Executive Functions in Preschool Children Born Preterm: Application of Cognitive Neuroscience Paradigms

Although children born preterm are at risk for neuropsychological impairments at school age and adolescence, including difficulties with visual motor integration, spatial/constructional skills, attention, arithmetic, and nonverbal executive functions, specific neuropsychological outcome has not been investigated adequately in preschoolers. Application of cognitive neuroscience tasks offers the opportunity to characterize early executive functions in young children born preterm. In a preliminary sample of 29 preschool children born preterm (M birth gestational age = 32.4 weeks), executive function outcome was compared to that of fullterm controls by contrasting performance on two prototypic delayed-response-type paradigms, Delayed Alternation and Spatial Reversal. Preschoolers born preterm correctly retrieved the reward on fewer trials on Delayed Alternation than did matched controls. Furthermore, preschool children born preterm used problem-solving strategies that included more perseverative errors than controls. These preliminary findings highlight the utility of cognitive neuroscience paradigms to understand neuropsychological outcome in preschool children born preterm and suggest areas of developmental vulnerability that may include dorsolateral prefrontal circuits.     

Executive functions in preschool children born preterm: application of cognitive neuroscience paradigms.

Although children born preterm are at risk for neuropsychological impairments at school age and adolescence, including difficulties with visual motor integration, spatial/constructional skills, attention, arithmetic, and nonverbal executive functions, specific neuropsychological outcome has not been investigated adequately in preschoolers. Application of cognitive neuroscience tasks offers the opportunity to characterize early executive functions in young children born preterm. In a preliminary sample of 29 preschool children born preterm (M birth gestational age = 32.4 weeks), executive function outcome was compared to that of fullterm controls by contrasting performance on two prototypic delayed-response-type paradigms, Delayed Alternation and Spatial Reversal. Preschoolers born preterm correctly retrieved the reward on fewer trials on Delayed Alternation than did matched controls. Furthermore, preschool children born preterm used problem-solving strategies that included more perseverative errors than controls. These preliminary findings highlight the utility of cognitive neuroscience paradigms to understand neuropsychological outcome in preschool children born preterm and suggest areas of developmental vulnerability that may include dorsolateral prefrontal circuits.     

Theoretical, Developmental & Cultural Orientations of School-Based Prevention Programs for Preschoolers

Schools are the primary environment in which to conduct prevention programs for school-age children. Educators, policy makers, and psychologist argue that prevention efforts should begin as early as possible to maximize their effectiveness. Surprisingly, there are relatively few school-based prevention programs targeted for preschoolers. Given the evidence supporting earlier rather than later prevention efforts and the fact that many children in the United States attend preschool programs, more research on the feasibility and effectiveness of prevention programs administered in preschool environments is warranted. In this article, we review the existing literature on school-based prevention programs targeted for preschool children. We examine whether school-based prevention programs are theory driven, developmentally appropriate, culturally sensitive, and aimed specifically at symptom reduction or behavior promotion. Based on the findings of this review, our aim is to identify gaps in the prevention research literature regarding programs for preschoolers and propose research to address such gaps to create more effective school-based prevention programs for young children.     

Assessment of executive function in preschool-aged children

Assessment of the overarching self-regulatory mechanisms, or executive functions, in any age group is challenging, in part due to the complexity of this domain, in part due to their dynamic essence, and in part due to the inextricable links between these central processes and the associated domain-specific processes, such as language, motor function, and attention, over which they preside. While much progress has been made in clinical assessment approaches for measuring executive functions in adults and to some extent in adolescents and school-aged children, the toolkit for the preschool evaluator remains sparse. The past decade, however, has seen a substantial increase in attention to executive functions in very young children from a developmental neuropsychological perspective. With this has come a necessity for better, more specific, and more internally valid performance measures, many of which are now described in the experimental literature. Few such tasks, however, have adequately demonstrated psychometric properties for clinical application. We present two performance tasks designed to tap selective aspects of executive function in preschoolers that are emerging from the experimental laboratory and hold promise of appropriate reliability and validity for the clinical laboratory. Performance tests alone, however, are insufficient to develop a comprehensive picture of a child's executive functioning. Thus, we present a rating scale of preschoolers' executive function in the everyday context, and advocate a model of executive function assessment that incorporates both controlled performance tasks that target specific aspects of executive function and parent/teacher ratings that target more global aspects of self-regulation in the everyday context.     

