Dissertations / Theses on the topic 'Questionnaire for the assessment of Executive Function'

La presente ricerca è stata realizzata con l’intento di approfondire alcuni temi cardine nello studio delle Funzioni Esecutive (FE). Il termine FE si riferisce a processi neurocognitivi, deliberati e top-down necessari per esercitare controllo volontario su pensieri ed emozioni e per la messa in atto di comportamenti finalizzati al raggiungimento di un obiettivo. Si tratta di abilità indispensabili in situazioni nuove ed ambigue. Al dominio esecutivo vengono ascritte non solo abilità puramente cognitive. Tra le FF figurano: controllo degli impulsi ed autoregolazione, attenzione, memoria di lavoro, iniziativa, pianificazione ed organizzazione, flessibilità cognitiva, problem solving, decision making affettivo, teoria della mente ed empatia. Ad oggi non esiste un punto di vista condiviso su alcuni temi che sono stati oggetto del nostro interesse: la valutazione, la struttura e lo sviluppo delle FE, i deficit esecutivi presenti in alcuni disturbi specifici dello sviluppo. Per quanto concerne la valutazione delle FE, uno dei nodi critici è la scarsa validità ecologica degli strumenti tradizionalmente utilizzati nella ricerca e nella clinica. Al fine di superare questo problema metodologico sono state proposte modalità alternative di valutazione basate sia sulla performance che su report di insegnanti e genitori. Nella presente ricerca abbiamo proposto una nuova batteria neuropsicologica volta a fornire una panoramica globale del dominio esecutivo mettendo il bambino davanti a problemi analoghi a quelli che la quotidianità elicita. La batteria include: Battersea Multitasking Paradigm Task, Test di Ragionamento visuo-spaziale, Test di Pianificazione Quotidiano, Junior Gambling Task e Test del Clacson. È stato inoltre elaborato un questionario, il Questionario per la valutazione delle Funzioni Esecutive, QuFE, del quale sono indagate struttura, attendibilità ed utilità clinica. A tale scopo il questionario è stato somministrato a genitori ed insegnanti di bambini con sviluppo tipico o atipico di età compresa tra gli 8 ed i 13 anni. I risultati suggeriscono una struttura a 5 fattori per la versione genitori ed una a 3 per la versione insegnanti. Le abilità che sembrerebbero essere indagate sono: abilità metacognitive, regolazione delle emozioni e del comportamento, organizzazione dei materiali, adattamento ed iniziativa. Entrambe le versioni del QuFE si caratterizzano per una elevata validità interna. Per quanto concerne l’utilità clinica, lo strumento sembrerebbe distinguere in modo efficace soggetti con sviluppo tipico da soggetti clinici, minore è la capacità di differenziare tra i profili di soggetti con differenti disturbi dello sviluppo. Lo sviluppo e la struttura delle FE sono stati esaminati somministrando ad un campione di 343 soggetti con sviluppo tipico di età compresa tra gli 8 ed i 13 anni la batteria presentata sopra. Sono stati documentati significativi cambiamenti nei profili di performance in tutti test somministrati. Dall’analisi fattoriale è emersa una struttura a 4 fattori distinti ma interdipendenti: vigilanza, comportamento strategico, inibizione/flessibilità cognitiva e memoria. La struttura è stabile nel tempo e non presenta differenze legate al genere. Infine sono stati indagati i profili esecutivi in bambini con Disturbo da Deficit dell’Attenzione ed Iperattività (ADHD) e Disturbi Specifici dell’Apprendimento (DSA). Sono state oggetto di valutazione le performance di bambini con sviluppo tipico (207) o atipico (65) di età compresa tra gli 8 ed i 13 anni. I nostri dati suggeriscono che i bambini con ADHD e DSA hanno competenze strategiche ed inibitorie sovrapponibili. In entrambi i gruppi si è osservato un deficit della vigilanza e della memoria, di estensione maggiore nel gruppo ADHD. Si conferma la presenza di un deficit esecutivo nelle due popolazioni oggetto di interesse, deficit però circoscritto e non generalizzato.

A child’s executive function (aspects: working memory, response inhibition, and set-shifting between sets of rules) capabilities have been found to strongly relate to their mathematics skills. However, while the relationship has been strongly supported by researchers, a consensus has not been reached regarding the specifics of the relationship between executive function and math skills, including which executive function aspect is most predictive of mathematical performance and the differences in said relationship that might be found when examining both numeracy, such as counting skills and basic operations, and geometry skills. The lack of consensus may be in part because researchers have assessed both executive function and mathematics in a variety of ways. To address the consensus issue, this study used a panel of face-to-face measures of executive function, a paper-and-pencil measure of executive function, and a broader measure of mathematical performance than has typically been used, one including numeracy and geometry. Using a longitudinal approach, with two assessment periods about six months apart (M = 5.61 mos., SD = 1.12), this study examined this relationship among 118 children (61 girls), ages 39 to 68 months (M = 52.58, SD = 6.35), living in both rural (n = 64) and urban (n = 54) areas in a state in the western United States. A longitudinal approach allowed for comparisons between results from the two assessment periods. Results suggest that while numeracy and geometry skill among preschool-age children are connected, there are some independent elements. Additionally, because of rapid cognitive growth, age is an important factor when selecting both assessments and analytic strategies, as statistically significant variations in the predictive power of measures and strategies occurred between assessment periods. Connections between younger children’s executive function and numeracy skills appeared to be best assessed through a non-number-based measure, older children’s numeracy ability can be predicted by a greater variety of executive function measures. Face-to-face executive function measures included in this study were more predictive of numeracy skill than geometry skill, and geometry skill appears to be connected to inhibitory control. Differences between rural and urban children were found on numeracy skill and working memory ability, but not on geometry skill. Statistically significant differences by gender were found on an inhibitory control measure, with boys scoring higher than girls in our sample.

