Self- and informant-reported executive function in young adults operated for atrial or ventricular septal defects in childhood

Background: Adults with simple congenital heart defects (CHD) have increased risk of neurodevelopmental challenges including executive dysfunction. It is unknown if the executive dysfunction is universal or if it is driven by dysfunction in specific clinical subscales and how it might affect psychosocial aspects of everyday life. Methods: The self-reported and informant-reported executive function of adults with an average age of 26 ± 5 (range 18–41) who underwent childhood surgery for atrial septal defects (n = 34) or ventricular septal defects (n = 32) and matched controls (n = 40) were evaluated using the Behavior Rating Inventory of Executive Functions - Adult version (BRIEF-A). Results: The CHD group reported having more executive dysfunction than controls in all BRIEF-A clinical subscales (p < 0.020) and more than their informants reported on their behalf (p < 0.006). The CHD group had received three times more special teaching (44% compared to 16%) and pedagogical psychological counselling (14% compared to none) and had a three times higher occurrence of psychiatric disorders than controls (33% compared to 11%). Lower educational levels and psychiatric disorders were associated with higher BRIEF-A scores (p < 0.03). Conclusions: Adults operated for septal defects in childhood report more challenges with all aspects of the executive functions than controls and more than relatives are aware of.

Functional connectivity based brain signatures of behavioral regulation in children with ADHD, DCD, and ADHD-DCD

Behavioral regulation problems have been associated with daily-life and mental health challenges in children with neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD). Here, we investigated transdiagnostic brain signatures associated with behavioral regulation. Resting-state fMRI data were collected from 115 children (31 typically developing (TD), 35 ADHD, 21 DCD, 28 ADHD-DCD) aged 7–17 years. Behavioral regulation was measured using the Behavior Rating Inventory of Executive Function and was found to differ between children with ADHD (i.e., children with ADHD and ADHD-DCD) and without ADHD (i.e., TD children and children with DCD). Functional connectivity (FC) maps were computed for 10 regions of interest and FC maps were tested for correlations with behavioral regulation scores. Across the entire sample, greater behavioral regulation problems were associated with stronger negative FC within prefrontal pathways and visual reward pathways, as well as with weaker positive FC in frontostriatal reward pathways. These findings significantly increase our knowledge on FC in children with and without ADHD and highlight the potential of FC as brain-based signatures of behavioral regulation across children with differing neurodevelopmental conditions.

The Impact of Household Chaos and Dietary Intake on Executive Function in Young Children

Children’s executive functions (EFs) emerge over time and can be shaped by household environments and dietary intake. However, there is a lack of knowledge about how these factors influence EFs in children aged 18–24 months. This study tested a model exploring the relations between parent-reported dietary intake, household chaos, and child EF. The sample consisted of 294 families participating in the STRONG Kids2 birth cohort study of nutrition and child health. Caregivers completed the Food Frequency Questionnaire (FFQ), the Confusion, Hubbub, and Order Scale (CHAOS), and the Behavior Rating Inventory of Executive Function®-Preschool Version (BRIEF-P) to assess model variables. Regression analyses revealed a significant and independent association between assorted snacks and processed foods and two EF subscales. There were also significant associations between household chaos and each EF subscale. There was no significant moderation effect. These findings suggest that family households characterized by dysregulation are associated with children’s EF difficulties during early childhood and that the role of unhealthy dietary intake in child EF should be explored further. Future longitudinal studies that include multi-method approaches are needed to document the mechanisms through which household chaos impacts child EF over time.

Development, Validity and Reliability of the Preschool Learning Skills Scale: A Tool for Early Identification of Preschooler at Risk of Learning Disorder in Mainland China (Preprint)

