Ratings Of Executive Function Research Articles

A - 140 The Association between Executive Functioning and Adaptive Outcomes in Pediatric Brain Tumor Survivors

Abstract Objective Pediatric brain tumor (PBT) survivors are at high risk for cognitive and adaptive challenges. We aimed to examine the relationship between executive functioning (EF) and adaptive functioning in PBT survivors to identify critical cognitive skills that are associated with functional impact to inform intervention and transition to adulthood. Method Retrospective neuropsychological data was collected for 95 clinically referred PBT survivors (8–24 years). A composite EF measure was created based on the average of selected EF subtest scores. The associations between EF skills, parent-report of child adaptive functioning, and full-scale IQ were analyzed using descriptive statistics, correlations, and multiple regression. Results Adaptive functioning was significantly related to parent (r = −0.701, p < 0.001) and teacher ratings (r = −0.372, p = 0.004) of EF, the testing composite measure of EF (r = 0.455, p = 0.033), as well as FSIQ (r = 0.386, p < 0.001), general cognitive ability (r = 0.328, p = 0.003), working memory (r = 0.279, p = 0.007), and processing speed (r = 0.425, p < 0.001). Parent reports of EF were not significantly related to the EF testing composite score, but both significantly predicted adaptive functioning (p < 0.001). Of parent-reported domains of EF, self-monitoring was most predictive of overall adaptive functioning (B = −0.415, p = 0.017). FSIQ and age did not impact the relationship between parent reports of EF and adaptive functioning. Conclusions Overall, EF on both parent reports and testing, especially self-monitoring, was predictive of adaptive functioning in PBT survivors, regardless of age and overall intellectual functioning. Future research should further examine the impact of individual and treatment factors.

A digital intervention to support childhood cognition after the COVID-19 pandemic: a pilot trial

Difficulties in executive functioning (EF) can result in impulsivity, forgetfulness, and inattention. Children living in remote/regional communities are particularly at risk of impairment in these cognitive skills due to reduced educational engagement and poorer access to interventions. This vulnerability has been exacerbated by the COVID-19 pandemic and strategies are needed to mitigate long-term negative impacts on EF. Here we propose a pilot trial investigating the benefits, feasibility, and acceptability of a school-based EF intervention for primary school students (6–8 years) living in regional, developmentally vulnerable, and socio-economically disadvantaged communities. Students were randomised to a digital intervention or teaching as usual, for 7 weeks. Children completed measures of EF and parents/educators completed ratings of everyday EF and social/emotional wellbeing at pre-intervention, post-intervention, and 3-month follow-up. Change in EFs (primary outcome), everyday EF, and social/emotional wellbeing (secondary outcomes) from pre- to post-intervention and pre-intervention to 3-month follow-up were examined. Feasibility and acceptability of the intervention was assessed through educator feedback and intervention adherence.Protocol Registration: The stage 1 protocol for this Registered Report was accepted in principle on 20 April 2023. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/WT3S2. The approved Stage 1 protocol is available here: https://osf.io/kzfwn.

Differences between parent- and teacher-reported executive functioning behaviors after traumatic injuries

ABSTRACT Deficits in executive functioning (EF) behaviors are very common following pediatric traumatic brain injury (TBI) and can linger well after acute injury recovery. Raters from multiple settings provide information that may not be appreciated otherwise. We examined differences between parent and teacher ratings of EF using data examining longitudinal outcomes following pediatric TBI in comparison to orthopedic injury (OI). We used linear mixed models to determine the association of rater type and injury type with scores on the Behavior Rating Inventory of Executive Functioning (BRIEF). After controlling for demographic variables, rater type and injury type accounted for a small but significant proportion of the variance in EF. Teachers’ ratings on the BRIEF were significantly higher than parent ratings for global EF and metacognition, but not for behavior regulation, regardless of injury type, indicating greater EF concerns. All BRIEF ratings, whether from teachers or parents, were higher for children with TBI than for those with OI. Results suggest that parents and teachers provide unique information regarding EF following traumatic injuries and that obtaining ratings from persons who observe children at school as well as at home can result in a better understanding of situation-specific variability in outcomes.

Association between motor skills and executive function of children with autism spectrum disorder in Taiwan and the United States.

