Measures of Executive Functioning and Their Relation to Functional Outcomes in a Sample of Youth with Attention-Deficit/hyperactivity Disorder (add)

The current study examined two commonly used neuropsychological assessments of executive functioning in a sample of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The Test of Everyday Attention for Children (TEA-Ch) is a performance-based, objective measure of executive functioning, and the Behavior Rating Inventory of Executive Functioning (BRIEF) is a subjective, parent-report measure. Confirmatory factor analysis (CFA) was used to establish the factor structures of these measures to determine their appropriateness with a sample of youth with ADHD. The association of these assessment tools with functional outcomes (academic achievement, social functioning) was examined to establish their ecological and incremental validity. A three-factor model for the TEA-Ch and a two-factor model with modifications for the BRIEF emerged as the best fitting models for each measure. Regarding ecological validity, the Behavioral Regulation factor of the BRIEF was positively associated with social difficulties, and the Switching factor of the TEA-Ch was positively related to achievement in math, written expression, and math fluency. No support for the incremental validity of executive functioning measures was provided. Results have implications for researchers, clinicians, and educators who study, assess, treat, and educate youth with ADHD experiencing executive dysfunction and associated difficulties