Factor structure of the Behavior Rating Inventory of Executive Functions (BRIEF-P) at age three years

The preschool period is an important developmental period for the emergence of cognitive self-regulatory skills or executive functions (EF). To date, evidence regarding the structure of EF in preschool children has supported both unitary and multicomponent models. The aim of the present study was to test the factor structure of early EF as measured by the Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P). BRIEF-P consists of five subscales and three broader indexes, hypothesized to tap into different subcomponents of EF. Parent ratings of EF from a nonreferred sample of children recruited from the Norwegian Mother and Child Cohort Study (N = 1134; age range 37–47 months) were subjected to confirmatory factor analyses (CFA). Three theoretically derived models were assessed; the second-order three-factor model originally proposed by the BRIEF-P authors, a “true” first-order one-factor model and a second-order one-factor model. CFA fit statistics supported the original three-factor solution. However, the difference in fit was marginal between this model and the second-order one-factor model. A follow-up exploratory factor analysis (EFA) supported the existence of several factors underlying EF in early preschool years, with a considerable overlap with the five BRIEF-P subscales. Our results suggest that some differentiation in EF has taken place at age 3 years, which is reflected in behavior ratings. The internal consistency of the BRIEF-P five clinical subscales is supported. Subscale interrelations may, however, differ at this age from those observed in the preschool group as a whole.     

Executive abilities in children with congenital visual impairment in mid-childhood

The role of vision and vision deprivation in the development of executive function (EF) abilities in childhood is little understood; aspects of EF such as initiative, attention orienting, inhibition, planning and performance monitoring are often measured through visual tasks. Studying the development and integrity of EF abilities in children with congenital visual impairment (VI) may provide important insights into the development of EF and also its possible relationship with vision and non-visual senses. The current study investigates non-visual EF abilities in 18 school-age children of average verbal intelligence with VI of differing levels of severity arising from congenital disorders affecting the eye, retina, or anterior optic nerve. Standard auditory neuropsychological assessments of sustained and divided attention, phonemic, semantic and switching verbal fluency, verbal working memory, and ratings of everyday executive abilities by parents were undertaken. Executive skills were compared to age-matched typically-sighted (TS) typically-developing children and across levels of vision (mild to moderate VI [MVI] or severe to profound VI [SPVI]). The results do not indicate significant differences or deficits on direct assessments of verbal and auditory EF between the groups. However, parent ratings suggest difficulties with everyday executive abilities, with the greatest difficulties in those with SPVI. The findings are discussed as possibly reflecting increased demands of behavioral executive skills for children with VI in everyday situations despite auditory and verbal EF abilities in the typical range for their age. These findings have potential implications for clinical and educational practices.     

Pregnancy hypertension and the risk for neuropsychological difficulties across early development: A brief report

Despite documented effects on fetal brain development, little is currently known about the relationship between maternal pregnancy hypertension and child neuropsychological outcomes. This brief report examined the association between maternal hypertension during pregnancy and children’s social cognition and executive functioning when children were 18 months, 3 years, and 4.5 years. A community sample of 501 families (23 hypertensive mothers; 478 nonhypertensive) was recruited when children were newborns. Social cognition (including theory of mind [ToM]) and executive functioning (EF) were measured using a battery of age-appropriate standardized and/or observational tasks. Information on pregnancy and prenatal factors were measured via maternal report when children were newborns. After controlling for prenatal and demographic covariates, the presence of hypertension difficulties during pregnancy was associated with all measures of social cognition, ToM, and EF. A secondary analysis comparing the hypertension group (n = 23) to a nonhypertensive matched control group (n = 23) supported the effect of pregnancy hypertension on children’s social-cognitive and EF development. Future studies using obstetrical records are encouraged based on these preliminary findings.     

The Role of Language in Temporal Cognition in 6- to 10-Year-Old Children

The ability to recognize temporal patterns and position events in time emerges during the preschool years and is refined in middle childhood. This study explored individual differences in temporal cognition in relation to verbal and nonverbal abilities. Children (30 boys, 32 girls; M_age = 8;2, age range = 6;0?10;8) completed 3 temporal-cognition tasks measuring estimation of temporal distance (how far events are from the present), knowledge of conventional times of events (specific days or months of events), and flexibility in using the calendar system (arranging nonconsecutive months in order), along with assessments of nonverbal intelligence, verbal short-term memory, visual-spatial working memory, receptive vocabulary, receptive grammar, and reading mastery. Controlling for age, performance across temporal-cognition tasks correlated with language abilities; nonverbal abilities accounted for little to no additional variance. The findings link language skills with the acquisition of conventional time patterns; such patterns developed alongside the ability to gauge distances of events in the past or future and form an organized timeline.     

