A systematic review and meta-analysis of the executive function-health behaviour relationship

Tunneling, cognitive load and time orientation and their relations with dietary behavior of people experiencing financial scarcity - an AI-assisted scoping review elaborating on scarcity theory

BACKGROUND

The concept of a financial scarcity mindset has raised much attention as an explanation for poor decision-making and dysfunctional behavior. It has been suggested that financial scarcity could also impair dietary behavior, through a decline in self-control. Underlying cognitive mechanisms of tunneling (directing attention to financial issues and neglecting other demands), cognitive load (a tax on mental bandwidth interfering with executive functioning) and time orientation (a shift towards a present time horizon, versus a future time horizon) may explain the association between financial scarcity and self-control related dietary behavior. The current scoping review gathers recent evidence on how these mechanisms affect dietary behavior of people experiencing financial scarcity. It builds on a theoretical framework based on insights from behavioral economics and health psychology.

METHODS

A literature search was executed in six online databases, which resulted in 9.975 papers. Search terms were tunneling, cognitive load and time orientation, financial scarcity, and dietary behavior. Screening was performed with ASReview, an AI-ranking tool. In total, 14 papers were included in the scoping review. We used PRISMA-ScR guidelines for reporting.

RESULTS

Limited evidence indicates that a scarcity mindset could increase tunneling, through attentional narrowing on costs of food, which then directly impacts dietary behavior. A scarcity mindset involves experiencing financial stress, which can be understood as cognitive load. Cognitive load decreases attentional capacity, which could impair self-control in dietary choices. Financial scarcity is related to a present time orientation, which affects dietary choices by shifting priorities and decreasing motivation for healthy dietary behavior.

CONCLUSIONS

A scarcity mindset affects dietary behavior in different ways. Tunneling and a shift in time orientation are indicative of an attentional redirection, which can be seen as more adaptive to the situation. These may be processes indirectly affecting self-control capacity. Cognitive load could decrease self-control capacity needed for healthy dietary behavior because it consumes mental bandwidth. How a changing time orientation when experiencing financial scarcity relates to motivation for self-control in dietary behavior is a promising theme for further inquiry.

Cross-sectional and longitudinal neural predictors of physical activity and sedentary behaviour from a 6-month randomized controlled trial

A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels. At baseline, a subset of participants (n = 26/61) underwent task-based functional magnetic resonance imaging (fMRI) to examine neural activity underlying executive control using the Now/Later task. MVPA and SB were measured objectively using the Sensewear Mini at baseline, and 2, 4, and 6 months follow-up. We then examined the associations of baseline neural activation underlying executive control with: (1) baseline MVPA or SB; and (2) changes in MVPA and SB over 6 months. Our results determined that there is a complex neurocognitive system associated with MVPA levels, while SB appears to lack any neurocognitive control. In other words, MVPA appears to require neurocognitive effort, while SB may be the default behavioural pattern in adults.

Variation in executive function relates to BMI increases in youth who were initially of a healthy weight in the ABCD Study

OBJECTIVE

The study aim was to determine whether (A) differences in executive function (EF) and cognition precede weight gain or (B) weight gain causes changes to EF and cognition.

METHODS

Data were gathered from the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0; ages 9-12 years old [N = 2794]; 100% had healthy weight at baseline [i.e., 9/10 years old], 12.4% had unhealthy weight by ages 11/12 years). EF and cognition were assessed across several domains (e.g., impulsivity, inhibitory control, processing speed, memory); BMI was calculated from height and weight. Nested random-effects mixed models examined (A) BMI ~ EF × Time (i.e., variation in EF/cognition precedes weight gain) and (B) EF ~ BMI × Time (weight gain causes changes to EF/cognition) and controlled for sex, puberty, and caregiver education; random effects were site and subject.

RESULTS

Variation in impulsivity, memory, learning, and processing speed was associated with greater increases in BMI trajectories from 9 to 12 years old. Weight gain was associated with a decrease in inhibitory control, but no other associations were observed.

