The role of executive functions in bilingual children with reading difficulties

To explore the joint effect of reading difficulties (RD) and bilingualism on executive functions, 190 children of four groups of 9–12 year‐olds (41 bilinguals with RD, 45 monolinguals with RD, 45 bilinguals without RD, and 59 monolinguals without RD) were examined on the Concentration game, Tower of Hanoi, and Stroop as measures of executive functioning tapping into inhibitory/attentional control, working memory and planning ability. The most prominent finding was that in terms of RD, the speed of performances decreased dramatically. This general decrease was more pronounced for bilingual children with RD than for their monolingual counterparts. In conclusion, the findings suggest that while bilinguals gain more from executive functions in normal reading, they lose in terms of RD. Such an outcome confirms that executive functions are essential components of both reading and bilingualism, which depending on whether reading conditions are normal or difficult will produce cognitive advantages or disadvantages. Further, it is argued that dissimilarity between the Farsi and Swedish languages may complicate handling of such a situation.     

Multivariate base rates for the assessment of executive functioning among children and adolescents

This study provides observed base rates of low executive functioning test scores among healthy children and adolescents, stratifies those base rates by narrow intellectual functioning and age groupings, and provides normative classification ranges to aid the interpretation of performances on the Delis-Kaplan Executive Function System (D-KEFS) in clinical practice and research. Participants included 875 children and adolescents between 8 and 19 years old from the D-KEFS normative sample (48% male; 52% female). Among these participants, 838 had complete data and were included in the current study. The racial/ethnic composition of the sample was: White (73.7%), African American (12.4%), Hispanic (11.1%), and other racial/ethnic backgrounds (2.7%). The Overall Test Battery Mean (OTBM) and the prevalence of low scores at various clinical cut-offs were calculated for the 13 primary scores from the D-KEFS Trail Making Test, Verbal Fluency Test, and Color-Word Interference Test. The OTBM and base rates were also calculated separately for those scores reflecting executive functioning (n = 7) and processing speed (n = 6). Healthy children and adolescents commonly obtained low scores on the D-KEFS tests considered here. Younger age, lower estimated full-scale intelligence quotient, and more test scores interpreted were associated with a greater frequency of low scores. Clinicians and researchers are encouraged to consider these multivariate base rates when assessing and attempting to identify executive functioning impairment among children and adolescents with the D-KEFS.     

Improving executive functions in 5‐ and 6‐year‐olds: Evaluation of a small group intervention in prekindergarten and kindergarten children

Research suggests a central role of executive functions for children's cognitive and social development during preschool years, especially in promoting school readiness. Interventions aiming to improve executive functions are therefore being called for. The present study examined the effect of a small group intervention implemented in kindergarten settings focusing on basic components of executive functions, i.e., working memory, interference control and cognitive flexibility. A total of 135 children enrolled in Swiss prekindergarten (5‐year‐olds) and kindergarten (6‐year‐olds) were involved. Results revealed that the small group intervention promoted gains in all three included components of executive functions: prekindergarten children substantially improved their working memory and cognitive flexibility processes, whereas significant training effects were found for the kindergarten children in interference control. Implications of these findings for early intervention programs and for tailoring preschool curricula are discussed, particularly with respect to children's school readiness. Copyright © 2011 John Wiley & Sons, Ltd.     

Development and preliminary validation of the Paediatric Awareness Questionnaire for children and adolescents with traumatic brain injury

There is a lack of validated measures for assessing self-awareness of deficits after pediatric traumatic brain injury (TBI). The current study aimed to develop and examine the psychometric properties of the Paediatric Awareness Questionnaire (PAQ), and investigate factors related to self-awareness. The PAQ was administered to 32 children aged 8–16 years with mild to severe TBI (72% male, M age = 11.75, SD = 2.9), their parents, and treating clinicians, and to 32 age- and gender-matched typically developing controls and their parents. Children with TBI and their parents also completed the Knowledge of Injury Checklist (KIC), and parents completed the Depression Anxiety and Stress Scale 21. The PAQ was found to have fair to excellent (α = .79–.97) internal consistency for all versions across both groups and good concordance between parent and clinician total scores (ICC = .78). There was also evidence of convergent validity between the PAQ and KIC for both child (r = ?.45, p < .05) and parent ratings (r = ?.66, p < .001). Poorer self-awareness was significantly related to younger age at injury for the TBI group and lower parental education for the total sample. ANCOVA identified that children with TBI demonstrated significantly poorer awareness than controls after controlling for parental education. Children with TBI typically overestimated their functioning compared to their parents, whereas typically developing children tended to rate their functioning lower than their parents. These findings provide preliminary support for the reliability and validity of the PAQ for assessing self-awareness after pediatric TBI.     

