Assessment of Executive Function in Everyday Life—Psychometric Properties of the Norwegian Adaptation of the Children’s Cooking Task

Abstract

Background: There are few standardized measures available to assess executive function (EF) in a naturalistic setting for children. The Children’s Cooking Task (CCT) is a complex test that has been specifically developed to assess EF in a standardized open-ended environment (cooking). The aim of the present study was to evaluate the internal consistency, inter-rater reliability, sensitivity and specificity, and also convergent and divergent validity of the Norwegian version of CCT among children with pediatric Acquired Brain Injury (pABI) and healthy controls (HCs).Methods: The present study has a cross-sectional design, based on baseline data derived from a multicenter RCT. Seventy-five children with pABI from two university hospitals with parent-reported executive dysfunction and minimum of 12 months since injury/completed cancer therapy, as well as 59 HCs aged 10–17 years, were assessed with CCT using total errors as the main outcome measure. The pABI group completed tests assessing EF (i.e., inhibition, cognitive flexibility, working memory, and planning) on the impairment level within the ICF framework (performance-based neuropsychological tests and the Behavioral Assessment of the Dysexecutive Syndrome for Children), and on the participation level (questionnaires). In addition, they completed tests of intellectual ability, processing speed, attention, learning, and memory. Finally, overall functional outcome (pediatric Glasgow Outcome Scale-Extended) was evaluated for the children with pABI.Results: Acceptable internal consistency and good inter-rater reliability were found for the CCT. Children with pABI performed significantly worse on the CCT than the HCs. The CCT identified group membership, but the sensitivity and specificity were overall classified as poor. Convergent validity was demonstrated by associations between the CCT and performance-based tests assessing inhibition, cognitive flexibility, and working memory, as well as teacher-reported executive dysfunction (questionnaires). Divergent validity was supported by the lack of association with performance-based measures of learning and memory, attention, and verbal intellectual ability. However, there was a moderate association between the CCT and performance-based tests of processing speed. Lastly, better performance on the CCT was associated with a better functional outcome.Conclusion: Our study with a relatively large sample of children with pABI and HC’s demonstrated good psychometric properties of the CCT. CCT performance was associated with the overall level of disability and function, suggesting that CCT is related to the level of activity in everyday life and participation in society. Hence, our study suggests that the CCT has the potential to advance the assessment of EF by providing a valid analysis of real-world performance. Nevertheless, further research is needed on larger samples, focusing on predictors of task performance, and evaluating the ability of CCT to detect improvement in EF over time. The patterns of error and problem-solving strategies evaluated by the CCT could be used to inform neuropsychological rehabilitation treatmentand represent a more valid outcome measure of rehabilitation interventions.

Influence of Regular Visual Thinking Strategies Activities on Sustained Attention Abilities of Quebec Primary School Students: A Developmental Perspective

“…Although our study is of small scale, its strategies rely on repeated direct measures (Hintze, 2005) implemented over a period of one school year with a control group, thus increasing its validity (Shadish et al, 2002) from a developmental perspective. Furthermore, research shows that testing related to executive functions, as is the case in our research, contains better predictive indicators than those related to IQ, memory or language (Burgess et al, 1998;Finnanger et al, 2022). In light of our results, we argue that regular VTS sessions favoured the development of sustained attention in both fourth and fifth graders.…”

Executive function in children with disruptive mood dysregulation disorder compared to attention-deficit/hyperactivity disorder and oppositional defiant disorder, and in children with different irritability levels

“…By task-performance, however, children with ADHD or DMDD + ADHD do not have significantly worse scores on inhibition or working memory compared to children with DMDD, nor clinically elevated scores compared to validated norms. Although ADHD was included in this study for identifying unique DMDD mechanisms only, we notice that the literature is ambiguous and that some report that not all persons with ADHD have EF deficits as demonstrated by task-performance and that future research should refine neuropsychological tests for such assessments (e.g., [ 44 , 45 ]).…”

Conceptualization of the term “ecological validity” in neuropsychological research on executive function assessment: a systematic review and call to action

“…Interestingly, as mentioned earlier, some studies that did find evidence for the test's ability to predict functional outcome did not link their study results with the term EV, referring instead to convergent or concurrent validity (Chevignard et al, 2010;Finnanger et al, 2022;Gilboa et al, 2019;Kenworthy et al, 2020;Oliveira et al, 2016;Orkin Simon et al, 2022;Pishdadian et al, 2022;Zartman et al, 2013). Yet, the methods and results of these articles could have legitimately warranted claims of EV (if relying on either of the two classical definitions of EV; Sbordone, 1996;Franzen & Wilhem, 1996), given that (a) the employed tests possessed face validity and (b) the tests showed the ability to predict functional outcomes.…”