Ophthalmic disorder may affect visuo-attentional performance in childhood

The aim of this study was to explore the visuo-attentional skills of children with an ophthalmic disorder. Twenty-four patients and 60 healthy controls between the ages 4 and 7 years, all right-handed with normal or corrected-to-normal close visual acuity, were divided into four age groups. Patients' diagnoses included refractive disorders (e.g., myopia, hypermetropia), strabismus, amblyopia, cataract, and nystagmus. All participants performed nine paper-and-pencil visuospatial tasks aiming to assess selective attention (cancellation tasks), spatial working memory (symbol orientation task), fine visual analysis (embedded figures test), and simple perceptual analysis (shape-matching task). In healthy children, the results showed that performance on all visuo-attentional tasks improved with age. While perception, orientation of attention, and visual working memory develop by the time children begin school (age 5), more sophisticated abilities such as attention disengagement and motor control continue to develop during late childhood. Moreover, a spatial bias in attention orienting appeared with reading acquisition (6–7 years). In ophthalmic children, at 4 years of age defects were observed in all assessed functions, but at 7 years an attentional deficit was virtually the only one remaining. Overall, the results demonstrate that children with an ophthalmologic disorder may experience difficulties with visuospatial tasks despite corrected-to-normal visual acuity.     

A Clinical Comparative Study Evaluating the Effect of Epilepsy Versus Adhd on Timed Cognitive Tasks in Children

Both children with epilepsy and children with ADHD may be characterized by slowing on reaction-time measurement. This is of particular interest, as neuropsychological assessment is often requested in the differential diagnosis between children with short non-convulsive epileptic seizures and children with ADHD. In this study we attempt to identify patterns of impairment on timed tasks that are specific for epilepsy, relative to ADHD. This study was an open, controlled parallel-group clinical investigation which included two groups of patients: 60 children with ADHD and 60 children with epilepsy. These children were compared with a control group (n =30) on two types of timed cognitive tasks: tasks with low information load (simple reaction-time measurement) and tasks with high information load (multiple decision reaction-time measurement). The simple reaction-time measurements show significant differences between ADHD and controls (all except for visual RT non-dominant hand) and between epilepsy and controls (only one test). No significant differences were found between epilepsy and ADHD. The two tests with high information load show significant slowing compared with the controls for epilepsy on the Binary Choice Reaction-Time Test and for ADHD on the Visual Searching Test. On both tests also the differences between epilepsy and ADHD are significant. The two tests in combination have a relatively satisfactory potential to classify the children with ADHD (75% correct classification) and the children with epilepsy (55% correct classification). We may conclude that complex reaction-time tests (i.e., timed tasks with high information load) have potential for assessing the differential impact of ADHD and epilepsy on attentional function. These tasks specifically reveal general slowing for children with epilepsy and slowing as an effect of failures of inhibitory self control on unstructured tasks for ADHD.     

Clinical Validity and Interpretation of the Gordon Diagnostic System in ADHD Assessments

Gordon Diagnostic System (GDS) data were analyzed for 165 referred children with ADHD combined type and 46 referred children without ADHD, 6–16 years of age. Results showed significant differences between children with and without ADHD on the GDS standard scores and the IQ-GDS differences scores. Using a GDS composite standard score of 13 points or more below IQ to classify children as having ADHD resulted in the highest diagnostic accuracy (86%), with positive predictive power equal to 91%, and negative predictive power 67%. Results for the GDS compared favorably with those reported for other continuous performance tests. The findings lend support to the GDS as a clinically useful component of an ADHD evaluation.     

Working memory training improves reading processes in typically developing children

The goal of this study was to investigate whether a brief cognitive training intervention results in a specific performance increase in the trained task, and whether there are transfer effects to other nontrained measures. A computerized, adaptive working memory intervention was conducted with 9- to 11-year-old typically developing children. The children considerably improved their performance in the trained working memory task. Additionally, compared to a matched control group, the experimental group significantly enhanced their reading performance after training, providing further evidence for shared processes between working memory and reading.     

Multigroup confirmatory factor analysis and structural invariance with age of the Behavior Rating Inventory of Executive Function (BRIEF)—French version

The parent and teacher forms of the French version of the Behavioral Rating Inventory of Executive Function (BRIEF) were used to evaluate executive function in everyday life in a large sample of healthy children (N = 951) aged between 5 and 18.

Several psychometric methods were applied, with a view to providing clinicians with tools for score interpretation. The parent and teacher forms of the BRIEF were acceptably reliable. Demographic variables (such as age and gender) were found to influence the BRIEF scores. Confirmatory factor analysis was then used to test five competing models of the BRIEF's latent structure. Two of these models (a three-factor model and a two-factor model, both based on a nine-scale structure) had a good fit. However, structural invariance with age was only obtained with the two-factor model.

The French version of the BRIEF provides a useful measure of everyday executive function and can be recommended for use in clinical research and practice.     

