Are Motor Inhibition and Cognitive Flexibility Dead Ends in ADHD?

Executive dysfunction has been postulated as the core deficit in ADHD, although many deficits in lower order cognitive processes have also been identified. By obtaining an appropriate baseline of lower order cognitive functioning light may be shed on as to whether executive deficits result from problems in lower order and/or higher order cognitive processes. We examined motor inhibition and cognitive flexibility in relation to a baseline measure in 816 children from ADHD and control families. Multiple children in a family were tested in order to examine the familiality of the measures. No evidence was found for deficits in motor inhibition or cognitive flexibility in children with ADHD or their nonaffected siblings: Compared to their baseline speed and accuracy of responding, children with ADHD and their (non)affected siblings were not disproportionally slower or inaccurate when demands for motor inhibition or cognitive flexibility were added to the task. However, children with ADHD and their (non)affected siblings were overall less accurate than controls, which could not be attributed to differences in response speed. This suggests that inaccuracy of responding is characteristic of children having (a familial risk for) ADHD. Motor inhibition and cognitive flexibility as operationalized with mean reaction time were found to be familial. It is concluded that poorer performance on executive tasks in children with ADHD and their (non)affected siblings may result from deficiencies in lower order cognitive processes and not (only) from higher order cognitive processes/executive functions.     

Parent-reported executive functioning in young children treated for cancer

It is well known that children treated for cancer are at risk for cognitive and functional impairments. Such research is largely based on studies of late effects in school-aged or older children. However, far less is known about executive function weaknesses in preschool-aged children treated for cancer. Thus, the aim of this study was to examine executive functioning in a clinically referred sample of young oncology patients, and its association with broader domains of functioning. Data from 61 young children with cancer, who were referred for clinical cognitive evaluations, were abstracted and included in this study. Patients were 5.00 years of age (SD = 0.72) at assessment, 54.1% male, and two-thirds (63.9%) had been treated for brain tumors. Most executive functions were significantly discrepant from the mean, with 47.5% of preschoolers having parent-reported working memory concerns within the clinically significant range. There were no differences in executive functioning based on diagnosis or treatment status. Parent-reported executive functioning was strongly correlated with global intelligence and adaptive functioning, with some indices also associated with nonverbal problem solving and pre-academic skills. Ultimately, results indicate the presence of emerging weaknesses in executive functioning in young children with cancer, and add to a growing body of literature highlighting the potential cognitive and behavioral risks associated with a cancer diagnosis in early childhood.     

Executive function, intellectual decline and daily living skills

Understanding the cognitive changes associated with compromised daily living skills in elderly individuals is important for making appropriate recommendations about the capacity for independent functioning. To this end, we retrospectively examined data from 92 elderly individuals presenting with cognitive decline who were administered measures of executive functioning, general intelligence, and daily living skills. Multiple regression analyses were used to examine the relationship between executive functioning and daily living skills, while controlling for age, depression, and either IQ decline or current IQ. Executive functioning accounted for additional variance in a broad range of daily living skills after controlling for IQ decline. When FSIQ was used in the regression model rather than IQ decline, executive functioning was no longer uniquely associated with daily living skills. Executive functions appear to be important for daily living skills until a critical threshold of low intellectual functioning is reached, reflecting the combined influence of premorbid ability and the extent of intellectual decline. Our results suggest that understanding the relative contribution of different cognitive domains to functional decline in elderly individuals should take into account general intellectual functioning and estimated decline, and that the initiation and/or persistence of self-directed cognitive processes may be important for adaptive daily functioning. These findings have implications for making more evidence-based recommendations about the capacity for independent living.     

Auditory sensory gating and performance on the Delis–Kaplan Executive Function System

Sensory gating is a neurological mechanism that inhibits redundant sensory information. Impaired sensory gating is not uncommon in otherwise healthy individuals, but its relationship with higher level cognitive function is poorly understood. It is plausible that cognitive fragmentation associated with poor sensory gating may affect an individual's higher level executive functioning. Fifty-one participants (Mean age?=?22.02; 24 males) were administered an electroencephalogram with a paired-tone paradigm to measure sensory gating as well as a comprehensive executive functioning battery—the Delis–Kaplan Executive Function System. Overall, better performance on the D-KEFS was related to more effective sensory gating. Also, tasks that measured cognitive flexibility predicted P50 latency as well as P200 amplitude and sensory gating. Understanding the relationship between sensory gating and cognitive processing has implications for healthy individuals and clinical groups alike.     

