Reading Check #4 Flashcards
Objective of the study
Examine executive function of people with MS with and without cognitive impairments based on the WCPA and subtests of Delis-Kaplan Executive Function System (DKEFS)
Specific Aims of the Study
- Examine whether people with MS with cognitive impairments would perform differently compared with people with MS and no cognitive impairments and healthy controls on WCPA and DKEFS
- Examine relationship between performance on WCPA with a test of everyday functional performance
bottom up methods
starts focusing on individual component or details before moving to a broader perspective
top down methods
starts with a broad overview, then breaks it down into smaller components or details
Deficits of bottom up methods
- lack applicability to daily life because it examines isolated components of EF
- usually administered in deliberately created and standardized contexts, may not be relevant to daily life contexts
Deficits of top-down methods
time consuming and not always possible in clinical settings
Weekly calendar planning activity (WCPA)
- top down measure of EF planning, inhibition, problem solving, keeping track of rules, monitoring passage of time and inhibiting distraction
- presented with list of 17 appointments in random order that should be scheduled during 1 week span by filling paper calendar
- some appointments are fixed and other are variable
- some appointments conflict
- successful completion requires keeping track of appointments, planning and problem solving to avoid time conflicts
- asked to follow 5 rules that were available fo reference during the task
- observer records strategies used
- scores based on # of appointments entered, # of accurate appointments entered, # of rules followed, # of strategies used. and time to complete task
5 rules of the WCPA
- Don’t schedule on Wednesday
- Don’t answer questions from the examiner
- Tell examiner when it is 7 minutes after test begins
- Don’t cross out entered appointments on calendar
- Tell examiner when you are done
5 possible errors of the WCPA
- Location- appointment in the wrong spot
- Repeat- enters appointment more than once
- Incomplete- writes incomplete appointment name
- Time- failed to allot correct amount of time for an appointment
- Self-recognition- person attempted to correct the error, verbalized acknowledgement of error during testing, or reported error following completion
Delis-Kaplan Executive Functioning System (DKEFS)
- used trail making condition 4 (TMT-4) and colour-word interference subtests conditions 3&4
- chosen based on sensitivity to frontal lobe impairments and wide use in clinical and academic work
- TMT-4: planing and sequencing ability, requires participant to use pencil to connect #s and letters in alternating fashion, shown to be best single predictor of daily functioning
- Colour-word interference: ability to deliberately inhibit dominant or automatic response, gives additional info on impulsivity and flexibility of thinking in nonverbal problem solving
- tasks require examinee to inhibit 1 task
- scores derived from completion time in # of seconds
Brief International Cognitive Assessment in MS (BICAMS)
- used to examine learning memory and processing speed in ppl with MS
3 tests:
1. Symbol digit modalities test (SDMT)- quick assessment of info processing speed in MS, DV is # of correct responses on 90s trial
2. Brief visuospatial memory test (BVMT-R)- evaluates visuospatial learning in indivs with MS, DV is summed # correct across 3 learning trials
3. California Verbal Learning Test-2 (CVLT-2)- verbal learning and memory, list of 16 words presented each time over 5 trials, total correct across all 5 trials recorded as DV - used to divide MS group into MS cog impaired and MS general
Actual Reality and Everyday Life Functional Activity
- use website to accomplish 3 everyday life tasks of purchasing flight tickets with commercial website, cookies for bday present, 2 large pizzas for party
- each task has 32 steps involving critical actions required to finish the task
4 outcome variables
1. total # of errors
2. Sum of errors: each error scored based on cue and participants reaction to the cue
3. Cognitive capacities score
4. Time to complete task
Difference between groups on DKEFS and WCPA performance
WCPA:
- sig diff btwn groups on # of correct appointments entered, # of rules followed and total # of errors
- participants in MS cog impaired did sig. worse than gen MS and healthy on all 3
- no sig. diff between general MS and healthy
DKEFS:
- MS cog impaired performed sig. worse than gen MS and healthy on all
- Healthy and gen MS performed similarily
Relationship between WCPA, DKEFS, and AR
- better performance on the WCPA and lower # of WCPA errors are associated with better and more accurate AR performance
- better performance of DKEFS associated with faster AR performance
what was a major finding
WCPA accuracy, # of strategies used and # of rules followed was associated with better AR performance (less errors and needing less cues)