Cognitive development in 7- to 24-month-old extremely/very-to-moderately/late preterm and full-term born infants: The mediating role of focused attention

The present study analyzed the links between prematurity, attention, and global cognitive performance in infancy and early childhood. At 7 months, focused attention (FA) was examined with an object examination task in 93 preterm infants (39 of them born extremely/very preterm, 54 born moderately/late preterm, and 38 infants born full-term). Global cognition was assessed at 7 and 24 months with the Bayley-II cognitive scale. Groups did not differ with respect to global cognitive performance but FA of infants born extremely/very preterm was significantly lower than in infants born moderately/late preterm. FA correlated significantly with both prematurity and cognitive performance at 7 months of age but not with global cognition in childhood. Findings point to a subtle adverse effect of prematurity on early attention and reveal evidence for the mediating role of FA on the effect of prematurity on cognition.     

The specificity of the Stroop interference score of errors to ADHD in boys

The Stroop Interference Test is widely used to assess the inhibition function; however, divergent results have emerged from meta-analyses in children with ADHD. This has led to conflicting results as to whether the Stroop test detects the level of inhibition in these children. We hypothesized that the general approach to include interference scores depending on response time causes conflicting results, whereas recordings of errors may prove a superior measure of the inhibition function in children with ADHD. In the present study, 39 children with an ADHD diagnosis, two subgroups with and without another comorbid mental health disorder, were compared with respect to their interference scores of response time and errors with two subgroups of children with no ADHD. The two subgroups comprised 33 children with another mental health disorder other than ADHD and 56 children with no psychiatric disorder. The between-group analyses detected a multivariate, marginal main effect of an ADHD diagnosis on the Stroop interference scores, and a univariate main effect of an ADHD diagnosis on the interference score of errors. Further, only the interference score of errors predicted significantly the parent reported scores on the Inhibit scale from the Behavior Rating Inventory of Executive Function. These findings support that a Stroop interference score of errors is sensitive for inhibition problems in children with ADHD and encourages the use of Stroop versions including error recordings independent of response time.     

Executive function in preschool children prenatally exposed to methadone or buprenorphine

Although an increasing number of children are born with prenatal methadone or buprenorphine exposure, little is still known about the potential long-term effects of these opioids. The aim of this study was to investigate executive function (EF) in children of women in opioid maintenance therapy (OMT). A total of 66 children (aged 48–57 months) participated in the study, 35 of which had histories of prenatal methadone or buprenorphine exposure. EF was measured using a battery of neuropsychological tests and the Behavior Rating Inventory of Executive Function—Preschool Version (BRIEF-P). Results showed that children of women in OMT perform lower on tasks of short-term memory and inhibition compared to nonexposed children, which was mainly associated with lower maternal education and employment rate. The OMT group scored significantly lower on all EF tasks compared to the nonexposed group, although scores fell within the average range on all measures. The development of these children should be monitored to assess for the possible problem behaviors and to promote optimal outcomes.     

Using Dichotic Listening to Study Bottom-up and Top-down Processing in Children and Adults

The study examined top-down attention modulation of bottom-up processing in children and adults under conditions of varying bottom-up stimulus demands. Voiced and unvoiced consonant-vowel syllables were used in a dichotic-listening situation to manipulate the strength of the bottom-up stimulus-driven right ear advantage when subjects were instructed to focus attention on, and report, either the left or right ear stimulus. We predicted that children would differ from adults in their ability to use attention to modulate a lateralized ear advantage, and particularly when there was a conflict between the direction of the bottom-up ear advantage and the direction of the top-down attention instruction. Thirty children and 30 adults were presented with dichotic presentations of consonant-vowel syllables. The results showed that the voicing manipulation affected the strength of the ear advantage, and that the children performed significantly below the adults when the voicing parameter caused a strong conflict between bottom-up and top-down processing. Thus, children seem to lack the cognitive flexibility necessary to modulate a stimulus-driven bottom-up ear advantage, particularly in situations where right ear advantage (REA) is enhanced by the acoustic properties of the stimuli and attentional demands require a left ear shift. It is suggested that varying the stimulus demands in a dichotic-listening situation may be a novel way to study cognitive development.     

Assessment of cognitive domains during treatment with OROS methylphenidate in adolescents with ADHD

Aim: To psychometrically assess cognitive domains in adolescents with ADHD during long-term open treatment with robust dosing of extended-release methylphenidate (OROS MPH).

Methods: Data were derived from a prospective clinical study of adolescent ADHD, employing the Cambridge Neuropsychological Test Automated Battery (CANTAB), before and after up to one year of treatment with OROS MPH. In the absence of placebo control, a similar age and gender group of youth without ADHD served as comparators.

Results: During the course of treatment with OROS MPH, ADHD youth’s performance significantly improved across multiple CANTAB tasks, including spatial working memory, rapid visual processing, verbal recognition memory, set shifting, and inhibition/vigilance. ADHD subjects’ scores in several CANTAB tasks, including spatial working memory, planning, and set shifting, were significantly more impaired at baseline compared to the non-ADHD comparison group; these significant differences were no longer seen at endpoint.

Conclusions: Statistically significant improvements in multiple cognitive domains were observed in a sample of adolescents with ADHD over the course of 12 months of robust treatment with extended-release methylphenidate. Rigorous, monitored stimulant treatment may be associated with objectively determined cognitive benefits; however, practice effects in this open trial cannot be ruled out. Further study on this important topic is warranted.