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Preliminary Psychometrics for the Executive Function Challenge Task: A Novel, “Hot” Flexibility, and Planning Task for Youth

  • Lauren Kenworthy (a1), Andrew Freeman (a2), Allison Ratto (a1), Katerina Dudley (a3), Kelly K. Powell (a4), Cara E. Pugliese (a1), John F. Strang (a1), Alyssa Verbalis (a1) and Laura G. Anthony (a1) (a5)...



Executive functions (EF) drive health and educational outcomes and therefore are increasingly common treatment targets. Most treatment trials rely on questionnaires to capture meaningful change because ecologically valid, pediatric performance-based EF tasks are lacking. The Executive Function Challenge Task (EFCT) is a standardized, treatment-sensitive, objective measure which assesses flexibility and planning in the context of provocative social interactions, making it a “hot” EF task.


We investigate the structure, reliability, and validity of the EFCT in youth with autism (Autism Spectrum Disorder; n = 129), or attention deficit hyperactivity disorder with flexibility problems (n = 93), and typically developing (TD; n = 52) youth.


The EFCT can be coded reliably, has a two-factor structure (flexibility and planning), and adequate internal consistency and consistency across forms. Unlike a traditional performance-based EF task (verbal fluency), it shows significant correlations with parent-reported EF, indicating ecological validity. EFCT performance distinguishes youth with known EF problems from TD youth and is not significantly related to visual pattern recognition, or social communication/understanding in autistic children.


The EFCT demonstrates adequate reliability and validity and may provide developmentally appropriate, treatment-sensitive, and ecologically valid assessment of “hot” EF in youth. It can be administered in controlled settings by masked administrators.


Corresponding author

*Correspondence and reprint requests to: Lauren Kenworthy, Ph.D., Center for Autism Spectrum Disorders, Children’s National Medical Center, 15245 Shady Grove Road, Suite 350, Rockville, MD20850, USA. Email:


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American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Barkley, R.A., & Fischer, M. (2011). Predicting impairment in major life activities and occupational functioning in hyperactive children as adults: Self-reported executive function (EF) deficits versus EF tests. Developmental Neuropsychology, 36, 137161.10.1080/87565641.2010.549877
Burgess, P.W., Alderman, N., Forbes, C., Costello, A., Coates, L.M.A., Dawson, D.R., Anderson, N.D., Gilbert, S.J., Dumontheil, I., & Channon, S. (2006). The case for the development and use of “ecologically valid” measures of executive function in experimental and clinical neuropsychology. Journal of the International Neuropsychological Society, 12, 194209.10.1017/S1355617706060310
Chevignard, M., Pillon, B., Pradat-Diehl, T., Taillerfer, C., Rousseau, S., Le Bras, C., & Dubois, B. (2000). An ecological approach to planning dysfunction: Script execution. Cortex, 36, 649669.10.1016/S0010-9452(08)70543-4
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). The Delis-Kaplan Executive Function System: Examiner’s Manual. San Antonio: Psychological Corporation.
DuPaul, G.J., Power, T.J., Anastopoulos, A.D., & Reid, R. (1998). ADHD Rating Scale IV: Checklists, Norms, and Clinical Interpretation. New York: Guilford Press.
Friedman, N.P. & Miyake, A. (2017). Unity and diversity of executive functions: Individual differences as a window on cognitive structure. Cortex, 86, 186204.10.1016/j.cortex.2016.04.023
Gioia, G.A., Isquith, P.K., Guy, S., & Kenworthy, L. (2000). BRIEF: Behavior Rating Inventory of Executive Function. Odessa, FL: Psychological Assessment Resources.
Gioia, G.A., Isquith, P.K., Kenworthy, L., & Barton, C. (2002). Executive signatures: Profiles of everyday executive function in acquired and developmental disorders. Child Neuropsychology, 8, 121137.10.1076/chin.
Goldsmith, H.H., & Rothbart, M.K. (1996). Prelocomotor and Locomotor Laboratory Temperament Assessment Battery, Lab-TAB; version 3.0. Technical Manual, Department of Psychology, University of Wisconsin, Madison, WI.
Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 6570.
Holmes-Bernstein, J., & Waber, D.P. (1990). Developmental neuropsychological assessment. In Boulton, A. A., Baker, G. B., Hiscock, M. (Eds.), Neuropsychology: Neuromethods (Vol. 17) (pp. 311371). Totowa, NJ: Humana Press.10.1385/0-89603-133-0:311
Jacobson, N.S. & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219.10.1037/0022-006X.59.1.12
Kenworthy, L., Anthony, L.G., Naiman, D.Q., Cannon, L., Wills, M.C., Luong-Tran, C., Adler Werner, M., Alexander, K.C., Strang, J., Bal, E., Sokoloff, J., & Wallace, G.L. (2014). Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. Journal of Child Psychology and Psychiatry, 55, 374383.10.1111/jcpp.12161
Kraybill, M.L., Thorgusen, S.R., & Suchy, Y. (2013). The push-turn-taptap task outperforms measures of executive functioning in predicting declines in functionality: Evidence-based approach to test validation. The Clinical Neuropsychologist, 27, 238255.10.1080/13854046.2012.735702
Lee, K., Bull, R., & Ho, R.M.H. (2013). Developmental changes in executive functioning. Child Development, 84, 19331953.10.1111/cdev.12096
Miodovnik, A., Harstad, E., Sideridis, G., & Huntington, N. (2015). Timing of the diagnosis of attention-deficit/hyperactivity disorder and autism spectrum disorder. Pediatrics, 136, 830837.10.1542/peds.2015-1502
Miyake, A. & Friedman, N.P. (2012). The nature and organization of individual differences in executive functions: Four general conclusions. Current Directions in Psychological Science, 21, 814.10.1177/0963721411429458
Miyake, A., Friedman, N.P., Emerson, M.J., Witzki, A.H., Howerter, A., & Wager, T.D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive Psychology, 41, 49100.10.1006/cogp.1999.0734
Moffitt, T.E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R.J., Harrington, H., Houts, R., Poulton, R., Roberts, B.W., Ross, S., Sears, M.R., Thomson, W.M., & Caspi, A. (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academic of Sciences, 108, 26932698.10.1073/pnas.1010076108
Murray, M.J. (2010). Attention-deficit/hyperactivity disorder in the context of autism spectrum disorders. Current Psychiatry Reports, 12, 382388.10.1007/s11920-010-0145-3
Ozga, J.E., Povroznik, J.M., Engler-Chiurazzi, E.B., & Vonder Haar, C. (2018). Executive (dys)function after traumatic brain injury: Special considerations for behavioral pharmacology. Behavioural Pharmacology, 29, 617637.10.1097/FBP.0000000000000430
Poland, S.E., Monks, C.P., & Tsermentseli, S. (2014). Cool and hot executive function as predictors of aggression in early childhood: Differentiating between the function and form of aggression. British Journal of Developmental Psychology, 34, 181197.10.1111/bjdp.12122
Prencipe, A., Kesek, A., Cohen, J., Lamm, C., Lewis, M.D., & Zelazo, P.D. (2011). Development of hot and cool executive function during the transition to adolescence. Journal of Experimental Child Psychology, 108, 621637.10.1016/j.jecp.2010.09.008
Pugliese, C.E., Anthony, L.G., Strang, J.F., Dudley, K., Wallace, G.L., Naiman, D.Q., & Kenworthy, L. (2016). Longitudinal examination of adaptive behavior in autism spectrum disorders: Influence of executive function. Journal of Autism and Developmental Disorders, 46, 467477.10.1007/s10803-015-2584-5
Rosseel, Y. (2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48, 136.10.18637/jss.v048.i02
Snyder, H.R., Miyake, A., & Hankin, B. (2015). Advancing understanding of executive function impairments and psychopathology: Bridging the gap between clinical and cognitive approaches. Frontiers in Psychology, 6, 124.10.3389/fpsyg.2015.00328
Strang, J.F., Anthony, L.G., Yerys, B., Hardy, K.K., Wallace, G.L., Armour, A.C., Dudley, K., & Kenworthy, L. (2017). The flexibility scale: Development and preliminary validation of a cognitive flexibility measure in children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 47, 25022518.10.1007/s10803-017-3152-y
Toplak, M.E., West, R.F., & Stanovich, K.E. (2013). Practitioner review: Do performance based measures and ratings of executive function assess the same construct? The Journal of Child Psychology and Psychiatry, 54, 131143.10.1111/jcpp.12001
van Buuren, S., & Groothuis-Oudshoorn, K. (2011). MICE: Multivariate imputation by chained equations in R. Journal of Statistical Software, 45, 167.
White, S.J. (2013). The triple I hypothesis: Taking another(’s) perspective on executive dysfunction in autism. Journal of Autism and Developmental Disorders, 43, 114121.10.1007/s10803-012-1550-8
Willcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., & Pennington, B.F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 13361346.10.1016/j.biopsych.2005.02.006
Zelazo, P.D. & Cunningham, W.A. (2007). Executive function: Mechanisms underlying emotion regulation. In Gross, J.J. (Ed.), Handbook of Emotion Regulation (pp. 135158). New York, NY: Guilford.


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Preliminary Psychometrics for the Executive Function Challenge Task: A Novel, “Hot” Flexibility, and Planning Task for Youth

  • Lauren Kenworthy (a1), Andrew Freeman (a2), Allison Ratto (a1), Katerina Dudley (a3), Kelly K. Powell (a4), Cara E. Pugliese (a1), John F. Strang (a1), Alyssa Verbalis (a1) and Laura G. Anthony (a1) (a5)...


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