Enhanced Interpretation of the

Behavior Rating Inventory of

Executive Function–Preschool
Version (BRIEF-P)

Jennifer A. Greene, PhD

Sue Trujillo, MS
Peter K. Isquith, PhD
Gerard A. Gioia, PhD
Kimberly Andrews Espy, PhD
 Executive Summary

There are several steps to describing the strengths and weak-

nesses of a child’s everyday executive functioning via Behavior
Rating Inventory of Executive Function–Preschool Version
(BRIEF-P) ratings: assessing validity of ratings, making norma-
tive comparisons, examining base rates of scale/index scores
in normative and clinical groups, interpreting profiles of scale
elevations within a protocol, and interpreting ratings between
raters (e.g., parents and teachers). These interpretive steps are
supported by the use of normative information provided in the
BRIEF-P Professional Manual as well as the additional base
rates, T-score profiles, and interrater statistics provided in
Appendix A, B, and C of this white paper. While assessing
validity and interpreting T scores are common practice, the
additional steps offered here provide for enhanced, and more
nuanced, interpretation of BRIEF-P ratings. In addition to
incorporating evidence from other sources, following these
steps offers a more comprehensive evaluation of the child’s
self-regulatory functioning across school and home environ-
ments. Enhanced BRIEF-P interpretation is demonstrated via
an illustrative case example.

2
 Introduction

The Behavior Rating Inventory of Executive Function–Preschool

Quick Links
Version (BRIEF-P; Gioia, Espy, & Isquith, 2003) is a rating scale for
parents and teachers of preschool-aged children that assesses everyday Appendix A: BRIEF-P Base Rates
behaviors associated with executive functions in the home and pre- of Clinically Elevated T Scores
school environments. It is designed for preschool children ages 2 years,
Appendix B: BRIEF-P Mean
0 months to 5 years, 11 months, including those with emergent learning T Scores
disabilities and attentional disorders; language disorders; traumatic brain
injuries; autism spectrum disorders; and other developmental, neurologi- Appendix C: Interrater Statistics
cal, psychiatric, and medical conditions.
The BRIEF-P is part of the BRIEF family of products, which includes
the BRIEF Second Edition (BRIEF2; Gioia, Isquith, Guy, & Kenworthy,
2015) and the BRIEF–Adult Version (BRIEF-A; Roth, Isquith, & Gioia,
2005). The BRIEF2 Parent and Teacher forms were developed for
parents and teachers of children ages 5 to 18 years, and the BRIEF2
Self-Report Form is for adolescents ages 11 to 18 years. The BRIEF-A
Self-Report Form and Informant Form are used with adults ages 18
years and older. Since the first BRIEF product was published in 2000,
the family of instruments has been translated or adapted for use in more
than 60 languages on six continents. Additionally, more than 1,300
studies published in peer-reviewed journals have included the BRIEF
family of instruments, adding to a large international body of evidence
for reliable and valid interpretation with typically developing individuals
and individuals with a broad spectrum of clinical conditions across the
life span. Since it was published in 2003, the BRIEF-P has been
included in more than 250 studies published internationally in peer-
reviewed journals, attesting to its validity for assessing the development
of executive functions in very young children.

The purpose of this white paper is to: Since it was published

a. Provide BRIEF-P users with new statistics to enhance in 2003, the BRIEF-P
BRIEF-P interpretation, including interrater agreement
metrics and base rate tables for various clinical groups
has been included in
and the standardization samples. more than 250 studies
b. Demonstrate enhanced BRIEF-P interpretation via an published internation­
illustrative case example. ally in peer-reviewed
journals.
An introduction to the BRIEF-P and executive function will first be
presented, followed by the steps for enhanced BRIEF-P interpretation
and the case example. BRIEF-P statistics are provided in Appendix A, B,
and C at the end of this white paper for use in your own interpretation
of BRIEF-P scores.
For professionals working with older children and adolescents, an
in-depth guide to enhanced interpretation for the school-age BRIEF2
Parent, Teacher, and Self-Report Forms is available in the BRIEF2
Interpretive Guide (Isquith, Gioia, Guy, & Kenworthy, 2017), which can
be purchased on parinc.com.

3
 What is Executive Function?

The executive functions are a collection of processes that are responsible for
guiding, directing, and managing cognitive, emotional, and behavioral functions,
particularly during novel problem solving. The term executive function represents an
umbrella construct that includes a collection of interrelated functions responsible for
purposeful, goal-directed, problem-solving behavior.
Specific subdomains that make up this collection of regulatory or management
functions include the ability to initiate behavior, inhibit competing actions or stimuli,
select relevant task goals, plan and organize a means to solve complex problems,
shift problem-solving strategies flexibly when necessary, and monitor and evaluate
behavior. The working memory capacity, whereby information is actively held
“online” in the service of complex, multistep problem solving, is also described as a
key aspect of executive function (Pennington, Bennetto, McAleer, & Roberts, 1996).
Finally, the executive functions are not exclusive to cognitive control but also include
regulatory control of emotional response and behavioral action. Because executive
function develops over time in typically developing children relative to the structural
and functional development of the brain, it is important to quantify what is atypical
executive functioning given a child’s age and also recognize that executive dysfunc-
tion can be an indication of other diagnoses.

The term The BRIEF-P

executive function The BRIEF-P contains 63 items within five clinical scales that measure different
represents an aspects of executive functioning: Inhibit, Shift, Emotional Control, Working Memory,
umbrella and Plan/Organize. Table 1 describes the clinical scales and two validity scales
construct that (Inconsistency and Negativity). The clinical scales form the three broader indexes of
Inhibitory Self-Control (ISCI), Flexibility (FI), and Emergent Metacognition (EMI) and
includes a
an overall composite score, the Global Executive Composite (GEC).
collection of inter­
related functions
Enhanced Interpretation of the BRIEF-P
responsible for
purposeful, goal- Strategies for interpreting the BRIEF-P scales are provided in the BRIEF-P Profes­
directed, problem- sional Manual. The following section describes an enhanced interpretation approach
solving behavior. as outlined in Table 2. Table 2 provides the key steps for interpreting the BRIEF-P
and includes associated references and examples of statements that might be
included in a report for each step. These steps are illustrated via a case example
introduced in the BRIEF-P Professional Manual and expanded on in the following
sections. Tables to aid in interpretation are found in the BRIEF-P Professional Manual
as well in Appendix A, B, and C of this white paper.

