Laurel B. Smith, Mary Vining Radomski, Leslie Freeman Davidson, Marsha Finkelstein, Margaret M. Weightman, Karen L. McCulloch, Matthew R. Scherer; Development and Preliminary Reliability of a Multitasking Assessment for Executive Functioning After Concussion. Am J Occup Ther 2014;68(4):439–443. https://doi.org/10.5014/ajot.2014.012393
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© 2019 American Occupational Therapy Association
OBJECTIVES. Executive functioning deficits may result from concussion. The Charge of Quarters (CQ) Duty Task is a multitask assessment designed to assess executive functioning in servicemembers after concussion. In this article, we discuss the rationale and process used in the development of the CQ Duty Task and present pilot data from the preliminary evaluation of interrater reliability (IRR).
METHOD. Three evaluators observed as 12 healthy participants performed the CQ Duty Task and measured performance using various metrics. Intraclass correlation coefficient (ICC) quantified IRR.
RESULTS. The ICC for task completion was .94. ICCs for other assessment metrics were variable.
CONCLUSION. Preliminary IRR data for the CQ Duty Task are encouraging, but further investigation is needed to improve IRR in some domains. Lessons learned in the development of the CQ Duty Task could benefit future test development efforts with populations other than the military.
Task completion was defined as the extent to which participants independently and accurately completed each assignment. Each assignment was scored 0 (not complete), 1 (partially complete or required cueing to complete), or 2 (completed to defined standard independently without cueing). The test included 17 assignments (some assignments required more than one task), with up to 2 points possible for each, for a total of 34 possible points for task completion.
Total rule breaks for the four rules were operationally defined on the score sheet. Each rule that was broken was recorded.
Frequency of rule breaks was recorded for each rule; it was possible to break the same rule multiple times. No limit was placed on the frequency of rule breaks.
Performance time was defined as the total time to complete the task.
Transits were defined as movements between work areas. Leaving one work area and entering another was considered one transit.
Performance-based assessments of multitasking may enable occupational therapy practitioners to identify executive function deficits after concussion.
Because of the complexity of scoring a multitask assessment, operational definitions for scoring are best developed on the basis of observed variations in task performance and differences in interpretation of that performance by multiple evaluators.
The lessons learned in the development of the CQDT may benefit occupational therapy practitioners interested in developing performance-based assessments of executive dysfunction tailored to populations and practice settings other than the military.
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