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CORNIS-POP, MASHIMA, ROTH ASHA 2010 EVALUATING COGNITIVE-COMMUNICATION IN PERSONS WITH MILD TBI Core Measures: well-established measures which cover outcome domains important to many studies Glasgow Outcome Scale – Extended (GOS-E) – A revision of the Glasgow Outcome Scale, a one-item scale with 5 possible ratings: dead, vegetative state, severe disability, moderate disability, and good recovery. The GOS-E provides eight categories of outcome: Dead, Vegetative State, Lower Severe Disability, Upper Severe Disability, Lower Moderate Disability, Upper Moderate Disability, Lower Good Recovery, Upper Good Recovery. Ratings are based on patient consciousness, independence, ability to work, social and leisure activities, social relationships, and other residue from TBI. These scales are the most commonly used TBI global outcomes and there is an extensive literature demonstrating reliability and validity for these scales. Use of these scales permits comparisons among international research on TBI outcomes. Rey Auditory Verbal Learning Test (RAVLT) – A word list learning task that takes approximately 10 minutes to administer that can be administered to individuals ranging in age between 7 and 85+ years. One of the most extensively studied neuropsychological performance measures consisting of 15 unrelated words repeated 5 times with recall after each presentation. The test requires immediate recall and delayed recall and recognition. The instrument has extensive normative data and meta-norms, good psychometric properties, and has been used in different languages, cultures, and ethnic groups. California Verbal Learning Test (CVLT)—similar to RAVLT and studies have shown high correlations of performances between two tests for persons with TBI. Trail Making Test (TMT) – Measure of attention, speed and mental flexibility and is sensitive to cognitive impairment associated with TBI. Brief test with good reliability. Available in adult and child forms and demographically-adjusted normative data are available for ages 20-85 years. Practice effectds are found over short retest intervals, but disappear after several administrations and only modest change is seen among healthy adults after longer intervals. Performance on TMT declines with aging. Wechsler Adult Intelligence Scale (WAIS III) Processing Speed Index – This Index is derived from the Digit Symbol Coding and Symbol Search subtests of the WAIS III. This measure represents the amount of time it takes to process a set amount of information, or the amount of information that can be processed within a certain unit of time. As part of the WAIS, it has extensive normative data and excellent psychometric properties. It is clinically one of the most sensitive cognitive measures to neurologic conditions. It is culturally, racially, and ethnically sensitive. Rivermead Post Concussive Symptom Questionnaire (RPQ) – 16-item self-report measure of the presence and severity of the 16 most commonly reported post-concussive symptoms found in the literature. The scale compares current symptoms to preinjury levels to account for potential symptom exacerbation due to TBI. The range of scores is 0-64 with values for each of 16 items rated 0 (not experienced at all), 1 (no more of a problem than before the injury), 2 (mild problem), 3 (moderate problem), and to 4 (severe problem). The total score is a summation of symptoms rated as >2 indicating post-concussion symptoms or an exaceration of a symptom present preinjury. Requires 5-10 minutes to complete. Most useful in assessing post-concussion symptoms in persons with mild to moderate TBI. Can be used for diagnostic and severity purposes, as well as to monitor change in response to treatment. The RPG is in public domain and is a widely used measure. Brief Symptom Inventory – 18 Item (BSI-18) – This instrument is a short form of the Symptom Checklist-90-R. It is designed to provide a brief self-report measure of psychological distress and has three subscales (Depression, Anxiety, and Somatization), as well s a Global Severity Index. The selfreport measure consists of 18 items rated on a 5-point rating scale, and can be completed manually or computerized administration. The BSI 18 provides a brief, global assessment of common psychological 2 issues in individuals with TBI, and has sound psychometric characteristics. It can be used for initial assessment, as well as to monitor change in response to treatment. Functional Independence Measure (FIM) – an 18-item ordinal scale, used with all diagnoses with a rehabilitation population. The FIM measures degree of independence in activities of self-care, sphincter control, transfers, locomotion, communication, and cognition. The FIM scores range from 1 (total or >75% assistance) to 7 (complete independence). Total scores range between 