The purpose of this study was to examine the relationship between parent ratings of motor skills and executive function (EF) in children with autism spectrum disorder (ASD) in the United States and Taiwan. One hundred and seventy-two parents/legal guardians of children (4-6 years and 11 months old) with ASD were recruited from two countries, Taiwan (n = 100) and the United States (n = 72). The parents or guardians of the child with ASD completed a questionnaire including demographic information, child's motor skills (using Children Activity Scale - Parents, ChAS-P), and child's EF (using Childhood Executive Functioning Inventory, CHEXI). A series of hierarchical multiple regressions were conducted to determine whether ChAS-P (total motor score, fine motor skills, and gross motor skill) was associated with CHEXI (total EF score, working memory, and inhibition), after controlling for covariates (i.e., age, gender, race, body mass index, whether children received physical activity or cognitive training, parental education level). Total motor skills, fine motor skills, and gross motor skills were significantly associated with EF in both working memory and inhibition as rated by parents in both countries (β = 0.21-0.57, p < 0.01), with the exception of a non-significant association between parent-rated total motor skills, fine motor skills, and gross motor skills, and inhibition among Taiwanese children with ASD. In addition, the associations between parent ratings of motor skills (i.e., fine motor and gross motor skills) and EF (i.e., working memory and inhibition) were similar between the two countries. Positive associations with specific aspects of parent ratings of fine motor and gross motor skills and working memory and inhibition were found in children with ASD from both countries. These findings have implications for future interventions and programs focused on improving early motor skills and EF development for young children with ASD from Taiwan and the United States.

Executive functions and ADHD symptoms predict educational functioning in children with ADHD: A two-year longitudinal study

The aim of this two-year longitudinal study was to investigate whether deficits in executive functions (EF) predict impaired everyday functioning after two years in children and adolescents with ADHD. A sample of 135 participants with and without ADHD were assessed with neuropsychological tests of EF and parent ratings of everyday functioning with the Child Behavior Checklist at baseline (Mage = 11.6, SD = 2.0), and after two years (Mage = 13.6, SD = 2.1). Results showed that ADHD symptoms and impaired EF at baseline predicted lower educational functioning when controlling for general cognitive ability (i.e. “IQ”) at two-year follow-up. Furthermore, the results indicated that increased ADHD symptoms predicted problems both with social functioning and functioning in leisure activities (i.e. sport/hobbies/chores/jobs), whereas higher IQ predicted better functioning in leisure activities. The current study primarily highlights the importance of detecting and treating ADHD symptoms in order to prevent reduced functional outcomes, and that EF tests may contribute to identify children in need of educational interventions targeting EF deficits.

Do Performance-Based Measures and Behavioral Ratings of Executive Functioning Complement Each Other in Predicting Reading and Mathematics in Chinese?

We examined what executive functioning (EF) components predict reading and mathematics within the same study and whether the effects of behavioral ratings of EF overlap or complement those of performance-based measures. One hundred and nine Grade 2 Mandarin-speaking Chinese students from Chengdu, China (55 girls, 54 boys, Mage = 8.15 years), were assessed on measures of EF (planning, inhibition, shifting, and working memory), speed of processing, reading and mathematics. Parents also rated their children's EF skills using the Childhood Executive Functioning Inventory. Results of hierarchical regression analyses showed that only working memory among the performance-based EF measures predicted reading and mathematics. In addition, none of the behavioral ratings of EF made a significant contribution to reading and mathematics after controlling for mother's education and speed of processing. Taken together, these findings suggest that working memory is a domain general predictor of academic achievement, but only when measured with cognitive tasks.

Associations between executive functioning and adherence in pediatric celiac disease

ABSTRACT A strict gluten-free diet is the only treatment for celiac disease (CD), yet dietary adherence can be challenging for youth and may be impacted by the youth’s executive functioning and attentional abilities. This study aimed to investigate whether attention and executive functioning (EF) were associated with dietary adherence in children with CD. Parents of 34 children (child age M(SD) = 13.01(3.88), 56% female) from a multidisciplinary CD clinic completed ratings of attention and EF and dietary adherence. Parent-reported adherence was negatively correlated with behavioral regulation (r = -.52, p < .01, r 2 = .27, 95% confidence interval (CI) [−.73, −.22]) and cognitive regulation (r = -.48, p < .01, r 2 = .23, 95% CI [−.71, −.17]), with an interaction by age (p = .01, adjusted R 2 = .35, B = −0.15, 95% CI [−0.29, −0.07]) for behavior regulation. Youth who were rated as less adherent by their parents were rated as having more problems with behavioral (e.g. inhibition and self-monitoring) and cognitive regulation (e.g. planning, organization), and adolescents with lower parent-rated adherence were rated as having more problems with behavioral regulation in particular. Executive functioning deficits are an important treatment consideration for CD, particularly during adolescence.

