Weekly Calendar Planning Research Articles

Validity of the Short Weekly Calendar Planning Activity in patients with Parkinson disease and nonmanifesting LRRK2 and GBA carriers.

Subtle executive dysfunction is common in people newly diagnosed with Parkinson disease (PD), even when general cognitive abilities are intact. This study examined the Short Weekly Calendar Planning Activity (WCPA-10)'s known-group construct validity, comparing persons with PD to healthy controls (HCs) and nonmanifesting carriers of LRRK2 and GBA gene mutations to HCs. Additionally, convergent and ecological validity was examined. The study included 73 participants: 22 with idiopathic PD (iPD) who do not carry any of the founder GBA mutations or LRRK2-G2019S, 29 nonmanifesting carriers of the G2019S-LRRK2 (n = 14) and GBA (n = 15) mutations, and 22 HCs. Known-group validity was determined using the WCPA-10, convergent validity by also using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT), and ecological validity by using the WCPA-10, Schwab and England Activities of Daily Living Scale (SE ADL), and Physical Activity Scale for the Elderly (PASE). Known-group validity of the WCPA-10 was established for the iPD group only; they followed fewer rules (p = 0.020), were slower (p = 0.003) and less efficient (p = 0.001), used more strategies (p = 0.017) on the WCPA-10, and achieved significantly lower CTT scores (p < 0.001) than the HCs. The nonmanifesting carriers and HCs were similar on all cognitive tests. Convergent and ecological validity of the WCPA-10 were partially established, with few correlations between WCPA-10 outcome measures and the MoCA (r = 0.50, r = 0.41), CTT-2 (r = 0.43), SE ADL (r = 0.41), and PASE (r = 0.54, r = 0.46, r = 0.31). This study affirms the known-group validity for most (four) WCPA-10 scores and partially confirms its convergent and ecological validity for PD.

Factors Contributing to Accurate Weekly Calendar Planning Activity (WCPA) Performance of Individuals With Multiple Sclerosis &amp; Healthy Controls

Abstract Date Presented 03/23/24 This study examines the performance of the Weekly Calendar Planning Activity (WCPA), a cognitive functional task, and highlights factors that promote accurate performance among individuals with multiple sclerosis (MS) and healthy controls (HCs). Primary Author and Speaker: Meirav Rosenfeld Contributing Authors: Yael Goverover

Cognitive Strategy Use During the Weekly Calendar Planning Activity in People With Parkinson's Disease

Abstract Date Presented 03/21/24 People with Parkinson's disease demonstrate inefficient use of strategies during a functional cognitive activity. Interventions can be designed to optimize their strategy use and support cognitive performance. Primary Author and Speaker: Kathleen Best Additional Authors and Speakers: Erin R. Foster Contributing Authors: Noelle Casem, Jill E. Jonas, Tasha D. Doty

Online awareness is associated with superior performance on assessments of functional cognition.

Intact awareness facilitates an individual's adoption of strategies to support community living skills. However, most studies have not examined awareness during ongoing complex task performance. Objective: To examine whether community-dwelling adult's Accuracy and Strategy use on the Weekly Calendar Planning Activity 17-item version (WCPA-17), Total Cues on the Performance Assessment of Self-care Skills Checkbook Balancing and Shopping Task (PCST), and scores on the self-report Alzheimer's Disease Cooperative Study - Activities of Daily Living Scale (ADCS-ADL) differ between groups who do and do not demonstrate awareness of performance difficulties on the WCPA-17. Using data collected as part of a larger study we performed a cross-sectional analysis of 274 community-dwelling adults aged 55 to 93 years. Two methods classified participants into groups aware or unaware of their performance. Independent sample t-tests examined group differences on four dependent variables: Accuracy and Strategy use on the WCPA-17, PCST Total Cues, and score on the ADCS-ADL. Using one classification method, aware individuals showed superior Accuracy (p < 0.001), used more Strategies (p = 0.002), needed fewer PCST Total Cues (p < 0.001), and reported greater independence on the ADCS-ADL (p < 0.004), similar trends were observed with the other method in Accuracy (p < 0.001) and PCST Total Cues (p < 0.001) but Strategy use and ADCS-ADL differences failed to reach significance after Bonferroni correction. Groups categorized as aware performed better on all measures. Intact awareness is critical to performance on complex everyday activities and can be evaluated with functional cognition assessments.

