Assessing Effort During Neuropsychological Evaluation with the TOMM in Children and Adolescents with Epilepsy

Effort assessment is of particular importance in pediatric epilepsy where neuropsychological findings may influence treatment decisions, especially if surgical interventions are being considered. The present investigation examines the Test of Memory Malingering (TOMM) in 60 children and adolescents with epilepsy. The overall pass rate for the sample was 90%. TOMM scores were unrelated to age, though there was a significant correlation between TOMM Trial 2 scores and intelligence estimates. Overall, the TOMM appears to be a valid measure of effort in young epilepsy patients, though caution should be used when interpreting scores for those with very low IQ, especially if behavioral problems are also evident. Caution should also be exercised in interpreting scores in children with ongoing interictal epileptiform activity that may disrupt attention.     

Neuropsychological Deficits in Childhood Epilepsy Syndromes

Seizure disorders are relatively common in childhood, and the International League Against Epilepsy (ILAE) provides a hierarchical classification system to define seizure types. At the final level of classification, specific epilepsy syndromes are defined that represent a complex of signs and symptoms unique to an epilepsy condition. The present review discusses the issues related to several of these epilepsy syndromes in childhood, including those classified as generalized idiopathic epilepsies (e.g., childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy), focal epilepsies (benign rolandic epilepsy, occipital epilepsy, temporal lobe epilepsy, frontal lobe epilepsy) and the "epileptic encephalopathies," including Dravet's Syndrome, West Syndrome, Lennox-Gastaut Syndrome, Myoclonic Astatic Epilepsy, and Landau-Kleffner Syndrome. For each syndrome, the epidemiology, clinical manifestations, treatments, and neuropsychological findings are discussed.     

Friendships with Peers Who are Low or High in Aggression as Moderators of the Link between Peer Victimization and Declines in Academic Functioning

This paper reports two prospective investigations of the role of friendship in the relation between peer victimization and grade point averages (GPA). Study 1 included 199 children (105 boys, 94 girls; mean age of 9.1 years) and Study 2 included 310 children (151 boys, 159 girls; mean age of 8.5 years). These children were followed for two school years. In both projects, we assessed aggression, victimization, and friendship with a peer nomination inventory, and we obtained children's GPAs from a review of school records. Peer victimization was associated with academic declines only when children had either a high number of friends who were above the classroom mean on aggression or a low number of friends who were below the classroom mean on aggression. These results highlight the importance of aggression levels among friends for the academic adjustment of victimized children.     

Neuropsychological Functioning in Children with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) has been associated with deficits in the areas of verbal memory and learning, executive functioning, working memory, and attention in adults. Findings have been less consistent in the few studies examining neuropsychological functioning in childhood PTSD, which are often limited by comparing children with PTSD to children without trauma histories, making it unclear whether observed neuropsychological deficits are related to trauma exposure or to PTSD symptomatology. In an ethnically diverse sample of 62 children who witnessed intimate partner violence (n = 27 PTSD+ and 35 PTSD?), children with PTSD exhibited slower and less effective learning, heightened sensitivity to interference, and impaired effect of rehearsal on memory acquisition on the California Verbal Learning Test – Children's Version, a word list learning task. Both groups performed in the below average range on measures of executive functioning, attention, and intellectual ability.     

Joint Contributions of Peer Acceptance and Peer Academic Reputation to Achievement in Academically At Risk Children: Mediating Processes

The longitudinal relationships between two dimensions of peer relationships and subsequent academic adjustment were investigated in a sample of 543 relatively low achieving children (M = 6.57 years at Year 1, 1(st) grade). Latent variable SEM was used to test a four stage model positing indirect effects of peer acceptance and peer academic reputation (PAR) assessed in Year 2 on academic achievement in Year 5, via the effects of the peer relationships variables on perceived academic competence in Year 3 and effortful engagement in Year 4. As expected, the effect of PAR on engagement was partially mediated by perceived academic competence, and the effect of perceived academic competence on achievement was partially mediated by engagement. In the context of PAR, peer acceptance did not contribute to the mediating variables or to achievement. Findings provide a clearer understanding of the processes by which early peer-relationships influence concurrent and future school-related outcomes. Implications for educational practice and future research are discussed.     

