Test of Executive Functioning

Test of Executive Functioning in an Emergency (TEFE)

The TEFE is a quick, performance-based tool designed to assess whether an individual can recall and carry out the basic steps needed during an emergency.

Traditional cognitive testing tells us how someone performs in structured settings.

The TEFE helps answer what matters most: Can they function safely when it matters most?

 

Why This Matters

Patients with mild cognitive impairment or early dementia often appear more capable than they are. They rely on routine, familiarity and compensation.

Even individuals who seem independent may be unable to:

  • Dial 911
  • Provide their address
  • Contact help

The TEFE provides a direct, observable way to assess real-world safety risk.

 

What the TEFE Measures

The TEFE evaluates both knowledge and behavior:

Knowledge

  • Emergency number (911)
  • Home address
  • Emergency contact

Behavior

  • Demonstrating how to make a call
  • Writing key information
  • Executing simple, real-world actions

Score Range: 0–6
Time to Administer: Less than 5 minutes

 

Clinical Use

The TEFE is helpful in:

  • Mild Cognitive Impairment (MCI)
  • Dementia (including Alzheimer’s disease)
  • Capacity evaluations
  • Independent living decisions
  • Safety and supervision planning

It provides practical data to support recommendations about:

  • Living alone
  • Caregiver involvement
  • Safety interventions

 

Evidence-Based Tool

The TEFE is peer-reviewed and published in Psychology & Neuroscience.

Research with 256 patients demonstrated:

  • Strong relationships with executive functioning
  • Sensitivity to dementia severity
  • Greater impairment in Alzheimer’s disease

Download the TEFE

⬇️ Click to download the TEFE and scoring sheet

 

About the Author

Dr. Wiechmann Profile Photo

April Wiechmann, PhD, MBA, FNAP
Chief Behavioral Health Officer, UNT Health
Chair of Psychology, National Academies of Practice

Clinical neuropsychologist specializing in cognitive health, aging, and functional assessment.

Citation

Wiechmann, A., Hall, J., & Azimipour, S. (2015).
Test of Executive Functioning in an Emergency (TEFE).
Psychology & Neuroscience, 8(4), 488–494

Copyright

© 2015 American Psychological Association
© 2026 April Wiechmann

For clinical and educational use only.
Not for redistribution without permission.