Objective: Whether neuropsychological measures can predict functional abilities (ecological validity) is not always certain. Theoretically, neuropsychological measures should predict functional skills, which in turn predict outcomes. This study examined if, in an acquired brain injury (ABI) population, cognitive abilities on the Neuropsychological Assessment Battery-Screening Module (NAB-SM) predicted clinical outcomes (Mayo-Portland Adaptability Inventory-4: MPAI-4) through a mediation by functional skills (Texas Functional Living Scale: TFLS). Method: Participants were 64 adults (65.6% male, M age = 44.94[11.29]) from a post-acute facility for individuals with severe ABIs. Archival data was collected from annual neuropsychological screenings from 2012–2015. Measures included the NAB-SM, TFLS, and MPAI-4. Participants were included from the most recent year with data on all three measures. Results: A regression analysis was conducted using SPSS to examine if functional performance (TFLS) mediated the relation between cognitive abilities (NAB-SM) and outcomes (MPAI-4). Results indicated that the NAB-SM Total score was a significant predictor...

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