The Children’s Cooking Task,a Performance-Based Assessment to Evaluate Executive Functions in Adolescents With Neurodevelopmental Disorders

RATIONALE AND BACKGROUND: The purpose of this study was to describe adolescents’ daily performance on a complex task assessing executive functions (EF) in a natural environment. Adolescents with neurodevelopmental disabilities (NDD) display functional difficulties in multiple performance areas, including daily functions, learning, playing and leisure, and social participation. Recent literature provides evidence for the centrality of EF as the cognitive mechanism underlying these difficulties. EF deficits are reflected in poor performance and decreased activity and participation because they hinder the ability to perform and participate effectively in everyday life. However, there is a shortage of standardized assessment tools suitable for investigating EF, activity, and participation. Performance-based assessments are the best method to evaluate EF because they require self-management and are open to conflicting stimuli. The Children’s Cooking Task (CCT; Chevignard et al., 2009) was developed to assess executive dysfunction in adolescents in a real-life open-ended setting.

METHOD: The study was designed as a comparative study and examined adolescents with and without NDD who experienced difficulties in daily functioning and EF. Parents completed the Behavior Rating Inventory of Executive Function (Gioia et al., 2000), and if they met the inclusion criteria (including a score of 65 or more in one of the indexes), their children were invited to an individual session to complete the CCT. Participants were 44 adolescents with NDD aged 10–18 (M age = 11.8 ± 1.06) and 44 age- and gender-matched typically developing adolescents (M age = 12.2 ± 1.33). Participants had to prepare two foods: chocolate cake and fruit juice. Data were processed with IBM SPSS Statistics Version 21 (IBM Corp., Armonk, NY). Descriptive statistics (means, standard deviations, percentages) were used to describe the study participants’ main variables. A Mann–Whitney U test was conducted to examine the differences between groups in CCT results.

RESULTS: Significant differences between the two groups were found for duration of the cooking task (z = 2.31, p = .02) and total number of errors (z = 7.67, p < .000).

CONCLUSION: EF deficits are more frequent in adolescents with NDD and have significant impacts across complex real-life open-ended tasks. Investigating EF during everyday activities is important in selecting an intervention program to emphasize personal strengths and address weaknesses in daily functions.

IMPACT STATEMENT: The study reinforces the discriminant and concurrent validity of the CCT. Additionally, data from the study support performance-based assessments as an integral part of the evaluation process. In practical terms, information learned from the study can assist in determining treatment goals and choosing the appropriate treatment approach for each adolescent.

References

Chevignard, M. P., Servant, V., Mariller, A., Abada, G., Pradat-Diehl, P., & Laurent-Vannier, A. (2009). Assessment of executive functioning in children after TBI with a naturalistic open-ended task: A pilot study. Developmental Neurorehabilitation, 12, 76–91. https://doi.org/10.1080/17518420902777019

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? Journal of Child Psychology and Psychiatry, 54, 131–143. https://doi.org/10.1111/jcpp.12001

Toussaint-Thorin, M., Marchal, F., Benkhaled, O., Pradat-Diehl, P., Boyer, F. C., & Chevignard, M. (2013). Executive functions of children with developmental dyspraxia: Assessment combining neuropsychological and ecological tests. Annals of Physical and Rehabilitation Medicine, 56, 268–287. https://doi.org/10.1016/j.rehab.2013.02.006