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Ineco Frontal Screening IFS MANUAL To Print
Ineco Frontal Screening IFS MANUAL To Print
Ineco Frontal Screening IFS MANUAL To Print
Goals
The objective of the creation of this tool is the detection of executive dysfunction in patients with
various pathologies that affect the frontostriatal circuits, and to provide health professionals with
an executive screening instrument that is sensitive and specific, and at the same time short and
easily administered to determine executive dysfunction in patients with various types of dementia
or other psychiatric diseases.
The design of the IFS was primarily conceived, representing three groups of cognitive tasks, as
indicated below: (a) response inhibition and set switching – evaluates the ability to switch from
one cognitive set to another, and to inhibit inappropriate responses in a manner verbal and motor;
(b) abstraction capacity – obtained from the interpretation of proverbs, the concrete interpretation
being typical of patients with damage to the frontal lobe; (c) working memory – refers to a brain
system that provides temporary storage and manipulation of information necessary for other
complex cognitive tasks.
Background
The Frontal Assessment Battery (FAB) (Dubois, Slachevsky, Litvan & Pillon) consists of 6
subtests that assess conceptualization, cognitive flexibility, motor programming, sensitivity to
interference, inhibitory motor control, and prehension behavior. The authors propose the
administration of this battery for the evaluation of different types of frontal dysfunctions, and
also to distinguish between neurological pathologies such as the behavioral variable of
Frontotemporal Dementia and Alzheimer's Disease (Slachevsky et al., 2004). These authors
report correlations with classic executive tests such as the Wisconsin Card Sorting Card (WSCT)
and with measures of general cognitive functioning (Mattis Dementia Scale), while they highlight
the lack of correlation with the Mini Mental State Examination (MMSE). The authors conclude
that the FAB battery is an easy tool to administer, and sensitive to executive dysfunction. On the
contrary, other studies have raised doubts regarding the sensitivity and specificity of the FAB,
and in particular, its ability to differentiate different types of dementia such as Alzheimer's
Disease and Frontotemporal Dementia (Castiglioni et al., 2006; Lipton et al. , 2005) in its early
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stages.
To create the IFS we incorporated some subtests of the FAB that demonstrated the highest
sensitivity in our daily clinic: programming of motor series, conflicting instructions and
inhibitory control. Of these included subtests, motor programming has been shown to have the
highest sensitivity in a study conducted by Lipton et al. (2005), while conflicting instructions and
inhibitory control are, in our experience, two subtests that usually generate difficulties for our
frontal patients.
To create a more sensitive and specific tool, we also included new subtests that have been shown
in various research studies to be sensitive to executive dysfunction: numerical working memory
(Digits in reverse order), verbal working memory (Months in reverse order). , spatial working
memory (Modified version of the Corsi Tapping Test), conceptualization (proverbs), and verbal
inhibitory control (Modified version of the Hayling Test; Burgess & Shallice).
Statistical References
The suggested cut-off point for the IFS is 25 points, having demonstrated a sensitivity of 96.2%
and a specificity of 91.5% in the differentiation of patients with various types of dementia.
Administration
Instruction: “Look carefully at what I'm doing (making the Luria series). Now
you do the same with your right hand, first with me, and then you alone . ”
Repeat the series 3 times with the patient and then say “ Now do it yourself . ”
Subjects are asked to hit the table once when the manager hits it twice, and to
hit it twice when the manager hits it once. To ensure that the subject has
correctly understood the instructions, a practice trial is carried out in which the
administrator hits the table once, three consecutive times; and then twice, three
times more. After the practice trial, the examiner completes the following series:
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1-1-2-1-2-2-2-1-1-2.
Instruction: “ Hit the table twice when I hit you once .” To make sure the subject
has understood, tap the table once. Repeat it 3 times. “ Now hit the table once
when I hit it twice.” To ensure that the subject has understood the message, tap
the table twice. Repeat it 3 times. Now perform the series 1-1-2-1-2-2-2-1-1-2.
Instruction: “ Hit the table once, when I hit it once.” To make sure the subject
has understood, tap the table once. Repeat it 3 times. “ Now don't hit when I hit
twice.” To ensure that the subject has understood the message, tap the table
twice. Repeat it 3 times. Now perform the following series: 1-1-2-1-2-2-2-1-1-2.
