Parent ratings of executive function in young preschool children with symptoms of attention-deficit/-hyperactivity disorder

Abstract

BackgroundRecent research has demonstrated that deficits in basic, self-regulatory processes, or executive function (EF), may be related to symptoms of attention-deficit/hyperactivity disorder (ADHD) already during the preschool period. As the majority of studies investigating these relations in young children have been based primarily on clinically administered tests, it is not clear how early symptoms of ADHD may be related to observations of EF in an everyday context. The preschool version of the Behavior Rating Inventory of Executive Function (BRIEF-P) was developed to provide information about EF through observable, behavioral manifestations of self-regulation, and is the most commonly used rating scale for EF assessment in children.MethodsRelations between symptoms of ADHD reported in the Preschool Age Psychiatric Assessment interview (PAPA), and EF as measured by the BRIEF-P (parent form), were investigated in a large, nonreferred sample of preschool children (37–47 months, n = 1134) recruited from the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The inventory’s discriminative ability was examined in a subsample consisting of children who met the diagnostic criteria for either ADHD, oppositional defiant disorder (ODD) or anxiety disorder, and typically developing controls (n = 308). The four groups were also compared with regard to patterns of EF difficulties reported in the BRIEF-P.ResultsOf the five BRIEF-P subscales, Inhibit and Working Memory were the two most closely related to ADHD symptoms, together explaining 38.5% of the variance in PAPA symptom ratings. Based on their scores on the Inhibit and Working Memory subscales (combined), 86.4% of the children in the ADHD and TD groups were correctly classified. ADHD symptoms were associated with more severe difficulties across EF domains, and a different EF profile in comparison to children with other symptoms (anxiety, ODD) and to typically developing controls.ConclusionsEarly symptoms of ADHD were linked to parent-reported difficulties primarily within inhibition and working memory, suggesting that deficiencies within these two EF domains characterize early forms of ADHD. Our findings support the clinical utility of the BRIEF-P as a measure of EF in young preschool children with symptoms of ADHD.

White Matter Microstructural Alterations in Children with ADHD: Categorical and Dimensional Perspectives

“…Combining parent ratings (BRIEF) and indices of cognitive performances on standardized tests can quantify cognitive functions in different environments (everyday vs in-lab), which has been revealed to aid in the identification of children with attention problems (Dewey et al, 2003). Besides, there is ample evidence that the BRIEF measures a concept of inhibition that is relevant to ADHD (Ezpeleta and Granero, 2015;Skogan et al, 2015). Details about all assessments are listed in Supplementary Methods Supplementary Table S1.…”

Attention-deficit/hyperactivity disorder: the impact of methylphenidate on working memory, inhibition capacity and mental flexibility

“…These abilities enable a human being to perceive stimuli in their environment, 1 respond dequately, change direction in a flexible ay, anticipate future objectives, consider the consequences and respond in an integrated way, using all these abilities to reach a final objective 3,4,5,6,7 . Attention-deficit/hyperactivity disorder can be considered a neurobiological condition that presents with changes in some brain areas and their associated circuits, mainly the prefrontal and parietal cortex, cerebellum, and basal ganglia, which may imply problems in EF, such as working memory (WM), inhibition capacity (IC) and mental flexibility (MF) 7,8 .…”

Parent-Teacher Concordance in Rating Preschooler Difficulties in Behavioural and Cognitive Functioning and Their Dyadic Predicting of Fluid Intelligence

“…Some researchers assess children's EF skills using experimental tests (e.g., Ardila, Pineda, & Rosselli, 2000;Arffa, 2007;Arffa, Lovell, Podell, & Goldberg, 1998;Friedman et al, 2006); however, such approach has been criticized as being too narrow and failing to accurately capture children's "real-surroundings" functioning (Bodnar, Prahme, Cutting, Denckla, & Mahone, 2007). Recently, increased number of researchers applied BRIEF-P questionnaire (Gioia et al, 2003) as a measure of EFs among preschoolers in the context of everyday environments together with experimental tests of working memory and other executive functions (Holmes et al, 2014;Mahone & Hoffman, 2007;Skogan et al, 2015).…”

“…CEC BEH [S] is used for the early identification and group screening of ADHD, and for the research studies of issues in behavioural, social, and emotional areas (Conners, 2009), whereas BRIEF-P is used to assess children's everyday functioning in home and preschool settings and through that assess cognitive processes and executive functions (Gioia, Espy, Isquith, 2003;Isquith, Gioia & Espy, 2004;Sherman & Brooks, 2010). Behavioural rating scales (both BRIEF and Conners' rating scales) are common instruments used in evaluations of ADHD and executive dysfunctions (Rohrer-Baumgartner et al, 2014;Deb et al, 2008;Holmes et al, 2014;Naglieri, Goldstein, Delauder, & Schwebach, 2005;Skogan et al, 2015, Sullivan & Riccio, 2007.…”