title: Executive functioning profiles from the BRIEF across pediatric medical disorders: Age and diagnosis factors.
abstract: The objective of the study was to compare executive functioning (EF) profiles across several pediatric medical conditions and explore the influence of age of diagnosis and evaluation. A retrospective, cross-sectional study of 734 children aged 5 to 18 years was conducted across five medical groups (brain tumor, leukemia [ALL], epilepsy [EPI], neurofibromatosis type 1 [NF1], and ornithine transcarbamylase deficiency [OTC-D]), attention deficit hyperactivity disorder (ADHD) controls, and matched healthy controls. We compared groups across the scales of a parent-completed Behavior Rating Inventory of Executive Functioning (BRIEF) using a repeated measures analysis of variance (ANOVA). Separate ANOVAs were conducted to look at age factors. The results showed that the ADHD group differed from all other groups and had the highest level of reported EF problems. The NF1 and OTC-D groups differed significantly from the healthy comparison group for overall EF problems, while the EPI and cancer groups did not. Working memory was the most elevated scale across medical groups, followed by plan/organize. Children with medical disorders were two to four times more likely than healthy controls to have clinically significant problems in several EF domains. There was a main effect for age at diagnosis and age at evaluation. A subset of children with medical disorders were found to have parent-reported EF difficulties, with particular vulnerability noted in working memory and organizational/planning skills. This has relevance for the development of interventions that may be helpful across disorders. Children with particular diagnoses and earlier age of diagnosis and evaluation had greater reported EF problems.
authors.affiliation: a Children's Hospital of Philadelphia and Perelman School of Medicine , University of Pennsylvania , Philadelphia , USA.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Krivitzky
authors.affiliation: b Children's National Health System , Washington , DC , USA.|c The George Washington University Medical Center , Washington , DC , USA.
authors.forename: Karin S
authors.initials: KS
authors.lastname: Walsh
authors.affiliation: b Children's National Health System , Washington , DC , USA.
authors.forename: Evelyn L
authors.initials: EL
authors.lastname: Fisher
authors.affiliation: b Children's National Health System , Washington , DC , USA.|c The George Washington University Medical Center , Washington , DC , USA.
authors.forename: Madison M
authors.initials: MM
authors.lastname: Berl
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D001932:Brain Neoplasms / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D009456:Neurofibromatosis 1 / Q000150:complications / Q000503:physiopathology*; D009483:Neuropsychological Tests; D020163:Ornithine Carbamoyltransferase Deficiency Disease / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: Age at diagnosis; Executive functions; Medical disorders; Pediatric; Working memory