Semi-Structured Scale for the Functional Evaluation of Hemi-inattention

Semi-Structured Scale for the Functional Evaluation of Hemi-inattention Evaluation Summary
  What does the tool measure? Unilateral Spatial Neglect (USN) in both the personal and extra personal space.
  What types of clients can the tool be used for? Patients with stroke.
  Is this a screening or assessment tool? Screening.
Time to administer It takes approximately 5 minutes to complete the personal neglect subscale and 15 minutes to complete the extra personal neglect subscale.
  Versions None.
Other Languages Not applicable.
Measurement Properties
  Reliability – One study examined the internal consistency of the Semi-Structured Scale and found adequate internal consistency.
– No studies have examined the test-retest reliability of the Semi-Structured Scale.
– One study examined the inter-rater reliability of the Semi-Structured Scale and reported excellent inter-rater reliability.
  Validity Construct: 
The extra personal subscale correlated with the Line Cancellation Test, Letter Cancellation Test, Wundt-Jastrow Area Illusion Test, and Sentence Reading Test. The personal subscale did not correlated with these conventional diagnostic tests and requires further validation.
  Does the tool detect change in patients? Although the scale is typically used as a screening measure, one study examined the responsiveness of the scale and found that the personal neglect subscale was not responsive to clinical change following rehabilitation; however the extra personal subscale was responsive to clinical change after rehabilitative treatment.
  Acceptability Both subscales cannot be completed by patients who do not have unilateral voluntary movement and control of the shoulder, elbow, and fingers. Furthermore, the extra personal neglect subscale cannot be completed by patients with deficits in language, cognition, or visual perception. Although it may be challenging for patients to perform these high-level activities soon after their stroke, this scale may become more useful to screen patients before they are discharged home from acute care or rehabilitation. Apraxia must be ruled out as this may affect the validity of test results. This test cannot be completed by proxy.
Feasibility The Semi-Structured Scale is one of the longer scales used to detect USN, and the personal neglect subscale requires further validation. The scale is simple to score, however training is required regarding how to use the rating scale. Simple and readily accessible equipment is required to complete the scale (Comb, Razor/Powder compact, Eyeglasses, Tea set, Playing cards, Picture).
How to obtain the tool? Not applicable.
To administer the personal neglect subscale of the Semi-Structured Scale, the clinician asks the patient to demonstrate the use of 3 common objects: comb, razor/powder compact, and eyeglasses. The objects are placed at the patient’s midline one at a time. To administer the extra personal neglect subscale, patients must serve tea, deal cards, describe a picture, and describe an environment. The patient is asked to perform these activities with objects that are provided on a table. A dialogue has been created for administering the Semi-Structured Scale and can be found under the tab ‘in-depth review – features of the measure’.