Secondary attention-deficit/hyperactivity disorder following perinatal and childhood stroke: impact on cognitive and academic outcomes

This cross-sectional retrospective clinical research study examines a large group of children followed within a pediatric stroke program and a developmental attention-deficit/hyperactivity disorder (ADHD) clinic at the Hospital for Sick Children, between May 2004 and June 2016. All children with a history of stroke who participated in a neuropsychological assessment between the ages of 4 and 18 years were considered for inclusion. From a sample of 275 participants with a history of stroke, 36 children (13.1%) received a diagnosis of secondary ADHD. Children with secondary ADHD were younger at the time of stroke and more likely to be identified as having a presumed perinatal stroke and persistent seizures than children without secondary ADHD diagnoses. There were no differences in pattern of lesion, size, or laterality between children who developed secondary ADHD and those who did not. Children with secondary ADHD had the lowest scores across all cognitive and academic measures compared to children with stroke-only and developmental ADHD. Findings highlight the added risk of receiving a diagnosis of secondary ADHD following pediatric stroke. Implications for future research and directed intervention are discussed.     

A Biologically Plausible Action Selection System for Cognitive Architectures: Implications of Basal Ganglia Anatomy for Learning and Decision‐Making Models

Several attempts have been made previously to provide a biological grounding for cognitive architectures by relating their components to the computations of specific brain circuits. Often, the architecture's action selection system is identified with the basal ganglia. However, this identification overlooks one of the most important features of the basal ganglia—the existence of a direct and an indirect pathway that compete against each other. This characteristic has important consequences in decision‐making tasks, which are brought to light by Parkinson's disease as well as genetic differences in dopamine receptors. This paper shows that a standard model of action selection in a cognitive architecture (ACT‐R) cannot replicate any of these findings, details an alternative solution that reconciles action selection in the architecture with the physiology of the basal ganglia, and extends the domain of application of cognitive architectures. The implication of this solution for other architectures and existing models are discussed.     

Arrows don’t look at you: Qualitatively different attentional mechanisms triggered by gaze and arrows

Eye gaze conveys rich information concerning the states of mind of others, playing a critical role in social interactions, signaling internal states, and guiding others’ attention. On the basis of its social significance, some researchers have proposed that eye gaze may represent a unique attentional stimulus. However, contrary to this notion, the majority of the literature has shown indistinguishable attentional effects when eye gaze and arrows have been used as cues. Taking a different approach, in this study we aimed at finding qualitative attentional differences between gazes and arrows when they were used as targets instead of as cues. We used a spatial Stroop task, in which participants were required to identify the direction of eyes or arrows presented to the left or the right of a fixation point. The results showed that the two types of stimuli led to opposite spatial interference effects, with arrows producing faster reaction times when the stimulus direction was congruent with the stimulus position (a typical spatial Stroop effect), and eye gaze producing faster reaction times when it was incongruent (a “reversed” spatial Stroop effect). This reversed Stroop is interpreted as an eye-contact effect, therefore revealing the unique nature of eyes as special social-attention stimuli.     

The influence of practicum supervisors’ facilitation styles on student teachers’ reflective thinking during collective reflection

Student teachers’ reflective thinking is closely associated with learning and improving practice. Novice student teachers require adequate support to reflect more deeply. The role of ‘others’ in collective reflection and knowledge generation as an outcome creates a platform for deep reflection, addressing both the processes and premises of reflective thinking. Facilitation styles of practicum supervisors could influence the level of student teachers’ reflective thinking during collective reflection. This is a case study using purposeful sampling involving a Malaysian teacher training institution that conducted an undergraduate early childhood programme in collaboration with a UK university. Sources of evidence were interviews, direct observations and documents. Data collected were analysed using both inductive and deductive methods. It was found that facilitation styles influence the depth of student teachers’ reflective thinking during group dialogic reflection. A continuum of facilitation styles from collaborative to instructive typologies was constructed. The implications of these findings are discussed.     

