Development and Initial Validation of the Functional External Memory Aid Tool

Purpose The purpose of this study was to develop the item pool and investigate the structure and measurement properties of the Functional External Memory Aid Tool (FEMAT), a performance-based measure of everyday strategy use for persons with mild memory impairments. The FEMAT examines one's use of strategies to compensate for cognitive communication impairments that interfere with the completion of complex daily tasks. Method During Phase 1, six expert panel members reviewed the initial item pool and scoring rubric to assess item verification. Each item was developed to elicit strategy use and represent a complex daily task. During Phase 2, 99 participants with possible mild neurocognitive disorder (as determined by screening procedures) responded to 11 items. The factor structure of the data was analyzed using confirmatory factor analysis. Reliability and relationships between the FEMAT and additional factors were also examined. Results The process of development (Phase 1) resulted in 11 items distributed among three factors: (a) Medical Tasks, (b) Instrumental Daily Tasks, and (c) Retrieval-Based Tasks. Internal consistency (Phase 2), assessed with confirmatory factor analysis, confirmed the proposed three-factor model. Reliability analyses revealed at least 62%-84% of within-test score variance was due to true score variance. Correlation analyses indicated weak and strong relationships between the FEMAT and participant demographic variables and additional assessment measures. Conclusions The FEMAT provides reliable measurement of everyday external memory aid use in persons with possible mild neurocognitive disorder. The FEMAT was designed to be used in clinical settings and to provide better guidance to clinicians to design person-centered interventions than currently available cognitive communication measures.