Executive function measured by BRIEF in adolescents diagnosed and treated for ADHD: problem profiles and agreement between informants

ABSTRACT Executive functional deficits (EFDs) play an important role in functional impairment in adolescents with attention deficit/hyperactivity disorder (ADHD). More knowledge of executive function (EF) profiles and informant discrepancies will guide clinicians and provide tailored treatment advice. The objectives of this study were to use teacher, parent, and self-reported EF ratings to describe (a) problem profiles and (b) the correlation and agreement between informants. This study included 100 adolescents aged 14–18 years with ADHD still experiencing clinically impairing symptoms despite standard treatment including medication. EFs were measured using the Behavior Rating Inventory of Executive Function (BRIEF). Agreement between informants was quantified using Pearson correlation and informant discrepancies were analyzed using paired samples t-test. Overall, the results indicated considerable EFDs in the study population. Correlation and agreement varied between the informants. Agreement was highest between adolescents and their parents, especially for female participants, and lowest between male participants and their teachers. Teachers reported the highest level of EFDs, whereas adolescents generally self-reported EFDs at a lower level than both parents and teachers. Identifying and tailoring treatment for EFDs might improve future prognosis for adolescents with ADHD, however, self-awareness of these difficulties is a challenge that needs to be considered when planning interventions.

Screening for executive function difficulties: An evaluation of the Behavior Rating Inventory of Executive Function-2nd Edition Screener, Teacher Report (BRIEF2-TS).

Executive functions (EFs) correlate positively with many developmental outcomes, and ecologically valid measures of EFs may be more predictive of some outcomes than performance-based measures. Accordingly, there is a need to evaluate short EF rating scales, such as the Behavior Rating Inventory of Executive Function-2nd Edition Screener, Teacher Report (BRIEF2-TS). Data from 1,322 kindergarten children in Singapore (50% girls; 61.3% Chinese, 10.6% Malay, 16.3% Indian, 4.0% other ethnicity, and 7.8% did not report their ethnicity), followed for 3 years, were used to examine the multilevel factor structure, gender and longitudinal invariance, reliability, and concurrent and predictive validity of BRIEF2-TS scores. Results indicated a two-factor within-level structure (11 items; cognitive and emotional-behavioral regulation) that was at least partially invariant across gender and time. Concurrent validity with direct EF measures and ratings of self-regulation, and predictive validity for socioemotional and academic skills were good. Overall, BRIEF2-TS scores showed evidence for good validity and reliability. Future research should consider correlates of the between-level structure and further consider structure and validity in clinical samples. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Structural and diffusion-weighted brain imaging predictors of attention-deficit/hyperactivity disorder and its symptomology in very young (4- to 7-year-old) children.

The current study aimed to identify the key neurobiology of attention-deficit/hyperactivity disorder (ADHD), as it relates to ADHD diagnostic category and symptoms of hyperactive/impulsive behaviour and inattention. To do so, we adapted a predictive modelling approach to identify the key structural and diffusion-weighted brain imaging measures and their relative standing with respect to teacher ratings of executive function (EF) (measured by the Metacognition Index of the Behavior Rating Inventory of Executive Function [BRIEF]) and negativity and emotion regulation (ER) (measured by the Emotion Regulation Checklist [ERC]), in a critical young age range (ages 4 to 7, mean age 5.52 years, 82.2% Hispanic/Latino), where initial contact with educators and clinicians typically take place. Teacher ratings of EF and ER were predictive of both ADHD diagnostic category and symptoms of hyperactive/impulsive behaviour and inattention. Among the neural measures evaluated, the current study identified the critical importance of the largely understudied diffusion-weighted imaging measures for the underlying neurobiology of ADHD and its associated symptomology. Specifically, our analyses implicated the inferior frontal gyrus as a critical predictor of ADHD diagnostic category and its associated symptomology, above and beyond teacher ratings of EF and ER. Collectively, the current set of findings have implications for theories of ADHD, the relative utility of neurobiological measures with respect to teacher ratings of EF and ER, and the developmental trajectory of its underlying neurobiology.