Deficits in executive functions (EF), such as planning, problem-solving and inhibition affect up to 75% of individuals with stroke and may compromise their ability to successfully return to community living and to work. Detection and effective treatment of these disorders is thus critical. Studies over the past decade have provided evidence of substantial gaps in our knowledge on how to effectively manage EF impairment post-stroke (Bayley et al., 2007; Canadian Stroke Network, 2008; Korner-Bitensky, Barrett-Bernstein, Bibas, & Poulin, 2011). To address these gaps there has been growing attention and research into the management of EF impairment post-stroke. The studies conducted as part of this thesis were designed to address some of these gaps specific to EF assessment and intervention research, and to promote increased use of evidence-based practices for the management of executive dysfunction post-stroke. The first manuscript provided a critical review of 17 performance-based EF tools that can be used across the continuum of stroke care to evaluate the daily consequences of executive dysfunction. The next step was to conduct a systematic review to identify and critically appraise the evidence for the use of specific EF interventions post-stroke. The systematic review of EF interventions described in the second manuscript identified different treatment approaches that were showing promise in helping persons with stroke to cope with EF deficits. The preliminary evidence on specific EF skill retraining suggested that structured, individualized and intense computerized EF training could improve targeted EF impairments (Stablum, Umilta, Mogentale, Carlan, & Guerrini, 2000; Westerberg et al., 2007). The evidence from studies on cognitive strategy training also supported the use of explicit strategies applied to ecologically relevant problems to improve some EF impairments (e.g., planning and problem-solving) and, possibly, real-world activities (Man, Soong, Tam, & Hui-Chan, 2006; Schweizer et al., 2008). However, further research was required to compare the impact of these different intervention approaches on a variety of outcomes. Accordingly, a pilot randomized controlled trial was conducted to determine the feasibility and preliminary efficacy of two promising interventions, a strategy-training approach – the Cognitive Orientation to daily Occupational Performance (CO-OP) approach which is based on the use of meta-cognitive problem-solving strategies to achieve self-selected functional goals – and a computer-based EF training program (see Manuscript 3). Our findings provide preliminary evidence supporting the feasibility and efficacy of using both CO-OP and Computerized EF training for select patients with executive dysfunction post-stroke. EF impairments and participation in everyday life were differentially impacted by the interventions.Finally, another important goal of my doctoral work was to enhance knowledge translation in the area of EF. As explained in the fourth manuscript, the thesis led to the creation of a series of web-based interactive learning modules on EF assessment and intervention, as well as user-friendly pocket cards designed to summarize EF rehabilitation best-practices for clinicians. These e-learning modules address the need to enhance expertise in the management of EF disorders post-stroke.
Les déficits des fonctions exécutives (FE) comme la planification, la résolution de problèmes et l'inhibition touchent jusqu'à 75% des personnes ayant subi un accident vasculaire cérébral (AVC) et perturbent la réalisation des activités quotidiennes et rôles sociaux, pouvant ainsi compromettre le retour à domicile ou au travail. La détection et la prise en charge de ces déficits est donc primordiale. Plusieurs études réalisées au cours des dix dernières années ont toutefois indiqué des lacunes importantes dans les connaissances reliées à la prise en charge de la dysfonction exécutive post-AVC (Bayley et al., 2007; Canadian Stroke Network, 2008; Korner-Bitensky et al., 2011), ce qui a mené à des efforts accrus en recherche afin de combler les lacunes dans ce domaine. Les études menées dans le cadre de cette thèse visaient à contribuer aux connaissances sur l'évaluation et le traitement des personnes ayant des déficits des FE, ainsi qu'à promouvoir une utilisation accrue de pratiques fondées sur les données probantes dans la prise en charge de la dysfonction exécutive post-AVC.Le premier manuscrit présente une revue critique de 17 évaluations des FE basées sur la performance de tâches fonctionnelles qui peuvent être utilisées au cours du continuum de soins post-AVC afin d'évaluer les conséquences de la dysfonction exécutive dans le quotidien. L'étape suivante a consisté à réaliser une revue systématique afin d'identifier et d'apprécier le niveau d'évidences supportant l'utilisation d'interventions pour améliorer les FE après un AVC. La revue systématique décrite dans le deuxième manuscrit a permis d'identifier différentes approches de traitement prometteuses pour la prise en charge de la dysfonction exécutive post-AVC. Des évidences limitées mais encourageantes suggèrent que l'utilisation d'un entraînement intensif, structuré et individualisé des FE à l'ordinateur peut améliorer les FE ciblées (Stablum et al., 2000; Westerberg et al., 2007). D'autres approches basées sur des stratégies cognitives suggèrent que l'utilisation de stratégies explicites appliquées à des situations concrètes de la vie quotidienne peuvent améliorer certains déficits des FE (ex.: résolution de problèmes et planification) et, possiblement, la réalisation des activités quotidiennes (Man et al, 2006; Schweizer et al., 2008). Cependant, des recherches additionnelles demeuraient nécessaires afin de comparer l'impact respectif de ces approches d'intervention sur différentes mesures de résultats.Un essai clinique randomisé pilote a donc été réalisé afin de déterminer la faisabilité et l'efficacité préliminaire de deux interventions prometteuses, l'une reposant sur l'utilisation de stratégies cognitives – l'approche Cognitive Orientation to daily Occupational Performance (CO-OP) dans laquelle la personne apprend à utiliser des stratégies de résolution de problèmes pour atteindre ses propres buts en termes d'activités fonctionnelles – et l'autre consistant en un programme d'entraînement des FE à l'ordinateur. Les résultats obtenus fournissent des évidences préliminaires appuyant la faisabilité et l'efficacité de chaque intervention auprès de certains groupes de patients ayant une atteinte des FE. Des améliorations spécifiques à chaque intervention ont été notées dans les déficits des FE ainsi que la participation dans les activités quotidiennes. Finalement, un autre objectif important était de favoriser le transfert des connaissances dans le domaine des FE. Tel qu'expliqué dans le quatrième manuscrit, mon travail de thèse a mené à la création d'une séries de modules d'apprentissage en ligne sur l'évaluation et le traitement des FE, ainsi que de cartes en format de poche résumant les meilleures pratiques cliniques auprès des personnes ayant une atteinte de FE post-AVC. Ces modules et outils d'apprentissage en ligne ont été créés en réponse au besoin d'accroître l'expertise des cliniciens dans la prise en charge de la dysfonction exécutive post-AVC.

Because low rate, covert responses are hard to observe and measure (e.g., Azrin & Wesolowski, 1974; Henderson, 1981; Jeffery, 1969; Reid & Patterson, 1976; Seymour & Epston, 1989), well-controlled behavior analytic investigations of stealing have been rare. In fact, systematic investigations to experimentally determine stealing functions have been limited to two studies targeting food (Lambert et al., 2019; Simmons, Akers, & Fisher, 2019). The dearth of studies examining stealing functions, partly attributable to low rate and covertness, may be forestalling additional intervention studies. Given the likely futility of unsystematic attempts to observe naturally occurring instances of an infrequent, clandestine response, a possible role for indirect assessment emerges (Iwata & Dozier, 2008). This two-part study concerned an investigation into the reliability and predictive validity of the Functional Analysis Screening Tool (Iwata, DeLeon, & Roscoe, 2013) and a similarly constructed tool (The Stealing Inventory or TSI) with the latter having questions oriented towards likely stealing functions. In doing so, the comparative viability of two trial-based functional analysis (FA) models (Bloom, Iwata, Fritz, Roscoe, & Carreau, 2011; Lambert, Bloom, & Irvin, 2012) was also examined. Across 42 respondent pairs, overall tool reliability and outcome reliability for suggested functions favored the TSI (85% and 92.9%, respectively) over the FAST (80% and 73.8%, respectively). Three out of 6 participants stole during one of their two respective FAs, and the identified function matched the respective TSI outcomes for each case. FA model superiority was unclear.

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O “Behavior Rating Inventory of Executive Function” (BRIEF) é um instrumento de avaliação das funções executivas refletindo aspectos da vida diária de crianças e adolescentes entre 5 e 18 anos de idade. Consta de três versões, ou seja, a escala para pais, professores e versão pessoal. O objetivo do presente estudo foi traduzir e adaptar, para o português do Brasil, o BRIEF, assim como analisar as propriedades psicométricas iniciais. O processo de tradução e adaptação seguiu os passos recomendados na literatura e amplamente preconizados pelo International Test Commission (ITC). Para análise da adequação da adaptação, assim como das propriedades psicométricas, foram realizados dois estudos pilotos, sendo que a versão final foi administrada numa amostra constituída por 277 pais, sendo 59,6% do sexo feminino, 282 professores, sendo 57,4% feminino, 112 pessoal, sendo 63,4% feminino. Os valores dos Alfas de Cronbach, avaliando consistência interna para os principais índices do questionário dos pais oscilaram entre 0,901 e 0,945, do questionário dos professores oscilaram entre 0,915 e 0,959 e, os do questionário pessoal oscilaram entre 0,924 e 0,957, indicando adequados coeficientes de fidedignidade do teste. A análise fatorial de componente principal extraiu dois fatores (Fator 1 Metacognição; Fator 2 Regulação do Comportamento). No questionário dos pais, os dois fatores foram correlatos (r=0,56). No questionário dos professores, a correlação foi 0,400, e no questionário pessoal, a correlação foi 0,70. Os valores encontrados na versão brasileira se assemelham ao relatados na versão original, indicando boa consistência interna do instrumento nas 3 versões.
Behavior Rating Inventory of Executive Function (BRIEF) is an instrument that assesses executive functions, reflecting daily life aspects of children and teenagers aged between 5 and 18 years old. It has three versions, that is, the parenting scale, the teachers’ scale and a personal version. The purpose of this study was to translate and to adapt, into Brazilian Portuguese, BRIEF, as well as to analyze the initial psychometric properties. The translation and adaptation process followed the steps recommended in literature and widely endorsed by International Test Commission (ITC). To analyze the adaptation’s adequacy, as well as the psychometric properties, two pilot studies were carried out, and the final version was administered to a sample comprised of 277 parents, being 59.6% female, 282 teachers, being 57.4% female, 112 personal, being 63.4% female. The Cronbach’s Alpha values, assessing internal consistency for the main items of the parents’ questionnaire ranged from 0.901 to 0.945, the ones concerning the teachers’ questionnaire ranged from 0.915 to 0.959 and those concerning the personal questionnaire ranged from 0.924 and 0.957, showing proper coefficients of test’s trustworthiness. The factorial analysis of main component extracted two factors (Factor 1: Metacognition; Factor 2: Behavior Regulation). In the parents’ questionnaire, both factors were correlated (r=0.56). In the teachers’ questionnaire, correlation was 0.400, and in the personal questionnaire correlation was 0.70. The values found in the Brazilian version are similar to those reported in the original version, showing good internal consistency of the instrument in the three versions.
TEDE
BV UNIFESP: Teses e dissertações

