The cognitive profile of Chinese children with mathematics difficulties

This study examined how four domain-specific skills (arithmetic procedural skills, number fact retrieval, place value concept, and number sense) and two domain-general processing skills (working memory and processing speed) may account for Chinese children’s mathematics learning difficulties. Children with mathematics difficulties (MD) of two age groups (7-8 and 9-11 years) were compared with age-matched typically achieving children. For both age groups, children with MD performed significantly worse than their age-matched controls on all of the domain-specific and domain-general measures. Further analyses revealed that the MD children with literacy difficulties (MD/RD group) performed the worst on all of the measures, whereas the MD-only group was significantly outperformed by the controls on the four domain-specific measures and verbal working memory. Stepwise discriminant analyses showed that both number fact retrieval and place value concept were significant factors differentiating the MD and non-MD children. To conclude, deficits in domain-specific skills, especially those of number fact retrieval and place value understanding, characterize the profile of Chinese children with MD.     

Neuropsychological, learning and psychosocial profile of primary school aged children with the velo-cardio-facial syndrome (22q11 deletion): evidence for a nonverbal learning disability?

In this exploratory study, the neuropsychological and learning profile of nine primary school age children with velo-cardio-facial syndrome (VCFS) was studied by systematic neuropsychological testing. In five out of nine children, the following profile was found: a VIQ-PIQ discrepancy (in favor of the VIQ), significantly better scores (.05 level) for reading (decoding) and spelling compared to arithmetic, deficient tactile-perceptual skills (difficulties mainly on the left side of the body), weak but not deficient visual-perceptual abilities, deficient visual-spatial skills, extremely poor psychomotor skills (gross motor skills more deficient than fine motor skills), problems with processing of new and complex material, poor visual attention, good auditory memory and relatively good language skills. These findings correspond to the pattern of neuropsychological assets and deficits that has been described for the syndrome of nonverbal learning disabilities (NLD) (Rourke, 1987, 1988, 1989, 1995). The psychosocial profile of all nine children with VCFS also correspond to that of children with NLD. Further studies on the relationship between cognitive function, behavior, psychiatric disorder and abnormalities in brain anatomy in young people with VCFS will be needed. In clinical practice, it is worthwhile exploring in greater depth the neuropsychological functions of children with VCFS to rule out NLD, since they may benefit from specific remediation following the learning principles of the NLD-treatment.     

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.     

Working Memory Interference Control Deficit in Children Referred by Teachers for ADHD Symptoms

In this exploratory study, the neuropsychological and learning profile of nine primary school age children with velo-cardio-facial syndrome (VCFS) was studied by systematic neuropsychological testing. In five out of nine children, the following profile was found: a VIQ-PIQ discrepancy (in favor of the VIQ), significantly better scores (.05 level) for reading (decoding) and spelling compared to arithmetic, deficient tactile-perceptual skills (difficulties mainly on the left side of the body), weak but not deficient visual-perceptual abilities, deficient visual-spatial skills, extremely poor psychomotor skills (gross motor skills more deficient than fine motor skills), problems with processing of new and complex material, poor visual attention, good auditory memory and relatively good language skills. These findings correspond to the pattern of neuropsychological assets and deficits that has been described for the syndrome of nonverbal learning disabilities (NLD) (Rourke, 1987, 1988, 1989, 1995). The psychosocial profile of all nine children with VCFS also correspond to that of children with NLD. Further studies on the relationship between cognitive function, behavior, psychiatric disorder and abnormalities in brain anatomy in young people with VCFS will be needed. In clinical practice, it is worthwhile exploring in greater depth the neuropsychological functions of children with VCFS to rule out NLD, since they may benefit from specific remediation following the learning principles of the NLD-treatment.     

