Neurocognitive impairment in early adolescence following prenatal alcohol exposure of varying duration.

The aims of the study were, first, to perform a comprehensive assessment of neurocognitive status in early adolescence of children exposed to alcohol prenatally; and, second, to examine whether duration of exposure continues to be predictive of outcome at this age. Twenty-seven exposed 12-14-year-olds and 39 non-exposed 13-14-year-olds underwent neuropsychological assessments (WISC-III, NEPSY subtests) of attention and executive functions, language, visuomotor functions, and memory. The group of non-exposed children was used to develop preliminary test norms for the 13-14-year-old exposed children whereas published test norms could be used for the 12-year-olds. The results demonstrated neurocognitive impairment across all types of tasks. Impairment varied in degree according to the duration of alcohol exposure. Children exposed throughout pregnancy, most of who had diagnoses of Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), performed well below the average range. It was concluded that the neurocognitive effects of alcohol exposure tend to be widespread and generalized. Attention and executive functions do not seem to be selectively affected. Further, the relationship between duration of prenatal alcohol exposure and neurocognitive development continues to be significant in early adolescence.     

Neuropsychological Effects at Early School Age of Fetal Alcohol Exposure of Varying Duration

A comprehensive neuropsychological assessment was performed with forty-six 5- to 9-year-old children exposed to alcohol in utero for varying durations. The children were subdivided according to duration of maternal alcohol abuse, as follows: during trimester I (n = 16), during trimesters I and II (n = 16), and throughout pregnancy (n = 14). A control group (n = 26) consisted of unexposed children. Fetal alcohol exposure throughout pregnancy had significant, diffuse effects on the development of the children, whereas exposure only during early pregnancy did not. Observed cognitive deficits included problems in naming, receptive language, attention, and visual-motor functions. Verbal and visual memory and manual motor precision did not significantly differ between the groups.     

Higher functioning children with prenatal alcohol exposure: Is there a specific neurocognitive profile?

Recent attempts to identify a neurocognitive profile of children with prenatal alcohol exposure (PAE) have led to an emerging “generalized deficit” conceptualization marked by diffuse information processing and integration difficulties as opposed to a specific profile. This study examines whether this conceptualization can be extended to higher functioning children with PAE who are without intellectual disability and addresses several limitations of previous research. One hundred twenty-five children aged 6–12 years with social skills deficits, 97 of whom met diagnostic criteria for a Fetal Alcohol Spectrum Disorder (FASD), underwent a comprehensive, multi-informant assessment of neurocognitive, emotional, social, behavioral, and adaptive functioning. Multivariate analyses of variance examined differences in functioning between the PAE group and a nonexposed comparison group with and without controlling for child IQ. Results indicated that the PAE group returned significantly poorer scores than the nonexposed group on every construct assessed, including executive functioning, attention, working/visuospatial memory, linguistic abstraction, adaptive behavior, emotional/behavioral functioning, and social cognition. These differences largely maintained after controlling for IQ and were similar regardless of informant, although teachers reported somewhat fewer group differences. Within the PAE group, no differences were found across FASD subtypes. These results provide evidence extending the emerging generalized deficit conceptualization of children with PAE to those higher functioning individuals without global intellectual disability.     

Biopsychosocial Influences That Promote and Impede Social Brain Maturation

ABSTRACT

Social, emotional, and executive function systems of the brain change greatly during adolescence as the result of biopsychosocial influences. These factors alter the course of adolescent behavior through effects on the component processes of social behavior. Specifically, the influences of chronic stress, social and economic adversity, alcohol and drugs, and brain injury as well as parental buffering and support, increased neural connectivity and mentalizing resources, and enriched environments can impede or promote maturation of the social and executive brain networks that regulate social adjustment and emotional expression. Hence, there are many early “windows of opportunity” to affect the biological and neurocognitive foundations of adolescent social executive functions such as empathy, theory of mind, self-monitoring, and social emotions.     

What Does Diffusion Tensor Imaging Reveal About the Brain and Cognition in Fetal Alcohol Spectrum Disorders?

