Advances in Cognitive Sciences

fa بررسی مقدماتی اعتباریابی و پایایی‌سنجی آزمون‌های کارکردهای اجرایی ویژه کودکان پیش‌دبستانی Validity and reliability of executive function tests for preschoolers: Pilot study روان شناسی شناختی پژوهشي اصیل Research <div style="text-align: justify;">مقدمه: آزمون‌های کارکردهای اجرایی توسط Adele Diamond جهت سنجش کارکردهای اجرایی کودکان طراحی شده است. این آزمونها سه مولفه حافظه کاری، بازداری و انعطاف‌پذیری شناختی را مورد ارزیابی قرار می‌دهند. هدف این پژوهش بررسی روایی، پایایی و قدرت افتراق این آزمون‌ها برای کودکان پیش‌دبستانی فارسی زبان است. روش کار: در یک طرح همبستگی، داده‌های 80 کودک 4 تا 6 سال شهر تهران به شیوه نمونهگیری در دسترس توسط پژوهشگر در مهدهای کودک گردآوری شد. اعتبار آزمون‌ها به روش روایی هم‌زمان در قیاس با زیرمقیاس‌های پرسشنامه درجه‌بندی رفتاری کارکردهای اجرایی که توسط والدین کودکان تکمیل شده بود؛ انجام شد و پایایی آن با استفاده از روش بازآزمایی بر روی نیمی از آزمودنی‌ها انجام شد. قدرت افتراق آزمون‌ها از طریق مقایسه میانگین گروه بالینی و هنجار انجام شد. یافته‌ها: نتایج نشان داد که آزمون‌ها دارای روایی رضایت‌بخش (ضریب همبستگی اسپیرمن 62/0 تا 89/0)، پایایی مطلوب (میزان همبستگی 71/0 تا 80/0) و قدرت تفکیک مطلوب (اختلاف معنادار در تمام مولفه‌ها بین نمرات دو گروه هنجار و بالینی) است. نتیجه‌گیری: آزمون‌های کارکردهای اجرایی اعتبار و پایایی رضایت‌بخشی جهت تشخیص و بررسی نتایج مداخلات در کودکان پیش‌دبستانی فارسی زبان دارد.  </div> Introduction <pre style="text-align:justify"> Executive functions organize thoughts toward purposeful behaviors (1). Defects in these functions can indicate damage to the prefrontal cortex. Early assessment can detect defects in this area in the early stages and consider rehabilitation programs for children (7). A wide variety of tests have long been available to evaluate executive functions. Among those that assess executive functions in children, it can be found the Fish Flanker Task, Dots Task (Hearts & Flowers), and the Form Span Task, designed by Adele Diamond.</pre> <pre style="text-align:justify"> These three tests examine the three basic components of executive functions: inhibitory control, cognitive flexibility, and working memory. Considering the usefulness of these tests, the importance and necessity of studying executive functions in children, and the lack of valid and special tools for preschool children to directly measure executive functions in the country, known tests in this area need to be translated and standardized. Therefore, this study was conducted with the aim of a preliminary study of three questions: 1- validity, 2- differential power, and 3- reliability of the mentioned tests to provide a tool for measuring executive functions in preschool children.</pre> <pre style="text-align:justify"> Methods</pre> <pre style="text-align:justify"> Seventy-four children aged 4 to 6 years in Tehran were evaluated in this study. After obtaining parental consent, they completed the Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P), the Child Behavior Checklist Preschool version (CBCL-P), and the demographic information form. After collecting and scoring the questionnaires, based on the scores of subscales of DSM of CBCL, the subjects were divided into normal and clinical groups. Then, Flanker task, Hearts & Flowers task and Form Span were taken from children in two sessions of 10-15 minutes. The data were analyzed using a correlation test to evaluate the simultaneous criterion validity. Then, to measure the differentiation power of the test, the mean scores of the normative and clinical groups were compared using the independent t-test. The tests were repeated five weeks apart for half of the subjects to check their reliability. Data were analyzed by Excel 2016 and SPSS-22.</pre> <pre style="text-align:justify"> Results </pre> <pre style="text-align:justify"> Spearman correlation was calculated between the results of the BRIEF questionnaire and the results of the Diamond tests to evaluate the validity of the tests. The correlation rate in the working memory component of the two tests was 0.63, the inhibitory control component was 0.87, and the flexibility component was 0.89.</pre> <pre style="text-align:justify"> Accordingly, a significant relationship was found between the components of executive function tests and BRIEF subscales.</pre> <pre style="text-align:justify"> In the next step, to evaluate the differentiation power of the tests, the scores of the subjects in the clinical group (n=15) were compared with 15 subjects in the normal group using the independent t-test. </pre> <pre style="text-align:justify"> The findings of Table 1 show that there is a significant difference in all components between the scores of normal and clinical groups (P<0.01). These differences indicate the optimal diagnostic validity of executive function tests.