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.     

Moving attention along the mental number line in preschool age: Study of the operational momentum in 3‐ to 5‐year‐old children's non‐symbolic arithmetic

People tend to underestimate subtraction and overestimate addition outcomes and to associate subtraction with the left side and addition with the right side. These two phenomena are collectively labeled 'operational momentum' (OM) and thought to have their origins in the same mechanism of 'moving attention along the mental number line'. OM in arithmetic has never been tested in children at the preschool age, which is critical for numerical development. In this study, 3–5 years old were tested with non‐symbolic addition and subtraction tasks. Their level of understanding of counting principles (CP) was assessed using the give‐a‐number task. When the second operand's cardinality was 5 or 6 (Experiment 1), the child's reaction time was shorter in addition/subtraction tasks after cuing attention appropriately to the right/left. Adding/subtracting one element (Experiment 2) revealed a more complex developmental pattern. Before acquiring CP, the children showed generalized overestimation bias. Underestimation in addition and overestimation in subtraction emerged only after mastering CP. No clear spatial‐directional OM pattern was found, however, the response time to rightward/leftward cues in addition/subtraction again depended on stage of mastering CP. Although the results support the hypothesis about engagement of spatial attention in early numerical processing, they point to at least partial independence of the spatial‐directional and magnitude OM. This undermines the canonical version of the number line‐based hypothesis. Mapping numerical magnitudes to space may be a complex process that undergoes reorganization during the period of acquisition of symbolic representations of numbers. Some hypotheses concerning the role of spatial‐numerical associations in numerical development are proposed.     

Attention in Williams syndrome and Down's syndrome: Performance on the new early childhood attention battery

Attentional problems are commonly reported as a feature of the behavioural profile in both Williams syndrome (WS) and Down's syndrome (DS). Recent studies have begun to investigate these impairments empirically, acknowledging the need for an approach that considers cross‐syndrome comparisons and developmental changes across the different component functions of attention. The present study assessed children with WS and DS using a new preschool attention battery (ECAB: early childhood attention battery), designed to be suitable for mental age 3–6 years including groups with developmental disorders. The ECAB has the advantage of giving an individual profile of attentional abilities for each child, covering different components of attention. In relation to test norms for their mental age, both groups showed a profile of strengths and weaknesses in the attention domain. Both syndrome groups performed relatively well on tests of sustained attention and poorly on aspects of selective attention and attentional control (executive function). The DS group showed a specific strength in auditory sustained attention, whilst the WS group showed a particular deficit in visuo‐spatial response control. There was also evidence for considerable differences in the developmental trajectory of these abilities across the two groups. The results provide evidence for syndrome‐specific patterns of impairment, and distinct profiles of strengths and weaknesses that may be useful in understanding the nature of everyday attention difficulties in these groups and tailoring interventions to meet these needs.     

The effects of spatial configuration on preschoolers' attention strategies,selective attention,and incidental learning

This study investigated the effects of spatial arrangement on preschool children's selective attention and incidental learning. Three‐ and four‐year old children were shown a multi‐coloured box designated as a ‘special place’ containing miniature chairs and models of animals. One category of objects were designated as relevant and one as irrelevant. Relevant items were placed in each of the apparatus' corners, in the middle of its walls, or in two corners and in the middle of two walls. Findings revealed that children shown relevant items in corners demonstrated the greatest number of correct relocations for relevant items while those shown relevant items in the middle of the walls showed the greatest number of correct relocations for irrelevant items. Findings also suggest that for both age groups, the ability to recall relevant items may have been independent of their ability to demonstrate a selective attention strategy. Copyright © 2005 John Wiley & Sons, Ltd.     

Perceptual load influences selective attention across development

Research suggests that visual selective attention develops across childhood. However, there is relatively little understanding of the neurological changes that accompany this development, particularly in the context of adult theories of selective attention, such as N. Lavie's (1995) perceptual load theory of attention. This study examined visual selective attention across development from 7 years of age to adulthood. Specifically, the author examined if changes in processing as a function of selective attention are similarly influenced by perceptual load across development. Participants were asked to complete a task at either low or high perceptual load while processing of an unattended probe stimulus was examined using event related potentials. Similar to adults, children and teens showed reduced processing of the unattended stimulus as perceptual load increased at the P1 visual component. However, although there were no qualitative differences in changes in processing, there were quantitative differences, with shorter P1 latencies in teens and adults compared with children, suggesting increases in the speed of processing across development. In addition, younger children did not need as high a perceptual load to achieve the same difference in performance between low and high perceptual load as adults. Thus, this study demonstrates that although there are developmental changes in visual selective attention, the mechanisms by which visual selective attention is achieved in children may share similarities with adults.     

