Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology Among Children in Developing Country Contexts: a Scoping Review of Current Tools

Abstract

Several tools have been developed to assess executive function (EFs) and adaptive functioning, although in mainly Western populations. Information on tools for low-and-middle-income country children is scanty. A scoping review of such instruments was therefore undertaken.We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis- Scoping Review extension (PRISMA-ScR) checklist (Tricco et al., in Annals of Internal Medicine 169(7), 467-473, 2018). A search was made for primary research papers of all study designs that focused on development or adaptation of EF or adaptive function tools in low-and-middle-income countries, published between 1^st January 1894 to 15^th September 2020. 14 bibliographic databases were searched, including several non-English databases and the data were independently charted by at least 2 reviewers.The search strategy identified 5675 eligible abstracts, which was pruned down to 570 full text articles. These full-text articles were then manually screened for eligibility with 51 being eligible. 41 unique tools coming in 49 versions were reviewed. Of these, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) had the most validations undertaken for EF tests. For adaptive functions, the tools with the most validation studies were the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition).There is a fair assortment of tests available that have either been developed or adapted for use among children in developing countries but with limited range of validation studies. However, their psychometric adequacy for this population was beyond the scope of this paper.

Keywords: Adaptive function; Assessment; Children; Developing countries; Executive function; Psychometrics.

Fig. 1

PRISMA flow diagram of study selection

Fig. 2

Top performing EF instruments in terms of total number of validation studies. *Studies is defined according to COSMIN guidelines as any individual validation conducted in any given research project/paper. Thus, some individual papers reported multiple validation “studies” within that single paper

Fig. 3

Break-down of most validated EF instruments in terms of individual types of Validation studies. *Studies as defined according to COSMIN guidelines as any individual validation conducted in any given research project/paper. Thus, some individual papers reported multiple validation “studies” within that single paper

Fig. 4

Top performing adaptive functioning instruments in terms of total number of validation studies. *Studies as defined according to COSMIN guidelines as any individual validation conducted in any given research project/paper. Thus, some individual papers reported multiple validation “studies” within that single paper. CFIRS: Child Function Impairment Rating Scale. CPAS: Children’s Participation Assessment Scale. CPQ: Child Participation Questionnaire. IBAS: Independent Behaviour Assessment Scale. PACS: Preschool Activity Card Sort. PADL: Participation in Activities of Daily Living. VABS: Vineland Adaptive Behaviour Scale