</pre> <pre style="text-align:justify"> </pre> <pre style="text-align:center"> 1. Results of independent t-tests to compare normal and clinical children for executive function components</pre> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom:1px solid black; width:141px; padding:0in 7px 0in 7px; border-top:1px solid black; border-right:1px solid black; border-left:1px solid black" valign="top"> <pre style="text-align:justify"> </pre> </td> <td colspan="2" style="border-bottom:1px solid black; width:208px; padding:0in 7px 0in 7px; border-top:1px solid black; border-right:1px solid black; border-left:none" valign="top"> <pre style="text-align:center"> Normal</pre> </td> <td colspan="2" style="border-bottom:1px solid black; width:194px; padding:0in 7px 0in 7px; border-top:1px solid black; border-right:1px solid black; border-left:none" valign="top"> <pre style="text-align:center"> Clinical</pre> </td> <td style="border-bottom:1px solid black; width:80px; padding:0in 7px 0in 7px; border-top:1px solid black; border-right:1px solid black; border-left:none" valign="top"> <pre style="text-align:justify"> </pre> </td> </tr> <tr> <td style="border-bottom:1px solid black; width:141px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:1px solid black"> <pre style="text-align:center"> Tasks</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> Mean</pre> </td> <td style="border-bottom:1px solid black; width:151px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> Standard Deviation</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> Mean</pre> </td> <td style="border-bottom:1px solid black; width:137px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> Standard Deviation</pre> </td> <td style="border-bottom:1px solid black; width:80px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> T Score</pre> </td> </tr> <tr> <td style="border-bottom:1px solid black; width:141px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:1px solid black"> <pre> Working memory</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 51.02</pre> </td> <td style="border-bottom:1px solid black; width:151px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 9.60</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 43.65</pre> </td> <td style="border-bottom:1px solid black; width:137px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 9.24</pre> </td> <td style="border-bottom:1px solid black; width:80px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 2.67</pre> </td> </tr> <tr> <td style="border-bottom:1px solid black; width:141px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:1px solid black"> <pre> Inhibitory control</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 52.36</pre> </td> <td style="border-bottom:1px solid black; width:151px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 7.83</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 43.41</pre> </td> <td style="border-bottom:1px solid black; width:137px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 7.62</pre> </td> <td style="border-bottom:1px solid black; width:80px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 3.97</pre> </td> </tr> <tr> <td style="border-bottom:1px solid black; width:141px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:1px solid black"> <pre> Cognitive flexibility</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 52.45</pre> </td> <td style="border-bottom:1px solid black; width:151px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 7.49</pre> </td> <td style="border-bottom:1px solid black; width:57px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 42.29</pre> </td> <td style="border-bottom:1px solid black; width:137px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 7.73</pre> </td> <td style="border-bottom:1px solid black; width:80px; padding:0in 7px 0in 7px; border-top:none; border-right:1px solid black; border-left:none"> <pre style="text-align:center"> 4.46</pre> </td> </tr> </tbody> </table> <pre style="margin-top:16px; text-align:justify"> Five weeks after the initial test, a retest was performed for half of the subjects to evaluate the reliability of the test. The correlation rate was 0.71 in the working memory component of the test and retest, 0.80 in the inhibitory control component, and 0.78 in the flexibility component. Accordingly, there is a good correlation between the scores of the components of executive function tests in the test and retest. Therefore, these tests have the desired reliability.