M7, T1, planning, executing and assessing everyday action

Question 1

Planning and execution everyday functions

Answer 1

• stored memory representations
• working memory
• bottom-up factors
• executive processes

Question 2

Stored memory representations

Answer 2

• before we perform a task, we need to retrieve a stored memory of how we normally perform it
• stereotypical way of performing an action = schema
• the specificity of the schema will depend on how often the behaviour is practiced (routine-ness)

Question 3

Action schemas

Answer 3

• usually described at the ‘basic’ level (e.g. put tea in teapot)
• this is used to direct actions at a lower ‘subordinate’ level (e.g. grasp the teabag)
• basic level action schemas are ‘context independent’ - allowing for generalisations and learning

Question 4

Working memory

Answer 4

• schemas for less routine tasks may be less specific
• for these tasks, basic level actions might need to be “computed on the fly” and require extra cognitive resources/demand
• goal and response states may form part of a temporary memory representation guiding performance for complex tasks

Question 5

Bottom up factors

Answer 5

• objects in the environment activate stored routines for action in a bottom up manner
  -> for example, getting in our car might activate a schema for driving to work
• objects can activate semantic information and that can activate associated responses to objects
  -> for example, when we name pictures of tools, motor areas in our brain are activated ready for action, this isn’t the case for things like animals

Question 6

Some research suggests visual stimuli directly activates action sequences without using semantics

Answer 6

• participants make gestures under deadline conditions to objects and words
• errors to words were semantic in nature - gesturing to written word ‘razor’ as a shaving brush
• errors to objects related to visual properties - gesturing to a razor as a hammer

Question 7

Multi-sequenced behaviour, bottom up and top down factors

Answer 7

• top down factors (e.g. working memory and stored knowledge) and bottom up factors likely interact top determine what is done in a multi step task
• in multi-sequenced behaviour, bottom up factors likely help moderate competition between different possible actions we could execute in a given moment
  -> e.g. whether I add milk to my tea before or after water may depend on whether the milk is on the bench

Question 8

Executive processes

Answer 8

• when we complete non-routine behaviours, it probably requires different processes compared to routine behaviours
• might require inhibition of a response that is appropriate in one situation, but not a novel situation, and to introduce new behaviours (e.g. adding sweetener rather than sugar)

Question 9

Assessment of everyday actions

Answer 9

• Functional Independence Measure (FIM)
• Multiple-Objects Test (MOT)
• Multi-Level Action Tests (MLAT)
• Naturalistic Action Test (NAT)

Question 10

Functional independence measure (FIM)

Answer 10

• Activities of daily living assessed using 7 point likert scale
• Complete dependence to complete independence
• Patients rated on 18 items:
  -> 13 motor items = self care and locomotion
  -> 5 cognitive items = communication and cognition
• Doesn’t differentiate between motor versus cognitive causes
  *look up image

Question 11

Multiple objects test (MOT)

Answer 11

• In order to assess planning and execution of everyday actions, the patient needs to be assessed while completing an action and given free reign to do so
• MOT used in research settings (e.g. DeRenzi & Lucchelli, 1988; Lehmkuhl & Poeck, 1981)
• Patients given multi-step tasks, e.g. “light a candle and pour a cup of tea”

Question 12

Multi level action test (MLAT)

Answer 12

• Extension of multiple-objects tests
  – Uses naturalistic tasks
  -> Making toast with jam and butter
  -> Gift wrapping a package
  -> Preparing lunchbox with drink and snack
• Tasks done in isolation or in pairs and one at a time with and without distractors
• Tasks untimed and types of errors noted, omission, sequence, substitution, addition, spatial etc.

Question 13

Naturalistic action test (NAT)

Answer 13

• Used to screen for naturalistic action impairment and rate severity of problem.
• NAT shorter and the scoring method simplified compared to MOT and MLAT that were developed for research purposes but lacked standardisation

Tests:
-> making toast with butter and jelly
-> Wrapping a gift
-> Prepare and pack a child’s lunch and pack a child’s schoolbag
*look up image
-> Items vary in difficulty and are scored according to number of steps.