Executive functions and problem solving are important skills for success in school and life. Measuring executive functions and problem solving with child-friendly tools that can be applied outside the traditional clinical settings remains a challenge. The overall aim of this PhD project was to design a new child-friendly online assessment tool (eFun) to better understand relationships among executive function constructs, problem solving and academic outcomes. The assessment tool eFun was developed in collaboration with designers, software developers, and researchers to ensure validity and usability. eFun measures problem solving ability and the core executive function constructs working memory, inhibition, and cognitive flexibility on an iPad. This PhD thesis addresses two major gaps in the executive function literature. Firstly, it introduces the development and evaluation of new cognitive tasks for children. Secondly, it addresses the relationship between executive functions, problem solving and academic outcomes. This research adds to the current limited evidence base by investigating children’s evaluation of game-based executive function and problem solving assessments and by exploring new approaches to measuring cognitive functions and validating executive function tasks for children. Furthermore, the thesis extends the literature by examining intercorrelations among the newly developed cognitive tasks and academic achievement, and compares results with existing theories. Findings indicate that children enjoy playing the newly developed eFun tasks, especially the inhibition task. Overall, low to medium associations were found between the performance scores of individual executive functions and between executive functions and problem solving. Furthermore, executive functions were found to be a predictor of academic success (grades), whereas the association between problem solving and academic outcomes was less clear. The eFun problem solving task was enjoyed more than the traditional Tower of Hanoi task. The eFun problem solving task performance was found to be positively associated with the Tower of Hanoi task performance, providing some initial evidence for convergent validity for the eFun problem solving task. The newly developed eFun tasks will offer enhanced opportunities to measure children’s cognitive functions (i.e., executive functions and problem solving) in a school context. This research advances the cognitive function literature and provides insights into new approaches to measuring cognitive functions in children.

Deficits in executive function are commonly reported following Traumatic Brain Injury (TBI) and are important for establishing functional impairments. Understanding the nature of executive dysfunction following TBI is often complicated by secondary factors that can impact measured ability. This study sought to clarify the persistent effects of TBI on executive function, as measured by the Wisconsin Card Sorting Test (WCST), while accounting for effort given during testing, as measured by the Portland Digit Recognition Test. Results suggested a dose-response relationship between TBI severity and subsequent WCST deficits. Mild TBI patients who provided good effort during testing showed no observable differences from locally matched controls on WCST performance. Effort during testing was found to have a larger overall effect on WCST performance than moderate-to-severe TBI or dementia. The present study highlights the need to account for secondary factors, such as effort during testing, to accurately measure cognitive dysfunction following compensable injuries.

Thesis (Ph.D.)--University of Florida, 2004.
Typescript. Title from title page of source document. Document formatted into pages; contains 128 pages. Includes Vita. Includes bibliographical references.

School Psychology
Ph.D.
According to the biopsychosocial model of bulimia, neurobiological mechanisms called endophenotypes cause eating disordered behavior. Impulsivity has been identified as a possible endophenotype for bulimia nervosa, and individuals with bulimia who present with multiple forms of impulsive behavior are known to have worse prognoses. Executive dysfunction in impulse control purportedly manifests as behavioral under-regulation in binge-purge episodes. Neuropsychological assessments were used to analyze the relationship between impulsivity and symptoms of bulimia. Twenty-eight inpatient adolescent and young adult women with bulimia completed the D-KEFS Color Word Task, which is a version of the Stroop that contains four trials including the classic Stroop and a switching Stroop, as well as the age appropriate versions of the BRIEF rating scale and a Type-T Survey of thrill-seeking. Performance on these measures was correlated with measures of bulimia symptoms, including the EDI-3, EDE-Q, and variables of illness severity. Delay of gratification was assessed by offering subjects a choice of compensation that was either immediate and smaller or delayed and larger. Mixed results were found. The sample did not differ from the D-KEFS normative sample on total number of errors or on speed of task completion for the switching Stroop, and the sample demonstrated faster performance than the normative sample on the classic Stroop. However, a tendency to favor speed over accuracy of performance was identified. On the BRIEF rating scales, the sample self-reported significantly higher rates of executive dysfunction compared to the normative data. Additionally, some variables of impulsivity, including greater frequency of errors on cognitive tasks and self-reported deficits of executive functioning, were significantly correlated with variables of bulimia symptom severity, including self-reported bulimia symptomatology on the EDI-3 and frequency of bingeing and purgeing. Risk-taking was also found to be correlated with symptoms of bulimia. Differences were found between subjects who chose the immediate prize versus those who chose the delayed prize, including differences in cognitive task performance and symptom severity. Differences were also found for subjects with a comorbid disorder of impulse control, including bipolar disorders and substance abuse. In conclusion, a unilateral deficit of impulse control was not found to be characteristic of this sample; however, a multi-impulsive cohort was identified as having deficits of cognitive impulse control.
Temple University--Theses