学前儿童抑制控制的发展趋势及其对言语理解和数学认知的预测作用

以长春市某幼儿园的122名3~6岁幼儿为被试,采用2(测试任务:无嵌套规则白天黑夜任务,有嵌套规则的白天黑夜任务)×2(测试时间:间隔9个月的第一次测试和第二次测试)×4(年龄分组:3.00~3.75岁组,3.76~4.50岁组,4.51~5.25岁组,5.26~6.00岁组)的三因素混合设计,来分析不同复杂程度的抑制控制在学前阶段的发展趋势,并在控制幼儿年龄和工作记忆水平后,分析不同复杂程度抑制控制对言语理解和数学认知的独立预测作用。结果发现:(1)对3~6岁儿童来说,有嵌套规则的白天黑夜任务的难度水平要显著高于无嵌套规则的白天黑夜任务;(2)较简单的抑制控制(无嵌套规则的白天黑夜任务)在学前阶段的发展速度先快后慢,但较复杂的抑制控制(有嵌套规则的白天黑夜任务)在3~6岁期间持续快速发展;(3)独立于年龄和工作记忆,较复杂的抑制控制能够显著预测幼儿的数学认知和言语理解,但较简单的抑制控制对言语理解和数学认知的预测作用不显著。根据上述结果,在描述学前儿童抑制控制发展趋势时要注意任务难度的设定,而且难度适当的抑制控制任务成绩更能预测幼儿的言语理解和数学认知。     

Measuring the development of executive control with the shape school

Although several neurodevelopmental and psychiatric disorders can emerge during the preschool period, there are comparatively few instruments to assess executive control. Evidence for validity of the Shape School (K. A. Espy, 1997) was examined in a sample of 219 typically developing young children. There was good evidence for validity, as Shape School performance variables were interrelated and were associated to other criterion measures considered to measure aspects of executive control. Also suggesting validity, the Shape School variables varied as a function of whether the task demands (a) were executive, (b) required inhibition of a prepotent response or context-controlled selection among relevant stimulus-response sets, and (c) included unitary or concurrent processing. The Shape School may be an effective tool by which to measure executive control in young children who have atypical developmental patterns.     

Are sluggish cognitive tempo symptoms associated with executive functioning in preschoolers?

The aim of this study is to investigate whether sluggish cognitive tempo (SCT) symptoms are associated with neurocognitive task performance and ratings of real-world executive functioning (EF) in preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD). The associations between parent- and teacher-rated SCT symptoms and neuropsychological task performance and ratings of EF in 61 4-year-old preschool children (51 boys, 10 girls) with self-regulation difficulties were examined, with regression analyses controlling for the effects of ADHD inattention symptoms. In the study sample, higher teacher-rated SCT symptoms are significantly associated with poorer performance on tasks of visual-perceptual abilities, auditory and visual attention, sustained and selective attention, inhibitory control, pre-numerical/numerical concepts, and slower processing speed, but SCT symptoms are not significantly associated with working memory, attention shifting or cognitive flexibility when controlling for ADHD inattention. Higher parent-rated SCT symptoms are significantly associated with visual-perceptual abilities. ADHD inattention symptoms are more strongly associated than SCT with daily life EF ratings; neither parent- nor teacher-rated SCT symptoms are significantly associated with daily life ratings of inhibition, working memory, or planning/organization after controlling for ADHD inattention. This study suggests that SCT symptoms contribute to EF deficits at least on neurocognitive tasks assessing visual-perceptual/spatial abilities, attention to detail and processing speed, as observed in this sample of young children at risk for ADHD, and may be an important intervention target.     

Parent-Child Interaction Therapy for ADHD: A Conceptual Overview and Critical Literature Review

ABSTRACT

Attention-Deficit/Hyperactivity Disorder (ADHD), a chronic disorder beginning in childhood, is identifiable and diagnostically valid during the preschool years. Compared to school-aged children, preschoolers have not received as much attention in the literature. Parent-Child Interaction Therapy (PCIT) is an empirically-supported parent training program for young children with disruptive behaviors that may also be effective in treating ADHD. The purpose of the current article was to explore the theoretical rationale for utilizing PCIT with this population and to conduct a literature review of published PCIT treatment outcome studies that measured ADHD symptoms. The literature demonstrates that children with ADHD have been included in PCIT research and evidence suggests that PCIT may be effective for young children with ADHD. However, future research is needed to specifically examine the effects of PCIT on ADHD.     