The WISC-V in children and adolescents with epilepsy

Despite its popularity in the neuropsychological evaluation of children, the utility of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) has not yet been investigated in children with epilepsy. Eighty clinically referred children and adolescents with epilepsy were administered the WISC-V as part of a comprehensive assessment and scores were compared to matched controls from the WISC-V standardization sample. T tests compared WISC-V indices and subtests between patients and controls and Chi-square analyses compared the rates of low scores. Correlational analyses assessed the relationships between epilepsy severity variables (e.g., age of onset, duration of epilepsy, number of antiepileptic drugs, seizure frequency). All WISC-V composites and subtests were significantly lower in patients versus controls and the rate of low scores was higher in patients than controls for all composites and subtests with the exception of Figure Weights. The Working Memory Index and Processing Speed Index were most sensitive to impairment, while the Verbal Comprehension Index and Fluid Reasoning Index were least sensitive. Of the epilepsy severity variables, age of seizure onset and number of antiepileptic drugs were strong predictors of deficits, whereas seizure frequency was the weakest predictor. Importantly, no significant differences were seen in children with right hemisphere epilepsy versus left on the five WISC-V composites, though a trend was seen towards a lower Visual-Spatial Index in those with right-sided focal seizures.     

Coping among children and adolescents with chronic illness

The present study was aimed to investigate age and gender effects on coping with everyday stressors among children and adolescents with chronic illness and healthy controls. Patients (8–13 years of age) with asthma (n=47), atopic dermatitis (n=52), and cancer (n=57) were compared to healthy controls (n=158) matched by age, gender, and grade. Self-report data on coping with academic and interpersonal stressors were collected. The primary results indicated that coping with everyday stressors was improved in children and adolescents with chronic illness compared to healthy controls. Thus, patients reported less passive avoidance on cross-situational coping and tended to show more situation-specific coping with social and school-related stressors than healthy controls. Additionally, among the clinical groups, patients with atopic dermatitis and cancer scored higher on positive self-instructions than patients with asthma. Conclusively, the results suggest that coping with a chronic illness may lead to more effective coping with everyday stressors. Implications for evaluating coping styles in patients with chronic illness are discussed.     

Effects of game‐based and standard executive control training on cognitive and academic abilities in elementary school children

Several studies indicate that executive functions (EF), such as working memory (WM), inhibition or flexibility can be improved by training and that these training‐related benefits in WM capacity generalize to reading and mathematical abilities. However, the results of these studies are inconsistent and most of them focused on WM training in children with learning difficulties. Evidence for typically developing children is rare and no study has investigated inhibition training or flexibility training. There is also a lack of studies taking motivational factors into account. Therefore, this study compared the effects of game‐based and standard training regimens targeting WM, inhibition, or flexibility in children. One hundred and fifty‐three typically developing elementary school students (mean age = 9.6 years, standard deviations  = 0.8) were investigated in an intervention design with a pretest, 21 sessions of training, a posttest and a follow‐up after three months. They were randomized into one of six training groups or a control group. We found training gains in all training groups and higher self‐reported motivation in the game‐based as compared to the standard training groups. Furthermore, there was domain‐specific transfer to untrained EF tasks across all training groups. We found greater performance improvements in reading ability (but not mathematics) in the game‐based flexibility training group and the game‐based inhibition training group as compared to the control group. Transfer effects were still significant at follow‐up. In sum, our findings provide first evidence for a systematic comparison of training on different domains of EF and their differential effects on academic abilities.     

