Executive Skills Research Articles

Exploring raw data transformations on inertial sensor data to model user expertise when learning psychomotor skills

This paper introduces a novel approach for leveraging inertial data to discern expertise levels in motor skill execution, specifically distinguishing between experts and beginners. By implementing inertial data transformation and fusion techniques, we conduct a comprehensive analysis of motor behaviour. Our approach goes beyond conventional assessments, providing nuanced insights into the underlying patterns of movement. Additionally, we explore the potential for utilising this data-driven methodology to aid novice practitioners in enhancing their performance. The findings showcase the efficacy of this approach in accurately identifying proficiency levels and lay the groundwork for personalised interventions to support skill refinement and mastery. This research contributes to the field of motor skill assessment and intervention strategies, with broad implications for sports training, physical rehabilitation, and performance optimisation across various domains.

Development of executive skill guitar students in the processor education in Higher Educational Institutions

Development of executive skill guitar students in the processor education in Higher Educational Institutions

Driving Towards Sustainable Future Through EV Health Monitoring System

Driving is a complex activity performed in a continually varying and stimulating environment. The coordination and execution of various skills like cognitive, sensory, psychomotor and physical are extremely necessary to drive safe. Most of the studies related to driving highlighted that 75% of traffic accidents occurs due to human factors including driver’s fatigue, deprived health condition, attention loss, bad emotional state, and lack of skills. Most of the developed country is ageing. Hence, the drivers above 60 years is also increasing. Ageing results are weakening in cognitive function and threaten driver safety. The aged drivers (age above 60 years) have a comparatively more significant risk of accident due to medical emergency than other factors like bad emotional state and lack of skills. The wellness of drivers’ is considered as a key factor of traffic accidents. Heart failure and non-traumatic disease (i.e., stroke) are the main risk factors for drivers’ death. Many of the victims have no prior knowledge of the presence of the condition. Stroke is a disease caused due to the disturbance in blood supply to the parts of the brain. After experiencing stroke, a driver’s ability to drive is generally affected by the visual, perceptual, motor, and cognitive deficits. Stroke leads to arm weakness, facing dropping, blurred vision, dizziness, coordination issue and speech difficulties of victims which are essential for driving. It is necessary to protect the driver’s those are possibly be the victims for stroke. Since, stroke onset during driving lead a serious threat to the other drivers and the general public. Now-a-days, there are lots of automotive industry competing not only to provide better performance in terms of the vehicle but also to provide the driver with better comfort even in long rides. Automakers are developing vehicle that could provide health monitoring service with Internet of Things (IoT). In IoT, an automobile or vehicle-treated as a “thing”. IoT plays an important role in connected vehicles development. It provide us cloud connectivity, health monitoring, safety and security. Automakers are developing vehicles with IoT enabled including healthcare, accident prevention, vehicle safety, driver safety, driver and passenger comfort, vehicle monitoring, etc. The paper aimed on summarizing the current developments in driver’s health and comfort monitoring through IoT.

Quantifying Executive Functions: Bilingual Education's Cognitive Impact in Special Education

This research examines how bilingual education affects the cognitive executive skills of kids in special education. The research investigates the correlation between bilingual proficiency and EFs, taking into account the moderating influence of demographic factors such as age, gender, and socioeconomic position (SES). The sample consisted of 120 kids who were part of special education programs. The study included evaluations of their multilingual competence and executive functions. Statistical methods such as t-tests, ANOVA, regression, correlation, and ANCOVA were used to investigate the relationships between bilingualism, executive functions (EFs), and demographic variables. The results show a strong positive correlation between bilingual proficiency and executive functions (EFs), indicating that increased proficiency is linked to improved EF performance. Moreover, socioeconomic status (SES) was shown to be a major predictor of executive functions (EFs), underscoring the relevance of including socioeconomic considerations when evaluating cognitive results. The findings highlight the cognitive benefits of bilingual education for kids in special education and provide valuable information for educational practice, policy, and future study.

