Date Presented 04/06/19 People with Multiple Sclerosis (PwMS) often experience executive function (EF) deficits affecting daily living. The Weekly Calendar Planning Activity (WCPA) is a recently developed tool requiring management of a cognitively challenging functional task. This study sought to validate the WCPA as an assessment of functional cognition for PwMS. We established the WCPA’s discriminant, concurrent, and construct validity. Overall, it can be a useful tool to assess EF function difficulties among PwMS. Primary Author and Speaker: Diane Rose Allid Additional Authors and Speakers: Melissa Orenstein Contributing Authors: Yael Goverover

OBJECTIVE. We examined the efficacy of a 12-wk educational socialization program, Community Reintegration for Socially Isolated Patients (CRISP), in improving self-efficacy for people with multiple sclerosis (MS). We also examined whether participants in the experimental group with increased self-efficacy experienced reduced loneliness and depression. METHOD. This randomized controlled group design included 91 participants with MS (experimental group, n = 51; control group, n = 40). Participants were between ages 20 and 68 yr, and the majority experienced a relapsing–remitting MS course (86%) and mild to moderate disability. Participants completed baseline and posttreatment assessments, including questionnaires assessing self-efficacy, loneliness, and depression. RESULTS. Experimental group participants significantly improved in self-efficacy compared with control group participants. Experimental group participants who demonstrated improved self-efficacy reported reduced perceptions of loneliness but not depressive symptoms. CONCLUSION. CRISP is a promising intervention to improve self-efficacy for people with MS. However, results need to be treated with caution given the study’s limitations.

Date Presented 3/31/2017 This study identifies a relationship between age and quality of life in persons with multiple sclerosis. It highlights the role of promoting coping in younger adults to prevent or decrease symptoms of depression or anxiety as a means of increasing quality of life. Primary Author and Speaker: Brocha Stern Contributing Authors: John DeLuca, Yael Goverover

Date Presented 4/9/2016 This study (1) describes cognitive impairments of executive functions and prospective memory that are experienced by persons with multiple sclerosis and the association between executive functions and prospective memory and (2) identifies how the research findings can be applied in to occupational therapy services. Primary Author and Speaker: Lara Borg Additional Author and Speaker: Yael Goverover

Date Presented 4/9/2016 This systematic review of the literature explores cognitive rehabilitation interventions for persons with multiple sclerosis, focusing on functional and long-term (post 1-yr) implications. Results indicate that research in this area is lacking. Recommendations for future research are given. Primary Author and Speaker: Charlene Woo Contributing Authors: Lara Borg, Shantel Isaac, Callah Kimble, Yael Goverover

We examined the variables most associated with activity limitation (i.e., cooking) and participation restriction (i.e., employment) in 72 people with multiple sclerosis (MS). Participants underwent a comprehensive neuropsychological test battery assessing memory, executive functions, visual perception, and processing speed and completed questionnaires assessing activity, participation, fatigue, and affective symptoms. Results showed that processing speed was the only variable consistently significantly related to both activity and participation. When examining specific aspects of activity and participation in isolation, employment status was significantly associated with education level, visual memory, fatigue, and processing speed. Cooking ability was associated with performance on tasks of working memory, verbal memory, and processing speed. These findings suggest that processing speed is a primary cognitive factor in MS influencing quality of both activity and participation in everyday life.

People with traumatic brain injury (TBI) experience memory and learning difficulties. Difficulty in the initial acquisition of information is a primary reason people with TBI experience difficulties in learning and memory. Treatment focusing on improving the acquisition of information will likely improve both recall and recognition performance. In the “generation effect,” items self-generated are remembered better than items read or otherwise provided. The purpose of this study was to examine the application of the generation effect in improving memory for functional activities. The study used a within-subjects design and included 10 participants with TBI and 15 healthy control participants. Results demonstrated that material learned under the generated learning conditions was recalled better than when generated under provided learning conditions. This finding was true in both the TBI and the control groups. These results provide initial evidence supporting the use of self-generation to improve new learning of functional tasks for people with TBI.

Research has indicated that many people with traumatic brain injury (TBI) experience learning and memory difficulties because of impairments in the initial acquisition of information. We examined a strategy, the spacing effect, known to enhance new learning in a laboratory setting in healthy control participants (HCs) and in people with TBI. The spacing effect indicates that information is learned better when presentation trials are distributed over time (spaced presentation) rather than consecutively (massed presentation). In this study, we examined the application of the spacing effect in improving functional tasks. We used a within-subject design and included 10 participants with TBI and 15 HCs. In both the TBI and the HC groups, material learned under the spaced learning condition was recalled better than that learned under massed learning conditions. These results provide initial evidence supporting the use of the spacing effect to improve new learning of functional tasks for people with TBI.

OBJECTIVE. The purpose of this study was to determine the interrater reliability and discriminant validity of Toglia’s Deductive Reasoning test for individuals with brain injuries. METHOD. Forty-two individuals with brain injuries and 51 participants without disabilities ranging in age from 18 to 84 years were given the Deductive Reasoning test three consecutive times. A between groups repeated measure design was used to examine differences between the two groups in performance of the Deductive Reasoning test across the three trials. RESULTS. An interclass correlation coefficient (ICC) was statistically significant, indicating good interrater reliability for participants without disabilities. A repeated measures analysis of variance (ANOVA) comparing performance across trials and between groups revealed a significant group main effect, F(1,91) = 52.68, p < .001, thus, participants with brain injuries performed significantly lower on the test than participants without disabilities. This analysis also revealed a significant increase in all participants’ scores across trials, F(1.63, 148.67) = 35.094, p < .001. CONCLUSION. Findings confirm acceptable interrater reliability of the Deductive Reasoning test. Further, comparison of the performance of the two groups supports the discriminant validity of the Deductive Reasoning test for individuals with brain injuries. Thus, the Deductive Reasoning test was found to be an appropriate, valid, and reliable assessment tool for occupational therapists to assess deductive reasoning skills in individuals with brain injuries. Additional research is needed to continue to investigate the psychometric value of the Deductive Reasoning test so that clinicians and researchers can use it appropriately.

OBJECTIVE. The purpose of this study was to examine the predictive relationship of categorization and deductive reasoning abilities to performance of instrumental activities of daily living (IADL) among adults with brain injury. METHOD. A correlational research design was used to examine the performance of 19 patients from a neurosurgery acute care unit on Toglia’s Category Assessment (TCA), the Deductive Reasoning test (DR), and the Observed Tasks of Daily Living–Revised. RESULTS. Multiple regression analysis indicated that categorization and deductive reasoning accounted for a significant proportion of the variance in IADL performance scores, with deductive reasoning making the greater contribution. Demographic characteristics such as age and education reduced the power of the previous variables, especially of the categorization. CONCLUSION. The results of this study indicate that assessments of categorization and deductive reasoning abilities of persons with brain injury may be good predictors of IADL functional performance. Results support the use of the TCA and DR as quick measures of a person’s cognitive and functional abilities. Furthermore, this study provides preliminary results to support that categorization and deductive reasoning abilities are fundamental for the performance of IADL skills.