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Behavior Rating Inventory of Executive Function - Parent Questionnaire

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Purpose

The BRIEF is an 86-item measure designed to assesses executive function skills in children 5-18 years completed by a parent.

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Instrument Details

Acronym BRIEF

Area of Assessment

Attention & Working Memory
Cognition
Executive Functioning

Assessment Type

Proxy

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$62.00

Cost Description

BRIEF Parent Questionnaire (Pack of 25), $62; BRIEF Parent Questionnaire Scoring Summary/Profile (Pack of 50), $50.00; BRIEF Manual, $75.00

Diagnosis/Conditions

  • Brain Injury
  • Multiple Sclerosis

Key Descriptions

  • Child’s parent or guardian completes form.
  • Parent must have had recent and extensive contact with the child over the past 6 months to complete form.
  • 8 clinical scales:
    1) Inhibit
    2) Shift
    3) Emotional Control
    4) Initiate
    5) Working Memory
    6) Plan/Organize
    7) Organization of Materials
    8) Monitor
  • Item level scores rated on a 3-point Likert scale from 1-3:
    1) Never
    2) Sometimes
    3) Often
  • Combined subscales also provide 3 index scores:
    1) Global Executive Composite (GEC) is the total score of all 8 clinical subscales
    2) Behavioral Regulation Index (BRI) is a score that includes Inhibit, Shift, Emotional Control)
    3) Metacognition Index (MCI) includes Initiate, Working Memory, Plan/Organize, Organization of Materials, and Monitor
  • Item scores are summed for each clinical scale and index.
  • Using the appropriate gender and age range table, the raw scores are converted to T-scores, percentile and 90% confidence intervals.
  • Versions of the BRIEF include the following:
    1) BRIEF (Parent and Teacher questionnaires for children aged 5-18)
    2) BRIEF Preschool (BRIEF-P completed by either teacher, parent, or day care provider for children aged 2.0 to 5.11 years)
    3) BRIEF-Self-Report (BRIEF-SR, for children aged 11-18 years)

Number of Items

86

Equipment Required

  • Pen or pencil
  • Parent form

Time to Administer

10-15 minutes

Required Training

Reading an Article/Manual

Age Ranges

Preschool Child

2 - 5

years

Child

6 - 12

years

Adolescent

13 - 17

years

Instrument Reviewers

Initial review completed by Louisa Frederick, MOT, OTR/L.

ICF Domain

Body Function

Measurement Domain

Cognition

Considerations

Further studies on the ecological validity of BRIEF in relation to behaviors within the home, classroom and community. Further refinement to increase parent teacher inter rater reliability. Change scores available to evaluate cognitive function of children with unilateral cerebral palsy with mild to moderate cerebral palsy should not be applied to children with more severe diagnosis of cerebral palsy or bilateral cerebral palsy. Further studies with children with ADHD in the presence of other comorbidities may influence generalization.

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Pediatric Disorders

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Standard Error of Measurement (SEM)

Children with Unilateral Cerebral Palsy (Piovesana et al, 2015; n=42; mean age = 11.96 years; 20 weeks ±2  between testing Time 1 and Time 2)

 

BRIEF Measures

Scale

SEM

Inhibit

7.68

Shift

6.89

Emotional Control

6.77

Initiate

6.63

Working Memory

5.08

Plan/Organize

4.4

Organization of Materials

3.68

Monitor

4.31

Behavioral Regulation Index(BRI)

6.14

Metacognition Index(MCI)

5.13

Global Executive Composite (GEC)

4.15

Minimal Detectable Change (MDC)

Children with Unilateral Cerebral Palsy (calculated from statistics in Piovesana et al, 2015)

BRIEF Measures

Scale

MDC

Inhibit

17.92

Shift

16.08

Emotional Control

15.08

Initiate

15.47

Working Memory

11.85

Plan/Organize

10.27

Organization of Materials

8.59

Monitor

10.06

Behavioral Regulation Index(BRI)

14.33

Metacognition Index(MCI)

11.97

Global Executive Composite (GEC)

9.68

Cut-Off Scores

Children aged 5-18 Years (Gioia et al, 2000; n=1419; mean age = 10.70(3.35) years; boys and girls)

  • A T-score of 65 or higher is interpreted as an abnormally elevated score for each of the scales and the three index measures.