Receptive vocabulary and semantic knowledge in children with SLI and children with Down syndrome

Receptive vocabulary and associated semantic knowledge were compared within and between groups of children with specific language impairment (SLI), children with Down syndrome (DS), and typically developing children. To overcome the potential confounding effects of speech or language difficulties on verbal tests of semantic knowledge, a novel task was devised based on picture-based semantic association tests used to assess adult patients with semantic dementia. Receptive vocabulary, measured by word-picture matching, of children with SLI was weak relative to chronological age and to nonverbal mental age but their semantic knowledge, probed across the same lexical items, did not differ significantly from that of vocabulary-matched typically developing children. By contrast, although receptive vocabulary of children with DS was a relative strength compared to nonverbal cognitive abilities (p < .0001), DS was associated with a significant deficit in semantic knowledge (p < .0001) indicative of dissociation between word-picture matching vocabulary and depth of semantic knowledge. Overall, these data challenge the integrity of semantic-conceptual development in DS and imply that contemporary theories of semantic cognition should also seek to incorporate evidence from atypical conceptual development.     

Caregiver ratings and performance-based indices of executive function among preschoolers with and without maltreatment experience

Despite the well-documented impact of early maltreatment on children’s executive function (EF), there has been limited consensus about how to best assess this neurocognitive domain in high-risk, vulnerable preschool-aged children. Relevant studies have generally utilized either performance-based tests or caregiver ratings of EF, yet multi-method research has been rare. This study examined the EF profiles of preschoolers exposed to maltreatment, as indexed by the Behavior Rating Inventory of Executive function – Preschool Version (BRIEF-P), and investigated associations between caregiver ratings and performance-based measures (Happy–Sad Stroop, Tapping Test, and Dimensional Change Card Sort – DCCS) of EF in this population. Maltreatment status was further tested as a moderator of associations between these measures. Participants were (n = 107) children aged 4–5 years (M = 4.75; SD = 0.57; 39% female), with various levels of exposure to maltreatment. Children exposed to maltreatment were found to exhibit significantly more caregiver-rated deficits in EF than non-maltreated children, with greater fluctuations apparent across all scales of the BRIEF-P. Consistent with previous research in neurologically impaired children, there were only limited and weak to moderate correlations between BRIEF-P scales and performance-based measures of EF. Furthermore, maltreatment status was found to moderate the association between scores on the BRIEF-P Inhibit Scale and the DCCS, such that the association between these indices was weaker among children exposed to higher levels of maltreatment.     

A longitudinal model of executive function development from birth through adolescence in children born very or extremely preterm

Executive function deficits are often reported as a specific weakness in preterm children. Yet, executive function development is still not fully understood. In a prospective longitudinal study, 115 preterm born children, ≤31 weeks of gestation, were recruited at birth and subject to neuropsychological assessments at ages 5.5 and 18 years. By applying Miyake and colleagues’ integrative framework of executive function to our data, two core components of executive function, working memory and cognitive flexibility, were identified through confirmatory factor analysis. Developmental stability was investigated in a serial multiple mediator structural equation model. Biological, medical, and social factors as well as mental development at 10 months were entered as predictors. Both components of executive function were highly stable from 5.5 to 18 years. Gestational age, intrauterine growth, lack of perinatal medical complications, and female sex were positively related to mental development at 10 months, which together with parental education influenced both core executive functions at 5.5 years. Working memory at 5.5 years mediated outcome in working memory at 18 years. In addition to the mediation of cognitive flexibility at 5.5 years, perinatal medical complications and restricted intrauterine growth had a continued direct negative impact on cognitive flexibility at 18 years. The application of a theoretical framework added to our understanding of executive function development in preterm born children. The study supports early identification of executive deficits among children born preterm, as deficits are unlikely to diminish with maturation.     

Structure and continuity of intellectual development in early childhood

We evaluated over 200 participants semiannually from 12 to 48 months of age on measures of intellectual (Bayley Scales, Stanford–Binet Scale) and verbal (MacArthur–Bates Inventory, Peabody Picture Vocabulary Test) status. Structural equation modeling and hierarchical linear (growth curve) analyses were applied to address the nature of development and individual differences during this time. Structural analyses showed a strong and robust simplex model from infancy to the preschool period, with no evidence of qualitative reorganizations or discontinuities. Growth-curve modeling revealed significant associations between level factors across the early and later measures of cognition, providing further evidence of continuity; the growth trajectory from the Bayley through 24 months predicted growth in a nonverbal factor, but not in a verbal factor. Altogether, the findings reveal continuous and stable development in intellectual function from late infancy through the preschool years. Additionally, the high level of continuity demonstrated across these ages was observed to be largely independent of growth in vocabulary.     

