A Case For The Development And Use Of Virtual Reality Measures For Assessment Of Executive Function

Neurocognitive assessment of executive functioning represents a principal objective of neuropsychological evaluations. The executive functions revolve around supervisory attentional networks that include: selective attention, inhibitory control, planning, problem solving, and some aspects of short-term memory. We argue that many of the traditional tests of executive function rely on either paper-and-pencil administrations or computer-automated versions of the paper-and-pencil tests that fall short of replicating real-world functioning. Over the course of the last several decades, neuropsychology and assessment of executive functioning have gained increasing recognition as a discipline with relevance to a number of diverse practice areas (e.g., neurology, neurosurgery, psychiatry, and family medicine) as well as neuroscience specific research areas (e.g., behavior, learning, and individual differences). As a result, neuropsychologists must apply a working understanding of psychology, physiology, and neurology to assess, diagnose, and treat patients with dysexecutive syndrome. Although today the procedures for neuropsychological assessment of executive functioning are widely used, clinical neuropsychologists have been slow to embrace technological advancements. Two essential limitations have resulted from this refusal of technological adaptation: First, current neuropsychological assessments of executive functioning represent a technology that has barely changed since the first scales were developed in the early 1900s. Second, while the historical purpose of neuropsychology assessment of executive functioning was differential diagnosis of brain pathology, technological advances in other clinical neurosciences have changed the neuropsychologist's role to that of making ecologically valid predictions about the impact of a given patients dysexecutive symptoms on everyday functioning. This chapter considers the use of virtual reality-based neuropsychological measures as new and better clinical tests of executive function. Virtual reality-based measures of executive function and dysexecutive syndrome could yield tasks bettersuited to the concerns of the clinician because of the increased ecological validity and generalizability. Further, the ability of virtual reality-reality based neuropsychological assessments of executive function to simulate the human context interaction might also provide useful constraints for purely experimental investigations.