Spatial memory and executive functions in children

A computerized hidden pathway maze-learning task was used to examine the development of spatial memory and executive functions in 6- to 9-year-olds. Pathway length was manipulated to investigate the impact of increases in maze matrix size on these abilities. Analysis showed that maze matrix size (and ipso facto pathway length) and age interacted to affect executive functions but not spatial memory. Executive errors differed as a function of age on the most difficult maze. Results are discussed in terms of factors affecting the development of executive functions and spatial memory.     

Theory of mind and its relationship with executive functions and emotion recognition in borderline personality disorder

Impaired social cognition has been claimed to be a mechanism underlying the development and maintenance of borderline personality disorder (BPD). One important aspect of social cognition is the theory of mind (ToM), a complex skill that seems to be influenced by more basic processes, such as executive functions (EF) and emotion recognition. Previous ToM studies in BPD have yielded inconsistent results. This study assessed the performance of BPD adults on ToM, emotion recognition, and EF tasks. We also examined whether EF and emotion recognition could predict the performance on ToM tasks. We evaluated 15 adults with BPD and 15 matched healthy controls using different tasks of EF, emotion recognition, and ToM. The results showed that BPD adults exhibited deficits in the three domains, which seem to be task‐dependent. Furthermore, we found that EF and emotion recognition predicted the performance on ToM. Our results suggest that tasks that involve real‐life social scenarios and contextual cues are more sensitive to detect ToM and emotion recognition deficits in BPD individuals. Our findings also indicate that (a) ToM variability in BPD is partially explained by individual differences on EF and emotion recognition; and (b) ToM deficits of BPD patients are partially explained by the capacity to integrate cues from face, prosody, gesture, and social context to identify the emotions and others' beliefs.     

音乐训练对执行功能的影响

尽管音乐训练影响许多认知加工,但这种广泛性影响背后的机制迄今仍不清楚。近年来,研究者认为音乐训练的迁移效应可能是通过执行功能起作用。本文将执行功能细分为抑制控制、工作记忆、认知灵活性三个核心成分,考察音乐训练对这三个成分的影响以及执行功能在音乐训练迁移效应中的中介作用。研究结果表明,音乐训练对执行功能不同成分的影响有不同特点。同时,前额叶结构与功能的变化在音乐训练影响执行功能的过程中发挥着重要作用。此外,关于执行功能在音乐训练迁移效应中的中介作用,目前研究还存在不一致的结果,未来研究应采用多种技术手段深入探讨这一问题。     

Developmental change in the relation between executive functions and symptoms of ADHD and co‐occurring behaviour problems

In a sample of 92 children aged 6–13 years this study investigates the normal developmental change in the relation between executive functioning (EF) and the core behavioural symptoms associated with attention deficit hyperactivity disorder (ADHD) (hyperactivity/impulsivity and inattention) as well as symptoms often co‐occurring with childhood hyperactivity (conduct‐ and internalizing problems). EF was assessed by using multiple tests grouped through prior factor analysis, resulting in cognitive measures relating to disinhibition, speed/arousal, verbal working memory, non‐verbal working memory, and fluency. The results showed that although disinhibition was positively related to hyperactivity/impulsivity and inattention mainly for the youngest age group, there were no significant age effects for these relations. Instead, age effects were found for the relations between speed/arousal and inattention as well as for the relations between verbal working memory/fluency and inattention. In the oldest age group poor performance on these cognitive measures was associated with high ratings of inattention. For the total sample a relation was obtained between disinhibition and hyperactivity/impulsivity as well as between both working memory measures and internalizing problems. In conclusion, the results from this study suggest that poor inhibition is most clearly associated with ADHD symptoms for younger children, whereas poor functioning with regard to later developing and more complex executive functions such as working memory and fluency is associated with ADHD symptoms for older children. Copyright © 2006 John Wiley & Sons, Ltd.     

