Community participation: measurement issues with persons with deficits in executive functioning.

Deficits in executive functioning and self-regulation, which are characteristic of many rehabilitation populations, can interfere with the provision of accurate and reliable responses to surveys designed to measure psychosocial constructs, including community participation. Using the Cognitive Aspects of Survey Methodology paradigm, survey researchers have found that respondents proceed through 4 processes that draw heavily on executive functions: (1) question comprehension and interpretation, (2) retrieval of applicable information from memory, (3) integration of retrieved information to form a judgment, and (4) configuration or mapping of the judgment to the response choices. Respondents without cognitive deficits frequently make errors because of challenges to their executive functions; it should therefore be anticipated that persons with deficits in executive functions will have even greater difficulties providing consistent and accurate responses. Research with persons with executive functioning deficits that empirically evaluates the various strategies recommended by survey researchers is sorely needed. At a minimum, survey design and administration should take into account potential sources of error resulting from executive functioning deficits by testing and incorporating strategies for reducing error. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.