, P.W., & Simons, J.S. (2005). Theories of frontal lobe executive function: clinical applications. In Halligan, P.W. & Wade, D.T. (Eds.), Effectiveness of rehabilitation for cognitive deficits (pp. 211–232). Oxford: Oxford University Press.Google Scholar
Burgess, P.W., Veitch, E., de Lacy Costello, A., & Shallice, T. (2000). The cognitive and neuroanatomical correlates of multitasking. Neuropsychologia, 38, 848–863.Google Scholar
Carelli, L., Morganti, F., Weiss, P.L., Kizony, R., & Riva, G. (2008, August). A virtual reality paradigm for the assessment and rehabilitation of executive function deficits post stroke: Feasibility study. In Virtual Rehabilitation, 2008 (pp. 99–104). Piscataway, New Jersey: IEEE.Google Scholar
Chan, R.C.K., Shum, D., Touloupoulou, T., & Chen, E.Y.H. (2008). Assessment of executive functions: Review of instruments and identification of critical issues. Archives of Clinical Neuropsychology, 23, 201–216.CrossRefGoogle ScholarPubMed
Chaytor, N., & Schmitter-Edgecombe, M. (2003). The ecological validity of neuropsychological tests: A review of the literature on everyday cognitive skills. Neuropsychology Review, 13, 181–196.CrossRefGoogle ScholarPubMed
Chaytor, N., Schmitter-Edgecombe, M., & Burr, M. (2006). Improving the ecological validity of executive functioning assessment. Archives of Clinical Neuropsychology, 21, 217–227.Google Scholar
Cherrier, M.M., Aubin, S., & Higan, C.S. (2009). Cognitive and mood changes in men undergoing intermittent combined androgen blockade for non-metastatic prostate cancer. Psycho-Oncology, 18 (30), 237–247.Google Scholar
Damasio, A.R. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 351, 1413–1420.Google Scholar
Duncan, J. (1986). Disorganization of behavior after frontal lobe damage. Cognitive Neuropsychology, 3, 271–290.Google Scholar
Elkind, J.S., Rubin, E., Rosenthal, S., Skoff, B., & Prather, P. (2001). A simulated reality scenario compared with the computerized Wisconsin Card Sorting Test: An analysis of preliminary results. CyberPsychology & Behavior, 4, 489–496.Google Scholar
Ellis, J. (1996). Prospective memory or the realization of delayed intentions: A conceptual framework for research. In Brandimonte, M., Einstein, G.O. & McDaniel, M.A. (Eds.), Prospective memory: Theory and applications (pp. 1–22). Mahwah, NJ, US: Lawrence Erlbaum Associates.Google Scholar
Ellis, J., & Kvavilashvili, L. (2000). Prospective memory in 2000: Past, present and future directions. Applied Cognitive Psychology Special Issue: New Perspectives in Prospective Memory, 14 (7), 1–9.Google Scholar
Eslinger, P.J., & Damasio, A.R. (1985). Severe disturbance of higher cognition after bilateral frontal ablation: Patient EVR. Neurology, 35 (3), 1731–1741.CrossRefGoogle ScholarPubMed
Gega, L., White, R., Clarke, T., Turner, R., & Fowler, D. (2013). Virtual environments using video capture for social phobia with psychosis. Cyberpsychology, Behavior, and Social Networking, 16 (6), 473–479.Google Scholar
Grafman, J., & Litvan, I. (1999). Importance of deficits in executive functions. Lancet, 354, 1921–1923.CrossRefGoogle ScholarPubMed
Greenwood, J.R., Barnes, B.P., McMillan, T.M., & Ward, C.D. (2003). Handbook of neurological rehabilitation (2nd ed.). East Sussex, England, Psychology Press.Google Scholar
Jansari, A., Debreceni, K., Bartfai, A., & Eriksson, M. (2008). Swedish JAAM? Adaptation of a virtual reality assessment of dysexecutive syndrome to a new culture and language. Brain Impairment, 9 (2), 220.Google Scholar
Jansari, A., Devlin, A., Kerrouche, B., Gilboa, Y., Davies, M., Fisher, H., . . . Chevignard, M. (in press). C’est ma fête! Can a French adaptation of a virtual reality assessment of children's executive functions (JEF-C©) work and be used with paediatric patients with acquired brain injury? Journal of the International Neuropsychological Society.Google Scholar
Jansari, A., Froggatt, D., Edginton, T., & Dawkins, L. (2013). Investigating the impact of nicotine on executive functions using a novel virtual reality assessment. Addiction, 108, 977–984.CrossRefGoogle ScholarPubMed
Jansari, A., Sosson, C., & Samson, D. (2013). Can a French adaptation of a virtual reality assessment of executive functions (JEF©) work? Brain Impairment, 14 (2).Google Scholar
Josman, N., Klinger, E., & Kizony, R. (2008). Performance within the virtual action planning supermarket (VAP-S): an executive function profile of three different populations suffering from deficits in the central nervous system. Proceedings of the 7th International Conference on Disability, Virtual Reality and Associated Technologies, Maia & Porto, Portugal (pp. 33–38).Google Scholar
Klinger, E., Chemin, I., Lebreton, S., & Marié, R.M. (2006). Virtual action planning in Parkinson's disease: A control study. CyberPsychology & Behavior, 9 (3), 342–347.CrossRefGoogle ScholarPubMed
