Executive Functioning (EF) refers collectively to a number of distinct, yet interrelated

higher order cognitive processes that enable self-control and flexible, goal-directed
behavior. Individual components typically incorporated under the umbrella of EF term
include response inhibition, woring memory, emotional and motivational self-
regulation, planning and problem solving, attentional control, and cognitive flexibility
(!ndersen, "##"$ %e&a, 'owieson, ( %oring, "##)). !daptive nature and engagement in
novel problem solving has been identified as a distinctive characteristic of EF processes
(%e&a et al, "##)).
*eficits in EF have been commonly reported in many developmental disorders, such as
oppositional-defiant disorder (+attis, ,anderschuren, ( -chutter, "#./), autism spectrum
disorders (0han et al, "##1$ 2obinson, 3oddard, *ritschel, 4isley ( 'owlin, "##1), and
dyslexia (2eiter, 5ucha, ( %ange, "##6) to name a few. !ttention deficit and
hyperactivity disorder (!*'*) in particular has been conceptuali&ed as primarily a
disorder of EF (7arley, .118).
!ttention *eficit 'yperactivity *isorder (!*'*) has been recogni&ed as the
most prevalent neurobehavioral disorder of a childhood (!merican !cademy of
9ediatrics, "###). It is estimated that /-8: of children are affected by !*'* (!merican
9sychiatric !ssociation, "###), although more recent studies report slightly higher
prevalence rate of ;.8: (Froehlich et el, "##8$ +ericangas et al, "#.#a$ +ericangas et al,
"#.#b). *eficits in EF have been well documented in children with !*'* (7erlin,
7ohlin, <yberg, ( =anols, "##)$ 9ennington and >&onoff, .11?) along with
abnormalities in associated neural substrate (0astellanos et al, "##"$ ,alera, Faraone,
+urray ( -eidman, "##8).
0opious evidence suggests that !*'* is associated with adverse outcomes in the areas
of academic achievement (Fra&ier, @oungstrom, 3lutting ( 4atins, "##8), social
functioning (-olantro, 9ope-7oyd, 5ryon ( -tepa, "##1) and adaptive sills, (-tein,
-&umowsi, 7londis ( 2oi&en, .116), with difficulties extending into adulthood
(7arley, Fischer, -mallish ( Fletcher, "##?). 9oor outcome have been lined directly to
the deficits in EF (7iederman et al., "##)). 0onsidering the significance of EF to various
forms of developmental psychopathology and various dimensions of adaptive
functioning, efficient EF assessment methods are needed in clinical practice.
5raditional performance-based approach to the assessment of EF has been
increasingly scrutini&ed (=urado ( 2osseli, "##8$ 7arley, "#." pp../-.8$ 7rown, "##?).
!lternatively the use of behavior rating scales has been proposed as a more ecologically
valid approach to the assessment of EF (IsAuith, 2oth ( 3ioia, "#./), with adeAuate
diagnostic sensitivity (2eddy, 'ale and 7rod&insy, "#..) and better association with
functional outcomes (7arley ( +urphy, "#..$ +cauley, 0hen, 3oos, -chachar (
0rosby, "#..).
4hile rating scales are deemed valuable contributors to the assessment of EF
deficits (IsAuith et al, "#./), relatively few such instruments are available. 2ecently a
new behavior rating scale, 7arley *eficits of Executive Functioning B 0hildren and
!dolescent (7*EF--0!) has been published. 5his instrument is intended for clinical use
in identification of individuals experiencing significant deficits in EF (7arley, "#.").
5he content of the scale was theoretically derived to reflect the model of EF put forth by
7arley. !ccording to this model inhibition constitutes a primary component of EF,
which adeAuate functioning in turn secures an optimal settings for an execution of
secondary EF, namely verbal woring memory, non-verbal woring memory, self-
regulation, and reconstitution (planning and problem solving) (7arley .118). Factor
analysis of the data obtained from 7*EF--0! normative sample confirmed five factor
structure of the scale (7arley, "#."). !lthough initial reliability and validity data,
obtained from the normative sample, is promising (7arley, "#."), to the best nowledge
of this author additional empirical evaluations of the nature and utility of 7*EF--0! are
currently not available. 5his study is suggested in order to further explore validity
characteristics of 7*IEF--0! beyond the data available from normative sample.