18-126. Subscores are available for motor and cognitive items. Scores may be used raw or converted to interval scores. The FIM is most useful as a measure of progress during inpatient rehabilitation. It has extensive normative data and excellent psychometric properties. It is most appropriate for Severe and Moderate disability levels of GOSE; ceiling effects limit utility in Good Recovery. The FIM is not sufficiently sensitive for mild TBI. Craig Handicap Asses & Rep Tech (CHART-SF) – Objective measure of the degree to which impairments and disabilities impact participation consisting of 19 items that comprise 6 subscales: Physical Independence, Cognitive Independence, Mobility, Occupation, Social Integration, and Economic Self Sufficiency. Each subscale has a maximum score of 100 corresponding to the level of performance typical for a person without a disability. Subscale scores can be added to obtain a Total Score (maximum = 600). Easy to administer. Best used with adults with moderate to severe disability and those who make a good recovery. It has demonstrated good reliability and validity in the TBI population. Satisfaction With Life Scale (SWLS) – A five item global measure of life satisfaction completed by the individual whose life satisfaction is being measured. The SWLS has shown consistent differences between populations that would be expected to have different qualities of life (e.g. psychiatric patients or male prison inmates). The SWLS ahs been found to change in the expected directions in response to major life events, and in patients receiving psychotherapy. JFK Coma Recovery Scale – Revised (CRS-R) – Standardized behavioral assessment instrument designed to measure neurobehavioral function in patients with disorders of consciousness. It is comprised of six subscales designed to assess auditory, visual, motor, oromotor/verbal, communication and arousal functions. The CRS-R is the only standardized assessment measure that directly incorporates the diagnostic criteria for coma, vegetative state, minimally conscious state (MCS) and emerging from MCS. The scale is intended for use by medical and allied health professionals. The CRSR has strong diagnostic sensitivity and specificity, correlates well with functional outcome, is useful for monitoring treatment effectiveness and is available in 9 languages. Additional Global Measures th Mayo-Portland Adaptability Inventory (4 edition; MPAI-4) – 30 items rated on a 5-point scale ranging from normal for age to severely restricted. Items selected represent key indicators in three interrelated subdomains represented by three subscales. Ability index (physical and cognitive abilities), Adjustment Index (emotional and behavioral self regulation, interpersonal activities), Participation Index (community integration). An overall score and scores for each index may be obtained. Specified modifications to the rating scales allow the measure to be applied across the age span for childhood through adulthood. Quality of Life after Brain Injury (QOLIBRI) – disease-specific health-related quality of life (HRQOL) tool devoted to TBI made up of a multidimensional structure containing 37 items on 4 satisfaction scales “Cognition”, “Self”, Daily Life & Autonomy”, “Relationships”, and 2 “Bothered scales “Emotions” and “Physical Problems” and a total score. There is an additional overall scale available with 6 items that can be used for screening purposes. Percent scores are available for the six subscales (with 100% indicating best QOL), and one total score. Higher scores on all scales indicate higher HRQOL after TBI. The questionnaire is validated in German, Finnish, Italian, French, English, Dutch and requires just 15 minutes to complete. Validation in 8 additional countries is in progress. (Computer Adaptive Test (CAT) in preparation.www.qolibri-international.com) 3 WHOQOL-BRIEF – developed as an international cross-culturally comparable quality of life assessment instrument. It assesses the individual’s perceptions in the context of their culture and value systems, and their personal goals, standards and concerns. The WHOQOL was developed in locations worldwide and has been widely field-tested. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. This instrument is a shorter version of the original instrument Disability Rating Scale (DRS) – A measure of general functioning over the course of recovery, the DRS is comprised of three areas of functioning including level of arousal, cognitive ability to perform basic activities of daily living including eating, grooming, and toileting and level of functioning including level of dependency and employability. It is applicable across a wide range of injury severity and recovery intervals. It may be useful in studies of moderate to severe TBI with serial measurement, particularly where initial measurement occurs in the acute post-injury interval. Short Form-36 Medical Outcome Study (SF-36v2)—This widely used subjective health status measure asks 36 questions to measure functional health and well-being from the individual’s point of view. It is a practical, reliable, and valid measure of physical and mental health that can be completed in 5-10 minutes. The subscales comprise physical functioning, physical role function, emotional role function, bodily pain, vitality, mental wellbeing, social functioning, and general health perception. An additional item measures change in health status during the previous year. A physical component score (PCS) and a mental component score (MCS) can be computed. This instrument has been used extensively in TBI research and has been shown to be sensitive to treatment related changes. Community Integration Outcomes (CIQ) – Developed to provide a measure of community integration after TBI that could be used in the TBI Model Systems program. Designed to be brief, administered in person or telephone interview and conducted with the person with TBI or with a proxy. Focus was on behaviors rather than feeling states; and without biases resulting from age, gender or socioeconomic status; sensitive to a variety of living situations and value neutral. The CIQ consists of 15 items relevant to home integration (H0), social integration (S), and productive activities (P). Subtotals are calculated for each of these domains as well as for community integration overall. Participation Assessment with Recombined Tools (PART) – A measure of community participation developed by the Traumatic Brain Injury Model Systems (TBIMS) by combining the primary measures found in the TBI literature (Community Integration Questionnaire, original and revised, Participation Objective, Participation Subjective (POPS), and the Craig Handicap and Assessment Reporting Technique). The psychometric data on the scale have not yet been published. Cognitive-communication measures The American Speech-Language-Hearing Association Functional Assessment of Communication Skills (ASHA-FACS) -- A questionnaire that was designed as a “means for assessing functional communication behaviors at the level of disability in a valid, reliable, sensitive yet efficient manner”. It was standardized on a group of 54 individuals with cognitive-communication impairments from mild, moderate and severe TBI. The overall score from the FACS is significantly correlated with other cognitive tests and the LOCF, but contributes unique variance attributable to factors in daily living not captured by other standard measures. Cognitive-Linguistic Quick Test (CLQT) – A screening tool that assesses five cognitive domains: attention, memory, language, executive functions, and visuospatial skills. For this study, two subtests have been selected: Symbol Cancellation and Clock Drawing. Symbol Cancellation is a nonlinguistic task that assesses visual attention, scanning, and visual discrimination. Abstract symbols are arranged in what appears to be a random pattern, with the target stimulus appearing three times in each quadrant. Other abstract symbols serve as foils. Information is collected on errors of omission (failure to cancel targeted symbols) and errors of commission (cancellation of foils). Clock Drawing is a commonly used screening for neurological dysfunction. This CLQT version provides a standardized scoring system that permits analysis of language, visuospatial planning skills, and conceptualization of time. The CLQT was normed on 171 non-clinical cases and 38 clinical cases, including TBI. It establishes criterion-referenced cut-off 4 scores within each task and severity ratings based on the distribution of scores of the clinical and nonclinical subjects. The Discourse Comprehension Test (DCT) – A test of narrative comprehension. Individuals listen or read narratives and answer yes/no questions that tap comprehension for explicit (stated or implied) and salient (main ideas and details) information. Measure of Cognitive Linguistic Abilities (MCLA) -- Designed to provide a systematic evaluation of clients who have mild to moderate impairments cased by TBI. The MCLA has three major purposes as stated in the manual: 1) To assess linguistic abilities, 2) To help identify cognitive deficits that have an impact on linguistic performance, and 3) To recognize the important interrelationship between cognition and language. The test was standardized on 204 healthy, English-speaking adults ages 16-50 with no history of TBI or other neurologic disorder. Ross Information Processing Assessment (RIPA-2) -- Proposes to assess cognitive-linguistic functioning in clients with traumatic brain injury. Standardized on a sample of 126 persons with TBI between 15-77 years of age from 9 states; representative of TBI cases relative to gender, area of residency, geographic area, and ethnic background as described in TBI literature relative to demographic information. Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) -- Provides a systematic method for assessing cognitive deficits associated with traumatic brain injury. 244 patients with TBI from 26 sites in U.S. and Canada. Consisted primarily of patients who suffered closed-head injuries. LaTrobe Communication Questionnaire (LCQ) -- 30 item questionnaire that measures perceived cognitive-communication ability in adults after severe traumatic brain injury by collecting data from different sources including self-perceptions and perceptions of others. Content and test-retest reliability and discriminant validity of the LCQ have been demonstrated with adults following TBI. The questionnaire has been shown to be sensitive to the effect of severity of injury. Attention Process Training APT II (APT III will come out soon) – This is a program is for treating impairments in attentional processing in persons with relatively mild cognitive disturbance, such as postconcussion syndrome. Activities address difficulties with sustained attention, slowed speed of information processing, distractability, shifting attention between multiple tasks, and paying attention to more than one source of information at a time. The manual has a placement test to determine the level at which treatment should be initiated. The program has an Attention Questionnaire that can be used to determine treatment effect. Test of Everyday Attention (TEA) -- The TEA gives a broad-based measure of the most important clinical and theoretical aspects of attention. The TEA can be used analytically to identify different patterns of attentional breakdown. Originally standardized on 154 normal volunteers in Australia, ranging in age from 18-80, stratified into 4 age groups and 2 levels of educational attainment; in addition, 80 unilateral stroke patients were given TEA 2 months post-CVA. The test has been validated successfully with closed head injured patients, stroke patients, and patients with Alzheimer’s Disease, including those of low educational level. Behavioural Assessment of the Dysexecutive Syndrome (BADS) -- Specifically assesses the skills and demands involved in everyday life. It is sensitive to the capacities affected by frontal lobe damage, emphasizing those usually exercised in everyday situations such as temporal judgment, thought flexibility, problem solving, strategy formation, and planning. Dysexecutive Questionnaire (DEX) – A rating scale designed to sample everyday problems commonly associated with frontal system dysfunction. The DEX was used as a validation tool for BADS, although it is not a formal part of the BADS. The DEX can also be used as a measure of awareness, by calculating the discrepancy score between self and informant responses. The DEX comprises 20 items sampling four domains: emotional, motivational, behavioral, and cognitive. 5 The Functional Assessment of Verbal Reasoning & Executive Strategies (FAVRES) -- was designed to assess verbal reasoning, complex comprehension, discourse, and executive functioning with functional tasks that challenge even those with subtle cognitive-communication disorders. The test requires processing of ‘real life’ amounts of verbal information, analysis of multiple facts and goals, integration of a variety of types of stimuli, and formulation of written and oral responses. Its strength is its ecological validity in that tasks simulate real world communications and incorporate context using natural settings, roles, and conversation. It is standardized on healthy controls and individuals with brain injury, ages 1879. Rivermead Behavioural Memory Test (RBMT) -- The goal of this test is to detect impairment of everyday memory functioning and to monitor change following treatment for memory difficulties. The test was initially standardized in the UK on a sample of brain damaged patients and a sample of 118 healthy subjects aged 16-69 years with a mean IQ of 106. The RBMT has since been standardized with community-dwelling elderly people aged 70 years and over, with healthy adolescents aged 11- 14 years, and with children aged 5- 10 years. Comprehensive Assessment of Prospective Memory (CAPM) – The CAMP is a self-rating scale, designed to measure specific, everyday prospective memory lapses. The CAMP comprises three sections. Section A contains 39 items examining perceived frequency of failure. It contains two statistically derived components: basic ADLs and IADLs. Section B uses the same 39 items from Section A to assess concerns about failures. Section C contains contains 15 items focusing on reasons associated with successes/failures. The CAMP was originally developed for older people, but has also been use with young people and people with TBI. Participation Objective Participation Subjective (POPS) – The POPS