Cognitive and emotional aspects of self-regulation in preschoolers

The goal of the present study was to examine the contribution of executive function (EF) and social cognition to individual differences in emotion regulation (ER) in preschool children. Sixty 3-, 4-, and 5-year-old children were administered a battery of EF tasks, two theory of mind tasks, a measure of verbal ability, and an ER task. In addition, parents completed the Behavior Rating Inventory of Executive Functioning—Preschool Version (BRIEF-P). Performance on the theory of mind tasks as well as parental ratings of executive function was not related to performance on the ER task. However, a component of EF (i.e., inhibition) approached significance with children's displays of positive behaviors during the ER task. Verbal ability was related to the regulation of positive but not negative emotions. Parental ratings of shifting accounted for a significant amount of variance in parental ratings of ER, even after controlling for verbal ability. The findings are discussed in the context of different conceptualizations of the developmental relation between ER and EF.     

The Relation Between Executive Function and Theory of Mind is More Than Skin Deep

A simple “expression” account of the relation between executive function (EF) and children's developing theory of mind (ToM) has difficulty accounting for the generality of the changes occurring in children's mental-state understanding during the preschool years. The current study of preschool children (N = 43) showed that EF—especially conflict EF—related uniformly to ToM measures that imposed either high or low executive demands, independent of verbal ability. These findings can be explained within an emergence account wherein executive skills are implicated in the acquisition of mental-state concepts as opposed to merely the expression of these concepts in task performance.     

Executive functioning deficits in preschool children with Fetal Alcohol Spectrum Disorders

Executive function (EF) deficit is a hallmark of Fetal Alcohol Spectrum Disorders (FASD), but the vast majority of available evidence comes from school-age children and adolescents. Very little is known about EF during the critical developmental period prior to 6 years of age in FASD. We evaluated EF in 39 children with FASD (3.0–5.5 years) and a comparison group of 50 age-matched, nonexposed controls. Measures included the EF Scale for Early Childhood and a Delay of Gratification task. Compared to age-matched controls, preschool children with FASD had impairments on the EF Scale and showed more impulsivity on the Delay of Gratification task. To confirm the EF Scale finding, FASD group performance was compared to a separate normative dataset (N = 1,400). Those with FASD performed below normal (M = –0.57, SD = 0.92). Within the FASD group, IQ was correlated with the EF Scale (partial r = .60, p = .001) and Delay of Gratification (partial r = .58, p = .005). EF Scale performance did not differ significantly across levels of FASD severity (fetal alcohol syndrome [FAS], partial FAS, or alcohol-related neurobehavioral disorder [ARND]). However, compared to normative data, those with FAS had the largest deficits (M = –0.91 SD from the mean, SE = 0.23), followed by partial FAS (M = –0.66 SD from the mean, SE = 0.26), then ARND (M = –0.36 SD from the mean, SE = 0.20). These novel data show that EF deficits manifest well before the age of 6 years in children with FASD, that they occur across the spectrum, and that EF may be most impaired in children with more severe forms of FASD and/or lower IQs.     

Genetic and Environmental Influences on the Development and Stability of Executive Functions in Children of Preschool Age: A Longitudinal Study of Japanese Twins

Executive functions (EF) are an important predictor of later adaptive development. A number of environmental influences, such as parenting, have been suggested as important promoters of EF development. However, behavioural genetic research has demonstrated that many environmental influences could be affected by genetic influences. Therefore, it is important to consider genetic variations when investigating environmental influences on EF development in children. To date, few studies have used genetically informative designs to assess the etiology of EF development during the preschool years, a period of rapid development. As a result, it remains unclear how and to what extent the environmental influences that are not confounded by genetic influences affect EF development during this developmental period. The present study explored EF development during the preschool years using a longitudinal and genetically informative design and a non‐Western population. Japanese twins were visited at their homes and individually tested on EF measures at 24, 36, and 48 months of age. Phenotypic correlations and confirmatory factor analyses suggested that EF are less cohesive at 24 months of age and emerge as a common single factor at 36 and 48 months. Additionally, longitudinal and multivariate behavioural genetic analyses indicated that the EF developmental change during this period is promoted by both shared and nonshared environmental influences as well as genetic influences, while EF stability is brought about by shared environments. The present findings elucidated the etiology of EF development during the preschool years and confirmed that this period is an important transitional stage for EF development. Copyright © 2016 John Wiley & Sons, Ltd.     

