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Executive Functioning of Children with ASD: An Analysis of the Brief-Questionnaire

Friday, 3 May 2013: 14:00-18:00
Banquet Hall (Kursaal Centre)
M. L. Bezemer and E. M. Blijd-Hoogewys, Autism Team North-Netherlands, Lentis, Groningen, Netherlands

Children with Autism Spectrum Disorders (ASD) often have problems with Executive Functions (EF). Administering EF tests take a considerable amount of time. A quick alternative can take the form of screening.

The BRIEF questionnaire (Behavior Rating Inventory of Executive Functions; Gioia et al., 2000) screens for EF problems in 5- to 18-year-olds. This questionnaire focuses on potential problems in the areas of inhibition, shifting, emotional control, initiation, working memory, planning and organizing, organization of materials, and monitoring.


The main question is whether there is a specific BRIEF score profile found in children with ASD. The consequential question is whether this profile differs for the three ASD subgroups (Autistic disorder, Asperger’s disorder & PDD-NOS). The final question regards the relation between IQ and BRIEF scores.


The sample consisted of 127 children between 5 and 18 years old (98 boys, 29 girls). All were diagnosed with a specific ASD (N=35 AD, N=27 AS & N=65 PDD-NOS). Parents filled in a BRIEF questionnaire. All children received an IQ test, the WISC-III.


The total ASD group (N=127) has significant higher scores - indicative of more EF problems - than the BRIEF norm group on all clinical scales (T-score: M≥50, p<.001), except for Organization of Materials. The shift scale even shows a significant clinical elevation (T-score: M≥65, p=.007).

Each ASD subgroup (AD, AS and PDD-NOS) has the same score profile as mentioned above (T-score: M≥50, p=.05-.001). Regression analysis demonstrates that they do not differ significantly. Next to that, decision tree analysis and hierarchical cluster analysis show that none of the BRIEF variables serve as a predictor for any of the ASD subgroups.

PIQ has significant negative correlations with the BRIEF scales Inhibit, Shift, Working Memory, Plan/Organize and Monitor. However, this is only true if there are no EF problems, except in the case of Inhibit. Also, the greater the distance between PIQ and VIQ (favoring PIQ), the less EF problems occur.

The negativity scale of the BRIEF - which should serve as a reliability index - deviates in the greater part of the participants (65%). This seems to be due to the fact that most of these items focus on rigidity, which is a main characteristic in ASD.


The BRIEF is a fairly new instrument. Consistent with other studies, children with ASD show problems on all BRIEF clinical scales, except for Organization of Materials. They have the most profound deficits in cognitive flexibility. No differentiation could be made between the three ASD subgroups, which is in agreement with the DSM-5 proposed revisions: dictating a single diagnostic category.

Based on the results, two recommendations can be made. First, one should take PIQ into account only when interpreting inhibition problems. Overall, the magnitude of the difference between PIQ and VIQ can be of importance. Second, it is advised to omit the negativity scale of the BRIEF as an indication of a negative answer tendency of parents of children with ASD.

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