Time Perception in Boys With Attention-Deficit/Hyperactivity Disorder According to Time Duration,Distraction and Mode of Presentation

The present study describes the incidence of test refusal at neuropsychological assessment, investigates its correlates, and its stability. The participants were 124 children aged 3.5 years whose development has been followed from birth in the Jyväskylä Longitudinal Study of Dyslexia (JLD). The frequency of test refusal on the Finnish version of the NEPSY was analyzed with respect to the children's concurrent and earlier cognitive and language skills, assessed using tests and parental ratings. Refusal during test-taking was found to be relatively common at this age, and high frequency of refusal at an earlier age was associated with similar tendency at a later age. High test refusal was associated with compromised neuropsychological and linguistic test scores. Missing data due to refusal were more common in neuropsychological tasks requiring verbal production. It is concluded that test refusals reflect a child's poor underlying skills and an attempt to avoid failure, rather than noncompliant or oppositional behavior.     

Neuropsychological profile of children with cryptogenic localization related epilepsy.

Up to one third of the epilepsy population consists of children with cryptogenic localization related epilepsy (CLRE). Unfortunately, the effect of CLRE on the development is still unclear. Behavioral and academic problems have been reported, but no conclusive study concerning the impact of CLRE on neuropsychological functioning is yet published. This study was a systematic cross-sectional open clinical and nonrandomized investigation, which included 68 children with CLRE. Several neuropsychological tests were analyzed and age-related normative values were used as reference. Differences between CLRE and reference values were tested with Paired-Samples t-tests. Z scores were computed to compare the different neuropsychological tests and to inspect whether a characteristic neuropsychological profile exists for CLRE. The Independent-Samples t-test was used to explore which epilepsy factors (seizure type, seizure frequency, age at onset, duration of epilepsy, and drug load) were influencing the cognitive profile of CLRE. There seems to be a characteristic cognitive profile for children with CLRE; children with CLRE experience cognitive difficulties on a wide range of areas-in particular, alertness, mental speed, and memory. Seizure type, seizure frequency, duration of epilepsy, and drug load do not influence this neuropsychological profile. Age at onset was an important risk factor; the earlier the age at onset, the worse the cognitive performance. In spite of the influence of age at onset, the revealed profile can be seen as a stable, independent of temporary factors, neuropsychological profile for children with CLRE.     

Contents

Up to one third of the epilepsy population consists of children with cryptogenic localization related epilepsy (CLRE). Unfortunately, the effect of CLRE on the development is still unclear. Behavioral and academic problems have been reported, but no conclusive study concerning the impact of CLRE on neuropsychological functioning is yet published.

This study was a systematic cross-sectional open clinical and nonrandomized investigation, which included 68 children with CLRE. Several neuropsychological tests were analyzed and age-related normative values were used as reference. Differences between CLRE and reference values were tested with Paired-Samples t-tests. Z scores were computed to compare the different neuropsychological tests and to inspect whether a characteristic neuropsychological profile exists for CLRE. The Independent-Samples t-test was used to explore which epilepsy factors (seizure type, seizure frequency, age at onset, duration of epilepsy, and drug load) were influencing the cognitive profile of CLRE.

There seems to be a characteristic cognitive profile for children with CLRE; children with CLRE experience cognitive difficulties on a wide range of areas—in particular, alertness, mental speed, and memory. Seizure type, seizure frequency, duration of epilepsy, and drug load do not influence this neuropsychological profile. Age at onset was an important risk factor; the earlier the age at onset, the worse the cognitive performance. In spite of the influence of age at onset, the revealed profile can be seen as a stable, independent of temporary factors, neuropsychological profile for children with CLRE.     

Early food refusal: Infant and family characteristics

This study compared infants who developed food refusal during the first year of life with a healthy control group concerning feeding, growth pattern, family situation, and infant behavioral characteristics. Infants with food refusal had a lower relative weight at inclusion in the study and at follow-up at the age of 2 years. Food refusal was also associated with weaning problems, parental reports of lower food consumption, a higher incidence of breast-feeding, a higher frequency of meals, psychosocial problems in the family, less positive perceptions of parenting, infant difficultness, and problematic behaviors. The findings have implications for identification and understanding of factors related to early food refusal.     