A Developmental Investigation of Prospective Memory: Effects of Interruption

The effects of interrupting an event-based prospective memory (PM) task and its associated ongoing task were compared for two groups of children: 8- to 9-year-olds (n?=?35) and 12- to 13-year-olds (n?=?28). Additionally, PM performance was examined as a function of attainment on a battery of tests of executive functioning (viz., Controlled Oral Word Association Test, Letter Number Sequencing Test, Stroop Color and Word Test, and Trail Making Test). A significant main effect of age indicated that the older children correctly carried out intended actions more often than the younger children. Consistent with the prefrontal model of PM, interruption had no impact on PM accuracy in the older group but produced reliable decrements to the accuracy of the younger group. Whereas IQ showed no association with PM performance, reliable relations between PM skills and aspects of their executive functioning were found.     

The beneficial effect of synchronized action on motor and perceptual timing in children

We examined the role of action in motor and perceptual timing across development. Adults and children aged 5 or 8 years old learned the duration of a rhythmic interval with or without concurrent action. We compared the effects of sensorimotor versus visual learning on subsequent timing behaviour in three different tasks: rhythm reproduction (Experiment 1), rhythm discrimination (Experiment 2) and interval discrimination (Experiment 3). Sensorimotor learning consisted of sensorimotor synchronization (tapping) to an isochronous visual rhythmic stimulus (ISI = 800 ms), whereas visual learning consisted of simply observing this rhythmic stimulus. Results confirmed our hypothesis that synchronized action during learning systematically benefitted subsequent timing performance, particularly for younger children. Action‐related improvements in accuracy were observed for both motor and perceptual timing in 5 years olds and for perceptual timing in the two older age groups. Benefits on perceptual timing tasks indicate that action shapes the cognitive representation of interval duration. Moreover, correlations with neuropsychological scores indicated that while timing performance in the visual learning condition depended on motor and memory capacity, sensorimotor learning facilitated an accurate representation of time independently of individual differences in motor and memory skill. Overall, our findings support the idea that action helps children to construct an independent and flexible representation of time, which leads to coupled sensorimotor coding for action and time.     

Emotion knowledge,emotion regulation,and psychosocial adjustment in children with nonverbal learning disabilities

Nonverbal learning disability is a childhood disorder with basic neuropsychological deficits in visuospatial processing and psychomotor coordination, and secondary impairments in academic and social-emotional functioning. This study examines emotion recognition, understanding, and regulation in a clinic-referred group of young children with nonverbal learning disabilities (NLD). These processes have been shown to be related to social competence and psychological adjustment in typically developing (TD) children. Psychosocial adjustment and social skills are also examined for this young group, and for a clinic-referred group of older children with NLD. The young children with NLD scored lower than the TD comparison group on tasks assessing recognition of happy and sad facial expressions and tasks assessing understanding of how emotions work. Children with NLD were also rated as having less adaptive regulation of their emotions. For both young and older children with NLD, internalizing and externalizing problem scales were rated higher than for the TD comparison groups, and the means of the internalizing, attention, and social problem scales were found to fall within clinically concerning ranges. Measures of attention and nonverbal intelligence did not account for the relationship between NLD and Social Problems. Social skills and NLD membership share mostly overlapping variance in accounting for internalizing problems across the sample. The results are discussed within a framework wherein social cognitive deficits, including emotion processes, have a negative impact on social competence, leading to clinically concerning levels of depression and withdrawal in this population.     

Serial neuropsychological assessment and evidence of shunt malfunction in spina bifida: a longitudinal case study.

Myelomeningocele is often accompanied by hydrocephalus (MMH), making it a potentially unstable neurological condition requiring shunt placement and possible revisions. Serial neuropsychological assessment is an important tool in monitoring children with MMH, as cognitive changes can indicate shunt malfunction and hydrocephalus. We present the case of a girl with MMH who had five neuropsychological assessments (ages 5, 7, 11, 12, and 14). Despite a lack of overt neurological symptoms or report of behavioral decline, testing at age 11 revealed decline in multiple neurobehavioral domains, and imaging at that time showed increased hydrocephalus, requiring shunt revision. Subsequent neuropsychological assessment conducted after a 2-year period of medical stability showed improvement and/or a return to baseline levels in some skill areas (i.e., working memory, verbal memory, visuomotor integration, and sustained attention), yet more lasting impairments in others (i.e., Verbal IQ, processing speed, organization, and response inhibition). These lasting cognitive deficits potentially impact independent completion of complex medical self-care tasks. This pattern of recovery highlights vulnerability of brain systems supporting executive functions in children with hydrocephalus and shunt failure.     