Neuropsychological task outcomes among survivors of childhood acute lymphoblastic leukemia in Malaysia

This study intended to explore the neuropsychological ramifications in childhood acute lymphoblastic leukemia (ALL) survivors in Malaysia and to examine treatment-related sequelae. A case-control study was conducted over a 2-year period. Seventy-one survivors of childhood ALL who had completed treatment for a minimum of 1 year and were in remission, and 71 healthy volunteers were enlisted. To assess alertness (processing speed) and essential executive functioning skills such as working memory capacity, inhibition, cognitive flexibility, and sustained attention, seven measures from the Amsterdam Neuropsychological Tasks (ANT) program were chosen. Main outcome measures were speed, stability and accuracy of responses. Mean age at diagnosis was 4.50 years (SD ± 2.40) while mean age at study entry was 12.18 years (SD ± 3.14). Survivors of childhood ALL underperformed on 6 out of 7 ANT tasks, indicating poorer sustained attention, working memory capacity, executive visuomotor control, and cognitive flexibility. Duration of treatment, age at diagnosis, gender, and cumulative doses of chemotherapy were not found to correlate with any of the neuropsychological outcome measures. Childhood ALL survivors in our center demonstrated significantly poorer neuropsychological status compared to healthy controls.

Relationships Between Executive Functions and Computational Thinking

Addressing cognitive disparities has become a paramount concern in computational thinking (CT) education. The intricate and nuanced relationships between CT and cognitive variations emphasize the needs to accommodate diverse cognitive profiles when fostering CT skills, recognizing that these cognitive functions can manifest as either strengths or limitations in different students. Consequently, understanding the connections between students’ cognitive functions and CT skills assumes pivotal importance in the design of personalized instructional strategies for CT. Despite a general consideration of learning variability in CT education, empirical insights exploring the correlation between cognitive skills and CT competencies remain notably scarce. This study endeavors to bridge this research gap by investigating the links between executive functions and CT skills, as well as the associations between their sub-dimensions. The results reveal a statistically significant correlation coefficient of 0.452 between these two domains, underscoring the notable connection between executive functions and CT abilities. Furthermore, the sub-dimensional analysis offers a comprehensive understanding of how specific executive functions uniquely contribute to certain CT skills. In light of these findings, this research offers a promising pathway for the development of tailored CT education programs that can cater to the unique needs of each individual, ultimately facilitating inclusive CT programs and making significant contributions to broaden STEM education and future workforce.

Unveiling the Biomechanical Insights: Motor Control Shifts Induced by Shoe Friction Adjustments and Their Impact on Defensive Slide, Crossover Dribbling, and Full Approach Jump in Basketball

This study endeavors to explore the intricate interplay between the fundamental skills of basketball—defensive slide, crossover dribbling, and full approach jump—and the shoe outsole friction coefficient, with the overarching goal of advancing our comprehension regarding the pivotal role of footwear in athlete performance. Employing a comprehensive methodology that integrates 3D motion capture, force platform dynamometry, and biomechanical modeling, the study seeks to quantify the inherent motor control intricacies associated with these fundamental skills. Data collection involved 12 varsity players, and the research systematically assesses the influence of the shoe friction coefficient on both skill quality and injury risk, utilizing a set of 13 parameters for evaluation. The findings unveil that, with an increased friction coefficient, the following changes occur: for the defensive slide, we observed decreased contact time (p < 0.05), boosted medio–lateral impulse (p < 0.05), and lowered ankle torque (p < 0.01); for crossover dribbling, we observed increased anterior–posterior impulse (p < 0.05) and ankle torque (p < 0.05); for the full approach jump, we observed decreased contact time (p < 0.05) and increased jump height (p < 0.05). Generally, the equal increment in the shoe outsole friction coefficient did not result in equal changes in the selected parameters of motor skill control, indicating a non-linear relationship between the performance quality of essential basketball skills and the shoe friction coefficient. The results suggest the potential existence of an optimal value for skill execution. Notably, the study identifies that, while an augmentation in the friction coefficient enhances specific skill aspects, there is a discernible saturation point, signifying diminishing returns. This investigation makes a substantial contribution to our understanding of the precise impacts of shoe friction coefficients on basketball skills, thereby prompting considerations for the judicious selection of optimal friction coefficients and advocating for possible personalized footwear recommendations based on individual biomechanical profiles.

Neuropsychiatric comorbidities in tuberous sclerosis complex patients with epilepsy: results of the TAND checklist survey.

