Development of Executive Functions in Children and Adolescents: Establishment of a Reference Norm for the Assessment of Executive Functions in Ecological Settings (eEFEe Tool) (DFEE)

The aim of this interventional study is to develop a normative reference for the ecological assessment of executive functions in children and adolescents using the eEFEe tool.

Executive functions are high-level cognitive abilities that support planning, behavioral regulation, and problem solving in everyday life. Current neuropsychological tests often fail to reflect real-life functioning. The eEFEe tool was designed to assess these abilities through tasks that simulate daily situations.

The study will include healthy children and adolescents aged 7 to 18 years, enrolled in regular schools in France. Participants will complete the eEFEe ecological tasks, as well as standardized cognitive and social cognition assessments, and parents will provide sociodemographic information.

Results from this study will be used to establish reference norms for the eEFEe tool and to examine how executive function performance varies according to age, cognitive development, and sociodemographic factors. These normative data will later support the clinical use of the eEFEe tool to better identify executive difficulties in children and adolescents.

Study Overview

• Status: Completed
• Conditions: Cognitive Development; Normative Data; Executive Functions (EF)
• Intervention / Treatment: Behavioral: eEFEe Ecological Assessment and Standardized Testing

• Study Type: Interventional
• Enrollment (Actual): 144
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Rennes, France, 35043
    • LP3C - Université Rennes II

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria (Children/Adolescents):

• Aged 7 to 18 years 11 months
• Enrolled in regular schools in France since early primary education
• Assent provided by child/adolescent and consent by parents/legal guardians; or consent by participant if 18 years old
• Covered by the French national health insurance system

Inclusion Criteria (Parents/Legal Guardians):

• Provided written consent
• Have a child participating in the DFEE study

Exclusion Criteria (Children/Adolescents):

- Significant motor impairments preventing completion of the eEFEe assessment

Exclusion Criteria (Parents/Legal Guardians):

- Insufficient spoken French proficiency preventing collection of sociodemographic data

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: eEFEe Assessment - Children/Adolescents and Parents; Children/Adolescents (7-18 years): Complete standardized cognitive and social cognition assessments and the eEFEe ecological executive function tasks. The ecological assessment includes six real-life tasks adapted to age and is video-recorded for later scoring of successes, errors, and verbal/non-verbal behaviors. Parents/Legal Guardians: Complete a sociodemographic questionnaire and the BRIEF Parent Form to provide information on family, schooling, and child behavior related to executive functions.

Behavioral: eEFEe Ecological Assessment and Standardized Testing; Children/Adolescents: Complete the eEFEe ecological executive function tasks (six daily-life tasks adapted to age) and standardized cognitive and social cognition tests (NEPSY-II, WISC-V/WAIS, Rey Figure, etc.). Sessions are video-recorded for later scoring. Parents/Legal Guardians: Complete a sociodemographic questionnaire and the BRIEF Parent Form to assess executive-related behaviors in daily life.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of successful actions on ecological assessments of executive functions in children (eEFEe test)	The eEFEe consists of six everyday tasks, adapted for different age groups in line with clinical and educational practices in the field. Each task is divided into several steps. Each step is scored according to the level of completion. An overall success score is assigned to each task. A high score indicates that the task has been successfully completed, while a low score indicates partial completion or failure to complete the task. The tasks in question are: Document sorting; Board game; Swimming bag and school bag; Vidéo game; Cooking; DIY	"eEFEe" visit : Between Day 0 and Day 60
Number of errors on ecological assessments of executive functions in children (eEFEe test)	Number of errors on the eEFEe test. The number of errors that occurred during the task is recorded. These are categorised into two types: action errors and behavioural errors. Action errors include omissions, incomplete actions, additional actions, sequencing errors and the identification of errors without correction. Behavioural errors include difficult decisions, dependency, failure to take advantage of assistance provided, lack of initiative, distractibility, lack of engagement with the environment, dangerous behaviour, inappropriate behaviour and interventions by the therapist. Test tasks : Document sorting; Board game; Swimming bag and school bag; Vidéo game; Cooking; DIY	"eEFEe" visit : Between Day 0 and Day 60
Performance on ecological assessments of executive functions in children (eEFEe test)	administration time for each assessment on the eEFEe test. Test tasks : Document sorting; Board game; Swimming bag and school bag; Vidéo game; Cooking; DIY	'eEFEe' visit: between Day 0 and Day 60
Performance on ecological assessments of executive functions in children (eEFEe test)	Assessment of task habituation For each task, the participant is asked whether they usually perform it in their daily life. They can answer either "yes" or "no." Test tasks : Document sorting; Board game; Swimming bag and school bag; Vidéo game; Cooking; DIY	'eEFEe' visit: between Day 0 and Day 60

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation with social cognition assessments	Relationship between eEFEe task performance and standardized social cognition tests	At the end of the study, when all the data have been collected
Correlation with standardized cognitive assessments	Relationship between eEFEe task performance and standardized cognitive tests	At the end of the study, when all the data have been collected
Influence of sociodemographic factors	Collection of sociodemographic data : Socio-professional category; Parents' educational level; Child's age; Birth order and sibling size; Family structure With the aim of correlating the results obtained on the eEFEe test with sociodemographic data (socio-professional category, parents' educational level, age, birth order and number of siblings, and family structure). Simple and adjusted linear regressions will be performed (Bravais-Pearson correlation).	Baseline Visit : Day 0
Age-related performance differences	Collection of participants' age in order to assign them to an age category. With the aim of comparing the results obtained with the eEFEe tool across age groups. Means and medians of the scores obtained at the two evaluations will be compared using Student's t-tests or ANOVA when data follow a normal distribution, or using Wilcoxon and Kruskal-Wallis tests when normality is not met.	Baseline visit : Day 0

Collaborators and Investigators

• Sponsor: Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape

Study record dates

Study Major Dates

• Study Start (Actual): February 6, 2024
• Primary Completion (Actual): December 2, 2025
• Study Completion (Actual): December 12, 2025

Study Registration Dates

• First Submitted: February 18, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2023-A02174-41

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No