BRIEF Test Review

Behavior Rating Inventory of Executive Function Test Review

Harriet Johnston
EDPS 612.02
Amanda Medland

BRIEF Test Review

Behavior Rating Inventory of Executive Function Test Review

Executive Functions are processes for guiding and managing cognitive, emotional and
behavioral functions. The term executive functions is an umbrella term overarching many of the
processes that allow for one to carry out the process of problem solving in order to reach a future
goal. As are many brain functions, executive functions are multidimensional making
identification difficult in a clinical testing setting, indicating a need for a reliable and valid
measure of executive functions. The following information is cited from the Behavior Rating
Inventory of Executive Function professional manual (Gioia, Isquith, Guy, & Kenworthy, 2000)
unless cited otherwise.
Test Summary
The Behavior Rating Inventory of Executive Function (BRIEF) was created by Gioia, Isquith,
Guy, and Kenworthy, in 2000 in order to address the lack of testing measurements that addressed
executive functions in both home and school environments. As the particular executive functions
are difficult to measure through clinical testing, the authors designed the BRIEF to be a quick,
easy to administer measurement using parent and teacher reports of observable behaviour. The
BRIEF serves to identify strengths and deficits in executive function for children ages 5-18 years
in age and contains 86 items on both a parent and a teacher report scale. It is estimated to take
approximately 10-15 minutes to administer and 15-20 minutes to score. An individual who has
training in interpretation of psychological tests should complete the scoring and interpretation of
the BRIEF. The BRIEF can be easily hand scored, but also comes with a computer scoring
option for quicker interpretation of scores. Upon completion, the BRIEF provides results on
eight derived scales: Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize,
Organization of Materials, and Monitor. In addition to the eight scales, two indexes are

BRIEF Test Review

computed; the Behavioral Regulation Index (BRI) and the Metacognition Index (MI), as well as
an overall score termed the Global Executive Composite (GEC). Each child will receive a score
for each of the scales, paired with a confidence range, as well as a score for the BRI, MI, and
GEC. All of which can be graphed in order to easily determine whether the child falls in the
normal, at risk or clinically significant range.
Standardization
Standardization was achieved using 1419 parent report forms (on 815 girls, 604 boys) and 720
teacher report forms (on 403 girls and 317 boys). Children selected were approximate to the
United States for age, gender, ethnicity, socioeconomic status, and geographical population
density. Children were gathered from both public and private schools in the state of Maryland, as
well as 18 children who had experienced Traumatic Brain Injury (TBI). Inclusion criteria
consisted of children ages 5-18, with the participants having no history of special education or of
psychotropic medication use. In addition, it was required that no more than 10% of the responses
be left blank on the questionnaires. During standardization, it was also determined that children
with Attention Deficit-Hyperactivity Disorder (ADHD), TBI, and Autism Spectrum Disorder
(ASD) scored significantly higher than the clinical trials on most scales (Toplak, Bucciarelli,
Jain, & Tannock, 2008). It was also determined that children with ADHD Combined subtype
were significantly elevated on the Behaviour Regulation Index, where as the children with
ADHD Inattentive Subtype scored with higher elevation on the Metacognition Index (Gioia et
al., 2010).
Reliability and Validity
Reliability was determined for internal consistency, inter-rater reliability and test-retest
reliability. Looking at the degree in which items on the BRIEF all measure the same underlying

BRIEF Test Review

constructs, reliability was determined as high, falling between r=.80 to r=.98. Determining interrater reliability on a measure such as the BRIEF was more difficult, as the raters are observing
and rating the behaviours in difference environments and under difference circumstances and
task demands. The children often experience differences in behaviour between home and school
environments, so an inter-rater reliability between teachers and parent reports is typically
considered acceptable at a lower level, with a rating of .30-.50 being considered acceptable. The
authors determined the BRIEF demonstrated a moderate reliability score of r=.32. In regards to
test-retest reliability, the authors determined that reliability of the parent sample over two weeks
was .81. Teachers were retested 3.5 weeks later with a reliability of .87, indicating high testretest reliability.
The content of the BRIEF was collected from clinical interviews from the authors notes,
as well as statements of specific behaviours and common complaints from parents were added.
The questions were then rated by neuropsychologists and assigned to a primary scale as well as a
secondary scale. The secondary scale was used due to the fact that executive functions are not
entirely independent. Any questions that showed discrepancies in categorization by
neuropsychologists were discarded, ensuring that content validity was high. In addition, a
multitrait-multimethod matrix was used to examine the convergent and discriminant validity of
the BRIEF. Factor analysis showed loading on two factors, which were identified as
metacognition and behavioral regulation. Because of the high commonalities between executive
functions, the typical eigenvalue value over one (1) was discarded and a factor loading of .40
determined acceptable instead. For the parent protocols, 76% of the variance was accounted for,
and with the teacher protocols, 83% was accounted for.

