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Assessing cognitive compensatory strategy use in epilepsy: Pilot validation of the everyday compensation
Stephanie Foryan1, Kayela Arrotta2
1College of Education, Department of Educational Policy, Research, & Administration, University of Massachusetts Amherst, Amherst, MA, the United States of America.
Objective:
Cognitive impairment is cited as one of the most consequential comorbidities of epilepsy. Cognitive difficulties may be managed using compensatory strategies. However, little is understood about how these strategies are used by adults with epilepsy. The Everyday Compensation (EComp) Questionnaire offers a means of assessing the use of these strategies but has only been validated for neurologically healthy older adults. The present study examined the preliminary psychometric properties of the EComp Questionnaire in epilepsy.
Methods:
37 adults with focal epilepsy participating in a randomized controlled trial of a cognitive prehabilitation program completed the EComp Questionnaire, Quality of Life Epilepsy Inventory-31 (QOLIE-31), and the Instrumental Activities of Daily-Living Scale (IADL-C) at baseline and follow-up. Analyses included evaluation of internal consistency, construct validity, test-retest reliability, and item-level performance.
Results:
Across 20 imputed datasets, the EComp Questionnaire demonstrated acceptable Cronbach's α values. Test-retest ICCs were moderate (0.50-.58) but imprecise, with 95 % CIs spanning poor to good reliability. Correlations between the EComp Questionnaire and the IADL-C (ρ = 0.34, p = 0.04) and QOLIE-31 (r = -0.43, p = 0.007) suggested support for construct validity. Select items demonstrated low endorsement and weak association with the total score.
Significance:
Findings provide preliminary support for the EComp as a tool for assessing compensatory strategy use in adults with epilepsy. Understanding these adaptive behaviors and functional needs can assist providers in formulating treatment plans and interventions. Future research with larger and diverse epilepsy samples will be necessary to confirm structural validity.