Over the past 5 years, Diffusion Tensor Imaging (DTI) has begun to provide new evidence about the effects of prenatal alcohol exposure on white matter development. DTI, which examines microstructural tissue integrity, is sensitive to more subtle white matter abnormalities than traditional volumetric MRI methods. Thus far, the available DTI data suggest that white matter microstructural abnormalities fall on a continuum of severity in Fetal Alcohol Spectrum Disorder (FASD). Abnormalities are prominent in the corpus callosum, but also evident in major anterior-posterior fiber bundles, corticospinal tracts, and cerebellum. These subtle abnormalities are correlated with neurocognitive deficits, especially in processing speed, non-verbal ability, and executive functioning. Future studies using larger samples, increasingly sophisticated DTI methods, and additional functional MRI connectivity measures will better characterize the full range of abnormalities in FASD. Ultimately, these measures may serve as indices of change in future longitudinal studies and in studies of interventions for FASD.     

Development of norms for executive functions in typically-developing Indian urban preschool children and its association with nutritional status

Executive functions (EFs) are essential and important for achieving success in children’s everyday lives and play a fundamental role in children’s cognitive, academic, social, emotional and behavioral functioning. A cross-sectional study was carried out to develop age- and sex-specific norms for EFs using the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P) among 2- to 5-year-olds from urban Bangalore, India. In addition, the association between EFs and anthropometric measures, a marker of nutritional status, is also examined. Primary caregivers of 412 children, equally distributed by age and sex, participated. Raw scores for each domain and indices were converted to standard t-scores and percentiles were computed. A t-score at or above 63 corresponding to the 90th percentile was considered as the cutoff for executive dysfunction in this sample. The prevalence of executive dysfunction is 10% based on the Global Executive Composite score of the BRIEF-P. The cutoff score for identifying executive dysfunction using existing United States (US) norms is higher compared to the cutoff score obtained in the current study. Therefore, using US norms for Indian children could result in the prevalence of executive dysfunction been underestimated. Multiple linear regression analysis revealed that stunted and underweight children have significantly elevated EF scores after adjusting for age, sex and socioeconomic status (SES; p < .01). A greater understanding of EFs in preschool children is important for the early identification of executive dysfunction and implementing interventions to improve their future prospects. This study also shows that undernourished children are more likely to have executive dysfunction.     

Neurocognitive development in 5- to 16-year-old North American children: A cross-sectional study

Executive functions are thought to be the latest functions to mature. However, this view has not been tested by assessing simultaneously memory, perception of emotions, visuospatial perception, and visuoconstructional skills. NEPSY II norm data from 1000 5- to 16-year-old U.S. children were obtained. Fifteen NEPSY II subtests with no floor or ceiling effects in any age group and no major changes in task type were selected. The 16-year level was attained at age 12 to 13 in all subtests with two exceptions: social perception (age 10 to 11) and narrative memory (age 14). Trend analyses showed that development was rapid in the age range 5 to 9 years followed by a deceleration in the rate of development. Peak performances were reached at 14 to 16 years but later in some subtests representing executive functions, verbal memory, and visuospatial performance. Thus, the study specified developmental time tables of neurocognitive functions. It demonstrated that not only executive functions but also verbal memory and visuospatial performance continue to develop beyond age 16.     

Portuguese category norms for children

This study presents Portuguese category norms for children of three different age groups: preschoolers (3- to 4-year-olds), second graders (7- to 8-year-olds), and preadolescents (11- to 12-year-olds). Three hundred Portuguese children (100 in each group) completed an exemplar-generation task. Preschoolers generated exemplars for 13 categories, second graders generated exemplars for 17 categories, and preadolescents generated exemplars for 21 categories. For each group, responses within each category were organized according to frequency of production in order to derive exemplar-production norms for sets of tested categories. The results also included information about the number of responses and exemplars, idiosyncratic and inappropriate responses, and commonality and diversity indexes for all the categories. A comparison of these children's norms with the Portuguese adult norms was also presented. The full set of norms may be downloaded from www.psychonomic.org/archive.     