The overall aim of this thesis was to explore the role of different assessment tools and training regimens in assessment and remediation for children with special educational needs in school. A central purpose of assessment explored was that it should inform remediation, teaching and instruction. The concepts of working memory, complex executive function and metacognitive strategy training for children with special educational needs were specifically explored in relation to this purpose of assessment. Complex executive function refers to planning and metacognitive ability, that many children with special educational needs struggle with, and which they are expected to handle in learning during school day. Of particular interest in the thesis was the contrast between working memory and complex executive function and how these concepts inform assessment and remediation practices. In this context, special attention was given to mathematical learning difficulties. The thesis was based on four studies (I‑IV). Study I explored the prevalence of different assessment tools, and dilemmas and challenges as perceived by assessment professionals, teachers and parents, in the work with children with special educational needs in Europe. In Study II, a metacognitive strategy training framework was developed as a training regimen, guided by research on complex executive function, and applied on working memory training. Effects of working memory training were compared between the two training regimens, with and without metacognitive strategy training, and also the overall effect of working memory training on cognitive functioning and the school related skills of reading, writing and arithmetic. In Study III, different types of measures of working memory and their predictive capacities in relation to mathematics achievement in national curriculum assessments were explored, as well as the effects of working memory training on mathematics achievement. In Study IV the role of working memory and complex executive function in identifying risk for mathematical learning difficulties in children with special educational needs was explored. The results from Study I suggested that assessment and remediation practices can contribute to a deficiency‑oriented outlook on children with special educational needs. In contrast parents and teachers in Sweden also reported that assessment could help them to better understand the needs of the child. Results from studies II-IV showed that only the use of a metacognitive strategy training regimen targeting complex executive function resulted in improvements following working memory training. The results also indicated that working memory training strongly predicted mathematical performance in national curriculum assessments of mathematics in school, and that a more complex change measure of working memory was a better predictor than simple working memory measures in this regard. Finally, the results also showed that complex executive function, defined as planning ability, was a better predictor than simple working memory in the assessment of risk for mathematical learning difficulties. The results from the studies were discussed in relation to the purpose of assessment to inform remediation, teaching and instruction for children with special educational needs. It was concluded that, in addition to working memory, as complex executive function – planning and metacognitive ability - seems to be an important cognitive function related to learning, this should be addressed both in the assessment of children with special educational needs as well as in the remediation when designing training regimens and interventions for children with special educational needs in general, and children at risk for mathematic learning difficulties in particular. It was also highlighted that in remediation, the role of the teacher as a mediator of metacognition and complex executive function seems vital.
Det övergripande syftet med avhandlingen var att undersöka den roll som olika utredningsverktyg och begrepp spelar i utformandet av utrednings‑ och stödinsatser för barn i behov av stöd i skolan. Ett centralt syfte med utredningar som utforskades är att de ska bidra med kunskaper vid utformande av stödinsatser och undervisning. I relation till detta syfte utforskades specifikt begreppen arbetsminne, komplex exekutiv funktion och metakognitiv strategiträning för barn i behov av stöd. Komplex exekutiv funktion syftar till planerings- och metakognitiv förmåga, något som många barn i behov av stöd upplevs ha svårigheter med, och som de förväntas kunna hantera i lärandet i skolans vardag. Av särskilt intresse i avhandlingen var kontrasten mellan arbetsminne och komplex exekutiv funktion och hur dessa begrepp bidrar till en förståelse i utformandet av utrednings- och stödinsatser. I detta sammanhang uppmärksammades särskilt matematiksvårigheter hos barn i behov av stöd. Avhandlingen bygger på fyra studier (I-IV). I Studie I undersöktes förekomsten av olika utredningsverktyg, samt utredares, lärares och föräldrars uppfattningar av dilemman och utmaningar i arbetet kring barn i behov av stöd, i Europa. I Studie II utformades ett koncept för metakognitiv strategiträning med utgångspunkt från forskning kring komplex exekutiv funktion och tillämpades i arbetsminnesträning. Effekten av arbetsminnesträning med och utan metakognitiv strategiträning jämfördes, liksom effekten av arbetsminnesträning på kognitiva funktioner och skolrelaterade färdigheter inom läsning, skrivning och aritmetik. I Studie III undersöktes olika mått på arbetsminne, och deras prediktiva kapacitet i relation till matematisk förmåga mätt genom nationella prov i matematik, samt effekten av arbetsminnesträning på matematisk förmåga. I Studie IV undersöktes vilken roll arbetsminne och komplex exekutiv funktion har i identifiering av barn i behov av stöd i riskzon för matematiksvårigheter. Resultaten från Studie I visade att utrednings- och stödinsatser kunde bidra till att förstärka ett brist-orienterat synsätt på barn i behov av stöd. I kontrast till detta, delgav lärare och föräldrar i Sverige att utredningar kunde hjälpa dem att förstå barnets behov på ett bättre sätt. Resultaten från studie II-IV visade att enbart den metakognitiva träningen, fokuserad på komplex exekutiv funktion, bidrog till förbättringar efter arbetsminnesträning. Resultatet indikerade också att arbetsminnesträning predicerar matematisk prestation i nationella prov i matematik, och att ett mer komplext arbetsminnesmått var en bättre prediktor än enklare arbetsminnesmått. Slutligen visade resultaten också att komplex exekutiv funktion i form av planeringsförmåga var en bättre prediktor än enkelt arbetsminnesmått vid utredning av risk för matematiksvårigheter. Resultaten från studierna diskuterades i relation till syftet med utredning: att bidra med kunskaper vid utformande av extra anpassningar, särskilt stöd och undervisning för barn i behov av stöd. Eftersom komplex exekutiv funktion –planerings- och metakognitiv förmåga - verkar vara en viktig kognitiv funktion i lärandet, bör man ta hänsyn till detta både i utrednings- och stödinsatser kring barn i behov av stöd generellt, och särskilt kring barn i riskzon för matematiksvårigheter. Det belystes också att i stödinsatser är lärarens roll som mediator av metakognition och komplex exekutiv funktion viktig.

Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 3 (inskickat), delarbete 4 (inskickat)

At the time of the doctoral defence the following papers were unpublished: paper 3 (submitted), paper 4 (submitted)

ABSTRACT Students with learning difficulties comprise one of the main groups of children referred for assessment to Australian occupational therapists. Teachers and parents typically express concern regarding difficulty with participation during school occupations. In particular, teachers and parents describe the cognitive aspects of participation as being a challenge. While much research has focused on the concept of participation for students with physical disabilities, little is known about the impact of cognitive dimensions of a learning difficulty on school participation. There are few ecological assessments which document difficulties with the cognitive aspects of school participation relative to the expectations of task performance. Specifically, there is a lack of standardised assessments which utilise the perspectives of teachers and parents. The initial purpose of this study was to explore the concept of participation and how students with learning difficulties used cognitive strategies to participate successfully in school occupations. The second purpose of the study was to develop a teacher and parent questionnaire that might assist in the occupational therapy assessment of the cognitive aspects of a student’s school participation. A review of the literature was motivated by the need to better understand the construct of participation and to determine how best to measure cognitive strategy use as a component of school participation. The subsequent research was then carried out in three phases. Phase One explored difficulties in school participation using a longitudinal retrospective case study of one student with a learning difficulty over 13 years. In addition, 50 teachers and 44 parents were surveyed regarding participation. Data collected from this phase formed the basis of Phase Two in which a teacher and ii parent questionnaire was constructed following principles of questionnaire construction. An instrument, PRPP@SCHOOL-Version 1(Teacher Questionnaire and Parent Questionnaire), was developed which reflected theoretical and empirical descriptions of cognitive strategies and descriptors used in an existing instrument, the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis. These questionnaires, designed to form a companion instrument to the PRPP System of Task Analysis, were trialled on 355 children, referred to a private occupational therapy clinic in Greater Western Sydney. Data were analysed to determine measurement viability. Phase Three of the study comprised reliability and validity testing on the PRPP@SCHOOL-1(TQ & PQ). Intraclass correlations indicated excellent test-retest reliability with a high level of agreement for the PQ. Content validity was determined through consumer review, peer review, and an expert panel review. Discriminant validity testing confirmed that the PRPP@SCHOOL-1(TQ & PQ) was able to differentiate between typically developing students and students with learning difficulties. Construct validity was assessed. Five factors emerged from the analysis which also demonstrated that the PRPP@SCHOOL-1(TQ & PQ) was functioning as a multidimensional measure. Findings indicated that for children in this study, participation in school occupations was undermined by challenges with inefficient cognitive strategy use. Teachers and parents were able to observe and clearly identify these difficulties using the PRPP@SCHOOL-1(TQ & PQ). This research adds a companion instrument to the PRPP System of Task Analysis in the form of teacher and parent questionnaires to be used with students who experience school participation difficulties. In so doing, the research contributes to the expansion of occupation-focused, criterion-referenced ecological instruments recommended by the profession as best practice assessment.

