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The Factor Structure of the Behavior Rating Inventory of Executive Function in Children and Adolescents with Autism Spectrum Disorders Replicates the Normative Sample

Friday, 3 May 2013: 14:00-18:00
Banquet Hall (Kursaal Centre)
Y. Granader1, B. E. Yerys2, G. L. Wallace3, R. Lawson1,4, M. Rosenthal5, M. Wills1, E. Dixon6, L. G. Anthony1, J. Pandey2, R. Thompson2, R. T. Schultz7 and L. Kenworthy8, (1)Center for Autism Spectrum Disorders, Children's National Medical Center, Rockville, MD, (2)Children's Hospital of Philadelphia, Philadelphia, PA, (3)National Institute of Mental Health, Bethesda, MD, (4)Loyola University Maryland, Baltimore, MD, (5)Child Mind Institute, New York, NY, (6)National Institute of Mental Health, National Institutes of Health, Bethesda, MD, (7)Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, (8)Children’s Research Institute, Children's National Medical Center, Washington, DC
Background:  Children with autism spectrum disorders (ASDs) have a high rate of executive functioning deficits, which can cause great difficulty in daily activities at both school and home. Given that executive function weaknesses are more common in children with ASDs than in the general population, it is important to screen for executive dysfunction in order to recommend appropriate clinical interventions. The Behavior Rating Inventory of Executive Function (BRIEF) assesses executive functioning skills in daily life. The psychometric properties and clinical utility of the BRIEF have been examined in clinical populations.  Elevated BRIEF scores have been reported in ASD; however, the factor structure of the BRIEF has not been explored in this population.

Objectives:  To investigate the factor structure of the BRIEF in a large sample of children with ASDs and to determine the frequency of BRIEF scale elevations in this sample.

Methods:  479 children with ASDs (405 males and 74 females, age range 5-18 years, mean = 10.6, SD = 3.2) were assessed at Children’s National Medical Center, National Institute of Mental Health, and the Children’s Hospital of Philadelphia. Participants with an IQ below 70 were excluded from this study. IQ ranged from 70-158 (mean = 101.0, SD = 17.7). Parents completed the BRIEF as part of a research protocol or neuropsychological evaluation. BRIEF scale elevations were determined to be of “potential clinical significance” (Gioia et al., 2000, p. 14) if the T-score was at or above 65. Principal component analyses (PCA) with oblique (promax) rotations were performed on the BRIEF subscale T-scores in order to explore the underlying structure.

Results:  Subscale elevations were generally consistent with previous research in ASD. The Shift, Initiate, Working Memory, Plan/Organize, and Monitor subscales were elevated in 51 to 63% of the sample. The PCA revealed one factor that accounted for 57.1% of the variance. When a two-factor solution was forced factor loadings ranged from .54 to .97. Five of the scales loaded highly on the first component (Plan/Organize, Working Memory, Organization of Materials, Initiate, and Monitor) and three of the scales loaded predominantly on the second component (Emotional Control, Shift, and Inhibit). No cross factor loadings were found. The two constructs defined by these component loadings replicated the original normative data in the BRIEF manual identifying two indices: Behavioral Regulation and Metacognition.

Conclusions:  This study provides preliminary psychometric and clinical descriptive data about the BRIEF subscale scores in a large sample of children with ASDs. The results of this study are similar to previous findings, which indicate that a substantial proportion of children with ASDs display significant difficulties with executive functions as measured by the BRIEF subscales. In addition, the PCA revealed one factor that corresponded to the original Global Executive Composite and when a two-factor solution was forced the factor structure corresponded to the original Behavioral Regulation and Metacognition Indices, and provided validation for using normative BRIEF data with children with ASDs. Future studies should use confirmatory factor analysis in order to further examine the validity of the BRIEF with this population.

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