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Behavior Rating Inventory of Executive Function

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The Behavior Rating Inventory of Executive Function (BRIEF) is an assessment of executive function behaviors at home and at school for children and adolescents ages 5–18. It was originally developed by Gerard Gioia, Ph.D., Peter Isquith, Ph.D., Steven Guy, Ph.D., and Lauren Kenworthy, Ph.D.

The 86-item questionnaire has separate forms for parents and teachers, and typically takes 10–15 minutes to administer and 15–20 minutes to score. Other versions of the BRIEF also exist for preschool children aged 2–5 (BRIEF-P), self-reports of adolescents aged 11–18 (BRIEF-SR), and self/informant-reports of adults aged 18–90 (BRIEF-A).


As of 2013, the BRIEF had been translated into 40 different languages or dialects across the various versions of the questionnaire.[1][2][3][4]


validity scales. These theoretically and statistically derived scales form two indexes: a) Behavioral Regulation (three scales) and b) Metacognition (five scales), as well as a Global Executive Composite[5] score which takes into account all of the clinical scales and represents the child's overall executive function.

Behavioral regulation scales

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Administration

Reliability and validity

Questions selected for inclusion in the BRIEF were determined based on inter-rater reliability correlations and item-total correlations that had the highest probability of being informative for the clinician.[5] The BRIEF has demonstrated good reliability, with high test-retest reliability (rs ≈ .88 for teachers, .82 for parents) internal consistency (Cronbach's alphas ≈ .80 – .98), and moderate correlations between parent and teacher ratings (rs ≈ .32 – .34). Evidence for the convergent and divergent aspects of the BRIEF's validity comes through its correlation with other measures of emotional and behavioral functioning. The BRIEF has also demonstrated utility in differentiating clinical and non-clinical children and adolescents with attention deficit/hyperactivity disorder (ADHD).[6]

Scoring and interpretation

Raw scores for all scales of the BRIEF questionnaire can be computed with the Software Portfolio (BRIEF-SP). This computer program provides separate normative tables for both the Parent and Teacher Forms in which figure T scores, percentiles, and 90% confidence intervals for four developmental age groups (5–18 years) by gender of the child. T scores provide information about the child's individual scores relative to the scores of other respondents in the standardization sample. Percentiles represent the percentage of children in the standardization sample who fall below a given raw score.

When interpreting the data, it is important to remember that all results "should be viewed in the context of a complete evaluation".[5] Clinical information gathered from the BRIEF questionnaire is best understood within the context of a full assessment that includes a description of the history of the child and the family and observations of the child's behavior. Accordingly, high scores obtained on the BRIEF do not indicate a "disorder of executive function" but rather suggest a higher level of dysfunction in a specific domain of executive functions. Particular attention should also be paid to the Inconsistency scale given that score equal or higher than 7 is indicative of a high degree of inconsistency in rater response.

Uses

The BRIEF is useful for evaluating children with a variety of disorders and disabilities. Specifically, it is often used for assessing executive functioning in children with developmental and/or acquired neurological conditions including: learning disabilities, tourette syndrome, traumatic brain injury, pervasive developmental disorders, high functioning autism, low birth weight.[7] The BRIEF is most often used to assess attention deficit hyperactivity disorder.

Attention deficit/hyperactivity disorder

The BRIEF is often used to evaluate ADHD in children and has been shown to be superior to other rating systems such as the Behavior Assessment System for Children (BASC) as it taps into unique behaviors typically associated with the disorder (e.g., working memory, metacognitive skills)[8]

McCandless & O'Laughlin (2007) found that the Metacognitive and Behavioral Regulation scales of the BRIEF are clinically useful for identifying children with and without ADHD. Specifically, the Metacognitive Scale (Working Memory subscale) is useful for identifying the presence of ADHD whereas the Behavioural Regulation scale (Inhibit subscale) has demonstrated clinical utility at distinguishing between the inattentive and combined (i.e., inattentive and hyperactive) subtypes of the disorder.[9]

The BRIEF has also been useful for highlighting differences between ADHD and other diagnoses. For example, Pratt (2000) examined parent reports on the BRIEF for children (ages 6–11) who had a diagnosis of ADHD, ADHD and reading disorder (RD), RD only, or no diagnosis. Children with ADHD demonstrated higher scores on all of the BRIEF scales compared to children with no formal diagnosis. Children with a reading disorder showed greater difficulties on the Working Memory and the Plan/Organize subscales of the Metacognitive Scale.[10] The BRIEF has been less useful for distinguishing between children with ADHD and tourette syndrome.[11]

References

  1. ^ "Psychological Assessment Resources". Archived from the original on 2014-04-29. Retrieved 2012-04-09.
  2. ^ "Psychological Assessment Resources". Archived from the original on 2014-04-29. Retrieved 2012-04-09.
  3. ^ "Psychological Assessment Resources". Archived from the original on 2014-04-29. Retrieved 2012-04-09.
  4. ^ "Psychological Assessment Resources". Archived from the original on 2014-04-29. Retrieved 2012-04-09.
  5. ^ a b c Isquith, Peter. "Behavior Rating Inventory of Executive Function Interpretive Report". Archived from the original on 2011-04-09. Retrieved 2012-04-09.
  6. ^ Sullivan, Jeremy R (2007). "Diagnostic Group Differences in Parent and Teacher Ratings on the BRIEF and Conners' Scales". Journal of Attention Disorders. 11 (3): 398–406. doi:10.1177/1087054707299399. PMID 17932389.
  7. ^ "Psychological Assessment Resources".
  8. ^ Jarratt, Kelly Pizzitola; Cynthia A. Riccio; Becky M. Siekierski (2005). "Assessment of Attention Deficit Hyperactivity Disorder (ADHD) using the BASC and BRIEF". Applied Neuropsychology. 12 (2): 83–93. doi:10.1207/s15324826an1202_4. PMID 16083397.
  9. ^ McCandless, Stephen; Liz O' Laughlin (2007). "The Clinical Utility of the Behavior Rating Inventory of Executive Function (BRIEF) in the Diagnosis of ADHD". Journal of Attention Disorders. 10 (4): 381–389. doi:10.1177/1087054706292115.
  10. ^ Pratt, B.M. (2000). "The comparative development of executive function in elementary school children with reading disorder and attention deficit/hyperactivity disorder". Dissertation Abstracts International. 60.
  11. ^ Mahone, E. Mark; Paul T. Cirino; Laurie E. Cutting; Paula M. Cerrone; Kathleen M. Hagelthorn; Jennifer R. Hiemenz; Harvey S. Singer; Martha B. Denckla (2002). "Validity of the behavior rating inventory of executive function in children with ADHD and/or Tourette syndrome". Archives of Clinical Neuropsychology. 17: 643–662. doi:10.1016/s0887-6177(01)00168-8.
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