Abstract

Background: Executive Functions (EFs) are assessed by performance-based measures in clinical settings and rating scales in ecological settings. Research has shown a lack of a correlation between both methods. In order to bridge the gap, the Unstructured Performance-Based Task (UPT) was developed. This assessment includes 42 questions randomly presented on a large piece of paper and is accompanied by a behavioral checklist. Aim: To examine the construct validity of the UPT and the behavioral checklist by examining group differences in UPT scores between children with and without Attention Deficit Hyper Disorder (ADHD) and EF deficits A further aim is to examine associations between the UPT and performance-based measures and rating scales. Method: The UPT was translated and culturally adapted for Hebrew speaking children in Israel. Participants were 42 children (aged 8-11 years), 21 with ADHD and EF deficits and 21 without a diagnosis or EF deficit. Parents completed a sociodemographic questionnaire, the Performance Skills Questionnaire, and the Behavior Rating Inventory of Executive Function (BRIEF) to assess EF deficits in ecological settings. Children completed the UPT and other widely used assessments: Digit Span Forward and Backward, Verbal Working Memory, Trail Making Test, and Tower of Hanoi. Results: Significant differences were found between groups in some of the UPT measures and the behavioral checklist. Associations were found between some UPT measures and the behavioral checklist and performance-based EF measures, as well as the BRIEF rating scale. Conclusions: The measures of Total Correct Items, Total Blank Items, and completion time in UPT may be valid for EFs assessment. The behavioral checklist may be a valid assessment for behavior in ecological settings. The UPT may assist in identifying EF deficits in children and setting goals in Occupational Therapy interventions.

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