CONCLUSIONS

Underlying variation in EF and cognition may be important for weight gain, but 2 years of weight gain may not be enough to have clinical implications for EF and cognition beyond inhibitory control. These findings suggest that more attention should be paid to the inclusion of EF programs in obesity prevention efforts.

Executive functioning as a moderator of flossing behaviour among young adults: a temporal self-regulation theory perspective

Background

Flossing among young adults is often infrequent and barriers not completely understood. One explanation concerns the capacity for executive functioning (EF) during the self-regulation of behaviour.

Methods

Using Temporal Self-Regulation Theory (TST) as a framework to explore EF, young adults from Norwegian universities completed a survey that measured monthly flossing frequency, flossing-related intentions and behavioural prepotency (BP), and EF using the Behaviour Rating Inventory of Executive Function - Adult Version (BRIEF-A).

Results

Data from 362 participants were analysed. The TST-model explained a substantial proportion of variance in monthly flossing (R2 = 0.74), and flossing was associated directly with intention and BP, and interactions between intention and both BP and global-EF. Sub-domains of EF were explored using the same model, revealing that behavioural regulation processes, specifically those related to emotional control and shifting between tasks, offered better fit. Simple slopes revealed that moderation effects were only present at lower levels of BP.

Conclusion

EF plays a role in moderating the translation of intentions into flossing behaviour. Specifically, emotional control and task-shifting appear to be influential, and this influence increases when habitual and environmental support (i.e. BP) is reduced. Overcoming EF-barriers may represent a key step in establishing flossing behaviours.

Self-reported interoceptive accuracy and interoceptive attention differentially correspond to measures of visual attention and self-regard

Background

Interoception, the perception of bodily functions and sensations, is a crucial contributor to cognition, emotion, and well-being. However, the relationship between these three processes is not well understood. Further, it is increasingly clear that dimensions of interoception differentially corresponds to these processes, yet this is only recently being explored. The present study addresses two important questions: Are subjective interoceptive accuracy and interoceptive attention related to self-regard and well-being? And are they related to exteroceptive (visual) attention?

Methods

Participants (N = 98; 29% women; aged 23-64 years) completed: a battery of questionnaires to assess subjective accuracy (how well one predicts bodily sensations), interoceptive attention (a tendency to notice bodily signals), self-regard (self-esteem, self-image, life satisfaction), state negative affect (depression, anxiety, and stress), a self-esteem Implicit Association Task (a measure of implicit self-esteem), and a flanker task to assess visual selective attention. Subjective interoceptive accuracy and attention served as dependent variables. Correlations and principal component analysis was used to establish correlations among variables and determine how, or whether, these measures are associated with subjective interoceptive accuracy or attention.

Results

Greater scores on measures of self-regard, implicit self-esteem, cognition and lower negative affect were broadly associated with greater subjective interoceptive accuracy. Conversely, only explicit self-esteem, satisfaction with life, and self-image corresponded to subjective interoceptive attention. An exploratory analysis with a more inclusive scale of interoceptive attention was conducted. Results of this exploratory analysis showed that the broader measure was a stronger correlate to self-regard than subjective interoceptive accuracy, though it, too, did not correlate with visual attention. In short, both subjective interoceptive accuracy and attention corresponded to well-being and mental health, but only accuracy was associated with exteroceptive attention.

Conclusion

These results add to a growing literature suggesting different dimensions of (subjective) interoception differentially correspond to indices of well-being. The links between exteroceptive and interoceptive attention, and their association with merit further study.

Do executive functions predict physical activity behavior? A meta-analysis

BACKGROUND

Executive functions (EFs) are important determinants of health behaviors. In the present study, a meta-analysis was conducted to investigate the relationship between EFs and physical activity (PA) behavior.

METHODS

Systematic searches were carried out in PsycInfo, MEDLINE, and SPORTDiscus databases throughout April 2021. Prospective empirical studies conducted with general healthy populations across the lifespan, which reported the relationship between baseline EFs and later PA behavior were selected.

