Performance-Based Executive Function Instruments Used by Occupational Therapists for Children: A Systematic Review of Measurement Properties.
Ivan Neil B Gomez, Sharleen Alyssa M Palomo, Ana Melissa U Vicuña and 5 others
PMID 34471400WHAT IT FOUND
Evidence for five performance-based executive function tests used by OTs with children is weak.
While these tools assess real-world tasks, their reliability and validity are inconsistent or unproven. Use them with caution and do not rely on them as definitive measures.
Key findings
01The review identified five performance-based executive function instruments for children (BADS-C, CCT, CKTP, Do-Eat, PETA) but found low certainty of evidence for their measurement properties due to limited studies and inconsistent results.
02For the Children's Cooking Task (CCT), reliability was limited because studies reported different types of reliability, and criterion validity was inconsistent across studies.
03The Do-Eat test showed high internal consistency but conflicting evidence for structural validity, with no correlation to other executive function assessments in one study and significant correlations in another.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only eight studies were included, leading to sparse data for many measurement properties. The COSMIN framework was originally designed for patient-reported outcomes, requiring adjustments for performance-based assessments. Some ratings relied on the reviewers' judgment, which may affect reproducibility. The strict inclusion criteria (requiring OT relevance) may have excluded other valid EF instruments used by different professions. Many studies did not report all relevant measurement properties (e.g., content validity, structural validity), leaving gaps in the evidence.
Declared interests
No conflicts of interest or funding sources are explicitly stated in the provided text.
The easy way to misread this
Do not assume that these performance-based tests are validated and reliable simply because they are used in occupational therapy. The evidence for their measurement properties is low, meaning their true accuracy might be significantly different from what is reported. Use them as part of a broader assessment rather than as standalone diagnostic tools.