Is the behavior rating inventory of executive function more strongly associated with measures of impairment or executive function?

The Behavior Rating Inventory of Executive Function (BRIEF) is commonly used in the assessment of children and adolescents presenting with a wide range of concerns. It is unclear, however, whether the questionnaire is more closely related to general measures of behavioral disruption and impairment or to specific measures of executive function. In the present study, associations between the Behavioral Regulation Index and Metacognition Index of the BRIEF and cognitive, behavioral, and academic measures were examined in a sample of clinic-referred youth (n = 60) and healthy youth (n = 37) 6-15 years of age. Measures included ratings of inattentive and hyperactive-impulsive symptoms in youth, ratings of how well youth functioned in their everyday environments, youth's scores on measures of reading and math, and youth's scores on measures of inhibition, performance monitoring, and working memory. Although both BRIEF indices were strongly related to parent and teacher ratings of behavioral disruption and impairment, neither was associated with youth's scores on the performance-based tasks of executive function. These findings support the use of the BRIEF as a clinical tool for assessing a broad range of concerns, but raise questions about the relation of the BRIEF to performance-based tasks that are commonly used to assess executive function.