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Comprehensive Executive Function Inventory
The Comprehensive Executive Function Inventory (CEFI) is a rating scale designed to measure behaviors associated with executive function (EF) in children and adolescents, ages 5 through 18 years. The CEFI can be completed by a parent, teacher, or youth. The CEFI comprises items related to attention, emotional regulation, flexibility, inhibitory control, initiation, organization, planning, self-monitoring, and working memory. EF strengths and weaknesses can be determined in different areas measured by the CEFI. The CEFI has been developed to have the highest psychometric qualities and to provide clinically meaningful data to support treatment and intervention. This entry focuses on the application and development of the CEFI.
CEFI’s Application
The CEFI can be used during an assessment and diagnostic process as one component of a comprehensive assessment battery. Standard scores from the CEFI allow the evaluator to effectively compare an individual to a nationally representative norm group. Scores generated by the CEFI can be integrated with other information to form a complete understanding of the individual. When used in combination with other assessment information, results from the CEFI help in guiding diagnostic decisions, treatment planning, and ongoing monitoring of treatment progress. The CEFI can also be used to evaluate the effectiveness of a treatment program for youth with EF deficits. Additionally, the CEFI can be used to screen a group of children to identify those who might benefit from additional support or are in need of a full evaluation. Low scores on the CEFI suggest that additional considerations are needed, such as further examination, a more thorough evaluation, or some type of treatment or intervention to modify impairing behaviors.
The CEFI is recommended for respondents who can accurately answer a questionnaire, including those with adequate reading skills and proficiency in English or Spanish. The CEFI can be completed and scored in a paper-and-pencil format or online and automatically scored. Paper-and-pencil forms can also be scored online by entering responses from a completed paper-and-pencil administration into the online program.
The Development of CEFI
The development of the CEFI encompassed three years of effort from 2009 to 2012. Thousands of ratings by parents, teachers and youth were collected and analyzed. Development of the CEFI occurred in four phases: (1) conceptualization/initial planning and item writing, (2) pilot study, (3) final scale construction (including normative reliability and validity studies) and development, and (4) development of the Spanish forms. Construction of the final scale began with the collection of normative and clinical/educational data. The normative samples included 3,500 ratings by parents and teachers and 700 by youth 12 to 18 years of age. These samples include ratings of 50 males and 50 females of each age and are representative of the U.S. population across several demographic variables. The clinical/educational samples included 872 ratings of youth, including 432 with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD), 99 with a diagnosis of an autism spectrum disorder, 95 with a mood disorder diagnosis, and 44 cases diagnosed with other disorders such as anxiety and oppositional defiance. Additionally, 202 youth were identified as having a learning disorder. The CEFI also includes a consistency index to detect inconsistent responding as well as negative and positive impression scales to detect response styles that make the rated individual appear unrealistically negative or positive.
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