Continuous executive function disruption interferes with application of an information integration categorization strategy

Category learning is often characterized as being supported by two separate learning systems. A verbal system learns rule-defined (RD) categories that can be described using a verbal rule and relies on executive functions (EFs) to learn via hypothesis testing. A nonverbal system learns non-rule-defined (NRD) categories that cannot be described by a verbal rule and uses automatic, procedural learning. The verbal system is dominant in that adults tend to use it during initial learning but may switch to the nonverbal system when the verbal system is unsuccessful. The nonverbal system has traditionally been thought to operate independently of EFs, but recent studies suggest that EFs may play a role in the nonverbal system—specifically, to facilitate the transition away from the verbal system. Accordingly, continuously interfering with EFs during the categorization process, so that EFs are never fully available to facilitate the transition, may be more detrimental to the nonverbal system than is temporary EF interference. Participants learned an NRD or an RD category while EFs were untaxed, taxed temporarily, or taxed continuously. When EFs were continuously taxed during NRD categorization, participants were less likely to use a nonverbal categorization strategy than when EFs were temporarily taxed, suggesting that when EFs were unavailable, the transition to the nonverbal system was hindered. For the verbal system, temporary and continuous interference had similar effects on categorization performance and on strategy use, illustrating that EFs play an important but different role in each of the category-learning systems.     

Common mechanisms of executive attention underlie executive function and effortful control in children

Executive Function (EF) and Effortful Control (EC) have traditionally been viewed as distinct constructs related to cognition and temperament during development. More recently, EF and EC have been implicated in top‐down self‐regulation ‐ the goal‐directed control of cognition, emotion, and behavior. We propose that executive attention, a limited‐capacity attentional resource subserving goal‐directed cognition and behavior, is the common cognitive mechanism underlying the self‐regulatory capacities captured by EF and EC. We addressed three related questions: (a) Do behavioral ratings of EF and EC represent the same self‐regulation construct? (b) Is this self‐regulation construct explained by a common executive attention factor as measured by performance on cognitive tasks? and (c) Does the executive attention factor explain additional variance in attention deficit hyperactivity disorder (ADHD) problems to behavioral ratings of self‐regulation? Measures of performance on complex span, general intelligence, and response inhibition tasks were obtained from 136 preadolescent children (M = 11 years, 10 months, SD = 8 months), along with self‐ and parent‐reported EC, and parent‐reported EF, and ADHD problems. Results from structural equation modeling demonstrated that behavioral ratings of EF and EC measured the same self‐regulation construct. Cognitive tasks measured a common executive attention factor that significantly explained 30% of the variance in behavioral ratings of self‐regulation. Executive attention failed to significantly explain additional variance in ADHD problems beyond that explained by behavioral ratings of self‐regulation. These findings raise questions about the utility of task‐based cognitive measures in research and clinical assessment of self‐regulation and psychopathology in developmental samples.     

Representation and working memory in early arithmetic

Working memory has been implicated in the early acquisition of arithmetic skill, but the relations among different components of working memory, performance on different types of arithmetic problems, and development have not been explored. Preschool and Grade 1 children completed measures of phonological, visual-spatial, and central executive working memory, as well as nonverbal and verbal arithmetic problems, some of which included irrelevant information. For preschool children, accuracy was higher on nonverbal problems than on verbal problems, and the best and only unique predictor of performance on the standard nonverbal problems was visual-spatial working memory. This finding is consistent with the view that most preschoolers use a mental model for arithmetic that requires visual-spatial working memory. For Grade 1 children, performance was equivalent on nonverbal and verbal problems, and phonological working memory was the best predictor of performance on standard verbal problems. For both age groups, problems with added irrelevant information were substantially more difficult than standard problems, and in some cases measures of the central executive predicted performance. Assessing performance on different components of working memory in conjunction with different types of arithmetic problems provided new insights into the developing relations between working memory and how children do arithmetic.     

Social support and verbal interaction are differentially associated with cognitive function in midlife and older age

Social engagement is associated with healthy aging and preserved cognition. Two dimensions of engagement, verbal interactions and perceived support, likely impact cognition via distinct mechanistic pathways. We explored the cognitive benefit of each construct among enrollees (N = 1,052, mean age = 60.2 years) in the Wisconsin Registry for Alzheimer’s Prevention study, who provide neuropsychological and sociobehavioral data at two-year intervals. Outcomes included six cognitive factor scores representing key domains of executive function and memory. Key predictors included self-reported perceived social support and weekly verbal interaction. Results indicated that after adjusting for lifestyle covariates, social support was positively associated with Speed and Flexibility and that verbal interactions were associated with Verbal Learning and Memory. These findings suggest that support, which may buffer stress, and verbal interaction, an accessible, aging-friendly form of environmental enrichment, are uniquely beneficial. Both are integral in the design of clinical and community interventions and programs that promote successful aging.     