The missing link? Testing a schema account of unitization

Unitization refers to the creation of a new unit from previously distinct items. The concept of unitization has been used to explain how novel pairings between items can be remembered without requiring recollection, by virtue of new, item-like representations that enable familiarity-based retrieval. We tested an alternative account of unitization – a schema account – which suggests that associations between items can be rapidly assimilated into a schema. We used a common operationalization of “unitization” as the difference between two unrelated words being linked by a definition, relative to two words being linked by a sentence, during an initial study phase. During the following relearning phase, a studied word was re-paired with a new word, either related or unrelated to the original associate from study. In a final test phase, memory for the relearned associations was tested. We hypothesized that, if unitized representations act like schemas, then we would observe some generalization to related words, such that memory would be better in the definition than sentence condition for related words, but not for unrelated words. Contrary to the schema hypothesis, evidence favored the null hypothesis of no difference between definition and sentence conditions for related words (Experiment 1), even when each cue was associated with multiple associates, indicating that the associations can be generalized (Experiment 2), or when the schematic information was explicitly re-activated during Relearning (Experiment 3). These results suggest that unitized associations do not generalize to accommodate new information, and therefore provide evidence against the schema account.     

Predicting ADHD Symptoms in Adolescence from Early Childhood Temperament Traits

Extreme levels of certain temperament traits can be early markers of different developmental pathways of attention-deficit/hyperactivity disorder (ADHD). However, the long-term utility of using these traits as predictors of ADHD is not fully known. This study includes 64 male adolescents (M age = 13.5), who have been followed since birth as part of a longitudinal study. The primary aim was to test effortful control (EC), activity level, and anger, measured in early childhood – both with mother’s reports and laboratory assessments –as predictors of ADHD symptoms in adolescence. Further, we investigated the specificity of this prediction to the different ADHD symptom domains. The results demonstrated that early temperament dimensions of EC and activity level were predictive of ADHD symptoms about 10 years later, when the participants reached adolescence. Moreover, activity level showed specificity only to hyperactivity-impulsivity symptoms whereas EC was a predictor of the two symptom domains. Anger had a predictive correlation with ADHD symptoms; however, it did not have a unique predictive contribution. These results emphasize the relevance of EC and activity level in the developmental course of ADHD. Identification of early risk factors can lead to more efficient design and implementation of intervention programs.     

Impact of Huntington Disease Gene-Positive Status on Pre-Symptomatic Young Adults and Recommendations for Genetic Counselors

Huntington disease (HD) is an autosomal dominant, progressive neurodegenerative disorder for which there is no cure. Predictive testing for HD is available to asymptomatic at-risk individuals. Approximately half of the population undergoing predictive testing for HD consists of young adults (≤35 years old). Finishing one’s education, starting a career, engaging in romantic relationships and becoming a parent are key milestones of young adulthood. We conducted a qualitative study to explore how testing gene-positive for HD influences young adults’ attainment of these milestones, and to identify major challenges that pre-symptomatic young adults face to aid the development of targeted genetic counseling. Results of our study demonstrate that 1) knowing one’s gene-positive status results in an urgency to reach milestones and positively changes young adults’ approach to life; 2) testing positive influences young adults’ education and career choices, romantic relationships, and family planning; 3) young adults desire flexible and tailored genetic counseling to address needs and concerns unique to this population. Findings of this study contribute to the understanding of the impact of predictive testing for HD on young adults, and highlight issues unique to this population that call for further research, intervention and advocacy.     

Action observation network in childhood: a comparative fMRI study with adults

Very little is known about the action observation network and the mirror neuron system (AON/MNS) in children and its age‐related properties compared with those observed in adults. In the present fMRI study we explored the activation of areas belonging to the AON/MNS in children and adults during observation of complex hand‐grasping actions, as compared to observation of simple grasping acts executed with the left and the right hand, seen from a first person perspective. The results indicate that during the action observation tasks in children there was activation of a cortical network similar to that found in adults, including the premotor cortex, the posterior part of the inferior frontal gyrus and the posterior parietal lobe. However, the activation in children was more widespread and showed a higher inter‐subject variability compared with adults. Furthermore, the activated network seems more lateralized to the left hemisphere in adults and more bilateral in children, with a linear growth of lateralization index as a function of age. Finally, in children the activation in the anterior intraparietal cortex (AIP) of each hemisphere was higher during observation of the contralateral hand (hand identity effect) and during the observation of complex actions relative to simple grasping acts, confirming the role of AIP for action‐related hand identity previously described in adults. These results support the assumption that structure and size of action representations are sensitive to mechanisms of development and show physiological plasticity. These properties of the AON/MNS could constitute a powerful tool for spontaneous reorganization and recovery of motor deficits after brain injury in children and in adults, as well as for specific rehabilitation programmes.