Longitudinal Behavioral and Academic Adjustment in Children with HIV Infection

This study investigated; the behavioral adjustment and academic status of children with HIV infection through serial evaluations over a ten-year period. The parents of children were assessed with Achenbach Child Behavior Checklist Parent Forms and the children were administered the Woodcock-Johnson Tests of Academic Achievement at regular intervals as part of their treatment in the HIV Program of a children’s hospital. Children with HIV were found to have behavioral adjustment within normal limits over time. Aggressive behavior was noted to decrease over time. Academic achievement mirrored IQ status, unlike other studies, which have reported poorer achievement than expected for IQ. Math skills appeared to improve over time. Thus, these findings suggest children with HIV infection did not show significant behavioral disturbance across time, however, aggressive behavior appeared to decrease. Academic achievement was stable over time.     

同伴团体对儿童青少年学业成就和社会功能关系的影响

运用同伴评价、教师评估和学校记录等多种渠道收集关于同伴团体、社会功能、同伴接纳以及学业成就的资料,旨在考察同伴团体与儿童青少年学业成就和社会功能的关系。研究发现：绝大多数儿童青少年都有自己的同伴团体。这些同伴团体在学业成就上有很高的同质性。学业成就与社会适应无论在团体内的个体水平还是在团体水平上都密切相关。而且,团体的学业表现是个体学业成就和社会适应间的重要调节因素,表明团体学业规范对个体水平上学业成就与社会功能的关系有增强或是减弱的作用。这项研究再一次证明同伴团体在儿童个体发展中的重要意义。     

Peer Perceptions and Liking of Children with Anxiety Disorders

Examined three aspects of childhood anxiety and peer liking: (1) whether or not children can detect anxiety in age-mates, (2) the degree to which peer-reported anxiety, self-reported anxiety, and presence of anxiety disorders are associated with peer liking, and (3) whether or not self-reported anxiety and presence of anxiety disorders are associated with peer liking after controlling for peer-reported anxiety. Peer raters (9.5–12.5 years) rated videotaped speech samples of target children with anxiety disorders (AD; 9.5–13 years) and target children without anxiety disorders (NAD; 9.5–13 years). Peer-rated anxiety was positively correlated with target children’s self-reported anxiety and was higher among children with AD and children with social phobia (SP). Peer liking was inversely related to peer-reported anxiety and was lower for target children with SP. Target children with SP were liked less regardless of how anxious peers perceived them to be. Peer rater and target child demographics did not moderate the relationship between peer-rated anxiety and peer liking.     

Neuropsychological Features of Lesion-related Epilepsy in Adults: An Overview

Lesional epilepsy is thought to be a direct consequence of focal brain lesions of dysgenetic, neoplastic, vascular, or traumatic origin. It has been estimated that at least half of all epilepsies are the result of such lesions. The current discussion includes an overview of the cognitive and behavioral presentations in adults with epilepsy secondary to focal pathology. The neuropsychological presentation in this population is influenced by many factors, including the location and nature of the underlying lesion, seizure characteristics, the effects of treatment, and patient variables. Few studies attempt to disentangle the specific contributions of these variables to cognitive performance. However, where available studies examining the separable effects of seizure-related variables on cognitive functioning in individuals with lesional epilepsy are also reviewed. This overview includes a discussion of focal malformations of cortical and vascular development and select foreign tissue and acquired lesions.     

Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

This article presents a review of studies that have investigated the neuropsychological effects of antiretroviral treatment (ART) for HIV-1 infection. It provides a brief overview of the era of monotherapy, dual-therapy, and an extended overview of the current era of combination antiretroviral therapy (CART). This review highlights that while CART has had a dramatic effect on the incidence and the severity of HIV-associated neurocognitive disorders (HAND), HAND, in its mild form, still remains prevalent. New causes of this sustained prevalence are poor CNS penetration of some antiretroviral agents, drug resistance, poor adherence, potential neurotoxicity, co-morbidities such as the long-term CART side effects in relation to cardio-vascular disease, and chronic HIV brain infection that may facilitate the expression of new forms of neurodegenerative processes. The review emphasizes the need to address methodological limitations of published studies and the need for large and representative cross-disciplinary longitudinal investigations across the HIV illness span.     

