Gestational age and gender influence on executive control and its related neural structures in preterm-born children at 6 years of age

Within preterm-born children, being born male and at a lower gestational age (GA) have both been associated with a heightened risk for developmental difficulties. However, in this population little is known about the combined effect and the influence of these risk factors on cortical structures and executive control. In the present study, 58 preterm-born children (GA ranging from 24.0 to 35.1 weeks) were administered the computerized Child Attention Network Task at 6 years of age. Brain magnetic resonance imaging was performed and analyzed using Voxel-Based Morphometry (VBM) in all children. At a behavioral level, boys born <28 weeks of GA had significantly less executive control than preterm-born girls <28 weeks (p = .001) and preterm-born boys ≥28 (p = .003). The reduced executive control in preterm-born boys <28 weeks gestation was related to lower cortical densities in the inferior frontal gyrus (IFG) and dorsolateral prefrontal cortex (DLPFC). The current study links the higher incidence of reduced executive control in preterm-born boys to a higher degree of prematurity (low GA) and identifies brain structural abnormalities in the prefrontal cortex related to these deficits. The implications of these results are discussed.     

Utility of the Behavior Rating Inventory of Executive Function – Preschool version (BRIEF-P) in young children with epilepsy

Executive functioning deficits are prominent in children with epilepsy. Although instruments, such as the Behavior Rating Inventory of Executive Function (BRIEF), are useful in detecting executive dysfunction in school-age children with epilepsy, little data are available for younger children. The present study evaluates the ability of the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P) to detect executive dysfunction in preschool-age children with epilepsy. Parents of 51 clinically referred children with epilepsy (age: M = 1.99 years, SD = 1.29 years, range = 2–5 years) completed the BRIEF-P. Using a cutoff t score of ≥65 as the threshold for impairment, the BRIEF-P’s ability to detect executive dysfunction within this clinical population was established. Additionally, correlational analyses were used to assess the relations between epilepsy severity factors and BRIEF-P indices. Epilepsy severity variables that were significantly related to BRIEF-P indices were entered into a linear regression model to explore their predictive ability. Emergent metacognition (emergent metacognition index [EMI]; 59%) and the global executive composite (43%) were the most frequently elevated indices. The most commonly elevated subscales were working memory (65%), inhibition (37%), and planning/organization (35%). Age of seizure onset, seizure frequency, and number of antiepileptic drugs were not significantly correlated with BRIEF-P indices. However, children with lower intellectual ability were rated as having greater executive dysfunction, specifically with EMI (r = ?.30). Still, intellectual functioning only accounted for a small percentage (9%) of the variance in EMI scores. The current pilot study demonstrates that the BRIEF-P shows promise in identifying executive dysfunction in preschool-age children with epilepsy.     

How age affects memory task performance in clinically normal hearing persons

The main objective of this study is to investigate memory task performance in different age groups, irrespective of hearing status. Data are collected on a short-term memory task (WAIS-III Digit Span forward) and two working memory tasks (WAIS-III Digit Span backward and the Reading Span Test). The tasks are administered to young (20–30 years, n = 56), middle-aged (50–60 years, n = 47), and older participants (70–80 years, n = 16) with normal hearing thresholds. All participants have passed a cognitive screening task (Montreal Cognitive Assessment (MoCA)). Young participants perform significantly better than middle-aged participants, while middle-aged and older participants perform similarly on the three memory tasks. Our data show that older clinically normal hearing persons perform equally well on the memory tasks as middle-aged persons. However, even under optimal conditions of preserved sensory processing, changes in memory performance occur. Based on our data, these changes set in before middle age.     

Cognitive skills among Nepalese child labourers

The cognitive skills of 61 Nepalese 10–14‐year‐old working children with at least 2 years working experience (WE) were compared to two groups of children, beginners (N=29) with less than 1 year of WE and a school group (N = 104) matched for age and ethnic background. All the children (N=194) were tested by the Bender test, WISC‐R for Arithmetic, Digit Span, and the Word Fluency test. The main results showed that the school group was better in all the cognitive tests, except for Digit Span Backwards, where the working group had the highest average score. The second main finding shows no major differences in cognitive skills between the beginner and working groups. However, the work experience as such was related to decreasing visuoconstructive skills and improving Digit Span Forward scores. This suggests that work in the carpet factories seem to develop the verbal short‐term memory functions of the children, while their visuoconstructive skills decrease by work experience. The third main finding showed that the boys were better in arithmetic skills than the girls when they had long working experience.     

Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms in Children Adopted from Poland and their Atypical Association Patterns: a Bayesian Approach

Although high rates of attention-deficit hyperactivity disorder (ADHD) symptoms have been observed among internationally adopted children, research on these symptoms in Polish adoptees is lacking. Therefore, we examined ADHD symptoms in Polish adoptees and their relationship to pre-adoptive risk factors, that is, time in institutional care, early deprivation, and prenatal alcohol exposure. We further compared the association patterns and gender distribution of ADHD symptoms in children adopted from Poland to those reported in the literature for ADHD symptoms in non-adopted children. Dutch adoptive parents of 121 Polish adoptees (52% boys; M _age = 10.9 years, range 6.2–15.6; M _ageadoption = 3.0 years, range 0.8–6.9) completed questionnaires regarding ADHD symptoms, pre-adoptive risk factors, attachment problems, conduct problems, and executive functioning deficits. Bayesian evaluation of informative hypotheses showed that Polish adoptees had increased levels of ADHD symptoms, compared to Dutch children in the general population. Time in institutional care, early deprivation, and prenatal alcohol exposure were not associated with ADHD symptoms. ADHD symptoms in Polish adoptees were more strongly associated with attachment problems and executive functioning deficits, but less strongly with conduct problems, compared to ADHD symptoms in non-adoptees. Furthermore, ADHD symptoms were more equally distributed among boys and girls than they are in non-adopted children. The findings indicate that Polish adoptees and their adoptive parents need special attention and support. The dissimilarities between ADHD symptoms in Polish adoptees and non-adoptees might indicate a different underlying causal mechanism, which may have important implications for clinical practice.     

Associations between evaluation anxiety,cognitive interference and performance on working memory tasks

According to Cognitive Interference Theory, evaluation anxiety leads to increased negative off‐task self‐dialogue which then results in diminished cognitive performance. Given that negative off‐task self‐dialogue is primarily verbal, the phonological loop and central executive components of the working memory system should be most affected by evaluation anxiety. Eighty‐eight participants were randomly assigned to receive evaluation anxiety inducing instructions or supportive instructions prior to administration of three tests (Digit Span, Visual Memory Span, and StroopColour‐Word) that measured the phonological loop, visuospatial sketchpad, and central executive components of working memory. Measures of evaluation anxiety and negative off‐task self‐dialogue were obtained during and after testing. Results showed that participants receiving anxiety inducing instructions reported significantly more evaluation anxiety and off‐task self‐dialogue. They also had significantly lower performance on the Digit Span Test and the StroopColour‐Word Test. Negative off‐task self‐dialogue also mediated the relationship between evaluation anxiety and performance on the Digit Span Test. Copyright © 2011 John Wiley & Sons, Ltd.     

Executive function performance on the children's kitchen task assessment with children with sickle cell disease and matched controls

Objective: The aim of this study was to compare executive function abilities of 8- to 12-year-old children with sickle cell disease (SCD) with a matched control sample. The measures included the parent and teacher Behavior Rating Inventory of Executive Function (BRIEF); the Delis-Kaplan Executive Function System (D-KEFS), Free Sorting Test and Color Word Interference Test; and the Children's Kitchen Task Assessment (CKTA), a new performance measure. Methods: Twenty-two children with SCD were recruited from one hematology clinic and 22 community children, matched on characteristics of age, gender, and race, were selected from a larger sample of controls for comparison. Parents and teachers completed rating scales. Results:As hypothesized, children with SCD scored significantly lower than matched controls on Digit Span Forward; on 5 of the 9 D-KFES Color Word Interference and Sorting tasks; on CKTA organization, initiation, and task completion; and on the BRIEF's parent and teacher Metacognitive Index (MI) and Global Executive Composite (GEC) scores. Conclusion:Cognitive and performance evaluations indicate lower executive function among children with SCD. Results substantiate the need for evaluative triangulation for children with SCD: Neurocognitive testing supported by performance testing, and adult reflection of a child's daily performance compared to other children. These elements will provide rich data to create educational support for children with SCD who have frequent hospitalizations, school absences, and the potential presence of cerebral vascular accident symptomology.     

Targeting self-regulation and academic functioning among preschoolers with behavior problems: Are there incremental benefits to including cognitive training as part of a classroom curriculum?

