Childhood Executive Functioning Inventory: Adaptação e Propriedades Psicométricas da Versão Brasileira

A psychometric study of an executive function assessment instrument (TDI-FE)

BACKGROUND

This study aims to present and discuss the psychometric properties of executive functions, which were measured using the TDI-FE instrument. The analysis encompasses its internal structure, potential sensitivity to fatigue factors, relationships with external criteria, and diagnostic accuracy.

METHODS

The study sample comprised 382 students from Brazil, aged 6-8 years. Child development variables were screened using the TDI-FE and gold standard tests (Cancellation Attention and Trail Making Tests). The proposed scale comprised four activities: a test with fruit images with three tasks, and one memory game.

RESULTS

The one-factor model of EF of the TDI-FE failed to fit to the data. However, fit substantially improved once a latent fatigue factor was controlled in the model. The latent factor of EF assessed by the TDI-FE tasks was coherently associated with a series of external variables, including two popular collateral measures of EF. The diagnostic accuracy was reasonable, and a cut-off of 37 points produced 70% of sensitivity and 60% of specificity.

CONCLUSION

Results indicated that the TDI-FE demonstrated sound psychometric properties and diagnostic accuracy, then consisting of an efficient alternative for the assessment of EFs in early childhood education. The study also proved the need to control for response biases such as fatigue in the latent variable models of EF. The TDI-FE is notable because of its low cost and easy application, and it might fulfill a need for instruments for individuals from different contexts at this stage of development in Brazil.

A Systematic Review of the Validity and Realiability of Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology among Children and Adolescents in Low- and Middle-Income Countries

Minimal but increasing number of assessment instruments for Executive functions (EFs) and adaptive functioning (AF) have either been developed for or adapted and validated for use among children in low and middle income countries (LAMICs). However, the suitability of these tools for this context is unclear. A systematic review of such instruments was thus undertaken. The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist (Liberati et al., in BMJ (Clinical Research Ed.), 339, 2009). A search was made for primary research papers reporting psychometric properties for development or adaptation of either EF or AF tools among children in LAMICs, with no date or language restrictions. 14 bibliographic databases were searched, including grey literature. Risk of bias assessment was done following the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) guidelines (Mokkink et al., in Quality of Life Research,63, 32, 2014). For EF, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) were the most rigorously validated. For AFs, the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition) were most validated. Most of these tools showed adequate internal consistency and structural validity. However, none of these tools showed acceptable quality of evidence for sufficient psychometric properties across all the measured domains, particularly so for content validity and cross-cultural validity in LAMICs. There is a great need for adequate adaptation of the most popular EF and AF instruments, or alternatively the development of purpose-made instruments for assessing children in LAMICs.

Systematic Review Registration numbers: CRD42020202190 (EF tools systematic review) and CRD42020203968 (AF tools systematic review) registered on PROSPERO website (https://www.crd.york.ac.uk/prospero/).

Psychometric properties of the childhood executive functioning inventory (CHEXI): A confirmatory factor analysis and measurement invariance by sex and age in Iranian children

This study aimed to examine the psychometric properties, factor structure, and measurement invariance of the Persian version of the Childhood Executive functioning Inventory (CHEXI). Participants were 1076 typically developing children, 6- to 12-years old (M _age=  9.2 years, SD _age=  1.96); females (52.1%) recruited from 17 provinces and 30 children with attention-deficit/ hyperactivity disorder (ADHD) (females, % 36) and 30 children with specific learning disability (SLD) (females, % 40). Children's parents completed CHEXI and the Barkley Deficits in Executive Functioning Scale-Children and Adolescents (BDEFS-CA). Confirmatory factor analysis (CFA) supported the two-factor structure, including (1) working memory and (2) inhibition, which had been identified previously. The Results showed that the CHEXI had high internal consistency and adequate test-retest reliability. The CHEXI was found to be invariant by sex (female vs. male) and age (7 age groups) across all factors. Lastly, the CHEXI demonstrated adequate convergent validity with the BDEFS-CA and known-group validity. We highlighted the implications of these findings for using CHEXI in typically developing children and clinical samples, along with directions for future research.