In addition to epilepsy, individuals with tuberous sclerosis complex (TSC) experience a wide range of behavioral, psychiatric, intellectual, academic, and psychosocial problems. They usually exert a large psychological burden on individuals with these illnesses. This cross-sectional study used TSC-associated neuropsychiatric disorders (TAND) checklist interviews conducted at a single medical center. The enrollment of all subjects was > 6years, and the comorbidities of neurodevelopmental disorders were assessed by clinical psychologists before enrollment. To assess the spectrum of TAND, the TAND checklist was applied as stated in the protocol, and the responses to the TAND checklist were evaluated by clinical psychologists. In the behavioral concerns of patients with TSC without epilepsy, those with epilepsy had excessive shyness, language delay, lack of eye contact, rigid behavior, inattentiveness, and restlessness. In psychiatric disorders, autism spectrum disorder and attention-deficit/hyperactivity disorder are significantly correlated with epilepsy history. Diminished academic skills, including reading, writing, and mathematics skills, are significantly associated with epilepsy history. For intellectual ability, TSC patients without epilepsy is associated normal intelligence level. Among neuropsychological skills, deficits in attention, dual tasking/multi-tasking, visuospatial tasking, and executive skills are significantly associated with epilepsy history. Epilepsy in patients with TSC contributes to comorbid neuropsychiatric disorders. In addition to epilepsy evaluation, it is crucial to evaluate the heterogeneous spectrum of neuropsychiatric disorders using a standard checklist during the annual clinical follow-up of patients with TSC.

Comparison of Executive Function Skills between Patients with Cerebral Palsy and Typically Developing Populations: A Systematic Review and Meta-Analysis.

Background: Children with CP show deficits in executive function compared to their typically developing peers, based on the majority of the available evidence. However, the magnitude of these deficits, as well as the proportions of the shortfalls in the three main components, have not yet been examined. This is the first meta-analysis to synthesize evidence on the magnitude of differences between patients with cerebral palsy (CP) and typically developing populations in different components of executive function skills (working memory, inhibitory control and cognitive flexibility), and thus makes recommendations on which areas of executive functioning are in greatest need of intervention. Methods: We conducted a systematic literature search of four databases for studies that measured executive functions in these two groups until 31 August 2023. We calculated the standardized mean difference (Hedges' g), an average effect size overall, and for the three components of executive function skills separately, we used several moderator analyses, including methodological differences between the primary studies. Results: Fifteen articles were included in the meta-analysis. The average mean difference in executive functioning overall was large (g+ = -0.82). Furthermore, large significant differences were found in working memory (g+ = -0.92) and inhibitory control (g+ = -0.82) and a moderate difference was identified in cognitive flexibility (g+ = -0.57). In addition, results of moderator analyses reveal the importance of a rigorous matching of control group participants and CP patients. Conclusions: The results demonstrate a severe impairment in all executive functions among CP patients compared to typically developing peers, which do not decrease over time.

Longitudinal Cognitive Trajectories in Older Adults with Restless Legs Syndrome or Willis-Ekbom Disease.

Background: Restless legs syndrome/Willis-Ekbom disease (RLS/WED) has occasionally but not consistently been associated with cognitive and most notably language and executive impairment. The present study was conducted to investigate the cognitive trajectories of older individuals with RLS/WED. Methods: Participants were drawn from the randomly selected, older (>64 years), population-based HELIAD cohort. Individuals without dementia and with available neuropsychological evaluations at baseline and follow-up were considered for potential eligibility. A comprehensive assessment examining five principal components of cognition (memory, visuo-spatial ability, attention, executive function, and language) was administered to the participants. Generalized estimating equation analyses were used to examine the unadjusted and adjusted (for critical factors and covariates) effects of RLS/WED on cognition over time. Results: A total of 1003 predominantly female (59.5%), older (72.9 ± 4.9 years) participants with follow-up evaluations after a mean of 3.09 ± 0.85 years and without dementia at baseline and follow-up were included in the present study. Among them, 81 were diagnosed with RLS/WED at baseline. Global cognition, memory, attention, and executive and visuo-perceptual skills did not differ between those with and without RLS/WED. However, the RLS/WED group performed worse on language at baseline by a standard deviation of 0.249, while demonstrating a mitigated language decline over time, by a standard deviation of 0.063. The unadjusted models yielded similar results. Conclusions: Our findings were indicative of a baseline language disadvantage among older individuals with RLS/WED, but the initial discrepancy tends to dissolve over time.

Profiling Bilateral Skills in High-Performance Male and Female Gaelic Footballers.

