Validity of the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) in children and adolescents with pediatric acquired brain injury

ABSTRACT

The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) was developed to address the need for a standardized ecologically valid test of executive function (EF) in the pediatric population. Our study aimed to investigate the discriminant, concurrent, and ecological validity of BADS-C in a sample with pediatric acquired brain injury (pABI). Seventy-four participants with pABI aged 10–17 years were included to a pre-registered randomized controlled trial, and baseline assessment was used for the current study. Controls consisted of 60 participants aged 10–17 years. Participants with pABI were assessed with neuropsychological tests and questionnaires of EF, and measurements of general intellectual ability (IQ). Results showed that all BADS-C subtests discriminated between participants with pABI and controls, except for the Playing Cards Test. Concurrent and ecological validity was demonstrated through associations between BADS-C total score, Key Search Test, and Zoo Map Test 1, and neuropsychological tests and teacher questionnaire ratings of EF. Key Search Test and Zoo Map Test 1 predicted teacher ratings of EF, beyond IQ and other neuropsychological test of EF. These findings provide support for BADS-C as a valid clinical assessment tool that can detect everyday executive dysfunction in the pABI population, and guide rehabilitation and treatment decisions.

KEYWORDS:

• Executive function
• ecological validity
• psychometric properties
• pediatric acquired brain injury
• cognitive outcome

Acknowledgements

We would like to thank the participants and their families, Head of Clinics, patient advisers, and the staff at St. Olavs Hospital and Oslo University Hospital for their participation and support. We would especially thank our research nurses, occupational therapists Lene Bobakk and Gøril Okkenhaug Johansen, test-technicians, neuropsychologists and pediatricians involved in this study. We also would like to thank pediatrician Bård Forsdal for help recruiting patients from at the University Hospital of North Norway, the Unit for Applied Clinical Research, Norwegian University of Science and Technology (NTNU) responsible for the monitoring and developing the webCRF, with special thanks to Anne Caroline Wiik.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The raw data supporting the findings of the manuscript can be found at the Children’s Clinic, St. Olavs Hospital, Trondheim, Norway. Due to regulations, the anonymity of the informants must be secured. In the raw data, it is possible to identify the informants, and restrictions therefore apply to the availability of these data. Reasonable requests concerning the data can be sent to the corresponding author.

Additional information

Funding

This work was supported by the Research Council of Norway (grant number 260680/H10); and grants from the Children’s Clinic, St Olavs Hospital, Trondheim University Hospital.