Test/Retest Reliability

Children aged 5-18 years  (Huizinga and  Smidts 2011, n=847; Dutch version)

 

Scale or Index

ICC

Inhibit

Excellent

.94

Shift

Excellent

.89

Emotional Control

Excellent

.90

Initiate

Excellent

.81

Working Memory

Adequate

.73

Plan/Organize

Excellent

.82

Organization of Materials

Excellent

.91

Monitor

Adequate

.75

Behavioral Regulation Index(BRI)

Excellent

.95

Metacognition Index(MCI)

Excellent

.84

Global Executive Composite (GEC)

Excellent

.86

Internal Consistency

Children Aged 5-18:

  • Excellent (Cronbach’s alphas = .80-.98)(Gioia, et al, 2000)

  • Adequate to Excellent  (Cronbach’s alphas = .76-.96) (Huizinga and Smidts)

Criterion Validity (Predictive/Concurrent)

Concurrent Validity:

ADHD and/or Tourette Syndrome (Mahone et al, 2002; n=76 (ADHD=18, mean age 11.20(2.5) years; Tourette Syndrome=21, mean age =10.00(1.80) years; Tourette Syndrome and ADHD=17, mean age 10.80(2.7)years, controls (n=20, mean age=10.60(3.60) years)

  • Excellent concurrent validity  between BRIEF WM with Child Behavior Checklist, Diagnostic Interview for Children and Adolescents (DICA) & ADHD rating scale (r=.82, .75 & .87 respectively) and BRIEF MCI on same measures with correlations at .81, .74 and .85 respectively/

Predictive validity:

ADHD:  (McCandless & O’Laughlin, 2007; n=70, mean age=8.24(1.85) years referred for ADHD assessment)

  • Excellent: Behavior Regulation differentiates ADHD-Combined Type from non ADHD r=.8

ADHD: (Reddy et al, 2011; n=58, mean age= 12.02(2.32months) years

  • Excellent correlation with BRI r=.77 classified 79% of children with ADHD versus control group

Construct Validity

Convergent Validity:

ADHD:  (Gioia et al, 2000, n=100, mean age=8.73(3.54)years)

  • Excellent correlations of the BRIEF BRI with the ADHD Rating Scale IV Inattention Index and Hyperactivity Index (r=.67, .70 respectively).

  • Excellent correlations of the BRIEF GEC with the ADHD Rating Scale’s Inattention and Hyperactivity Indexes at 0.63 & 0.60 respectively

  • Adequate correlations of the BRIEF Initiate scale to Child Behavior Checklist Scales (CBCL) with Withdrawn, Anxious/Depressed and Attention Problems(r=.50,r=.52 , r=0.5 respectively)

ADHD:  (McCandless & O’Laughlin, 2007; n=70, mean age=8.24(1.85) years referred for ADHD assessment)

  • Excellent correlations of the BRIEF BRI with the ADHD Rating Scale IV Inattention Index and Hyperactivity Index (r=.67, .70 respectively).

Content Validity

  • Items were selected from clinical interviews of parents, teachers, and agreement from an expert panel of 12 pediatric neuropsychologists was also used.

  • Items refined via item-total correlations and interrater agreement (Gioia et al, 2000)

Face Validity

  • Items were selected from clinical interviews of parents, teachers, and agreement from an expert panel of 12 pediatric neuropsychologists was also used.

  • Items refined via item-total correlations and interrater agreement (Gioia et al, 2000)

Bibliography

Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. Behaviour Rating Inventory of Executive Function. Odessa, FL: Psychological Assessment Resources; 2000.

Gioia G, Isquith P, Retzlaff P, Espy K. Confirmatory factor analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in a clinical sample. Child Neuropsychology [serial online]. December 2002;8(4):249-257

Huizinga M, Smidts D. Age-Related Changes in Executive Function: A Normative Study with the Dutch Version of the Behavior Rating Inventory of Executive Function (BRIEF). Child Neuropsychology [serial online]. January 2011;17(1):51-66

Mahone EM, Cirino PT, Cutting LE, Cerrone PM, Hagelthorn KM, Hiemenz, J.R., et al. Validity of the behavior rating inventory of executive function in children with ADHD and/or Tourette syndrome. Arch Clin Neuropsychol. 2002; 17 (7):643–62.

McCandless S, O’ Laughlin L. The Clinical Utility of the Behavior Rating Inventory of Executive Function (BRIEF) in the Diagnosis of ADHD. Journal of Attention Disorders. 2007; 10(4):381-389. doi: 10.1177/1087054706292115.

Piovesana, A. M., Ross, S., Whittingham, K., Ware, R. S., & Boyd, R. N. (2015). Stability of Executive Functioning Measures in 8–17-Year-Old Children With Unilateral Cerebral Palsy. The Clinical Neuropsychologist, 29(1), 133-149.

Rasmussen, Carmen, Rosalyn McAuley, and Gail Andrew. "Parental ratings of children with fetal alcohol spectrum disorder on the behavior rating inventory of executive function (BRIEF)." J FAS Int 5.e2 (2007): 1-8.

Reddy LA, Hale JB, Brodzinsky LK. Discriminant validity of the Behavior Rating Inventory of Executive Function Parent Form for children with attention-deficit/hyperactivity disorder. School Psychology Quarterly. 2011; 26(1):45-55. doi: 10.1037/a0022585.

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