The ecological validity of executive tests in a severely brain injured sample

It is unclear how well performance on recently developed, specialized executive tests, reflects problems that patients and their relatives complain of in real life. The ecological validity of four specialised tests of executive function: the Hayling and Brixton Tests, and the Zoo Map and Key Search sub-tests from the Behavioural Assessment of Dysexecutive Syndrome (BADS) battery, was assessed against the Dysexecutive Questionnaire from the BADS in a sample of 59 severely brain injured individuals. Results indicated that only the Hayling C was significantly negatively correlated (r = −.26, P < .05) with the informant version of the Dysexecutive Questionnaire. An index of insight was not correlated with any of the executive tests. It is concluded that these tests have limited ecological validity when used to assess patients following severe head trauma.