Selective Learning in Children after Traumatic Brain Injury: A Preliminary Study

Selective learning (SL) is the ability to select items to learn from among other items. It requires the use of the executive processes of metacognitive control and working memory, which are considered to be mediated by the frontal cortex and its circuitry. We studied the efficiency with which verbal items of greater value are selectively learned from among items varying in value in 14 children ages 8-15 years who had sustained severe traumatic brain injury (TBI) and in 39 typically developing age-matched children. We hypothesized that children with TBI would be disproportionately compromised in selective learning efficiency in contrast to memory span when compared to normally developing children. The results supported our hypothesis, as children with TBI performed significantly worse than controls on a measure of selective learning efficiency, but the two groups performed similarly on a measure of word recall within the same task. Furthermore, the effect of TBI on performance was demonstrated to take place at the time of encoding, rather than at retrieval.     

The effect of age-at-testing on verbal memory among children following severe traumatic brain injury

Memory deficits are a common sequelae following childhood traumatic brain injury (TBI), which often have serious implications on age-related academic skills. The current study examined verbal memory performance using the Rey Auditory Verbal Learning Test (RAVLT) in a pediatric TBI sample. Verbal memory abilities as well as the effect of age at-testing on performance were examined. A sample of 67 children following severe TBI (age average = 12.3 ± 2.74) and 67 matched controls were evaluated using the RAVLT. Age effect at assessment was examined using two age groups: above and below 12 years of age during evaluation. Differences between groups were examined via the 9 RAVLT learning trials and the 7 composite scores conducted out of them. Children following TBI recalled significantly less words than controls on all RAVLT trials and had significantly lower scores on all composite scores. However, all of these scores fell within the low average range. Further analysis revealed significantly lower than average performance among the older children (above 12 years), while scores of the younger children following TBI fell within average limits. To conclude, verbal memory deficits among children following severe TBI demonstrate an age-at-testing effect with more prominent problems occurring above 12 years at the time of evaluation. Yet, age-appropriate performance among children below 12 years of age may not accurately describe memory abilities at younger ages following TBI. It is therefore recommended that clinicians address child’s age at testing and avoid using a single test as an indicator of verbal memory functioning post TBI.     

The role of collaborative planning in children's source-monitoring errors and learning.

The aim of this research was to provide empirical evidence for a cognitive process that may contribute to children's learning from another person. A cornerstone of Vygotsky's sociocultural theory is that knowledge is internalized from others; however, the cognitive processes that support this transformation are underspecified. In a series of three studies, kindergarten children (mean age 5 years 8 months) participated in a categorization task with an adult in several collaborative and noncollaborative conditions and then were tested on their memory of who had performed which actions in the task. After the memory task, children were asked to recategorize the items on their own. Source-monitoring patterns and children's learning varied across conditions according to predictions. A measure of recoding was related to children's planning language that, in turn, predicted learning among the children. The results suggest that one process that contributes to children's internalization of knowledge may involve recoding of agent information and that recoding can be indexed by source-monitoring performance.     

Leveling the playing field: Attention mitigates the effects of intelligence on memory

Effective attention and memory skills are fundamental to typical development and essential for achievement during the formal education years. It is critical to identify the specific mechanisms linking efficiency of attentional selection of an item and the quality of its memory retention. The present study capitalized on the spatial cueing paradigm to examine the role of selection via suppression in modulating children and adolescents’ memory encoding. By varying a single parameter, the spatial cueing task can elicit either a simple orienting mechanism (i.e., facilitation) or one that involves both target selection and simultaneous suppression of competing information (i.e., IOR). We modified this paradigm to include images of common items in target locations. Participants were not instructed to learn the items and were not told they would be completing a memory test later. Following the cueing task, we imposed a 7-min delay and then asked participants to complete a recognition memory test. Results indicated that selection via suppression promoted recognition memory among 7–17 year-olds. Moreover, individual differences in the extent of suppression during encoding predicted recognition memory accuracy. When basic cueing facilitated orienting to target items during encoding, IQ was the best predictor of recognition memory performance for the attended items. In contrast, engaging suppression (i.e., IOR) during encoding counteracted individual differences in intelligence, effectively improving recognition memory performance among children with lower IQs. This work demonstrates that engaging selection via suppression during learning and encoding improves memory retention and has broad implications for developing effective educational techniques.     