Bilateral skill symmetry in sport refers to an individual's ability to successfully perform sporting actions with both sides of the body. Two scarcely researched areas in relation to bilateral skills are the effects of opposition proximity on skill execution and bilateral skill in high-performance female athletes. In this study, we used Nacsport to code all skill executions (hand pass, kick pass, hop, solo and shot) during 121 games by both male and female participants (76 male, 45 female), classified as Tier 1 (n = 181, 134) and Tier 2 (n = 238, 115) high performance, adult Gaelic Football players. Irrespective of the participants' tier group or gender, these players relied upon their dominant side for most skill executions (Kick Pass Dominant Foot Mdn: MT1 = 90%, MT2 = 98.6%, FT1 = 100%, FT2 = 100%; Solo Dominant Foot: Mdn MT1 = 95%, MT2 = 97.3%, FT1: 100%, FT2: 100%; Hand Pass Dominant Hand Mdn: MT1: 83.7%, MT2: 99%, FT1: 95.5%, FT2: 95.5%; Hop Dominant Hand Mdn: MT1: 91.9%, MT2: 94.7%, FT1: 98.1%, FT2: 98.1%; Play Dominant Foot Mdn: MT1: 74.5%, MT2: 94.5%, FT1: 94.7%, FT2: 88.2%). There were no consistent differences between tier groups or genders in relation to dominant side use, but top tier male players were generally less reliant on the dominant limb than were female players from both tiers. In general, top tier male players performed more successfully than either second tier male players or female players in both tiers. Most skills were executed under conditions of low opponent proximity, limiting the requirement for participants to use their non-dominant limbs. These findings illustrate the demands of Gaelic football in relation to bilateral skills, and we identified new research questions for future investigators.

The Effects of Fluoxetine and Agomelatine on Neurocognitive Functions and Sleep in Patients with Major Depressive Disorder.

We aimed to evaluate the effects of 6 weeks of agomelatine versus fluoxetine treatment on cognition and sleep. Agomelatine 25 mg/day and fluoxetine 20 mg/day were administered to major depressive disorder (MDD) patients. Assessments were conducted before the treatment and at the sixth week of treatment via psychometric measures and comprehensive neurocognitive assessments of various functions, including executive skills, attention, memory, verbal fluency, and speed of processing. They both improved the evaluated neurocognitive test scores (P < .05), except for the scores of the Digit Span Test (P > .05), but only fluoxetine significantly improved the scores of the Controlled Oral Word Association Test (P = .018). Only in relation to the subjective sleep quality part of the Pittsburgh Sleep Quality Index (P = .035) and the Trail Making Test-B (TMT-B) (P = .046) was there an important difference between the study groups, and agomelatine showed better effects than fluoxetine in these measures. Both drugs improved the neurocognitive functioning in the participants. However, the better effect of agomelatine in improving the TMT-B scores suggests that it is a suitable option for MDD patients with noticeable executive disturbances.

Unsupervised Screen Exposure and Poor Language Development: A Scoping Review to Assess Current Evidence and Suggest Priorities for Research.

Screen exposure has both negative and positive effects on the level of language skills a child acquires. The purpose of this review is to address current literature on the possible relationship between unsupervised screen exposure and language development in children and to provide recommendations to caregivers regarding screen exposure of children, taking into consideration the possible effects. A scoping review was conducted using the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online) database. A total of 590 articles were retrieved and considered for inclusion. Twenty-one articles were finally included and reviewed with an emphasis on language, communication, and executive skills as well as cognitive development. The negative effects of screen exposure for children outweigh the positive effects. The largest number of studies demonstrate that unsupervised screen exposure may negatively impact a child's language usage and cognitive and executive skills, disrupt playtime, and affect the quality of sleep. On the other hand, supervised screen use is associated with improved language skills. More evidence is needed on unsupervised exposure in children to new types of screens. As technology could play a significant role in schools in the future, additional research is required to create educational media for schoolchildren with specific guidelines.