The utility of a popular test of planning, the Tower of London (TOL), was improved by addressing its limitations. The ceiling effect of the most commonly used version was removed by modifying the materials to increase item difficulty. To improve reliability, psychometric criteria were used to select the test items. An initial pool of 33 problems was administered to 65 children (M = 6.92 years, SD = 1.08) and 73 adults (M = 43.62 years, SD = 19.96) to derive 11 items of graded difficulty and maximal item discrimination. When these items were administered to 33 undergraduates (M = 26.10 years, SD = 9.79), the single item which did not retain its difficulty level was removed. Although low, the internal consistency in this sample (split-half r = .39) was higher than that of the TOL (Cronbach's alpha = .30) which was administered to 23 undergraduates (M = 25.61 years, SD = 8.69). Normative data for the modified version (the TOL4) were collected for a total of 447 people aged between 5 and 53 years. The split-half reliability in this sample was acceptable (r = .60), as was the 1-month test-retest reliability of .71 for a sample of 61 adults and children (M = 26.08 years, SD = 13.98). Although there was a slight practice effect, F(1,60) = 6.80, p = .01, the improvement was not clinically important (Mtime1 = 20.59, SD = 4.34; Mtime2 = 21.49, SD = 3.16). The construct validity of the total score as a measure of planning was demonstrated in three ways. First, the developmental improvement in the normative sample was consistent with both cognitive theory and previous research with the TOL. Second, in a sample of 73 undergraduates (M = 24.77 years, SD = 8.39) the total score correlated with measures of planning (Tinkertoy Test, r = .28, p < .05; Porteus Mazes; r = -.27, p < .05), but not with measures of other abilities, such as concept formation, verbal fluency, switching and memory. Finally, in a principal components analysis with the same sample, the total score loaded with a measure from the Porteus Mazes on a Planning component. In contrast, the planning time measure had a different developmental trajectory and different correlations. It appeared to measure response inhibition and the speed of encoding and conceptualising problems. The results of this study have several implications for improving the assessment of planning in both clinical and experimental contexts. Most important, users can be confident that the TOL4 accurately measures aspects of planning ability, is suitable for repeated administrations with the same client, and is applicable across a wide age range. Additional research to extend the norms to older adults and to evaluate criterion-related validity would further improve the utility of the TOL4.
Thesis (Masters)
Master of Philosophy (MPhil)
School of Applied Psychology
Griffith Health
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Among the various diseases that affect the elderly stand out from them cardiovascular disease among them heart failure (HF). Recently seeks to check for cognitive impairment associated with physical and psychological damage commonly known in the IC. We analyzed a population of patients with heart failure in order to compare their cognitive performance with that of individuals with normal aging in paired age. It was also verified whether there was any more specific impairment of some cognitive function in these HF patients. Through neuropsychological tests it was compared to 78 elderly and 37 in the control group (mean age 68.3 ± 6.3), 41 clinical group with mean age of 68.6 ± 6.9). The subjects were matched to the level of education with a predominance of elderly people with 0-4 years of education (65.9% in the Clinical Group and 59.5% in the control group). We used 11 neuropsychological tests covering the cognitive functions: attention, language, memory, mood and executive function. The results showed significant differences mainly in executive functions which include planning capacity, organization, alternation and evocation of Previously stored information. Cognitive performance in other functions was similar between the groups. The data collected when indicating cognitive impairment in individuals with HF, suggest that new studies be performed with this population since the impairments in cognitive abilities have implications in the daily life of the individual, in their independence and quality of life, as well as in adherence to treatment.
Dentre as diversas patologias que acometem os idosos destacam-se as doenças cardiovasculares, entre elas a Insuficiência Cardíaca (IC). Recentemente, busca-se verificar a existência de prejuízos cognitivos associados a prejuízos físicos e psicológicos, comumente conhecidos na IC. Analisamos uma população de pacientes com insuficiência cardíaca com o objetivo de comparar seu desempenho cognitivo com o de indivíduos com envelhecimento normal em idade pareada. Verificou-se, ainda, se havia nesses pacientes com IC algum comprometimento mais específico de alguma função cognitiva. Foram utilizados onze testes neuropsicológicos abrangendo as funções cognitivas: atenção, linguagem, memória, humor e função executiva. A amostra foi composta de 78 idosos ao total. O grupo controle foi composto de 37 indivíduos (com idade média de 68,3 ± 6,3) e o grupo clínico de 41 indivíduos (com idade média de 68,6 ± 6,9). Os sujeitos foram pareados em relação ao nível de escolaridade, com predomínio de idosos com 0 a 4 anos de estudo (65,9% no Grupo Clínico e 59,5 % no Grupo Controle). Os resultados apontaram diferenças significativas entre os grupos, principalmente nas funções executivas, que englobam capacidade de planejamento, organização, alternância e evocação da informação anteriormente armazenada. O desempenho atentivo mostrou-se alterado no que se refere à atenção alternada, bem como no que diz respeito à velocidade de processamento, tendo o grupo clínico mostrado pior desempenho nessas habilidades. A memória de curto prazo também possui pior desempenho no grupo clínico, grupo que, ademais, apresentou dificuldades na memória de longo prazo, sofrendo interferência de prejuízos executivos nessa habilidade. Os dados colhidos ao apontarem prejuízos cognitivos nos indivíduos com IC sugerem que novos estudos sejam realizados com essa população, visto que os prejuízos nas habilidades cognitivas implicam em danos no cotidiano do indivíduo, na sua independência e na qualidade de vida, bem como na adesão ao tratamento.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The assessment of cognition and behavior in early childhood education has been the subject of several studies, which suggest the importance of this school stage for children development as well as the possibility of identifying early signs predictive of future learning difficulties. Among the learning-related skills are the executive functions (EFs), which relate to behavior-oriented goals that enables people to act adaptively in the world. There is evidence that children who have better performance in EFs activities do better in school and also have better behavioral indicators. The objective of this research was to investigate the development of EFs. And their relationship with language and behavior in 3-6-year-old children. The subjects were 32 children, of both sexes, from Nursery and Levels 1 and 2, in a private school for early childhood education located in São Paulo. The instruments used to assess EFs were Trail Making Test, Computerized Stroop Test for preschoolers, Attention Test for Cancellation and EFs and Children s Regulations Inventory (IFERI). To evaluate oral language were used the Phonological Awareness Test, Peabody Picture Vocabulary Test, Words and Non-Words Repetition Test and Child Naming Test. Written language was evaluated by the recognition of letters and sounds, writing the name and reading and writing activities. Children s behavior was assessed by the Strengths and Difficulties Questionnaire (Strengths and Difficulties Questionnaire SDQ). The questionnaires were answered by children s guardians and teachers. Parametric and nonparametric analysis revealed effect of series on at least on measure of all instruments used, except IFERI-Parents, indicating that EFs tend to develop with school progression. There were several significant correlations between tests of the same skill and between different measures. In tests that assess EFS, measures that assess attention had very high and high correlations with measures of oral language and written language. This result points out that in fact EFs appear to be related to reading and writing, being important for the development of oral language and early literacy. Such relationships are considered unique, with little national and international reference about it. This result should be investigated more specifically in future research and can reveal that since very early ages, EFs are already important to the development of oral language, and vice versa, perhaps in a bilateral relationship of mutual influence. Correlation analysis between test and the answers in inventories showed few significant correlations of high magnitude, however lower scores in EFs tests tend to be more correlates to complaints in situations that assess executive functions (IFERI) and behavior (SDQ) reported by parents and in children from kindergarten, as revealed significant relationships between EFs, oral and written language and behavioral measures. Although it is no possible to derive a causal relationship, the results support the importance of identifying delays in the development of skills assessed and develop early interventions.
A avaliação da cognição e do comportamento na Educação Infantil tem sido alvo de diversas pesquisas, as quais sugerem a importância dessa fase escolar para o desenvolvimento das crianças, assim como a possibilidade de identificar precocemente sinais preditores de futuras dificuldades de aprendizagem. Dentre as habilidades relacionadas à aprendizagem estão as funções executivas (FEs), que se relacionam a comportamentos orientados a objetivos que permitem ao indivíduo agir de forma adaptativa no mundo. Há evidências de que crianças que possuem melhor desempenho em atividades de FEs têm melhor desempenho escolar e melhores indicadores comportamentais. O objetivo dessa pesquisa foi investigar o desenvolvimento das FEs e sua relação com a linguagem e comportamento em crianças de 3 a 6 anos. Participaram 32 crianças, de ambos os sexos, do Maternal e Níveis 1 e 2, de uma escola particular de Educação Infantil de São Paulo. Os instrumentos utilizados para avaliar as FEs foram Teste de Trilhas, Teste de Stroop Computadorizado para pré-escolares, Teste de Atenção por Cancelamento e Inventário de FEs e Regulação Infantil (IFERI). Para avaliar a linguagem oral foram utilizadas a Prova de Consciência Fonológica por Produção Oral, o Teste de Vocabulário por Imagens Peabody, o Teste de Repetição de Palavras e Pseudopalavras e o Teste Infantil de Nomeação. A linguagem escrita foi avaliada pelo reconhecimento de letras e sons, escrita do nome e leitura e escrita. O comportamento infantil foi avaliado pelo Strengths and Difficulties Questionnaire (Questionário de Capacidades e Dificuldades - SDQ). Os questionários foram respondidos por responsáveis e professores das crianças. Análises paramétricas e não paramétricas revelaram efeito de série em pelo menos uma medida de todos os instrumentos utilizados, com exceção do IFERI-Pais, indicando que as FEs tendem a se desenvolver com a progressão escolar. Houve várias correlações significativas entre testes de uma mesma habilidade e também entre diferentes medidas. Nos testes que avaliam FEs, as medidas que avaliam atenção tiveram correlações muito altas e altas com medidas de linguagem oral e linguagem escrita. Esse resultado ressalta que, de fato, as FEs parecem estar relacionadas com a leitura e a escrita, sendo importantes para o desenvolvimento da linguagem oral e para o início da alfabetização. Tais relações são consideradas originais, havendo pouca referência sobre isso, tanto nacional quanto internacionalmente. Esse resultado deve ser investigado de forma mais específica em pesquisas futuras e pode revelar que, desde idades bastante precoces, as FEs já são importantes para o desenvolvimento da linguagem oral, e vice-versa, talvez em uma relação bilateral de influência mútua. As análises de correlação entre os testes e as respostas nos inventários demonstraram poucas correlações significativas de alta magnitude, porém menores escores nos testes de FEs tenderam a se relacionar com mais queixas nas situações que avaliam as funções executivas (IFERI) e comportamentos (SDQ), relatados por pais e professores. A presente pesquisa corroborou os pressupostos teóricos sobre o efeito de série das FEs em crianças da Educação Infantil, assim como revelou relações significativas entre FEs, linguagem oral e escrita e medidas comportamentais. Embora não seja possível derivar uma relação causal, os resultados corroboram a importância de se identificar atrasos no desenvolvimento das habilidades avaliadas e desenvolver intervenções precoces. 

