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Discrepancies in Performance-Based Measures and Teacher Ratings of Executive Function in the Assessment of FASD

Abstract

Objectives

Canadian guidelines for diagnosing fetal alcohol spectrum disorder (FASD) recommend that test scores and informant ratings be used to assess executive functioning skills; however, there are discrepancies between these forms of measurement and most studies only use caregiver ratings. As children spend half their time at school, this neglects a significant source of information. The purpose of the present study was to examine the relationship between tests and teacher ratings of executive function in children with prenatal alcohol exposure (PAE), with and without the diagnosis of FASD.

Methods

A retrospective chart review of 303 children with PAE was completed. Teacher ratings of executive functioning were measured using the Behavior Rating Inventory of Executive Function. Direct measures of executive functioning included select subtests from the Delis-Kaplan Executive Function System; NEuroPSYchological Assessment, Second Edition; Wechsler Intelligence Scale for Children, Fourth Edition; Wechsler Intelligence Scale for Children, Fifth Edition; and Wechsler Adult Intelligence Scale, Fourth Edition.

Results

This research found significant group differences across all teacher ratings of executive functioning. Most correlations between tests and teacher ratings of executive function that we expected to be related were not significantly associated.

Conclusions

Results suggest that tests and teacher ratings of executive functioning may not measure the same construct or other factors may be impacting this relationship.

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Data Availability

Ethics approval for this project did not include the transmission of data outside of our study team and institution, the SSCY Centre. Based on the ethics approval of this project, all data was required to remain on-site and to be physically housed and accessed internally at the SSCY Centre.

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Acknowledgements

We would like to thank the participating families and their children; the families that inspire this research; the Manitoba FASD Centre, SSCY Centre; The Department of Clinical Health Psychology, University of Manitoba; Excellence in Neurodevelopment and Rehabilitation Research in Child Health (ENRRICH); The Children's Hospital Research Institute of Manitoba (CHRIM); Cari Slayen for her assistance with data entry, literature review, and manuscript preparation; Alyssa Romaniuk for her assistance with manuscript preparation; and Marvin Routley, Sydney Lisi, Kristi MacDonald, and Kevin Solar for their assistance with data entry. We would also like to thank Dr. Nicole Taylor for her helpful suggestions and Drs. Tracie Afifi and Leslie E. Roos for their mentorship.

Funding

This study was funded by the Office of the VP (Research and International), University of Manitoba; the Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba; and the Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba.

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Authors and Affiliations

Authors

Contributions

K. Cheung: designed and executed the study, completed data analyses, analyzed the data, and wrote sections of the paper. K. Clayton: designed and executed the study, assisted with data analysis planning, analyzed the data, and wrote sections of the paper.  S.D.: designed and executed the study, assisted with data analysis planning, analyzed the data, and wrote sections of the paper. All authors assisted with editing and reviewing of the final manuscript and approved the final version of the manuscript for submission.

Corresponding author

Correspondence to Kristene Cheung.

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Ethics Approval

This retrospective chart review study involving human participants was approved by The University of Manitoba Research Ethics Board and the Specialized Services for Children and Youth (SSCY) Research and Evaluation Committee. Given the retrospective nature of this study, informed consent to participate and publish was not required based on the above ethics approval.

Conflict of Interest

The authors declare no competing interests.

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The authors have no recent, present, or anticipated employment by any organization that may gain or lose financially through publication of this manuscript.

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Cheung, K., Clayton, K. & Doyle, S. Discrepancies in Performance-Based Measures and Teacher Ratings of Executive Function in the Assessment of FASD. Adv Neurodev Disord 5, 463–472 (2021). https://doi.org/10.1007/s41252-021-00219-5

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  • DOI: https://doi.org/10.1007/s41252-021-00219-5

Keywords

  • Assessment
  • Executive functioning
  • Fetal alcohol spectrum disorder
  • Prenatal alcohol exposure