Factorial Validity and Reliability of the Executive Function‐Related Toothbrushing Behavior Questionnaire Among Adults With Intellectual Disability at Commuting Welfare Facilities

OBJECTIVES: To understand and improve toothbrushing behavior among persons with intellectual disability (ID) and who have difficulties with toothbrushing and vulnerabilities in executive function (EF), using the 'Executive Function-related Toothbrushing Behaviour Questionnaire' (EF-TB). This study aimed to evaluate the validity and reliability of the EF-TB in a population of adults with ID. METHODS: In total, 92 participants with ID who utilize commuting (non-residential) welfare facilities were rated by family members or guardians using the EF-TB and by facility staff using the Dysexecutive Questionnaire (DEX). The DEX was used as an external standard to assess the concurrent validity of the EF-TB. The comparison group, comprising 70 participants without ID, completed the EF-TB. Factor structure, internal consistency reliability, discriminant validity, and concurrent validity were investigated. RESULTS: Exploratory factor analysis yielded three factors: 'Systematic implementation', 'Sustained implementation', and 'Start and Finish'. The Cronbach's alpha and item-total correlation showed good levels of internal consistency reliability. All three sub-scale scores and the total score, showed statistically significant differences between the two groups, indicating a satisfactory level of discriminant validity for the EF-TB. Futhermore, a significant correlation was observed between the total scores of the two measures, suggesting an acceptable level of concurrent validity of the EF-TB. CONCLUSIONS: The EF-TB is a valid and reliable tool for assessing EF related to toothbrushing behavior among persons with ID. The EF-TB scores offer useful information for developing effective ways of improving oral health behavior in this population.