On the ecological validity of the behavioural assessment of dysexecutive syndrome measure in mild traumatic brain injury.

Background: A growing concern in neuropsychology is whether neuropsychological test measures (NTMs) can predict functional outcome (i.e. ecological validity). The relationship between neuropsychological tests and return to work (RTW) outcomes following mild traumatic brain injury (mTBI) found that the majority of tests were either weakly or completely unrelated. As such, many have opined that clinical neuropsychology should adopt new tests that relate test performance to real-world functioning, such as the Behavioural Assessment of Dysexecutive Syndrome (BADS). Further investigation into the BADS sensitivity to employment status in a mTBI sample is needed.

Present study: We aimed to investigate if the BADS is better at differentiating between employment status compared to traditional pen-and-paper neuropsychological test measures in a sample of patients in the post-acute period of recovery after mTBI.

Results: Following correction of family-wise error, neither the BADS nor traditional tests could differentiate employment status in patients with mTBI who were in the post-acute period of recovery.

Conclusions: The lack of significant findings in the majority of the tests highlights the importance of other facets of a complete neuropsychological assessment. Furthermore, researchers may benefit from investigating other forms of assessment that could prove to be more ecologically valid.