Executive Functions in Preschool Children with Externalizing Behavior Problems: A Meta-Analysis

Deficits in executive functions (EF) have been found in school-age children and adolescents with externalizing behavior disorders. Present meta-analysis was carried out to determine whether these EF impairments can also be found in preschool children with externalizing behavior problems. Twenty-two studies were included with a total of 4021 children. Four separate meta-analyses were conducted, concerning overall EF, working memory, inhibition and cognitive flexibility. A medium correlation effect size was obtained for overall EF (ESzr?=?0.22) and for inhibition (0.24), whereas a small effect size was found for working memory (0.17) and for cognitive flexibility (0.13). Moderator analyses revealed a stronger effect for older preschoolers compared to younger preschoolers, and for children from referred samples compared to community samples. These results show that EF, especially inhibition, is related to externalizing behavior problems already in preschool years.     

Parent-reported executive functioning in young children treated for cancer

It is well known that children treated for cancer are at risk for cognitive and functional impairments. Such research is largely based on studies of late effects in school-aged or older children. However, far less is known about executive function weaknesses in preschool-aged children treated for cancer. Thus, the aim of this study was to examine executive functioning in a clinically referred sample of young oncology patients, and its association with broader domains of functioning. Data from 61 young children with cancer, who were referred for clinical cognitive evaluations, were abstracted and included in this study. Patients were 5.00 years of age (SD = 0.72) at assessment, 54.1% male, and two-thirds (63.9%) had been treated for brain tumors. Most executive functions were significantly discrepant from the mean, with 47.5% of preschoolers having parent-reported working memory concerns within the clinically significant range. There were no differences in executive functioning based on diagnosis or treatment status. Parent-reported executive functioning was strongly correlated with global intelligence and adaptive functioning, with some indices also associated with nonverbal problem solving and pre-academic skills. Ultimately, results indicate the presence of emerging weaknesses in executive functioning in young children with cancer, and add to a growing body of literature highlighting the potential cognitive and behavioral risks associated with a cancer diagnosis in early childhood.     

Performance on Stroop‐like assessments of inhibitory control by 4‐ and 5‐year‐old children

The rapid development of an aspect of executive functioning (EF), inhibitory control (IC), between the ages of 3‐ and 5‐years, leads to an increase in a child's capacity to suppress inappropriate responding and therefore activate the necessary resources to carry‐out goal‐directed activity (Psychological Bulletin, 1997, 121 , 65–94). To measure EF in children, tasks administered clinically to adults are adapted. The Day–Night Stroop (DNS) is a pictorial modification of the Stroop Test (Journal of Experimental Psychology, 1935, 18 , 642–662), developed for pre‐literate children. Although suitable as a measure of IC in 3‐ to 4‐year‐old children, ceiling effects have been reported on the DNS in slightly older preschoolers. The present study attempted to overcome this limitation by examining the suitability of two modified versions of the DNS in 4‐ to 5‐year‐old preschoolers. To investigate the executive demands made by both Stroop‐like tasks, their associations with another measure of IC (stop‐signal task) and a measure of working memory were examined. Counter to expectations, no significant association was found in performance between the two Stroop‐like tasks; however, the modified DNS developed in this study showed significant relationships with the other executive tasks. The results are discussed in relation to the different methodologies used by these Stroop measures. Implications of this study suggest that researchers should consider more test‐specific factors when assessing EF in young children. Copyright © 2010 John Wiley & Sons, Ltd.     

Developmental associations between bilingual experience and inhibitory control trajectories in Head Start children

Children from lower socioeconomic (SES) backgrounds tend to be at‐risk for executive function (EF) impairments by the time they are in preschool, placing them at an early disadvantage for academic success. The present study examined the potentially protective role of bilingual experience on the development of inhibitory control (IC) in 1146 Head Start preschoolers who were followed for an 18‐month period during the transition to kindergarten as part of the longitudinal Family and Child Experiences Survey (FACES) 2009 study. Using three waves of data, we predicted individual variation in developmental trajectories of IC for three groups that differed in bilingual experience—English monolinguals, Spanish‐English bilinguals, and a group of children who transitioned from being Spanish monolingual to Spanish‐English bilinguals during the course of the study. Compared to their English monolingual peers, bilingual children from Spanish‐speaking homes showed higher IC performance at Head Start entry, as well as steeper IC growth over time. Children who were Spanish monolingual at the beginning of Head Start showed the lowest IC performance at baseline. However, their rate of IC growth exceeded that of children who remained English monolingual and did not differ from that of their peers who entered Head Start being bilingual. These results suggest that acquiring bilingualism and continued bilingual experience are associated with more rapid IC development during the transition from preschool to kindergarten in children from lower SES backgrounds.     

