The psychometric Properties of the Test of Everyday Attention (TEA) for Persons with Stroke

Background and purposes: Attention impairment, one of the common problems in persons with stroke, often impedes recovery of functions following stroke. The Test of Everyday Attention (TEA), developed on the basis of Posner’s model of attention, is a measure with theoretical basis. The TEA has three parallel versions, which allow it to be administered on successive occasions to reduce the practice effect from one occasion to the next. The parallel-form reliability, construct validity, and responsiveness are critical psychometric properties when the TEA is applied to evaluate the efficacy of attention rehabilitation. Nevertheless, these critical properties of the TEA in stroke have not been well established. Therefore, we aimed to evaluate the parallel-forms reliability, convergent validity, and responsiveness for persons with stroke. ethods: This study was separated into two sections. For the parallel-form study, we recruited outpatients with stroke aged over 18 from the three hospitals in Taipei City. The patients were excluded if they met the exclusion criteria, such as pre-existing major diseases, presence of unilateral neglect and aphasia, inability to follow oral commands, etc. The eligible participants were thereafter assigned to one of the three groups (Groups AB, BC, and AC) and all were evaluated twice with the TEA by a trained examiner. The interval between the two administrations of the TEA ranged from 3 to 7 days. For the validity and responsiveness study, we recruited consecutive admissions with stroke to the rehabilitation wards at National Taiwan University Hospital. To examine the convergent validity of the TEA, the TEA, three additional tests of attention, and Barthel Index were then given to the participants. Before the participants were discharged from the wards, they would accomplish the follow-up administration of the TEA. esults: In the parallel-form reliability study, 40 participants were recruited. In the validity and responsiveness study, 27 participants were enrolled for the convergent validity. Of these, 10 accomplished the follow-up administration of the TEA. The results showed the five subtests of the TEA (i.e., Map Search, Elevator Counting, Visual Elevator, Telephone Search, and Lottery) had good to excellent parallel-form reliability (ICC=.60 to .96; SRD%=22.3% to 45.4%) and adequate to excellent convergent validity (r=.34 to .80). Furthermore, the Telephone Search, Telephone Search while Counting, and Lottery subtests were the higher responsive measures of attention in comparison with the other subtests (SRM=.69 to .86). iscussion and Conclusion: This study is the first to assess the alternate-form reliability between any two versions of the TEA, to examine the convergent validity of the TEA with the additional tests of attention, and to investigate the responsiveness of the TEA. Our findings suggest that the TEA had satisfactory parallel-form reliability and convergent validity to measure sustained, selective, and switching attention for persons with stroke. If the evidence of the responsiveness is well established, the use of the TEA as an evaluative measure for the persons with stroke can be suggested.