B-57Sensitivity and Inter-rater Reliability of the Behavior Rating Inventory of Executive Function-Preschool Version in Children with Epilepsy

Moshe Maiman · Sloane Sheldon · Marsha Vasserman · Heather E. Murphy · William S. MacAllister

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Developmental and Educational Neuropsychology Epilepsy research and treatment Historical and Modern Theater Studies

Abstract

Objective: Executive dysfunction is common in children with epilepsy. Despite earlier studies demonstrating that the Behavior Rating Inventory of Executive Function (BRIEF) is a clinically useful instrument for detecting executive deficits in a school-age epilepsy population, little is available for younger children. The purpose of this study is to evaluate the sensitivity of the preschool age version of this instrument (BRIEF-P) in young children with epilepsy and to examine its inter-rater reliability. Method: The parents of 22 clinically referred children with epilepsy (Age: M = 4.05, SD=. 95, Range = 2–5; IQ: M = 83.31, SD= 25.65, Range: = <40–129) completed the BRIEF-P as part of a more comprehensive neuropsychological evaluation. For a smaller subset (n = 12), teachers also submitted BRIEF-P forms. Using a cutoff t-score of ≥65 as the threshold for impairment, sensitivity of the BRIEF-P variables was established. Intra-class correlation coefficients (ICCs) assessed inter-rater reliability (IRR) of the parent and teacher forms. Results: At the parent scale level, emergent metacognition (EMI) (Parent = 59%, Teacher = 42%) and global executive composite (GEC) (Parent = 41%, Teacher = 42%) were frequently elevated. The most commonly elevated subscales were inhibition (Parent = 36%, Teacher = 60%), working memory (Parent = 63%, Teacher = 75%) and planning/organization (Parent = 41%, Teacher = 33%). With the exception of the emotional control subscale on the BRIEF-P, all other indices demonstrated moderate to excellent IRR, ranging from an ICC of .532 to .918. Conclusion: This study provides preliminary support for the BRIEF-P in preschool aged children with epilepsy; both the parent-report form and teacher-report form show sensitivity to executive dysfunction in these children. Furthermore, the BRIEF-P appears to have strong inter-rater reliability.

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