Attention Processes in Children with Movement Difficulties, Reading Difficulties or Both

Reading difficulties (RD) and movement difficulties (MD) co-occur more often in clinical populations than expected for independent disorders. In this study, we investigated the pattern of association between attentional processes, RD and MD in a population of 9 year old school children. Children were screened to identify index groups with RD, MD or both, plus a control group. These groups were then tested on a battery of cognitive attention assessments (TEA-Ch). Results confirmed that the occurrence of RD and MD was greater than would be predicted for independent disorders. Additionally, children with MD, whether or not combined with RD, had poor performance on all attention measures when compared with typically developing children. Children with RD only, were no poorer on measures of attention than typical children. The results are discussed with respect to approaches proposed to account for the co-occurrence of disorders.     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

An Investigation into the Relationship Among ADHD Symptomatology,Creativity, and Neuropsychological Functioning in Children

This paper examined the relationship between creativity and ADHD symptomatology. First, the presence of ADHD symptomatology within a creative sample was explored. Secondly, the relationship between cognitive functioning and ADHD symptomatology was examined by comparing four groups, aged 10–12 years: 1) 29 ADHD children without creativity, 2) 12 creative children with ADHD symptomatology, 3) 18 creative children without ADHD symptomatology, and 4) 30 controls. Creativity, intelligence, processing speed, reaction time, working memory, and inhibitory control were measured. Results showed that 40% of the creative children displayed clinically elevated levels of ADHD symptomatology, but none met full criteria for ADHD. With regard to cognitive functioning, both ADHD and creative children with ADHD symptoms had deficits in naming speed, processing speed, and reaction time. For all other cognitive measures the creative group with ADHD symptoms outperformed the ADHD group. These findings have implications for the development and management of creative children.     

Social Anxiety and Peer Relations in Early Adolescence: Behavioral and Cognitive Factors

This study investigated factors associated with social anxiety during early adolescence using multiple informants, including self and peer perspectives, teacher ratings, and direct observations. Negative social performance expectations, maladaptive coping strategies, and social skill deficits were examined as correlates of social anxiety and mediators linking social anxiety with poor peer relations. Participants were 84 middle school students (47 girls, 37 boys) over-sampled for elevated social anxiety. Analyses revealed correlations linking social anxiety with decreased peer acceptance and increased peer victimization. Path analysis indicated that negative social performance expectations and social withdrawal-disengagement accounted for the association between social anxiety and decreased peer acceptance. Social anxiety, self-directed coping strategies, and social withdrawal-disengagement were each directly linked with increased peer victimization for boys. The results replicate findings based on clinical samples, extend understanding of cognitive, social, and behavioral factors associated with social anxiety in middle school, and provide new information regarding gender differences in the correlates of social anxiety.     

Executive Function and Emotional,Behavioral, and Social Competence Problems in Children with Epilepsy

Many researchers have reported elevated rates of emotional, behavioral, and social competence problems (EBSP) in children with epilepsy. Although executive function has been found to be associated with EBSP in children with typical development, almost no research has looked at the individual components of executive function as potential predictors of EBSP in children with epilepsy. This is surprising given the deficits in executive function in children with epilepsy. We investigated EBSP and executive function in 42 children with epilepsy, aged 6.0 to 18.1 years and found, as expected, that EBSP were associated with executive function in these children even after epilepsy-related variables, such as seizure type, were accounted for. However, different components of executive function were related to different emotional, behavioral, and social competence problems in these children. Shifting of mental sets was a significant predictor of emotional, behavioral, and social competence problems whereas inhibition was a significant predictor of behavioral problems. This suggests that different executive function profiles in children with epilepsy may place them at-risk for developing different types of emotional, behavioral, and social competence problems. These results may help researchers and clinicians develop new techniques to identify and treat emotional, behavioral, and social competence problems in children with epilepsy.     