Executive Function,Intellectual Decline and Daily Living Skills

ABSTRACT

Understanding the cognitive changes associated with compromised daily living skills in elderly individuals is important for making appropriate recommendations about the capacity for independent functioning. To this end, we retrospectively examined data from 92 elderly individuals presenting with cognitive decline who were administered measures of executive functioning, general intelligence, and daily living skills. Multiple regression analyses were used to examine the relationship between executive functioning and daily living skills, while controlling for age, depression, and either IQ decline or current IQ. Executive functioning accounted for additional variance in a broad range of daily living skills after controlling for IQ decline. When FSIQ was used in the regression model rather than IQ decline, executive functioning was no longer uniquely associated with daily living skills. Executive functions appear to be important for daily living skills until a critical threshold of low intellectual functioning is reached, reflecting the combined influence of premorbid ability and the extent of intellectual decline. Our results suggest that understanding the relative contribution of different cognitive domains to functional decline in elderly individuals should take into account general intellectual functioning and estimated decline, and that the initiation and/or persistence of self-directed cognitive processes may be important for adaptive daily functioning. These findings have implications for making more evidence-based recommendations about the capacity for independent living.     

Do executive and reactive disinhibition mediate the effects of familial substance use disorders on adolescent externalizing outcomes?

The present study examined the potential mediating roles of executive and reactive disinhibition in predicting conduct problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, and substance use among adolescents with and without a family history of substance use disorders. Using data from 247 high-risk adolescents, parents, and grandparents, structural equation modeling indicated that reactive disinhibition, as measured by sensation seeking, mediated the effect of familial drug use disorders on all facets of the adolescent externalizing spectrum. Executive disinhibition, as measured by response disinhibition, spatial short term memory, and "trait" impulsivity, was associated with ADHD symptoms. Moreover, although executive functioning weakness were unrelated to familial substance use disorders, adolescents with familial alcohol use disorders were at risk for "trait" impulsivity marked by a lack of planning. These results illustrate the importance of "unpacking" the broad temperament style of disinhibition and of studying the processes that underlie the commonality among facets of the externalizing spectrum and processes that predict specific externalizing outcomes.     

Executive functions and ADHD in adults: evidence for selective effects on ADHD symptom domains

Dual-process models of attention-deficit/hyperactivity disorder (ADHD) suggest that both executive functioning and regulatory functions (e.g., processing speed) are involved and that executive function weaknesses may be associated specifically with symptoms of inattention-disorganization but not hyperactivity-impulsivity. Adults aged 18-37 (105 with ADHD, 90 controls) completed a neuropsychological battery. The ADHD group had weaker performance than did the control group (p<.01) on both executive and speed measures. Symptoms of inattention-disorganization were uniquely related to executive functioning with hyperactivity-impulsivity controlled. Inattention was associated with slower response speed, and hyperactivity-impulsivity with faster output speed. Results were not accounted for by IQ, age, gender, education level, or comorbid disorders. Findings are discussed in terms of developmental and dual-process models of ADHD leading into adulthood.     

早期儿童数学学习与执行功能的关系

执行功能是个体对复杂的认知活动的自我调节和以明确目标为导向的活动过程, 对早期儿童的数学学习起着重要的作用。早期儿童数学学习与执行功能呈显著正相关, 执行功能是儿童数学学习的重要认知加工机制。早期儿童执行功能和数学学习之间存在着相互预测的关系, 执行功能可以预测数学成绩, 数学成绩可以预测执行功能。高质量的早期数学教育可能具有发展儿童执行功能和数学能力的双重价值。未来研究可以明确执行功能的界定和统一测量工具, 提供更可靠的证据证明早期儿童执行功能与数学能力的因果关系, 以及进一步探究语言、数学以及执行功能三者之间的关系。     

