Finally, behavioral assessment of executive function

can also contribute to treatment monitoring and eventual

outcome evaluation. Given the inherent difficulty in
administering performance measures of executive
function in a repeated fashion, behaviorally anchored
measures may be more suited to such within-subjects
methods. For example, a patient concerned about
attentional difficulties might reveal problems with inhibitory control and working
memory on the BRIEF. After
appropriate interview and clinical diagnosis, treatment
methods might include medication and cognitive-behavior
therapy. To evaluate effectiveness of treatment, the measure
may be administered again after starting medication, and
again after a longer period to determine whether the effects
of treatment are maintained. Ratings can be provided by
the individual themselves or an informant in their environment who has the
opportunity to regularly observe their
behavior (e.g., parent, teacher, spouse).
such as ADHD, TBI, lesions of the frontal lobes, Type 1
Diabetes Mellitus, autism spectrum disorders, learning
disabilities, myelomeningocele and hydrocephalus,
Tourette�s syndrome, phenylketonuria, bipolar disorder,
obstructive sleep apnea, 22q11 deletion syndrome, galactosemia, sickle cell
disease, and early focal frontal lesions.
The BRIEF-Adult Version has been examined in individuals with Mild Cognitive
Impairment, ADHD, Multiple
Sclerosis, Alzheimer�s disease, epilepsy, and TBI. The
measures also show promise for veridicality, i.e., predicting behavior in the
natural environment. The measures
are increasingly being examined in relationship to other
indications of everyday functioning. Correlational
analyses suggest strong, logical relationships between
executive function and everyday behaviors such as impulsivity with aggression and
working memory with attention problems. Correlations with other real-world
functioning such as adaptive functioning are reported in
individuals with developmental disabilities and scholastic
achievement. Teacher ratings of executive function on the
BRIEF predict student performance on high-stakes
testing. While there are modest correlations between the
BRIEF and performance tests that tap aspects of executive
functions, there are more intriguing relationships between
the BRIEF and biological markers such as genetic
conditions (e.g., 22q11 deletion syndrome), brain injuries
(e.g., frontal lobe lesions), metabolic conditions (e.g.,
phenylketonuria), and structural and functional imaging
(e.g., frontal volume and activation). Finally, certain
profiles of executive function in the everyday environment predict diagnosis of
ADHD.
An understanding of the individual�s profile of executive function strengths and
weaknesses can lead to targeted
pharmacological, behavioral, cognitive, or other therapeutic interventions. Such
strategies may be specifically targeted toward one area of executive functions such
as
antecedent management for children with inhibitory control deficits, or may be more
programmatic, such as the
comprehensive cognitive rehabilitation programs. The
BRIEF has potential uses for clinical treatment design,
monitoring, and outcome measurement. Data from the
BRIEF can help the clinician focus on potentially problematic areas requiring
further assessment. The same data may
inform decisions about targets for treatment and types of
interventions based on the potential for ameliorating realworld problems. Given
that the BRIEF captures the patient�s
everyday functioning, the scales can suggest specific problems for which treatment
goals and strategies can be
targeted. For example, an individual who is described as
disinhibited in the everyday world might have treatments
and supports targeted specifically toward boosting