Cognitive outcomes of pediatric stroke

A limited number of longitudinal studies have investigated long-term neuropsychological development in the pediatric stroke population. This study retrospectively examines cognitive outcomes in 41 children with a history of stroke, with reference to age at stroke, laterality, region and mechanism of stroke. In the course of recovery, neuropsychological measures of intellectual functioning and memory were administered at two time points, whilst executive functioning, attention and academic skills were administered at one time point. As predicted, children with stroke performed significantly worse compared to normative expectations on all neuropsychological measures. Up to two thirds of children scored in the borderline impaired and impaired ranges on at least one domain of cognition. Performance on intellectual and memory assessment remained relatively stable over time. Younger age at stroke was found to be associated with poorer intellectual functioning. No effects of laterality of stroke on neuropsychological performance over time were found. Children with subcortical stroke demonstrated a greater improvement in immediate memory over time than children with cortical stroke. These findings reveal that children with stroke display long-term cognitive difficulties that typically remain stable over time. Attention and academic skills are particularly vulnerable to impairment. Further evidence that age at stroke is a significant factor in terms of cognitive outcome is provided, in support of the “early vulnerability” position.     

Fitness to drive following cerebral pathology: The Rookwood Driving Battery as a tool for predicting on‐road driving performance

The use of neuropsychological testing to determine fitness to drive in people with neuropathology is likely to be an increasingly attractive alternative to on‐road testing for many candidates for assessment. The Rookwood Driving Battery has been shown to have good predictive value for determining some who are likely to fail an on‐road test in early studies. This study replicated earlier research by examining the predictive value and theoretical validity of the battery on a larger sample of 391 participants, as well as extending earlier analysis by examining the effect of older age (over 70 years) and the interaction between age and pathology on battery and on‐road performance. The battery demonstrated good positive and negative predictive values for predicting on‐road performance. There were significant effects of older age on both the Rookwood Battery performance and the on‐road test, with older adults performing significantly poorer on both. There was no interaction between age and pathology on the Rookwood Battery but on‐road age interacted with some pathologies to produce significantly poorer performances. Furthermore, correlation and regression analysis indicate that the battery is a powerful instrument that encompasses tests of core neuropsychological functions needed for driving.     

The interplay among temperament,neuropsychological abilities,and global functioning in young hyperactive/inattentive children

Cognition and emotion have been shown to interact and influence psychological functioning. However, to date these interactions have only been examined cross‐sectionally among inattentive and/or hyperactive/impulsive children. This study investigated the moderating effects of neuropsychological functioning at age 3–4 years on the relation between negative emotionality at age 3–4 years and global functioning 1 year later, at age 4–5 years. Hyperactive/inattentive (H/I; n = 114) preschoolers entered the study (BL: baseline) and were seen again 1 year later (F1). Children's BL scores on a neuropsychological test (NEPSY) and their temperament as rated by parents (Child Behavior Questionnaire) and teachers (Temperament Assessment Battery for Children‐Revised) were obtained, as were clinicians’ ratings of their global functioning (Children's Global Assessment Scale) at F1. Hierarchical linear regression analyses revealed that BL temperament variables accounted for significant variance in F1 Global Functioning. Significant interactions indicated that higher Verbal Executive abilities were associated with better child functioning when parent‐rated Effortful Control was high, but not when Effortful Control was low. Additionally, high levels of Nonverbal Executive skills were associated with higher child global functioning when both parent‐ and teacher‐rated negative affect was low, but not when negative affect was high.     

The effect of cognitive testing and feedback on older adults’ subjective age

Subjective age, or how old a person feels, is an important measure of self-perception that is associated with consequential cognitive and health outcomes. Recent research suggests that subjective age is affected by certain situations, including cognitive testing contexts. The current study examined whether cognitive testing and positive performance feedback affect subjective age and subsequent cognitive performance. Older adults took a series of neuropsychological and cognitive tests and subjective age was measured at various time points. Participants also either received positive or no feedback on an initial cognitive task, an analogies task. Results showed that participants felt older over the course of the testing session, particularly after taking a working memory test, relative to baseline. Positive feedback did not significantly mitigate this subjective aging effect. Results suggest that subjective age is malleable and that it can be affected by standard cognitive and neuropsychological test conditions.     

