Cognitive functioning, particularly executive functioning, is a strong predictor of functional outcomes in people with schizophrenia. Cognitive remediation has been shown to improve specific cognitive processes, but adjunctive interventions are required for meaningful gains in adaptive functioning, particularly in people with chronic illness. This study examined whether (and how) environmental adaptations, used without training, may circumvent cognitive difficulties and facilitate everyday task performance in individuals with chronic schizophrenia. Forty-two individuals with chronic schizophrenia/schizoaffective disorder were administered cognitive measures and two versions of the Naturalistic Action Test (NAT)—a standard version (ST-NAT), and a user-centered version (UC-NAT) that incorporated environmental adaptations designed to facilitate task performance. The NAT conditions were counterbalanced across participants. Analyses compared performance between the NAT versions and examined the cognitive correlates of each NAT condition. Individuals with schizophrenia made fewer errors on the UC-NAT as compared to the ST-NAT; this between-group difference was significant for all error types. Compared to the ST-NAT, the UC-NAT performance was not significantly associated with an executive function measure of planning. Environmental adaptations may be implemented without extensive training to improve everyday action in individuals with chronic schizophrenia. Environmental adaptations that reduce planning demands may be most effective in this population. (JINS, 2015, 21, 319–329)

Error monitoring is critical to an individual's ability to function autonomously. This study characterized error detection and correction behaviors within the service of everyday tasks in individuals with dementia. Also, the impact of neuropsychological functioning on error detection and correction was examined. Fifty-three participants diagnosed with Alzheimer's disease (AD) or vascular dementia (VaD) were administered a neuropsychological protocol and the Naturalistic Action Test, which requires performance of three everyday tasks. Error detection, correction, and the point at which correction occurred (i.e., microslip—before the error was completed, immediate—just after the error was made, delayed—after performing other task steps) was coded. Dementia participants detected 32.7% of their errors and corrected 75.8% of detected errors. Participants were more likely to engage in microslips than delayed corrections. Tests of executive control and language predicted detection and correction variables; moreover, detection and correction were each related to different aspects of executive functioning. Microslips were related to naming ability. AD and VaD patients did not differ on detection/correction variables, and regression analyses indicated that dementia severity and memory abilities were unrelated to detection/correction. The results specify the error monitoring deficits in AD and VaD and have implications for improving functional abilities in dementia. (JINS, 2008, 14, 199–208.)