-pecifically, this study aims (.) to explore if five factor structure of the scale could be
replicated in independent sample$ (") to explore the sensitivity and specificity of the
7*EF--0! with children with nown !*'* diagnosis in comparison to control group
and (/) to examine concurrent validity of 7*EF--0! by comparing it to 0onners /9
rating scale (0onners, "##;).
Methods
!rchival data, collected for a larger study, will be used for this study. >riginal study has
been approved by Cniversity of 4indsor 2esearch Ethics 7oard.
Participants
9articipants included 1; children (?1 male, "1 female) ranging in age from ; to .6 years
old. 0hildren were recruited from community through various meansD referral from
psychiatrist, university participant pool, summer camps, paid advertisement, and word of
the mouth. 0hildren were included in !*'* group (nE)1) based on the parental report
of prior !*'* diagnosis. In the ADHD group there were 10 children diagnosed with
ADHD-Inattentive type, 5 diagnosed with ADHD-Hyperactive/Impulsive type, and 10
diagnosed with ADHD-Combined type. Twenty-four parents were not aware of the
subtype. 9articipants without prior !*'* diagnosis were included in the control group
(nE)1).
Procedures
5o address the first Auestion of this study, exploratory factor analysis with orthogonal
rotation will be conducted using the data from the total sample. 5o explore discriminant
validity of 7*EF--0!, !*'* and control groups will be used for comparison. 2eceiver
>perant 0haracteristic (2>0) analysis will be used to evaluate specificity and sensitivity
of 7*EF--0! !*'* index score in discriminating children with and without !*'*
diagnosis. Finally, correlation analysis will be used to explore correspondence between
selected 7*EF--0! scales and 0onnerFs -/ scales.
Measures
BDEFS-CA (2012) is the parent-report behavior rating scale purported to reflect
components of executive functioning in daily life activities. The measure is intended for
children aged 6-17. Parents are asked to rate behavioral statement on a four point scale: 1
= Never or rarely; 2 = Sometimes; 3 = Often; 4 = Very Often. Items produce five
subscale scores that correspond to five dimensions of EF as presented in Barkleys
model: Self-Management to Time, Self-Organization/Problem Solving, Self-Restraint,
Self-Motivation, and Self-Regulation of Emotion. Subscales combine to form Total EF
summary score. Additionally, ADHD-EF Index is available as a summary of ten items
that are more frequently elevated in children with ADHD. Suggested interpretation is that
the scores falling between the 76
th
and 84
th
percentile are described as marginally
clinically significant; those between the 85
th
and 92
nd
percentile are described as
borderline or somewhat deficient; those between the 93
rd
and 95
th
percentiles would be
mildly deficient; those between the 96
th
and 98
th
percentiles are considered moderately
deficient; those at the 99
th
percentile are considered markedly deficient or severe. BDEFS-
CA has been standardized on the representative normative sample of 1800 children.
Reported internal reliability coefficients were .987 for Total EF summary score, and in .
904 to .972 range for subscales. Significant validity evidence is also provided in the
manual (Barkley, 2012).
5he 4I-0-I, ("##/) is the measure of cognitive ability for children between the ages ?-
.?. It contains .# core and 6 supplemental subtests, with core subtests forming four Index
scoresD ,erbal 0omprehension, 9erceptual 2easoning, 4oring +emory, and 9rocessing
-peed. 4I-0-I, was standardi&ed on representative sample of ""## children. 5his
measure is well researched, has strong psychometric properties, with reliability
coefficients range .;;-.18 for Index scores, and .8#-.1# for subtest scores$ further validity
evidence is substantial (-attler, "##.).
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