Neuropsychological performance in older insomniacs

ABSTRACT

The purpose of this study was to examine daytime performance in older adults fulfilling the diagnostic criteria for DSM-IV Insomnia, using a comprehensive battery of neuropsychological tests, and to compare these objective findings with measures of self-reported cognitive functioning. A total of 121 participants (69% women) with a mean age of 64.0 were part of a thorough neuropsychological examination at a University-based neuropsychological clinic in Western Norway. Twenty-five percent of the participants fulfilled the diagnostic criteria for insomnia. In sum, the insomnia patients were not different from the good sleepers on any neuropsychological test measure, and none of the results on the performance measures were associated with the sleep-related daytime complaints. However, the insomniacs did rate their subjective memory performance as significantly worse than the good sleepers, and they also reported more depressive symptoms. We conclude that DSM-IV defined insomnia was not associated with any performance based measure; only with self-reported symptoms.     

Developmental changes in the linguistic performance correlates of reading achievement

The present study evaluated the hypothesis that measures of linguistic skills differentially contribute to the variability in reading achievement at different ages. Linguistic skills that develop earlier and are more important for earlier phases of reading were predicted to contribute more to the variability of reading achievement at earlier ages (5–7) than at older ages (10–12). Conversely, linguistic skills that develop later and are more important for later phases of reading were predicted to contribute more to the variability in reading achievement at older ages (10–12) than at younger ages (5–7). To test these developmental hypotheses, measures of language skills with different developmental rates were administered to cross-sectional samples of disabled and nondisabled readers at three mean ages: 5.5, 8.5, and 11 years. Reading group differences were apparent at each age on measures assumed to develop earlier, thus failing to confirm the first prediction. However, these measures may not have been sensitive to linguistic skills important for beginning reading. Reading group differences on measures of later developing language skills were apparent only for older readers, thus confirming the second prediction. The latter age-dependent relationships provided additional evidence for developmental changes in the linguistic correlates of reading achievement.     

Normative data for eight neuropsychological tests based on a Danish sample

Normative neuropsychological data have been provided using a sample of 101 persons aged 20 to 54 years. Eighty-seven of the subjects were recruited among patients who had undergone minor surgery, and 14 subjects were volunteers from the staff at the hospital laundry. The measures consisted of seven subjects from the WAIS-R, the trail-making test, symbol digit modalities test, auditory-verbal learning test, story recall test, visual gestalt test, recurring figures test, verbal fluency, and Purdue pegboard test. These measures were selected because of suitability in regard to time taken for testing each subject and their sensitivity to subtle changes in neuropsychological functioning. The sample was arbitrarily divided into three age groups, and for each of the three samples, mean, standard deviation, and range were calculated for each test. The results of the Information and Vocabulary subtests from the WAIS-R, education, and social status were applied as independent variables in linear regression analyses where each of the neuropsychological tests, in turn, was the dependent variable. For the oldest age group, age in addition was used as an independent variable. Significant linear relationships, which accounted for an optimal part of the variance, were selected for clinical application.     

Sources of variability in sequelae of very low birth weight.

Few investigations have examined the specificity of sequelae of very low birth weight (VLBW, <1500 g) or sources of variability in outcome. To better understand the nature and determinants of outcome, we assessed neuropsychological and achievement skills at mean age 11 years in 62 children with <750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Distinct cognitive constructs were identified by factor analysis, and the three birthweight groups were compared on these constructs and on composite measures of achievement. Although the group with <750 g birth weight performed less well on all tests than term-born controls, group differences in a perceptual planning factor and in mathematics remained even when IQ was controlled, and deficits were more pronounced in mathematics than in reading. Results from structural equation modeling were consistent with the hypothesis that neuropsychological skills mediated the relationship between birth weight and achievement. The findings confirm the differential deficit hypothesis, support the need to consider multiple sources of variability in VLBW outcomes, and highlight the importance of neuropsychological constructs in developing an explanatory framework.     

