Environmental factors and daily functioning levels among adolescents with executive function deficits

Abstract

Introduction This study examines parents’ perceptions of environmental factors in home, school and community settings on daily functioning of adolescents with executive function deficits. The aim was to map environmental supports and barriers and identify factors that predict functioning. Method Parents of 81 adolescents (10–14 years) completed the Behavior Rating Inventory of Executive Function, Participation and Environment Measure for Children and Youth (PEM-CY) part B and Child Evaluation Checklist (CHECK). We used the BRIEF scores to form a group of adolescents with executive function deficits ( n = 41) and a matched group with typical development ( n = 40). Correlation and discriminate analyses compared environmental factors across groups (PEM-CY) and identified those that predict daily functioning (CHECK). Results Compared to parents of adolescents with typical development, parents of adolescents with executive function deficits reported significantly more environmental barriers than supports (PEM-CY). School and community social demands of activity predicted the adolescents’ current daily functioning (CHECK). Conclusion Cognitive and social demands of activities appear to be common factors that limit functioning of adolescents with executive function deficits in home, school and community environments. The PEM-CY part B can promote awareness of the main support and barrier factors and help focus goals for efficient intervention programmes for these adolescents.

Exploring the Impacts of Environmental Factors on Adolescents’ Daily Participation: A Structural Equation Modelling Approach

“…In a previous study, Fogel and colleagues [ 7 ] highlighted the environmental factors that, according to parents’ reports, best predicted adolescents with EFD. For the school environment, these factors include the activity’s cognitive and social demands and staff and teachers’ attitudes.…”

“…This study refers to a secondary analysis using data from a previously published study, which detailed the participant inclusion and exclusion criteria [ 7 , 13 ]. In the current study, the data refer to all participants as one group with no separation between adolescents with and without EFD profiles.…”

“…Specifically, Maciver et al showed that school routines and structures, objects and spaces and peers and adults are representations of the environment (context). Concerning identified mechanisms, Fogel et al [ 7 ] showed that children with executive function deficits (EFD) faced more barrier factors in the environment than did their peers and found the activities’ social and cognitive demands to be the most challenging.…”

“…The literature indicated that EFs might serve as an underlying mechanism in neurodevelopmental disorders such as attention deficit hyperactive disorder (ADHD), specific learning disorder and developmental coordination disorder. The contribution of EFs to adolescents’ participation [ 7 ], scholastic achievements [ 10 ] and daily functioning has been reported [ 11 ]. The transition from childhood into adolescence often brings a new set of responsibilities and self-regulatory requirements (e.g., in school and social environments) [ 12 ] that necessitate adolescents to rely more on this emerging cognitive control.…”

Special issue: Optimizing children’s participation for health and wellbeing I: Meaning and context

“…Again drawing on information obtained from the PEM-CY, Fogel et al (2020) focus on the specific environmental factors that can influence the participation of adolescents with executive function deficits. The finding that the cognitive demands of activities, social contexts in which they occur, and importantly the attitudes of people with whom these activities are being undertaken alert us to the potential of environmental considerations to serve as both facilitators and barriers to participation.…”