Abstracts

The Behavior Rating Inventory of Executive Function (BRIEF) was developed for assessing cognitive processes essential for solving problems that involve intentional planning and the use of feedback to guide behavior and make decisions. Children with focal frontal or extrafrontal brain lesions have been reported to have more deficits of executive function on the BRIEF than age and gender matched normal controls (Jacobs et al., 2000). The usefulness of the BRIEF for defining deficits of executive function in epilepsy was evaluated by comparing parent ratings for children with generalized or focal epilepsy (frontal vs. extrafrontal) to ratings for children with focal lesions, metabolic disorders, or psychiatric disorders., There were 64 children/adolescents (mean age 11.5 years) grouped according to six diagnostic categories: primary generalized epilepsy (PGE), frontal epilepsy (FE), extrafrontal epilepsy (EFE), MRI-lesion without epilepsy (LES), metabolic disorder (PKU), and psychiatric disorder (PSY). Groups did not differ in age or level of intellectual functioning (mean FSIQ 94.3; SD 13.5). The psychiatric group had significantly more males than other groups. The BRIEF was completed by parents as part of comprehensive neuropsychological assessments. BRIEF items (n=86) are rated as never, sometimes, or often true and comprise eight theoretically and empirically derived clinical scales (Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, and Monitor) and three global scales (Composite, Behavior Regulation, Metacognition) for which there are normative standard scores (T-scores)., BRIEF T-scores of the six diagnostic groups were compared by multifactor analyses of variance (ANOVA). Results showed significant differences for 7 of the 11 scales (p [lt] .05) with the psychiatric group having the greatest problems across all scales. Post hoc analyses showed differential effects according to the type of executive process. Behavioral regulation was not problematic for groups other than the psychiatric group. Metacogniton was problematic for the PGE and LES groups, especially working memory and planning/organization. FE and XFE groups differed minimally; self-monitoring was the highest score for FE and working memory was highest for XFE., Based on parent ratings of executive functioning in children/adolescents, those with epilepsy or metabolic disorders had significantly fewer and less severe problems than those with psychiatric conditions. Working memory was relatively poor in PGE and XFE, while monitoring one[apos]s effect on others and assessing goal attainment were relatively poor in FE. The value of the BRIEF for discriminating deficits of executive function in epilepsy requires further study.,