Behavior Ratings of Executive Function among Preschoolers with ADHD

Abstract

The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, Espy, & Isquith, 2003) was developed to assess executive function (EF) behaviors in children aged 2 to 5 years. We compared parent ratings of 25 preschool children with ADHD to 25 age-, sex-, and SES-matched controls from the BRIEF-P standardization sample. Children with ADHD were rated significantly higher than controls (p < .01) on all five primary scales (Inhibit, Shift, Emotional Control, Working Memory, Plan/Organize), and on all four indices (Inhibitory Self Control, Flexibility, Emerging Metacognition, General Executive Composite). The largest effect size was on the Working Memory scale. All five BRIEF-P clinical scales were significantly intercorrelated in the control group, and seven of ten scale intercorrelations were significant in the ADHD group. Within the ADHD group, the BRIEF-P Index scores were significantly correlated with ratings on the Conners' Parent Rating Scale, but only moderately correlated with an estimate of Verbal IQ. The BRIEF-P had low, non-significant correlations with performance-based measures of EF, and patterns of correlations were not significantly different than those between the BRIEF-P and non-EF measures (sensorimotor, receptive vocabulary). Similar to its predecessor, the BRIEF-P is sensitive to symptoms of ADHD, but appears to measure different elements of EF than those tapped by performance-based measures.

Keywords:

• ADHD
• Attention
• BRIEF
• Executive functions
• Preschool

ACKNOWLEDGMENTS

A portion of this paper was presented at the 33rd Annual Meeting of the International Neuropsychological Society in St. Louis, February 4, 2005. The research was supported by a grant from the Thomas Wilson Sanitarium for the Children of Baltimore. The authors wish to thank Gerard Gioia, Ph.D., and the authors of the BRIEF-P, for providing access to data from the BRIEF-P standardization sample for comparison purposes in the current study.

Notes

Standard deviations in (). All comparisons ns.

Effect size d = (mean of ADHD group-mean of control group)/pooled standard deviation of two groups. All comparisons ADHD > controls p < .01.

ISCI = Inhibitory Self-Control Index; FI = Flexibility Index; EMI = Emergent Metacognition Index; GEC = Global Executive Composite. Values above the diagonal represent correlations within the ADHD group only (n = 25); values below the diagonal represent correlations within the control group only (n = 25). Correlations in regular font are significant at p < .01; correlations in italics are significant at p < .05; correlations in bold are not significant.

CPRS-R = Conners' Parent Rating Scale-Revised; ISCI = BRIEF-P Inhibitory Self-Control Index; FI = BRIEF-P Flexibility Index; EMI = BRIEF-P Emergent Metacognition Index; GEC = BRIEF P Global Executive Composite. Correlations based on T-scores.

*p < .05;

**p < .01.

EF = Executive Function; MBT = Multiple Boxes Test total errors; NR = Number Recall, Kaufman Assessment Battery for Children (KABC); Statue = NEPSY Statue; VA = NEPSY Visual Attention, total; IHP = NEPSY Imitating Hand Positions total; VMP = NEPSY Visuomotor Precision, total; Omi = ACPT-P omissions; Com = ACPT-P commissions; RT = ACPT-P mean response time for hits; Var = ACPT-P variability. ScS = Scaled score (mean = 10, SD = 3); SS = Standard score (mean = 100, SD = 15).

Partial correlations are correcting for age; EF = Executive Function; MBT = Multiple Boxes Test total errors; NR = Number Recall, Kaufman Assessment Battery for Children (KABC); Statue = NEPSY Statue; VA = NEPSPY Visual Attention, Cats Trial, time to completion; IHP = NEPSY Imitating Hand Positions total; VMP = NEPSY Visuomotor Precision, Car Trial, errors; Omi = ACPT-P omissions; Com = ACPT-P commissions; RT = ACPT-P mean response time for hits; Var = ACPT-P variability; ISCI = Inhibitory Self-Control Index; FI = Flexibility Index; EMI = Emergent Metacognition Index; GEC = Global Executive Composite. For Number Recall, Statue, PPVT-3, and IHP, higher scores indicate better performance. For all other tests, lower scores indicate better performance. All correlations based on raw scores from children with ADHD only (n = 25). All partial correlations listed are ns.