Fonctions exécutives : construire une évaluation situationnelle adaptée à la population accueillie en maison d'accueil spécialisée

The disabilities affecting the lives of victims of severe head injury may be largely attributed to dysexecutive cognitive-behavioral syndromes. The usual paper-and-pencil tests as well as ecological assessments have limited usefulness where the most severe dysexecutive syndromes are concerned, and prove of little pertinence in displaying the residual initiative-taking capacities of these individuals. For this reason, we have constructed, for the residents of a specialized care home, a method of contextualized assessment which aims to describe the evolution of executive functions as they benefit from social-medical accompaniment throughout the chronic phase. This assessment consists in analyzing the execution script for two simple tasks. The first, which has more explicit instructions, concerns the preparing of a sandwich. The second task is “free”. This experiment is based on a definition of executive functions which is not exclusively cognitive and is part of a project seeking to describe the evolution of the cognitive and psychological functioning of brain-injured patients living in a home for specialized care in the framework of an ongoing research attempt to evaluate daily care.