A novel unstructured performance-based task of executive function in children with attention-deficit/hyperactivity disorder

ABSTRACT

Objective: Executive functions (EFs) have been assessed with performance-based measures and rating scales. Research has shown a lack of association between these two methods. One factor that might contribute to this difference is the structure provided on performance-based measures that is not provided on rating scales. This study examined the role of structure on self-directed task completion, an aspect of EF, using a novel unstructured performance-based task (UPT).

Method: Children aged 8–12 years (38 attention-deficit/hyperactivity disorder, ADHD; 42 typically developing) and their caregivers participated. We compared performance on the UPT, performance-based measures of EF (Stroop test and Trail-Making Test), and a rating scale to assess EF (Barkley Deficits in Executive Functioning Scale–Children and Adolescents, BDEFS–CA).

Results: Group differences were found across all measures. Significant associations emerged between the UPT and Stroop test, Trail-Making Test, and BDEFS–CA, but no significant associations were found between the Stroop test or Trail-Making Test and the BDEFS–CA. In regression analyses, performance-based tasks and the rating scale both uniquely predicted UPT performance. The UPT was a significant predictor of group status when entered with performance-based tasks, but the UPT did not enter as a significant predictor when entered with the rating scale.

Conclusion: The UPT is a promising measure to assess self-directed task completion in children with ADHD.

KEYWORDS:

• Attention-deficit/hyperactivity disorder
• executive function
• performance-based tasks
• rating scales
• self-directed completion

Acknowledgments

The authors wish to thank the Canadian ADHD Resource Alliance, The Possibilities Clinic, and The Children’s Learning Projects Lab headed by James Bebko for aid in participant recruitment. We also wish to thank Rachael Lyon and Lee Propp for assistance in participant recruitment, testing, and data management.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. To the best of our knowledge no studies have yet been published that include correlations between the recently published second edition of the Behavior Rating Inventory of Executive Function (BRIEF–2; Gioia, Isquith, Guy, & Kenworthy, 2015) and performance-based tasks. It is not clear whether the changes to this rating scale would impact its associations with performance-based tasks; however, no new items were added to the clinical scales, making it unlikely that different results would be obtained.

Additional information

Funding

This study was supported by a Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Grant to M. Toplak [grant number 435-2013-1359].