SPECIAL SYMPOSIUM: Executive Function in the Real World: “BRIEF” Lessons from Mark Ylvisaker SS3

It is now well established that injuries to the brain adversely affect the executive functions and their development. Mark Ylvisaker had a substantial impact on how we assess and treat children and adolescents with disrupted executive functions secondary to traumatic brain injury. Mark articulated the core principles for effective assessment and intervention so eloquently and simply, emphasizing the importance of real-world meaning, application and “everyday people.” After all, execution of one’s thoughts, feelings and behavior in a controlled manner is an everyday, real-world thing! Mark taught us that assessment that captures a child’s everyday functioning in the context of real-world demands is often more informative, and translatable, than traditional neuropsychological measures alone. Furthermore, interventions that improve one’s executive functioning in the real-world environment are most useful. His pragmatic model influenced our own efforts to measure executive function and to develop guiding intervention systems for children with executive function deficits. This talk will review the model behind the development of the Behavior Rating Inventory for Executive Function as an approach to ecological assessment of children and adolescents with traumatic brain injury. We will also review some new thinking along these lines that will make Mark smile. As we take what we learned from Mark, it becomes increasingly apparent that our assessment and intervention methods, especially as related to the executive functions, demand an everyday, real-world context. The goal of this symposium is to provide a forum for interaction on pediatric topic areas. In particular, focus will be on areas that Mark emphasized in his work following the mantra, “In the absence of meaningful engagement in chosen life activities, all interventions will ultimately fail”.