consists of a list of 26 items comprising of elements of participation (e.g., going to the movies, housework, opportunities to meet new people). Two types of questions are presented: objective questions and subjective questions. The 26 items are sorted into five categories: Domestic Life; Major Life Activities; Transportation; Interpersonal Interactions and Relationships; and Community, Recreational and Civic Life. The test was designed with the TBI population in mind but the items refer to normative activities. Doors and People -- Doors and People is a broad-based test of long-term explicit memory It yields a single age-scaled overall score with separate measures available for visual and verbal memory, recall and recognition, and forgetting. It is designed for use both as a clinical tool and as a research instrument. The test comprises four subcomponents: visual recognition, visual recall, verbal recognition, and verbal recall. Factor analysis of an age-stratified sample of 238 normal subjects indicated a strong general memory factor, followed by a weaker visual/verbal factor. Studies indicate that the test is sensitive across a wide range of abilities, from elderly patients with Alzheimer’s disease, of low educational level, to young graduate students. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) – RBANS is a brief neurocognitive battery designed to detect and track declining neurocognitive deficits in dementia and other disorders. It is comprised of four alternate forms, that measure immediate and delayed memory, attention, language, and visuospatial skills. Speed and Capacity of Language Processing (SCOLP) – SCOLP is a measure of the slowing in cognitive processes that can be experienced by individuals with brain damage. It can differentiate between individuals who have always been slow and individuals whose performance reflects impairment as a result of brain damage or some other stressor. It is sensitive to the effects of TBI, normal aging, Alzheimer’s disease, schizophrenia and to a wide range of drugs and stressors, including alcohol. Stroop Color and Word Test (Stroop) -- This test measures the Stroop Effect, described by John Ridley Stroop in 1935, which shows how one area of the brain can dominate and inhibit other functional areas. The cognitive dimension tapped is associated with cognitive flexibility, resistance to interference from 6 outside stimuli, creativity, and psychopathology, all of which influence the individual’s ability to cope with cognitive stress and to process complex input. Prospective Memory Training Screening (PROMS) – The PROMS samples prospective responding to both time and event cues. Prospective memory has been shown to relate to attention and to various other executive functions, especially relevant to everyday memory demands. A modification of this test, the Prospective Memory Test, was developed by Raskin & Buckheit, 1998 that provides a larger number of tasks, including action and verbal tasks and provides a system for scoring a number of different types of errors. Pragmatics Rating Scale -- A pragmatic communication scale established and based on assessments of 144 subjects with TBI. The assessment is based on a rating scale of pragmatic behaviors developed for the Defense and Veterans Brain Injury Center. The scale measures nonverbal, verbal, and interactional aspects of communication, based on samples of conversation, narrative discourse, and procedural discourse. Boston Naming Test (BNT-2) -- The Boston Naming Test (BNT) consists of 60 black and white line drawings of objects. It measures confrontation naming. This type of picture-naming vocabulary test is useful in the evaluation of adults with brain injury. Delis-Kaplan Executive Function System (D-KEFS) -- Standardized set of tests to evaluate higherlevel cognitive functions in children and adults. Consists of nine stand-alone tests, comprehensively assessing the components of executive functions mediated primarily by the frontal lobe. Woodcock-Johnson-III (WJ-III) – The WJ-III consists of 7 cognitive tests and 11achievement tests that measure general intellectual ability and specific cognitive abilities; including short term memory, long term retrieval, processing speed, auditory processing, visual processing, comprehension-knowledge and fluid reasoning. In addition, a few subtests evaluate performance in a controlled-learning context: visualauditory learning, concept formation, and analysis-synthesis. Normative data is available for ages 2 through 90+ and has been used extensively in the educational model for evaluating students of all ages with learning disabilities, including those with acquired TBI. In a study of the relationship of the Automated Neuropsychological Assessment Metrics (ANAM) and the WJ-III, Jones et al (2008) demonstrated a strong relationship between these measures of