Serial Neuropsychological Assessment and Evidence of Shunt Malfunction in Spina Bifida: A Longitudinal Case Study

Myelomeningocele is often accompanied by hydrocephalus (MMH), making it a potentially unstable neurological condition requiring shunt placement and possible revisions. Serial neuropsychological assessment is an important tool in monitoring children with MMH, as cognitive changes can indicate shunt malfunction and hydrocephalus. We present the case of a girl with MMH who had five neuropsychological assessments (ages 5, 7, 11, 12, and 14). Despite a lack of overt neurological symptoms or report of behavioral decline, testing at age 11 revealed decline in multiple neurobehavioral domains, and imaging at that time showed increased hydrocephalus, requiring shunt revision. Subsequent neuropsychological assessment conducted after a 2-year period of medical stability showed improvement and/or a return to baseline levels in some skill areas (i.e., working memory, verbal memory, visuomotor integration, and sustained attention), yet more lasting impairments in others (i.e., Verbal IQ, processing speed, organization, and response inhibition). These lasting cognitive deficits potentially impact independent completion of complex medical self-care tasks. This pattern of recovery highlights vulnerability of brain systems supporting executive functions in children with hydrocephalus and shunt failure.     

Adaptive training leads to sustained enhancement of poor working memory in children

Working memory plays a crucial role in supporting learning, with poor progress in reading and mathematics characterizing children with low memory skills. This study investigated whether these problems can be overcome by a training program designed to boost working memory. Children with low working memory skills were assessed on measures of working memory, IQ and academic attainment before and after training on either adaptive or non‐adaptive versions of the program. Adaptive training that taxed working memory to its limits was associated with substantial and sustained gains in working memory, with age‐appropriate levels achieved by the majority of children. Mathematical ability also improved significantly 6 months following adaptive training. These findings indicate that common impairments in working memory and associated learning difficulties may be overcome with this behavioral treatment.     

Neuropsychological assessment in illiterates: visuospatial and memory abilities

A basic neuropsychological battery of visuospatial and memory abilities was administered to extreme educational groups (illiterates and professionals). Subjects were matched according to sex and age. The following visuospatial tasks were included: figure copy (cube, house, and Rey-Osterrieth complex figure), telling time, recognition of superimposed figures, recognition of a map, and drawing of the plan of the room. The following memory tasks were used: basic information, digit retention (forward and backward), memory curve, delayed verbal recall, sentence repetition, logical memory, delayed logical memory, immediate recall of the Rey-Osterrieth complex figure, immediate reproduction of a cube, visuospatial memory, and sequential memory. In visuospatial tasks all differences between the two groups were statistically significant. Five of the seven visuospatial tasks (all but telling time and recognition of superimposed figures) showed differences between age groups with a better performance found in the younger groups and four of the tasks (cube, house, Rey-Osterrith complex figure copying, and telling time) were significant between sexes with a better performance in men. In memory tasks, with the exception of the immediate memory of sentences, all tasks showed statistically significant differences between educational groups. Eight of the 13 memory tasks (digits forward and backward, delayed memory of words, immediate and delayed logical memory, Rey-Osterrieth immediate memory, cube immediate memory, and sequential memory) showed significant differences for age while 4 of the tasks (digits backward, memory curve, Rey-Osterrieth immediate memory, and cube immediate memory) were significant for sex. Results are analyzed with regard to current theories in cognitive psychology and anthropology. Emphasis is placed on the finding that cognitive skills usually examined by neuropsychological tests represent learned and highly trained abilities.     