Case Example: Adam

Background Information
Adam is a 3-year, 8-month-old boy who presents with marked impulsivity,
hyperactivity, and distractibility. His medical and developmental histories are benign,
but he has a strong family history of attentional and behavioral disorders, and his
parents divorced when he was 1 year of age. Adam’s impulsivity has resulted in

4
 Table 1
Description of the BRIEF-P Scales
Scale/index N of items Description
Clinical scale/index
Inhibit 16 Controls impulses and behavior; appropriately stops and modulates
own behavior at the proper time or in the proper context
Shift 10 Moves freely from one situation, activity, or aspect of a problem to
another as the situation demands; makes transitions; solves problems
flexibly
Emotional Control 10 Modulates emotional responses appropriately to situational demand
or context
Working Memory 17 Holds information in mind for the purpose of completing a task or
making the appropriate response; stays with, or sticks to, an activity
Plan/Organize 10 Anticipates future events or consequences; uses goals or instructions
to guide behavior in context; develops or implements appropriate
steps ahead of time to carry out an associated task or action
Inhibitory Self-Control Index (ISCI) 26 Composed of the Inhibit and Emotional Control scales
Flexibility Index (FI) 20 Composed of the Shift and Emotional Control scales
Emergent Metacognition Index (EMI) 27 Composed of the Working Memory and Plan/Organize scales
Global Executive Composite (GEC) 63 Composed of all clinical scales (Inhibit, Shift, Emotional Control,
Working Memory, and Plan/Organize)
Validity scales
Inconsistency 10 pairs Indicates the extent to which the respondent answers similar BRIEF-P
items in an inconsistent manner
Negativity 10 Measures the extent to which the respondent answers selected
BRIEF-P items in an unusually negative manner

Table 2
BRIEF-P Interpretation
Step Reference Procedure Example statements
1. Examine validity Tables 2-3a and Review Inconsistency and Negativity Ratings on the BRIEF-P were valid.
BRIEF-P Scoring scales and other indications of
Summary/Profile compromised validity.
Form
a
2a. Interpret scores
Appendixes A Review and report BRIEF-P T scores Parent ratings noted difficulties on
a
and B , BRIEF-P
relative to normativeand percentiles for scales, indexes, the Inhibit, Working Memory, and
expectations
Score or Interpre- and GEC. Plan/Organize scales but function-
tive Report ing was typical on the Shift and
Emotional Control scales.
2b. Examine base rates Appendix A Compare T scores to base-rate tables Elevations of this magnitude on the
of typically developing children and Inhibit and Working Memory scales
children with various acquired and occur in less than 10% of typically
developmental disorders. developing children his age.
3. Interpret within-test Appendix B Review and report BRIEF-P T-score The profile pattern is like that seen
score profile peaks and valleys; examine profile in students diagnosed with ADHD.
relative to diagnostic groups.
4. Interpret ratings between Appendix C
Examine discrepancies between raters; Teacher and parent ratings revealed
informants
consider interrater reliabilities, base a similar pattern of concerns with

rates and significance levels of inhibitory control, working memory,

differences, and possible explanations. and planning and organization
but also suggested problems with
emotional control in the classroom
setting.
Teacher and parent ratings were in
good agreement in general.
Note. GEC = Global Executive Composite.
a
Appears in Gioia, Espy, & Isquith (2003).