Lors d'une évaluation neuropsychologique, il est attendu du patient une mobilisation optimale de ses capacités cognitives, afin d’objectiver de la façon la plus précise possible son tableau clinique. Sa collaboration et son implication au cours de l'examen sont en effet fondamentales puisqu’elles participent fortement à la validité de ses résultats, et de ce fait à la solidité des conclusions diagnostiques. Le biais de réponse se définit aujourd’hui comme l’ensemble des comportements visant à intentionnellement modifier ses performances cognitives. Malgré une abondante littérature sur ce concept au cours des deux dernières décennies, plusieurs questions perdurent, particulièrement en regard de ses aspects qualitatifs et des mécanismes associés. A travers quatre études, ce projet de thèse a tenté de répondre à ces problématiques, en apportant des connaissances complémentaires sur le biais de réponse. Une première expérimentation s’est ainsi intéressée à préciser la nature des comportements liés au biais de réponse, en l’explorant de façon originale dans plusieurs domaines cognitifs et au sein d’un échantillon mixte, incluant notamment des patients présentant une altération cognitive. Elle a permis de mettre en lumière un large répertoire de ses manifestations, et a apporté des arguments en faveur d’une participation de facteurs cognitifs dans la production du biais de réponse. Les deux études suivantes se sont vouées à adapter et valider trois outils psychométriques spécifiques à l’évaluation du biais de réponse (Performance Validity Tests), en testant leur pertinence et leur efficacité dans une large population francophone clinique et générale. Enfin, le dernier volet a cherché à comprendre le rôle joué par les facteurs associés au biais de réponse, en analysant son lien avec les processus exécutifs et métacognitifs. L’analyse des observations a alors confirmé l’existence d’une influence du fonctionnement exécutif dans le biais de réponse. L’ensemble des résultats recueillis à l’issue de ce travail souligne la complexité et la richesse du biais de réponse et permet de suggérer une nouvelle modélisation de ce concept, tenant compte de son caractère multidimensionnel et possiblement multifactoriel
During a neuropsychological evaluation, optimal mobilization of the patient’s cognitive capacities is required in order to accurately objectify their clinical picture. The collaboration and involvement of the patient during the examination are fundamental to the validity of the results and hence the strength of the diagnostic. The current definition of response bias is the set of behaviours intended to intentionally modify one's cognitive performances. Despite an extensive literature on this concept over the last two decades, several questions remain, particularly regarding the qualitative aspects and the associated mechanisms. Through four studies, this dissertation has tried to answer these issues by providing complementary knowledge on response bias. The first experiment aimed to clarify the nature of behaviours related to response bias, in several cognitive domains and in a mixed sample including patients with cognitive impairment. This has shed light on a broad repertoire of its manifestations and has provided arguments for the participation of cognitive factors in the production of response bias. The following two studies have adapted and validated three specific psychometric tools known as Performance Validity Tests, by testing their relevance and effectiveness in large French-speaking samples including neurological patients and the general population. Finally, the last part sought to understand the role played by the factors associated with response bias, by analysing its link with the executive and metacognitive processes. The observations analysis has confirmed the existence of an impact of the executive functioning in response bias. All the results gathered underline the complexity and richness of response bias and suggest a new modelling of this concept, considering its multidimensional and possibly multifactorial nature

`Background:` It is known that individuals born preterm are at risk of developing executive function and behavioural difficulties. Nevertheless, most studies in this field have focussed on school-age children, as investigation of executive functions of younger preschool and early school-age children (under six years old) has only recently gained attention. Consequently, there is little knowledge about social and perinatal risk factors contributing to executive function difficulties in young preterm children and how to best identify those at risk of developing executive function difficulties. The overall aims of the present thesis were to explore the relationship between executive functioning and social and perinatal risk factors in four- to five-year-old preterm children, and how to best identify children most at risk of executive function difficulties prior to starting formal schooling. This thesis integrates three published or submitted articles, each addressing a separate research question related to the overarching thesis aims. All articles incorporate information regarding a sample of 141 children born preterm (< 33 weeks of gestation) and 77 term comparison children who were assessed using standardized measures of general intelligence and performance-based executive function tests prior to starting kindergarten at the age of four years. Parental and teacher reports of executive functioning and behaviour were completed when the children commenced kindergarten at four to five years of age. `Study` `1` Aim: To establish whether four- to five-year-old preterm children had more executive function difficulties than their term peers, and if so, to identify the social and perinatal risk factors associated with such discrepancy. Methods: The preterm and term groups were compared on measures of intelligence and executive functions using independent group t-tests, and multivariate regression analyses were performed to identify social and medical risk factors predictive of intelligence and executive functioning in the preterm group. Results: The preterm group performed significantly more poorly than the term group on all intelligence and performance-based executive function assessments. The parental reports relating to executive function for preterm and term children did not significantly differ, but the teachers reported more executive function difficulties for the preterm group than the term group. Overall, higher social risk, and in particular lower educational level of the main caregiver, was the strongest predictor for the preterm children’s intelligence and executive function difficulties. `Study` `2` Aim: To determine whether specific performance-based executive function assessment tools were associated with executive functioning in everyday life as reported by parents and teachers of four- to five-year-old preterm and term children. Methods: The associations between performance-based intelligence, executive function assessments, and executive function questionnaires were explored by using multiple regression analyses. `Study` `3` Aim: To investigate the congruency of parent and teacher reporting of executive functions and behaviour of kindergarten-age preterm and term children. Methods: Parent and teacher reporting of executive function and behaviour were compared using 2x2 mixed ANOVA and Kappa statistics. Results: Parents reported higher levels of executive function and behavioural difficulties than the teachers for both groups combined (preterm and term). The parent and teacher reports of behaviour and executive function differed significantly and were not in agreement relating to which children exhibited clinically significant executive function and behavioural problems. `Conclusion:` Formal guidelines relating to surveillance of young preterm children’s executive function and behaviour difficulties are needed, especially relating to selection criteria for follow-up (i.e., based solely on gestational age or also other factors), recommended assessment batteries, and the timing of the assessments. To assist in achieving these outcomes, it is recommended that future studies focus on improving the ecological validity of psychometric assessments of preterm children. Increased accuracy in early identification of at-risk preterm children could enable timely executive function and behavioural support and intervention, which could lead to narrowing the current gap in developmental and educational outcomes between preterm and term children.