Children's Spatial Behavior is Differentially Affected After Traumatic Brain Injury

Spatial behavior in 20 children with severe traumatic brain injury (TBI) and 20 healthy controls was investigated using the Kiel Locomotor Maze. Children had to remember defined locations in an experimental chamber with completely controlled intra- and extra-maze cues until learning criterion was reached. In a second experiment, spatial orientation strategies were assessed. Children with TBI were shown to be impaired in spatial learning and spatial memory. Spatial orientation was found to be deficient even in cases where spatial learning and memory proved to be unimpaired, especially in tasks that demanded the use of relational place strategies. Children who suffered a TBI at an early age proved to be more severely impaired in spatial learning and orientation than older children.     

Children's spatial behavior is differentially affected after traumatic brain injury.

Spatial behavior in 20 children with severe traumatic brain injury (TBI) and 20 healthy controls was investigated using the Kiel Locomotor Maze. Children had to remember defined locations in an experimental chamber with completely controlled intra- and extra-maze cues until learning criterion was reached. In a second experiment, spatial orientation strategies were assessed. Children with TBI were shown to be impaired in spatial learning and spatial memory. Spatial orientation was found to be deficient even in cases where spatial learning and memory proved to be unimpaired, especially in tasks that demanded the use of relational place strategies. Children who suffered a TBI at an early age proved to be more severely impaired in spatial learning and orientation than older children.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Stimulus modality and working memory performance in Greek children with reading disabilities: Additional evidence for the pictorial superiority hypothesis

This study investigated the effects of stimulus presentation modality on working memory performance in children with reading disabilities (RD) and in typically developing children (TDC), all native speakers of Greek. It was hypothesized that the visual presentation of common objects would result in improved learning and recall performance as compared to the auditory presentation of stimuli. Twenty children, ages 10–12, diagnosed with RD were matched to 20 TDC age peers. The experimental tasks implemented a multitrial verbal learning paradigm incorporating three modalities: auditory, visual, and auditory plus visual. Significant group differences were noted on language, verbal and nonverbal memory, and measures of executive abilities. A mixed-model MANOVA indicated that children with RD had a slower learning curve and recalled fewer words than TDC across experimental modalities. Both groups of participants benefited from the visual presentation of objects; however, children with RD showed the greatest gains during this condition. In conclusion, working memory for common verbal items is impaired in children with RD; however, performance can be facilitated, and learning efficiency maximized, when information is presented visually. The results provide further evidence for the pictorial superiority hypothesis and the theory that pictorial presentation of verbal stimuli is adequate for dual coding.     

Impaired discourse gist and working memory in children after brain injury

Emerging evidence suggests that a traumatic brain injury (TBI) in childhood may disrupt the ability to abstract the central meaning or gist-based memory from connected language (discourse). The current study adopts a novel approach to elucidate the role of immediate and working memory processes in producing a cohesive and coherent gist-based text in the form of a summary in children with mild and severe TBI as compared to typically developing children, ages 8-14 years at test. Both TBI groups showed decreased performance on a summary production task as well as retrieval of specific content from a long narrative. Working memory on n-back tasks was also impaired in children with severe TBI, whereas immediate memory performance for recall of a simple word list in both TBI groups was comparable to controls. Interestingly, working memory, but not simple immediate memory for a word list, was significantly correlated with summarization ability and ability to recall discourse content.     

对学前儿童语言学习能力诊断量表的效度评价

以所编制的量表为工具 ,对采集的数据进行效度分析 ,结果表明各分测验与全量表有较好的相关 ,说明量表的内容效度是比较高的。使用因素分析的方法 ,将全部变量作系统分类 ,研究量表的结构 ,绝大部分分测验在所得的四个因素上的共通性都大于 0 .70 ;保留下的分测验与所属因素的相关系数在0 .5 3 -0 .84之间 ,它们在各个因素上有较高的负荷量 ,说明量表有较好的结构效度。从效度分析的结果看 ,本量表的测量结果应该是准确的。另外 ,还根据因素分析结果指示的方向 ,调整了分测验 ,调整后的量表结构不但与假设的量表结构十分吻合 ,而且更条理化。     

Memory coding in individuals with Down syndrome

Previous research has identified a deficit in phonological short-term memory in individuals with Down syndrome.

The present work aimed to analyze how a group of 30 individuals with Down syndrome performed in a picture span task compared with 30 typically developing children of the same mental age. The task involved four conditions (i.e., dissimilar, phonologically similar, visually similar, and long-name items) chosen to analyze the strategy used by individuals with Down syndrome to code visually presented nameable items.