5
several accidents that required doctors’ office It is important to note that how, or whether, we report information
visits for stitches, but none with alteration of about validity of ratings should be approached with care. If validity
consciousness. He is quick to hit, kick, or scales are not elevated, the simple statement parent and teacher ratings
throw things when his needs are not met. on the BRIEF-P were valid will suffice. Noting that a score was not valid
Because of his behavior, he has been asked may not be necessary or helpful. For example, writing parent ratings
to leave two day care programs, and his were overly negative or teacher ratings were inconsistent can have
mother now stays at home to care for him. negative consequences for the relationship between parent, teacher,
and clinician. Thus, it is often preferable for clinicians to review the
Adam’s pediatrician referred him for an
validity scales on the BRIEF-P and to follow up via interview when the
evaluation of his current difficulties and
scales are elevated or questionable rather than to state specifics in the
development of intervention recommenda-
report. Information about validity is meant to assist the clinician in
tions. During his evaluation, he demonstrated
interpreting scores, not necessarily to provide feedback to the family
a broad range of affect that was mercurial,
or educational team.
ranging from excitement at finding a new
object in the office to anger when not allowed Step 2a: Interpret Scores Relative to Normative Expectations
to leave the room on demand. As part of the Adam’s mother’s ratings on the BRIEF-P Inhibit and Emotional Control
evaluation, both parent (Adam’s mother) and scales were clinically elevated. Likewise, the ISCI score, which is com-
teacher (Adam’s former day care teacher) posed of these two scales (see Figure 1), was also clinically elevated.
BRIEF-P ratings were obtained; their scores Adam’s teacher rated Adam as clinically elevated on the Inhibit scale
are presented in Figure 1. and ele­vated but within normal limits on the Emotional Control scale.
Scores for both Adam’s mother and his teacher on the Working Memory
Steps for BRIEF-P Interpretation
and Plan/Organize scales were also clinically elevated, as was the EMI
Step 1: Examine Validity score. Of interest, the score on the Shift scale was not elevated for
Before interpreting BRIEF-P parent or either rater, suggesting that Adam does not exhibit behavioral rigidity
teacher scores, the clinician should carefully or cognitive inflexibility. Indeed, one of Adam’s difficulties is that he
consider the validity of the data provided. The has no routines and does not adhere to the same patterns of daily
inherent nature of rating scales (i.e., reliance functioning—behaviors that are opposite of those captured on the Shift
on a third party for ratings of a child’s scale. Because the Emotional Control scale score was elevated and the
behav­ior) potentially introduces bias to the Shift scale score was not, the associated FI score was only moderately
scores. The BRIEF-P includes two scales elevated for both the parent and teacher ratings. In sum, Adam’s parent
(Inconsistency and Negativity) that provide and teacher BRIEF-P scores suggest marked inhibitory control deficits.
information about validity. Because Adam does not have adequate ability to inhibit, his behaviors
are impulsive and his emotions are volatile. Further, he is unable to
Adam’s parent and teacher Inconsistency
sustain working memory, reflected in his inability to remain attentive
scores were in the Acceptable range, but the or focused for reasonable lengths of time. In Adam’s report, we might
parent Negativity score was Elevated. This write: Parent and teacher ratings of Adam’s everyday executive function-
score raised the possibility of overly negative ing indicated marked problems inhibiting impulses, sustaining working
views by his mother, who completed the memory and attention, and planning and organizing problem solving.
scale, but it must also be viewed in the Parent ratings also indicated marked problems regulating emotions.
context of Adam’s fairly extreme behaviors.
Adam’s mother rated him as often having Step 2b: Examine Base Rates
difficulties on many items, with the exception BRIEF-P T scores and percentiles provide information about the level
of items on the Shift scale. Because of the of concern relative to typically developing peers. The base rate of a
consistency among the ratings, his history of given score brings an important context to the score by highlighting
expulsion from day care programs, and his how often similar scores occur in typically developing children versus
marked impulsivity and activity level during children with clinical conditions. Base rates of clinically elevated
the evaluation, the ratings likely reflect T scores (≥65) for the BRIEF-P parent and teacher standardization
extreme behaviors rather than an overly samples as well as clinical groups (ADHD, ASD, TBI, SLI, DS, and
negative rater perspective. Indeed, Adam’s preterm birth) are presented in Appendix A. Given Adam’s presentation,
behaviors were extreme, and the Negativity BRIEF-P T scores from Adam’s mother can be compared to those in the
scale was designed to capture behaviors that BRIEF-P parent standardization sample and to children with ADHD and
are rarely endorsed except in cases of ASD (see Figure 1). In Adam’s report, we could write: Elevations of this
extreme behaviors or negative bias. magnitude (T ≥ 65) on the Inhibit, Working Memory, and Plan/Organize

6
 BRIEF-P Parent BRIEF-P Teacher
Base rates
BRIEF-P
Scale/index/composite T score Qualitative label standardization ADHD ASD T score Qualitative label
Inhibit 86 Clinically elevated 9 77 88 84 Clinically elevated
Shift 55 Within normal limits 88 71 31 54 Within normal limits
Emotional Control 72 Clinically elevated 8 47 75 63 Within normal limits

7
Working Memory 72 Clinically elevated 9 71 75 78 Clinically elevated
Plan/Organize 75 Clinically elevated 9 77 56 86 Clinically elevated
Inhibitory Self-Control Index (ISCI) 83 Clinically elevated 10 77 94 79 Clinically elevated
Flexibility Index (FI) 65 Clinically elevated 9 29 75 60 Within normal limits
Emergent Metacognition Index (EMI) 75 Clinically elevated 9 71 69 82 Clinically elevated
Global Executive Composite (GEC) 79 Clinically elevated 9 71 81 80 Clinically elevated

Figure 1. Results from the BRIEF-P Parent and Teacher Form ratings for Adam. ADHD = attention-deficit hyperactivity disorder; ASD = autism spectrum
disorder.
scales are seen in less than 10% of valleys that reflect areas of relatively scale score is highly elevated, which
typically developing children but are greater concern and areas of more is similar to children with either
commonly seen in children diagnosed typical function. ADHD or ASD. However, his low Shift
with attention disorders. The elevation scale score is more like the profile of
on the Emotional Control scale is Figure 2 plots Adam’s BRIEF-P children with ADHD rather than ASD,
also seen in less than 10% of typi­­- parent T scores along with mean who tend to have marked elevations
cally developing children but only in T scores from the BRIEF-P parent on the Shift scale. In Adam’s report,
approximately 50% of children standardization sample and children we might write: The profile pattern is
with ADHD. diagnosed with ADHD and ASD. like that seen in children diagnosed
with ADHD.
Step 3: Interpret Within-Test
Score Profile Most ratings of children Step 4: Interpret Ratings Between
Scores on the BRIEF-P scales have peaks and valleys Informants
provide information about the level of that reflect areas of Gathering multiple perspectives in
concern compared with children in the assessment of a child’s function-
the standardization sample. It is
relatively greater ing provides a more comprehensive
often useful to interpret scores concern and areas of set of data with which to understand
relative to other scales within a more typical function. his or her needs, with similarities and
profile, or to examine the peaks and differences between raters often
valleys within a single protocol and to Appendix B presents the mean providing clinically useful information.
compare this profile to profiles in In the most clear-cut cases, each
T scores for these and various other
known clinical groups such as in informant will have a generally similar
clinical groups. Visual inspection
children with ADHD or ASD. Clinical perspective with overall agreement
shows that Adam’s scores are more
experience suggests that it is unusual across scales and indexes. A more
to find a flat profile across BRIEF-P similar to those of children with challenging case occurs when there
scales (i.e., all scales with similar ADHD than to children with ASD is disagreement. There may be
T-score levels) for an individual or to typically developing children. several reasons for differences
referred for evaluation. Rather, most Comparing Adam’s scores to both between ratings, and these reasons
ratings of children have peaks and clinical profiles reveals that his Inhibit may lead to different interventions.