Objective: This work consisted of three research projects bridged by their focus on a multivariate assessment of executive functions in research and practice: (a) a systematic review and re-analysis of latent variable studies on executive function test batteries, (b) a confirmatory factor analysis (CFA) of the Delis-Kaplan Executive Function System (D-KEFS), the most commonly administered executive function test battery in clinical practice, and (c) the derivation of multivariate base rates for the D-KEFS, offering a psychometric resource with direct applications to clinical practice. Method: Systematic review. The systematic review identified 45 eligible samples (N=9,498 participants, mean age range: 3.01-74.40 years-old) and 21 correlation matrices eligible for re-analysis, comparing seven competing models including the most commonly evaluated factors: updating/working memory, inhibition, and shifting. Model results were summarized based on the mean percent accepted (i.e., mean rate at which models both properly converged and met fit thresholds: CFI≥.90/RMSEA≤.08). CFA. Using adults from the D-KEFS normative sample (N=425; 20-49 years-old), eight alternative measurement models were evaluated for a subset of D-KEFS tests. Factors from the accepted measurement model predicted three tests measuring constructs less often evaluated in the executive function literature: abstraction, reasoning, and problem solving. Base rates. The frequency of low scores occurring among the D-KEFS normative sample (N=1,050; 16-89 years-old) was calculated for the full D-KEFS and two brief batteries using stratifications for age, education, and intelligence. Results: Systematic review. The most often accepted models varied by age (preschool=one/two-factor; school-age=two/three-factor; adolescent/adult=three/nested-factor; older adult=two/three-factor), and most frequently included updating/working memory, inhibition, and shifting factors. The nested-factor and three-factor models were accepted most often and at similar rates among adult samples: 33-34% and 25-32%, respectively. No model was accepted most often for child/adolescent samples, but those with shifting differentiated garnered less support. CFA. A three-factor model including inhibition, shifting, and fluency fit the data well (CFI=0.938; RMSEA=0.047), although a two-factor model merging shifting/fluency fit similarly well (CFI=0.929; RMSEA=0.048). A bifactor model fit best (CFI=0.977; RMSEA=0.032), but rarely converged. Shifting best predicted tests of reasoning, abstraction, and problem solving (p<0.05; R2=0.246-0.408). Base rates. Low scores, based on commonly used clinical cutoffs, occurred frequently among healthy adults. For a three-test, four-test, and full D-KEFS battery, 62.8%, 71.8%, and 82.6% obtained ≥1 score(s) ≤16th percentile, respectively, and 36.1%, 42.0%, 50.7%, obtained ≥1 score(s) ≤5th percentile, respectively. The frequency of low scores increased with lower intelligence and fewer years of education. Discussion: The systematic review effort did not identify a definitive model of executive functions for either adults or children/adolescents, demonstrating the continued need to re-evaluate the conceptualization and measurement of this construct in future research. The D-KEFS CFA offers some evidence of clinical measures capturing theoretical constructs, but is not directly translatable into clinical practice; while the multivariate base rates are useful to clinicians, but do not bridge theory and assessment. This research reaffirms the elusive nature of executive functions in both research and clinical spheres, and represents a step forward in an enduring scientific process towards a true understanding of this mysterious construct.
Graduate
2018-07-24

Preschool years are an important period for executive function (EF) development. The two common ways of assessing EF in preschoolers are performance-based (PB) and rating measures. One of the most commonly used rating scales for preschoolers is the Behaviour Rating Inventory of Executive Function – Preschool Version (BRIEF-P). The current study explored the longitudinal relationship between three PB measures (Grass/Snow, Shape School, Self-ordered Pointing) and corresponding BRIEF-P scales (Inhibit, Shift, Working Memory) in typically developing preschoolers. There were three assessments in six-month intervals. Participants included 101 children at Time 1, with 86 and 75 in subsequent assessment time points. Using a latent variable approach, longitudinal measurement invariance was tested, supporting partial strong invariance. Results showed a lack of direct correlations between PB measures and corresponding BRIEF-P scales across time. These findings were interpreted in the context of existing literature, yielding a more nuanced understanding of what these two types of measures assess. Specifically, it is proposed that BRIEF-P measures children’s subjective, average level of EF, while PB tasks measure their objective, in-the-moment EF.
Graduate

Objective: The Six Elements Task (SET; Shallice and Burgess, 1991; Burgess et al., 1996) measures examinees’ ability to plan and organize their behaviour, form strategies for novel problem solving, and self-monitor. The task has adequate specificity (Wilson et al., 1996), but questionable sensitivity to mild impairments in executive function (Jelicic, et al., 2001). The SET is vulnerable to practice effects. There is a limited range in possible scores, and ceiling effects are observed. This dissertation sought to evaluate the validity and clinical utility of a modification of the SET by increasing the difficulty of the test, and expanding the range of possible scores in order to make it more suitable for serial assessments. Participants and Methods: The sample included 26 individuals with mixed acquired brain injury, and 26 healthy matched controls (20 – 65 years). Participants completed a battery of neuropsychological tests on two occasions eight weeks apart. To control for confounding variables in executive function test performance, measures of memory, working memory, intelligence, substance abuse, pain, mood and personality were included. Self and informant reports of executive dysfunction were also completed. The two groups’ performances on the various measures were compared, and the external validity of the 12ET was examined. In addition, normative data and information for reliable change calculations were tabulated. Results: The ABI group exhibited very mild executive function deficits on established measures. The matched control group attempted more tasks on the 12ET, but the difference was non significant. Neither group tended to break the rule of the task. The 12ET showed convergent validity with significant correlations with measures of cognitive flexibility (Trailmaking B and Ruff Figural Fluency), and a measure of planning (Tower of London). The 12ET and published measures were also significantly correlated with intelligence in the brain-injured group. The 12ET did not show divergent validity with a test of visual scanning speed (Trailmaking A). No demographic variables were found to be significant predictors of 12ET performance at Time 2 over and above performance at Time 1, and both participant groups obtained the same benefit from practice. The 12ET did not suffer from ceiling effects on the second administration, and the test-retest reliability of the 12ET variables ranged from low (r = .22 for Rule Breaks in the brain-injured group) to high (r = .78 for Number of Tasks Attempted in the control group). Conclusions: Despite their (often severe) brain injuries, this sample of brain injured participants did not demonstrate executive impairments on many published tests and their scores were not significantly different from the control group’s scores. Therefore, it was not possible to determine if the 12ET was a more sensitive measure of mild executive deficits than the SET. However, the increase in range did reduce the tendency for participants to perform at ceiling levels. The 12ET showed a number of significant correlations with other executive measures, particularly for the brain-injured group, though these correlations may have been moderated by general intelligence. Two variables of the 12ET, deviation from the optimal amount of time per task and Number of Tasks Completed, showed promise as measures of reliable change in this sample over an 8-week interval.