The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes

Klenberg, L., Jämsä, S., Häyrinen, T., Lahti‐Nuuttila, P. & Korkman, M. (2010). The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes. Scandinavian Journal of Psychology, 51, 439–448. This study presents a new inventory, the Attention and Executive Function Rating Inventory (ATTEX), and examines the psychometric properties and the clinical utility of ATTEX in indentifying the attention deficit hyperactivity disorder combined type (ADHD‐C) and the ADHD predominantly inattentive type (ADHD‐I) in school environments. A normative sample of Finnish 7‐ to 15‐year‐old children and adolescents (N = 701) and a clinical sample consisting of children with ADHD‐C (N = 190) and ADHD‐I (N = 25) were examined with the ATTEX and the ADHD Rating Scale‐IV. The ATTEX and its scales had good internal consistency reliability (0.67–0.98) and criterion validity (0.68–0.95). Normative data was provided for the total normative sample and for boys and girls separately. Gender differences were noted in the ATTEX scores, boys having consistently higher scores on all ATTEX scales. The effect of age was significant only for one of the ten scales, the Motor hyperactivity scale, 7‐year‐olds having more problems of hyperactivity than 14‐year‐olds. Lower parent education level and the child’s learning difficulties were related to higher ratings of EF problems in ATTEX. When different cutoff scores for boys and girls were applied, ATTEX was sensitive in identifying children with attention deficit disorders. In addition, ATTEX was accurate in differentiating children with ADHD‐I from children with ADHD‐C. In this Finnish sample, ATTEX showed solid psychometric properties and could be used as a reliable tool in the diagnostic evaluation of ADHD‐C and ADHD‐I.     

Parenting and the dysregulation profile predict executive functioning in children with acquired brain injury

Background: Children with acquired brain injury (ABI) present with high rates of psychological disorders commonly accompanied by deficits in hot and cold executive functions (EFs). Impairments in EFs have been reported to precede mental health problems. Moreover, children who are vulnerable to developing mental health problems in adulthood frequently present with a dysregulation profile in childhood, characterized by impairments in cognitive, behavioral and emotional regulation. Objective: To identify profiles of behaviors associated with impairment in hot and cold EFs and compare injury factors, environmental stressors and dysregulation profile between them. Methods: A latent profile analysis was conducted with 77 children with ABI aged between 6 and 12. Injury factors, child IQ, environmental stressors and the dysregulation profile were compared between these behavioral profiles. Logistic regressions were conducted to predict profile membership. Results: Two profiles were identified: Profile M, with mild deficits (1–2 SD above the mean) in working memory and social skills, and profile C, presenting clinically significant deficits (2–3 SD above the mean) in shift, initiate, working memory, planning and social skills and mild deficits in inhibit, emotional control and task monitor. Proximal environmental stressors (dysfunctional parenting practices, parental stress, parent’s executive dysfunction, anxiety-trait, and depressive symptoms) and dysregulation symptoms predicted profile membership, whereas injury factors, child IQ and distal environmental stressors did not. Conclusion: Following ABI, children with profile C are at risk of mental health problems and present with more proximal stressors. The dysregulation profile may be useful as a proxy for risk for later mental health problems in children with ABI.     

Linking vitamin D status,executive functioning and self‐perceived mental health in adolescents through multivariate analysis: A randomized double‐blind placebo control trial

The aim of the present randomized double‐blind placebo control trial was to investigate if vitamin D supplementation had an effect on vitamin D status, executive functioning and self‐perceived mental health in a group of Norwegian adolescents during winter time. Fifty adolescents were randomly assigned into an intervention group (vitamin D pearls) or a control group (placebo pearls). Before (pre‐test in December/January) and after (post‐test in April/May) the intervention period the participants were exposed to a test procedure, consisting of blood draw, completion of cognitive tests (Tower of Hanoi and Tower of London), and the Youth Self‐report version of the Child Behavior Checklist. Multivariate data analysis showed that participants with low vitamin D status scored worse on the Tower of London tests and the more difficult sub‐tasks on the Tower of Hanoi tests. They also had a tendency to report higher frequency of externalizing behavior problems and attention deficit. At pre‐test, the overall mean vitamin D status measured as 25‐hydroxy vitamin D was 42 nmol/L, defining deficiency (Intervention group = 44 nmol/L, Control group = 39 nmol/L). However, vitamin D supplementation caused a significant increase in vitamin D status resulting in a sufficient level in the Intervention group at post‐test (mean 62 nmol/L). The results also revealed that the intervention group improved their performance on the most demanding sub‐tasks on the ToH. Overall, the study indicates that vitamin D status in adolescents may be important for both executive functioning and mental health.