90
 Adam’s mother l ADHD
85  n Standardization u ASD
80

75 
70  
u
T scores

l
u l
65 u u u
l
60
l
55 
l
50 n n n n n
45
Inhibit Shift Emotional Control Working Memory Plan/Organize
BRIEF-P scales

Figure 2. Adam’s BRIEF-P Parent and Teacher Form scale T scores plotted against mean scale T scores for
various clinical groups. ADHD = attention-deficit hyperactivity disorder; ASD = autism spectrum disorder.

8
For example, a child may show better flexibility or adapt- difference between specific scores is. The lower the
ability at home than in school or vice versa, and this can percentage, the more uncommon the difference. Uncom­
suggest ways to import supports that are helpful from one mon discrepancies between raters should be investigated
environment into the other. In order to facilitate inter­ to determine why they exist. As seen in Table C.2, approxi-
pretation across raters, it can be helpful to examine mately 60% of rater pairs are within 10 T-score points of
differences between raters’ T scores and the base rates of each other, with an additional 15% within 10 to 20 T-score
the differences and to consider interrater reliabilities (see points, resulting in the majority of rater pairs being within
Appendix C). 20 T-score points of each other. Thus, it is unusual to have
ratings that are 20 or more T-score points apart. As a
To facilitate clinical interpretation of differences between
general rule, differences between raters of more than 10
parent and teacher ratings, reliable change index (RCI)
T-score points might suggest very different perspectives
scores are provided (see Table C.1). The T-score values
that warrants further exploration. As shown in Figure 3,
required to indicate a significant difference between parent
the largest difference between Adam’s mother’s and his
and teacher BRIEF-P scores are listed for each scale and
teacher’s ratings was found on the Plan/Organize scale.
index at the 80% (p < .20), 90% (p < .10), 95% (p <
This difference was also relatively uncommon, occurring in
.05), and 99% (p < .01) confidence levels. In the clinical
only 14.3% of the sample, indicating that Adam’s mother
setting, a T-score difference that exceeds the 80% confi-
and his teacher disagreed about the severity of his prob-
dence level is usually considered meaningful. To interpret lems more than is typical, though the difference was not
the significance of the difference between two scores of statistically significant. In Adam’s report, we might simply
the same scale or index, calculate the absolute difference write: Parent and teacher ratings were in good agreement.
between the two scores and compare with the values in
Table C.1. Figure 3 shows Adam’s parent and teacher Putting It All Together
T-score differences for each scale and index and the While these interpretive steps may seem cumbersome
significance levels. For example, Adam’s mother’s ratings at first, they can result in a more thorough and nuanced
on the Inhibit scale resulted in a T score of 86, and his interpretation of BRIEF-P profiles. In this case, following the
teacher ratings on the same scale resulted in a T score of steps in Table 2 would result in an interpretive paragraph
84 for an absolute difference of 2. Table C.1 shows that similar to the following:
this difference is not significant.
Parent and teacher ratings of Adam’s everyday executive
In addition to considering the significance of T-score functioning were in good agreement and indicated marked
differences between raters, the percentages of T-score problems inhibiting impulses, sustaining working memory and
differences derived from the interrater sample should be attention, and planning and organizing problem solving.
reviewed to determine how common the absolute Parent ratings also indicated marked problems regulating

BRIEF-P BRIEF-P
Parent Teacher Absolute Significance % of
Scale/index/composite T score T score difference level sample
Inhibit 86 84 2 ns 60.0
Shift 55 54 1 ns 64.3
Emotional Control 72 63 9 ns 58.9
Working Memory 72 78 6 ns 61.3
Plan/Organize 75 86 11 ns 14.3
Inhibitory Self-Control Index (ISCI) 83 79 4 ns 61.1
Flexibility Index (FI) 65 60 5 ns 62.9
Emergent Metacognition Index (EMI) 75 82 7 ns 64.0
Global Executive Composite (GEC) 79 80 1 ns 58.4

Figure 3. BRIEF-P Parent and Teacher score discrepancies for Adam. ns = not significant.

9
emotions. Elevations of this magnitude (T ≥ 65) on the BRIEF-P Inhibit,
Working Memory, and Plan/Organize scales are seen in less than 10% of
typically developing children but are commonly seen in children diagnosed
with attention disorders. The elevation on the Emotional Control scale is
also seen in less than 10% of typically developing children but in approxi-
mately 50% of children with ADHD. Adam’s profile of strengths and
weaknesses in self-regulation is similar to students diagnosed with ADHD.

Recommendations for Adam

With this BRIEF-P profile, Adam is at high risk for continued behav-
Following these steps offers
ioral, social, and emotional difficulties that will likely interfere with his a more comprehensive
success across multiple domains. Recommendations should focus on evaluation of the child’s
bolstering inhibitory control as the primary need. Because of the self-regulatory functioning
extreme nature of his difficulties and their effect on his functioning,
Adam may be referred for pharmacological consultation. Because Adam
across school and home
is too young and too impulsive to consider consequences with any environments.
delay, he and his family should be referred to a behavioral specialist
who can design a program focused on controlling antecedents to his
impulsive behaviors. At the same time, consequences—as long as they
are meaningful, consistent, and immediate—could be helpful in support-
ing better inhibitory control and better social interactions. Minimal focus
was given to working memory and metacognitive aspects of executive
function because inhibitory control needs to improve first.