RESULTS

Eight studies were found eligible. Results of the multilevel meta-analysis revealed a small but significant total effect size for EFs on PA behavior of z = 0.12. High heterogeneity was observed among studies. When potential moderators were tested, residual heterogeneity remained significant and the effects of the moderators were not significant. The effect size dropped when accounted for publication bias.

CONCLUSIONS

Despite limitations, the study provided evidence for EFs' determinant role on PA behavior. More research is however encouraged to inform PA promotion programs that are well-prepared for individual differences in EFs.

Disinhibited Eating and Executive Functioning in Children and Adolescents: A Systematic Review and Meta-Analysis

A growing body of research suggests disinhibited eating and weaker executive function (EF) are two risk factors for pediatric obesity. Emerging brain imaging and behavioral findings support the notion that EF skills impact eating regulation. However, a major gap in the current literature is a synthesis of the association between various EF skills and disinhibited eating patterns across child development. To address this gap, a systematic review and meta-analysis was conducted to examine the effect of EF skills on disinhibited eating behaviors among youth ages 3-18 years old. PubMed and PsychINFO databases were utilized and data from 15 studies with a total sample of 4909 youth were included. A random effects meta-analysis revealed a small negative effect of overall EF skills on disinhibited eating behavior, r = -0.14, p < 0.01. Analysis of individual EF skills found working memory had an overall medium negative effect on disinhibited eating behavior, r = -0.25, p < 0.05. Taken together, findings from this meta-analysis support an inverse relationship between EF abilities and disinhibited eating patterns in children and adolescents, such that poorer EF abilities are associated with higher levels of disinhibited eating. Given the effect on eating behavior, future research is needed to assess whether EF difficulties may be a barrier to effective weight management in youth. Specifically, research is needed to examine whether EF skills may be a key target to consider for effective obesity prevention and treatment in children and adolescents.

Socioeconomic inequalities in adolescent health behaviours across 32 different countries - The role of country-level social mobility

Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11-15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.

A network meta-analysis comparing the effects of exercise and cognitive training on executive function in young and middle-aged adults

AbstractIn young and middle-aged adults, executive function is associated with success in work-life and mental health. Physical activity with and without cognitive training has the potential to benefit executive function, but its relative effectiveness remains unclear. This network meta-analysis compares the effectiveness of different exercise and cognitive training types and their combination on executive function in young and middle-aged adults. PubMed, Web of Science, MEDLINE, Cochrane, PsycINFO, and SPORTDiscus were searched for experimental studies that compared pre- to posttest changes in inhibitory control and/ or working memory between one or more intervention groups and a control group. Interventions were ranked on their relative effectiveness using P-scores. Study quality was rated using the PEDro scale. Forty-six studies were included and yielded 30 and 70 pair-wise effect sizes for the inhibitory control and working memory networks, respectively. With one exception, all studies were of high quality. Combined exercise and working memory training induced the greatest benefits for working memory (standardized mean differences, SMD = 0.59), whereas training a single executive function (SMD = 0.32) was most effective for inhibitory control. The effectiveness of working memory training (SMD ≥ 0.27) and coordinative exercise (SMD ≥ 0.20 to 0.29) ranked second and third for both executive function outcomes. In contrast, the effectiveness of endurance exercise was comparable to active controls on both networks. In young and middle-aged adults, exercise with coordinative demands seems to have an effectiveness similar to working memory training. The combination of exercise and cognitive training further increases executive function benefits.

Top-down self-regulation processes as determinants of oral hygiene self-care behaviour: A systematic scoping review

Objectives

Understanding the psychological mechanisms that moderate oral hygiene self‐care behavior is anticipated to benefit efforts to change such behavior. Top‐down self‐regulatory (TSR) processes represent one group of relatively unexplored, yet potentially influential, moderating factors. This systematic scoping review aims to explore whether there is evidence that TSR processes moderate oral hygiene self‐care engagement within the current literature.

Methods

CINAHL, The Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched up to April 2020 for articles that compared measures of TSR processes (such as self‐monitoring, inhibitory control, and task switching) to oral hygiene self‐care behavior, or tested interventions that aimed to change or support TSR processes.

