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  2. Weekly Calendar Planning Activity

Weekly Calendar Planning Activity

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Purpose

Observations made from the WCPA provide in-depth information to assess performance on a complex, cognitive, instrumental activity of daily living (IADL), as well as about executive functioning abilities, for those ranging in age from 12-94 years old.

Link to Instrument

Acronym WCPA

Area of Assessment

Attention & Working Memory
Cognition
Executive Functioning

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$140.00

Cost Description

$150 for the public, $99 for American Occupational Therapy Association members

Populations

Multiple Sclerosis

Key Descriptions

  • Administration
    The examiner chooses between 3 levels of graded assessments based on the age and cognitive functioning of the participant. The presentation and format vary in complexity based on the selected level.
    ? Level 1: used for adults who are lower functioning
    ? Level 2: most commonly used and has been researched more extensively than level 1 or 3. Forms tailored for:
    1. Adult/older adult: Version A & B
    Alternative short form (WCPA-short) uses the same appointment lists from Versions A & B but the appointment lists are reduced from 17 to 10 items
    2. Middle school/high school: two alternative appointment lists designated for students age 12-18
    3. Youth: two alternative appointments lists designed for students 16-21
    ? Level 3: used for adults who are exceptionally high functioning
  • The participant is asked to enter a series of appointments into a calendar for one week while following certain rules and completing competing tasks. The task involves following and organizing a list of either 17 (adult version) or 18 (youth version) appointments or errands into a weekly schedule while keeping track of rules, avoiding conflicts, monitoring passage of time, and inhibiting distractions.
  • A post-test interview examines insight/ awareness & unobservable strategies. There is an additional post-test self-rating of awareness questionnaire completed by the participant that is optional.
  • Scoring is based on the participant's ability to 1) identify appointments as entered or missing, 2) place appointments in the correct day/time, 3) correctly label the appointment, and 4) self-recognize errors. Min/Maximum possible points: 0-17 (raw score).
  • The raw score is matched to a predetermined weighted score, which is used to calculate the efficiency score (total time (sec) / weighted score = efficiency score). Examining both time and accuracy together provides an indication of efficiency. A high efficiency score indicates lower performance. Interpretation requires careful analysis and consideration of all aspects of performance.

Number of Items

Long form: 17 items for the adult version, 18 items for the youth version

Short form: 10 items

Equipment Required

  • Examiner Directions for All Levels
  • WCPA Recording Form (Appendix E.6)
  • After Task Interview and Rating Scale (Appendix E.7)
  • Optional adult background form (appendix E.5)
  • Optional Observation Form (Appendix E.8)
  • Stopwatch
  • Scoring Forms (used after administration)
  • Calendar Scoring Worksheet (Appendix A-D, depending on which WCPA is used, to score appointment accuracy immediately after the activity)
  • Optional: Forms to Summarize results (Appendix F)
  • Weekly calendar activity instruction sheet (Appendix E.1)
  • Appointments and Errands to Be Scheduled List (Levels I or II) or paragraph (Level III, Appendices A-D)
  • Blank weekly calendar (Appendix E.2) and the weekly calendar samples which have several times (Appendix E.3) and appointments (Appendix E.4) filled in
  • Watch or clock within clear sight (or placed on the table)
  • Pen
  • 2 different colored highlighters (Levels II & III)
  • 1 or 2 pieces of blank scrap paper (Levels II & III)

Time to Administer

10-40 minutes

Short form: approximately 10-15 minutes

Level 1 & 2: approximately 20-25 minutes

Level 3: 30-40 minutes

Required Training

Reading an Article/Manual

Required Training Description

Administration requires a full understanding of the dynamic interactions among cognitive abilities, activity demands, and context, as well as skills in observation of occupational performance, activity analysis and interviewing. The WCPA was designed to be administered and interpreted by occupational therapists, who have a unique focus on analysis of performance and performance-based assessment and whose educational training includes cognition, activity analysis and interviewing skills. Examiners should carefully review all sections of the WCPA manual before administering the WCPA.

