The concept of executive functions was initially introduced by Karl Pribram [1]. Executive functions refer to cognitive processes that supervise and regulate behaviors and abilities required to accomplish a specific objective and they are essential for goal-oriented behavior. Different authors provide different definitions for what executive functions are. Dr Russell Barkley defines executive functions as “the use of self-directed actions so as to choose goals and to select, enact, and sustain actions across time toward those goals usually in the context of others often relying on social and cultural means for the maximization of one’s longer-term welfare as the person defines that to be” [2]. Individuals with executive function deficits encounter challenges, such as poor time management, problems with attention, impulsivity, difficulty in planning to achieve goals, poor self-control, difficulty in remembering instructions, and so on. Components of executive functions include non-verbal and verbal working memory, inhibition, emotional self-regulation, self-motivation, and planning and problem-solving abilities. Working memory is the ability to hold and manipulate information over short periods. Inhibitory control is the ability to suppress automatic or dominant responses to achieve a goal. Planning and organization is the ability to create and implement strategies to achieve specific objectives. Self-monitoring is the skill to observe and evaluate one's own performance and behavior. These functions are interrelated and often work together to facilitate complex cognitive tasks. They are largely mediated by the prefrontal cortex of the brain, which continues to develop into early adulthood. Generally, executive functions start developing from very young age, develop most rapidly between ages 3–5, then during adolescent years and mature by around age 30. Genetic and environmental factors play an essential role in the development of these skills. The prefrontal cortex primarily govern executive functioning skills. Executive functions, however, also depend on other brain areas such as basal ganglia and thalamus. Executive functions are crucial for various aspects of daily life, such as academic performance, behavioral regulation and mental health. Individuals with effective executive functions can exhibit better academic performance due to having better time management and problem solving skills, being able to follow instructions, etc [3]. Executive functions enable individuals to control impulses, and behave in socially appropriate ways. Various childhood neurodevelopmental disorders, including ADHD and autism spectrum disorders are associated with deficits in executive functions. Children with ADHD typically experience delayed development of executive functions compared to their peers [4]. Dr. Russell Barkley and Dr. Tom Brown, prominent researchers, have extensively investigated changes in executive functioning in children and adolescents with ADHD. Most of the time there is deficit in executive functioning in individuals with ADHD, but not all executive function deficits are related to ADHD [5]. Some symptoms of ADHD such as hyperactivity and impulsivity tend to diminish with age. But problems with attention regulation, etc persist. Consequently, ADHD symptoms may not be evident in older children and adults. However, ADHD is not only a behavioral disorder; older children and adults who do not display typical ADHD symptoms may still experience executive function deficits. Testing executive functions can give valuable insights when diagnosing ADHD [6]. When individuals do not exhibit common ADHD symptoms, diagnosing it becomes challenging due to comorbid disorders, for example, examining executive functions can provide useful information. Improving executive functioning can lead to a reduction in ADHD symptoms. Therefore, assessing executive functions during the diagnosis of ADHD or other childhood neurodevelopmental disorders can be useful [7]. Early identification of executive function skill deficiencies can lead to earlier intrvention and it can improve long-term outcomes. ADHD is a chronic condition and cannot be treated completely, however
assessing executive function deficits can help pinpoint problem areas and aid in creating intervention programs to enhance the development of lacking skills. In this way, the symptoms of ADHD may be alleviated [8].
Assessing executive functions can be challenging due to their multifaceted nature. Standardized scales and tests have been developed to measure different components of executive functioning [9, 10]. These tests include Behavior Rating Inventory of Executive Function (BRIEF-2) and Conners 4™. Barkley Deficits in Executive Functioning Scale - Children and Adolescents (BDEFS-CA), evaluates various executive function deficits in young people. The long form of BDEFS-CA evaluates multiple domains, including time management, organization, self-restraint, motivation, and emotional regulation. The scale has been validated in various populations and is used in both clinical and research settings. The short form of BDEFS-CA was created based on the long form as a quick screening tool [11]. There is no available executive function rating scale in Azerbaijani. Having a tool to use for evaluating executive function deficits in Azerbaijani would be useful, especially for screening purposes in research, clinical and educational settings.
Aim of the present study
The aim of the present study is to evaluate the validity and reliability of the Azerbaijani translation of the Barkley Deficits in Executive Functioning Scale - Children and Adolescents (BDEFS-CA).
Procedure
Permission to translate the BDEFS-CA and use it in our research in Azerbaijan was obtained from Guilford Press.
The study was approved by Baku State University as part of a doctoral dissertation.
Translation
The scale was translated from English into Azerbaijani by two translators. One of the translators was a bilingual clinical psychologist with Azerbaijani as a native language and the other one, a professional translator. The two versions were then compared, and a single version was prepared. This single Azerbaijani version underwent a backward translation into English and was checked by a native speaker, who is an English language teacher, to ensure the meaning was not lost during translation. After that, some minor changes were made to the original Azerbaijani translation and a final version was prepared and checked by two professors from the psychology department at Baku State University and approved for use. The final version of the scale was pilot tested on a small sample to assess whether the questions were clearly understood. The participants read the questions and were asked if there was anything they did not understand. According to the pilot group, questions were all clear and understandable and no change was made to the final version of BDEFS-CA Azerbaijani translation. This final version of the scale was used in the survey.
Participants
177 parents of children between the age of 6 and 17 participated in this study. Their first language was Azerbaijani. To ensure participation from diverse backgrounds and regions of Azerbaijan, a web survey form was created and distributed to various parents' and teachers' groups, resulting in 177 respondents answering the questions. The responses that were missing two or more items were excluded. 144 responses were completed fully. The four responses with only one missing item were completed and these items were answered with a 1 (never or rarely) as per recommendation of Dr Russel Barkley [10]. 148 participants’ responses were analyzed. So, there were no missing values in all variables in the analyzed data set.
Statistical analysis of the data
The analysis of the data was performed using SPSS version 29 (IBM) and SPSS AMOS version 26 (IBM). Descriptive statistics were conducted to describe demographic characteristics of respondents.
Internal consistency: The Cronbach’s alpha and McDonald’s omega coefficient was used for evaluating the internal consistency.
Construct validity: Confirmatory Factor Analysis (CFA) was performed to check construct validity of the translated scale. Fenn et al. suggest CFA to be performed for translated tests too [12]. Since BDEFS-CA short version was prepared based on the BDEFS-CA long version, for factor analysis the five-factor model of the long version was considered.
