Differing Perspectives: Examining Reports of Executive Function in Children with ASD & ADHD

Background: Measuring Executive Function (EF) skills is imperative in assessing overall behavior and outcomes in children as they progress through school. EF deficits are prominent among children who have an Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD).

Objectives: This study aims to evaluate how parents, teachers and observers report EF behavior among the two diagnostic groups.

Methods: A sample of mainstream school children either with an ASD (N=46) or ADHD (N=103) (ages M=10.03; SD=.89) participated in a school-based EF intervention study. Student behavior was observed by treatment-blinded research staff twice within the school year, and teachers reported on behavior using a modified version of the SKAMP (Swanson, 1992). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) (Gioia et al., 2000). SKAMPS and classroom observations yield scores on several EF skills, including transitioning, attending to work, and following rules, while the BRIEF assesses EF in the school and home environments. Greater impairment of EF skills are indicated by lower scores on the classrooms observations and higher scores on the SKAMPS.

Results: Within the entire sample, parent scores on the BRIEF Global Executive Composite index (GEC) were correlated with teacher’s reports of EF skills on the SKAMP (r=.222, p<.002). Total SKAMP and classroom observation scores were significantly correlated for both groups (r=-.340, p<.00). When divided by diagnosis, differences were found between the two groups, specifically in regards to parent report. Children with ASD had similar overall levels of EF skills, as reported on the SKAMP and classroom observations (r= -.486, p <.000). However, BRIEF GEC scores were not correlated with SKAMP scores. When parents reported difficulties within the Monitor scale on the BRIEF, correlations were found for SKAMP items, including: the total SKAMP score, sticking with tasks, and getting started on assignments. Within the ADHD sample, teacher and parent ratings were significantly correlated (r=.216, p<.010). Observation total scores and BRIEF GEC scores were not correlated (r=.005, p<.943).

Conclusions: Among teachers, parents, and blinded observers, agreement was significant within the entire sample for behaviors related to EF. However, differences were found within the two diagnostic groups, suggesting that multi-informant approaches are important when measuring outcomes. Varying the lenses for reporting EF skills in children is important in capturing different behaviors, as well as across diagnoses.