Results

The search returned 6626 articles, with 25 included in the final sample. Weak evidence supported both the role of TSR processes as moderators of interdental cleaning and the value of interventions targeting self‐monitoring of interdental cleaning behavior. Overall, methodological limitations rendered the findings somewhat inconclusive, with an absence of objective assessments of TSR capacity, and little focus on TSR processes as moderators of intervention effects.

Conclusions

The inconclusive, but reasonably promising, findings point to the value of continuing to apply TSR processes within studies of oral hygiene behavior. Exploring why interdental cleaning appears more reliant on TSR processes than toothbrushing, employing objective neuropsychological assessment, and measuring TSR constructs within interventions targeting TSR processes, are encouraged. As a scoping review, the study hopes to generate interest and serve as a starting point for further investigation.

Subjective Socioeconomic Status, Cognitive Abilities, and Personal Control: Associations With Health Behaviours

Objective

To examine subjective and objective socioeconomic status (SSES and OSES, respectively) as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours.

Design

A cross-sectional study including 197 participants aged 30–50 years, recruited from the crowd-working platform, Prolific.

Main Outcome Measure

The Good Health Practices Scale, a 16-item inventory of health behaviours.

Results

SSES was the most important predictor of health behaviours (beta = 0.19, p &lt; 0.01). Among the OSES indicators, education (beta = 0.16, p &lt; 0.05), but not income, predicted health behaviours. Intelligence (r = −0.16, p &lt; 0.05) and memory (r = −0.22, p &lt; 0.01) were negatively correlated with health-promoting behaviours, and the effect of memory was upheld in the multivariate model (beta = −0.17, p &lt; 0.05). Personal control perceptions (mastery and constraints) did not act as mediators.

Conclusion

SSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours.

Feasibility of a Home-Based Task-Switching Training in Middle-Aged Caregivers

The current study aimed at investigating feasibility of a self-administered task-switching training in a middle-aged working population. Eighty-one caregivers (41–62 years old) were instructed to train at home 8 times either within a 7- or 14-day interval. Only 56.7% performed more than 50% of the instructed number of training sessions. However, compliant caregivers (who completed more than 4 training sessions) showed significant training gains and transfer to an untrained task-switching task. Although transfer effects to other cognitive tasks were not found, trained participants tended to report fewer everyday memory failures than a control group. In conclusion, the implementation of a home-based task-switching training in everyday life of caregivers is possible. However, there is only limited evidence for generalization of results of previous laboratory studies. Adherence and transfer to other cognitive tasks are discussed as important challenges in conveying laboratory findings into real life.

Impact on Executive Dysfunctions of Gamification and Nongamification in Playing Board Games in Children at Risk of Social Exclusion

Objective: Modern board and card game-based cognitive interventions and gamification practices showed effectiveness in boosting executive functions and decreasing behavioral problems in children. However, the combination of both game-based methods has not been tested. Therefore, the main aim of this study was to test the effectiveness of gamification in modern board and card game-based cognitive interventions in Spanish schoolchildren at risk of social exclusion. Materials and Methods: In this multicenter single-blind study with a quasi-experimental design, 176 schoolers (6-13 years old) were assigned to a gamified group (with a narrative context and a rewarding system) and 107 to a nongamified group (with no narrative context or rewarding system). The interventions were implemented in regular classes. Behavioral executive dysfunction was assessed using the Behavior Rating Inventory of Executive Function, Second Revision (BRIEF-2) (Teacher form), pre- and postintervention. Results: We found significant time effects in all BRIEF-2 domains with small and medium effect sizes (d = -0.35 to d = -0.62). The nongamified group showed significantly higher decreases in all measures than those who used gamification. Conclusions: It is possible that playing for the joy of playing in the nongamified group was enough motivation to focus on the task, while adding gamification elements did not favor greater effectiveness of the program.