Executive Function in Pediatric Bipolar Disorder and Attention-Deficit Hyperactivity Disorder: In Search of Distinct Phenotypic Profiles

Often, there is diagnostic confusion between bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD) in youth due to similar behavioral presentations. Both disorders have been implicated as having abnormal functioning in the prefrontal cortex; however, there may be subtle differences in the manner in which the prefrontal cortex functions in each disorder that could assist in their differentiation. Executive function is a construct thought to be a behavioral analogy to prefrontal cortex functioning. We provide a qualitative review of the literature on performance on executive function tasks for BD and ADHD in order to determine differences in task performance and neurocognitive profile. Our review found primary differences in executive function in the areas of interference control, working memory, planning, cognitive flexibility, and fluency. These differences may begin to establish a pediatric BD profile that provides a more objective means of differential diagnosis between BD and ADHD when they are not reliably distinguished by clinical diagnostic methods.     

Behavioral dysexecutive symptoms in normal aging

Executive deficits of normal aging such as deficits in planning, organization or decision making are likely to affect elderly individuals in their daily life functioning. Therefore, executive functioning in aging seems to be interesting to study not only in cognitive terms but also in relation to the behavioral area. This pilot study aimed to investigate the nature of behavioral dysexecutive problems in a sample of normal elderly adults as measured by the Dysexecutive Questionnaire. Factor analysis showed that five interpretable factors could be derived from the DEX: intentionality (factor 1), interference management (factor 2), inhibition (factor 3), planning (factor 4), and social regulation (factor 5), suggesting that different components may underlie the behavioral dysexecutive symptoms of normal aging. The relationship between these factors and neuropsychological measures of Executive Functions were also briefly explored.     

The rise and fall of executive functions in high-level football players

IntroductionExecutive functions are higher-level cognitive functions. Despite being relevant to many aspects of everyday life, it is contentious whether executive functions are important for high performing athletes. Executive functions increase throughout the career of an athlete, yet it remains unknown what are the main contributors. Therefore, this study examined the effect of age and experience on executive functions in a cohort of high performing football players.MethodsData were collected over three seasons, resulting in a mixed longitudinal sample of 1018 observations in 343 male players (1–5 observations/player, age: 10.34–34.72 years; playing experience: 5–22 years) from the U12-Senior age groups of a professional German football club. Players participated in four cognitive tasks aimed at measuring higher-level cognitive functioning: a precued choice reaction-time task, a stop-signal reaction-time task, a sustained attention task, and a multiple-object tracking task, from which a total of eight dependent variables related to response time and/or accuracy were derived.ResultsLinear and non-linear mixed effects regressions were used to investigate the relationship between age, experience and executive functions. A second order polynomial revealed that, generally, a negatively accelerated curve best described the relationship between age, experience and executive functions. An increasingly smaller difference in executive functioning was generally observed between subsequent age groups, with a performance plateau evident around adulthood (~21 years old). Age and experience only explained a very low to moderate proportion of the variance in executive functions (marginal explained variance ranged between 2 and 57%). A significant age by field position interaction effect was only observed for the sustained attention task’s accuracy and response time components (p < 0.001).ConclusionsBoth age and experience showed a negatively accelerated relationship with executive functions in youth football players, and this relationship was generally field position-independent. These negatively accelerated curves seem to reflect those observed in general populations, where a plateau phase in the development of higher-level cognitive functioning is also observed around 21 years, reflecting the maturation of the central nervous system in normally developing individuals. Therefore, this study challenges the assumption surrounding the use and validity of executive functions as a measure of football performance potential in high performing athletes.     

Original and revised reinforcement sensitivity theory in the prediction of executive functioning: A test of relationships between dual systems

Executive functioning relates to cognitive processes that are effortful and controlled, whereas processes underlying personality are assumed to be routine and automatic (Elliot and Thrash, 2002, Elliot and Thrash, 2010). We evaluated potential influences between these dual systems by examining the link between executive functioning and biologically based personality measures associated with original reinforcement sensitivity theory (o-RST) and revised reinforcement sensitivity theory (r-RST). Results showed that flight (a tendency to commit to poorly planned, escape behavior) negatively predicted executive functioning. We find partial support for the general hypothesis of links between the dual systems. Generally, r-RST was a better predictor of executive functioning than o-RST. The proposed structure of the r-RST measurement model was confirmed.     

