Using board games as neuropsychological tests with children with acquired brain injury.

This research project investigated the use of two board games, Guess Who and Connect 4, as initial neuropsychological assessment measures with children and young people. The validity of novel measures derived from game-play was investigated in a group of typically developing participants (N=14). The level of engagement offered by the games and the potential ecological validity of this assessment method was also investigated. This was to identify potential additional benefits to this method of assessment compared with traditional testing procedures. The performance of a small group of participants with acquired brain injury (N=5) was also explored to identify the potential of the novel measures to discern cognitive deficits in this group. The results showed that a measure of strategy derived from Guess Who demonstrated concurrent validity with two established measures of executive function, the D-KEFS Twenty Questions Test and the Zoo Map Test. The number of wins identified on Connect 4 showed concurrent validity with a measure of visual search and attention, the Trail-Making Test Part A. The scores of the participants with acquired brain injury on the novel measures appeared weaker than the typically developing group, particularly for those scoring poorly on a measure of non-verbal ability. Participants did not rate the games as any more engaging or any less anxiety provoking than the established measures. In-session observations during game-play did not shed light on the functional difficulties reported by parents on a standardised proxy report (the BRIEF). Alterations to game set-up that could increase the discriminant validity of the novel measures are discussed. The remaining potential for this method to increase engagement in a less-high-functioning sample in acute care is also discussed. Issues with the “gamification” of assessment procedures are considered, including the difficulty in simultaneously gathering observational data and quantitative measures.