Assessing executive performance during cognitive rehabilitation

Executive functioning influences a host of other cognitive processes and people who attend neuropsychological services are more likely to display executive dysfunction than any other cognitive deficit (Stuss & Levine, 2002 Stuss, D. and Levine, B. 2002. Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual Review of Psychology, 53: 401–433. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Impairment in executive functioning disrupts a person's ability to effectively employ their intact areas of functioning, and undermines effective self-management of other areas of dysfunction, hampering attempts to employ compensatory strategies. Therefore, assessment of a person's executive functioning is a high priority as part of a comprehensive neurorehabilitation plan. Guided by the International Classification of Functioning, Disability, and Health model (ICF model; Peterson, 2005 Peterson, D. 2005. International Classification of Functioning, Disability and Health: An introduction for rehabilitation psychologists. Rehabilitation Psychology, 50: 105–112. [Crossref], [Web of Science ®] , [Google Scholar]), we suggest that an important development in the field is moving to formal assessment of executive performance in functional contexts, in addition to more traditional assessment of executive impairment. We outline a number of existing studies in this area, review current measures that can provide clinicians with useful information on these issues, and discuss how this research could be further advanced.