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Christina Bustamante Executive Function Performance Test A group of cognitive processes which mediate goal directed activity and are involved in task execution (Baum, 2008, p.1) Purpose Executive Function Component Cueing System Componet Clients Designed for: Setting: Home environment or office setting properly equipped with a stove top Theoretical framework: N/A newly designed assessment Cost: Free What is an executive function ? The EFPT examines the execution of four basic tasks that are essential for self-maintenance and independent living: simple cooking, telephone use, medication management, and bill payment. Used too:
To determine which executive functions are impacting function
To determine an individual’s capacity for independent functioning
To determine the amount of assistance necessary for task completion Learning Objectives - The student will understand the purpose and process of the EFPT assessment
-The student will understand how to administer the medication management subtest
-The student will understand the executive function components, expected behaviors, and cueing system Adolescents
13-17 years old
18-64+ years Multiple
Sclerosis Stroke Clients not suitable for: Children Time Requried : 30-45 minutes Type of assessment : Normative Reliability:
Test-Retest:Not published Observation Validity Methods of Evaluation: Inter-Rater reliability:
Excellent reliability for
overall 0.91 Good (content)
Very specific measures what it says it measures Special user qualifications: There is not a formal training and certification for this assessment. Review of manual and practice in administering hierarchy of cues with participants is sufficient Source: Developed by Carolyn Baum and avaliable at www.ot.wustl.edu Case Study Betty Betty is a 67 year old female, with high blood pressure, who recently suffered from a cerebrovascular accident/stroke (she suffered an ischemic stroke, in which arteries are blocked by blood clots, buildup of plaque or other fatty deposits causing decreased or zero blood flow to parts of the brain). She has mild hemiparesis in her left arm, making it difficult to groom and dress herself, prepare simple meals and open her blood pressure medication pill bottles. She has some cognitive problems, including some loss in the ability to control and organize her thoughts and behaviors, because of this she has trouble thinking through the steps to complete a task and is easily frustrated. Before her stroke, Betty lived alone in a one bedroom apartment on the third floor of her building. She is also facing some memory problems and reports forgetting where her apartment is located. An OT decides to administer the Executive Function Performance Test (EFPT) in order to get an understanding of the level of assistance Betty needs to carry out a task. Do you take medication? 1=yes 2=No
Can you tell me where you keep your medication? 1=yes 2= No
When do you take your medicine? 1=morning 2=afternoon 3=evening 4=before bed
5=more than once a day _other times ex. 2x week
Will you be able to take the medicine? 0= by yourself 1=with verberal guidance 2=with physical assistance 3= I wont be able to do this task Pre-Test Intervention Based on the assessment, we found that the areas needing interventions were mainly her organization and sequencing, memory, and judgment.
In order to assist with her memory, the OT can teach her different mnemonic techniques and strategies including internal (techniques carried out via mental effort by the person) and external (methods used by the therapist or cues in the environment that will trigger her recall) (Wheatley, 2001, p.463).
We also thought it would be good for her to use a pill box that was labled with the days of the week so she would know what pills to take when with out having to read her instructions. She could also use an alarm to let her know it is time to take her medication to further assist her memory.
In order to help with her organization and sequencing, the OT can provide her with a checklist stating the items she needs and directions for taking her medication that she can keep by her pill box.
The checklist will remind her when and how many pills to take so that she does not take too little or too many, therefore, assiting her with her judgment. OTPF Demonstration:
Medication Management POST PRESENTATION QUIZ 1. What are the three purposes of EFPT?
2. How much does it cost?
3.How long does it take to administer?
6. Does it have reliability and validity?
7. Where can it be administered? Setting? EFPT Scoring Summary
Sheet References American Occupational Therapy Association. (2008). Occupational
therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625-683.
Pedretti, L. W., & Early, M. B. (2001). Occupational therapy: Practice
skills for physical dysfunction. St. Louis: Mosby.
Pennies for Stroke. (2013). National Stroke Association. Retrieved from
Welcome to OT.WUSTL.edu! (n.d.). WUSTL Occupational Therapy.
Retrieved from http://www.ot.wustl.edu/
Welcome to The College of Health. (2007). University of Utah The
College of Health. Retrieved from http://www.health.utah.edu/ Perfomance The EFPT helps the OT get a better understanding of whether or not certain occupations and activities are successful or causing problems for the client, specifically simple cooking, telephone use, medication management, and bill payment. Since these four basic tasks are essential for self-maintenance and independent living, this assessment also gives the OT an idea of which environment, whether it be living alone or in an assisted living facility, may support or inhibit the client’s needs. The pre-test questions for each subtest give the OT some insight on the client's occupational history in each area. The pre-test questions also give the OT a baseline to compare what the client thinks they can accomplish and what they actually accomplish for each subtest, leading to information on the client’s perception of self efficacy. The data obtained from this assessment relates to areas of the Occupational Therapy Practice Framework (OTPF-2) including ADLs (simple cooking), IADLs (paying bills, medication management, telephone use), body functions (memory), sequencing and timing (completing the tasks in the correct order), cognitive skills (memory), routines (when they take their medication and if they receive help for completing certain routines) and emotional regulation (the client's emotions displayed while completing the task) (AOTA, 2008). Scoring Sheet