A comparison of neuropsychological and situational assessment for predicting employability after closed head injury

The relationships among neuropsychological assessment, situational assessme nt, and judgments of future employability in 127 survivors of moderate to s evere closed head injury were evaluated. Participants received a comprehens ive neuropsychological battery and a situational vocational evaluation. Two groups mere created, based on employment recommendation from the situation al evaluation. a seven-factor model was found to account for the prepondera nce of variance within the neuropsychological battery used, and one factor mas predictive of group assignment from situational assessment. However, th e present data reinforce the predominance of Endings in the literature that indicate that, in general, no individual neuropspchological test can be us ed to predict vocational performance in more environmentally relevant envir onments. Exceptions to this "rule" may occur when comparisons between resul ts of formal neuropsychological tests and situational evaluation are limite d to very simple, very circumscribed, and/or very well-defined functions. T hus, situational assessment is seen as a critical adjunct to neuropspcholog ical assessment in making "real-world" predictions, The particular situatio nal assessment used in this study was internally valid, an important findin g given the importance of situational assessment in ecologically valid pred ictions.