Right Superior Frontal Gyrus Cortical Thickness in Pediatric ADHD

Objective: We investigated the right Superior Frontal Gyrus (right-SFG) and Anterior Cingulate Cortex (ACC) in children with ADHD and their clinical relevance with Executive Function (EF) and ADHD symptom severity. Methods: About 26 children with ADHD and 24 typically developing children (TDC; 7‒16 years) underwent Magnetic Resonance Imaging (MRI) and completed an EF assessment battery. Results: Significantly thinner right-SFG in the ADHD group was found compared to the TDC group (t (48) = 2.81, p = .007, Cohen’s d = 0.84). Linear regression models showed that 12.5% of inattention, 13.6% of hyperactivity, and 9.0% of EF variance was accounted for by the right-SFG thickness. Conclusions: Differences in the right-SFG thickness were found in our ADHD group and were associated with parent ratings of inattentive and hyperactive symptoms as well with EF ratings. These results replicate previous findings of thinner right-SFG and are consistent with the delayed cortical maturation theory of ADHD.

Prenatal organophosphorus pesticide exposure and executive function in preschool-aged children in the Norwegian Mother, Father and Child Cohort Study (MoBa)

IntroductionPrenatal exposure to organophosphorus pesticides (OPPs) has been associated with neurodevelopmental deficits in children, however evidence linking OPPs with specific cognitive mechanisms, such as executive function (EF), is limited. ObjectiveThis study aims to evaluate the association between prenatal exposure to OPPs with multiple measures of EF in preschool-aged children, while considering the role of variant alleles in OPP metabolism genes. MethodsWe included 262 children with preschool attention-deficit/hyperactivity disorder (ADHD), and 78 typically developing children, from the Preschool ADHD substudy of the Norwegian, Mother, Father, and Child Cohort Study. Participants who gave birth between 2004 and 2008 were invited to participate in an on-site clinical assessment when the child was approximately 3.5 years; measurements of EF included parent and teacher rating on Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P), and three performance-based assessments. We measured OPP metabolites in maternal urines collected at ∼17 weeks' gestation to calculate total dimethyl- (ΣDMP) and diethyl phosphate (ΣDEP) metabolite concentrations. We estimated multivariable adjusted β′s and 95% confidence intervals (CIs) corresponding to a change in z-score per unit increase in log-ΣDMP/DEP. We further characterized gene-OPP interactions for maternal variants in PON1 (Q192R, M55L), CYP1A2 (1548T > C), CYP1A1 (IntG > A) and CYP2A6 (-47A > C). ResultsPrenatal OPP metabolite concentrations were associated with worse parent and teacher ratings of emotional control, inhibition, and working memory. A one log-∑DMP increase was associated with poorer teacher ratings of EF on the BRIEF-P (e.g. emotional control domain: β = 0.55, 95% CI: 0.35, 0.74), when weighted to account for sampling procedures. We found less consistent associations with performance-based EF assessments. We found some evidence of modification for PON1 Q192R and CYP2A6 -47A > C. Association with other variants were inconsistent. ConclusionsBiomarkers of prenatal OPP exposure were associated with more adverse teacher and parent ratings of EF in preschool-aged children.

Validity of the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) in children and adolescents with pediatric acquired brain injury

ABSTRACT The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) was developed to address the need for a standardized ecologically valid test of executive function (EF) in the pediatric population. Our study aimed to investigate the discriminant, concurrent, and ecological validity of BADS-C in a sample with pediatric acquired brain injury (pABI). Seventy-four participants with pABI aged 10–17 years were included to a pre-registered randomized controlled trial, and baseline assessment was used for the current study. Controls consisted of 60 participants aged 10–17 years. Participants with pABI were assessed with neuropsychological tests and questionnaires of EF, and measurements of general intellectual ability (IQ). Results showed that all BADS-C subtests discriminated between participants with pABI and controls, except for the Playing Cards Test. Concurrent and ecological validity was demonstrated through associations between BADS-C total score, Key Search Test, and Zoo Map Test 1, and neuropsychological tests and teacher questionnaire ratings of EF. Key Search Test and Zoo Map Test 1 predicted teacher ratings of EF, beyond IQ and other neuropsychological test of EF. These findings provide support for BADS-C as a valid clinical assessment tool that can detect everyday executive dysfunction in the pABI population, and guide rehabilitation and treatment decisions.

