Purpose
The EFPT examines the execution of four basic tasks that are essential for self-maintenance and independent living: simple cooking, telephone use, medication management, and bill payment.
Title/Author(s):
Executive Function Performance Test (EFPT)
Developed by: Joan Toglia, Kathleen Golisz, and Yael Goverover
Edition and Year:
Developed and published in 2010.
Distributed by New York University Steinhardt School of Culture, Education, and Human Development.
Identify TWO Types:
Standardized assessment (standardized instructions and scoring)
Occupation-based and performance-based assessment (assesses functional cognition through real-world tasks)
Cost & Accessibility:
Cost:
Free for non-commercial clinical, educational, and research use.
Access:
Official overview: Shirley Ryan AbilityLab EFPT Page
Practitioner resources: The OT Toolbox – Executive Function Tests
Population:
Adults and older adults with:
Neurological conditions (e.g., stroke, traumatic brain injury (TBI), multiple sclerosis, Parkinson’s disease)
Cognitive impairment (e.g., dementia, mild cognitive impairment)
Mental health conditions impacting executive functioning (e.g., schizophrenia, major depressive disorder, bipolar disorder)
Settings:
Inpatient rehabilitation centers
Outpatient occupational therapy clinics
Skilled nursing facilities
Home health care
Community-based rehabilitation programs
Acute care settings (as part of cognitive screening for discharge planning)
Purpose:
To evaluate a person's executive functioning (planning, organization, initiation, sequencing, safety, and completion) through real-world, occupation-based tasks.
To determine the level of assistance required and guide therapeutic intervention planning.
Tasks Assessed:
Preparing a simple meal (oatmeal)
Using a telephone to make an appointment
Managing medications
Paying bills
Cognitive Domains Evaluated:
Initiation
Organization
Sequencing
Judgment and safety
Task completion
Administration:
Time Required: Approximately 30–45 minutes.
Format:
Administered individually.
Client is provided with standardized instructions for each task.
Graded cueing system is used if the client struggles (to maintain standardization and clinical utility).
User Qualifications:
Should be administered by a licensed occupational therapist or trained healthcare professional familiar with cognitive and functional assessment techniques.
Materials Required:
EFPT test kit, including:
Oatmeal packet, bowl, spoon, water, microwave
Telephone (landline or simulator)
Sample medication bottles and pill organizer
Sample bills, checkbook, pen, and envelope
EFPT manual and standardized scoring sheets
Scoring:
Each cognitive domain is rated for each task using a 0–5 scale:
0 = Independent
1 = Verbal guidance
2 = Gestural cueing
3 = Demonstration
4 = Physical assistance
5 = Task completed by therapist
Higher total scores indicate greater executive function impairment and need for assistance.
Subscores can be used to analyze which cognitive domains are most impaired.
Reliability:
Demonstrates excellent interrater reliability and strong internal consistency.
Validity:
Shows construct validity in populations with stroke, brain injury, and cognitive impairment.
Correlates well with other executive function and ADL performance assessments (e.g., Kitchen Task Assessment).
Norms:
No large normative sample available.
Interpretation is based on comparison to clinical expectations for independent performance.
Ecologically valid — Assesses executive function through familiar, meaningful tasks, rather than artificial paper-pencil tests.
Standardized cueing system — Promotes consistency across clinicians and settings.
Functionally relevant — Provides direct information about real-world cognitive challenges.
Supports intervention planning — Highlights which executive function skills are impaired and what supports may be needed.
Widely used and accessible — Freely available for non-commercial use without licensing fees.
Requires specific materials — Some setup is needed (microwave, fake medications, telephone), limiting quick administration in some environments.
Time-intensive — Completing all tasks can take up to 45 minutes, which may be challenging in fast-paced settings.
Scoring interpretation requires training — Consistency in scoring and cueing relies on proper therapist training.
Not norm-referenced — Must be interpreted with clinical judgment rather than compared to standardized population norms.
Limited pediatric application — Designed and validated for adult and older adult populations; not appropriate for younger children.
Toglia, J., Golisz, K., & Goverover, Y. (2010). Executive Function Performance Test (EFPT) [Assessment manual]. New York University Steinhardt School of Culture, Education, and Human Development.
Shirley Ryan AbilityLab. (2019, August 1). Executive Function Performance Test (EFPT). Rehabilitation Measures Database. https://www.sralab.org/rehabilitation-measures/executive-function-performance-test
Coppola, L. (2022, August 30). Executive Function Tests: A guide to executive functioning assessments in therapy. The OT Toolbox. https://www.theottoolbox.com/executive-function-tests/