</pre> <pre style="text-align:justify"> Conclusion</pre> <pre style="text-align:justify"> The presence of these tasks in preschool age is essential for early detection of defects in the prefrontal cortex. Seemingly, due to the use of color shapes and game format, the child communicates better with the tasks and provides more realistic results of the child's ability than the interview and paper-pencil tests. Another advantage of these tasks is that they are specific to the task area. In many questionnaires, the terms used to score several abilities are common or overlapping. However, in these tasks, according to the possibility of calculating the score in each part of the task, the score of selective attention, shifting, inhibition, and flexibility can be obtained separately. Furthermore, since the reaction time is recorded in computer tests, scores can be calculated and compared separately regarding accuracy and speed. This feature allows therapists to design appropriate interventions and exercises according to the subject's needs. These tests can be used in various cases, such as measuring and diagnosing executive function disorders in clinical groups, such as attention deficit/hyperactivity disorder, coping disorder, anxiety disorders, and depressive disorders. These tests also can be used for designing children's interviews.</pre> <pre style="margin-bottom:16px; text-align:justify"> In a similar study in Canada on 42 children aged 3-5 years, there was a strong correlation between the components of inhibitory control, working memory, and flexibility in a set of tests designed to measure executive function and BRIEF questionnaire scores. These findings confirm the results of the present study. One of the limitations of this study is the impossibility of sampling in other cities and larger samples.</pre> Ethical Considerations Compliance with ethical guidelines <pre style="margin-bottom:16px; text-align:justify"> All participants participated in the study with their consent and their parents' consent. The children were free to leave the room whenever they did not want to continue the assessment or felt tired. Individuals' information is protected. In performing the test, the examiner behaved in such a way that the child did not feel defeated or weak, and participating in this study did not cause any psychological or physical harm.</pre> Authors' contributions <pre style="margin-bottom:16px; text-align:justify"> Samineh S. Pourtakdoust, Javad Hatami & Alireza Moradi: Designed and conceived the presented idea. Samineh S. Pourtakdoust: performed experiments and analyzed data. Samineh S. Pourtakdoust: Performed testing section during the experiment. All authors supervised the research & provided critical feedback, and reviewed the initial and final versions.</pre> Funding <pre style="margin-bottom:16px; text-align:justify"> This research received no financial support from any funding agency in the public, commercial, or not-for-profit sectors.</pre> Acknowledgments <pre style="margin-bottom:16px; text-align:justify"> The authors thank all the participants, colleagues, and experts who helped us conduct this study.</pre> Conflicts of interest <pre style="margin-bottom:16px; text-align:justify"> The authors acknowledged no potential conflicts of interest regarding this article's research, authorship, and/or publication.</pre> آزمون فراخنای اشکال, آزمون فلنکر, آزمون نقطه‌‌ها, ارزیابی کودکان پیش‌دبستانی, روایی و پایایی Flanker test, Dots test, Form span, Preschool children assessment, Validity and reliability 60 72 http://icssjournal.ir/browse.php?a_code=A-10-1378-1&slc_lang=fa&sid=1 Samineh S. Pourtakdoust ثمینه سادات پورتاک‌دوست 100319475328460015351 100319475328460015351 No PhD Student in Cognitive Psychology, Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran دانشجوی دکتری روان‌شناسی شناختی، موسسه آموزش عالی علوم شناختی، تهران، ایران Javad Hatami جواد حاتمی Hatamijm@ut.ac.ir 100319475328460015352 100319475328460015352 Yes Professor of Psychology, Department of Psychology, University of Tehran, Tehran, Iran/ Adjunct Professor, Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran استاد روان‌شناسی، دانشکده روان‌شناسی، دانشگاه تهران، تهران، ایران/ استاد وابسته، موسسه آموزش عالی علوم شناختی، تهران، ایران Alireza Moradi علیرضا مرادی 100319475328460015353 100319475328460015353 No Professor of Clinical Psychology, Department of Clinical Psychology, Kharazmi University, Tehran, Iran/ Adjunct Professor, Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran استاد روان‌شناسی بالینی، گروه روان‌شناسی بالینی، دانشگاه خوارزمی، تهران، ایران/ استاد وابسته، موسسه آموزش عالی علوم شناختی، تهران، ایران