Addressing Participation in Adults With Postconcussive Symptoms Using Cognitive Strategy Training: A Feasibility Trial.

Some people experience persistent symptoms after a concussion that greatly affect occupational performance. To evaluate the feasibility and preliminary effect of metacognitive strategy training in a sample of adults with postconcussive symptoms. Single-group, prospective design. University research laboratory. Adults with persistent concussive symptoms affecting function (N = 14). Ten 45-min sessions of a metacognitive strategy training intervention, Cognitive Orientation to daily Occupational Performance (CO-OP). Assessed feasibility outcomes included recruitment, retention, and adherence rates, and intervention acceptability was evaluated with the Client Satisfaction Questionnaire-8. The preliminary effect was measured on occupational performance (Canadian Occupational Performance Measure), concussive symptoms (Neurobehavioral Symptom Inventory), sleep (Pittsburgh Sleep Quality Inventory), vision (College of Optometrists in Vision Development-Quality of Life Outcomes Assessment), and cognition outcomes (Dysexecutive Questionnaire, Weekly Calendar Planning Activity, and National Institutes of Health Toolbox Cognition Battery). Acceptable recruitment (32%), retention (93%), and adherence rates (100%) were observed, along with a high level of acceptability to participants. Large intervention effects were present for occupational performance, general concussive symptoms, and cognitive functioning. Findings suggest that the CO-OP is feasible to administer for adults with postconcussive symptoms and perceived as suitable for the needs of this population. Feasibility findings, coupled with improvements in occupational performance outcomes, provide the foundation for a future larger scale trial. Plain-Language Summary: The Cognitive Orientation to daily Occupational Performance intervention is practical to use to address the functional impact of persistent concussive symptoms in adults. Further research is needed to evaluate the efficacy of the CO-OP intervention with this population.

Screening older adults for potential deficits in IADL using the Menu Task and Medi‐Cog‐R

AbstractBackgroundThe identification of deficits in functional performance is critical to sustaining the community independence of older adults. Screening for difficulties in the performance of cognitively demanding instrumental activities of daily living (IADL) can facilitate earlier identification of and intervention for people with impairment (Rodakowski et al., 2014). We examined whether two brief performance‐based screening measures ‐ the Menu Task and the Medi‐Cog‐R ‐ can identify those at risk of functional cognitive deficits as indicated by poor performance on the Weekly Calendar Planning Activity (WCPA).MethodUsing a cross‐sectional design we administered the Menu Task, Medi‐Cog‐R, and the WCPA to community dwelling adults 55 years of age and older (N = 280). Using established cut scores, we examined the sensitivity and specificity of the two screening measures to poor performance on WCPA Accuracy (≤ 20th percentile). Known‐group construct validity were examined by comparing impaired and unimpaired groups on the screening measures on subtests of the WCPA.ResultThe sample was 73.57% female and 73.57% white. Mean age was 69.72 (SD = 8.81) and mean education was 15.61 (SD = 3.30) years. The Menu Task demonstrated a sensitivity of .84 and a specificity of .62 and the Medi‐Cog‐R demonstrated a sensitivity of .77 and a specificity of .66 in correctly classifying individuals with potential for impaired IADL as indicated by a score at or below the 20th percentile on the WCPA. The impaired groups on both screening measures scored significantly lower on WCPA subtests of Accuracy, Appointments Entered, Efficiency, Rules, and Strategies than the unimpaired group (p &lt; .001).ConclusionThe Menu Task and the Medi‐Cog‐R could both alert clinicians to the potential for functional cognitive deficits and need for IADL support in community dwelling older adults. Performance‐based screening measures of functional cognition can be used to prompt further assessment and intervention to promote community independence.