Targeting executive function for weight loss in adults with overweight or obesity

Obesity is associated with a multitude of negative health sequalae. Behavioral weight loss (BWL) is currently the recommended behavioral treatment for obesity; however, it is not effective for approximately half of the individuals who participate. BWL requires individuals to carry out many tasks requiring executive function (EF; i.e., higher order cognitive functions such as planning and problem solving) in order to be successful. Growing research supports that lower EF may be associated with attenuated weight loss following BWL, and targeting EF in treatment could improve outcomes. This paper aims to describe the rationale for the development of Novel Executive Function Training for Obesity (NEXT), which adapts Compensatory Cognitive Training to be delivered in conjunction with BWL. We summarize evidence relating EF to obesity and reduced weight loss following BWL, as well as the past success of cognitive training on EF. Then we describe the treatment model for NEXT followed by initial data suggesting that NEXT is feasible and acceptable and may impact EF and weight. Obesity treatments incorporating cognitive training, especially those that train compensatory strategies, may improve weight-loss outcomes and provide a more durable treatment than traditional interventions, but larger randomized control trials are necessary.

Do different cognitive domains mediate the association between moderate-to-vigorous physical activity and adolescents' off-task behaviour in the classroom?

Background

Accumulating evidence suggests that adolescents’ moderate‐to‐vigorous physical activity (MVPA) is associated with less off‐task behaviour in the classroom. However, the contribution of cognitive functions to this relation still remains unclear. Executive function and aspects of social cognition, which appear to be correlated with MVPA, have been found to determine academic behaviours.

Aim

This study examines the direct association between MVPA and off‐task behaviour as well as mediations by different cognitive domains.

Sample

Forty‐six‐male and 67‐female adolescents aged 13.0 ± 1.3 years were recruited from local schools.

Methods

Participants recalled their MVPA. Using video cameras, their classroom behaviours were recorded and a 6‐min period was rated for off‐task behaviour. Additionally, participants completed a modified Flanker task, which assessed both inhibitory control and cognitive flexibility, a Sternberg paradigm, which assessed working memory, and an Emotion Recognition task.

Results

Path‐analyses revealed that higher MVPA was associated with less off‐task behaviour. Inhibitory control accounted for a partial mediation of this association. The mediating role of inhibitory control was most pronounced for the relation between MVPA and off‐task behaviours related to noise.

Conclusion

These findings provide a first indication that curricular and extracurricular physical activities targeting specific improvements in inhibitory control may promise transfer effects to classroom behaviours.

Explaining socioeconomic disparities in health behaviours: A review of biopsychological pathways involving stress and inflammation

The purpose of this article was to explore how individuals' position in a socioeconomic hierarchy is related to health behaviours that are related to socioeconomic disparities in health. We identified research which shows that: (a) low socioeconomic status (SES) is associated with living in harsh environments, (b) harsh environments are related to increased levels of stress and inflammation, (c) stress and inflammation impact neural systems involved in self-control by sensitising the impulsive system and desensitising the reflective system, (d) the effects are inflated valuations of small immediate rewards and deflated valuations of larger delayed rewards, (e) these effects are observed as increased delay discounting, and (f) delay discounting is positively associated with practicing more unhealthy behaviours. The results are discussed within an adaptive evolutionary framework which lays out how the stress response system, and its interaction with the immune system and brain systems for decision-making and behaviours, provides the biopsychological mechanisms and regulatory shifts that make widespread conditional adaptability possible. Consequences for policy work, interventions, and future research are discussed.

Psychosocial considerations in the assessment of hand transplant candidates: A single-center experience and brief literature review

Vascularized composite allograft, including hand transplantation (HT), has gained wider usage as a reconstructive treatment over the past 30 years. HT recipients face unique psychosocial challenges compared to their solid organ and/or bone marrow transplant counterparts. Accordingly, the psychosocial evaluation among HT candidates continues to evolve, leaving a lack of consensus as to the critical psychosocial domains and psychometric testing instruments to help evaluate individuals considering HT. The present manuscript describes the psychosocial evaluation process within the Duke HT program, which been contacted by 80 potential candidates since 2014. The Duke HT evaluation process incorporates a comprehensive psychosocial assessment within domains including personality, cognitive function, mood, behavioral adherence, social support, and substance use history, among others. Our experience underscores the potential utility of collecting thorough psychosocial evaluations, supplemented by psychometric test data, to comprehensively assess potential HT candidates.