Cognitive and attentional functioning in adolescents and young adults with Tetralogy of Fallot and d-transposition of the great arteries

The objective of this study is to investigate cognitive and attentional function in adolescents and young adults with operated congenital heart disease. Previous research has indicated that children with congenital heart disease have deficits in broad areas of cognitive function. However, less attention has been given to survivors as they grow into adolescence and early adulthood. The participants were 18 non-syndromic adolescents and young adults with tetralogy of Fallot and d-transposition of the great arteries that required cardiac surgery before the age of 5 years, and 18 healthy, unaffected siblings (11–22 years of age for both groups). Cases with congenital heart disease and their siblings were administered Wechsler Intelligence scales and reported attention problems using the Achenbach System of Empirically Based Assessments. Cases were compared to both healthy siblings and established norms. Cases performed significantly lower than siblings on full scale IQ and processing speed, and significantly lower than norms on perceptual reasoning. Cases also reported more attention problems compared to both siblings and norms. Effect sizes varied with medium-to-large effects for processing speed, perceptual reasoning, working memory, and attention problems. Findings suggest that neurocognitive function may continue to be affected for congenital heart disease survivors in adolescence and young adulthood, and that comparisons to established norms may underestimate neurocognitive vulnerabilities.     

Behavior Problems in Children Adopted from Psychosocially Depriving Institutions

Behavior problems were investigated in 342 6- to 18-year-old children adopted from psychosocially depriving Russian institutions that provided adequate physical resources but not consistent, responsive caregiving. Results indicated that attention and externalizing problems were the most prevalent types of behavior problems in the sample as a whole. Behavior problem rates increased with age at adoption, such that children adopted at 18 months or older had higher rates than never-institutionalized children but younger-adopted children did not. There was a stronger association between age at adoption and behavior problems during adolescence than at younger ages at assessment. Children adopted from psychosocially depriving institutions had lower behavior problem rates than children adopted from severely depriving Romanian institutions in the 1990s. The implications of these results are that early psychosocial deprivation is associated with behavior problems, children exposed to prolonged early deprivation may be especially vulnerable to the developmental stresses of adolescence, and severe institutional deprivation is associated with a higher percentage of behavior problems after a shorter duration of exposure.     

Recollection improves with age: children’s and adults’ accounts of their childhood experiences

ABSTRACT

Since the time of Freud, psychologists have drawn conclusions about children’s memory on the basis of retrospective research with adults. Here, we turn the tables by examining what prospective studies with children and adolescents can tell us about the retrospective memory accounts provided by adults. Adults were interviewed about recent events and events from different points during their childhood (Age 5, Age 10) and early adolescence (Age 13). Children (5- and 8- to 9-year-olds) and young adolescents (12- to 13-year-olds) were interviewed about recent events. When matched for age at the time of encoding, adults recalled more about the target events than did 5-year-olds, even though the retention interval for adults was substantially longer. We conclude that retrospective studies with adults may lead researchers to overestimate the content of the early childhood memories that survive. We discuss the theoretical implications of these findings for an understanding of memory development and the practical implications for the interpretation of adults’ retrospective accounts in the courtroom.     

Neurological subtle signs and cognitive development: A study in late childhood and adolescence

Introduction and Aim: Neurological subtle signs (NSS) are often observed during the neurological examination of children and tend to disappear with age. Their persistence into late adolescence or young adulthood has been related to psychiatric and neurocognitive disorders. To provide a better understanding of their functional basis, a longitudinal correlational study with neurocognitive measurements was performed.

Method: We conducted multiple regression and correlation analyses of NSS with demographic and cognitive measures on a subset of 341 healthy children (56% males), taking part in a longitudinal dental study. Participants, whose ages ranged between 11–15 years, at first evaluation, undertook yearly, during 5 years, a 6-item NSS exam (producing a total score ranging between 0–18) and a comprehensive battery of neurocognitive tests. Effects of age, gender, IQ, and 7 neurocognitive factors on NSS were analyzed.