Age Ranges

Adolescent

12 - 17

years

Adult

18 - 64

years

Elderly Adult

+

years

Instrument Reviewers

Kim Benrath, Courtney Bohna, Breanna Purzycki, Ruby Wilson

Master of Occupational Therapy students

Faculty mentor: Danbi Lee, PhD, OTD, OTR/L

Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle

ICF Domain

Body Function

Measurement Domain

Cognition

Considerations

WCPA is only appropriate for those people who are independent in routine or basic ADL’s but who may have difficulties in non-routine or complex activities. The person should be oriented, able to sustain attention for at least 10 minutes, and able to comprehend written sentences without difficulty.

 

The WCPA also includes the option of a test-teach-retest dynamic assessment, to examine responsiveness of the person to change performance with guidance from another person. This method goes beyond observation and analysis of quality of performance and is hypothesized to provide direct information related to intervention planning. However, the dynamic format had not been empirically studied at the time of publication.

Multiple Sclerosis

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Normative Data

Multiple Sclerosis: (Goverover, Toglia & DeLuca, 2019; n = 100; MS with cognitive impairment n = 21, Mean Age = 49.8(7.7), Time Since Diagnosis = 233.6 months; MS with no cognitive impairment n = 41, Mean Age =48.6(10.5), Time Since Diagnosis = 164.2 months; Healthy n = 38, Mean Age = 45.02(10.1); WCPA level unspecified)

 

 

Mean (SD)

Scores

MS-Cognitive Impairment

MS- No Cognitive Impairment

Healthy Control

Entered appointments

16.0(1.2)

16.39(0.86)

16.7 (7.7)

Total accuracy

10.5(3.8)

13.6(2)

14.6 (1.8)

Rules followed

3.1(1.3)

4.1(8.5)

4.6(0.68)

Strategies

5.1(1.7)

5.7(1.7)

5.8(1.4)

Planning time

2.9(3.9)

1.5(5.4)

1.6(3.4)

Total time

14.8(7)

16.8(7.6)

13.4(5.02)

Location errors

2.7(1.9)

1.7(1.5)

1.08(1.04)

Repeat errors

0.24(0.62)

0.14(0.42)

0.08(0.27)

Incomplete errors

0.42(0.81)

0.05(0.31)

0.08(0.36)

Time errors

2.1(1.9)

0.80(0.79)

0.78(0.88)

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Multiple Sclerosis:  (Goverover, Toglia & DeLuca, 2019)

  • Adequate to excellent concurrent validity of WCPA with Actual Reality (AR) performance. Better performance of the WCPA (accuracy, strategy use, following rules) was associated with better and more accurate AR performance. (r=-.26 - -.59). Lower number of WCPA errors (number of errors, location errors and time errors) was associated with better and more accurate AR performance. (r=.34-.64)
  • Adequate concurrent validity of WCPA with Delis-Kaplan Executive Function System (DKEFS). Better DKEFS scores were associated with better performance of the WCPA (r=.3-.4)

Construct Validity

Multiple Sclerosis: (Goverover, Toglia & DeLuca, 2019)

  • Significant group differences in WCPA number of correct appointment entered, number of rules followed, and total numbers of errors committed (p<0.001)
  • No significant group difference in number of strategies used to complete the task, number of appointments entered, planning time, and total completion time.

Brain Injury

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Construct Validity

Discriminant Validity:

Acquired Brain Injury (Doherty, 2017; Age=12-18; Time since injury= 1month-2 years; acquired brain injury n=11; neurotypical control n=15; WCPA Level II Middle School/ High School)

  • Adequate convergent validity of WCPA with Digit Span Backwards; Delis-Kaplan Executive Function System Tower Test, Color-Word Interference Test, Trail Making Test Parts A and B and Behavior Rating Inventory of Executive Function (r= .30-.50)
  • Adequate discriminant validity for WCPA between the ABI and control groups. Significant group difference intotal time (p=.02) and the total number of rules followed (p=.04). The severe ABI group took more time to complete the task (p= .02), entered fewer accurate appointments (p =.004), and followed fewer rules (p =.04).

