The Pictorial Interview of Children's Metacognition and Executive Functions (PIC-ME): Cultural Adaptation for Ultra-Orthodox Jewish Populations.

Introduction: Executive functions (EFs) are strongly linked to attention deficit hyperactivity disorder (ADHD). The pictorial interview of children's metacognition and executive functions (PIC-ME) assesses children's self-perceptions regarding their EF. This study is aimed at describing the cultural adaptation of the PIC-ME to the ultra-Orthodox (UO) Jewish population in Israel. Method: In the first of three stages, 30 occupational therapists, who were experienced in working with children with ADHD from the UO population, completed a questionnaire about the suitability of PIC-ME for the UO community. In the second stage, six therapists participated in a focus group to discuss the recommendations and the adaptations made following the first stage. In the third stage, 20 UO children aged 5-10 participated in the tool validation process. Results: First stage: most of the items of the original tool were found to be appropriate in representing the EFs of UO children and did not need to be adapted. No significant differences were found between the boys' and girls' versions regarding the tool's adaptability. However, most of the therapists suggested that the pictures in both versions needed adaptations. Second stage: additional recommendations led to the development of a final adapted version. Third stage: over 70 percent agreement was found among UO children regarding the clarity of the adapted pictures. No significant differences were found between boys and girls or between age groups. Conclusions: This study presented wide agreement on the necessity for cultural adaptation of the PIC-ME to the UO population and described the adaptation process. Based on its face validity, the UO version may be a useful tool to assess the self-perception of EF among UO children. Further studies are needed to assess its psychometric properties and its usefulness as an outcome measure. The study findings may contribute to the cultural adaptation of other tools for culturally distinct populations.

Comparison of Children With and Without ADHD on a New Pictorial Self-Assessment of Executive Functions.

OBJECTIVE: We examined the Pictorial Interview of Children's Metacognition and Executive Functions' (PIC-ME's) reliability and validity, targeting children's appraisal of their executive function (EF) in daily life. METHOD: One hundred children with attention deficit hyperactivity disorder (ADHD) and 44 typically developing children (ages 5-10 yr) completed the PIC-ME. Parents completed the PIC-ME and Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: Cronbach's α for the child PIC-ME was .914. A high correlation was found between the parent PIC-ME total and the BRIEF (r = .724). Comparisons between groups revealed significant differences on the parent PIC-ME (p < .0001) but none on the child PIC-ME. Children with ADHD identified a median of eight EF challenges they wanted to set as treatment goals. CONCLUSION: Results support the PIC-ME's initial reliability and validity among children with ADHD. Children were able to identify several EF challenges and engage in goal setting.

Effectiveness of Cognitive-Functional (Cog-Fun) occupational therapy intervention for young children with attention deficit hyperactivity disorder: a controlled study.

OBJECTIVE: The purpose of this study was to examine the effectiveness of the Cognitive-Functional (Cog-Fun) intervention for young children with attention deficit hyperactivity disorder (ADHD). METHOD: Nineteen children ages 5-7 yr diagnosed with ADHD were allocated to treatment and wait-list control groups. After the 12-wk intervention, the control group was crossed over to treatment. Follow-up was conducted 3 mo after treatment. Outcome measures included the Behavior Rating Inventory of Executive Function and the Canadian Occupational Performance Measure. RESULTS: Before crossover, significant differences were found between groups in change scores on the outcome measures. After crossover, no significant differences were found in treatment effects, and significant moderate to large treatment effects were found for both COPM and BRIEF scores. Treatment gains were maintained at follow-up. CONCLUSION: The study supports the effectiveness of the Cog-Fun intervention in improving occupational performance and executive functions in daily life for young children with ADHD.

The Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch): a new instrument for assessing learning potential.

OBJECTIVE: To describe the development and psychometric properties of the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch), a dynamic criterion-referenced assessment of cognitive abilities and learning potential for children with cognitive and learning difficulties. METHOD: A series of studies analyzed the age standards, criterion cutoff scores, and percentage of mediation cues required for typically developing children 6-12 years of age, as well as reliability and validity. RESULTS: MANOVA analyses determined four age groups that best fit the outcome data: 6-6.11, 7-8.11, 9-10.11, and 11-12 years. Criterion cutoff scores of 25% for at-risk and under 10% for deficient performance were obtained for each age group. Dynamic percentage scores were determined. Significant high interrater reliability and moderate to high internal consistency reliability were found. Construct validity was supported by comparing children with traumatic brain injury and learning disabilities to typically developing children, and ecological validity of children with attention deficit hyperactivity disorder by comparing performance on the DOTCA-Ch to the School Function Assessment. CONCLUSIONS: The DOTCA-Ch is a reliable and valid assessment that provides learning potential and can facilitate intervention for cognitive difficulties that manifest themselves in daily functions among school-age children.