Individuals with Down syndrome performed less well than typically developing children. Both groups showed the visual similarity effect.

Taken together, our results confirm that individuals with Down syndrome have a verbal working memory deficit, even when nameable items are presented visually. Mental age appears to be an important determinant of memory coding stage in individuals with Down syndrome.     

Facilitation and impairment of event memory produced by photograph review

Selectively reviewing some items from a larger set of previously learned items increases memory for the items that are reviewed but may also be accompanied by a cost: Memory for the nonreviewed items may be impaired relative to cases where no review occurs at all. This cost to nonreviewed items has primarily been shown in contexts of verbal list learning and in situations where the reviewed and nonreviewed items are categorically or semantically related. Using a more naturalistic impetus to selective review--photographs relating to previously experienced events--we assessed whether the memory of older and younger adults for unrelated complex activities that they themselves had performed was also impaired due to nonreview. Both younger and older adults showed impaired memory for nonreviewed activities when tested with free recall (Experiment 1), but not when tested with recognition or cued recall (Experiment 2). If mitigating retrieval cues are unavailable, selective review may impair memory for nonreviewed everyday events.     

Working memory deficits in developmental dyscalculia: The importance of serial order

Although a number of studies suggests a link between working memory (WM) storage capacity of short-term memory and calculation abilities, the nature of verbal WM deficits in children with developmental dyscalculia (DD) remains poorly understood. We explored verbal WM capacity in DD by focusing on the distinction between memory for item information (the items to be retained) and memory for order information (the order of the items within a list). We hypothesized that WM for order could be specifically related to impaired numerical abilities given that recent studies suggest close interactions between the representation of order information in WM and ordinal numerical processing. We investigated item and order WM abilities as well as basic numerical processing abilities in 16 children with DD (age: 8–11 years) and 16 typically developing children matched on age, IQ, and reading abilities. The DD group performed significantly poorer than controls in the order WM condition but not in the item WM condition. In addition, the DD group performed significantly slower than the control group on a numerical order judgment task. The present results show significantly reduced serial order WM abilities in DD coupled with less efficient numerical ordinal processing abilities, reflecting more general difficulties in explicit processing of ordinal information.     

Prospective Memory and Pediatric Traumatic Brain Injury: Effects of Cognitive Demand

This study investigated the effects of pediatric traumatic brain injury (TBI) on prospective memory. Fourteen children and 14 adolescents with TBI were compared with 25 and 23 noninjured children and adolescents, respectively. Based on a prefrontal model, the cognitive demand on the ongoing component of a prospective-memory task was manipulated. Overall, those with TBI had poorer prospective-memory performance than their noninjured peers. Performance was worse in a high cognitive-demand condition than a low, and younger children performed worse than adolescents. Decreases in performance from the low- to high-demand conditions were not significantly different between the two children's groups but were between the two adolescents' groups. Furthermore, the age and injury effects were reflected in the performances on executive function tests: the Self-ordered Pointing Task (SOPT), and the Stroop Color Word Interference Test. The Tower of London (TOL), which did not produce age or injury effects, was nevertheless found to be an important predictor of performance on the high-demand task in those with TBI. Although previous research has demonstrated impaired prospective memory performance in children with TBI, this study attempted to explain why this might occur, specifically that the prefrontal regions might be implicated.     

Three-year-old children can access their own memory to guide responses on a visual matching task

Many models of learning rely on accessing internal knowledge states. Yet, although infants and young children are recognized to be proficient learners, the ability to act on metacognitive information is not thought to develop until early school years. In the experiments reported here, 3.5-year-olds demonstrated memory-monitoring skills by responding on a non-verbal task originally developed for non-human animals, in which they had to access their knowledge states. Children learned a set of paired associates, and were given the option to skip uncertain trials on a recognition memory test. Accuracy for accepted items was significantly higher than for skipped on a subsequent memory task that included all items. Additionally, children whose memory-monitoring assessments more closely matched actual memory performance showed superior overall learning, suggesting a correlation between memory-monitoring and memory itself. The results suggest that children may have implicit access to internal knowledge states at very young ages, providing an explanation for how they are able to guide learning, even as infants.     

Prospective memory and pediatric traumatic brain injury: effects of cognitive demand.