Common neuropsychological deficits associated with stroke survivors' impaired performance on a useful field of view test

Useful field of view is a measure of information processing in peripheral vision that has potential for predicting impaired driving performance. The present study was performed to examine whether common neuropsychological deficits resulting from stroke might be associated with useful field of view impairment. 46 stroke survivors had impaired useful field of view test performance when compared to individuals without stroke (t30.6= -4.33, p<.001). The impairments in useful field of view of stroke survivors were associated with impaired peripheral fields, slowed processing speeds, and diminished attention. Such impairment was not localized to lesions in any particular brain area. Results allow the inference that common neuropsychological impairments may have contributed to inefficient extraction of visual information from peripheral vision.     

Sources of Variability in Sequelae of Very Low Birth Weight

Few investigations have examined the specificity of sequelae of very low birth weight (VLBW, &lt;1500 g) or sources of variability in outcome. To better understand the nature and determinants of outcome, we assessed neuropsychological and achievement skills at mean age 11 years in 62 children with &lt;750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Distinct cognitive constructs were identified by factor analysis, and the three birthweight groups were compared on these constructs and on composite measures of achievement. Although the group with &lt;750 g birth weight performed less well on all tests than term-born controls, group differences in a perceptual planning factor and in mathematics remained even when IQ was controlled, and deficits were more pronounced in mathematics than in reading. Results from structural equation modeling were consistent with the hypothesis that neuropsychological skills mediated the relationship between birth weight and achievement. The findings confirm the differential deficit hypothesis, support the need to consider multiple sources of variability in VLBW outcomes, and highlight the importance of neuropsychological constructs in developing an explanatory framework.     

Neuropsychological sequelae following pediatric stroke: A nonlinear model of age at lesion effects

Aim: The distribution and quality of brain recovery following pediatric arterial ischemic stroke remains controversial. The literature suggests that age at stroke may be an important modulator of neuropsychological outcome, with reports inferring either greater vulnerability or plasticity in the nascent brain. Our aim was to investigate neuropsychological outcomes following pediatric stroke in a clinical sample with reference to age at lesion, lesion laterality, elapsed time from stroke to assessment, and persistent neurological sequelae.

Methods: Using comprehensive neuropsychological assessment batteries, we investigated retrospectively a large (n?=?44) and evenly distributed group of children who had ischemic stroke during “infancy” (1 month to 1 year), “early childhood” (1 to 6 years), and “late childhood” (6 to 16 years).

Results: Children who suffered a stroke performed significantly worse on a range of neuropsychological measures when compared to a normative sample. However, children who suffered a stroke between 1 and 6 years old demonstrated better preserved neuropsychological profiles than either the earlier (before age 1) or later (after age 6) age groups. In addition, those children suffering a left hemisphere lesion performed more poorly on a range of neuropsychological measures than did children with right hemisphere lesions.

Interpretation: Age at stroke is an important determinant of recovery following insult and may modulate neuropsychological and cognitive outcome.     

Neuropsychological test norms controlled for physical health: Does it matter?

The objective of the present study was to investigate the effects of physical health on neuropsychological test norms. Medical and neuropsychological data from 118 healthy volunteer controls, aged 26–91 years, were collected during five recruitment occasions. The examinations included a clinical investigation, brain neuroimaging, and a comprehensive neuropsychological test battery. Test‐specific statistical regression‐weights for age, education and gender were calculated to establish preliminary test norms. Hierarchical regression analyses demonstrated that control in addition for physical health moved best performance from age 60 to 65 for abstraction; replaced a plateau above age 70 for verbal fluency, with a continued rise in performance; eliminated significant negative influences of age on auditory learning, spatial reasoning and complex copying; reduced them on wordlist recall, psychomotor speed, visual scanning and mental shifting; and slightly reduced negative influences of low education on most verbal tests, several memory tests, and psychomotor speed, indicating rises in normative scores of up to 0.8 SD at age 80 and 0.4 SD at age 60. No differences were found at age 40. Although the sample size is not adequate to be used for normative data, the findings indicate that norms uncontrolled for health overestimate the negative influence of advanced age and low education, implying a risk of drawing false diagnostic conclusions.     