The impact of spatial cues on preschoolers' selective attention

The effects of spatial arrangement on preschool children's ability to selectively attend were investigated. Three- and 4-year old children were shown a multicolor dollhouse room intended to serve as a special place containing miniature chairs and models of animals. One category of objects was designated as relevant and 1 as irrelevant. Relevant items were placed in each of the apparatus's corners or in the middle of its walls. Children in the corners condition correctly relocated more relevant items than children in the wall or control conditions. The findings suggest that for both age groups, the ability to recall relevant items may be independent of their ability to demonstrate a selective attention strategy.     

Cross-cultural differences in cognitive development: attention to relations and objects

Growing evidence indicates a suite of generalized differences in the attentional and cognitive processing of adults from Eastern and Western cultures. Cognition in Eastern adults is often more relational and in Western adults is more object focused. Three experiments examined whether these differences characterize the cognition of preschool children in the two cultures. In Experiment 1, 4-year-olds from the two cultures (N=64) participated in a relational match-to-standard task in two conditions, with simple or richly detailed objects, in which a focus on individual objects may hurt performance. Rich objects, consistent with past research, strongly limited the performance of U.S. children but not Japanese children. In Experiment 2, U.S. and Japanese 4-year-olds (N=72) participated in a visual search task that required them to find a specific object in a cluttered, but organized as a scene, visual field in which object-centric attention might be expected to aid performance and relational attentional pattern may hinder the performance because of relational structure that was poised by the scene. U.S. children outperformed Japanese children. In Experiment 3, 4-year-olds from both cultures (N=36) participated in a visual search task that was similar to Experiment 2 but with randomly placed objects, where there should not be a difference between the performance of two cultures because the relational structure that may be posed by the scene is eliminated. This double-dissociation is discussed in terms of implications for different developmental trajectories, with different developmental subtasks in the two cultures.     

Visual exogenous and endogenous attention and visual memory in preschool children who stutter

PurposeAttention develops gradually from infancy to the preschool years and beyond. Exogenous attention, consisting of automatic responses to salient stimuli, develops in infancy, whereas endogenous attention, or voluntary attention, begins to develop later, in the preschool years. The purpose of this study was to examine (a) exogenous and endogenous attention in young children who stutter (CWS) and children who do not stutter (CWNS) through two conditions of a visual sustained selective attention task, and (b) visual short-term memory (STM) between groups within the context of this task.Method42 CWS and 42 CWNS, ages 3;0–5;5 (years;months), were pair-matched in age, gender (31 males, 11 females per group), and socioeconomic status. Children completed a visual tracking task (Track-It Task; Fisher et al., 2013) requiring sustained selective attention and engaging exogenous and endogenous processes. Following each item, children were asked to recall the item they had tracked, as a memory check.ResultsThe CWS group demonstrated significantly less accuracy in overall tracking and visual memory for the tracked stimuli, compared to the CWNS group. Across groups, the children performed better in sustained selective attention when the target stimuli were more salient (the condition tapping both exogenous and endogenous attention) than when stimuli were less so (the condition tapping primarily endogenous processes).ConclusionsRelative to peers, preschool-age CWS, as a group, display weaknesses in visual sustained selective attention and visual STM.     

Laterality and selective attention in hyperactive children

Laterality and selective attention were investigated in a group of 20 hyperactive children and their matched controls using a dichotic listening task. There was a strong rightear advantage for both groups indicating that hyperactive children were not different from normal children in hemispheric specialization for verbal stimuli. In the selective attention experiment hyperactive children were again not different from normal children in their ability either to select the input designated as relevant or to resist the distraction of input designated irrelevant. Both groups gave more correct responses from the right ear than from the left ear, and more intrusions from the right ear than from the left. The results do not suggest abnormalities of lateralization for verbal material or indicate the existence of a selective attentional deficit. It is suggested that such reported deftcits may be situation or taskspecific.     