10
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social impairment in Cornelia de Lange syndrome. Journal Warren, S. F., Gilkerson, J., Richards, J. A., Oller, D. K., Xu, D.,
of Neurodevelopmental Disorders, 9, 33. Yapanel, U., & Gray, S. (2010). What automated vocal
analysis reveals about the vocal production and language
O’Meagher, S., Kemp, N., Norris, K., Anderson, P., & Skilbeck,
learning environment of young children with autism.
C. (2017). Risk factors for executive function difficulties
Journal of Autism and Developmental Disorders, 40,
in preschool and early school-age preterm children. Acta
555-569.
Paediatrica, 106, 1468-1473.
Wilde, L., & Oliver, C. (2017). Brief report: Contrasting pro-
Pennington, B. F., Bennetto, L., McAleer, O. K., & Roberts,
files of everyday executive functioning in Smith–Magenis
R. J. (1996). Executive functions and working memory:
syndrome and Down syndrome. Journal of Autism and
Theoretical and measurement issues. In G. R. Lyon & N. A.
Developmental Disorders, 47, 2602-2609.
Krasnegor (Eds.), Attention, memory and executive func-
tion (pp. 327-348). Baltimore: Paul H. Brookes. Wittke, K., & Spaulding, T. J. (2018). Which preschool chil-
dren with specific language impairment receive language
Pritchard, A. E., Kalback, S., McCurdy, M., & Capone, G. T.
intervention? Language, Speech, and Hearing Services in
(2015). Executive functions among youth with Down
Schools, 49, 59-71.
syndrome and co-existing neurobehavioural disorders.
Journal of Intellectual Disability Research, 59, 1130-1141. Wittke, K., Spaulding, T. J., & Schechtman, C. J. (2013).
Specific language impairment and executive functioning:
Roberts, G., Lim, J., Doyle, L. W., & Anderson, P. J. (2011).
Parent and teacher ratings of behavior. American Journal
High rates of school readiness difficulties at 5 years of
of Speech-Language Pathology, 22, 161-172.
age in very preterm infants compared with term controls.
Journal of Developmental and Behavioral Pediatrics, 32, Zantinge, G., van Rijn, S., Stockmann, L., & Swaab, H. (2017).
117-124. Physiological arousal and emotion regulation strategies in
young children with autism spectrum disorders. Journal of
Roth, R. M., Isquith, P. K., & Gioia, G. A. (2005). Behavior
Autism and Developmental Disorders, 47, 2648-2657.
Rating Inventory of Executive Function–Adult Version. Lutz,
FL: PAR.

12
 Appendix A:
BRIEF-P Base Rates of Clinically Elevated T Scores

Table A.1
BRIEF-P Base Rates of Clinically Elevated T Scores (≥65) for the
Parent and Teacher Standardization Samples and Various Clinical Samples
BRIEF-P BRIEF-P
a a a a b c d d e
Sample standardization standardization ADHD ASD ASD DS DS DS DS
Rater (parent or teacher) Parent Teacher Parent Parent Parent Parent Teacher Teacher Parent
n 406 302 17 16 39 26 19 25 22
Scale/index/composite
Inhibit 9 9 77 88 49 31 36 32 32
Shift 12 13 29 69 36 23 10 20 19
Emotional Control 8 11 47 75 33 7 24 15 15
Working Memory 9 11 71 75 54 62 75 62 60
Plan/Organize 9 10 77 56 39 43 44 40 32
Inhibitory Self-Control Index (ISCI) 10 8 77 94 49 19 — — 29
Flexibility Index (FI) 9 10 29 75 36 19 — — 19
Emergent Metacognition Index (EMI) 9 10 71 69 44 57 — — 73
Global Executive Composite (GEC) 9 11 71 81 51 42 — — 53

Mild/
Language moderate
a f f a g h h
Sample disorders SLI SLI Preterm Preterm TBI Severe TBI
Rater (parent or teacher) Parent Parent Teacher Parent Parent Parent Parent
n 21 19 19 34 66 63 23
Scale/index/composite
Inhibit 32 — — 12 — — —
Shift 29 — — 21 — — —
Emotional Control 29 — — 9 — — —
Working Memory 39 — — 35 — — —
Plan/Organize 29 — — 18 — — —
Inhibitory Self-Control Index (ISCI) 29 — — 15 — — —
Flexibility Index (FI) 29 — — 9 — — —
Emergent Metacognition Index (EMI) 32 — — 29 — — —
Global Executive Composite (GEC) 36 16 32 18 24 27 42
a
Appears in Gioia, Espy, & Isquith (2003). bAppears in Smithson et al. (2013). cAppears in Lee et al. (2011). dAppears in Daunhauer et al. (2014).
e
Appears in Loveall, Conners, Tungate, Hahn, & Osso (2017). fAppears in Wittke, Spaulding, & Schechtman (2013). gAppears in Loe, Feldman, &
Huffman (2014). hAppears in Karver et al. (2012). ADHD = attention-deficit hyperactivity disorder; ASD = autism spectrum disorder; DS = Down
syndrome; SLI = speech/language impairment; Preterm = preterm birth; TBI = traumatic brain injury.

13
 Appendix B:
BRIEF-P Mean T Scores for the BRIEF-P Standardization Samples and Various Clinical Groups


ADHD l Preterm u SLI
75 
ASD  DS n BRIEF-P Parent
Standardization

70 



  
65  u 
T scores

60
u 


55 u
 u l u

l l
50 n n
l 
n n n
l
45
Inhibit Shift Emotional Control Working Memory Plan/Organize
BRIEF-P scales

Figure B.1. Mean scale T scores for the BRIEF-P Parent standardization sample and various clinical groups. ADHD =
attention-deficit hyperactivity disorder; ASD = autism spectrum disorder; Preterm = preterm birth; DS = Down syn-
drome; SLI = speech/language impairment.

Table B.1
Mean T Scores for the BRIEF-P Parent
and Teacher Standardization Samples
a a
Rater (parent or teacher) Parent Teacher
n 460 302
Scale/index/composite
Inhibit 50.02 49.99
Shift 49.98 50.00
Emotional Control 50.00 50.08
Working Memory 50.05 50.06
Plan/Organize 50.00 49.99
Inhibitory Self-Control Index (ISCI) 50.01 49.86
Flexibility Index (FI) 50.03 49.99
Emergent Metacognition Index (EMI) 50.03 50.05
Global Executive Composite (GEC) 50.00 50.05
a
Appears in Gioia, Espy, & Isquith (2003).

