Abstract

Objective: The present study examined executive function (EF) late effects in pediatric acute lymphoblastic leukemia (ALL) survivors via both performance-based and behavioral ratings measures. Convergence of parent and teacher EF ratings was also explored. Method: Subjects included 19 children and adolescents ages 10–19 treated with chemotherapy-alone and in survivorship. Performance-based EF measures included the Trail Making Task (Condition 2 and 4) and Tower Test of the Delis-Kaplan Executive Function System (D-KEFS). Parent/teacher EF ratings included the Shift and Plan/Organize subscales of the Behavior Rating Inventory of Executive Function (BRIEF). Pearson correlation coefficients (two-tailed) were computed to examine the relationship between the performance-based measures and EF ratings. Results: For the Tower test, results indicate that, when compared to the population mean, participants performed significantly better than expected, t(18) = 2.207, p = .0205. Results for the Trail Making test did not show a significant difference, t(18) = −.800, p = .217. Correlations were not significant between the Tower test and parent-teacher ratings on the Plan/Organize clinical scale. Similarly, correlations were not significant between the Trail Making test and parent-teacher ratings on the Shift clinical scale. Conclusion(s): Parent/teacher behavior ratings demonstrated low convergent validity with performance-based measures of EF. Clinically, follow-up of EF in ALL survivors should include both behavioral ratings and performance-based measures to ascertain a comprehensive understanding of functioning, as well as a more sensitive and ecologically valid measure of every day EF (i.e., the BRIEF).