Intellectual and adaptive functioning in Sturge-Weber Syndrome

The present study examined the intellectual and adaptive functioning in a sample of children and young adults with Sturge-Weber Syndrome (SWS). A total of 80 research participants from a SWS study database underwent full neurological evaluation as part of their participation or concurrent medical care. Twenty-nine of the participants received neuropsychological evaluations. Analyses indicated no significant demographic or neurological differences between those who did and did not receive neuropsychological evaluations. Overall, the neuropsychological evaluation sample displayed significantly lower functioning relative to published normative data across domains of intellectual and adaptive functioning. Thirty-two percent of the sample displayed impaired performance (standard score ≤ 75) in intellectual functioning and 58% displayed impaired performance in adaptive functioning. Hemiparesis status independently predicted overall adaptive functioning while seizure frequency independently predicted overall intellectual functioning. Younger participants displayed significantly higher (more intact) ratings in adaptive functioning compared to older participants, specifically in overall adaptive functioning, motor skills, and community living skills. A composite measure of neurological status (SWS-NRS) incorporating seizure and hemiparesis status effectively distinguished between individuals with impaired or nonimpaired adaptive and intellectual functioning and showed promise as a screening method for identifying individuals with more involved intellectual and/or adaptive needs.     

Word memory test performance in children.

One-hundred and thirty-five children between the ages of 7 and 18 years were evaluated clinically. Their diagnoses included Fetal Alcohol Syndrome (FAS) or Effects, Schizophrenia, Bipolar Mood Disorder, various neurological diseases, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional-Defiant Disorder and learning disabilities. As part of a comprehensive neuropsychological assessment, the children were given the Word Memory Test (WMT; Green, Allen, & Astner, 1996; Green & Astner, 1995), containing various subtests which measure, respectively, effort and verbal memory. Although age and verbal intelligence are known to affect scores on most ability tests, they were not found to be significant determinants of WMT effort scores. Younger children did not score any lower on the effort subtests than older children. The children scored as well as a group of parents seeking custody of their children and they scored higher than adult patients with mild head injuries. The computerized WMT requires some basic reading skills and some children with lower than a grade 3 reading level scored at a relatively low level on the effort subtests. The current data suggest that most children with at least a grade 3 reading level can pass the WMT using the adult criteria. It is concluded that the WMT is potentially useful in the evaluation of effort during pediatric neuropsychological evaluations. Further research is needed to replicate these findings and to develop child norms for the memory subtests.     

Cross language learning disabilities and verbal versus spatial memory

The research reported in this talk involves comparisons of verbal and spatial memory tasks across groups of children (and adults) with different types of learning difficulties. The research focuses on children with literacy acquisition problems and investigates whether such problems are related to specific areas of deficit. In the first piece of research, children with dyslexia (literacy learning problems) and dyspraxia (motor deficits) were contrasted on measures of memory (for example, tasks that required the retention of sequences of verbal material or spatial movements) and additional measures of literacy (reading and spelling), phonological (awareness of sounds within words) and motor (fine and gross motor tasks) functioning. The data were consistent with a dissociation between tasks/groups such that dyslexics showed weak phonological processing but intact visuo-spatial processing, whereas children with dyspraxia showed weaknesses on task involving visuo-spatial information, but average levels of performance on tasks that required phonological processing. Similar results were identified amongst adult groups, consistent with a deviant level of functioning rather than a developmental delay. A second line of research contrasted children with or without literacy problems across language backgrounds (English, Arabic, Chinese and bilingual children). Consistent with the dyslexia data, children with poor English literacy skills showed weaknesses in verbal/phonological memory tasks but not in visuo-spatial memory. However, for Chinese-language children, visuo-spatial memory differed between good and poor literacy learners, but there was little evidence for verbal memory differences. In contrast, the Arabic and bilingual children showed differences in both verbal and visuo-spatial areas, although the evidence was consistent with enhanced visual/spatial skills amongst the good literacy groups, rather than poor literacy children showing weaknesses in those tasks. These data suggest that the influence of memory skills on learning may vary with the language of instruction. A final line of enquiry considers whether teaching strategies to children with learning difficulties may overcome some of the identified memory deficits and lead to better levels of learning. English language children with learning difficulties were taught visual and verbal strategies to support retention of materials in short-term memory tasks. In the majority of cases, learning was improved when it focused on visuo-spatial strategies but not when verbal strategies were used. These data support the relationship between learning difficulties and different aspects of short-term memory that may lead to poor levels of learning. It also presents evidence that memory (particularly those related to visuo-spatial) processes are influenced by the context within which learning is taking place, both in terms of the language of instruction and the strategies used to support learning. For some children with educational difficulties based around language-related deficits, visuo-spatial strategies may support acquisition.     