Maternal Coping Skills as a Moderator Between Depression and Stressful Life Events: Effects on Children's Behavioral Problems in an Intervention Program

In this study, I report secondary analyses using data from the Infant Health and Development Program (IHDP). The IHDP included parent-targeted as well as child-targeted components as an integral part of early intervention programs. I examined three questions: (1) Do the IHDP early intervention services enhance adaptive maternal coping skills? (2) Do maternal coping skills moderate the relationship between stressful life events and maternal depression? (3) Are maternal coping skills associated with children's behavioral scores? Mothers in the treatment group have more adaptive coping skills than follow-up only mothers, and these effects are moderated by maternal characteristics. Adaptive coping skills moderate the effects of negative life events on maternal depression. Adaptive maternal coping skills are significantly associated with fewer behavioral problems for children at age three. These effects are moderated by the intervention. Implications for early intervention programs are discussed.     

Impaired auditory attention skills following middle-ear infections.

The present study investigated auditory attention skills in a sample of children with non-chronic otitis media with effusion (OME). Twenty children with repeated episodes of OME but not found in the need for myringotomy and insertion of ventilating tubes were compared to 20 control children with no known episodes of OME based on parental reports and medical records. Mean age during assessment was 9 years, and none of the children showed signs of impaired language functions and with normal general cognitive abilities. They were assessed with dichotic listening CV-syllables (DLCV-108) free recall and directed attention tasks. The control children showed the expected right ear advantage during free recall and the directed right condition, and demonstrated a shift toward a left ear advantage during the directed left. The children with a history of OME showed a predominant right ear advantage across all three tasks. Although some change in ear accuracy occurred across tasks, impaired auditory attention skills were found following a history of middle ear infections. These results replicate those reported earlier from a sample of children with persistent otitis media with effusion, and suggest that treatment with ventilating tubes does not appear to make any difference in the development of auditory attention skills, whereas occurrence of OME must be considered when testing auditory attentional skills as a part of a neuropsychological assessment.     

A follow-up of cognitive performance and diurnal salivary cortisol changes in former burnout patients

The purpose of this study was to determine whether recovery from burnout is associated with improved cognitive functioning, and whether such improvement is associated with changes in hypothalamic-pituitary-adrenal axis activity and return to work. Forty-five former burnout patients were followed up after 1.5 years with a neuropsychological examination, diurnal salivary cortisol measurements, dexamethasone suppression test (DST), and self-ratings of cognitive problems. At follow-up, improved cognitive performance was observed on several tests of short-term memory and attention. Self-rated cognitive problems decreased considerably, but this decrease was unrelated to the improvement on neuropsychological tests. Diurnal salivary cortisol concentrations at awakening, 30?min after awakening, and in the evening, did not change from baseline to follow-up, nor did the cortisol awakening response. However, slightly, but significantly, stronger suppression of cortisol in response to the DST was observed at follow-up. Improvements in subjective or objective cognitive functioning and changes in diurnal cortisol concentration were unrelated to the extent of work resumption. However, a decreased DST response at follow-up was partially related to improved cognitive performance and work resumption. The clinical implications are that burnout seems to be associated with slight and significantly reversible cognitive impairment, and that self-rated cognitive change during recovery poorly reflects objective cognitive change.     

Neuropsychological Findings in Congenital and Acquired Childhood Hydrocephalus

Hydrocephalus is an increase in cerebrospinal fluid volume that can be caused by a variety of etiologies. The most common connatal and acquired causes of hydrocephalus are spina bifida, aqueduct stenosis, and preterm low birthweight infants with ventricular hemorrhage. In general, the literature suggests mild neuropsychological deficits associated with hydrocephalus, which are predominant in visuospatial and motor functions, and other nonlanguage skills. Although the precise nature of the neuropsychological deficits in hydrocephalus are not completely known, several factors such as etiology, raised intracranial pressure, ventricular size, and changes in gray and white matter tissue composition as well as shunt treatment complications have been shown to influence cognition. In fact, the presence of complications and other brain abnormalities in addition to hydrocephalus such as infections, trauma, intraventricular hemorrhage, low birthweight, and asphyxia are important determinants of the ultimate cognitive status, placing the child at a high risk of cognitive impairment.