Mixed Populations

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Normative Data

Healthy Adults: (Toglia, 2015; n = 386;  Young(18-39), n=114, Mean Age=28.6 (6.4); Middle(40-64),n= 142, Mean Age=53.1 (8.3); Older (65-94), n=130, Mean Age=73.6 (6.2); WCPA Level II, Version A)

 

Average Scores on the WCPA Level II (version A) by age group

 

 

Young

 

Middle

 

Older

 

Scores

Mean (SD)

Mean (SD)

Mean (SD)

Entered appointments

16.5 (.8)

16.4 (.9)

16 (1.3)

 

Accurate appointments

13.5 (2.7)

12.2 (3)

11.5 (3)

Rules followed

4.3 (.7)

4.3 (.7)

3.8 (1)

Strategies used

5 (2.3)

5.2 (2.4)

4.2 (2.2)

Time of task completion

16.3 (6.7)

14.1 (5)

16.2 (7.3)

 

Median (Range)

Median (Range)

Median (Range)

Planning time (mins)

1.0 (0-20.5)

1.1 (0-14)

.8 (0-19)

Efficiency score

77.6 (27.9-478.7)

67.8 (17.237)

91.7 (26.8-654.3)

 

Community Youth: (Toglia & Berg, 2013; n = 49; Mean Age= 18.9 (Age Range=16-21); WCPA Youth Level II, Version A)

 

Average Scores on the WCPA Youth Level II (version A)

 

Scores

Mean (SD)

Entered appointments

17.4 (0.9)

Accurate appointments

14.2 (2.6)

Rules followed

4.29 (0.9)

Strategies used

14.31 (2)

Time of task completion (mins)

15.96 (6.13)

 

Median (Range)

Planning time (mins)

0.05 (0-14)

Efficiency score

73 (28-316)

Test/Retest Reliability

Psychiatric, Neurodevelopmental or Mild Intellectual Disorders: (Holmqvist et al., 2019; n = 24; Mean Age= 37 years; Swedish Sample; Swedish version of WCPA (WCPA-SE) Level I)

  • Poor test-retest reliability between first and second test occasions (ICC = .42 to .66)
  • Acceptable to Excellent test-retest reliability between second and third test occasions (ICC = .65 to .91)
  • Considerable random variation in scores between first and second test occasions (SDC= 2.00 to 11.00)
  • Possible learning effects observed between second and third test occasions; variation may also be attributed to population’s intra-individual variability

Interrater/Intrarater Reliability

Community and At-Risk Youth: (Toglia & Berg, 2013; n=153; At-risk group, n=109, Mean Age=18.4 (1.3); Community group, n = 49, Mean Age = 18.9 (1.3), WCPA Youth Level II, Version A)

  • Excellent interrater reliability with a subset of n = 38 participants with 5 hours of training: (ICC = .986)

 

ADHD: (Lahav et al., 2015; n = 157; Age Range = 20-30 (Isreali Sample)

  • Moderate to High test-retest reliability with a subset of n=94 healthy Isreali students (ICC range = .60 to .85)
  • Excellent Interrater reliability for three out of six performance measures: 1) the number of appointments entered correctly; 2) the number of appointments missing; and 3) stating the time left for completion (r= .937 to -.989)

Construct Validity

Community and At-Risk Youth: (Toglia & Berg, 2013)

  • Supports discriminant validity. WCPA distinguished group differences between at-risk adolescent and their peers at local high school in entered appointments transformed, total accurate, total errors, location errors, self-report errors, repetition errors, time errors, rules followed, number of strategies and strategies used. (p≤0.001)

 

ADHD: (Lahav et al., 2015)

  • Excellent discriminant validity. Significant differences between ADHD and control in number of correctly entered appointments (p= .013), number of missing appointments (p= .024), total performance time (p=.000), stating 10 minutes left (p = .001), total number of strategies used (p= .022)Control used three strategies more frequently: read before began (p= .021), uses finger (p=.027), self-talk (p= .001)

