Kennedy Krieger Institute, Baltimore, MD, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Int Neuropsychol Soc. 2020 Nov;26(10):1036-1044. doi: 10.1017/S1355617720000636. Epub 2020 Jul 9.
Executive function (EF) difficulties are commonly found in youth with intellectual disability (ID). Given mixed results from studies using performance-based EF measures, the EF profile has not been well characterized for this population. No published work has examined the clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in distinguishing EF in ID. We hypothesized that the BRIEF2 would show greater elevations in youth with ID compared to the Average IQ comparison group.
Participants included a large sample of 504 youth (157 in ID group; aged 8-18 years) referred for (neuro)psychological evaluation (2015-2019) and identified as meeting criteria for either ID or Average IQ comparison group.
Significant elevations were found across BRIEF2 indices and scales. Only mild elevations were noted in selective cognitive regulation scales within the Average IQ group. Groups differed significantly across all EF dimensions, with greater differences observed in behavioral regulation (Self-Monitoring, Inhibition), Shift, and Working Memory. An elevated but less variable pattern of index scores was noted in ID, while the overall pattern of scaled scores appeared similar between groups.
The less variable and consistently elevated profile may suggest fewer EF dimensions in individuals with ID than the model proposed in the test manual. Similar profiles between groups may reflect differences in severity, rather than differences in constructs measured by the EF factors, per se. Additional examination is needed to confirm potential structural differences in EF for youth with ID as measured by BRIEF2, with a clinical implication for greater efficiency of EF assessment in this population.
执行功能（EF）障碍在智障（ID）青少年中很常见。鉴于使用基于表现的 EF 测量方法的研究结果不一致，因此尚未很好地描述该人群的 EF 特征。尚无研究探讨行为评估执行功能第二版（BRIEF2）在区分 ID 中的 EF 的临床实用性。我们假设 BRIEF2 在 ID 青少年中比平均智商对照组的 EF 升高更为明显。
参与者包括一个由 504 名青少年（ID 组 157 名；年龄 8-18 岁）组成的大样本，这些青少年因（神经）心理评估而被转介（2015-2019 年），并被确定符合 ID 或平均智商对照组的标准。
BRIEF2 指标和量表均存在显著升高。在平均智商组中，仅在选择性认知调节量表中观察到轻度升高。所有 EF 维度上的组间差异均有统计学意义，行为调节（自我监测、抑制）、转换和工作记忆的差异更大。ID 组的指数得分呈升高但变化较小的模式，而组间的量表得分总体模式似乎相似。
ID 个体的 EF 维度较少，变化较小，这可能表明该测试手册中提出的模型存在差异。组间的相似模式可能反映了 EF 因素所测量的结构差异，而不是严重程度的差异。需要进一步检查以确认 BRIEF2 对 ID 青少年 EF 的潜在结构差异，这对该人群的 EF 评估效率具有临床意义。