Neuro‐oscillatory mechanisms of intersensory selective attention and task switching in school‐aged children,adolescents and young adults

The ability to attend to one among multiple sources of information is central to everyday functioning. Just as central is the ability to switch attention among competing inputs as the task at hand changes. Such processes develop surprisingly slowly, such that even into adolescence, we remain slower and more error prone at switching among tasks compared to young adults. The amplitude of oscillations in the alpha band (~8–14 Hz) tracks the top‐down deployment of attention, and there is growing evidence that alpha can act as a suppressive mechanism to bias attention away from distracting sensory input. Moreover, the amplitude of alpha has also been shown to be sensitive to the demands of switching tasks. To understand the neural basis of protracted development of these executive functions, we recorded high‐density electrophysiology from school‐aged children (8–12 years), adolescents (13–17), and young adults (18–34) as they performed a cued inter‐sensory selective attention task. The youngest participants showed increased susceptibility to distracting inputs that was especially evident when switching tasks. Concordantly, they showed weaker and delayed onset of alpha modulation compared to the older groups. Thus the flexible and efficient deployment of alpha to bias competition among attentional sets remains underdeveloped in school‐aged children.     

Closing-in behaviour in preschool children

Many pre-school children show closing-in behaviour (CIB) in graphic copying tasks: a tendency to place their copy abnormally close to or even on top of the model. Similar phenomena have been studied in patients with dementia, though it is unclear whether the superficial similarities between CIB in development and dementia reflect common underlying cognitive mechanisms. The aim of the present study was to investigate the cognitive functions involved in CIB in pre-school children. Forty-one children (3–5 years) were assessed for CIB, and completed a neuropsychological battery targeting visuospatial abilities, short term memory (verbal and spatial) and attention (sustained attention, selective attention and attention switching). Binary logistic regression found that performance on the attention subtests was the best unique predictor of CIB. A second analysis, in which the three attention subtests were entered as separate predictors, suggested that attention switching ability was most strongly related to CIB. These results support the view that CIB in children reflects inadequate attentional control. The convergence of these results with similar observations in patients with dementia further suggests that similar cognitive factors underlie CIB in these two populations.     

Age-related changes in visual and auditory sustained attention in preschool-aged children

Objective: The development of sustained attention in the preschool years is not yet fully understood. Delineating age-related changes of attentional proficiencies and deficiencies is important for understanding atypical developmental trajectories, specifically in neurodevelopmental disorders that are characterized by attentional difficulties. The objective of the current study was to develop preschool-appropriate measures for assessing sustained attention and to chart developmental changes in attention in early childhood. Method: Using adapted computerized paradigms, the present study investigated age-related changes in visual and auditory sustained attention in seventy typically developing children aged 3 to 6 years. Results: The results indicated that similar age-related gains in performance emerged across both visual and auditory attention tasks. Conclusion: The findings suggest that the adapted measures developed in this study are sensitive enough to capture developmental variations in attention performance.     

Selective attention in children with reading problems: A developmental study of incidental learning

The performance of poor readers and control children at three grade levels, first, third, and fifth grades, was compared on an incidental learning task adapted by Hagen (1967). A significant group by task interaction in a repeated measures ANOVA indicated that reading ability was differentially related to performance on the tasks. Relative to control children at all grade levels, poor readers obtained lower scores on the central task and higher scores on the incidental task. The absence of a grade × task × reading ability interaction indicated that selective attention follows the same developmental course in poor readers as in control children. The data suggest that the development of selective attention as reflected in performance on this task is delayed from 2 to 4 years in poor readers.We wish to thank the Sachem School District for permission to test the children, Mr. Morgan, reading specialist, and the teachers and children involved for their cooperation. We thank especially Mr. David Mello, principal of the Chippewa Elementary School for his invaluable assistance. We also thank Gordon Hale for providing the stimulus materials used in the study and for helpful suggestions regarding procedural details.     

