Assessment of unilateral neglect in stroke: Simplification and structuring of test items.

STATEMENT OF CONTEXT: Unilateral neglect is a complex impairment that is common after stroke and limits occupational performance. Sensitive assessment of unilateral neglect is critical for planning treatment and ensuring safe community discharge. CRITICAL REFLECTION ON PRACTICE: This reflection describes unexpected findings in the assessment of neglect with two individuals in the acute phase of recovery post stroke. When trialing a new activity based test battery, we observed few neglect behaviors during test tasks despite observation of multiple neglect behaviors outside of the testing situation. Upon reflection, we better understood how simplification and structuring of test items and environments could impact the observation and assessment of neglect behaviors. IMPLICATIONS FOR PRACTICE: This practice analysis further supports the use of multiple assessments when evaluating unilateral neglect and specifically encourages the inclusion of assessment methods that maintain the complexity of everyday tasks and environments.