 

Adolescents with Genetic Generalized Epilepsies (GGEs) and Healthy Adolescents: (Zlotnik et al., 2018; n = 40; Mean Age= 15.86 years; WCPA level unspecified)

  • Excellent discriminant validity. Adolescents with GGEs were significantly less accurate (p?<?.01), less efficient (p?<?.01), and used different and fewer strategies (p?<?.05) on the WCPA than peers
  • Poor discriminant validity. No differences in planning times, total performance time and number of entered meetings between groups

 

Healthy Adults: (Toglia & Berg, 2017; n = 808; Younger Group Age=18-39, Middle-age Group Age= 40-64, Older Group Age ≥ 65, US and Israeli samples)

  • Supports discriminant validity: Significant differences by age group (p<.05)
    • Middle-aged group significantly faster than younger (p= .005) and older groups (p=.0001)
    • Younger and Middle-aged group more accurate, more efficient, entered more appointments, followed more rules, used more strategies, and longer planning times than older group (p=.0001 for all)
    • Younger- aged group more accurate, entered more appointments, used more strategies, and had longer planning times than middle-aged group (p≤.008)

Face Validity

At- Risk Youth: (Weiner, Toglia, & Berg., 2012; n = 113; Mean Age = 18.4; WCPA Level II)

  • Task replicates real- world task for population
  • Task may be modified by changing appointments to suit different populations

Floor/Ceiling Effects

At- Risk Youth: (Weiner, Toglia, & Berg., 2012)

  • Excellent ceiling effects observed in overall accuracy

Bibliography

Doherty, M., Dodd, J., & Berg, C. (2017). Validation of the Weekly Calendar Planning Activity with teenagers with acquired brain injury. Archives of Physical Medicine and Rehabilitation, 98(10).  https://doi.org/doi:10.1016/j.apmr.2017.08.423

Goverover, Y., Toglia, J., & Deluca, J. (2019). The Weekly Calendar Planning Activity in multiple sclerosis: A top-down assessment of executive functions. Neuropsychological Rehabilitation, 30(7), 1372-1387.  https://doi.org/doi:10.1080/09602011.2019.1584573

Holmqvist, K. L., Holmefur, M., & Arvidsson, P. (2019). Test–retest reliability of the Swedish version of the Weekly Calendar Planning Activity – a performance-based test of executive functioning. Disability and Rehabilitation, 1–6. https://doi.org/10.1080/09638288.2019.1568590

Lahav, O., Ben-Simon, A., Inbar-Weiss, N., & Katz, N. (2015). Weekly Calendar Planning Activity for university students: Comparison of individuals with and without ADHD by gender. Journal of Attention Disorders, 22(4), 368–378. https://doi.org/10.1177/1087054714564621

Toglia, J. (2015). Weekly Calendar Planning Activity. AOTA Press.

Toglia, J., & Berg, C. (2013). Performance-based measure of executive function: Comparison of community and at-risk youth. American Journal of Occupational Therapy, 67(5), 515-523.  https://doi.org /10.5014/ajot.2013.008482

Toglia, J., Lahav, O., Ari, E. B., & Kizony, R. (2017). Adult age and cultural differences in performance on the Weekly Calendar Planning Activity (WCPA). American Journal of Occupational Therapy, 71(5). https://doi.org/10.5014/ajot.2016.020073

Weiner, N. W., Toglia, J., & Berg, C. (2012). Weekly Calendar Planning Activity (WCPA): A performance-based assessment of executive function piloted with at-risk adolescents. American Journal of Occupational Therapy, 66(6), 699-708.  https://doi.org 10.5014/ajot.2012.004754

Zlotnik, S., Schiff, A., Ravid, S., Shahar, E., & Toglia, J. (2018). A new approach for assessing executive functions in everyday life, among adolescents with genetic generalised epilepsies. Neuropsychological Rehabilitation, 30(2), 333-345.  https://doi.org 10.1080/09602011.2018.1468272

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