Further validation of the Menu Task: Functional cognition screening for older adults

Abstract Date Presented 04/22/2023 A new cut-off score for impairment on the Menu Task identified individuals who performed poorly on the Weekly Calendar Planning Activity. The Menu Task can identify those in need of further functional cognition assessment. Primary Author and Speaker: Timothy Marks Additional Authors and Speakers: Muhammad AL-Heizan, Gordon Giles, Dorothy Edwards

Translation, cross-cultural adaptation and validation of the 10-item Weekly Calendar Planning Activity in Spanish-speaking ABI patients: a multicenter study.

We present the process of translation, adaptation, and validation in the Spanish context of the 10-item version of the Weekly Calendar Planning Activity (WCPA-10), a performance-based measure of cognitive instrumental activities of daily living (C-IADL). The study consisted of two phases: I) translation/cultural adaptation of the WCPA, conducted by professional bilingual translators, a panel of experts, and a pilot study, and II) validation in a sample of 42 acquired brain injury patients (ABI) and 42 healthy participants (HC). WCPA primary outcomes showed expected convergent/discriminant validity patterns with socio-demographical and clinical variables and cognitive processes identifying those WCPA outcomes that best predicted executive and memory deficits measured with a battery of traditional neuropsychological tests. In addition, performance on the WCPA was a significant predictor of everyday functioning over variables such as socio-demographics or global cognition when measured with traditional tests. External validity was established by the WCPA's ability to identify everyday cognitive deficits in ABI patients compared to HC, even in those with subtle cognitive impairment based on neuropsychological tests. The Spanish WCPA-10 seems an appropriate and sensitive assessment tool to identify cognitive-functional impairment in ABI-patients, even those with subtle cognitive impairment. The results also highlight the relevance of this kind of test, as they indicate a better prediction of patients' real-world functioning than traditional neuropsychological tests.

Do symptoms moderate the association between participation and executive functions outcomes among people with schizophrenia?

BackgroundLiterature explains participation limitations among people with schizophrenia through the context of metacognitive limitations, specifically in symptoms and in executive functions (EF). Research has shown mixed results regarding associations between symptoms and participation, reporting association with negative symptoms, positive symptoms, or only metacognitive limitations. The aim of this study was to deepen understanding of the symptoms’ impact on the association between participation and executive function among people with schizophrenia.MethodsForty-three participants with schizophrenia received 8 group sessions of focused metacognitive intervention (MCG) aimed at promoting participation by focusing on EF components (e.g., analyzing individual cognitive strategy use). Three measures were administered: the Positive and Negative Syndrome Scale (PANSS) to evaluate symptoms, the Weekly Calendar Planning Assessment (WCPA) to assess EF, and the Activity Card Sort (ACS) to measure participation at the baseline and 12 weeks following completion of the intervention. Scores were compared to a matched control group of 41 people with schizophrenia who instead received treatment as usual. The role of PANSS as moderator was examined using multiple hierarchical regressions, entering interactions between the PANSS scores and WCPA change scores in the final regression step.ResultsRelationships were not significant for participants with high PANSS scores. A positive relationship existed between change in WCPA and change in ACS for participants with low PANSS scores.ConclusionsThese results demonstrate that low PANSS scores moderate the association between EF and participation and highlight the importance of symptoms as a predictor of participation following the MCG intervention.Trial registrationThe trial was retrospectively registered at clinical.trial.gov. ClinicalTrials.gov Identifier: NCT05556941. Clinicaltrial.gov registration date: 27/09/2022.

Weekly Calendar Planning Activity (WCPA): Validating a Measure of Functional Cognition for Adolescents With Attention Deficit Hyperactivity Disorder