cognitive function. Behavior Rating Inventory of Executive Function (BRIEF-Adult) -- BRIEF-A is used to assess executive functioning in adults up to 90 years of age. Results are useful for evaluating and planning treatment strategies for a wide spectrum of developmental and acquired neurological conditions including, ADHD, Tourette’s disorder, Traumatic Brain Injury, and Autism. It is suitable for individuals who have been diagnosed with developmental, systemic, neurological, or psychiatric disorders. The eight nonoverlapping clinical scales form two broader indexes: Behavioral Regulation (three scales) and Metacognition (five scales). A Global Executive Composite score is also produced. Multiple Errands Test -- Multiple Errands Test was developed to reflect how executive impairments are manifested in the context of everyday functioning. It was designed for people who performed within or above the normal range when tested using existing psychometric measures. The procedures were administered and subjects tested in a public place. Knight, Alderman, and Burgess (2002) explored an abbreviated hospital-based version of the test. Awareness Questionnaire (AQ) -- Developed as a measure of impaired self-awareness after TBI. The AQ consists of 3 forms to be completed by: the individual with TBI, a family member or significant other, and a clinician. 7 References GOS-E: Jennett B, Bond M. (1975). Assessment of outcome after severe brain injury. A practical scale. Lancet, 1:480-484. Wilson JTL, Pettigrew LEL, Teasdale GM. (1998). Structured interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for their use. J Neurotrauma, 15: 573-85. RAVLT: Strauss E, Sherman E, Spreen O (2006). Rey Auditory Verbal Learning Test. In Compendium of rd Neuropsychological Tests (3 Edition) Oxford University Press: 776-807. CVLT: Delis, DC, Kramer, JH, Kaplan E, OberCali, BA. (2000). California Verbal Learning Test – Second Edition (CVLT-II). Pearson Education Inc, San Antonio, TX. TMT: Reitan, R, & Wolfson, D (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychology Press. Processing Speed Index: Wechsler Adult Intelligence Scale II/IV. Processing Speed Index. Pearson Education Inc, San Antonio, TX. RPQ: King, NS, Crawford S, Wenden, FJ, Moss NE & Wade, DT (1995). The Rivermead Post Concussion Symptoms Questionnaire: A Measure of Symptoms Commonly Experienced after Head Injury and its Reliability. Journal of Neurology 242:587-92. BSI: Derogatis, L.R. (2001). Brief Symptom Inventory 18 (BSI 18): Administration, Scoring and Procedures Manual, Minneapolis, MN: NCS Pearson, Inc. FIM: Granger CV. (1998). The emerging science of functional assessment: our tool for outcomes analysis. Arch Phys Med Rehabil, 79(3): 235-240. CHART: Whiteneck G, Charlifue S, Gerhart K, Overholser J, Richardson G. Quantifying handicap: a new measure of long-term rehabilitation outcomes (1992). Arch Phys Med Rehab, 73:519-526. Mellick, D. (2000). The Craig Handicap Assessment and Reporting Technique. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/ combi/chart (accessed April 7, 2010 ). SWLS: Diener E, Emmons R, Larsen J, Griffin S. (1985). The Satisfaction with Life Scale. J Personality Assessment, 49:71-75. JFK CRS-R: Giacino JT Kalmar K. Whyte J. (2000). The JFK Coma Recovery Scale-Revised: Measurement Characteristic and Diagnostic Utility. Archives of PMR 85(12); 2020-2029. MPAI-4: Malec JF, Moessner AM, Kragness M, Lezak MD. (2003). Refining a measure of brain injury sequelae to predict postacute rehabilitation outcome: rating scale analysis of the Mayo-Portland Adaptability Inventory (MPAI). J Head Trauma Rehabil, 15(1):670-82. Malec JF. The Mayo-Portland Participation Index: A brief and psychometrically sound measure of brain injury outcome. Arch Phys Med Rehabil 2004;85:1989-96. Detailed manual, forms, and translations available for download at: www.tbims.org/combi/mpai QOLIBRI: Quality of Life after Brain Injury (QOLIBRI) – Scale Validity and Correlates of Quality of Life. Von Steinbuechel N, Wilson L, Gibbons H, Hawthorne G Hofer S, Schmidt S, Bullinger M, Maas A, Neugebauer E, Powell J, von Wild K, Zitnay G, Bakx W, Christensen AL, Koskinen S, Formisano R, Sarajuuri, Sasse N, Truelle JL. Journal of Neurotrauma, 2010 Mar 8. WHOQOL: Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H (2000). Australian WHOQoL instruments: User’s manual and interpretation guide. Australian WHOQoL Field Study Centre, Melbourne, Australia. World Health Organization (1993). WHOQoL Study Protocol. WHO (MNH7PSF/93.9). 