Word Memory Test Performance in Children

One-hundred and thirty-five children between the ages of 7 and 18 years were evaluated clinically. Their diagnoses included Fetal Alcohol Syndrome (FAS) or Effects, Schizophrenia, Bipolar Mood Disorder, various neurological diseases, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional-Defiant Disorder and learning disabilities. As part of a comprehensive neuropsychological assessment, the children were given the Word Memory Test (WMT; Green, Allen, & Astner, 1996; Green & Astner, 1995), containing various subtests which measure, respectively, effort and verbal memory. Although age and verbal intelligence are known to affect scores on most ability tests, they were not found to be significant determinants of WMT effort scores. Younger children did not score any lower on the effort subtests than older children. The children scored as well as a group of parents seeking custody of their children and they scored higher than adult patients with mild head injuries. The computerized WMT requires some basic reading skills and some children with lower than a grade 3 reading level scored at a relatively low level on the effort subtests. The current data suggest that most children with at least a grade 3 reading level can pass the WMT using the adult criteria. It is concluded that the WMT is potentially useful in the evaluation of effort during pediatric neuropsychological evaluations. Further research is needed to replicate these findings and to develop child norms for the memory subtests.     

Phonological sensitivity and memory in children with a foreign language learning difficulty

The phonological processing and memory skills of 12- and 13-year-old Italian children with difficulty in learning English as a foreign language (foreign language learning difficulty, FLLD) were examined and compared with those of a control group matched for age and nonverbal intelligence. Three experiments were conducted. A dissociation between verbal and visuo-spatial working memory was observed when compared to the control group; children with FLLD showed a poorer performance in a phonological working memory task but performed to a comparable level in a visuo-spatial working memory task (Experiment 1). In Experiment 2 the word length and the response modality of an auditory word span task were manipulated in order to examine the efficiency of the phonological loop and the relevance of the spoken output. The FLLD group did not show sensitivity to the word length effect and showed no advantage in the picture pointing recall condition. In Experiment 3 children with FLLD were shown to be sensitive to phonological similarity but again they showed neither a word length effect nor a slower articulation speed. Furthermore, in all three experiments children with FLLD were shown to be less efficient in phonological sensitivity tasks and this deficit appeared to be independent of the phonological memory problem. All three experiments consistently showed that children with FLLD have an impairment in phonological memory and phonological processing, which appear to be independent from one other but both contribute to the children's difficulty in learning a second language.     

Relationship of temporal lobe volumes to neuropsychological test performance in healthy children

Ecological validity of neuropsychological assessment includes the ability of tests to predict real-world functioning and/or covary with brain structures. Studies have examined the relationship between adaptive skills and test performance, with less focus on the association between regional brain volumes and neurobehavioral function in healthy children. The present study examined the relationship between temporal lobe gray matter volumes and performance on two neuropsychological tests hypothesized to measure temporal lobe functioning (visual perception-VP; peabody picture vocabulary test, third edition-PPVT-III) in 48 healthy children ages 5-18 years. After controlling for age and gender, left and right temporal and left occipital volumes were significant predictors of VP. Left and right frontal and temporal volumes were significant predictors of PPVT-III. Temporal volume emerged as the strongest lobar correlate with both tests. These results provide convergent and discriminant validity supporting VP as a measure of the "what" system; but suggest the PPVT-III as a complex measure of receptive vocabulary, potentially involving executive function demands.     

