ABSTRACT 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.
Ishiguro‐Matsumoto et al. (2026) studied this question.