Complementary assessments of executive function in preterm and full-term preschoolers

Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children’s EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children’s adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children’s EF profiles and to customize treatment.     

Glycosylated Hemoglobin Level,Race/Ethnicity,and Cognition in Midlife and Early Old Age

Empirical evidence linking racial/ethnic differences in glycosylated hemoglobin levels (HbA1c) to cognitive function in midlife and early old age is limited. We use biomarker data from the Health and Retirement Study (HRS, 2006–2014), on adults 50–64 years at baseline (57–73 years by 2014), and fit multinomial logistic regression models to assess the association between baseline HbA1c, cognitive function (using Langa–Weir classifications) and mortality across 8 years. Additionally, we test for modification effects by race/ethnicity. In age- and sex-adjusted models high HbA1c level was associated with lower baseline cognition and higher relative risk ratios (RRR; vs. normal cognition) for cognitive impairment no dementia (CIND; RRR = 2.3; 95%CI = [1.38;3.84]; p < .01), and dementia (RRR = 4.00; 95%CI = [1.76;9.10]; p < .01). Adjusting for sociodemographic, behavioral risk factors, and other health conditions explained the higher RRR for CIND and attenuated the RRR for dementia by approximately 30%. HbA1c levels were not linked to the slope of cognitive decline, and we found no evidence of modification effects for HbA1c by race/ethnicity. Targeting interventions for glycemic control in the critical midlife period can protect baseline cognition and buffer against downstream development of cognitive impairment. This can yield important public health benefits and reductions in burdens associated with cognitive impairment, particularly among race/ethnic minorities who are at higher risk for metabolic diseases.     

What's mom got to do with it? Contributions of maternal executive function and caregiving to the development of executive function across early childhood

Executive functions (EFs; e.g. working memory, inhibitory control) are mediated by the prefrontal cortex and associated with optimal cognitive and socio‐emotional development. This study provides the first concurrent analysis of the relative contributions of maternal EF and caregiving to child EF. A group of children and their mothers (n = 62) completed age‐appropriate interaction (10, 24, 36 months) and EF tasks (child: 24, 36, and 48 months). Regression analyses revealed that by 36 months of age, maternal EF and negative caregiving behaviors accounted for unique variance in child EF, above and beyond maternal education and child verbal ability. These findings were confirmed when using an early child EF composite‐our most reliable measure of EF – and a similar pattern was found when controlling for stability in child EF. Furthermore, there was evidence that maternal EF had significant indirect effects on changes in child EF through maternal caregiving. At 24 months, EF was associated with maternal EF, but not negative caregiving behaviors. Taken together, these findings suggest that links between negative caregiving and child EF are increasingly manifested during early childhood. Although maternal EF and negative caregiving are related, they provide unique information about the development of child EF. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=NPKXFbbrkps     

Individual cognitive patterns and developmental trajectories after preterm birth

Cognitive outcome after preterm birth is heterogeneous, and group level analyses may disguise individual variability in development. Using a person-oriented approach, this study investigated individual cognitive patterns and developmental trajectories from preschool age to late adolescence. As part of a prospective longitudinal study, 118 adolescents born preterm, with a birth weight < 1,500 g, participated in neuropsychological assessments at age 5½ years and at 18 years. At each age, four cognitive indices, two tapping general ability and two tapping executive functions, were formed to reflect each individual’s cognitive profile. Cluster analyses were performed at each age separately, and individual movements between clusters across time were investigated. At both 5½ and 18 years, six distinct, and similar, cognitive patterns were identified. Executive functions were a weakness for some but not all subgroups, and verbal ability was a strength primarily among those whose overall performance fell within the normal range. Overall, cognitive ability at 5½ years was highly predictive of ability at age 18. Those who performed at low levels at 5½ years did not catch up but rather deteriorated in relative performance. Over half of the individuals who performed above the norm at 5½ years improved their relative performance by age 18. Among those performing around the norm at 5½ years, half improved their relative performance over time, whereas the other half faced increased problems, indicating a need for further developmental monitoring. Perinatal factors were not conclusively related to outcome, stressing the need for cognitive follow-up assessment of the preterm-born child before school entry.