14
 Table B.2
BRIEF-P Mean T Scores for Various Attention-Deficit Hyperactivity Disorder (ADHD) Samples
Skogan Ezpeleta & Mahone &
a,b
et al. c Graneroc Schneider, Lam, & Hoffman
Reference BRIEF-P (2015) (2015) Mahone (2016) (2007)
Rater (parent or teacher) Parent Parent Parent Parent Teacher Parent
n 17 104 23 33 33 25
M T score
Scale/index/composite across studies
Inhibit 76.25 63.50 65.25 — — 69.80 68.70
Shift 56.75 48.75 48.75 — — 59.10 53.34
Emotional Control 62.50 54.25 49.25 — — 61.60 56.90
Working Memory 73.75 61.75 61.75 — — 76.20 68.36
Plan/Organize 74.00 59.00 56.00 — — 71.80 65.20
Inhibitory Self-Control Index (ISCI) 73.00 60.75 59.75 — — 69.00 65.63
Flexibility Index (FI) 60.75 51.75 48.75 — — 61.70 55.74
Emergent Metacognition Index (EMI) 73.25 60.00 60.00 — — 75.80 67.26
Global Executive Composite (GEC) 74.25 — 59.25 73.39 66.91 73.40 69.44
a b c
Appears in Gioia, Espy, & Isquith (2003). T scores computed from reported item means. T scores computed from reported raw scores.

Table B.3
BRIEF-P Mean T Scores for Various Autism Spectrum Disorder (ASD) Samples
Zantinge,
Rijn, Jahromi,
Stockmann, Smithson Warren Bryce, &
a,b
Etemadc & Swaabc et al. et al. Swanson
Reference BRIEF-P (2011) (2017) (2013) (2010) (2013)
Rater (parent or teacher) Parent Parent Parent Parent Parent Parent
n 16 50 27 39 26 20
M T score
Scale/index/composite across studies
Inhibit 78.25 65.25 71.00 61.97 — — 69.12
Shift 70.00 64.75 67.50 61.10 — — 65.84
Emotional Control 75.25 59.50 — 59.05 — — 64.60
Working Memory 76.00 69.75 — 67.46 — — 71.07
Plan/Organize 74.00 62.00 — 61.10 — — 65.70
Inhibitory Self-Control Index (ISCI) 79.00 — — 62.28 — 51.68 64.32
Flexibility Index (FI) 79.00 — — 61.13 — — 70.07
Emergent Metacognition Index (EMI) 77.50 — — 66.18 — — 71.84
Global Executive Composite (GEC) 81.75 — — 65.31 46.50 — 64.52
a
Appears in Gioia, Espy, & Isquith (2003). bT scores computed from reported item means. cT scores computed from reported raw scores.

15
 Table B.4
BRIEF-P Mean T Scores for Various Down Syndrome (DS) Samples
Loveall,
Pritchard, Conners,
Kalback, Tungate,
McCurdy, Hahn, Wilde &
& Capone Daunhauer et al. Lee et al. & Osso Oliver Edgin et al.
a
Reference (2015) (2014) (2011) (2017) (2017) (2015)
Rater (parent or teacher) Parent Parent Teacher Parent Parent Parent Parent Parent
n 24 25 19 26 22 17 19 10
Scale/index/composite
Inhibit — 59.76 63.90 56.60 56.00 66.00 56.00 53.00
Shift — 54.72 55.50 56.20 51.60 55.30 53.00 48.00
Emotional Control — 49.88 55.20 49.80 48.10 51.00 47.50 48.50
Working Memory — 67.08 71.10 68.50 65.60 74.60 63.30 60.30
Plan/Organize — 60.76 65.80 61.00 57.20 64.20 61.50 57.60
Inhibitory Self-Control Index (ISCI) 48.00 56.92 61.30 54.00 52.60 — — —
Flexibility Index (FI) 47.00 53.28 55.90 53.40 49.80 — — —
Emergent Metacognition Index (EMI) 59.00 67.08 66.80 66.70 63.30 — — —
Global Executive Composite (GEC) — 62.32 66.20 61.00 58.30 — 58.00 54.00

Daunhauer, Nelson,
Gerlach- Crawford,
McDonald, Reid, Moss,
Will, & Fidler & Oliver
b b b
Reference (2017) d'Ardhuy et al. (2015) (2017)
Rater (parent or teacher) Parent Parent Parent Parent Parent Parent
n 36 34 34 27 26 20
M T score
Scale/index/composite across studies
Inhibit 62.00 — — — — 51.00 58.15
Shift 54.00 — — — — 57.00 53.83
Emotional Control 52.00 — — — — 49.00 50.10
Working Memory 70.00 — — — — 58.00 66.48
Plan/Organize 62.00 — — — — 53.00 60.29
Inhibitory Self-Control Index (ISCI) — — — — — — 55.00
Flexibility Index (FI) — — — — — — 51.92
Emergent Metacognition Index (EMI) — — — — — — 64.57
Global Executive Composite (GEC) — 57.50 55.50 50.25 49.25 — 57.25
a b
T scores computed from reported item means. T scores computed from reported raw scores.

16
 Table B.5
BRIEF-P Mean T Scores for Various Speech/language Impairment (SLI) Samples
Vugs, Hendriks,
Cuperus, & Wittke, Spaulding, &
Reference Verhoeven (2014) Schechtman (2013) Wittke, & Spaulding (2018)
Rater (parent or teacher) Parent Parent Teacher Teacher Teacher Teacher
a
n 58 19 19 31 23 23
M T score
Scale/index/composite across studies
Inhibit 58.89 — — — — — 58.89
Shift 54.81 — — — — — 54.81
Emotional Control 54.83 — — — — — 54.83
Working Memory 63.94 — — — — — 63.94
Plan/Organize 55.23 — — — — — 55.23
Inhibitory Self-Control Index (ISCI) — 53.84 56.00 — — — 54.92
Flexibility Index (FI) — 53.16 55.63 — — — 54.40
Emergent Metacognition Index (EMI) — 58.11 62.47 — — — 60.29
Global Executive Composite (GEC) 59.92 55.53 59.95 47.71 60.57 44.83 54.75
a
Articulation disorder sample.

