Ecological Validity

Many assume that a patient who obtains average scores on neuropsychological tests will also perform normal in everyday performances. However, rehabilitation and the assessment of the memory functions happen in an artificial environment unlike to the real-world habitat, which makes it hard to foresee how well the patient will do in a noisy, distractive, and color-full environment. An individual may perform well in organized and structured situations, but everyday memory impairments may not be noticed by the staff of the rehabilitation center or the patient until he or she returns back home. For example, someone could easily learn and remember a list of food items at home, but when the person enters grocery store he may have lost the ability

The reliability of a test refers to the extent that it provides consistent and stable results. The validity refers to the concept of the test measuring what it is supposed to measure. Ecological validity is closely related, but not the same as external validity. It refers to whether or not the findings obtained on a laboratory test will also generalize to real-world settings. The importance of ecological validity was discussed by Neisser in 1978 in his famous talk “Memory: What are the important questions?” in which he criticizes traditional laboratory tests, because they do not measure memory in the real world and therefore he insists that researching memory should occur within the field (Cohen & Conway, p. 3, 2008). Yet, studying memory in the field is more demanding because in an uncontrolled environments exist more variables, which are difficult to control. Also, if too many variables exist scores fluctuate and the test will not generalize to a larger population. Moreover, field studies take a long time to complete because the researcher needs follow the patient throughout his or her day. Alternatively, clinician can choose to use standardized assessment tool have good reliability, validity, and ecological

At first, neuropsychological tests were developed to detect the presence of a brain damage and not how well the patient may function in daily settings (Kibby at al. 1998). Consequences arise if the therapist wrongly interprets the patient’s functional abilities due to low test scores or the behavior of the patient during assessment. For example, someone could score well on a standardized test due to a high educational level, but forget important appointments with clients, to make phone calls, or he could forget the food in the oven and leave the house. Ultimately, this is problematic because the clinician could provide wrong recommendations regarding living independently or returning to work (Chaytor and Schmitter-Edgecombe, 2003). Wilson (1993) states that neurocognitive tests fail to investigate the problems that an individual will face in everyday life, yet he stats a full range of testing is necessary to predict the impairments and the ‘future progress’. The psychologist is able to make better predictions about the patients functional ability if he knows what measures on a particular tests possess the best predictability in what kinds of everyday