Adolescents with attention deficit hyperactivity disorder (ADHD) often experience difficulties with executive function and participation in life roles. Ecologically valid performance-based tests (PBTs) are needed to assess functional cognition in this population. To examine the known-groups, concurrent, and ecological validity of a functional cognition PBT, the Hebrew version of the Weekly Calendar Planning Activity (WCPA) Middle/High School Version, among adolescents with and without ADHD. Cross-sectional between-groups design. Community. One hundred two adolescents (ages 12-18 yr), with (n = 52) and without (n = 50) ADHD. The Hebrew version of the WCPA Middle/High School Version, MOXO™-Continuous Performance Test (MOXO-CPT), Behavior Rating Inventory of Executive Function (BRIEF) parent form, and Child and Adolescent Scale of Participation (CASP). The results showed significant between-groups differences with medium to large effect sizes for scores on most WCPA measures, with the ADHD group receiving significantly lower scores. Significant correlations in the expected direction were found between scores on the MOXO-CPT Attention and Hyperactivity indices and WCPA measures. Significant correlations were also found between most WCPA measures and the BRIEF Global Executive Composite (GEC) and the CASP. Multiple linear regression on the CASP indicated that the WCPA strategy score and the BRIEF GEC were significant predictors in the model. Results support the known-groups validity of the WCPA Middle/High School Version between adolescents with and without ADHD. Concurrent and ecological validity were supported by significant associations with measures of cognition and participation. What This Article Adds: These results reinforce the premise that the WCPA Middle/High School Version can be implemented as a valid measure of functional cognition among adolescents with ADHD.

Further Validation of the Menu Task: Functional Cognition Screening for Older Adults.

Occupational therapists need a brief tool to identify the potential for functional cognitive deficits leading to impaired occupational performance. The objective is to establish the sensitivity and specificity, concurrent and known-group validity of the Menu Task by comparison with performance on the Weekly Calendar Planning Activity (WCPA). Using a cross-sectional design, we administered the Menu Task and the WCPA to a community-dwelling convenience sample of 287 adults aged from 55 to 93 years. The receiver operating characteristic (ROC) analysis estimated sensitivity and specificity. Concurrent and known-group construct validity was examined by comparing scores on the Menu Task with the WCPA scores. As a result, a new cutoff score of 9 was established for the Menu Task (area under the curve [AUC] = 0.80, sensitivity = 0.89, 95% confidence interval [CI] = [0.73, 0.97]; specificity = 0.58, 95% CI = [0.52, 0.64]). Both concurrent and construct validity were supported. The Menu Task demonstrates sensitivity to functional cognitive impairments in a community sample.

Validity of the Weekly Calendar Planning Activity on Measurement of Executive Function for Adults With Stroke

Abstract Date Presented 04/01/2022 This study provides evidence for the validity of the Weekly Calendar Planning Activity-10 (WCPA-10) for adults with stroke. The WCPA-10 is a valuable tool for assessing executive function (EF) among stroke patients because it can provide in-depth information on the process and quality of performance. This study also demonstrates the need to use performance-based tests even with patients who perform normally on cognitive screening tests to detect subtle EF difficulties that may affect daily functioning. Primary Author and Speaker: Chen Gong Contributing Authors: Ninghua Wang

The Weekly Calendar Planning Activity to Assess Functional Cognition in Parkinson Disease.

The Weekly Calendar Planning Activity (WCPA) may improve understanding of functional cognition in people with Parkinson disease (PwPD) without dementia. We aimed to determine if WCPA performance (a) discriminates between PwPD with and without cognitive impairment and healthy controls and (b) correlates with other indicators of cognition and daily function. This was a cross-sectional study. Parkinson disease (PD) participants without dementia were divided into normal cognition (PD-NC, n = 25) and possible mild cognitive impairment (PD-MCI, n = 21) groups. Their WCPA performance was compared with that of a normative sample (n = 196) and correlated with neuropsychological test performance and self-reported cognition and participation. Both the PD-MCI and PD-NC groups had impaired WCPA performance. WCPA performance correlated with executive function, processing speed, and self-reported cognition and participation. The WCPA can detect functional cognitive deficits in PwPD without dementia and can inform occupational therapy interventions to support functional cognition, occupational performance, and participation in this population.

Initial Validation of the Weekly Calendar Planning Activity With Adolescents With ABI.

