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Ecological Assessment of Executive Functions: A New Virtual Reality Paradigm

  • Ashok S. Jansari (a1), Alex Devlin (a2), Rob Agnew (a2), Katarina Akesson (a2), Lesley Murphy (a2) and Tony Leadbetter (a2)...

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.

Corresponding author
Address for correspondence: Ashok S. Jansari, Department of Psychology, Goldsmiths, University of London, Lewisham Way, New Cross, London SE 14 6NW, UK. E-mail:
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N. Alderman , P.W. Burgess , C. Knight , & S. Herman (2003). Ecological validity of a simplified version of the multiple errands shopping test. Journal of the International Neuropsychological Society, 9 (1), 3144.

A. Baddeley , S. Della Sala , C. Papagno , & H. Spinnler (1997). Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. Neuropsychology, 11 (2), 187194.

P.C. Bennett , B. Ong , & J. Ponsford (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, 606613.

P.W. Burgess , & J.S. Simons (2005). Theories of frontal lobe executive function: clinical applications. In P.W. Halligan & D.T. Wade (Eds.), Effectiveness of rehabilitation for cognitive deficits (pp. 211232). Oxford: Oxford University Press.

P.W. Burgess , E. Veitch , A. de Lacy Costello , & T. Shallice (2000). The cognitive and neuroanatomical correlates of multitasking. Neuropsychologia, 38, 848863.

R.C.K. Chan , D. Shum , T. Touloupoulou , & E.Y.H. Chen (2008). Assessment of executive functions: Review of instruments and identification of critical issues. Archives of Clinical Neuropsychology, 23, 201216.

N. Chaytor , & M. Schmitter-Edgecombe (2003). The ecological validity of neuropsychological tests: A review of the literature on everyday cognitive skills. Neuropsychology Review, 13, 181196.

N. Chaytor , M. Schmitter-Edgecombe , & M. Burr (2006). Improving the ecological validity of executive functioning assessment. Archives of Clinical Neuropsychology, 21, 217227.

M.M. Cherrier , S. Aubin , & C.S. Higan (2009). Cognitive and mood changes in men undergoing intermittent combined androgen blockade for non-metastatic prostate cancer. Psycho-Oncology, 18 (30), 237247.

A.R. Damasio (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, 14131420.

J. Duncan (1986). Disorganization of behavior after frontal lobe damage. Cognitive Neuropsychology, 3, 271290.

J.S. Elkind , E. Rubin , S. Rosenthal , B. Skoff , & P. Prather (2001). A simulated reality scenario compared with the computerized Wisconsin Card Sorting Test: An analysis of preliminary results. CyberPsychology & Behavior, 4, 489496.

, & (). . , , –. J. Ellis L. Kvavilashvili 2000 Prospective memory in 2000: Past, present and future directions Applied Cognitive Psychology Special Issue: New Perspectives in Prospective Memory 14 (7) 19

P.J. Eslinger , & A.R. Damasio (1985). Severe disturbance of higher cognition after bilateral frontal ablation: Patient EVR. Neurology, 35 (3), 17311741.

L. Gega , R. White , T. Clarke , R. Turner , & D. Fowler (2013). Virtual environments using video capture for social phobia with psychosis. Cyberpsychology, Behavior, and Social Networking, 16 (6), 473479.

J. Grafman , & I. Litvan (1999). Importance of deficits in executive functions. Lancet, 354, 19211923.

A. Jansari , D. Froggatt , T. Edginton , & L. Dawkins (2013). Investigating the impact of nicotine on executive functions using a novel virtual reality assessment. Addiction, 108, 977984.

E. Klinger , I. Chemin , S. Lebreton , & R.M. Marié (2006). Virtual action planning in Parkinson's disease: A control study. CyberPsychology & Behavior, 9 (3), 342347.

C. Knight , N. Alderman , & P.W. Burgess (2002). Development of a simplified version of the multiple errands test for use in hospital settings. Neuropsychological Rehabilitation, 12 (3), 231255.

A.R. Luria (1966). Higher cortical functions in man. New York: Basic Books.

J.D. Masson , D. Dagnan , & J. Evans (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, 457467.

P. McGeorge , L.H. Phillips , J.R. Crawford , S.E. Garden , S. Della Sala , & A.B. Milne (2001). Using virtual environments in the assessment of executive dysfunction. Presence: Teleoperators & Virtual Environments, 10, 375383.

C. Montgomery , N. Hatton , J. Fisk , R. Ogden , & A. Jansari (2010). Assessing the functional significance of ecstasy-related memory deficits using a virtual paradigm. Human Psychopharmacology: Clinical and Experimental, 25, 318325.

C. Montgomery , A.L. Seddon , J.E. Fisk , P.N. Murphy , & A. Jansari (2012). Cannabis-related deficits in real-world memory. Human Psychopharmacology: Clinical and Experimental, 27, 217225.

L. Pugnetti , L. Mendozzi , E.A. Attree , E. Barbieri , B.M. Brooks , C.L. Cazzullo , A. Motta , & F.D. Rose (1998). Probing memory and executive functions with virtual reality: Past and present studies. CyberPsychology & Behavior, 1, 151161.

D. Rand , S. Basha-Abu Rukan , P.L. Weiss , & N. Katz (2009). Validation of the Virtual MET as an assessment tool for executive functions. Neuropsychological Rehabilitation, 19 (4), 583602.

A. Rizzo , & G.J. Kim (2005). A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence: Teleoperators & Virtual Environments, 14 (2), 119146.

T. Shallice , & P. Burgess (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727741.

D.T. Stuss , & M.P. Alexander (2000). Executive functions and the frontal lobes: a conceptual view. Psychological Research, 63, 289298.

D.T. Stuss , & D.F. Benson (1984). Neuropsychological studies of the frontal lobes. Psychological Bulletin, 95, 328.

N. Titov , & R.G. Knight (2005). A computer-based procedure for assessing functional cognitive skills in patients with neurological injuries: The virtual street. Brain Injury, 19 (5), 315322.

T. Zalla , C. Plassiart , B. Pillion , J. Grafman , & A. Sirigu (2001). Action planning in a virtual context after prefrontal cortex damage. Neuropsychologia, 39 (8), 759770.

B.A. Wilson , J.J. Evans , H. Emslie , N. Alderman , & P. Burgess (1998). The development of an ecologically-valid test for assessing patients with a dysexecutive syndrome. Neuropsychological Rehabilitation, 8, 213228.

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Brain Impairment
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