Translation and adaptation of the French Protocol FEE – FONCTIONS EXÉCUTIVES CHEZ L’ENFANT to Portuguese/Brazil
instruments adaptation, executive functions, adolescence, childhood
Currently, the interest on executive functions (EF) neuropsychological assessment researches is increasing. However, in Brazil, standardized tests and protocols used on the evaluation of children's EF are disperse, turning it difficult to realize multicenter studies and identify regional characterization. Furthermore, tests used on children's EF evaluation are usually adaptations of tasks used on adults, showing little ecological validity, and are designed to be hard, weakening its capability of discriminating specific functions and deficiencies, since different executive components are required in a single task. The aim of this study is the translation and adaptation of the French protocol FEE (Roy, Le Gall, Fournet, 2011) to Portuguese/Brazil. FEE is an EF neuropsychological assessment protocol aiming children and adolescents between 6 and 15 years old, designed to modify and/or enhance, in terms of materials, instructions, procedures and/or corrections, the main paradigms and EF evaluation tests. It intends to fill the insufficiencies of existing tasks and to adapt internationally acclaimed tasks. Cultural adaptation of the FEE will be conducted according to the model proposed by Borsa et al (2012), structured around 6 steps (translation of the instrument, synthesis of the versions, synthesis evaluation by experts, evaluation by the target audience, back-translation, pilot study). Firstly, the original instrument was subjected to two independent translations from the mother language (French) to Brazilian Portuguese. For the second step (Synthesis of the Versions), three judges – all psychologists, doctorate students and experts in neuropsychological assessment – participated, as well as the original research authors. Judges rated the experimental, idiomatic and semantical equivalence as good. However, still in step 2, modifications were made in the Portuguese version in order to better adjust it to the target-population. In step 3 (Synthesis evaluation by experts), three different judges – PhD scholars from different regions of Brazil – participated, evaluating structure, format, instructions, and comprehensiveness and adequateness of the expressions used on each item of the instrument. Agreement between judges was evaluated by Cohen’s Kappa (0.4945), indicating moderate agreement. In step 4 (Evaluation by the target population), 30 children and adolescents participated, with 10 children aged between 6 and 7 years old, 10 children aged between 10 and 11 years old and 10 adolescents aged between 15 and 16 years old. Generally, it was observed broad comprehensiveness of protocol instructions. In step 5 the instrument was back-translated twice, independently, from Brazilian Portuguese to the mother language (French). After the back-translations synthesis, the instrument was sent back to the original authors, who judged it adequate. Finally, step 6 (pilot study) consisted in administering the battery to 60 children and adolescents aged between 6 and 15 years old, from public and private schools from Natal’s educational system. The instrument proved adequate for evaluation of executive functions in Brazilian cultural context. The further development of this project will enable to widen comprehensiveness on children and adolescents EF, as well as on the semiotics of EF disturbs. Lastly, there is also the possibility of performing transcultural studies on EF development.