Multidisciplinary Capstone Senior Design Projects: A Comparative Analysis of Industry–Sponsored and Faculty–Sponsored Projects Using Comprehensive Performance Metrics

Engineering education has continually evolved to embrace Project–Based Learning (PBL), a dynamic classroom approach emphasizing learning through engagement in real–world projects. The study conducts a comparative analysis of multidisciplinary Capstone Senior Design Projects across Electrical Engineering, Mechanical Engineering, and Computer Science at Texas A&amp;M University at Texarkana. The research emphasizes understanding the dynamics of student collaboration within these disciplines and scrutinizes the impact of industry and faculty sponsorship on these projects. The methodology involves a comprehensive comparative analysis, employing diverse performance metrics to evaluate the effectiveness of different sponsorship models. This approach aims to uncover the influence of these models on project outcomes and students’ educational experiences. The results reveal notable differences between industry–sponsored and faculty–sponsored projects. Industry sponsorship leads to higher performance in overall project execution and professional skills development. In contrast, faculty–sponsored projects are more effective in nurturing teamwork and communication abilities among students. The findings suggest that each sponsorship type presents unique benefits and challenges. Industry–sponsored projects provide valuable hands–on problem–solving experience, though they may suffer from inconsistencies in mentorship and varying expectations. Faculty–sponsored projects offer a more stable and consistent educational environment but might lag slightly in performance metrics. Integrating elements from both sponsorship models could provide students with a more balanced and enriching learning experience.

Mindfulness in a digital math learning game: Insights from two randomized controlled trials

AbstractBackgroundMindfulness practices enhance executive function skills and academic achievement, spurring interest in integrating mindfulness interventions into education. Embedding mindfulness practice into a digital math game may provide a low‐cost, scalable way to induce mindfulness and boost game‐based learning, yet this approach remains unexplored.ObjectivesWe investigated the learning benefits of integrating mindfulness exercises in a digital math learning game and examined how students' trait mindfulness might moderate the outcomes.MethodsTwo classroom studies were conducted with 404 5th and 6th grade students from six public schools in the U.S. (nStudy 1 = 227, nStudy 2 = 177). The two randomized controlled experiments assigned students to one of the three conditions: passive control (playing the digital learning game Decimal Point), story‐enriched active control, or mindfulness‐enriched condition. Trait mindfulness, learning gains, and in‐game problem‐solving (including problem‐solving duration, error count and correctness after reminder) were assessed. Study 2 included a manipulation check to better understand the effects of the mindfulness intervention.ResultsFindings showed no significant differences in learning gains, problem‐solving duration or error count among the conditions. Students' trait mindfulness did not moderate these outcomes. Mindfulness reminders in the mindfulness‐enriched game led to more correct answers after errors than jokes in the story‐enriched game. Study 2 revealed that we failed to induce higher state mindfulness through the mindfulness inductions.ConclusionsMindfulness prompts could be especially beneficial for students experiencing frustration during gameplay, warranting more exploration for digital game‐based instruction. We highlight barriers and future directions for fostering mindfulness through computer‐based instruction in classrooms.

Self-Regulation and Academic Learning in Preschoolers with Autism Spectrum Disorder: Links to School Engagement and Levels of Autism Characteristics.

Children with autism spectrum disorder often demonstrate self-regulation challenges and academic difficulties. Although self-regulation has been well documented as an important factor for academic achievement in neurotypical children, little is known about how it is related to academic learning in autistic children, especially during preschool, a critical developmental period for both emergent academic skills and self-regulatory abilities. It is also unclear whether school engagement or autism characteristics influence the relation between self-regulation and academic learning in autistic children during preschool. Thirty-two autistic preschoolers participated in this study. Direct measures and parent reports were used to measure three dimensions of self-regulation, including executive function, effortful control, and emotion regulation. Classroom-based data from multiple academic programs were used to reflect their average rates of achieving new literacy and mathematics learning goals. Teachers reported the participants' levels of school engagement, and their autism characteristics were measured directly. Emotion regulation was significantly linked to the rate of meeting literacy learning goals in autistic preschoolers, whereas multiple executive function skills, including inhibitory and attentional control and working memory, were associated with their mathematics learning rate. Emotion regulation demonstrated a stronger association with literacy learning when autistic children were more engaged in classroom activities. Levels of autism characteristics did not mediate or moderate the association between self-regulation and academic learning. Future interventions and teaching should consider fostering self-regulation and facilitating school engagement for autistic preschoolers besides targeting their learning performance on specific academic content to promote their current and future academic success.