Neurocognition applied to psychotherapy: A brief theoretical proposal based on the complex neural network perspective

Impairments on executive functions, attention, memory, and self-perception had been systematically associated and document across several psychological disorders. Individuals with anxiety, depression, and schizophrenia spectrum disorders tend to manifest difficulties in response modulation/inhibition, cognitive flexibility, selective attention, updating autobiographical memory patterns, and maintenance in the sense of self and boundaries of others. Difficulties in cognitive, emotional, behavioral, and interpersonal functions in intrapsychic and interpsychic mental domains may be theoretically related to the maladaptive functioning of several neural networks. Frontal-Parietal Executive Network (FPEN), Salience Network (SN), Amygdaloid-Hippocampal Memory Network (AHMN), and Default Mode-Network (DMN) are four major complex neural pathways associated with these neurocognitive processes, sharing some neuroanatomical elements. These shared elements may support a latent factor that accounts for the common neurocognitive symptomatology across several psychopathological conditions. Based on these preliminary observations a new theoretical neurocognitive syndrome is hypothesized, potentially a productive target for clinical case conceptualization. Several articulations bettween neurocognition and psychotherapy are discussed and a new assessment measure is proposed.

Conscientiousness and engagement with national health behaviour guidelines

High conscientiousness is associated with better health and longer life. This relationship is partly accounted for by the performance of health behaviours. The current study aimed to investigate whether conscientiousness was associated with adherence to national health behaviour guidelines as an indicator of healthy lifestyle. A cross-sectional design was used, where participants (N= 886) completed online questionnaires to assess conscientiousness and the facets of conscientiousness (order, virtue, traditionalism, self-control, responsibility, industriousness) and the performance of four health behaviours (fruit and vegetable consumption, alcohol intake, smoking, and physical activity). An index was calculated to combine the health behaviours. Conscientiousness and all its facets significantly predicted the health behaviour guideline index. In comparing high and low conscientious sub-groups, the low conscientious group had lower levels of adherence to all health behaviours guidelines measured. Strikingly, the number of high conscientious participants meeting all health behaviour guidelines was nearly twice the number of low conscientious participants meeting all guidelines. Conscientiousness is associated with adherence to multiple national health behaviour guidelines. Therefore, the positive associations between conscientiousness and health/longevity may be accounted for, in part, by the adoption of a healthy lifestyle across multiple health domains.

A New Assessment for Activities of Daily Living in Spanish Schoolchildren: A Preliminary Study of its Psychometric Properties

BACKGROUND

Activities of daily living (ADL), which are divided into basic (BADL) and instrumental (IADL), allows us to survive and to live in the society. Cognitive skills are a key aspect in BADL outcomes. After reviewing existing BADL tools for Spanish schoolchildren, issues such as not covering the full age range or not having a BADL-centred vision were found. We aim to develop a new tool for BADL assessment in Spanish schoolchildren.

METHODS

The new tool was administered to 375 participants (47.2% boys and 52.8% girls) from 6 to 12 years of age. Analyses were carried out to find out the structure (semiconfirmatory factor analysis) and internal consistency (ordinal alpha) of BADL.

RESULTS

Four scales formed the instrument (Eating, Personal Hygiene, Getting Dressed, and General Functioning) with an interpretable solution of 12 factors (Manual Dexterity, Proprioception, Oral Sensitivity, Good Manners, Hygiene and Grooming, Toileting Needs Communication, Bladder and Bowel Control, Showering, Independent Dressing Tasks, Full Dressing, Executive Functions, and Self-Regulation) with 84 items + 6 qualitative items for girls. The reliability values obtained were acceptable (.70-.88).

CONCLUSIONS

The tool seems to be a practical and reliable instrument to assess BADL and cognitive skills during BADL in Spanish schoolchildren.