Mar 1, 2026 · 1 hr 26 min · 11 segments
Today we give you our discussion with Dr. Yana Suchy about executive functioning and everyday living, centering on her work with the Contextually Valid Executive Assessment (or ConVExA) model. Show…
Yana SuchyGuestRyan Van PattenHostJohn BelloneHostI read in grad school where there's a nice diagram showing on the one hand, you have the hierarchy of neural organization.
At the lowest level, we have muscle activation, you know, synapsing from the spinal cord on a muscle and we make a movement and you move up that hierarchy to the Unimodal association, polymodal association, cortices in the brain, higher level integrating more information.
In parallel, we have simple behaviors and then moving up from what we might consider very straightforward motor activation all the way up to the most complex executive functioning.
And we sometimes take for granted how complex the behaviors that we are engaged in are and how other animals can do pretty amazing things, but they can't do them flexibly in the same way we can and can adapt in the same way we can.
And like you mentioned, the social pressures that we have really drove the need for language and this complexity that we deal with.
And so we want to talk more about that throughout the rest of the conversation.
And the test of executive functioning, they have a similar historical trajectory to tests in other cognitive domains and that in the early days, our tests were used primarily to localize lesions and But with the advancement of neuroimaging techniques, this is not as needed.
And we transitioned the field transition toward using our tools to spend more time characterizing cognitive functioning broadly, predicting everyday functioning.
There are obviously still scenarios where it is useful to use tests to detect brain pathology or lesions like, you know, correlations with Alzheimer's disease or intraoperative brain mapping procedures.
There's a couple of examples, but our field is really, it seems to be moving toward the prediction of daily activities.
So I'm curious if you agree and how you think about these different purposes that our tests serve.
I think, you know, in terms of what we say in our reports, We don't say, oh, this performance on this test suggests that there is a lesion in the right temporal whatever.
And in fact, I always say this to my students, like if you talk a lot about the brain in your report, it suggests you're not a neuropsychologist.
I read in grad school where there's a nice diagram showing on the one hand, you have the hierarchy of neural organization.
At the lowest level, we have muscle activation, you know, synapsing from the spinal cord on a muscle and we make a movement and you move up that hierarchy to the Unimodal association, polymodal association, cortices in the brain, higher level integrating more information.
In parallel, we have simple behaviors and then moving up from what we might consider very straightforward motor activation all the way up to the most complex executive functioning.
And we sometimes take for granted how complex the behaviors that we are engaged in are and how other animals can do pretty amazing things, but they can't do them flexibly in the same way we can and can adapt in the same way we can.
And like you mentioned, the social pressures that we have really drove the need for language and this complexity that we deal with.
And so we want to talk more about that throughout the rest of the conversation.
And the test of executive functioning, they have a similar historical trajectory to tests in other cognitive domains and that in the early days, our tests were used primarily to localize lesions and But with the advancement of neuroimaging techniques, this is not as needed.
And we transitioned the field transition toward using our tools to spend more time characterizing cognitive functioning broadly, predicting everyday functioning.
There are obviously still scenarios where it is useful to use tests to detect brain pathology or lesions like, you know, correlations with Alzheimer's disease or intraoperative brain mapping procedures.
There's a couple of examples, but our field is really, it seems to be moving toward the prediction of daily activities.
So I'm curious if you agree and how you think about these different purposes that our tests serve.
I think, you know, in terms of what we say in our reports, We don't say, oh, this performance on this test suggests that there is a lesion in the right temporal whatever.
And in fact, I always say this to my students, like if you talk a lot about the brain in your report, it suggests you're not a neuropsychologist.
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