Discrepancies in Performance-Based Measures and Teacher Ratings of Executive Function in the Assessment of FASD

Objectives Canadian guidelines for diagnosing fetal alcohol spectrum disorder (FASD) recommend that test scores and informant ratings be used to assess executive functioning skills; however, there are discrepancies between these forms of measurement and most studies only use caregiver ratings. As children spend half their time at school, this neglects a significant source of information. The purpose of the present study was to examine the relationship between tests and teacher ratings of executive function in children with prenatal alcohol exposure (PAE), with and without the diagnosis of FASD. Methods A retrospective chart review of 303 children with PAE was completed. Teacher ratings of executive functioning were measured using the Behavior Rating Inventory of Executive Function. Direct measures of executive functioning included select subtests from the Delis-Kaplan Executive Function System; NEuroPSYchological Assessment, Second Edition; Wechsler Intelligence Scale for Children, Fourth Edition; Wechsler Intelligence Scale for Children, Fifth Edition; and Wechsler Adult Intelligence Scale, Fourth Edition. Results This research found significant group differences across all teacher ratings of executive functioning. Most correlations between tests and teacher ratings of executive function that we expected to be related were not significantly associated. Conclusions Results suggest that tests and teacher ratings of executive functioning may not measure the same construct or other factors may be impacting this relationship.