# Tele-Assessment of Executive Functions in Young Adults with ADHD: A Pilot Study
## 2 Assessment in Adults with ADHD
Among these scales, we identify the Barkley Deficits in Executive Functioning Scale (BDEFS), an 89-item questionnaire [26]; the Barkley Functional Impairment Scale (BFIS), which measures psychosocial impairment in patients with ADHD across various domains of functioning [27]; the Adult Executive Functioning Inventory (ADEXI), a 14-item questionnaire consisting of two subscales that assess working memory and response inhibition, respectively [28]; the Behavior Rating Inventory of Executive Function (BRIEF-A), a 75-item questionnaire [29]; the Questionnaire for Experiences of Attention Deficits (FEDA), a questionnaire divided into three subscales: distractibility and cognitive slowing, fatigue and slowing during practical activities, and avolition; and the Mind Excessively Wandering Scale (MEWS), a 15-item questionnaire that evaluates the frequency of difficulties in thought processing in patients with ADHD [30; 31]. There are other questionnaires validated in the literature that assess additional dimensions. Specifically, the Subjective Distress Associated with Adult ADHD (SDAA-SR) measures the level of distress perceived by adult patients with ADHD [31]. The scale consists of 33 items divided into three subscales: distress caused by inattention/disorganization, distress caused by hyperactivity/impulsivity, and distress caused by low self-esteem. The Sensory Gating Inventory (SGI) evaluates the patient's ability to control their sensitivity to sensory stimuli and is composed of 36 items [32]. The Everyday Life Attention Scale (ELAS) is designed to assess the patient's self-perception of attention in various daily life situations. The scale contains 30 items [33]. The ADHD Cognition Scale (ACS) measures the frequency of automatic thoughts in patients with ADHD. The scale consists of seven items, to which patients respond using a five-point Likert scale [34]. Questionnaires that measure the quality of life in patients with ADHD include the Adult ADHD Quality of Life (AAQoL), which comprises 29 items [35], and the Impairment Rating Scale (IRS), consisting of 12 items [36]. Turning to digital tools developed to remotely assess executive functions (EFs) in adult populations, the following can be cited [37; 38; 39]. The MOXO d-CPT is a computerized continuous performance test that incorporates visual and auditory distractors to simulate real-world conditions. It evaluates attention, impulsivity, hyperactivity, and timing in individuals aged 6-70 and has shown strong ecological validity in both clinical and tele-assessment contexts, particularly with ADHD populations [40; 41]. CNS Vital Signs is a well-established computerized neurocognitive battery used to assess the executive function, processing speed, and attention. It is supported by large normative datasets and can be administered remotely [42]. Similarly, the Cambridge Brain Sciences (CBS) Battery offers gamified, online tasks measuring working memory, reasoning, inhibition, and planning, with applications in both healthy and clinical adult populations [43]. Other tools, such as Cogstate (New Haven, CT, USA) and Neurotack (Redwood City, CA, USA), offer brief, scalable cognitive assessments, including EF-related tasks, and are used primarily for aging populations or the early detection of cognitive decline. Both platforms support remote use and are increasingly used in clinical trials and longitudinal monitoring [44; 45]. Although these tools vary in their scope and target population, they reflect a broader shift towards a remote performance-based assessment of executive functioning in adulthood, offering new possibilities for clinical diagnostics, research, and intervention planning. As can be seen, there are numerous self-report and informant-based questionnaires for assessing symptoms, executive functioning, and the impact of ADHD symptoms on daily functioning in the adult population [46; 47; 48; 49; 50; 51].