Assessment of Attention in Preschoolers

In the past two decades, there has been an increased interest in the assessment and treatment of preschool children presenting with concerns about attention problems. This article reviews the research and clinical literature involving assessment of attention and related skills in the preschool years. While inattention among preschoolers is common, symptoms alone do not necessarily indicate a disorder, and most often represent a normal variation in typical preschool child development. Thus, accurate identification of ??disordered?? attention in preschoolers can be challenging, and development of appropriate, norm-referenced tests of attention for preschoolers is also difficult. The current review suggests that comprehensive assessment of attention and related functions in the preschool child should include thorough review of the child??s history, planned observations, and formal psychometric testing. The three primary methods of psychometric assessment that have been used to characterize attentional functioning in preschool children include performance-based tests, structured caregiver interviews, and rating scales (parent, teacher, and clinician). Among performance-based methods for measurement of attention in the preschool years, tests have been developed to assess sustained attention, selective (focused) attention, span of attention (encoding/manipulation), and (top-down) controlled attention??including freedom from distractibility and set shifting. Many of these tests remain experimental in nature, and review of published methods yields relatively few commercially available, nationally normed tests of attention for preschoolers, and an overall dearth of reliability and validity studies on the available measures.     

Selective attention,filtering, and the development of working memory

Selective attention is fundamental for learning across many situations, yet it exhibits protracted development, with young children often failing to filter out distractors. In this research, we examine links between selective attention and working memory (WM) capacity across development. One possibility is that WM is resource‐limited, with development resulting in an increase in the amount of resources available for processing information. However, it is also possible that development results in greater efficiency of using available resources. In the current research, we explore the latter possibility by examining the developmental trajectory of selectivity and filtering in relation to WM capacity. We report that filtering efficiency of adults (N = 30), 7‐year‐olds (N = 29), and 4‐year‐olds (N = 28) was uniquely predictive of WM capacity. We also report that filtering efficiency continues to develop after 7 years of age, whereas WM capacity may reach an asymptote around 7 years of age. The latter finding suggests that selective attention plays a critical role in developmental and individual differences in visual working memory capacity.     

Early development of subcortical regions involved in non-cued attention switching

This study examined the cognitive and neural development of attention switching using a simple forced-choice attention task and functional magnetic resonance imaging Fourteen children and adults made discriminations among stimuli based on either shape or color. Performance on these trials was compared to performance during blocked trials requiring all color or all shape discriminations. Magnetic resonance echo planar images were acquired during performance of the task. Both children and adults showed robust bilateral activity of the caudate nucleus when switching attention between color and shape discriminations that correlated negatively with mean response latency on these trials. However, neither switching costs nor caudate activity correlated with age, suggesting early development of the underlying neural circuitry involved in switching between salient stimulus sets. Overall, children and adults differed in performance and patterns of brain activity on the task, with adults responding more accurately and faster than children, and recruiting more prefrontal and parietal regions. These results suggest an important role of subcortical regions (i.e. caudate nucleus) in non-cued attention switching, with increasing recruitment of cortical regions with age.     

Story Comprehension in Children with ADHD

A wealth of research is available examining children's story comprehension. However, little attention has been directed toward understanding the story comprehension of children with attention deficit hyperactivity disorder (ADHD). The present paper attempts to integrate the developmental literature on children's story comprehension with the little that is known about the story comprehension processes of children with ADHD. This review is guided by a network model of story representation that emphasizes the structure of causal and enabling relations between story events. Examination of the available studies indicates that children with ADHD lag behind their peers in their understanding of causal relations, and that their attentional problems may contribute to difficulties in understanding factual information in the preschool years and causally related information in the elementary years. Some evidence also is presented suggesting that children with ADHD are less effective in taking advantage of story structure features in guiding their recall of story events. Suggestions for future research are offered that would elaborate our knowledge of the developmental progression in the processing of complex information by children with ADHD.     

Knowledge as process: contextually-cued attention and early word learning

Learning depends on attention. The processes that cue attention in the moment dynamically integrate learned regularities and immediate contextual cues. This paper reviews the extensive literature on cued attention and attentional learning in the adult literature and proposes that these fundamental processes are likely significant mechanisms of change in cognitive development. The value of this idea is illustrated using phenomena in children novel word learning.     

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.