A Systematic Review of the Validity and Reliability of Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology among Children and Adolescents in Low- and Middle-Income Countries

Kwabena Kusi-Mensah; Nana Dansoah Nuamah; Stephen Wemakor; Joel Agorinya; Ramata Seidu; Charles Martyn-Dickens; Andrew Bateman

doi:10.1007/s11065-022-09538-3

A Systematic Review of the Validity and Reliability of Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology among Children and Adolescents in Low- and Middle-Income Countries

Neuropsychol Rev. 2022 Dec;32(4):974-1016. doi: 10.1007/s11065-022-09538-3. Epub 2022 Mar 29.

Authors

Kwabena Kusi-Mensah^{1

2}, Nana Dansoah Nuamah³, Stephen Wemakor⁴, Joel Agorinya⁵, Ramata Seidu⁵, Charles Martyn-Dickens⁶, Andrew Bateman^{7

8}

Affiliations

¹ Department of Psychiatry, University of Cambridge, Clifford Allbutt Building, Cambridge Biomedical Campus CB2 OAH, Cambridge, UK. kpk27@cam.ac.uk.
² Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana. kpk27@cam.ac.uk.
³ Pantang Hospital, Accra, Ghana.
⁴ Department of Psychiatry, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
⁵ Accra Psychiatric Hospital, Accra, Ghana.
⁶ Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana.
⁷ Department of Psychiatry, University of Cambridge, Clifford Allbutt Building, Cambridge Biomedical Campus CB2 OAH, Cambridge, UK.
⁸ School of Health and Social Care, University of Essex, Colchester, UK.

Abstract

Minimal but increasing number of assessment instruments for Executive functions (EFs) and adaptive functioning (AF) have either been developed for or adapted and validated for use among children in low and middle income countries (LAMICs). However, the suitability of these tools for this context is unclear. A systematic review of such instruments was thus undertaken. The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist (Liberati et al., in BMJ (Clinical Research Ed.), 339, 2009). A search was made for primary research papers reporting psychometric properties for development or adaptation of either EF or AF tools among children in LAMICs, with no date or language restrictions. 14 bibliographic databases were searched, including grey literature. Risk of bias assessment was done following the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) guidelines (Mokkink et al., in Quality of Life Research, 63, 32, 2014). For EF, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) were the most rigorously validated. For AFs, the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition) were most validated. Most of these tools showed adequate internal consistency and structural validity. However, none of these tools showed acceptable quality of evidence for sufficient psychometric properties across all the measured domains, particularly so for content validity and cross-cultural validity in LAMICs. There is a great need for adequate adaptation of the most popular EF and AF instruments, or alternatively the development of purpose-made instruments for assessing children in LAMICs.Systematic Review Registration numbers: CRD42020202190 (EF tools systematic review) and CRD42020203968 (AF tools systematic review) registered on PROSPERO website ( https://www.crd.york.ac.uk/prospero/ ).

Keywords: Adaptive function; Assessment instruments; Children; Developing countries; Executive Function; Psychometrics; Systematic review.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adolescent
Brain
Child
Developing Countries*
Executive Function
Humans
Psychometrics
Quality of Life*
Reproducibility of Results
Surveys and Questionnaires