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Neuropsychol Rehabil. 2017 Jul;27(5):603-617. doi: 10.1080/09602011.2016.1176934. Epub 2016 May 6.

Validation and clinical utility of the executive function performance test in persons with traumatic brain injury.

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a Occupational Therapy , Washington University School of Medicine , St. Louis , MO , USA.
b Saw Swee Hock School of Public Health, National University of Singapore , Singapore.
c Department of Physical Medicine & Rehabilitation , University of Michigan , Ann Arbor , MI , USA.
d Department of Physical Therapy , University of Delaware, College of Health Sciences , Newark , DE , USA.
e Department of Psychiatry , UC San Diego , La Jolla , CA , USA.
f Department of Physical Medicine & Rehabilitation , Northwestern University , Chicago , IL , USA.


This study examined the relationships between the Executive Function Performance Test (EFPT), the NIH Toolbox Cognitive Function tests, and neuropsychological executive function measures in 182 persons with traumatic brain injury (TBI) and 46 controls to evaluate construct, discriminant, and predictive validity. Construct validity: There were moderate correlations between the EFPT and the NIH Toolbox Crystallized (r = -.479), Fluid Tests (r = -.420), and Total Composite Scores (r = -.496). Discriminant validity: Significant differences were found in the EFPT total and sequence scores across control, complicated mild/moderate, and severe TBI groups. We found differences in the organisation score between control and severe, and between mild and severe TBI groups. Both TBI groups had significantly lower scores in safety and judgement than controls. Compared to the controls, the severe TBI group demonstrated significantly lower performance on all instrumental activities of daily living (IADL) tasks. Compared to the mild TBI group, the controls performed better on the medication task, the severe TBI group performed worse in the cooking and telephone tasks. Predictive validity: The EFPT predicted the self-perception of independence measured by the TBI-QOL (beta = -0.49, p < .001) for the severe TBI group. Overall, these data support the validity of the EFPT for use in individuals with TBI.


Executive function; NIH Toolbox; performance-based testing; traumatic brain injury

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