Instruction: “ I am going to tell you some digits and, when I finish, repeat them
backwards and forwards. For example, if I say 7-1-9, what would you have to
say?” . If the subject answers the grouped numbers, he or she is asked to do so
one at a time.
The subject is asked to list the months of the year in reverse order, starting with
December. This subtest evaluates the same function as the previous test, but
with the difference that the series is highly known by all people.
Instruction: “ Say the months of the year in reverse order, starting with the last
month of the year.”
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reverse order. There are four trials performing a sequence of 2, 3, 4 and 5
squares respectively.
Instruction: “ I am going to point out the squares in a certain order. I want you
to point them out in reverse order.” Do it slowly. The patient can choose the
hand of preference.
Instruction: “ Now I am going to read you a saying, and I would like you to
explain its meaning to me.” The first proverb is read and only on the first
occasion, if the patient presents a concrete explanation of it, is he or she asked
to provide an explanation beyond the concrete meaning. Example: “Dog that
barks does not bite” ; If the patient says: “When the dog is tied he cannot bite,”
he is told: “ Beyond the dog, what would be the meaning of this saying?” .
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strategies should be discouraged each time the subject uses them.
Punctuation
Motor Series (3 points): If the subject completes six consecutive series by himself, the score
awarded is 3 points. If you perform at least three consecutive sets alone, the score awarded is 2
points. If they cannot perform at least three consecutive series by themselves, but can perform it
correctly by copying the administrator, the score awarded is 1 point, otherwise it is 0.
Conflicting Instructions (3 points): If the subject did not make any errors, then the score
awarded is 3 points. If they made one or two errors, the score awarded is 1 point. If the subject
copied the administrator at least four consecutive times, the score awarded is 0 points.
Go-No Go (3 points): If the subject did not make any errors, then the score awarded is 3 points.
If they made one or two errors, the score awarded is 1 point. If the subject copied the
administrator at least four consecutive times, the score awarded is 0 points.
Digits in Reverse Order (6 points): The score is equivalent to the number of correct numbers
that the subject has said in any of the two trials.
Verbal working memory (2 points): If the subject does not make errors, then the score awarded
is 2 points. If you make a mistake, the score awarded is 1 point. Otherwise, it is 0 points.
Spatial working memory (4 points): The number of trials performed correctly is scored.
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Abstraction Capacity (Interpretation of proverbs) (3 points): For each proverb, 1 point is
awarded if the subject provided an adequate explanation of the proverb. If the subject provides a
correct example, the score awarded is 0.5, otherwise it is 0.
Verbal Inhibitory Control (6 points): only the second part is scored. For each sentence a score
of two points is assigned if the word is not related to the sentence. A score of one is assigned if
the word is semantically related to the word that would correctly complete the sentence, and a
score of 0 if it uses the expected word. (a table for correct punctuation is attached).
Supplementary table for the correct scoring of verbal inhibitory control responses.
Completely related
word
Word that coherently completes the sentence. 0
Unrelated word
Word not semantically related to the sentence and not
morphologically related (does not respect morphological
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agreement)
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0
INECO FRONT SCREENING
MOTOR SERIES Yo /3
"Look carefully at what I 'm doing . " The examiner performs Luria 's series three times . song, palm". Now do the same with your hand : ha. First with me and then you
will." The examiner performs the series 3 times with the patient and then says it . "Wshore, do it yourself."
Score : Consecutive series only: 3 / at hands 3 consecutive series = only : 2 / The patient fails in 1 arrest achieves 3 consecutive series with the examiner: 1 / The
patient does not achieve 3 consecutive series with the examiner : 3
CONFLICTING INSTRUCTIONS | /3
"Strike twice when I strike once." To ensure that the patient understood the instructions correctly, perform a series of 3 tests: 1 1- 1. " "I hit Pee once when I hit Peo
twice." To ensure that the patient understood the instructions well . _ _ _ _ perform a series of 3 tests: 2-2-2. The examiner performs the following series: 1-1-2-1-2- 2-
2-1-1- 2. Score: No error: 3/ One or two errors: 2/ More errors : 1/ The patient hits like the examiner at least 4 consecutive times: 0
TOTAL IFS:
1
1
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