title: Sensitivity of the Wisconsin Card Sorting Test (64-Card Version) versus the Tower of London (Drexel Version) for detecting executive dysfunction in children with epilepsy.
abstract: Executive function deficits are common in children and adolescents with epilepsy. Though the Wisconsin Card Sorting Task (WCST) is often considered the "gold standard" for executive function assessment, its sensitivity-particularly in the case of the 64-card version (WCST-64)-is insufficiently established in pediatric samples, including children and adolescents with epilepsy. The present investigation assesses the sensitivity of the WCST-64 in children and adolescents with epilepsy in comparison to another measure: the Tower of London - Drexel Version (TOL-DX). A total of 88 consecutively referred children and adolescents with epilepsy were administered both the WCST-64 and TOL-DX as part of a comprehensive neuropsychological evaluation. The sensitivity of WCST-64 and TOL-DX variables were established and relations with epilepsy severity measures and other executive function measures were assessed. Of the WCST-64 variables, Perseverative Responses is the most sensitive, but detected executive function impairment in only 19% of this clinically referred sample; in contrast, the TOL-DX Rule Violations detected executive function impairment in half of the sample. Further, TOL-DX performances are more strongly related to epilepsy severity variables and other executive function measures in comparison to the WCST-64. Despite its popularity amongst clinicians, the WCST-64 is not as sensitive to executive dysfunction in comparison to other measures of comparable administration time, such as the TOL-DX.
authors.affiliation: a Department of Neurology, Comprehensive Epilepsy Center , New York University , NY , USA.
authors.forename: William S
authors.initials: WS
authors.lastname: MacAllister
authors.affiliation: b Department of Psychology , Drexel University , Philadelphia , PA , USA.
authors.forename: Moshe
authors.initials: M
authors.lastname: Maiman
authors.affiliation: c Private Practice , South Windsor , CT , USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Marsh
authors.affiliation: d Private Practice , New York , NY , USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Whitman
authors.affiliation: e Child and Adolescent Psychiatry , NYU Langone Medical Center.
authors.forename: Marsha
authors.initials: M
authors.lastname: Vasserman
authors.affiliation: f Department of Neuropsychology , Arnold Palmer Hospital for Children , Orlando , FL , USA.
authors.forename: Robyn J
authors.initials: RJ
authors.lastname: Cohen
authors.affiliation: g Space Coast Neuropsychology Center , Melbourne , FL , USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Salinas
mesh_terms: D000293:Adolescent; D002648:Child; D004827:Epilepsy / Q000150:complications / Q000523:psychology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011340:Problem Solving; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D000073218:Wisconsin Card Sorting Test
keywords: Adolescent; Child; Epilepsy; Executive function; Problem-solving