Education in a pandemic, learning to guarantee inclusive education from an approach psychosocial

This paper pretends to investigate the effectiveness of distance education during the COVID-19 pandemic time. Its objective was to analyze variables that impacted the results of emergency distance education, the challenges that arise for teacher training and comprehensive and inclusive education during and after pandemic periods. It corresponds to a documentary investigation, uses qualitative content analysis, and is framed in a stage of initial results on peer-reviewed academic articles from the Web of Science and websites of institutions relevant to the topic studied. The total sample was 70 articles. The results identify variables mostly studied in the scientific literature that affected distance learning, related to socio-emotional, motivational, self-regulation and executive skills of the students, along with those coming from particular family and social contexts and the organization of schools. It is expected that the conclusions will contribute to educational policy decisions on teacher training and intersectoral actions to face future emergencies that involve school closures and constitute a set of evidence of the main barriers and facilitators of educational work in a period of health emergency available to the educational community, useful for the design of improvements in educational quality for the diversity of students in different scenarios.

The Synergistic Effects of Preterm Birth and Parent Gender on the Linguistic and Interactive Features of Parent-Infant Conversations.

To investigate the language environments experienced by preterm-born infants, this study compared the linguistic and interactive features of parent-infant conversations involving 2-year-old preterm- and term-born infants. The study also explored how mother-infant and father-infant conversations may be differentially affected by preterm/term birth status. Twenty-two preterm-born (< 37 weeks' gestation) and 25 term-born (≥ 37 weeks' gestation) 2-year-old infants engaged in dyadic mother/father-infant free-play interactions that were transcribed to quantify the linguistic (parental volubility, speech rate, lexical diversity, and morphosyntactic complexity) and interactive (infant/parent responsiveness, turn-taking, and conversational balance) features of parent-infant conversations. Language, cognitive, socioemotional, and executive function skills were assessed via standardized tools. Compared to the term group, the preterm group was characterized by lower maternal speech rate, parental lexical diversity, and parent-infant turn-taking, as well as greater mother-infant conversational balance. The preterm group presented poorer language and executive function skills when compared to the term group. Both similarities and differences exist between the language environments of preterm and term groups. Similarities may be due to the partial developmental catch-up of preterm-born infants (cognitive and socioemotional skills) and parental scaffolding. Differences may partly reflect a parental adaptation to the language and executive function difficulties of preterm-born infants. These findings suggest that researchers/clinicians should appraise the language environment with respect to the unique developmental needs of preterm/term-born infants. Future research directions are provided to advance a more holistic characterization of the language environment and a deeper understanding of the developmental significance of preterm-term differences in such environments. https://doi.org/10.23641/asha.25021931.

Post-stroke Cognition is Associated with Stroke Survivor Quality of Life and Caregiver Outcomes: A Systematic Review and Meta-analysis.

Disability arising from post-stroke cognitive impairment is a likely contributor to the poor quality of life (QoL) stroke survivors and their carers frequently experience, but this has not been summarily quantified. A systematic literature review and meta-analysis was completed examining the association between general and domain-specific post-stroke cognitive functioning and adult stroke survivor QoL, caregiver QoL, and caregiver burden. Five databases were systematically searched, and eligibility for inclusion, data extraction, and study quality were evaluated by two reviewers using a standardised protocol. Effects sizes (r) were estimated using a random effects model. Thirty-eight studies were identified, generating a sample of 7365 stroke survivors (median age 63.02years, range 25-93) followed for 3 to 132months post-stroke. Overall cognition (all domains combined) demonstrated a significant small to medium association with QoL, r = 0.23 (95% CI 0.18-0.28), p < 0.001. The cognitive domains of speed, attention, visuospatial, memory, and executive skills, but not language, also demonstrated a significant relationship with QoL. Regarding caregiver outcomes, 15 studies were identified resulting in a sample of 2421 caregivers (median age 58.12years, range 18-82) followed for 3 to 84months post-stroke. Stroke survivor overall cognitive ability again demonstrated a significant small to medium association with caregiver outcomes (QoL and burden combined), r = 0.17 (95% CI 0.10-0.24), p < 0.001. In conclusion, lower post-stroke cognitive performance is associated with significant reductions in stroke survivor QoL and poorer caregiver outcomes. Cognitive assessment is recommended early to identify those at risk and implement timely interventions to support both stroke survivors and their caregivers.

Six elements test vs D-KEFS: what does "Ecological Validity" tell us?

Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities relative to traditional EF measures. Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS. Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.