Stability of Executive Functioning Measures in 8–17-Year-Old Children With Unilateral Cerebral Palsy

Abstract

The study investigated the stability of executive functioning (EF) measures in children and adolescents aged 8–17 years with unilateral cerebral palsy (CP). Here 44 participants with unilateral CP (mean age = 11 years, 11 months; Manual Abilities Classification Scale Level I = 6 and Level II = 37; Gross Motor Function Classification Scale Level I = 22 and Level II = 22) were randomized into the wait-list control group of a large randomized controlled trial. Participants had baseline testing with Wechsler Intelligence Scale for Children – Fourth Edition Short Form (WISC-IV-SF) and Delis-Kaplan Executive Function System (D-KEFS) subtests. Parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF). Participants were re-assessed 20 ±2 weeks later with a shortened test battery including the D-KEFS subtests; Digit Span, Coding and Symbol Search (WISC-IV); and BRIEF. Pearson’s test–retest reliabilities and Reliable change scores were calculated. Results indicated excellent to fair test–retest reliabilities (r = 0.91–0.74) for all measures except Digit Span Backwards (r = 0.62), Inhibition (r = 0.69), and Initiate (r = 0.68). Reliable change scores applying 90% confidence intervals for estimating reliable change while accounting for practice effects were provided for all measures. The data support the stability of EF measures in this population.

Keywords:

• Cerebral palsy
• Executive functioning
• Test–retest reliability
• Children
• Adolescents.

Acknowledgments

The authors would like to thank the children and their families who participated in this study. Gratitude also extends to Anton Hinton-Bayre for his statistical support and guidance and for providing the Reliable Change Calculator used for analyses. This research was supported by the Financial Markets Foundation for Children Grant (2011–2010); Queensland Government – Department of Science, Information Technology, Innovation and the Arts Co-investment Fund; Perpetual Foundation – The Aldred Charitable Endowment, Margaret Augusta Farrell, Williams H P Trust Fund, Love J S, and The Jessica and Wallace Hore Foundation (FR2012/0796); Queensland Government – Health Practitioner Research Scheme; and the National Health and Medical Research Council Career Development Fellowship (473840, 1037220).