The association between the behavior rating inventory of executive functioning and cognitive testing in children diagnosed with a brain tumor

Figures & data

Table 1. Participants’ demographic and clinical characteristics.

Characteristics	n		Percentage
Gender male/female	40/42		49/51
Medical information
High grade/low grade tumor	34/48		41.5/58.5
Hydrocephalus	39		48
Location
Infratentorial	36		44
Supratentorial	46		56
Tumor type and grade
High grade	34		42
Medulloblastoma	12		15
Supratentorial PNET	8		10
Ependymoma	5		6
Astrocytoma gr III	5		6
Germ cell tumor	4		5
Low grade	48		59
Low-grade glioma	35		43
Craniopharyngioma	7		9
Plexus papilloma	6		7
Treatment
Radiotherapy	35		43
Chemotherapy	35		43
Surgery	72		88
Biopsy	19		23
Surgery/biopsy/pressure relief only	39		48
	Mean	SD	Range
Age at diagnosis	6.9	3.8	0.4–14.2
Age at assessment	13.8	3.2	8.0–18.8
Time since diagnosis	7.0	3.6	2.1–17.0
Verbal Intelligence Quotient	91.0	16.1	50.7–117.4
Performance Intelligence Quotient	91.0	18.9	46.0–133.0
Total Intelligence Quotient	89.7	18.7	40.5–125.5

Table 2. Correlation between questionnaires and tasks measuring neurocognitive functioning.

	Tasks
Questionnaires	Attention ANT-IICV,^1a	Inhibition Stop Signal Task SSRT,^2a	Visual memory Visual Sequencing^b	Working memory Digit Span,^3b	Cognitive flexibility ANT-Executive,^4a
BRIEF-parent (n = 82)	r	r (n = 77)	r	r	r
Scales
Inhibit	−.01	−.05	.04	.02	−.14
Shift	.02	.03	−.01	−.02	.01
Emotional control	−.09	−.15	.00	.10	−.19
Initiate	−.07	−.11	−.05	−.02	.11
Working memory	.22	.07	−.12	−.24	.17
Plan/organize	−.08	−.10	.23	.12	−.06
Organization of materials	−.21	−.21	.26	.21	−.24
Monitor	−.11	.03	.19	.01	.03
Index and Total scores
Behavioral Regulation Index	−.04	−.08	.02	.04	−.14
Meta-cognition Index	−.04	−.08	.12	.01	.01
Total score	−.04	−.10	.09	.03	−.06
BRIEF teacher (n = 73)		(n = 68)
Scales
Inhibit	.31**	.06	−.20	−.20	.07
Shift	.28	.12	−.27	−.27	.20
Emotional control	.21	−.04	−.20	−.30	.10
Initiate	.45**	.31	−.31**	−.27	.19
Working memory	.47**	.38**	−.31**	−.36**	.24
Plan/organize	.36**	.20	−.19	−.18	.14
Organization of materials	.21	.04	−.06	−.13	.14
Monitor	.35**	.275	−.25	−.25	.17
Index and Total scores
Behavioral Regulation Index	.32**	.05	−.26	−.31**	.17
Meta-cognition Index	.41**	.31**	−.27	−.29	.22
Total score	.41**	.22	−.29	−.32**	.22

Correlations between the BRIEF and EF tasks that aim to measure the same constructs are indicated in italics.

^aPositive correlation expected.

^bNegative correlation expected.

**p <.01.

¹Attention Network Test Intraindividual coefficient of variation.

²Stop signal reaction time.

³Wechsler Intelligence Scale for Children Digit Span raw score.

⁴Attention Network Test Executive reaction time.

Table 3. Comparison and correlation of BRIEF-Parent and BRIEF-Teacher T scores.

	BRIEF-Parent		BRIEF-Teacher
	(n = 73)
	M	SD	M	SD	F (1,72)	ηp^2	r
Scales
Inhibit	51.73	11.03	48.29	9.58	6.00	.08	.33**
Shift	52.49	9.17	51.79	13.24	0.13	.00	−.06
Emotional control	54.75	12.01	52.78	13.86	0.75	.01	−.12
Initiate	55.85	8.69	52.10	15.78	3.36	.05	.07
Working memory	56.75	9.39	53.58	15.49	2.79	.04	.22
Plan/organize	51.71	8.21	50.53	13.00	0.41	.01	−.04
Organization of materials	48.42	10.12	49.78	11.67	0.56	.01	−.01
Monitor	50.97	8.84	50.82	12.12	0.01	.00	.09
Index and Total scores
Behavioral Regulation Index	53.70	11.32	50.89	12.41	1.87	.03	−.09
Meta-cognition Index	53.51	7.99	51.89	13.90	0.75	.01	.02
Total	53.77	8.38	51.21	12.74	1.92	.03	−.08

Higher scores indicate more executive functioning problems.

**p < .01, η_p², partial eta squared effect size: .01 = small, .06 = medium, .14 = large (Cohen, 1988), effect size of r: .1 = small, .3 = medium, .5 = large (Cohen, 1988)

Table 4. Comparison of EF task performance of children with and without clinical scores on the BRIEF-Parent or BRIEF-Teacher Total or Index scores.

	Index scores or Total score BRIEF-Parent/BRIEF-Teacher						Working memory scale, Index scores, or Total score BRIEF-Teacher
	Non clinical (n = 45)		Clinical^a (T > 65) (n = 31)		t(74)^b	d^c	Non clinical (n = 56)		Clinical^d (T > 65) (n = 17)		t(71)^e	d^3
Tasks	M	SD	M	SD			M	SD	M	SD
Attention ANT-IICV^f	0.22	0.06	0.24	0.08	−1.27	0.28	0.21	0.06	0.29	0.07	−4.45***	1.23
Inhibition Stop Signal Task SSRT^g	256.01^h	68.55	253.40^j	52.80	0.17	0.04	244.24^j	53.06	294.36^k	84.83	−2.76**	0.71
Visual memoryVisual Sequencing^l	13.44	4.04	13.58	4.68	−0.14	0.03	14.14	4.32	10.94	3.51	2.79**	0.81
Working memory Digit Span^m	13.44	3.49	12.48	4.29	1.07	0.25	13.91	3.50	10.29	3.96	3.62**	0.97
Cognitive flexibility ANT-Executive^n	38.11	40.65	40.00	48.33	−0.18	0.04	31.95	39.19	58.28	54.01	−2.21*	0.56

* p <.05, ** p <.01, *** p <.001.

^aChildren with a clinical score on the BRIEF-Parent or BRIEF-Teacher Behavioral Regulation Index, Meta-cognition Index or Total score.

^bFor the Stop Signal Task t(69).

^cCohen’s d effect sizes were calculated using the pooled SD of both groups: .20 = small, .50 = medium, .80 = large (Cohen, 1988).

^dChildren with a clinical score on the BRIEF-Teacher Working Memory scale, Index scores, or Total score; which correlated best with the EF tasks.

^eFor the Stop Signal Task t(66).

^fAttention Network Test Intraindividual coefficient of variation; higher scores indicate worse performance.

^gStop Signal Reaction Time; a higher score indicates worse performance.

^hn = 43.

ⁱn = 28.

^jn = 54.

^kn = 14.

^lA higher score indicates a better performance.

^mWechsler Intelligence Scale for Children Digit Span raw score; higher scores indicate better performance.

ⁿAttention Network Test Executive reaction time; higher scores indicate worse performance.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, New jersey: L Erlbaum.

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