Screening Parent Form Report
by Peter K. Isquith, PhD, Gerard A. Gioia, PhD, Steven C. Guy, PhD, Lauren
Kenworthy, PhD, and PAR Staff
Client name : Sample Client
Client ID : 111
Gender : Male
Age : 8
Grade : 3rd
Test date : 06/16/2015
Test form : Parent Form
Rater name : Not Specified
Relationship to child : Parent
This report is intended for use by qualified professionals only and is not to be shared
with the examinee or any other unqualified persons.
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BRIEF®2 Screening Form: Score Report Copyright © 1996, 1998, 2000, 2015 by PAR. All rights reserved. May not be reproduced in
whole or in part in any form or by any means without written permission of PAR.
Version: 2.4.0.0
Executive Function Screening
Raw Score Percentile Level
Clinically
30 97
Elevated
Overview
Sample Client’s parent completed the Behavior Rating Inventory
of Executive Function®, Second Edition (BRIEF®2) Screening
Parent Form, a 12-item questionnaire designed to detect
problems with self-regulation, on 06/16/2015. There are no
missing item responses in the protocol.
Summary and Recommendations
Sample’s Executive Function Screening raw score of 30 was
higher than 97% of other male’s his age, indicating that there is a
greater likelihood that this score is outside of normative
expectations. Scores at this level are considered Clinically
Elevated.
Students with clinically elevated scores are at substantially
increased risk for self-regulatory difficulties. Referral for further
evaluation, including completing the full BRIEF2 rating scale, is
clearly warranted.
Sample Client (111) 2
06/16/2015
Item # Parent Screening Item Response
1 When given three things to do, remembers only the first or last Sometimes
2 Remaining content redacted for sample report purposes Often
3 Often
4 Sometimes
5 Often
6 Sometimes
7 Sometimes
8 Often
9 Often
10 Often
11 Sometimes
12 Sometimes
*** End of Report ***
Sample Client (111) 3
06/16/2015