Knight, C., Alderman, N., & Burgess, P.W. (2002). Development of a simplified version of the multiple errands test for use in hospital settings. Neuropsychological Rehabilitation, 12 (3), 231–255.Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (Eds.) (2004). Neuropsychological assessment (4th ed.). New York: Oxford University Press.Google Scholar
Luria, A. (1973). The working brain: An introduction to neuropsychology. New York: Basic Books.Google Scholar
Luria, A.R. (1966). Higher cortical functions in man. New York: Basic Books.Google Scholar
Masson, J.D., Dagnan, D., & Evans, J. (2010). Adaptation and validation of the Tower of London test of planning and problem solving in people with intellectual disabilities. Journal of Intellectual Disability Research, 54, 457–467.CrossRefGoogle ScholarPubMed
Mateer, C.A. (1999). Executive function disorders: Rehabilitation challenges and strategies. Seminars in Clinical Neuropsychiatry, 4, 50–59.Google Scholar
McGeorge, P., Phillips, L.H., Crawford, J.R., Garden, S.E., Della Sala, S., & Milne, A.B. (2001). Using virtual environments in the assessment of executive dysfunction. Presence: Teleoperators & Virtual Environments, 10, 375–383.CrossRefGoogle Scholar
Mills, R. (2009). Investigating higher level cognitive impairments as a consequence of Androgen Deprivation Therapy (ADT) in men with prostate cancer using a new virtual reality assessment. Unpublished Graduate Diploma dissertation, University of East London.Google Scholar
Montgomery, C., Ashmore, K., & Jansari, A. (2011). The effects of a modest dose of alcohol on executive functioning and prospective memory. Human Psychopharmacology: Clinical & Experimental, 26, 208–215.Google Scholar
Montgomery, C., Hatton, N., Fisk, J., Ogden, R., & Jansari, A. (2010). Assessing the functional significance of ecstasy-related memory deficits using a virtual paradigm. Human Psychopharmacology: Clinical and Experimental, 25, 318–325.CrossRefGoogle ScholarPubMed
Montgomery, C., Seddon, A.L., Fisk, J.E., Murphy, P.N., & Jansari, A. (2012). Cannabis-related deficits in real-world memory. Human Psychopharmacology: Clinical and Experimental, 27, 217–225.Google Scholar
Norman, D.A. & Shallice, T. (1986). Attention to action: Willed and automatic control of behaviour. Consciousness and Self-Regulation, 4, 1–18.Google Scholar
Pugnetti, L., Mendozzi, L., Attree, E.A., Barbieri, E., Brooks, B.M., Cazzullo, C.L., Motta, A., & Rose, F.D. (1998). Probing memory and executive functions with virtual reality: Past and present studies. CyberPsychology & Behavior, 1, 151–161.CrossRefGoogle Scholar
Rand, D., Basha-Abu Rukan, S., Weiss, P.L., & Katz, N. (2009). Validation of the Virtual MET as an assessment tool for executive functions. Neuropsychological Rehabilitation, 19 (4), 583–602.Google Scholar
Reger, G.M., Parsons, T.D., Gahm, G.A., & Rizzo, A.A. (2010). Virtual reality assessment of cognitive functions: A promising tool to improve ecological validity. Brain Injury, 7, 24–26.Google Scholar
Renison, B., Ponsford, J., Testa, R., & Jansari, A. (2008). The use of virtual reality in assessment of executive function following traumatic brain injury. Brain Impairment, 9 (1), 47.Google Scholar
Renison, B., Ponsford, J., Testa, R., Richardson, B., & Brownfield, K. (2012). The ecological and construct validity of a newly developed measure of executive function: The virtual library task. Journal of the International Neuropsychological Society, 18, 440–450.Google Scholar
Rizzo, A., & Kim, G.J. (2005). A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence: Teleoperators & Virtual Environments, 14 (2), 119–146.Google Scholar
Shallice, T., & Burgess, P. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741.CrossRefGoogle ScholarPubMed
Stuss, D.T., & Alexander, M.P. (2000). Executive functions and the frontal lobes: a conceptual view. Psychological Research, 63, 289–298.Google Scholar
Stuss, D.T., & Benson, D.F. (1984). Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 3–28.Google Scholar
Titov, N., & Knight, R.G. (2005). A computer-based procedure for assessing functional cognitive skills in patients with neurological injuries: The virtual street. Brain Injury, 19 (5), 315–322.Google Scholar
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (1996). Behavioural Assessment of the Dysexecutive Syndrome (BADS). Edmunds, Bury St., UK, Thames Valley Test Company.Google Scholar
Wilson, B.A., Evans, J.J., Emslie, H., Alderman, N., & Burgess, P. (1998). The development of an ecologically-valid test for assessing patients with a dysexecutive syndrome. Neuropsychological Rehabilitation, 8, 213–228.Google Scholar
Zalla, T., Plassiart, C., Pillion, B., Grafman, J., & Sirigu, A. (2001). Action planning in a virtual context after prefrontal cortex damage. Neuropsychologia, 39 (8), 759–770.Google Scholar