17
 Table B.6
BRIEF-P Mean T Scores for Various Preterm Birth Samples
Alduncin,
O’Meagher, Anderson, Adams, Huffman,
Kemp, Norris, Loe & McNamara, Feldman, Feldman,
Anderson, & Feldman Andridge, & Huffman, & & Loe
a,b
Reference BRIEF-P Skilbeck (2017) (2016) Keim (2015) Loe (2015) (2014)
Rater (parent or teacher) Parent Parent Teacher Parent Parent Parent Parent Parent Parent
n 34 81 105 82 10 31 20 34 70
Scale/index/composite
Inhibit 58.00 52.50 50.92 — — — — —
Shift 56.75 49.63 47.48 — — — — —
Emotional Control 54.25 50.90 46.15 — — — — —
Working Memory 63.75 55.48 54.09 — — — — —
Plan/Organize 56.00 51.62 52.92 — — — — —
Inhibitory Self-Control Index (ISCI) 56.00 51.88 48.86 — — — — —
Flexibility Index (FI) 56.25 49.99 46.92 — — — — —
Emergent Metacognition Index (EMI) 61.25 54.23 53.87 — — — — —
Global Executive Composite (GEC) 59.75 — — 54.10 45.40 56.20 64.65 48.48 54.30

Loe, Roberts,
Feldman, Lim, Doyle, Baron, Erickson,
& Huffman & Anderson Ahronovich, Baker,
Reference Baron et al. (2014) (2014) (2011) & Litman (2011)
Rater (parent or teacher) Parent Parent Parent Parent Parent Parent Parent Parent
n 397 196 72 66 195 60 22 38
M T score
Scale/index/composite across studies
Inhibit 47.69 47.53 47.43 — — 52.00 50.90 52.70 51.09
Shift 46.77 47.12 46.29 — — 50.20 49.00 51.00 49.60
Emotional Control 46.64 46.78 45.49 — — 47.00 43.50 49.30 47.98
Working Memory 49.69 50.11 49.40 — — 54.60 53.70 55.20 53.99
Plan/Organize 47.76 48.00 47.65 — — 51.60 50.70 52.20 50.69
Inhibitory Self-Control Index (ISCI) 46.89 47.04 46.19 — — 49.80 47.10 51.70 49.58
Flexibility Index (FI) 46.27 46.53 45.33 — — 48.30 45.60 50.10 48.55
Emergent Metacognition Index (EMI) 48.82 49.13 48.75 — — 53.00 52.40 53.40 52.62
Global Executive Composite (GEC) 47.38 47.79 46.81 54.30 54.60 51.60 49.70 52.80 50.83
a
Appears in Gioia, Espy, & Isquith (2003). bT scores computed from reported item means.

18
 Table B.7
BRIEF-P Mean T Scores for Various Traumatic Brain Injury (TBI) Samples
Crowe,
Catroppa, Babl, &
Reference Anderson (2013) Karver et al. (2012)
Rater (parent or teacher) Parent Parent Parent Parent Parent Parent
n 19 16 63 63 23 23
M T score
Scale/index/composite across studies
Inhibit — — — — — —
Shift — — — — — —
Emotional Control — — — — — —
Working Memory — — — — — —
Plan/Organize — — — — — —
Inhibitory Self-Control Index (ISCI) 51.21 53.87 — — — — 52.54
Flexibility Index (FI) 50.16 49.31 — — — — 49.74
Emergent Metacognition Index (EMI) 50.18 54.88 — — — — 52.53
Global Executive Composite (GEC) 50.89 53.88 50.02 52.24 53.68 59.63 53.39

Table B.8
BRIEF-P Mean T Scores for Various Clinical Samples
Pritchard, Nelson, Holt, Beer,
Kalback, Crawford, Kronenberger,
Ezpeleta & Skogan McCurdy, Reid, Moss, Wilde & Pisoni, &
Granero et al. & Capone & Oliver Oliver Lalonde
b b a b
Reference (2015) (2015) (2015) (2017) (2017) (2012)
Rater (parent or teacher) Parent Parent Parent Parent Parent Parent Parent Parent Parent
Cornelia Smith– Deaf with
ADHD/ DS+ DS+ de Lange Magenis cochlear
Sample ODD ODD ODD Anxiety ASD DBD syndrome syndrome implant
n 10 51 39 48 67 98 25 13 45
Scale/index/composite
Inhibit 28.10 22.96 56.00 50.75 — — 56.00 77.92 55.00
Shift 13.10 13.10 48.75 53.75 — — 64.75 66.92 53.00
Emotional Control 13.30 12.76 57.00 54.25 — — 58.50 71.85 51.00
Working Memory 26.50 22.36 53.75 53.75 — — 63.75 81.00 54.72
Plan/Organize 15.20 13.52 52.50 49.75 — — 56.00 72.54 51.00
Inhibitory Self-Control Index (ISCI) 41.40 35.72 57.25 52.25 65.50 74.00 — — —
Flexibility Index (FI) 26.40 25.86 53.25 53.25 62.25 60.75 — — —
Emergent Metacognition Index (EMI) 41.70 35.88 53.25 52.25 82.50 76.00 — — —
Global Executive Composite (GEC) 96.30 84.70 — — — — — — 53.81
Note. ADHD = attention-deficit hyperactivity disorder; ODD = oppositional defiant disorder; ASD = autism spectrum disorder; DS = Down syndrome; DBD =
disruptive behavior syndrome.
a
T scores computed from reported item means. bT scores computed from reported raw scores

19
 Appendix C:
Interrater Statistics

Table C.1
BRIEF-P Parent and Teacher Interrater T Score Differences by Significance Level
Significance level
Scale/index/composite ns .20 .10 .05 .01
Inhibit 0-14 15-19 20-23 24-30 31+
Shift 0-14 15-18 19-22 23-29 30+
Emotional Control 0-15 16-19 20-23 24-30 31+
Working Memory 0-15 16-20 21-24 25-32 33+
Plan/Organize 0-16 17-21 22-25 26-34 35+
Inhibitory Self-Control Index (ISCI) 0-15 16-19 20-23 24-30 31+
Flexibility Index (FI) 0-14 15-19 20-23 24-30 31+
Emergent Metacognition Index (EMI) 0-16 17-20 21-24 25-32 33+
Global Executive Composite (GEC) 0-15 16-20 21-24 25-32 33+
Note. ns = not significant.

