Stability of executive functioning measures in 8-17-year-old children with unilateral cerebral palsy
Adina M Piovesana1, Stephanie Ross, Koa Whittingham
1a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland , Brisbane , QLD 4029 , Australia.
Insights
This study shows that executive functioning (EF) measures are stable in children and adolescents with unilateral cerebral palsy (CP). These findings support the reliable assessment of cognitive skills in this population.
Area of Science:
- Neuroscience
- Developmental Psychology
- Rehabilitation Medicine
Background:
- Executive functioning (EF) is crucial for daily life and can be impacted by unilateral cerebral palsy (CP).
- Assessing the stability of EF measures is essential for tracking development and treatment effects in children with CP.
- Previous research has not extensively evaluated the test-retest reliability of various EF measures in this specific pediatric population.
Purpose of the Study:
- To investigate the test-retest reliability and stability of executive functioning (EF) measures in children and adolescents with unilateral cerebral palsy (CP).
- To provide reliable change scores for EF assessments in this population, accounting for practice effects.
- To support the accurate evaluation of cognitive abilities in individuals with unilateral CP.
Main Methods:
- 44 participants (8-17 years) with unilateral CP were assessed at baseline and 20±2 weeks later.
- Measures included the Wechsler Intelligence Scale for Children--Fourth Edition Short Form (WISC-IV-SF), Delis-Kaplan Executive Function System (D-KEFS) subtests, and the Behavior Rating Inventory of Executive Functioning (BRIEF).
- Pearson's test-retest reliabilities and reliable change scores were calculated using 90% confidence intervals.
Main Results:
- Most EF measures demonstrated excellent to fair test-retest reliability (r = 0.91-0.74).
- Lower reliabilities were observed for Digit Span Backwards (r = 0.62), Inhibition (r = 0.69), and Initiate (r = 0.68).
- Reliable change scores were successfully calculated for all measures, considering practice effects.
Conclusions:
- The executive functioning (EF) measures utilized in this study exhibit good stability in children and adolescents with unilateral cerebral palsy (CP).
- The provided reliable change scores can aid clinicians and researchers in interpreting changes in EF over time for this population.
- These findings validate the use of these EF assessments for research and clinical practice in unilateral CP.
Abstract:
The study investigated the stability of executive functioning (EF) measures in children and adolescents aged 8-17 years with unilateral cerebral palsy (CP). Here 44 participants with unilateral CP (mean age = 11 years, 11 months; Manual Abilities Classification Scale Level I = 6 and Level II = 37; Gross Motor Function Classification Scale Level I = 22 and Level II = 22) were randomized into the wait-list control group of a large randomized controlled trial. Participants had baseline testing with Wechsler Intelligence Scale for Children--Fourth Edition Short Form (WISC-IV-SF) and Delis-Kaplan Executive Function System (D-KEFS) subtests. Parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF). Participants were re-assessed 20 ±2 weeks later with a shortened test battery including the D-KEFS subtests; Digit Span, Coding and Symbol Search (WISC-IV); and BRIEF. Pearson's test-retest reliabilities and Reliable change scores were calculated. Results indicated excellent to fair test-retest reliabilities (r = 0.91-0.74) for all measures except Digit Span Backwards (r = 0.62), Inhibition (r = 0.69), and Initiate (r = 0.68). Reliable change scores applying 90% confidence intervals for estimating reliable change while accounting for practice effects were provided for all measures. The data support the stability of EF measures in this population.
