***Post written by Tracy Hed, Ph.D., Sheridan County School District #2, WSPA Ethics/Professional Standards Chair for WSPA***

(Review of The Behavior Rating Inventory of Executive Function, 2nd Edition.  Authors: Isquith, Gioia, Guy & Kenworthy. Publisher: PAR)

It’s hard to believe that this is the start of my 20th year as a school psychologist, working in the K-12 public education setting.   If you’re like me, you’re always on the look-out for instruments or evaluation tools that not only help to provide information on whether a child meets eligibility criteria for special education, but also provides practical, useful information that will benefit the child educationally.

I’ve found the Behavior Rating Inventory of Executive Function, Second Ed. (BRIEF-2) to be such an instrument.  I’ve found it so valuable, in fact, that I now use it as part of most of the evaluations I complete.

The BRIEF-2 screens for executive functioning concerns.  Briefly (no pun intended), it provides scores for ten clinical scales, as well as four composite scores.  The Behavior Regulation Index (BRI) is composed of the Inhibit and Self Monitor clinical scales. The Emotional Regulation Index (ERI) includes the Shift and Emotional Control scales, and the Cognitive Regulation Index (CRI) includes the Initiate, Working Memory, Plan/Organize, Task-Monitor, and Organization of Materials scales.  The fourth and final composite is the Global Executive Composite (GEC), an overall score for the rating scale. (There are teacher, parent, and self rating versions of the rating scale available.)

The computer scoring report is quite lengthy (but with a large font size, lots of white space between sections, and large margins), but it can be edited when printing to include only some sections and not others.  Even so, I often end up with a 40 or 50 page report.

What I’ve found most valuable is the section on executive function interventions.  This section starts with a brief description of the scale (another section describes each of the executive functions in more detail), and then includes ideas for interventions.  These ideas are organized into two parts: 1) external structuring, accommodations, and modifications, and 2) student-focused interventions. These intervention ideas are very practical, specific, and focused for each of the executive functioning areas or scales.

Over the past couple of years, I’ve started taking selected intervention ideas from the child’s 2 or 3 highest or most problematic executive functioning areas, and including them in the recommendation section of our team report.  I’ve also copied these sections ahead of time, and given them to the child’s special education teacher, if the child qualified for services and an IEP was written. I’ve had very good feedback from special education teachers, regular education teachers, and parents on the quality and practicality of these intervention ideas.

Another part of the the computer scoring report that I’ve found increasingly valuable are the  sections entitled “Comparison of BRIEF-2 Working Memory and Inhibit Scale to ADHD Groups,” and “Comparison of BRIEF-2 Shift Scale to Children with ASD.”   It is not uncommon when evaluating a child for the question to arise whether the child is exhibiting more ADHD symptoms or ASD symptoms, or fits one eligibility category or the other (i.e., OHI or ASD).

I’ve found these two group sections to be incredibly valuable in differentiating between these two diagnoses, as they have quite a different profile of scores on the BRIEF-2.  (There is also a different profile between ADHD-Inattentive Type and ADHD-Combined Type, which has also proved quite helpful.) For example, last year we had one kindergartener who was about to be evaluated by a developmental pediatrician, who had a history of very frequently diagnosing children with ASD.  I was able to provide both the parent & teacher BRIEF-2 rating profiles to the pediatrician, which both strongly indicated that the child fit the diagnostic criteria for ADHD-Combined type, but the profile did not fit for ASD; more importantly, I was able to explain why. The outcome was that the child was appropriately diagnosed and medicated, which in his case had a very significant positive impact on his ability to focus and attend in class.

In summary, I have found the BRIEF-2 to be an incredibly useful tool.  I use the BASC-3 rating scale as frequently and find it to be a powerful diagnostic tool, but quite frankly, I have not found the intervention ideas from the BASC-3 to be anywhere near as useful – I find they often throw in everything but the kitchen sink into their recommendations.  (There is also the BRIEF-2 Interpretive Guide, which I’ve found very useful.) The BRIEF-2 is well worth considering as an addition to your assessment tool box!