Table C.2
Percentages of the Interrater Sample That Obtained Various BRIEF-P T-Score Differences
BRIEF-P scale/index/composite
Emotional Working Plan/
T-score difference Inhibit Shift Control Memory Organize ISCI FI EMI GEC
Parent more than 20 T-score points > teacher 3.6 3.2 4.4 5.0 7.0 3.9 4.2 5.5 3.9
Parent 10-20 T-score points > teacher 16.3 13.3 13.9 13.6 12.2 15.5 13.4 10.6 14.6
Parent and teacher within ±10 T-score points 60.0 64.3 58.9 61.3 58.6 61.1 62.9 64.0 58.4
Parent 10-20 T-score points < teacher 14.7 12.7 16.9 12.2 14.3 14.0 13.6 11.9 16.0
Parent more than 20 T-score points < teacher 5.1 6.6 6.0 8.1 7.5 5.2 6.4 7.9 6.8
Note. N = 302. ISCI = Inhibitory Self-Control Index; FI = Flexibility Index; EMI = Emergent Metacognition Index; GEC = Global Executive Composite.

Table C.3
BRIEF-P Parent and Teacher Interrater Correlations
Parent Teacher
Mean
T-score difference r M SD M SD difference d
Inhibit .25** 49.28 9.62 49.99 9.97 –0.71 0.07
Shift .28** 49.45 9.71 50.00 9.98 –0.55 0.06
Emotional Control .25** 49.51 9.91 50.08 9.93 –0.57 0.06
Working Memory .14* 49.08 9.56 50.06 9.89 –0.98 0.10
Plan/Organize .06 49.36 9.71 49.99 9.95 –0.63 0.06
Inhibitory Self-Control Index (ISCI) .24** 49.27 9.72 49.86 9.95 –0.59 0.06
Flexibility Index (FI) .26** 49.47 9.87 49.99 9.97 –0.52 0.05
Emergent Metacognition Index (EMI) .11 49.13 9.48 50.05 9.95 –0.92 0.09
Global Executive Composite (GEC) .17** 49.11 9.74 50.05 9.99 –0.94 0.10
Note. N = 302.
*p < .05. **p < .01.

20
 Jennifer A. Greene, PhD
Coordinator–Digital Product
Design & Psychometrics
jgreene@parinc.com
1.800.331.8378

Jennifer A. Greene, PhD, works in Research and Development at PAR. She holds a PhD in Measurement
and Evaluation from the University of South Florida. In her role at PAR, she is responsible for conducting
statistical analyses and norming assessments, as well as developing digital assessments.

Sue Madden Trujillo, MS

Clinical Assessment Developer
strujillo@parinc.com
1.800.331.8378

Sue Madden Trujillo has worked for PAR since 2005. In her first role, she managed all data collection
efforts, including those for gold star products like the BRIEF2, the RIAS-2, the EDDT, and the Feifer
product line. Currently, she is a clinical assessment developer, combining data collection workload
with product development. As a former school psychologist in Connecticut, Sue brings firsthand
knowledge of child development, assessment needs, and test UX/UI to the development of user-
friendly assessment products.

21
 Peter K. Isquith, PhD

Dr. Isquith is a psychologist licensed in Vermont and New Hampshire with a specialty in pediatric
neuropsychology. He completed his BA in psychology/speech and hearing sciences at the University of
Michigan, his doctorate in child clinical psychology and law at the University of Buffalo, and his clinical
internship and postdoctoral training at Boston Children’s Hospital. He spent the 1990s in Baltimore at
Mt. Washington Pediatric Hospital and Johns Hopkins Hospital and joined the Dartmouth faculty in
2000. He remains a member of the adjunct faculty at both Dartmouth Medical School and Antioch New
England Graduate School. He is also developing an independent practice in pediatric neuropsychology.
Dr. Isquith specializes in working with deaf and hard-of-hearing individuals. His primary area of research
is the development and disorders of self-regulation in children and adolescents. He is a coauthor of the
Behavior Rating Inventory of Executive Function (BRIEF) family of instruments, including the gold-
standard measure for executive function, the BRIEF2.

Gerard A. Gioia, PhD

Dr. Gioia is division chief of pediatric neuropsychology at Children’s National Health System and
professor of pediatrics and psychiatry at the George Washington University School of Medicine. He is
a coauthor of the Behavior Rating Inventory of Executive Function (BRIEF) family of instruments,
including the primary author of the gold-standard measure for executive function, the BRIEF2. He has
developed a host of other assessment tools and has published numerous articles on executive
function in children. As a researcher, he has multiple interests including the clinical manifestation of
executive dysfunction in children and the identification of post-concussion outcomes in children. He is
a former school psychologist.

22
 Kimberly Andrews Espy, PhD

Dr. Espy is the provost and vice president for academic affairs at the University of Texas at San Antonio.
Prior to joining UTSA, she served as the senior vice president for research at the University of Arizona
and vice president for research and innovation and dean of Graduate School at the University of Oregon.
A licensed clinical psychologist and translational clinical neuroscientist, Dr. Espy has written more than
90 journal articles and is a coauthor of the Behavior Rating Inventory of Executive Function–Preschool
Version (BRIEF-P). She earned her bachelor’s degree in psychology from Rice University and her
master’s and doctoral degrees in psychology and clinical neuropsychology at the University of Houston.

Copyright © 2019 by PAR. All rights reserved. May not be reproduced in whole or in part in any form or by any means without
written permission of PAR.
To cite this document, use:
Greene, J. A., Trujillo, S., Isquith, P. K., Gioia, G. A., & Espy, K. A. (2019). Enhanced Interpretation of the Behavior Rating Inventory
of Executive Function–Preschool Version (BRIEF-P) [white paper]. PAR.

23