Verbal ability and executive functioning development in preschoolers at head start

Research suggests that executive functioning skills may enhance the school readiness of children from disadvantaged homes. Questions remain, however, concerning both the structure and the stability of executive functioning among preschoolers. In addition, there is a lack of research addressing potential predictors of longitudinal change in executive functioning during early childhood. This study examined the structure of executive functioning from fall to spring of the preschool year using a multimethod battery of measures. Confirmatory factor analyses revealed a unidimensional model fit the data well at both time points, and tests of measurement invariance across time points indicated that children's mean latent executive functioning scores significantly improved over time. Verbal ability was a significant predictor of longitudinal change in executive functioning. Theoretical implications and directions for future research are discussed.     

Early executive control and risk for overweight and obesity in elementary school

An emerging literature suggests that poor executive control (EC) may be associated with clinical weight problems, e.g., body mass index (BMI) for age percentile ≥85 in children. However, our understanding of the impact of EC on overweight and obesity in childhood is limited by the lack of longitudinal studies spanning critical developmental periods and assessing EC using comprehensive performance-based batteries. The current study addresses these limitations in a longitudinal examination of 212 children who completed an extensive laboratory-based EC task battery in preschool (age 4 years and 6 months) and were followed through elementary school (Grades 1 through 4) with objective measures of weight status. The logistic regression results indicate that poorer EC in preschool is associated with significantly greater risk for clinical weight problems (either overweight or obese status, as defined by BMI-for-age percentile ≥ 85) in elementary school, controlling for maternal education. EC in preschool was not significantly associated with risk for obese status, specifically (defined by BMI-for-age percentile ≥ 95), but the trend was in the expected direction. The results suggest that early executive abilities are relevant for children’s subsequent health status, with deficits in EC in the critical period of preschool conferring risk for later problems with weight. Based on these findings, early interventions to promote stronger EC may be a promising, yet currently overlooked, component in pediatric obesity prevention efforts.     

Developmental changes in the relations between inhibitory control and externalizing problems during early childhood

Deficits in executive function, and in particular, reduced capacity to inhibit a dominant action, are a risk factor for externalizing problems (EP). Inhibitory control (IC) develops in the later preschool and early childhood periods, such that IC might not regulate EP in toddlers and younger preschoolers. Aggression was observed during peer play for 66 girls and 49 boys, from 2.75 to 6.00 years (M=4.14, S.D.=0.78). Mothers reported on children's IC and EP concurrently and 12 months later, and concurrent teacher reports of EP were also collected. Factor analysis supported aggregation of mother and teacher‐reported EP and observed physical aggression into one measure of externalizing difficulties. Mothers reported lower IC for children with more externalizing difficulties, and the inverse relation between IC and externalizing difficulties strengthened over the toddler, preschool and kindergarten periods. Similar relations between IC and EP were observed 12 months later, and increases in IC also predicted reductions in EP over 1 year. These data demonstrate that the preschool years are a dynamic period of developmental change in the relations between IC and EP. Copyright © 2010 John Wiley & Sons, Ltd.     

正念训练提升3~4岁幼儿注意力和执行功能

正念训练是指个体将注意力集中于当下体验的一种心理干预方法。先前研究表明正念训练可以促进其注意力、执行功能、情绪调节等的发展, 而正念训练对幼儿心理发展的作用机制并不清楚。因此, 为了考察正念训练对3~4岁幼儿注意力和执行功能的影响。采用前后测设计, 对正念组进行每周2次, 每次20~30分钟, 共12次的正念训练; 对照组不进行任何训练。结果发现：(1) 在注意力方面, 正念组与对照组前测差异不显著, 训练后正念组幼儿持续性注意力得分显著高于对照组。(2) 在执行功能方面, 正念组和实验组在抑制控制、认知灵活性以及工作记忆上前测得分差异不显著, 训练后正念组幼儿抑制控制和认知灵活性得分显著优于对照组, 而两组幼儿工作记忆差异不显著。研究表明, 正念训练促进了3~4岁幼儿注意力和执行功能的发展, 且在执行功能方面主要表现为对抑制控制和认知灵活性的提升。     