Psychometric properties and clinical utility of the executive function inventory for children and adolescents: a large multistage populational study including children with ADHD

Executive functions (EF) are a set of high order mental abilities that regulate cognition, emotions, and behavior. This study aims to report the construction and validation of a rating scale instrument for EF in children and adolescents aged from 5 to 18 years (EFICA), as well as to report the results of a comparison between children with ADHD and their peers without it. Thus, we conducted a population-based cross-sectional study relying on a sample composed of 3,284 typical children and adolescents accessed to study the psychometric properties of the parents' inventory (EFICA-P) and the teacher's inventory (EFICA-T) within a Structural Equation Modeling framework (SEM). Exploratory and confirmatory analyses were fitted, as well as the Cronbach's alpha and the McDonald's omega reliability indices. The known-groups method was carried out by independent Welch t-tests between untreated ADHD children and their peers. We concluded that the parents' inventory is composed of three dimensions (Cool Index 1, Cool Index 2, and Hot Index): χ² (1,649) = 4,607.852 p < .01, CFI = .965, TLI .963, RMSEA = .053, whereas the teachers´ inventory is composed of two dimensions (Cool Index and Hot Index): χ² (1,273) = 5,158.240, p < .01, CFI = .991, TLI = .991, RMSEA = .077. The internal consistency of both inventories was >.9. Significant differences between the ADHD groups were found in all domains accessed. These findings indicate that both inventories have a high degree of validity regarding their internal structures, as well as supporting their clinical utility.

Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology Among Children in Developing Country Contexts: a Scoping Review of Current Tools

Several tools have been developed to assess executive function (EFs) and adaptive functioning, although in mainly Western populations. Information on tools for low-and-middle-income country children is scanty. A scoping review of such instruments was therefore undertaken.

We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis- Scoping Review extension (PRISMA-ScR) checklist (Tricco et al., in Annals of Internal Medicine 169(7), 467–473, 2018). A search was made for primary research papers of all study designs that focused on development or adaptation of EF or adaptive function tools in low-and-middle-income countries, published between 1^st January 1894 to 15^th September 2020. 14 bibliographic databases were searched, including several non-English databases and the data were independently charted by at least 2 reviewers.

The search strategy identified 5675 eligible abstracts, which was pruned down to 570 full text articles. These full-text articles were then manually screened for eligibility with 51 being eligible. 41 unique tools coming in 49 versions were reviewed. Of these, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) had the most validations undertaken for EF tests. For adaptive functions, the tools with the most validation studies were the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition).

There is a fair assortment of tests available that have either been developed or adapted for use among children in developing countries but with limited range of validation studies. However, their psychometric adequacy for this population was beyond the scope of this paper.

Assessing executive functions in Brazilian children: A critical review of available tools

The goal of this review is to perform a critical analysis of the instruments used to assess executive functions (EFs) in preschool and school-age children in Brazil. We identified 37 assessment measures through a systematic review. Some performance-based tests for assessing working memory and inhibition were identified. However, there is a lack of rating measures and instruments to assess flexibility and planning in clinical practice. We observed regional differences in the performance of EFs measures. One possible explanation may be the use of normative samples from more highly-developed regions to characterize performance in less-developed regions. However, there may be alternative explanations, such as variations in the exposure to testing and the adequacy of test materials in different regions. Joint efforts among research groups should be encouraged in order to obtain normative references that are more representative of the socio-cultural diversity of the country. This improvement is essential to better understand the typical and atypical development of EFs and how the peculiarities of each country's context and culture can impact its trajectory.

Assessment of Sensory Processing and Executive Functions in Childhood: Development, Reliability, and Validity of the EPYFEI

The aim of this study was to determine the psychometric properties of the "Assessment of Sensory Processing and Executive Functions in Childhood" (EPYFEI), a questionnaire designed to assess the sensory processing and executive functions of children aged between 3 and 11 years. The EPYFEI was completed by a sample of 1,732 parents of children aged between 3 and 11 years who lived in Spain. An exploratory factor analysis was conducted and showed five main factors: (1) executive attention, working memory, and initiation of actions; (2) general sensory processing; (3) emotional and behavioral self-regulation; (4) supervision, correction of actions, and problem solving; and (5) inhibitory. The reliability of the analysis was high both for the whole questionnaire and for the factors it is composed of. Results provide evidence of the potential usefulness of the EPYFEI in clinical contexts for the early detection of neurodevelopmental disorders, in which there may be a deficit of executive functions and sensory processing.