Noncredible Effort during Pediatric Neuropsychological Exam: A Case Series and Literature Review

Neuropsychological test interpretation rests upon the assumption that the examinee has exerted full effort. If an individual provides inadequate effort during exam, the resulting data will be invalid and represent an underestimate of the person's true abilities. Although youth have been assumed historically to be less capable of deception than adults, acts of deception in childhood are not uncommon, even in normative populations. Yet, very few cases of children who have provided suboptimal effort during neuropsychological exam have appeared in the scientific literature. We present six clinical cases illustrating that children down to at least age 8 years can present with noncredible performance. The cases include those in which clear external incentives could be identified to those in which intrinsic or psychological factors were presumed to predominate. The fairly diverse nature of the presented cases, along with other recent work, suggests that suboptimal effort in children is apt to occur more frequently than previously recognized, even if it might occur less often than in comparable adult samples. In most of the presented cases, noncredible performance would not have been detected definitively by clinical judgment alone, reinforcing the value of routinely incorporating symptom validity tests into the neuropsychological assessment of school-aged children. The number of effort tests that have demonstrated utility in children pales in comparison to those available to the adult practitioner, although recent research now supports the use of several standalone measures with pediatric patients.     

Classroom Peer Relationships and Behavioral Engagement in Elementary School: The Role of Social Network Equity

Applying social capital and systems theories of social processes, we examine the role of the classroom peer context in the behavioral engagement of low-income students (N = 80) in urban elementary school classrooms (N = 22). Systematic child observations were conducted to assess behavioral engagement among second to fifth graders in the fall and spring of the same school year. Classroom observations, teacher and child questionnaires, and social network data were collected in the fall. Confirming prior research, results from multilevel models indicate that students with more behavioral difficulties or less academic motivation in the fall were less behaviorally engaged in the spring. Extending prior research, classrooms with more equitably distributed and interconnected social ties—social network equity—had more behaviorally engaged students in the spring, especially in classrooms with higher levels of observed organization (i.e., effective management of behavior, time, and attention). Moreover, social network equity attenuated the negative relation between student behavioral difficulties and behavioral engagement, suggesting that students with behavioral difficulties were less disengaged in classrooms with more equitably distributed and interconnected social ties. Findings illuminate the need to consider classroom peer contexts in future research and intervention focused on the behavioral engagement of students in urban elementary schools.     

Peer Influence in Elementary School: The Importance of Assessing the Likeability of Popular Children

Abstract

We examined the degree to which children perceive influence behaviors and influence over social norms from different types of high-status children to vary in a sample of 453 3^rd through 5^th grade children. Using a cluster analysis of peer-nominated popularity and likeability measures, we identified a seven-cluster solution, including three high-status clusters: Well-Liked, Popular, and Popular/Well-Liked. Popular children were perceived as using ridicule and having influence over misbehavior. Popular/Well-Liked children were perceived as using playful teasing and modeling and influencing over trend-setting and sports norms, at a degree similar to Popular children. However, Popular/Well-Liked children were not perceived as using ridicule or influencing over misbehavior; rather, they scored higher than all other status groups for prosocial assertion and academic motivation. Well-Liked children were perceived as using prosocial assertion and influencing over academic motivation at a higher degree than Average children but at a lower degree than Popular or Popular/Well-Liked children. Although the influence associated with likeability alone appeared relatively limited, likeability in conjunction with popularity seems to make a difference regarding influence behaviors and norms. A person-centered approach that takes into account multiple facets of social status is likely to enhance understanding of high-status children’s influence on their same-age peers.     

前摄干扰对汉语听写困难儿童字形工作记忆的影响

字形工作记忆（O-WM）是书写加工过程中汉字部件的临时存储点,其重要功能之一是保证部件表征的区分性特征。关于汉语O-WM的研究主要来自脑损伤个案,目前还没有关于汉语听写困难儿童是否存在O-WM损伤的报道。本研究采用两个实验,分别探讨视觉和语音前摄干扰对听写困难儿童汉字部件再认的影响。结果发现：（1）听写困难儿童的部件判断存在视觉前摄干扰效应,而正常儿童没有表现出视觉前摄干扰效应（实验一）;（2）两组儿童均没有出现明显的语音前摄干扰效应（实验二）。该结果表明,汉语听写困难儿童O-WM在保证部件视觉表征的区分性功能上存在缺陷,并支持汉语O-WM中汉字部件的表征是以字形为基础的观点。