Objective: Executive functions govern our ability to navigate complex and novel situations in day-to-day life. There is increased interest on environmental influences that may cause changes to executive functioning. The current thesis involves two studies examining the derivation and performance of an executive behaviour screener from the Behavioral Assessment System for Children (BASC-2-PRS; Reynolds & Kamphaus, 2004) on two different adolescent samples using a previously derived four-factor model of executive functioning (Garcia-Barrera et al., 2011, 2013). Participants and Methods: Study 1. BASC-2 PRS standardization data consisting of a demographically matched American sample of 2722 12-21 year olds was obtained. The screener was derived using 25 items assigned a priori to each executive factor. Confirmatory factor analysis (CFA), invariance testing, and multiple indicators multiple causes (MIMIC) models were used to evaluate the screener. Study 2. The screener was applied to a previously collected sample of 479 elite adolescent hockey players from Canada with or without a history of concussion, followed through a single season of play. CFA, invariance testing, and MIMIC models were used to evaluate the screener and the hockey sample was compared to the standardization sample. Results: Study 1. Acceptable-to-good reliability was obtained for all factors (α = .75-.89). The four-factor model was the best fit to the data (CFI = .990, TLI = .989, RMSEA = .037). Configural, metric, and scalar but not latent mean invariance was shown for sex. Age-related uniform differential item functioning (DIF) and SES-related uniform and non-uniform DIF were shown. Standardized norms for use in clinical settings were created. Study 2. Acceptable-to-good reliability was shown for 3 factors (α = .72-.85). Emotional Control showed poor reliability (α = .58). The four-factor model was the best fit to the data (CFI = .991, TLI = .990, RMSEA = .026). Configural, metric, and scalar but not latent mean invariance was shown between the two samples. Uniform and non-uniform DIF were not observed for those with an increasing number of past concussions. Conclusions: Findings support the four-factor model measured through the screener in adolescence. Females and hockey players demonstrate fewer executive behaviour problems overall. Sex, age, and SES may influence the interpretation of factor scores. Continued exploration and development of the screener is suggested.
Graduate
2018-09-27

Executive functioning skills are paramount to our ability to purposefully and successfully mediate our actions within our day-to-day environment. Dysfunction of the executive system can result in a multitude of behavioral manifestations in all stages of life. Increasing evidence supports the use of rating scales to obtain a more comprehensive and ecologically valid understanding of an individual’s executive functioning. The current thesis involves two articles examining the use of behavioral rating scales in the assessment of executive functions. Study 1: In response to a recent proliferation of executive functions rating scales, this article reviews and discusses currently available scales for the assessment of executive functions across the lifespan. Study 2: This study derived an executive functions screener from the Behavioral Assessment System for Children (BASC-2-SRP-COL) for use in young adults and evaluated it against a well-known executive function rating scale (the Behavior Rating Inventory of Executive Function-Adult Version).
Graduate
0622
0632
eduggan@uvic.ca

This dissertation explores the occurrence of symptoms of temporolimbic dysfunction with persons with mood disorder. Groups of pacients was concerned to persons with depression and manic depression disorder. The occurrence of symptoms was examined by questionnaire method. It is assumed that mood disorders are result of damage of structures in the temporolimbic area and that they will also manifest in the questionnaires being used. Theoretical part describes anatomy of the temporolimbic area and temporolimbic dysfunction. Practical part is focused on the evaluation of the outcomes from submitted questionnaires. KEY WORDS Temporolimbic disfunction, limbic system, depression, manic depression

Dissertação de Mestrado Integrado em Psicologia apresentada à Faculdade de Psicologia e de Ciências da Educação
Introdução: O envelhecimento da população é cada vez mais evidente nas últimas décadas e, por esse motivo, torna-se importante entender as especificidades deste processo. A avaliação (neuro)psicológica tem contribuído para esse entendimento, com o desenvolvimento e a validação de vários testes, questionários/inventários, visando o conhecimento mais aprofundado das pessoas idosas, em termos de perfil de funcionamento cognitivo, quer no envelhecimento dito normativo, quer no patológico. Especificamente, considerando a sua importância para a saúde mental, as funções executivas constituem-se como um domínio a explorar/investigar.Objetivo: A presente investigação tem como principal objetivo contribuir para a validação para a população portuguesa de um inventário de funções executivas, o Inventário de Avaliação Comportamental de Funções Executivas – Versão para Adulto (BRIEF-A; The Behavior Rating Inventory of Executive Function – Adult Version; Roth, Isquith, & Goia, 2005).Método: Foram recrutados na comunidade 109 sujeitos e os seus respetivos informadores, perfazendo um total de 218 participantes. Para além do trabalho de tradução do instrumento, nas suas versões para o próprio/autorrelato e para o informador, foram elaboradas análises no âmbito da precisão – estudo da consistência interna (alfa de Cronbach) e do acordo entre avaliadores (coeficiente de correlação intraclasses), - e da validade -validade de construto (análise fatorial exploratória), e validade concorrente (correlações com o MoCA e a GDS-30).Resultados: Foram observados valores bons e muito bons de consistência interna, para o valor total e índices do BRIEF-A, e razoáveis a bons nas escalas, exceto para a escala de Inibição da versão autorresposta (α=.49), e um bom acordo entre avaliadores (sujeito e informante significativo) entre as duas versões. Relativamente à estrutura do instrumento, foi replicada a do estudo original, sendo o instrumento composto por dois fatores (IMC e IRC) que explicam, no caso da versão autorresposta, 66.99% da variância e, no caso da versão informante, 70.70%. Por fim, na validade concorrente, obtiveram-se correlações positivas entre os indicadores do BRIEF-A e a GDS-30 e correlações negativas entre os indicadores do BRIEF-A e o MoCA.Conclusão: Neste estudo exploratório, o BRIEF-A, nas suas versões de autorresposta e para o informador significativo, evidenciou propriedades psicométricas adequadas. Nesse sentido, pode constituir-se como um instrumento relevante para avaliação das funções executivas, potenciando a compreensão do perfil de funcionamento (neuro)psicológico de adultos e adultos idosos portugueses.
Introduction: The human population aging is increasing therefore it is important to understand the specificity of this process. The neuropsychological assessment contributes to understanding aging, with the development and validation of various tests and inventories, and the establishment of neuropsychological profiles, either in normative and pathological aging. Specifically, considering their importance to mental health, executive functions constitute a relevant domain of research.Objective: This research aims to contribute to the validation process for the Portuguese population of an inventory of executive functions, the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A; Roth, Isquith, & Goia, 2005).Method: A total of 109 subjects and their informants were recruited from the community, making a total of 218 participants. In addition to the translation of the instrument, in its self-report and informant versions, reliability analyzes [internal consistency (Cronbach's alpha) and agreement between evaluators (intraclass correlation coefficient)], and validity analizes [construct validity (exploratory factor analysis), and concurrent validity (correlations with MoCA and GDS-30)] were performed.Results: Good and very good internal consistency values were observed for the BRIEF-A’s total result and acceptable and good for scales’ results, except for the Inhibit scale in Self- Report Form (α = .49). Results evidenced adequate inter raters (subjectand informant) values. Regarding construct validity, the original factorial structure of the instrument was replicated: two factors (MI and BRI) that explain 66.99% of variance in the Self-Report Form, and 70.70% in the Informant-Report Form. Evidence of concurrent validity was demonstrated by positive correlations between BRIEF-A and the GDS-30 and negative correlation between BRIEF-A and MoCA.Conclusion: In this exploratory study, the BRIEF-A/Self-Report Form and the Informant-Report Form evidenced adequate psychometric properties. Thus, it’s a promising instrument for the evaluation of executive function of Portuguese adults and older adults.

v anglickém jazyce Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Author: Klaudie Gregorová Supervisor: Doc. MUDr. Josef Herink, DrSc. Title of diploma thesis: Signs of epilepsy spectrum disorder in a student sample of non- smokers and smokers The diploma thesis deals with signs of epilepsy spectrum disorder in a student sample of non-smokers and smokers and it continues in thesis of the author M. Světlák and of the author P. Zitová. The diploma thesis is divided into the two main parts - the theoretical part summarized the issue of the temporo-limbic dysfunction, the research part answers the put questions. The main goal of the diploma thesis was to describe the issue of the temporo-limbic dysfunction in the university student sample divided into smokers and non-smokers.