Neurobehavioral Characteristics of Children with Duchenne Muscular Dystrophy

This study investigated cognitive, metacognitive, and psychosocial aspects of neurobehavioral functioning in 22 boys with Duchenne muscular dystrophy (DMD) and 18 unaffected siblings, all between the ages of 6 and 16 years. Probands and siblings completed the Wechsler Abbreviated Scale of Intelligence, as well as selected subtests from the Children's Memory Scale and from the Delis-Kaplan Executive Function System, while parents completed the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function. Compared to siblings, probands demonstrated relative weaknesses on both verbal and nonverbal measures of delayed recall and response generation and were rated by parents as having more difficulties with social interaction, initiation, and adaptation. It is concluded that DMD is associated with mild but potentially significant difficulties in a range of neurobehavioral areas, likely related to deficient dystrophin levels in an integrated brain circuit that includes the cerebellum, hippocampus, and association neocortex.     

Identification and Description of New Tests of Executive Functioning in Children

The understanding of executive functioning in pediatric neuropsychological evaluation is of clinical significance, yet there are few developmentally appropriate executive function measures that have been adequately normed in this population. The present study provides normative data, collected on a sample of 89 normal children from ages 7-12, for several measures thought to be appropriate for assessing executive functioning in children. Executive function measures were selected and/or modified to be developmentally appropriate, to tap less complex and integrative aspects of executive function, and to assess fundamental working memory (Self-Ordered Pointing: Delayed Alternation/Non-alternation) and inhibitory control (Developmental Stroop tasks: Go/No Go) dimensions of executive functioning. The results supported the potential utility of these measures in assessing those abilities in children.     

The role of executive functions in social impairment in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by socio-communicative impairments. Executive dysfunction may explain some key characteristics of ASD, both social and nonsocial hallmarks. Limited research exists exploring the relations between executive function and social impairment in ASD and few studies have used a comparison control group. Thus, the objective of the present study was to investigate the relations between executive functioning using the Behavioral Rating Inventory of Executive Functioning (BRIEF), social impairment as measured by the Social Responsiveness Scale (SRS), and overall autistic symptomology as measured by the Autism Diagnostic Observation Schedule (ADOS) in children and adolescents with and without ASD. Seventy children and adolescents diagnosed with ASD and 71 typically developing controls were included in this study. Findings showed that behavioral regulation executive processes (i.e., inhibition, shifting, and emotional control) predicted social function in all children. However, metacognitive executive processes (i.e., initiation, working memory, planning, organization, and monitoring) predicted social function only in children with ASD and not in typically developing children. Our findings suggest a distinct metacognitive executive function-social symptom link in ASD that is not present in the typical population. Understanding components of executive functioning that contribute to the autistic symptomology, particularly in the socio-communicative domain, is crucial for developing effective interventions that target key executive processes as well as underlying behavioral symptoms.     

Comparisons of the BRIEF parental report and neuropsychological clinical tests of executive function in Fetal Alcohol Spectrum Disorders: data from the UK national specialist clinic

Extant literature is sparse with regards to the relationship between caregiver reports and neuropsychological tests of executive functioning in Fetal Alcohol Spectrum Disorders (FASD). The goal of this paper was determining the clinical utilities of executive functioning measures used in the United Kingdom national FASD clinic. We examined relationships between outcomes on the Behavior Rating Inventory of Executive Function (BRIEF) and the Delis-Kaplan Executive Function System (D-KEFS), as part of an ongoing service evaluation. Profiles of executive functioning measures were reported in order to contribute to delineating a profile of executive dysfunction in FASD. Caregivers of 49 people with FASD completed the Parent BRIEF, and 61 people with FASD were administered the D-KEFS. Pearson’s Correlations between all 11 BRIEF scales and the 18 selected D-KEFS subscales showed little relationship. The BRIEF showed a profile of clinically significant elevations in all three Index scores and seven out of the eight Scale scores. Several D-KEFS tests showed below average executive functioning. Both executive function measures have separate clinical utility in demonstrating executive function deficits in FASD. The sample population used in this study also show a similar pattern to FASD populations internationally, suggesting a similar neuropsychological profile is seen in the United Kingdom. However, caregiver reports display little relationship to neuropsychological tests. These measures likely monitor different aspects of executive functioning in different settings. Future research should focus on identifying tests that better relate findings from clinical settings to behavior in daily life.     