BRIEF Test Review

Lastly during scoring, the BRIEF also identifies a negativity score as well as
inconsistency score derived from questions answered in the questionnaire. Particular items for
negativity can be scored and compared with a protocol classification of acceptable, elevated,
or highly elevated. Additionally, the inconsistency score can be determined to identify if the
rater had acceptable, questionable, or inconsistent answering of questions.
Critical Analysis
Test Summary. As an initial measure of its kind, the BRIEF does an acceptable job in identifying
strengths and weaknesses of executive functioning in children. The easy administration and the
quick item response time make the BRIEF ideal for both parents and teachers. The BRIEF itself
is 14 years old and it would be beneficial if a second edition were created in order to address
some of the shortcomings suggested below.
Standardization. The authors used large sample size to standardize the measure, ensuring that the
demographics were matched to those of the United States. Despite a large standardization
sample, it would be of benefit to have the BRIEF Canadian normed as well, since it is a measure
that is accessible and used in Canada. Secondly, when looking into the qualifications for
acceptable responses, Gioia et al., (2000) identified that the response booklet could have up to 8
missing responses (10%). I believe this is a little high for standardization considering the fact
that a total of more than 14 items makes the test incomplete and not fit for scoring.
Reliability and Validity. In regards to reliability, internal consistency and test-retest reliability
were both shown as high. Concerns begin when we look at the inter-rater reliability. The authors
indicate that a lower score is expected between the parent and teacher scores although a slightly
higher score than the identified r=.32 would have been preferable. Research into either between
two parents or between two teachers inter-rater reliability may solve this lower reliability score.

BRIEF Test Review

In addition, when discussing the differences in scores, the authors mention and discuss the low
scores pertaining to the Initiate and Organization of Material differences (r=.18 and r=.15
respectively) but fail to look into the low scores of Emotional Control and Shift (Gioia, Isquith,
Guy, & Kenworthy, 2010; McCandless & OLaughlin, 2007). This is something that the authors
claim will be covered and corrected in the next edition of the BRIEF (Gioia et al., 2010). When
looking at factor analysis, parent reports for the normative sample shows the Inhibit scale
incorrectly loading on the Metacognition Index, while in the test, and on all other summaries,
Inhibit loads correctly with the Behavioural Regulation Index. Understanding that executive
functions are not one-dimensional, this can be understood, but in order for the inhibit scale to be
utilized in the Behavioural Regulation Index further examination should be given on why it
loaded incorrectly. Lastly, the BRIEF as a third-party observer rating, gives insight into the
executive functions of the children rated, but couples the reports with emotional involvement.
(Denckla, 2010). Through the use of the negativity scale, the BRIEF attempts to control for
overly negative view and reports of a child, but there is always the risk of underrepresentation of
behaviours due to the emotional bond between parents, teachers and the children.
Conclusion
The BRIEF was created address the lack of standardized insight into executive functions in
children. For this purpose, the BRIEF has been shown to be a valid and effective measure to
identify strengths and weaknesses in executive functioning, as well as given insight into potential
clues leading to a diagnosis of ADHD, both Inattentive and Combined type. Going forward, the
authors have identified areas to be addressed in future editions of the BRIEF in order to increase
its validity and usefulness. Despite its effectiveness, this first edition leaves room for
improvements in order to provide the most reliable and valid results of childrens strengths and

BRIEF Test Review

deficits in regards to executive functions, and a second edition is welcomed.

BRIEF Test Review

References
Denckla, M.B. (2010). The behavior rating inventory or executive function: commentary. Child
Neuropsychology: A Journal on Normal and Abnormal Development in Child and
Adolescence, 8(4), 304-306.
Gioia,G.,Isquith,P.,Guy,S.,&Kenworthy,L.(2000).TheBehaviorRatingInventoryof
ExecutiveFunction.Lutz,FL:PsychologicalAssessmentResources.
Gioia, G.A., Isquith, P.K., Guy, S.C., & Kenworthy, L. (2010). Test review behavior rating
inventory or executive function. Child Neuropsychology: A Journal on Normal and
Abnormal Development in Child and Adolescence, 6(3), 235-238.
McCandless, S., & OLaughlin, L. (2007). The clinical utility of the behavior rating inventory of
executive function in the diagnosis of ADHD. Journal of Attention Disorders, 10(4), 381389. Doi:10.1177/1087054706292115.
Toplak, M.E., Bucciarelli, S.M., Jain, U., Tannock, R. (2008). Executive functions: performance
based measures and the behaviour inventory of executive function (BRIEF) in
adolescents with attention deficit hyperactivity disorder (ADHD). Child
Neuropsychology: A Journal on Normal and Abnormal Development in Childhood
Adolescence, 15(1), 53-72.