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Development and preliminary reliability of a multitasking assessment for executive functioning after concussion.

Laurel B Smith1, Mary Vining Radomski2, Leslie Freeman Davidson3

  • 1Laurel B. Smith, MS, OTR/L, is Captain, U.S. Army, and Research Occupational Therapist, U.S. Army Research Institute of Environmental Medicine, 15 Kansas Street, Natick, MA 01760; laurel.b.smith.mil@mail.mil.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
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Summary

The Charge of Quarters (CQ) Duty Task shows promising interrater reliability for assessing executive functioning after concussion in servicemembers. Further development is needed to enhance reliability across all assessment metrics.

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Area of Science:

  • Neuroscience
  • Military Medicine
  • Cognitive Psychology

Background:

  • Concussion can lead to executive functioning deficits.
  • Assessing these deficits in servicemembers is crucial for effective treatment and return to duty.
  • Existing assessment tools may not fully capture the complexities of cognitive impairment post-concussion.

Purpose of the Study:

  • To describe the development of the Charge of Quarters (CQ) Duty Task, a novel multitask assessment.
  • To evaluate the preliminary interrater reliability (IRR) of the CQ Duty Task.
  • To explore the utility of the CQ Duty Task for assessing executive functioning in servicemembers after concussion.

Main Methods:

  • The CQ Duty Task was developed based on established principles of executive functioning assessment.
  • Twelve healthy participants were observed performing the CQ Duty Task by three independent evaluators.
  • Interrater reliability (IRR) was quantified using the Intraclass Correlation Coefficient (ICC) for various performance metrics.

Main Results:

  • The ICC for overall task completion demonstrated excellent interrater reliability (ICC = .94).
  • Reliability metrics for other specific assessment domains were variable, indicating areas for improvement.
  • Pilot data suggest the CQ Duty Task is a feasible and potentially reliable measure.

Conclusions:

  • Preliminary IRR findings for the CQ Duty Task are encouraging, particularly for task completion.
  • Further research and refinement are necessary to optimize IRR for all measured executive functions.
  • Lessons learned from developing the CQ Duty Task may inform future cognitive assessment tool development for diverse populations.