Parent rating of executive function in fetal alcohol spectrum disorder: A review of the literature and new data on Aboriginal Canadian children

Aboriginal children in Canada are at high risk of fetal alcohol spectrum disorder (FASD) but there is little research on the cognitive impact of prenatal alcohol exposure (PAE) in this population. This paper reviews the literature on parent report of executive functioning in children with FASD that used the Behavior Rating Inventory of Executive Function (BRIEF). New data on the BRIEF is then reported in a sample of 52 Aboriginal Canadian children with FASD for whom a primary caregiver completed the BRIEF. The children also completed a battery of neuropsychological tests. The results reveal mean scores in the impaired range for all three BRIEF index scores and seven of the eight scales, with the greatest difficulties found on the Working Memory, Inhibit and Shift scales. The majority of the children were reported as impaired on the index scores and scales, with Working Memory being most commonly impaired scale. On the performance-based tests, Trails B and Letter Fluency are most often reported as impaired, though the prevalence of impairment is greater for parent ratings than test performance. No gender difference is noted for the parent report, but the boys had slightly slower intellectual functioning and were more perseverative than the girls on testing. The presence of psychiatric comorbidity is unrelated to either BRIEF or test scores. These findings are generally consistent with prior studies indicating that parents observe considerable executive dysfunction in children with FASD, and that children with FASD may have more difficulty with executive functions in everyday life than is detected by laboratory-based tests alone.     

Socioeconomic risk moderates the link between household chaos and maternal executive function

We examined the link between household chaos (i.e., noise, clutter, disarray, lack of routines) and maternal executive function (i.e., effortful regulation of attention and memory), and whether it varied as a function of socioeconomic risk (i.e., single parenthood, lower mother and father educational attainment, housing situation, and father unemployment). We hypothesized that: 1) higher levels of household chaos would be linked with poorer maternal executive function, even when controlling for other measures of cognitive functioning (e.g., verbal ability), and 2) this link would be strongest in the most socioeconomically distressed or lowest-socioeconomic status households. The diverse sample included 153 mothers from urban and rural areas who completed a questionnaire and a battery of cognitive executive function tasks and a verbal ability task in the laboratory. Results were mixed for Hypothesis 1, and consistent with Hypothesis 2. Two-thirds of the variance overlapped between household chaos and maternal executive function, but only in families with high levels of socioeconomic risk. This pattern was not found for chaos and maternal verbal ability, suggesting that the potentially deleterious effects of household chaos may be specific to maternal executive function. The findings implicate household chaos as a powerful statistical predictor of maternal executive function in socioeconomically distressed contexts.     

Parental Reports of Executive Dysfunction in Adolescents with Bipolar Disorder

Bipolar disorder (BPD) is a serious mental illness that affects children and adolescents at a rate similar to that seen in adults. Extremely little is known, however, about cognitive functioning in childhood and adolescent BPD. The present study represents an initial effort to examine executive functioning in adolescents with BPD who are in a manic or mixed mood state, by collecting data from caregivers about the participants' performance on everyday tasks thought to be mediated by executive functioning abilities, using the Behavior Rating Inventory of Executive Function. In comparison to healthy volunteers, adolescents with BPD exhibited significant elevations across all of the measured functional domains. These elevations were evident even in adolescents with BPD who did not have comorbid ADHD, although they were most prominent in those with comorbidity. The findings suggest that adolescents with BPD have functional deficits on tasks requiring executive functioning skills that are not explicable solely on the basis of comorbid ADHD.