BACKGROUND Early identification of children at risk of learning disorder (LD) may mitigate the negative effects of delayed intervention by guiding children to receive preventive services at an earlier age. However, there is no assessment tool for early identification of children at risk of LD in Mainland China. OBJECTIVE This study aimed to create a Chinese version of the Preschool Learning Skills Scale and to investigate its validity and reliability. METHODS Firstly, a pilot scale was designed based on literature review and expert review. Secondly, a pre-survey of the pilot scale was conducted. In phase 3, a formal survey was carried out to test the reliability and validity of the scale by involving 2678 preschool children from 7 kindergartens into it. Data was collected using a checklist for demographic characteristics, the preschool learning skills scale(PLSS), the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P), and Conners’ Rating Scales. RESULTS The final scale included 38 items under 7 factors. The reliability tests confirmed that the Cronbach’s alpha, split-half reliability, and test-retest reliability coefficient of the PLSS was 0.946, 0.905 and 0.941. As to construct validity, the Spearman correlations of factor-total score ranged from 0.691 to 0.859. The results of criterion-related validity showed a direct and significant association between the PLSS with the Behavior Rating Inventory of Executive Function-Preschool Version (r = 0.643, P< 0.001) and Conners’ Rating Scales (r = 0.652, P< 0.001). The model had a good fit [CFI = 0.910, TLI = 0.901, RMSEA = 0.047, and SRMR = 0.038]. CONCLUSIONS Findings demonstrate that the PLSS has a good internal validity, good test–retest reliability, and acceptable construct validity, which indicates that the scale can be used for early identification of preschool children at risk of LD.

Univariate and Multivariate Base Rates of Score Elevations, Reliable Change, and Inter-Rater Discrepancies in the BRIEF-A Standardization Samples

The Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A) is a standardized rating scale of subjective executive functioning. We provide univariate and multivariate base rates (BRs) for scale/index scores in the clinical range ( T scores ≥65), reliable change, and inter-rater information not included in the Professional Manual. Participants were adults (ages = 18–90 years) from the BRIEF-A self-report ( N = 1,050) and informant report ( N = 1,200) standardization samples, as well as test–retest ( n = 50 for self, n = 44 for informant) and inter-rater ( n = 180) samples. Univariate BRs of elevated T scores were low (self-report = 3.3%–15.4%, informant report = 4.5%–16.3%). Multivariate BRs revealed the common occurrence of obtaining at least one elevated T-score across scales (self-report = 26.5%–37.3%, informant report = 22.7%–30.3%), whereas virtually none had elevated scores on all scales. Test–retest scores were highly correlated (self = .82–.94; informant = .91–.96). Inter-rater correlations ranged from .44 to .68. Significant ( p < .05) test–retest T-score differences ranged from 7 to 12 for self-report, from 6 to 8 for informant report, and from 16 to 21 points for inter-rater T-score differences. Applications of these findings are discussed.

1232Relationship between leucine metabolism and executive function development: the GUSTO cohort

Background Molecular biomarkers for cognitive function have also been widely investigated. However, few investigated early development of executive function (EF) comprehensively, which is a higher-level of cognitive function responsible for coordinating other cognitive ability. Methods We investigated the metabolomic biomarkers for EF in a multi-ethnicity birth cohort in Singapore. Circulating level of 165 metabolites were quantified using a nuclear magnetic resonance (NMR)-based metabolomics platform in 457 and 524 children at age 6 and 8 years. EF was assessed in 495 children (∼7 years) using parent-reported Behavior Rating Inventory of Executive Function, Second Edition. We incorporated genetic data and performed mediation analysis to investigate the role of rs1260326 (GCKR) in the relationship between leucine metabolism and EF. Results Higher circulating level of leucine was consistently associated with poorer EFs (Initiate, Working Memory, Plan/Organize, Task-Monitor, and Organization of Materials) after adjusting for age, sex, maternal ethnicity, maternal educational level, household income at recruitment, and child body-mass index (BMI). Comparing to CT genotype, CC genotype in rs1260326 is potentially associated with poorer EFs. But these associations were not mediated via circulating leucine level or BMI. Higher circulating leucine exerts effect on EFs and part of the effect may be via impact on BMI. Leucine-BMI interaction may exist in CT subgroup. Conclusions Our analysis suggested that leucine exerts harmful effect on EF, but at a lower level, leucine-BMI interaction may counteract with the effect of leucine. Key messages Higher level of circulating leucine was associated with poorer EF. Leucine-BMI interaction influences the leucine-EF association.

