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

Guerra, Amanda; Hazin, Izabel; Siebra, Cibele; Rezende, Marinna; Silvestre, Isadora; Gall, Didier Le; Roy, Arnaud

doi:10.1080/21622965.2020.1775598

Cited by 15 publications

(11 citation statements)

References 52 publications

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“…There are some limitations to our study that should be addressed in future researches. Firstly, the sample size does not allow normative data to be used in clinical settings and does not allow for generalization to the Brazilian context (see Guerra et al, 2020b for a review). In addition, analyses of the structure and organization of the EF can only be conducted as an initial approach.…”

Section: Discussionmentioning

confidence: 99%

“…Brazilian studies have shown differences in EF between children from different geopolitical regions ( Hazin et al, 2016 ), from urban and rural backgrounds ( Santos and Bueno, 2003 ; Santos et al, 2005 ), and even between children living in the same city but with different SES ( Magalhães et al, 2016 ). However, to the best of our knowledge, studies that considered at least the three basic executive components are scarce and no study proposed so far the analysis of the structure and organization of EF in Brazilian children ( Guerra et al, 2020b ). Therefore, the main objective of this study was to investigate the developmental trajectories of the basic components of EF: inhibition, cognitive flexibility (including shifting), WM (including updating); and one more complex component: planning.…”

Section: Introductionmentioning

confidence: 99%

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Developmental Profile of Executive Functioning in School-Age Children From Northeast Brazil

et al. 2021

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The development of executive functions (EF) is recognizably correlated to culture, contextual and social factors. However, studies considering all the basic EF are still scarce in Brazil, most notably in the Northeast region, which is known for its social inequality and economic gap. This study aimed to analyze the developmental trajectories and structure of four EF, namely inhibition, flexibility, working memory and planning. In addition, the potential effects of socioeconomic status (SES) and gender were examined. The sample included 230 Brazilian children between 7-12 years old, homogeneously distributed by age, gender and type of school. The EF were assessed through the Brazilian version of the Child Executive Functions Battery (CEF-B). A global effect of age was found for most of the EF measures evaluated. Gender effect was mostly non-significant, except for 4 of the 12 tasks. There was a significant SES effect on 8 tasks, all in favor of private school children. Exploratory factorial and correlation analysis showed a 4-factor EF structure, corroborating the theoretical distribution considered in the CEF-B. A developmental progression is evident in the results for all of the EF measures evaluated. While gender had little influence on EF, SES seems to significantly impact the development of EF. As normative data are still lacking in Northeast Brazil, this study may help to understand EF development trajectories and provide tools for neuropsychological evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developmental Profile of Executive Functioning in School-Age Children From Northeast Brazil

et al. 2021

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“…A recent systematic review identified 37 executive measures used in Brazil in the pediatric context (Guerra et al 2020a). Despite the great variety of tests found, only 13 are allowed to be used in clinical practice by the Federal Council of Psychology.…”

Section: Assessment Of Ef In Childrenmentioning

confidence: 99%

“…The remaining five correspond to tests created for the assessment of EF in adults that had their sample expanded for the evaluation in children, without considering the dynamic aspects of executive development. Also, researches that considered at least the three basic executive components are scarce and, to date, no specific battery for assessing EF in Brazilian children is available (Guerra et al 2020a).…”

Section: Assessment Of Ef In Childrenmentioning

confidence: 99%

“…This inherent "noise" in executive measures is enhanced in child assessment since the non-executive processes are potentially under development and contribute to age-related variations (Roy et al 2017). These variables highlight the importance of using appropriate and reliable executive measures for children to meet the objectives of neuropsychological assessment and reduce the potential risk of false positives and false negatives in clinical practice (Guerra et al 2020a).…”

Section: Assessment Of Ef In Childrenmentioning

confidence: 99%

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Pieces of evidences of reliability of the Brazilian version of the Child Executive Functions Battery (CEF-B)

Guerra

Hazin

Roulin

et al. 2021

Psicol. Refl. Crít.

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Executive dysfunctions are central symptoms in different neurological, developmental, and context-related conditions. The assessment of these functions is then essential in neuropsychological pediatric clinical practice. Given the need for reliable and valid evaluation batteries for clinical practice in Brazil, this study aimed to present the pieces of evidences of reliability of the Child Executive Functions Battery (CEF-B). A total of 230 Brazilian children with typical development aged between 7 and 12 years participated in the study. Internal consistency was determined by the split-half method, Cronbach’s α, and Ω. In addition, measurements of test-retest reliability and intraclass coefficient were also performed. Retest indicators were mostly weak and moderate (between .43 and .75). Overvall, coefficients show a satisfactory internal consistency reliability for planning and inhibition measures (between .72 and .92). Considering the measures of WM, results were also satisfactory for both α and Ω indexes. This study revealed that the CEF-B has satisfactory internal consistency reliability coefficients. However, several tests have shown low reliability assessed through the test-retest method. In general, findings reveal interesting pieces of initial evidence of reliability of the Brazilian version. The methodological approach could be improved in future studies by including children with executive disorders.

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

Kusi-Mensah

Nuamah²,

Wemakor

et al. 2022

Neuropsychol Rev

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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/).

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

Cited by 15 publications

References 52 publications

Developmental Profile of Executive Functioning in School-Age Children From Northeast Brazil

Developmental Profile of Executive Functioning in School-Age Children From Northeast Brazil

Pieces of evidences of reliability of the Brazilian version of the Child Executive Functions Battery (CEF-B)

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

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