Development of a simplified version of the multiple errands test for use on a hospital ward
Problems with executive functioning may have catastrophic consequences following brain injury. Assessment of these complex functions is critical in planning necessary interventions, yet they present a challenge to traditional methodologies. The review considered the issues that comprise this challenge, and the increasingly important role ecologically valid measures play in neuropsychological assessment is highlighted. Shallice and Burgess (1991) described the Multiple Errands Test (MET), which successfully reflected executive impairments manifest in the context of everyday functioning. Surprisingly, the methodology has been relatively under exploited for use in clinical settings. In the present study, the utility of a simplified MET designed for use on a hospital ward was explored. The measure was designed to be appropriate for patients who are unable to undergo assessment in public settings, and suitable for use with patients who are in the early stages of recovery. Twenty four healthy participants and 21 people with acquired brain injury took part. The main findings were as follows: 1) the test discriminated well between neurological patients and controls, and the groups effects remained when the difference in current general cognitive function and familiarity with the environment were considered; 2) test performance was found to be strongly associated with performance on an established ecologically valid measure of executive function; and 3) preliminary findings indicated that two patterns of error making style were associated with different dysexecutive symptoms in everyday life. The results demonstrated the clinical utility of the ward version of the MET-with the advantage to clinicians in its brevity and sensitivity, whilst capturing aspects of everyday executive difficulties that are not readily accessible from many psychometric measures.