Is there any incremental benefit to conducting neuroimaging and neurocognitive assessments in the diagnosis of ADHD in young children? A machine learning investigation

Given the negative trajectories of early behavior problems associated with ADHD, early diagnosis is considered critical to enable intervention and treatment. To this end, the current investigation employed machine learning to evaluate the relative predictive value of parent/teacher ratings, behavioral and neural measures of executive function (EF) in predicting ADHD in a sample consisting of 162 young children (ages 4–7, mean age 5.55, 82.6 % Hispanic/Latino). Among the target measures, teacher ratings of EF were the most predictive of ADHD. While a more extensive evaluation of neural measures, such as diffusion-weighted imaging, may provide more information as they relate to the underlying cognitive deficits associated with ADHD, the current study indicates that measures of cortical anatomy obtained in research studies, as well cognitive measures of EF often obtained in routine assessments, have little incremental value in differentiating typically developing children from those diagnosed with ADHD. It is important to note that the overlap between some of the EF questions in the BRIEF, and the ADHD symptoms could be enhancing this effect. Thus, future research evaluating the importance of such measures in predicting children’s functional impairment in academic and social areas would provide additional insight into their contributing role in ADHD.

Executive Function in Autism: Association with ADHD and ASD Symptoms.

There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD symptom severity, but not to ASD severity. Thus, functioning in the domains of Shift and Emotional control appear relatively spared, whereas performance in all other EF was impaired in relation to ADHD symptoms.

Executive function training in very preterm children: a randomized controlled trial

Objective of the current study was to assess whether game-formatted executive function (EF) training, is effective in improving attention, EF and academic performance in very preterm and/or extremely low birthweight children aged 8–12 years. A multi-center, double-blind, placebo- and waitlist controlled randomized trial (NTR5365) in two academic hospitals in The Netherlands was performed. Eighty-five very preterm children with parent-rated attention problems on the Child Behavior Checklist were randomized to one of three treatment conditions: EF training, placebo training or waitlist condition. EF or placebo training was completed at home (6 weeks, 25 sessions of 30–45 min each). At baseline, 2 weeks after training or being on the waitlist, and five months after first follow-up visit, children underwent assessments of primary outcomes (parent and teacher ratings of attention) and secondary outcomes (parent and teacher ratings of daily-life EF, computerized EF tasks and academic performance). Linear mixed model analyses were performed for all outcome measures. There were no significant differences in improvement over time on parent- and teacher ratings of attention, parent- and teacher ratings of daily-life EF, computerized EF tasks, and academic performance (arithmetic and reading) between the EF training, placebo training and waitlist condition. In conclusion, game-formatted EF training does not improve attention, EF or academic performance in very preterm children with parent-rated attention problems.

Indexing Executive Functions with Test Scores, Parent Ratings and ERPs: How Do the Measures Relate in Children versus Adolescents with ADHD?

ObjectiveRating scales and neuropsychological tests including continuous performance tests (CPTs) are widely used to assess executive functions (EFs). Event-related potentials (ERPs) are also used to index certain EFs such as action preparation and inhibition. In this descriptive study, we examined the associations between results on an EF rating scale, a CPT and ERP components in ADHD as a function of age.MethodsFifty-nine patients with ADHD (and more often than not with comorbid disorders) in two age groups (9–12 years and 13–17 years) were assessed using EF ratings, a visual CPT and ERPs (CueP3, P3go and P3no-go).ResultsThere were age related changes in the ERPs with the CueP3 amplitude being stronger in children, and the P3no-go amplitude stronger in adolescents. The associations between the EF measures were different in the two age groups. In particular, the P3no-go seemed to reflect different EF-related processes in children versus adolescents.ConclusionAge group effects were seen on a selection of ERP amplitudes in this sample of patients with ADHD. Ratings, test scores and EF-related ERPs seem to capture different aspects of EF in ADHD, and the associations differed depending on age group. The results show that different measures of EF are not interchangeable and highlight the importance of age when interpreting ERPs.