The purpose of this study was to assess the validity of the Weekly Calendar Planning Activity Middle/High School (WCPA) in adolescents with acquired brain injuries (ABI). We recruited neurotypical controls (n = 27) and adolescents with ABI (n = 14) to complete a 90-min battery of cognitive tests. Adolescents with ABI were further divided into mild and severe groups by Glasgow Coma Scale Score and compared with controls. Mann-Whitney U tests revealed significant differences (p = .05) on the WCPA between groups in total time to complete and rules followed. Between the controls and severe group, a significant difference (p = .05) was found for total time spent, errors, rules followed, strategies used, and accurate appointments (p = .01). Moderate correlations were found between the WCPA and neuropsychological tests (ρ = .31-.45). The WCPA is a valid performance-based assessment of functional cognition that can be used to detect deficits in adolescents with severe ABI.

Awareness of Performance on a Functional Cognitive Performance-Based Assessment Across the Adult Lifespan.

As people age, their cognitive skills and ability to complete complex instrumental activities of daily living often decline in subtle ways. Older adults who are aware of these slight cognitive and functional changes spontaneously adapt and implement strategies to maximize performance. On the other hand, older adults with limited self-awareness are less likely to adjust performance or initiate compensatory strategies as they may not recognize the need to do so. This places them at higher risk of functional decline and loss of independence. Research on awareness of functional performance in healthy adults is, however, limited, and there is a paucity of assessment tools available to address questions of awareness and strategy use in functional tasks. We used the Weekly Calendar Planning Activity (WCPA) – a performance-based assessment of functional cognition including measures of awareness and strategy use – to investigate differences in performance, awareness, and strategy use across the adult lifespan. The WCPA requires examinees to schedule appointments into a weekly calendar while following rules designed to increase task demands. Healthy adults (n=342) from ages 18–92 were observed for strategy use and error recognition, while a post-test interview probed participants’ reported strategy use and estimation of accuracy. The discrepancy between participant estimation and actual accuracy provided a measure of online awareness of performance where a larger estimation discrepancy indicated over-estimation of performance. Performance on the WCPA declined across the adult lifespan. Older adults were less likely to use self-monitoring strategies and used less effective strategies overall. Overestimation was associated with use of fewer strategies and lower accuracy in all age groups. Importantly, twice as many older adults overestimated compared to younger adults. Furthermore, the subset of older adults who had good awareness of performance was more likely to use effective strategies, to recognize errors, and achieved accuracy on par with their younger counterparts. Our results emphasize the importance of examining self-awareness of performance and analyzing the strategies used to perform a complex functional task. This information can provide a foundation for early detection of functional decline in aging and for designing interventions to maximize functional independence in aging.

ביסוס מהימנות ותוקף לאבחון ה- Contextual Memory Test (CMT)-2 בקרב מתבגרים ישראלים

The CMT-2 assessment, a computerized version of the original Contextual Memory Test (CMT), evaluates memory and meta-memory skills. Assessing these skills among adolescents’ is important for the development of interventions improving daily function. The objectives of this study were to evaluate (1) test re-test reliability, (2) internal consistency, (3) and concurrent validity with the Weekly Calendar Planning Activity (WCPA). Method: Twenty-two Israeli teenagers (12 boys and 10 girls) aged 12-18 years were recruited by convenience sampling. Participants completed the CMT-2 assessment, followed by the WCPA. Results: The reliability between raters was (r=0.94-0.96), indicating good results. Significant positive correlations were found between performance estimations of the immediate and delayed recall memory tasks (internal consistency) (r=0.519, p&lt;0.05), as well as between the total number of strategies used and the total number of items remembered. Moreover, a significant positive correlation was found between the number of strategies and self-awareness (r=0.343, p&lt;0.05). However, concurrent validity with the WCPA measure was not found. Conclusions: The findings of the study suggest that the CMT-2 measure can be used to assess memory and memory strategies in adolescents. Nonetheless, future research is required to adapt the CMT-2 to the Israeli population, and to determine concurrent validity with a different measure evaluating similar cognitive elements.

