Date Presented 04/03/2025
This study uses dynamic testing with graduated prompts to enhance the performance of adolescents with executive function deficits. It aims to provide evidence-based OT approaches to improving executive functioning and outcomes.
Primary Author and Speaker: Yael Fogel
PURPOSE: To investigate the impact of graduated prompts training on the cognitive and occupational performance of adolescents with executive function deficits (EFD) during the Rey-Osterrieth Complex Figure (ROCF) task. Due to inefficient cognitive-strategy use, these adolescents struggle with daily tasks and have difficulty organizing, problem-solving, and self-monitoring.
DESIGN: Secondary quantitative data analysis using a dynamic testing approach with pretest, training, and posttest phases. Participants meeting EFD inclusion criteria were assessed with the Wechsler Intelligence Scale for Children and Behavioral Rating Inventory of Executive Function.
METHOD: Trained occupational therapists collected data on 41 participants from the ROCF dynamic version: initial copying, immediate recall, graduated prompts training, and posttest phase. The training phase used structured prompts. Accuracy and organization strategy scores measured performance; interrater reliability was scored independently.
RESULTS: Participants’ scores significantly improved in the copying and memory phases after training. Copying organization increased 50%, copying accuracy 67%, memory accuracy 180%, and memory organization 237%. Scores were positively correlated, associating one aspect’s improvements with the others.
CONCLUSION: Graduated prompts training can enhance performance in adolescents with EFD, evidenced by improved ROCF task accuracy and organization. Findings highlight the training’s potential to support this population’s cognitive and occupational performance, offer a validated method to improve cognitive strategies, and inform occupational therapy practices and interventions to enhance daily functioning and quality of life.
IMPACT STATEMENT: This research provides compelling evidence of the efficacy of graduated prompts training in improving cognitive strategies among adolescents with EFD, enhancing occupational therapy interventions and outcomes.
References
Davies, S. R., Field, A. R., Andersen, T., & Pestell, C. (2011). The ecological validity of the Rey-Osterrieth complex figure: Predicting everyday problems in children with neuropsychological disorders. Journal of Clinical and Experimental Neuropsychology, 33(7), 820–831. https://doi.org/10.1080/13803395.2011.574608
Osterrieth, P. A. (1944). Le test de copie d’une figure complexe; contribution à l’étude de la perception et de la mémoire [Test of copying a complex figure; contribution to the study of perception and memory]. Archives de Psychologie, 30, 206–356.
Resch, C., Keulers, E., Martens, R., van Heugten, C., & Hurks, P. (2019). Does strategy instruction on the Rey-Osterrieth Complex Figure task lead to transferred performance improvement on the Modified Taylor Complex Figure task? A randomized controlled trial in school-aged children. The Clinical Neuropsychologist, 33(1), 108–123. https://doi.org/10.1080/13854046.2018.1448438
Veerbeek, J., Vogelaar, B., & Resing, W. (2019). Process-oriented dynamic testing in a complex figure task. Journal of Cognitive Education and Psychology, 18(1), 67–80. https://doi.org/10.1891/1945-8959.18.1.67