Similarities and differences across countries in the development of executive functions in children: A systematic review

AbstractA systematic review was conducted to gain a more nuanced understanding of similarities and distinctions across countries in the development of executive functions (EF). The review includes 26 studies, with child and adolescent participants, that were published between 2006 and 2018. Both similarities and differences within developmental patterns of EF are identified across different countries. Across countries, bilingual children are shown to outperform their monolingual peers. Task improvement with age is not consistently reported in all studies, with no linear effects apparent in children from developing countries or regions. Gender differences on EF measures also vary between countries. Girls perform better than boys on EF tasks and parent and teacher ratings of EF in both Western and East Asian samples. Yet, in Iran and Tanzania, boys receive higher EF scores. From preschool age through adolescence, East Asians outperform Western counterparts on direct assessment measures of EF. However, strong discrepancies can be found between measures of direct EF assessment and parent and teacher ratings of children's EF. Chinese parents rate their children's EF as lower compared with parents from other countries. The role of contextual factors explaining differences in EF development is discussed.Highlights This paper presents the first systematic review on the topic of cross‐national variation in children's EF development. A clearly defined conceptual framework regarding EF facets and analysis of a wide age span underpin this review. From preschool age through adolescence, East‐Asian children outperform their Western counterparts on direct assessment measures of EF.

Common mechanisms of executive attention underlie executive function and effortful control in children.

Executive Function (EF) and Effortful Control (EC) have traditionally been viewed as distinct constructs related to cognition and temperament during development. More recently, EF and EC have been implicated in top-down self-regulation - the goal-directed control of cognition, emotion, and behavior. We propose that executive attention, a limited-capacity attentional resource subserving goal-directed cognition and behavior, is the common cognitive mechanism underlying the self-regulatory capacities captured by EF and EC. We addressed three related questions: (a) Do behavioral ratings of EF and EC represent the same self-regulation construct? (b) Is this self-regulation construct explained by a common executive attention factor as measured by performance on cognitive tasks? and (c) Does the executive attention factor explain additional variance in attention deficit hyperactivity disorder (ADHD) problems to behavioral ratings of self-regulation? Measures of performance on complex span, general intelligence, and response inhibition tasks were obtained from 136 preadolescent children (M=11years, 10months, SD=8months), along with self- and parent-reported EC, and parent-reported EF, and ADHD problems. Results from structural equation modeling demonstrated that behavioral ratings of EF and EC measured the same self-regulation construct. Cognitive tasks measured a common executive attention factor that significantly explained 30% of the variance in behavioral ratings of self-regulation. Executive attention failed to significantly explain additional variance in ADHD problems beyond that explained by behavioral ratings of self-regulation. These findings raise questions about the utility of task-based cognitive measures in research and clinical assessment of self-regulation and psychopathology in developmental samples.

The relationship of teacher ratings of executive functions to emergent literacy in Head Start

The purpose of this study was to investigate the concurrent relationships between selected teacher-rated executive function (EF) and a comprehensive array of emergent literacy skills in preschool children after adjusting for targeted covariates including at-risk status. The sample comprised 114 three-year-olds who were attending Head Start preschool. The teacher-completed Behavior Rating Inventory of Executive Function-Preschool was used to generate three predictor variables: Inhibitory Self-Control, Flexibility, and Emergent Metacognition. The emergent literacy outcomes included the Teacher Ratings of Oral Language and Literacy Reading, Writing, and Language scales, Stanford Binet Intelligence Scale 5 Vocabulary Subtest, Test of Early Reading-3 Convention Subtest, and Print Knowledge and Phonological Awareness subtests from the Test of Preschool Early Literacy. Findings revealed that after controlling for selected covariates (age, gender, classroom) and at-risk status, when the three EF indices were included in the model the amount of variance significantly increased for all of the emergent literacy outcomes, with the total variance accounted for ranging from 32% (Phonological Awareness) to 59% (pre-Writing). Emergent Metacognition was a significant predictor for nearly every outcome except Phonological Awareness and Reading Conventions; Flexibility and Inhibitory Self-Control were significant predictors of Language. Significant interactions were present for at-risk status and teacher ratings of both Flexibility and Inhibitory on TERA-3 Conventions, but these findings appeared to be affected more by the not at-risk group than the at-risk group. Results reinforce the potential added importance of teacher ratings of EF, particularly with respect to the integrity of early developing EF, in the prediction of emergent literacy skills in young preschool children.