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UBC Theses and Dissertations

Updating our approach to neuropsychological assessments : examining the validity of eye tracking with the computerized Wisconsin Card Sorting Test Leitner, Damian William


Each year approximately 50,000 Canadians, one million Americans, and millions of people worldwide are hospitalized for stroke (Mozzaffarian, Benjamin, Go, et al., 2015). Cognitive impairment is common after experiencing a stroke and known to affect functioning on daily tasks (Nys et al., 2005; Barker-Collo & Feigin, 2006). While neuropsychological assessments are often employed to assess cognitive abilities and make inferences about functional capability there is growing interest in integrating contemporary technologies to augment the assessment (Burgess, Alderman, Forbes, et al., 2006; Bilder, 2011; Parsey & Schmitter-Edgecombe, 2013; Parsons, 2016). Eye tracking allows previously overlooked information, overt visual attention based on fixations and saccades, to be quantified to help elucidate how responses are made during testing. The current dissertation, comprised of three studies, investigated the validity of eye tracking during completion of the computerized Wisconsin Card Sorting Test (cWCST), a common test of higher-level cognition. Overall, current findings supported the validity of eye tracking with the cWCST across separate population samples. More specifically, results across the three studies provided initial evidence for the construct and criterion validity of fixations and saccades on cWCST, as well as the ecological validity for inpatients recovering from a stroke. Fixation counts, dwell times, and average time per fixation, as well as saccade count were shown to be influenced by cognitive load and response styles and also differentiated between healthy older adults and those who experienced a stroke. Last, findings also found that select fixation measures had concurrent and predictive validity for inpatients recovering from a stroke. This dissertation provided preliminary support for eye tracking during neuropsychological assessment of cognitive functions. Clinical implications and areas for future research are also discussed.

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