Establishing a nexus between executive functions and management efficacy of academic leaders

Executive functions enable an individual to initiate and stop actions, track and modify behavior, and plan imminent behavior when faced with specific tasks and circumstances. This study, therefore, identified a connection between the executive functions and management efficacy of academic leaders of a State University in the Philippines. The Behavior Rating Inventory of Executive Function-Adult Version was used in a correlation analysis to gauge the executive functions of academic leaders and a researcher-made questionnaire was administered to determine their management efficacy. The study was conducted using t-scores, means, and Pearson r. The stronger the potential of academic leaders to carry out their management skills, the more their emotional regulation leans towards the borderline. As academic leaders' management skills become remarkable, the more they are predisposed to functioning on their own initiative and can control their actions in the light of the circumstances. Further, when academic leaders normally conduct change, self-monitoring, initiation, planning/organization, and task monitoring functions, they exemplify outstanding performance in their communication skills, adaptability, interpersonal relationships, and initiative, and imagination. But when their working memory, cognitive control, inhibition, and arrangement of materials is at the borderline, better interpersonal relationships, decision-making and judgment, and initiative and imagination are achieved.

Real-world executive functioning for autistic children in school and home settings

Executive function challenges are commonly reported in the home setting for children with an autism spectrum disorder diagnosis (hereafter, autism), but little is known about these challenges in the school setting. A total of 337 youth (autism, N = 241 and typically developing, N = 96) were assessed using Behavior Rating Inventory of Executive Function ratings from home and school settings. Within each setting, we examined differences in specific executive function skills between diagnostic groups. Then, we examined if the autism group showed similar peak executive function impairments, associations with age, and relationships with adaptive behavior across settings. Finally, we examined inter-rater reliability. Autism and typically developing groups differed on all Behavior Rating Inventory of Executive Function scales in both settings. The Shift scale was the peak impairment in the autism group in both settings. There was also an effect of age on executive function impairment in both settings, and executive function ratings in both settings significantly predicted individual adaptive behavior domains. Inter-rater correlations for autistic participants were similar to inter-rater reliability correlations from the Behavior Rating Inventory of Executive Function standardization sample. This study shows that autistic children experience similar but not identical real-world executive function challenges across school and home settings and that supports may vary by setting. Lay abstract Executive functioning skills are important for children to be able to control thoughts, emotions, and actions, and for their ability to adapt to different settings. Previous studies have found that autistic children have difficulty with executive functioning, but most of these studies took place in the home setting. Executive functioning skills in autistic children have not yet been fully examined in the school setting. This is a knowledge gap that needs to be addressed because the school setting is potentially one of the most demanding in terms of executive functioning and is a setting where executive function interventions are already being used for autistic children. In order to learn more about executive functioning for autistic children in the school setting, this study compared ratings of executive function from autistic children’s caregivers and school professionals. The study found that autistic children experience similar but not identical executive function challenges across school and home settings and that supports may differ in each setting. Having information about differences in executive functioning challenges and supports for autistic children across settings can help lead to development of supports that are tailored to each setting.

A-34 Comparison of BRIEF, SRS Relationships among Children with Autism and Comorbid ADHD

Objective Recent investigations have found specific relationships between subscales of the Social Responsiveness Scale (SRS) and the Behavior Rating Inventory of Executive Functioning (BRIEF) among individuals with autism spectrum disorder (ASD). Aim: Examine whether Social-Executive relationships differ among individuals with ASD versus comorbid autism and attention-deficit/hyperactivity disorder (ASD + ADHD). Method Parent ratings on the SRS and BRIEF were obtained from the ABIDE-II database. Final sample: 25 ASD, 37 ASD + ADHD (5–12 years). T-tests examined group differences in BRIEF and SRS T-scores. Hierarchical multiple regressions examined the effect of BRIEF Index T-scores (Metacognition, MI; Behavioral Regulation, BRI) on SRS total and subscale T-scores, as well as the potential moderating effect of comorbid ADHD diagnosis. Results T-tests revealed that the ASD + ADHD group had higher severity T-scores on the BRIEF MI (T = 3.70, p &lt; 0.01) and SRS Awareness (T = 4.00, p &lt; 0.001) scales. ADHD diagnosis was associated with less severe deficits in social cognition (B = −6.33, p = 0.02). However, ADHD diagnosis did not significantly moderate the relationship between BRIEF and SRS scores. The relationship between BRIEF BRI and SRS Motivation was marginally significant and stronger among children with ADHD (B = 0.81, p = 0.0513). Conclusions Overall, similar profile of social-executive relationships were observed among participants with ASD and ASD + ADHD. ADHD diagnosis was associated with better understanding of social situations and ability to interpret social cues appropriately. There is some indication that ADHD diagnosis may be associated with a stronger relationship between behavior regulation and social motivation. Future work should replicate these findings with a larger sample size.