Executive Functions Assessment: D-KEFS and BADS-C

D-KEFS age range

The D-KEFS is designed for individuals aged 8-89 years.

D-KEFS

The Delis-Kaplan Executive Function System (D-KEFS) is a battery of 9 stand-alone executive-function tests

D-KEFS Trail Making Test measure

Cognitive flexibility / set shifting, inhibition, sequencing

D-KEFS Trail Making Protocol

Connect numbers, then letters, then alternate 1-A-2-B-3-C as quickly as possible. Simpler conditions check visual scanning, sequencing and motor speed.

Strength of the D-KEFS Trail Making Test

A strength is that baseline conditions help indicate whether poor switching performance is due to motor, visual, or sequencing slowing.

Theory related to the D-KEFS Trail Making Test

It is related to set shifting/cognitive flexibility - the ability to disengage from one mental set and switch to another.

D-KEFS Verbal Fluency Test measure

Fluency, cognitive flexibility, rule learning

D-KEFS Verbal Fluency Test protocol

The protocol requires generating as many words as possible in 60 seconds by letter, semantic category, and alternating semantic categories.

Strength of the D-KEFS Verbal Fluency Test

It compares simple verbal generation with a more complex executive switching condition.

D-KEFS Design Fluency Test measure

It measures visual-spatial fluency/productivity, creativity, flexibility, and inhibition.

D-KEFS Design Fluency Test protocol

The protocol involves producing as many different four-line designs as possible using filled dots, empty dots, and then switching between filled and empty dots.

Strength of the D-KEFS Design Fluency Test

It provides a non-verbal fluency measure to compare with Verbal Fluency.

D-KEFS Colour-Word Interference Test measure stroop

It mainly measures inhibition, plus switching/flexibility.

D-KEFS Colour-Word Interference Test protocol

The protocol includes colour naming, word reading, inhibiting reading to name ink colour, then switching between reading and colour naming.

D-KEFS Sorting Test measure

It measures concept formation, problem solving, and cognitive flexibility.

D-KEFS Sorting Test protocol

Sort six cards into groups in as many different ways as possible, e.g. animals/vehicles, colour, shape. Also identify sorting rules made by the examiner.

Strength of the D-KEFS Sorting Test

It distinguishes generating concepts from recognizing concepts.

D-KEFS Twenty Questions Test measure

It measures hypothesis testing, problem solving, abstract thinking, and use of feedback.

D-KEFS Twenty Questions Test protocol

Identify one target from 30 objects using the fewest possible yes/no questions.

D-KEFS Word Context Test measure

It measures deductive reasoning, hypothesis testing, flexibility, and feedback use.

D-KEFS Word Context Test protocol

Guess the meaning of a pseudo-word from five increasingly informative clues, updating guesses after each clue.

Strength of the D-KEFS Word Context Test

It shows whether the person can revise a hypothesis when new evidence appears.

Theory related to the D-KEFS Word Context Test

Flexible executive function requires updating beliefs in response to new information rather than perseverating.

D-KEFS Tower Test measure

It mainly measures planning, plus problem solving, inhibition, and maintaining cognitive set.

D-KEFS Tower Test protocol

Rearrange five disks across three pegs to reproduce a target in the fewest moves, moving one disk at a time and never placing a larger disk on a smaller one.

Strength of the D-KEFS Tower Test

It measures several aspects of performance including moves, time, and rule violations, and has easier items for younger children.

Theory related to the D-KEFS Tower Test

It relates to goal-directed planning - sometimes inhibiting an immediately tempting action to achieve a future goal.

D-KEFS Proverb Test measure

It measures abstract thinking and generalisation.

D-KEFS Proverb Test protocol

Explain what sayings such as "You can't judge a book by its cover" actually mean, rather than just their literal meaning.

Strength of the D-KEFS Proverb Test

It distinguishes literal/concrete from abstract interpretation.

Weaknesses/task impurity of the D-KEFS Proverb Test

It is strongly affected by culture, language, education, and previous exposure. Child norms are also limited.

BADS-C

Behavioural Assessment of the Dysexecutive Syndrome for Children.

BADS-C age range

7-16 years.

BADS-C overall assessment

Executive functioning through relatively open-ended, everyday-like tasks, including planning, organisation, inhibition, flexibility and performance monitoring.

BADS-C subtests

Playing Cards Test

Water Test

Key Search Test

Zoo Map Tests 1 and 2

Six Part Test

DEX-C questionnaire.

Strengths of the BADS-C

Designed for greater ecological validity than highly structured EF tests; uses open-ended problems; requires children to generate and organise their own strategy; DEX-C adds caregiver/teacher information.

Weaknesses of the BADS-C

Task impurity; performance can depend on comprehension, attention, motor/visual-spatial skills; DEX-C is subjective.

Theory related to BADS-C

The ecological validity problem in EF assessment - structured tests provide goals, whereas everyday life requires children to generate and monitor their own behaviour.

BADS-C Playing Cards Test measure

Shifting/flexibility, changing strategy and inhibition.

BADS-C Playing Cards Test protocol

Rule 1: yes to red, no to black; Rule 2: yes if the card is the same colour as the previous card, no if different.

BADS-C Water Test measure

Mainly planning, with problem solving/flexibility.

BADS-C Water Test protocol

Child must work out how to remove a cork from the bottom of a tube using available materials.

BADS-C Key Search Test measure

Planning, inhibition and performance monitoring.

BADS-C Key Search Test protocol

Child imagines they have lost keys in a field and draws how they would search.

BADS-C Zoo Map Test measure

Planning, organisation and inhibition.

BADS-C Zoo Map Test 1 protocol

Child must plan their own route to visit 6 of 12 zoo locations.

BADS-C Zoo Map Test 2 protocol

Low-demand condition: child follows a written plan instead of planning the route themselves.

Reason for comparing Zoo Map Tests 1 and 2

If the child struggles with planning their own route (1) but can follow a supplied route (2), it supports a planning difficulty.

BADS-C Six Part Test measure

Planning, organisation, task scheduling, performance monitoring and inhibition.

BADS-C Six Part Test protocol

Child has six tasks and limited time; must attempt something from all six while following set rules.

DEX-C

Dysexecutive Questionnaire for Children.

DEX-C description

A 20-item Likert-scale questionnaire completed by a caregiver/teacher about the child's everyday dysexecutive behaviour.

Why DEX-C is useful

Provides information about everyday functioning at home/school, complementing BADS-C performance tests.

BADS-C low score interpretation

Does not prove a specific executive-function deficit; look at overall profile and caregiver information.

Choosing between BADS-C and D-KEFS

Choose D-KEFS for examining specific executive processes; choose BADS-C for assessing everyday executive functioning.