Phonological sensitivity and memory in children with a foreign language learning difficulty

The phonological processing and memory skills of 12- and 13-year-old Italian children with difficulty in learning English as a foreign language (foreign language learning difficulty, FLLD) were examined and compared with those of a control group matched for age and nonverbal intelligence. Three experiments were conducted. A dissociation between verbal and visuo-spatial working memory was observed when compared to the control group; children with FLLD showed a poorer performance in a phonological working memory task but performed to a comparable level in a visuo-spatial working memory task (Experiment 1). In Experiment 2 the word length and the response modality of an auditory word span task were manipulated in order to examine the efficiency of the phonological loop and the relevance of the spoken output. The FLLD group did not show sensitivity to the word length effect and showed no advantage in the picture pointing recall condition. In Experiment 3 children with FLLD were shown to be sensitive to phonological similarity but again they showed neither a word length effect nor a slower articulation speed. Furthermore, in all three experiments children with FLLD were shown to be less efficient in phonological sensitivity tasks and this deficit appeared to be independent of the phonological memory problem. All three experiments consistently showed that children with FLLD have an impairment in phonological memory and phonological processing, which appear to be independent from one other but both contribute to the children's difficulty in learning a second language.     

Number processing and calculation in Brazilian children aged 7-12 years

Numerical cognition is based on two components - number processing and calculation. Its development is influenced by biological, cognitive, educational, and cultural factors. The objectives of the present study were to: i) assess number processing and calculation in Brazilian children aged 7-12 years from public schools using the Zareki-R (Battery of neuropsychological tests for number processing and calculation in children, Revised; von Aster & Dellatolas, 2006) in order to obtain normative data for Portuguese speakers; ii) identify how environment, age, and gender influences the development of these mathematical skills; iii) investigate the construct validity of the Zareki-R by the contrast with the Arithmetic subtest of WISC-III. The sample included 172 children, both genders, divided in two groups: urban (N = 119) and rural (N = 53) assessed by the Zareki-R. Rural children presented lower scores in one aspect of number processing; children aged 7-8 years demonstrated an inferior global score than older; boys presented a superior performance in both number processing and calculation. Construct validity of Zareki-R was demonstrated by high to moderate correlations with Arithmetic subtest of WISC-III. The Zareki-R therefore is a suitable instrument to assess the development of mathematical skills, which is influenced by factors such as environment, age, and gender.     

Autistic traits and neuropsychological performance in 6- to-10-year-old children: a population-based study

Clinical studies of children with autism spectrum disorder (ASD) provide evidence for poorer neuropsychological performance within specific domains compared to age, gender, and sometimes IQ-matched controls. Since recent evidence suggests that autistic symptoms form a spectrum that extends into the general population, it was our goal to evaluate the nature of the relationship between autistic traits and neuropsychological performance across the continuum in the general population. We examined neuropsychological performance across five different domains in 1019 6-to-10-year-old children participating in a population-based study of child development. Autistic traits were assessed when the children were 6 years of age using the Social Responsiveness Scale and ASD diagnoses were obtained via medical records. Neuropsychological functioning was measured using the NEPSY-II-NL and included the domains of attention and executive function, memory and learning, sensorimotor functioning, language, and visuospatial functioning. We found that children with higher autistic traits showed significantly lower neuropsychological performance in all domains investigated and that this association remained even after excluding children with the highest autistic traits or confirmed ASD. When comparing 41 children with confirmed ASD diagnosis to typically developing controls, children with ASD showed significantly lower neuropsychological performance across all domains. Taken together, our results suggest that children with both ASD and subclinical autistic traits have lower neuropsychological performance. Thus, this may provide an understanding of why some children without an ASD diagnosis may require some additional assistance within academic settings.