This study investigated the effects of pediatric traumatic brain injury (TBI) on prospective memory. Fourteen children and 14 adolescents with TBI were compared with 25 and 23 noninjured children and adolescents, respectively. Based on a prefrontal model, the cognitive demand on the ongoing component of a prospective-memory task was manipulated. Overall, those with TBI had poorer prospective-memory performance than their noninjured peers. Performance was worse in a high cognitive-demand condition than a low, and younger children performed worse than adolescents. Decreases in performance from the low- to high-demand conditions were not significantly different between the two children's groups but were between the two adolescents' groups. Furthermore, the age and injury effects were reflected in the performances on executive function tests: the Self-ordered Pointing Task (SOPT), and the Stroop Color Word Interference Test. The Tower of London (TOL), which did not produce age or injury effects, was nevertheless found to be an important predictor of performance on the high-demand task in those with TBI. Although previous research has demonstrated impaired prospective memory performance in children with TBI, this study attempted to explain why this might occur, specifically that the prefrontal regions might be implicated.     

The role of interference control in working memory: A study with children at risk of ADHD

The study aimed to test whether the impairment in a working memory task observed in children at risk of ADHD was due to a lack of control of interfering information being processed whilst carrying out the memory task. Two groups of children at risk of ADHD with or without a learning disability (reading impairment) were compared to a control group in a working memory task. Activation of irrelevant items was tested with a lexical decision task presented immediately after the final recall in about half of the trials. Results showed a poor working memory performance in children at risk of ADHD and reading disability associated with a larger activation of irrelevant information than that of control children. Results indicated that the to-be-excluded and interfering items are still highly accessible to working memory in children that fail the working memory task. The examination of working memory and interference control of children at risk of ADHD with a learning disability revealed a counterintuitive picture of children with poor working memory showing better recall/activation of processed information. This picture is consistent with a view of working memory related to an efficient inhibitory control that influences cognitive functioning.     

The role of interference control in working memory: a study with children at risk of ADHD

The study aimed to test whether the impairment in a working memory task observed in children at risk of ADHD was due to a lack of control of interfering information being processed whilst carrying out the memory task. Two groups of children at risk of ADHD with or without a learning disability (reading impairment) were compared to a control group in a working memory task. Activation of irrelevant items was tested with a lexical decision task presented immediately after the final recall in about half of the trials. Results showed a poor working memory performance in children at risk of ADHD and reading disability associated with a larger activation of irrelevant information than that of control children. Results indicated that the to-be-excluded and interfering items are still highly accessible to working memory in children that fail the working memory task. The examination of working memory and interference control of children at risk of ADHD with a learning disability revealed a counterintuitive picture of children with poor working memory showing better recall/activation of processed information. This picture is consistent with a view of working memory related to an efficient inhibitory control that influences cognitive functioning.     

Seven-year-olds allocate attention like adults unless working memory is overloaded

Previous studies have indicated that visual working memory performance increases with age in childhood, but it is not clear why. One main hypothesis has been that younger children are less efficient in their attention; specifically, they are less able to exclude irrelevant items from working memory to make room for relevant items. We examined this hypothesis by measuring visual working memory capacity under a continuum of five attention conditions. A recognition advantage was found for items to be attended as opposed to ignored. The size of this attention-related effect was adult-like in young children with small arrays, suggesting that their attention processes are efficient even though their working memory capacity is smaller than that of older children and adults. With a larger working memory load, this efficiency in young children was compromised. The efficiency of attention cannot be the sole explanation for the capacity difference.     

Metamemory following childhood brain injury: A consequence of executive impairment

In this study, we investigated the influence of children’s level of executive functioning on two types of metamemory knowledge following a traumatic brain injury (TBI). For this purpose, 22 children (aged 7 to 14 years) who had sustained a moderate to severe TBI and 44 typically developing children were recruited. The children with TBI were divided into two groups according to the severity of their executive impairment. Injury severity was determined by the Glasgow Coma Scale (GCS) score on admission or by the duration of unconsciousness. All children were then tested on both their knowledge of general memory functioning and their level of memory self-awareness, respectively assessed using the total number of correct responses on an adapted version of a metamemory interview and a self-other discrepancy score on a questionnaire evaluating everyday memory abilities. Data analyses revealed that participants with TBI who suffered impaired executive functions demonstrated less general metamemory knowledge, and underestimated the frequency of their memory problems, compared with children with TBI who had preserved executive functions and with control participants. Considering the well-established effect of metamemory knowledge on people’s spontaneous implementation of strategies, the interest and the importance of these findings on both theoretical and clinical grounds are discussed.