Contrasting speed and accuracy approaches to measure executive functions in three low-and middle-income countries

• Type of Material: Article
• Authors: Charlotte Wray, University of Oxford; Alysse J. Kowalski, Emory University; Feziwe Mpondo, University of the Witwatersrand; Laura Ochaeta, Institute of Nutrition of Central America and Panama; Delia Belleza, University of San Carlos; Ann DiGirolamo, Georgia State University; Rachel Waford Hall, Emory University; Linda Richter, University of the Witwatersrand; Nanette Lee, University of San Carlos; Gaia Scerif, University of Oxford; Alan Stein, University of Oxford; Aryeh D Stein, Emory University
• Language: English
• Date: 2023-08-31
• Publisher: PLoS
• Publication Version: Final Published Version
• Copyright Statement: © 2023 Wray et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1371%2Fjournal.pone.0290238
• Title of Journal or Parent Work: PLoS One
• Volume: 18
• Issue: 8
• Start Page: e0290238
• Grant/Funding Information: This study was funded by the Bill and Melinda Gates Foundation (OPP1164115). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: accuracy; cognitive flexibility; generalisability; cross-culturally; inhibition; reaction time; interpretation issues; diverse populations; executive functions (EF); scoring methods
• Research Categories: Psychology, Cognitive; Health Sciences, Health Care Management

Abstract

Executive functions (EF) can be measured by tests assessing accuracy, reaction times and by computing scores which combine these two components. Interpretation issues can arise from the use of different scoring methods across studies. Given that EF measures and their scoring methods are predominantly developed and validated in high income countries, little is known about the generalisability of such methods cross- culturally. The current paper compares two different established scoring approaches for measures of inhibition and cognitive flexibility: difference scores (which utilise reaction time only) and computed scores (combining accuracy and reaction time). We utilised data collected in adulthood from three low- and middle-income birth cohorts (Guatemala, Philippines, South Africa). Non-normal distributions were observed for both scoring methods in all three samples; however, this was more pronounced for the difference score method. Differing distribution patterns were observed across the three cohorts, which was especially evident in the Guatemala cohort, highlighting potential issues with using these methods across diverse populations. The data suggest that the computed scores may be a reliable measure of EF. However, the different ways of scoring and interpreting EF instruments need to be considered carefully for each population before use.