Results: Over the years, NSS scores correlated consistently with selective attention (Stroop test), motor speed (finger tapping), and visuomotor speed (pegboard speed).

Discussion: These results suggest that the disappearance of NSS in late childhood and adolescence occurs primarily in parallel with the development of motor and visuomotor functions and secondarily in relation to higher order functions such as selective attention (Stroop) and executive control (B-A Trails difference).     

Violence Exposure and the Development of School-Related Functioning: Mental Health, Neurocognition, and Learning

The relation between history of violence exposure and the development of academic and mental health problems is explored. Violence exposed children have an increased risk of developing school-related problems including: mental health problems, learning disabilities, language impairments, and other neurocognitive problems. These problems interact to create a complex web of deficits and disabilities where intervention access points are difficult to assess. Often mental health problems and academic problems develop in parallel. Timing of violence exposure and the developmental stage of the child during exposure complicate our understanding of the underlying mechanism. A model is presented that explores pathways linking violence exposure to aspects of school-related functioning, both academically and behaviorally. Early life stress, in the form of violence exposure, is related to neurocognitive deficits, including executive functioning and problems in self-regulation. Deficits in self-regulation at the level of behavior, and cognitive control and executive functioning, at the level of brain processing, are related to both academic and mental health problems, suggesting a possible psychological mechanism. Biological mechanisms are also included in the model to illustrate the contribution of the stress response, neuroendocrine system response, and neuroanatomical structural and functional impairments associated with violence exposure.     

Intervention Induced Changes in Perceptions of Parenting and Risk Opportunities Among Rural African American

A randomized prevention trial was conducted contrasting families who took part in the Strong African American Families Program (SAAF), a preventive intervention for rural African American parents and their 11-year-olds, with control families. The trial, which included 671 families, indicated that intervention-induced changes occurred in intervention-targeted parenting and youth behavior, as well as youth initiation of alcohol use and sexual activity. Four waves of data collected were obtained at pretest, 3-month post-test, 29 month long-term follow up; and 65 month long-term follow up. Three data points were selected and analyzed in the current study: pretest, post-test, and 65 month long-term follow up to capture the sustainability of SAAF during three critical developmental stages—middle childhood, early adolescence, and late adolescence. Intervention-induced changes in parenting mediated the effect of intervention-group influences on changes in the onset and escalation of alcohol use and sexual activity over 65 months through its positive influence on youths’ perceptions and internalization of parental norms and resistance to engaging in risk opportunities. These findings highlight the potential for family-based prevention programs to enhance positive developmental outcomes to reduce HIV-related risk behaviors among rural African American youth.     

Prenatal cigarette exposure and infant learning stimulation as predictors of cognitive control in childhood

Prenatal exposures to neurotoxins and postnatal parenting practices have been shown to independently predict variations in the cognitive development and emotional-behavioral well-being of infants and children. We examined the independent contributions of prenatal cigarette exposure and infant learning stimulation, as well as their inter-relationships in predicting variations in the proficiency of executive attention, a core element of cognitive control and self-regulation. Participants were an ethnic-racially, socio-economically diverse sample of 249 children followed from birth in the Project on Human Development in Chicago Neighborhoods. We obtained histories of prenatal exposure to alcohol, cigarettes, and other drugs, and we assessed socio-economic status and learning stimulation during a home visit when the participants were infants. In childhood we utilized the Attention Networks Test to assess the proficiency of executive attention during two home visits, one year apart. Accounting for age, SES, prenatal alcohol exposure, and baseline performance, we found that prenatal cigarette exposure impaired the speed of executive attention. Infant learning stimulation mitigated these effects, and predicted better accuracy of executive attention as well, suggestive of both protective and health promoting effects. Effect sizes for these relations, whether examined independently or by their inter-relationships, were comparable to if not greater in magnitude than the effects of age on speed and accuracy, highlighting the importance of these very early experiences in shaping the proficiency of self-regulation. Since executive attention is central to cognitive control and self-regulation, previously described relations between prenatal cigarette exposure, parenting practices, and some forms of childhood psychopathology may be contingent on how early learning stimulation contributes to the proficiency of executive attention through direct and indirect effects. Furthermore, considering the prolonged developmental trajectory of executive attention, interventions to support provision of learning stimulation may mitigate poor outcomes for some at-risk children by promoting development of more proficient executive attention.     

