Behavior Rating Inventory of Executive Function - Parent Questionnaire

Link to instrument: Link to Instrument

Acronym:

BRIEF

Purpose:

The BRIEF is an 86 item measure designed to assesses executive function skills in children 5-18 years completed by a parent.

Description:

• Child's parent or guardian completes form.
• Parent must have had recent and extensive contact with the child over the past 6 months to complete form
• Eight clinical scales: Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, Monitor
• Item level scores rated on a three point Likert scale from 1-3(1=never, 2=sometimes, 3= often)
• Combined subscales also provide three index scores: (1) Global Executive Composite(GEC) is the total score of all 8 clinical subscales; (2) Behavioral Regulation Index (BRI) is a score that includes Inhibit, Shift, Emotional Control); and (3) Metacognition Index (MCI)includes Initiate, Working Memory, Plan/Organize, Organization of Materials, and Monitor
• Item scores are summed for each clinical scale and index
• Using the appropriate gender and age range table, the raw scores are converted to T-scores, percentile and 90% confidence intervals
• Versions of the BRIEF include the following: BRIEF (Parent and Teacher questionnaires for children aged 5-18); BRIEF Preschool (BRIEF-P completed by either teacher, parent, or day care provider for children aged 2.0 to 5.11 years); BRIEF-Self-Report (BRIEF-SR, for children aged 11-18 years).

Area of Assessment: Attention and Working Memory, Cognition, Executive Function

Body Part: Not Applicable

ICF Domain: Body Function

Domain: Cognition

Assessment Type: Proxy

Length of Test: 06 to 30 Minutes

Time to Administer:

Approximately 10 - 15 Minutes

Number of Items: 86

Equipment Required:

Pen or pencil, and parent form.

Training Required:

Training would be provided by reading the manual; Interpretation of scores and profiles requires graduate training in psychology, school counseling, occupational therapy, speech–language pathology, social work, education, special education, or closely related field; as well as relevant training or coursework in the interpretation of psychological tests.

Type of training required: Reading an Article/Manual, Training Course

Cost: Not Free

Actual Cost:

BRIEF Parent Questionnaire (Pack of 25), $62; BRIEF Parent Questionnaire Scoring Summary/Profile (Pack of 50), $50.00; BRIEF Manual, $75.00

Age Range: Preschool Child: 2-5 years, Child: 6-12 years, Adolescent: 13-17 years

Administration Mode: Paper/Pencil

Diagnosis: Acquired Brain Injury, Multiple Sclerosis, Traumatic Brain Injury

Populations Tested:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Traumatic Brain Injury (TBI)
• Tourette's Disorder
• Reading Disorder
• Low Birth Weight
• Autism spectrum disorders
• Phenylketonuria (PKU)
• Bipolar disorder vs. ADH
• Childhood onset Multiple Sclerosis
• Galactosemia
• Obstructive sleep apnea
• Sickle cell disease
• 22q11 deletion

Standard Error of Measurement (SEM):

Children with Unilateral Cerebral Palsy (Piovesana et al, 2015; n=42; mean age = 11.96 years; 20 weeks ±2  between testing Time 1 and Time 2)

BRIEF Measures
Scale	SEM
Inhibit	7.68
Shift	6.89
Emotional Control	6.77
Initiate	6.63
Working Memory	5.08
Plan/Organize	4.4
Organization of Materials	3.68
Monitor	4.31
Behavioral Regulation Index(BRI)	6.14
Metacognition Index(MCI)	5.13
Global Executive Composite (GEC)	4.15

Minimal Detectable Change (MDC):

Children with Unilateral Cerebral Palsy (calculated from statistics in Piovesana et al, 2015)

BRIEF Measures
Scale	MDC
Inhibit	17.92
Shift	16.08
Emotional Control	15.08
Initiate	15.47
Working Memory	11.85
Plan/Organize	10.27
Organization of Materials	8.59
Monitor	10.06
Behavioral Regulation Index(BRI)	14.33
Metacognition Index(MCI)	11.97
Global Executive Composite (GEC)	9.68

Minimally Clinically Important Difference (MCID):

Not Established

Cut-Off Scores:

Children aged 5-18 Years (Gioia et al, 2000; n=1419; mean age = 10.70(3.35) years; boys and girls)

• A T-score of 65 or higher is interpreted as an abnormally elevated score for each of the scales and the three index measures.

Normative Data:

Not Established

Test-retest Reliability:

Children aged 5-18 years  (Huizinga and  Smidts 2011, n=847; Dutch version)

Scale or Index	ICC
Inhibit	Excellent	.94
Shift	Excellent	.89
Emotional Control	Excellent	.90
Initiate	Excellent	.81
Working Memory	Adequate	.73
Plan/Organize	Excellent	.82
Organization of Materials	Excellent	.91
Monitor	Adequate	.75
Behavioral Regulation Index(BRI)	Excellent	.95
Metacognition Index(MCI)	Excellent	.84
Global Executive Composite (GEC)	Excellent	.86

Interrater/Intrarater Reliability:

Not Established

Internal Consistency:

Children Aged 5-18:

• Excellent (Cronbach's alphas = .80-.98)(Gioia, et al, 2000)
• Adequate to Excellent  (Cronbach's alphas = .76-.96) (Huizinga and Smidts)

Criterion Validity (Predictive/Concurrent):

Concurrent Validity:

ADHD and/or Tourette Syndrome (Mahone et al, 2002; n=76 (ADHD=18, mean age 11.20(2.5) years; Tourette Syndrome=21, mean age =10.00(1.80) years; Tourette Syndrome and ADHD=17, mean age 10.80(2.7)years, controls (n=20, mean age=10.60(3.60) years)

• Excellent concurrent validity  between BRIEF WM with Child Behavior Checklist, Diagnostic Interview for Children and Adolescents (DICA) & ADHD rating scale (r=.82, .75 & .87 respectively) and BRIEF MCI on same measures with correlations at .81, .74 and .85 respectively/

Predictive validity:

ADHD:  (McCandless & O'Laughlin, 2007; n=70, mean age=8.24(1.85) years referred for ADHD assessment)

• Excellent: Behavior Regulation differentiates ADHD-Combined Type from non ADHD r=.8

ADHD: (Reddy et al, 2011; n=58, mean age= 12.02(2.32months) years

• Excellent correlation with BRI r=.77 classified 79% of children with ADHD versus control group

Construct Validity (Convergent/Discriminant):

Convergent Validity:

ADHD:  (Gioia et al, 2000, n=100, mean age=8.73(3.54)years)

• Excellent correlations of the BRIEF BRI with the ADHD Rating Scale IV Inattention Index and Hyperactivity Index (r=.67, .70 respectively).
• Excellent correlations of the BRIEF GEC with the ADHD Rating Scale's Inattention and Hyperactivity Indexes at 0.63 & 0.60 respectively
• Adequate correlations of the BRIEF Initiate scale to Child Behavior Checklist Scales (CBCL) with Withdrawn, Anxious/Depressed and Attention Problems(r=.50,r=.52 , r=0.5 respectively)

ADHD:  (McCandless & O'Laughlin, 2007; n=70, mean age=8.24(1.85) years referred for ADHD assessment)

• Excellent correlations of the BRIEF BRI with the ADHD Rating Scale IV Inattention Index and Hyperactivity Index (r=.67, .70 respectively).

Content Validity:

• Items were selected from clinical interviews of parents, teachers, and agreement from an expert panel of 12 pediatric neuropsychologists was also used.
• Items refined via item-total correlations and interrater agreement (Gioia et al, 2000)

Face Validity:

• Items were selected from clinical interviews of parents, teachers, and agreement from an expert panel of 12 pediatric neuropsychologists was also used.
• Items refined via item-total correlations and interrater agreement (Gioia et al, 2000)

Floor/Ceiling Effects:

Not Established

Responsiveness:

Not Established

Considerations:

• Further studies on the ecological validity of BRIEF in relation to behaviors within the home, classroom and community
• Further refinement to increase parent teacher inter rater reliability
• Change scores available to evaluate cognitive function of children with unilateral cerebral palsy with mild to moderate cerebral palsy should not be applied to children with more severe diagnosis of cerebral palsy or bilateral cerebral palsy
• Further studies with children with ADHD in the presence of other comorbidities may influence generalization

Bibliography:

Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. Behaviour Rating Inventory of Executive Function. Odessa, FL: Psychological Assessment Resources; 2000.

Gioia G, Isquith P, Retzlaff P, Espy K. Confirmatory factor analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in a clinical sample. Child Neuropsychology [serial online]. December 2002;8(4):249-257

Huizinga M, Smidts D. Age-Related Changes in Executive Function: A Normative Study with the Dutch Version of the Behavior Rating Inventory of Executive Function (BRIEF). Child Neuropsychology [serial online]. January 2011;17(1):51-66

Mahone EM, Cirino PT, Cutting LE, Cerrone PM, Hagelthorn KM, Hiemenz, J.R., et al.  Validity of the behavior rating inventory of executive function in children with ADHD and/or Tourette syndrome.  Arch Clin Neuropsychol.  2002; 17 (7):643–62.

McCandless S, O' Laughlin L. The Clinical Utility of the Behavior Rating Inventory of Executive Function (BRIEF) in the Diagnosis of ADHD. Journal of Attention Disorders. 2007; 10(4):381-389. doi: 10.1177/1087054706292115.

Piovesana, A. M., Ross, S., Whittingham, K., Ware, R. S., & Boyd, R. N. (2015). Stability of Executive Functioning Measures in 8–17-Year-Old Children With Unilateral Cerebral Palsy. The Clinical Neuropsychologist, 29(1), 133-149.

Rasmussen, Carmen, Rosalyn McAuley, and Gail Andrew. "Parental ratings of children with fetal alcohol spectrum disorder on the behavior rating inventory of executive function (BRIEF)." J FAS Int 5.e2 (2007): 1-8.

Reddy LA, Hale JB, Brodzinsky LK. Discriminant validity of the Behavior Rating Inventory of Executive Function Parent Form for children with attention-deficit/hyperactivity disorder. School Psychology Quarterly. 2011; 26(1):45-55. doi: 10.1037/a0022585.

Year published: 2000

Instrument in PDF Format: No

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