The purpose of this study was to examine the additional benefit of an adaptive Cogmed working memory training (CWMT) to a social-emotional/self-regulation classroom curriculum for preschoolers with externalizing behavior problems (EBP). Participants for this study included 49 children (71% boys, M_age = 4.52) with at-risk or clinically elevated levels of EBP. Children participated in an 8-week summer treatment program for Pre-Kindergarteners (STP-PreK), where they were randomly assigned to either adaptive CWMT (n = 24), or nonadaptive CWMT (n = 25). Multiple repeated measures analyses were conducted to examine the impact of adaptive versus nonadaptive CWMT on pre and posttreatment parent-/teacher-reported behavioral functioning, parent-/teacher reported and child task performance of executive functioning, and standardized academic achievement measures. Repeated measures analyses found that children in both groups improved on all measures (d’s = .23-.86). However, there were no significant time X condition effects for parent or teacher-reported behavior, reported or observed executive functioning, or standardized academic measures. These findings suggest that CWMT does not appear to provide any incremental benefits to children’s executive functioning, behavior, or academics when implemented within a comprehensive behavioral modification intervention.     

White matter hyperintensities and working memory: an explorative study

White matter hyperintensities (WMH) are commonly observed in elderly people and may have the most profound effect on executive functions, including working memory. Surprisingly, the Digit Span backward, a frequently employed working memory task, reveals no association with WMH. In the present study, it was investigated whether more detailed analyses of WMH variables and study sample selection are important when establishing a possible relationship between the Digit Span backward and WMH. To accomplish this, the Digit Span backward and additional working memory tests, WMH subscores, and cardiovascular risk factors were examined. The results revealed that performance on the Digit Span backward test is unrelated to WMH, whereas a relationship between other working memory tests and WMH was confirmed. Furthermore, a division between several white matter regions seems important; hyperintensities in the frontal deep white matter regions were the strongest predictor of working memory performance.     

Basic visual perceptual processes in children with typical development and cerebral palsy: The processing of surface,length, orientation,and position

The present study aims to assess how the processing of basic visual perceptual (VP) components (length, surface, orientation, and position) develops in typically developing (TD) children (n = 215, 4–14 years old) and adults (n = 20, 20–25 years old), and in children with cerebral palsy (CP) (n = 86, 5–14 years old) using the first four subtests of the Battery for the Evaluation of Visual Perceptual and Spatial processing in children. Experiment 1 showed that these four basic VP processes follow distinct developmental trajectories in typical development. Experiment 2 revealed that children with CP present global and persistent deficits for the processing of basic VP components when compared with TD children matched on chronological age and nonverbal reasoning abilities.     

White Matter Hyperintensities and Working Memory: An Explorative Study

ABSTRACT

White matter hyperintensities (WMH) are commonly observed in elderly people and may have the most profound effect on executive functions, including working memory. Surprisingly, the Digit Span backward, a frequently employed working memory task, reveals no association with WMH. In the present study, it was investigated whether more detailed analyses of WMH variables and study sample selection are important when establishing a possible relationship between the Digit Span backward and WMH. To accomplish this, the Digit Span backward and additional working memory tests, WMH subscores, and cardiovascular risk factors were examined. The results revealed that performance on the Digit Span backward test is unrelated to WMH, whereas a relationship between other working memory tests and WMH was confirmed. Furthermore, a division between several white matter regions seems important; hyperintensities in the frontal deep white matter regions were the strongest predictor of working memory performance.     

Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

Timed performance weaknesses on computerized tasks in pediatric brain tumor survivors: A comparison with sibling controls

With more children surviving a brain tumor, insight into the late effects of the disease and treatment is of high importance. This study focused on profiling the neurocognitive functions that might be affected after treatment for a pediatric brain tumor, using a broad battery of computerized tests. Predictors that may influence neurocognitive functioning were also investigated. A total of 82 pediatric brain tumor survivors (PBTSs) aged 8–18 years (M = 13.85, SD = 3.15, 49% males) with parent-reported neurocognitive complaints were compared to a control group of 43 siblings (age M = 14.27, SD = 2.44, 40% males) using linear mixed models. Neurocognitive performance was assessed using measures of attention, processing speed, memory, executive functioning, visuomotor integration (VMI), and intelligence. Tumor type, treatment, tumor location, hydrocephalus, gender, age at diagnosis, and time since diagnosis were entered into regression analyzes as predictors for neurocognitive functioning. The PBTSs showed slower processing speeds and lower intelligence (range effect sizes .71–.82, p < .001), as well as deficits in executive attention, short-term memory, executive functioning, and VMI (range effect sizes .40–.57, p < .05). Older age at assessment was associated with better neurocognitive functioning (B = .450, p < .001) and younger age at diagnosis was associated with lower intelligence (B = .328, p < .05). Medical risk factors, e.g., hydrocephalus, did not show an association with neurocognitive functioning. Late effects in PBTSs include a broad range of neurocognitive deficits. The results suggest that even PBTSs that were traditionally viewed as low risk for neurocognitive problems (e.g., surgery only, no hydrocephalus) may suffer from decreased neurocognitive functioning.     

