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Brief report: Relationship between performance testing and parent report of attention and executive functioning
Lauren Krivitzky1, Danielle D Bosenbark2, Rebecca Ichord3
1a Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania , Philadelphia , PA , USA.
Insights
Children with perinatal arterial ischemic stroke (PAIS) show attention and executive functioning (EF) weaknesses. Parent reports and performance tests showed little agreement, highlighting the need for multiple data sources for accurate assessment.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Psychology
Background:
- Perinatal arterial ischemic stroke (PAIS) is linked to attention and executive functioning (EF) deficits in children.
- Discrepancies often exist between parent-reported and performance-based assessments of these skills in pediatric populations.
Purpose of the Study:
- To compare parent-reported and performance-based measures of attention and EF in children with PAIS.
- To investigate the consistency between different data sources for assessing cognitive skills in this population.
Main Methods:
- Forty children (ages 3-16) with PAIS underwent neuropsychological testing for seven attention and EF domains.
- Parents completed standardized questionnaires (ADHD Rating Scale-IV, BRIEF) assessing real-world functioning.
- Correlational analyses compared parent report scores with performance-based composite scores.
Main Results:
- Correlations between ADHD Rating Scale-IV and performance-based Attention/Inhibition were non-significant.
- Some significant negative correlations were observed between BRIEF Global Executive Composite (GEC) and performance-based Verbal Retrieval/Processing Speed.
- Only one significant correlation was found between BRIEF Working Memory Index and the performance-based Working Memory composite.
Conclusions:
- Children with PAIS exhibit attention and EF difficulties across both parent report and performance measures.
- There is a notable lack of significant agreement between these two assessment types in this cohort.
- Multiple data sources, including informant reports and objective testing, are crucial for a comprehensive understanding of attention and EF in children with PAIS.
Abstract:
Children with perinatal arterial ischemic stroke (PAIS) have increased rates of attention and executive functioning (EF) weaknesses. Research in other pediatric disorders has documented poor consistency between parent report of these skills and performance-based measures. We compared these data sources in children with PAIS. Forty full-term (≥37 weeks) children ages 3-16 (median = 7.2 years; 58% male) with PAIS completed neuropsychological testing and composite scores were created for seven attention and EF domains (Processing Speed; Attention; Working Memory; Verbal Retrieval; Inhibitory Control; Flexibility/Shifting; Planning). Parents completed "real-world" functioning questionnaires (ADHD Rating Scale-IV, BRIEF). Correlational analysis were used to compare parent and performance measures. Correlations between ADHD Rating Scale-IV scores and the performance-based Attention and Inhibition composite scores were nonsignificant. Significant negative correlations were found between the BRIEF GEC and performance-based Verbal Retrieval and Processing Speed composites, but remaining GEC/composite comparisons were nonsignificant. Analyses between parent report BRIEF index scores and the corresponding performance-based domain identified one significant negative correlation between the BRIEF Working Memory Index and the Working Memory composite score. While children with PAIS demonstrate difficulties in attention and EF on both parent report and performance measures, little significance was found in comparisons of these two types of measures. There may be several explanations for this dissociation: measures assessing different aspects of the same underlying construct; performance-based measures lacking ecological validity; and parents underestimating/underreporting their child's deficits. Thus, multiple sources of informant and performance data are necessary to make more accurate conclusions about functioning in these domains.
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