Early executive functioning in a global context: Developmental continuity and family protective factors

This study extends the methodological and theoretical understanding of executive functions (EFs) in preschoolers from low‐ and middle‐income countries (LMIC). First, the authors describe a rigorous process of adapting and evaluating six EF tasks to produce a culturally and developmentally appropriate measure of emerging EFs in a large sample of at‐risk children in rural Pakistan. Next, the authors identify critical developmental and family factors that relate to preschoolers’ EFs over the first 4 years of life. Direct assessment of children's general cognitive skills at age two showed developmental continuity with EFs at age four, and these early cognitive skills mediated the effect of an antecedent parenting intervention on EFs as well as associations of targeted individual and family factors with EFs. Furthermore, directly assessed maternal cognitive capacities and observed maternal scaffolding uniquely predicted EFs in preschoolers. This study is also the first to demonstrate a significant overlap between direct assessments of IQ and EFs in young children from LMIC. Children's general intelligence mediated the associations of EFs with antecedent physical growth and cognitive skills as well as concurrent family factors (maternal verbal intelligence, maternal scaffolding, and home stimulation). After controlling for shared variance between preschoolers’ general intelligence and EFs, three factors emerged as unique predictors of EFs: exposure to an early parenting intervention, physical growth status at age two, and number of older siblings. The findings have important implications for the design of interventions that aim to improve EFs in young children in LMIC. A video abstract of this article can be viewed at https://vimeo.com/316329544/5abde94cd7     

Measurement of attention and related functions in the preschool child

The goal of this review of the clinical and research literature is to identify, describe, and critique published methods for assessment of attention and related functions in preschool children (ages 6 and younger). The need for valid assessment of preschool children has grown dramatically in the past two decades following the implementation of special education services for infants, toddlers, and preschoolers under Public Law 99-457. At the same time, the number of preschool children presenting to clinicians for assessment of attention problems has grown at a steady rate. In contrast to assessment methods for school-age children, the availability of reliable and valid measures of attention for preschool children is much more limited. The majority of instruments developed to measure attention in preschoolers are described in the experimental literature, with fewer available commercially. Attention tests that can be appropriately used with children aged 3 and younger are scarce. Most preschool tests of attention report validity data involving sensitivity in contrasting clinical groups to controls, while the literature describing the utility of these measures in differentiating between clinical groups is much more limited. The review provides information on performance based tests (e.g., continuous performance, cancellation, auditory/visual span), as well as parent and teacher rating scales. The review concludes that valid assessment of attention and related skills can be effectively achieved in preschool children, with appropriate cautions.     

The Influence of Mothers’ Emotional Expressivity and Class Grouping on Chinese Preschoolers’ Emotional Regulation Strategies

Emotional regulation within the context of social situations refers to an individual’s ability to respond to emotions in socially acceptable ways in order to adapt quickly and to maintain good interpersonal relationships. Emotional regulation is a psychological characteristic at the core of social stability. The preschool period is a stage in which children’s emotional regulation develops rapidly. Because homes and preschools are the two main places where preschoolers grow and spend their time, their mothers and peers play key roles in their social interactions. Therefore, the present study explored how the emotional regulation strategies of preschool children in China are affected by children’s class grouping and their mothers’ emotional expressivity. The participants were 182 preschoolers (ages 3–5) who were recruited for this study. The Emotional Regulation Strategy Questionnaire and the Self-Expressiveness in the Family Questionnaire were used to explore preschoolers’ emotional regulation strategies and their mothers’ emotional expressivity, respectively. The study results are as follows. (1) As they develop, preschool children use more positive emotional regulation strategies and fewer negative emotional regulation strategies. (2) Children in mixed-age classes use fewer passive reaction strategies than children in same-age classes do. For replacement activity strategies, only 4-year-old children in mixed-age classes score higher than children in same-age classes. (3) Mothers’ tendencies toward positive emotional expression can positively predict their children’s use of positive emotional regulation strategies, and their displays of negative emotions can positively predict their children’s use of negative emotional regulation strategies.