Greater delay discounting among girls,but not boys,with ADHD correlates with cognitive control

Cognitive neuroscience models suggest both reward valuation and cognitive control contribute to reward-based decision-making. The current study examined the relationship between cognitive control and delay discounting (i.e., choosing smaller, immediate over larger, delayed rewards) in a large sample of boys and girls diagnosed with attention-deficit/hyperactivity disorder (ADHD; N = 95) and typically developing control children (TD; N = 59). Specifically, we examined performance on multiple measures of cognitive control (i.e., Go/No-Go task, Stop Signal task, and Spatial Span task) and delay discounting (i.e., Classic Delay Discounting and Real-Time Delay Discounting tasks), as well as the relationship between these measures. Results indicated that sex moderated the effects of group on task performance. Specifically, girls with ADHD, but not boys with the disorder, exhibited atypical delay discounting of real-time rewards. Results from correlational analyses indicated that delay discounting and cognitive control were not significantly correlated in the overall sample. Multiple regression analyses demonstrated that among girls with ADHD poorer spatial working memory and inhibitory control predicted greater real-time discounting. Collectively, findings provide support for distinct patterns of cognitive control and delay discounting among school-aged girls and boys with ADHD. Additionally, findings suggest that among girls with ADHD, those who exhibit relatively poor working memory and inhibitory control might be a particularly vulnerable subgroup with the greatest propensity to exhibit maladaptive decision-making.     

Sleep disturbance and neuropsychological function in young children with ADHD

Sleep disturbance, common among children with ADHD, can contribute to cognitive and behavioral dysfunction. It is therefore challenging to determine whether neurobehavioral dysfunction should be attributed to ADHD symptoms, sleep disturbance, or both. The present study examined parent-reported sleep problems (Children’s Sleep Habits Questionnaire) and their relationship to neuropsychological function in 64 children, aged 4–7 years, with and without ADHD. Compared to typically developing controls, children with ADHD were reported by parents to have significantly greater sleep disturbance—including sleep onset delay, sleep anxiety, night awakenings, and daytime sleepiness—(all p ≤ .01), and significantly poorer performance on tasks of attention, executive control, processing speed, and working memory (all p < .01). Within the ADHD group, total parent-reported sleep disturbance was significantly associated with deficits in attention and executive control skills (all p ≤ .01); however, significant group differences (relative to controls) on these measures remained (p < .01) even after controlling for total sleep disturbance. While sleep problems are common among young children with ADHD, these findings suggest that inattention and executive dysfunction appear to be attributable to symptoms of ADHD rather than to sleep disturbance. The relationships among sleep, ADHD symptoms, and neurobehavioral function in older children may show different patterns as a function of the chronicity of disordered sleep.     

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.     

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.     

Examining the Regulatory and Reactive Temperamental Characteristics as Predictors of Low Income Preschool Children’s Executive Function

The current study is an examination of low income children’s reactive and regulatory temperamental characteristics as predictors of their executive function, with a particular focus on children’s regulatory temperament (i.e., inhibitory control and attentional focusing) as moderators of associations between reactive temperament (i.e., negative emotionality) and executive function. Participants were 291 children (159 boys) ages 37 to 70 months (M = 53.88 months, SD = 6.44 months) enrolled in 17 classrooms within 3 different preschools serving low income children in two Midwestern cities in the United States. Temperament was assessed via parent report during Fall 2014, and executive function were assessed via structured tasks implemented by independent researchers during Spring and Summer 2015. SAS PROC MIXED was used to test hierarchical regression models of children nested within classrooms. After controlling for child age, gender, ethnicity, and parent education, regulatory temperament moderated the association between reactive temperament and executive function. Children’s reactive temperament was inversely associated with their executive function. These findings suggest that understanding children’s regulatory and reactive temperamental characteristics may help to improve their executive functioning in early childhood.     

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.     

The backward span of the Corsi Block-Tapping Task and its association with the WAIS-III Digit Span

The Corsi Block-Tapping Task measures visuospatial short-term and working memory, but a standardized backward condition is lacking. The authors present a standardized backward procedure that was examined in 246 healthy older adults (ages 50 to 92), comparing the results with the Digit Span subtest of the Wechsler Adult Intelligence Scale--Third Edition. Principal component analysis resulted in a two-factor model, dissociating a verbal and a spatial working-memory factor. Also the Corsi backward is not more difficult than the Corsi forward, in contrast to the Digit Span backward that is more difficult than the Digit Span forward. This may suggest that the Corsi Block-Tapping Task backward task relies on processing within working-memory's slave systems, whereas the Digit Span backward also relies on the central executive component of working memory. Finally, regression-based normative data and cutoff scores for older adults are presented for use in clinical practice.