Assessment & Research

Executive functions among youth with Down Syndrome and co-existing neurobehavioural disorders.

Pritchard et al. (2015) · Journal of intellectual disability research : JIDR 2015
★ The Verdict

The BRIEF-P reliably profiles executive function in Down Syndrome and pinpoints different weak spots when autism or behavior disorders co-exist.

✓ Read this if BCBAs assessing preschool or early-elementary kids with Down Syndrome
✗ Skip if Clinicians who only serve older school-age or adult populations

01Research in Context

01

What this study did

Austin et al. (2015) checked if the BRIEF-P keeps its three-factor shape in kids with Down Syndrome. They also asked if kids with DS plus autism or behavior disorders look different on executive function.

Parents filled out the preschool BRIEF-P. The team ran stats to see if the usual three factors still showed up.

02

What they found

The three-factor structure held. Kids with DS plus autism scored lowest on metacognition. Kids with DS plus behavior disorders scored worst on inhibition.

In short, the BRIEF-P works for DS and spots different weak spots when extra diagnoses are present.

03

How this fits with other research

Smit et al. (2019) later showed the school-age BRIEF also gives reliable scores in DS, so the whole BRIEF family seems solid.

Waldron et al. (2023) moved to the newer BRIEF2 and found the same three-factor shape again, building on these 2015 results.

Soltani et al. (2025) went one step further: low working memory on the BRIEF predicted later behavior problems in DS, proving these scores have real-world value.

04

Why it matters

You can trust the BRIEF-P to map executive function in young clients with Down Syndrome. Use the scores to pick targets: boost planning for DS+ASD kids, boost stop-control for DS+DBD kids. Re-assess yearly; weak working memory today flags bigger behavior issues tomorrow.

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Give the BRIEF-P to your next DS client and plan skill programs around the lowest factor score.

02At a glance

Intervention
not applicable
Design
other
Sample size
188
Population
down syndrome, autism spectrum disorder, mixed clinical
Finding
positive

03Original abstract

BACKGROUND: Executive function (EF) deficits are a recognised component of the cognitive phenotype of youth with Down Syndrome (DS). Recent research in this area emphasises the use of behaviour ratings, such as the Behavior Rating Inventory of Executive Functions-Preschool Version (BRIEF-P), to capture the real-world applications of executive functions. To account for the intellectual functioning of youth with DS, this measure is used out of age range; however, its psychometric properties when used in this fashion are unknown. The goals of this study are to evaluate psychometric characteristics of the BRIEF-P among youth with DS and to examine the pattern of EF strengths/weaknesses in children with DS and co-occurring psychiatric conditions. METHOD: A total of 188 clinically referred youth with DS, ages 3-13 were rated by their caregivers using the BRIEF-P. These youth were evaluated by a clinician with expertise in DS and were characterised as having no co-occurring behavioural disorder (Typical DS group), co-occurring Autism Spectrum Disorder (DS + ASD) or co-occurring Disruptive Behaviour Disorder (DS + DBD). RESULTS: An exploratory factor analysis of item-level BRIEF-P data from clinically referred youth with DS supported the theoretically derived three-factor structure originally proposed for the BRIEF-P (Emergent Metacognition, Flexibility and Inhibitory Self-Control); however, the item composition of each factor varied somewhat in comparison to the original structure of the measure. Group comparisons indicate that, while youth with typical DS evidence fewer executive function difficulties across all domains, youth with DS + ASD show the greatest weaknesses in Emergent Metacognition, and youth with DS + DBD show significant difficulties in both Emergent Metacognition and Inhibition. CONCLUSIONS: These findings offer preliminary support for use of the BRIEF-P with clinically referred youth with Down Syndrome. Some scoring modifications may be necessary if the theoretically derived index scores are to be used with this population. BRIEF-P scores may offer an empirical basis for differentiating DS youth with varying behavioural profiles.

Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12217