Potential consequences of abandonment in preschool-age: Neuropsychological findings in institutionalized children

Objective: Several longitudinal studies had shown that early deprivation and institutionalization during the first six months of life affects the emotional, cognitive, social and neurophysiologic development. Nevertheless, our understanding of possible similar effects of delayed institutionalization, in preschool-age remains unclear to this day. The goal of this study is to evaluate the cognitive performance of institutionalized children with history of preschool-age physical abandonment. Method: 18 male institutionalized children with history of abandonment during the preschool-age (2-5 years old) and comparison group matched by age, handedness, gender, educational and socioeconomic level were tested on multiple tasks of attention, memory and executive functions. Results: We found a cognitive impairment in the institutionalized children in several measures of attention, memory and executive functions. This is the first report of cognitive impairment related to late abandonment and institutionalization effects (after 2 years old), extending the already known effects on early institutionalization. Conclusions: This preliminary study suggests that environmental factors including abandonment and institutional care, can affect not only the infancy period, but also the preschool period providing new insights into our understanding of neurocognitive development.     

Familiarity and attraction to stimuli: Developmental change or methodological artifact?

One hundred thirteen 7-, 9-, and 11-year-old children viewed a series of stimuli consisting of Chinese characters exposed a different number of times. Following exposure to the stimuli, children ranked the stimuli according to liking. Seven- and 9-year-olds preferred the more familiar characters to those seen less frequently, but the oldest children preferred novel stimuli. In rankings taken 3 weeks after original exposure, a subsample of 11-year-olds preferred the more familiar characters. These results suggest that discrepancies obtained in previous research on the affective consequences of mere exposure are of methodological rather than developmental origin. Possible critical differences in procedure are discussed.     

Executive Functioning Predicts Social Skills Following Prenatal Alcohol Exposure

Adverse sequelae of prenatal alcohol exposure include executive function and social skills impairments, although these two domains have not been empirically linked in alcohol-exposed individuals. This study investigated this relationship using the BRIEF and the SSRS in 98 children aged 6 to 11 years. Executive functions explained a significant percentage of variance in parent and teacher rated social skills. No differences were found among children with diagnoses of FAS, partial FAS, or alcohol-related neurodevelopmental disorder. It may be helpful to consider executive functioning in designing social skills interventions for alcohol-exposed children whether or not they have full FAS.     

Executive functioning predicts social skills following prenatal alcohol exposure.

Adverse sequelae of prenatal alcohol exposure include executive function and social skills impairments, although these two domains have not been empirically linked in alcohol-exposed individuals. This study investigated this relationship using the BRIEF and the SSRS in 98 children aged 6 to 11 years. Executive functions explained a significant percentage of variance in parent and teacher rated social skills. No differences were found among children with diagnoses of FAS, partial FAS, or alcohol-related neurodevelopmental disorder. It may be helpful to consider executive functioning in designing social skills interventions for alcohol-exposed children whether or not they have full FAS.     

The development of memory for own- and other-race faces

This study demonstrates that experience and development interact to influence the "cross-race effect." In a multination study (n=245), Caucasian children and adults of European ancestry living in the United States, Norway, or South Africa, as well as biracial (Caucasian-African American) children and adults living in the United States, were tested for recognition of Asian, African, and Caucasian faces. Regardless of national or biracial background, 8- to 10-year-olds, 12- to 14-year-olds, and adults recognized own-race faces more accurately than other-race faces, and did so to a similar extent, whereas 5- to 7-year-olds recognized all face types equally well. This same developmental pattern emerged for biracial children and adults. Thus, early meaningful exposure did not substantially alter the developmental trajectory. During young childhood, developmental influences on face processing operate on a system sufficiently plastic to preclude, under certain conditions, the cross-race effect.