The item level psychometrics of the behaviour rating inventory of executive function-adult (BRIEF-A) in a TBI sample

Primary objective: To determine whether the psychometrics of the BRIEF-A are adequate for individuals diagnosed with TBI. Research design: A prospective observational study in which the BRIEF-A was collected as part of a larger study. Methods and procedures: Informant ratings of the 75-item BRIEF-A on 89 individuals diagnosed with TBI were examined to determine items level psychometrics for each of the two BRIEF-A indexes: Behaviour Rating Index (BRI) and Metacognitive Index (MI). Patients were either outpatients or at least 1 year post-injury. Main outcomes and results: Each index measured a latent trait, separating individuals into five-to-six ability levels and demonstrated good reliability (0.94 and 0.96). Four items were identified that did not meet the infit criteria. Conclusions: The results provide support for the use of the BRIEF-A as a supplemental assessment of executive function in TBI populations. However, further validation is needed with other measures of executive function. Recommendations include use of the index scores over the Global Executive Composite score and use of the difficulty hierarchy for setting therapy goals.