The Calendar Study: Reliability and Validity of the Weekly Calendar Planning Activity (WCPA) to Assess Executive Function (EF) in College Students

Abstract Date Presented 03/28/20 This study examined reliability and validity of the WCPA, an assessment of EF. Participants were 300 college students. Performance on two levels of the WCPA was compared to other EF measures and between students with and without learning differences. There were small–moderate correlations between tests with Level II and no differences between students with and without learning differences, necessitating a more challenging version of the WCPA. Primary Author and Speaker: Eddie Chu Additional Authors and Speakers: Rashelle Nagata, Margaret Goodfellow, Katherine Tao, Ria Mehta, Sharon Cermak Contributing Authors: Patricia Tobey, Cheryl Vigen

Impact of Time on Performance on the Weekly Calendar Planning Activity (WCPA)

Abstract Date Presented 03/27/20 This study examined the association between total time to complete the WCPA and the number of cognitive strategies used and total errors on the test. Results suggest that more time taken on the WCPA may increase the number of cognitive strategies used, but it may not necessarily result in improved overall test performance. These findings support the importance of understanding factors that contribute to successful performance and interpretation of WCPA scores. Primary Author and Speaker: Timothy Marks Contributing Authors: Vanessa Everson, Meaghan Leighton, Shelby Manor, Lionel Palomar, Guadalupe Rivas, Muhammad Al-Heizan, Dorothy Farrar Edwards

VALIDATION OF A NEW FUNCTIONAL COGNITION SCREENING MEASURE

Identification of cognitive deficits that contribute to functional dependence in acute and post-acute care settings is important. The Menu Task (MT) is a brief cognitive 12 item screening measure designed to identify older adults at risk for IADL impairment in community settings. The objective was to compare the psychometric properties of the Menu Task a series of neurocognitive and functional cognitive performance measures including the Brief Interview of Mental Status (BIMS), the Montreal Cognitive Assessment (MoCA) the Weekly Calendar Planning Activity (WCPA) and the Performance Assessment of Self-Care Skills (PASS) in a sample of 200 community dwelling older adults. Participants were administered the MT, BIMS, MoCA, WCPA, and the PASS checkbook and shopping tasks. ROC analysis identified an MT cut score, sensitivity and specificity. We computed Cronbach’s alpha, correlations among study measures and t-tests between groups impaired or unimpaired on the MT. Mean age of participants was 70.44(SD 8.3), the sample was predominately female ((76%), and white (81%). Mean MT score was 8.22 (SD 2.01) and the mean completion time was 185.5 sec (SD 108.11). The Menu Task has moderate internal consistency (α= 0.65). The AUC statistic was 0.83 with an optimal MT cut score of “7” and sensitivity of .90 and specificity of .70. Significant differences (p < 0.01) were observed between impaired and not impaired MT groups on BIMS, MoCA, WCPA, and PASS. The Menu Task has moderate to strong evidence supporting its psychometric properties and the value of screening for functional cognitive deficits.

CAN THE BRIEF INTERVIEW OF MENTAL STATUS (BIMS) IDENTIFY RISK FOR IMPAIRED IADLS DUE TO FUNCTIONAL COGNITIVE DEFICITS

The Brief Interview of Mental Status (BIMS) was introduced to the Minimum Data Set (MDS) 3.0 as a cognitive screening tool. It includes temporal orientation and word recall (Saliba et al., 2012). This study examined the ability of the BIMS to identify impairment on performance-based functional cognitive screening tests that assess instrumental activities of daily living (IADLs). We recruited a cross-sectional sample of 200 participants who met the following inclusion criteria: age 55 and older, living independently in the community, and able to read and communicate in English.. Participants ranged in age from 55 to 92 years (Mean 70.96:SD = 8.56),were predominantly White (68%) and female (65%). Participants were administered the BIMS and a battery of performance-based tests of functional cognition -the Performance Assessment of Self Care Skills and the Weekly Calendar Planning Activity (WCPA). There was a mismatch in screening results: Among Individuals identified as cognitively intact on the BIMS 22-45% were found to be impaired on the PASS and/or the WCPA. Sensitivity of the BIMS to identify impaired IADL function did not exceed .06, although specificities were high (< .95). These findings suggest that individuals categorized as cognitively normal by the BIMS may be impaired on more complex IADL tasks. Individuals classified as unimpaired on the BIMS, may benefit from more complex functional cognitive screening to further assess IADLs function to better estimate ability to live independently in the community. Performance based assessments can improve discharge planning by identifying elders at risk after hospitalization.