8 DRS: Rappaport, M, Hall KM, Hopkins K, Belleza T, Cope DN (1982). Disability Rating Scale for Severe Head Trauma: Coma to Community. Archives of PMR, 63:118-123. SF36: Jenkinson C, Coulter A, Wright, L (1993). Short form 36 *SF#^) health survey questionnaire: normative data for adults of working age. BMJ 306:1437-1440. ASHA-FACS: Frattali C, Thompson C, Holland A, Wohl C, Ferketic M. American Speech Language Hearing Association Functional Assessment of Communication Skills for Adults. Rockville, MD: American Speech Language Hearing Association; 1995 APT II: Sohlberg, M.M., Johnson, L., Paule, L., Raskin, S.A., & Mateer, C.A. Attention Process Training II: A program to address attentional deficits for persons with mild cognitive dysfunction. Puyallup, WA: Association for Neuropscyhological Research and Development, 1994. BADS: Wilson B, Alderman N, Burgess P, Emslie H, Evan J. Behavioural Assessment of the Dysexecutive System, including the DEX questionnaire, Pearson: PsychCorp. 1996 CAMP: Shum, D.H. & Fleming, J.M. Comprehensive Assessment of Prospective Memory: Manual. Brisbane: Applied Cognitive Neurosicence Research Center. CIQ: Dijkers, M. (2000). The Community Integration Questionnaire. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/ combi/ciq ( accessed April 7, 2010 ).* CLQT: Helm-Estabrooks N. Cognitive Linguistic Quick Test. San Antonio, TX: Psychological Corporation; 2001. DCT: Brookshire RH, Nicholas LE, Brookshire R, Nicholas L. Discourse Comprehension Test. Tucson, AZ: Communication Skill Builders, 1993. LCQ: Douglas, J., O’Flaherty, C., & Snow, P. (2000). Measuring perception of communicative ability: the development and evaluation of the La Trobe communication questionnaire. Aphasiology 14. 251-268. Douglas, J., Bracey, C., & Snow, P. (2007). Measuring perception of communicative ability: reliability and validity of the La Trobe communication questionnaire. Journal of Head Trauma Rehabilitation. 22(1). 3138. FAVRES: MacDonald S. Functional Assessment of Verbal Reasoning and Executive Strategies. Guelph, Ontario: CCD Publishing; 2005. MCLA: Wendy J. Ellmo, Jill M. Graser, Elizabeth A. Krchnavek, Deborah B. Calabrese, and Kimberyly Hauck. Measure of Cognitive Linguistic Abilities. The Speech Bin, Inc., 1995. RIPA: Ross-Swain . Ross Information Processing Assessment, Second Edition, Pro-Ed, 1996. RBMT: Wilson, Cockburn and Baddeley. Rivermead Behavioural Memory Test. Wstern Psychological Services, 1985. SCATBI: Adamovich & Henderson. Scales of Cognitive Ability for Traumatic Brain Injury. Pro-Ed, 1992. TEA: Robertson, Ward, Ridgeway & Nimmo-Smith. Test of Everyday Attention (TEA). Thames Valley Test Company, 1994. POPS: Brown, M. Participation Objective, Participation Subjective. (2006). The Center for Outcome Measurement in Brain Injury.http://www.tbims.org/combi/pops (accessed November 11, 2010). 9 DOORS AND PEOPLE: Nimmo-Smith, Ian, Emslie, Hazel, and Baddeley, Alan. Doors and People. Pearson Assessment, 2006. RBANS: Repeatable Battery for the Assessment of Neuropsychological Status. Randolph, Christopher. Pearson Assessment,1998. SCOLP: Speed and Capacity of Language Processing. Baddeley, Alan, Emslie, Hazel, Nimmo-Smith, Ian.1992. Pearson Assessment, 1992. STROOP: Stroop Color and Word Test. Golden, Charles J. and Freshwater, Shawna M. Western Psychological Services, 2002. PROMS: Prospective Memory Training Screening. Sohlberg, M. & Mateer, C. Introduction to cognitive rehabilitation: Theory and practice. The Guilford Press, (1989). Raskin, S. & Buckheit, C. (1998). Prospective memory in traumatic brain injury. Cognitive Neuroscience Society, San Francisco, CA. Groot, Y., Wilson, B.A., Evans, E., Watson, P. (2002). Prospective memory functioning in people with and without brain injury. Journal of International Neuropsychological Society, 8, 645-654. PRAGMATICS: Pragmatics Rating Scale: MacLennan, DL, Cornis-Pop, M., Picon-Nieto, L., and Sigford, B. Premier Outlook, 3(4), 2002. Premieroutlook.com BNT: Boston Naming Test (BNT-2). Kaplan, Edith, Goodglass, Harold, Weintraub, Sandra (2001) Pro-Ed. http://www.proedin.com D-KEFS: Delis-Kaplan Executive Function System. Delis, D.C., Kaplan, E. & Kramer, J.H. Pearson Assessment, 2001. WJ-III. Woodcock-Johnson-III. Woodcock, R.W., McGrew, K.S., & Mather, N. Itasca, IL: Riverside Publishing, 2001. WJ-III. Jones, W.P., Loe, S.A., Krach, S.K., Rager, R.Y., & Jones, H.M. (2008). Automated Neuropsychological Assessment Metrics (ANAM) and Woodcock-Johnson III Tests of Cognitive Ability: A concurrent validity study. The Clinical Neuropsychologist, 22:305-320. BRIEF: Behavior Rating Inventory of Executive Function – Adult version. Roth, R., Isquith, P., & Gioia, G. Lutz, FL: Psychological Assessment Resources, Inc., 2005. Multiple Errands Test. Shallice,T. & Burgess, P.W. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727-741. Knight, C., Alderman, N., & Burgess (2002). Development of a simplified version of the multiple errands test for use in hospital settings. Neuropsychological Rehabilitation,12(3), 231-255. Awareness Questionnaire (AQ). Sherer, M. (2004). The Awareness Questionnaire. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/ combi/aq (accessed November 11, 2010 ). 10