Parenthood and parental functions as a result of the experience of parallel psychotherapy with children and parents

The concept of parenthood as defined in classical theory and later theorizations is discussed. Parenthood is defined as a transformative process, activated by the idea of having a child and by interaction with the child, through which a constellation of affective and psychic capacities is developed, promoting growth and psychic change and evolving over time. Parental functions, rather than being learnable skills, are considered as mind functions linked to character traits that cannot be split from the personality as a whole and are, as such, susceptible to improvement through psychotherapeutic work. The author illustrates this with a model of psychotherapies and parallel analyses of parents and children tested and elaborated in public and private practice, showing its therapeutic and cognitive advantages. The central thesis of the paper is that whatever the approach and working method with the parents, the therapeutic space offered encourages certain processes that are vital for the structuring of the self and the psychic growth of the child: creation of a space for the representation and emotional investment of the child; improvement in the parental functions; and identification with the therapist as a new or reactivated developmental object. Two clinical cases illustrate the parallel evolution of therapeutic relationships and of the parent‐child relationship.     

Evidence for the Syndrome of Nonverbal Learning Disabilities in Children with Brain Tumors

This study examined the predicted utility of the Nonverbal Learning Disabilities syndrome (NLD) (Rourke, 1995) for characterizing neurocognitive and psychosocial outcomes in 123 children with brain tumors. Children with brain tumors were found to be at high risk of having a specific academic deficit, particularly in arithmetic. Children with arithmetic deficit evidenced a higher rate of impairment on nonverbal tasks than on verbal tasks, whereas children with reading deficit evidenced a higher rate of impairment on verbal tasks than on nonverbal tasks. However, significant differences between children with arithmetic and reading deficits were not found for all of the component features of the NLD syndrome, and arithmetic deficit was not related to treatment with irradiation.     

Neurocognitive development in 5- to 16-year-old North American children: A cross-sectional study

Executive functions are thought to be the latest functions to mature. However, this view has not been tested by assessing simultaneously memory, perception of emotions, visuospatial perception, and visuoconstructional skills. NEPSY II norm data from 1000 5- to 16-year-old U.S. children were obtained. Fifteen NEPSY II subtests with no floor or ceiling effects in any age group and no major changes in task type were selected. The 16-year level was attained at age 12 to 13 in all subtests with two exceptions: social perception (age 10 to 11) and narrative memory (age 14). Trend analyses showed that development was rapid in the age range 5 to 9 years followed by a deceleration in the rate of development. Peak performances were reached at 14 to 16 years but later in some subtests representing executive functions, verbal memory, and visuospatial performance. Thus, the study specified developmental time tables of neurocognitive functions. It demonstrated that not only executive functions but also verbal memory and visuospatial performance continue to develop beyond age 16.     

Disentangling component learning and executive processes in hidden pathway maze learning in children: A process-based approach

Identification of cognitive processes that affect children’s ability to manage complex information is critical to understanding the development of executive functions. However, characterization of these processes is hampered by a lack of appropriate tasks and reliance on single outcome measures that are unsuitable for studying complex aspects of executive function. The current study aimed to circumvent these limitations by employing a hidden maze learning paradigm (Groton Maze Learning Test; independence of component cognitive GMLT) to evaluate the processes—spatial memory and rule use—that underlie hidden pathway maze learning in children. Specifically, we investigated the impact of withholding rule instructions (Study 1) and nonrepeating pathways on each trial (Study 2) on the ability to use rules and to locate pathways in 10 × 10 mazes in a sample of 8-year-old children. Results of these studies suggested that manipulations of task rules did not affect spatial memory and that manipulations of the maze pathway did not affect rule use. These findings demonstrate the independence of spatial memory and rule use on the GMLT and provide evidence of a “double dissociation” of cognitive processes that underlie hidden maze learning in children. Implications for understanding the coordination of component cognitive processes that underlie executive function in childhood are discussed.     

Neurological subtle signs and cognitive development: A study in late childhood and adolescence

Introduction and Aim: Neurological subtle signs (NSS) are often observed during the neurological examination of children and tend to disappear with age. Their persistence into late adolescence or young adulthood has been related to psychiatric and neurocognitive disorders. To provide a better understanding of their functional basis, a longitudinal correlational study with neurocognitive measurements was performed.

Method: We conducted multiple regression and correlation analyses of NSS with demographic and cognitive measures on a subset of 341 healthy children (56% males), taking part in a longitudinal dental study. Participants, whose ages ranged between 11–15 years, at first evaluation, undertook yearly, during 5 years, a 6-item NSS exam (producing a total score ranging between 0–18) and a comprehensive battery of neurocognitive tests. Effects of age, gender, IQ, and 7 neurocognitive factors on NSS were analyzed.

Results: Over the years, NSS scores correlated consistently with selective attention (Stroop test), motor speed (finger tapping), and visuomotor speed (pegboard speed).

Discussion: These results suggest that the disappearance of NSS in late childhood and adolescence occurs primarily in parallel with the development of motor and visuomotor functions and secondarily in relation to higher order functions such as selective attention (Stroop) and executive control (B-A Trails difference).     

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.     

A novel executive function battery for preschoolers: Sensitivity to age differences

The present study investigated sensitivity to age differences in a novel executive function (EF) battery for children aged 18 months to 5 years, and whether the pattern of associations among the measures was consistent with a hierarchical model of EF development. Participants (n = 261, aged 18–67 months) were administered a battery of novel tasks designed to assess 3 key EF components (working memory, inhibition, and shifting). The results indicate that the EF tasks were sensitive to age differences and provide partial support for the hierarchical model of EF development.     

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.     

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.     

ATTENTIONAL FLEXIBILITY AND PERSEVERATION: DEVELOPMENTAL ASPECTS IN YOUNG CHILDREN

Whereas a growing interest in the development of attentional flexibility (AF) and in perseverative behavior, being one marker of this component, exists in neuropsychological studies and in the domain of developmental psychopathology (e.g., PKU, infantile schizophrenia, autism and Parkinson's disease) (Pennington &; Ozonoff, 1996 Pennington, B. and Ozonoff, S. 1996. Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37: 51–88. [PUBMED][INFOTRIEVE][CSA][Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Stahl &; Pry, 2002 Stahl, L. and Pry, R. 2002. Joint attention and set-shifting in young children with autism. Autism, 6(4): 383–396. [PUBMED][INFOTRIEVE][CROSSREF][Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), only a few studies have concerned themselves with this subject in normal children. It is thus of interest to add more empirical data to the existing literature in this domain. Therefore, the aim of our study was to explore the development of AF and of perseverative errors in young preschool children with normal development, aged 1.5 to 6 years. Using set-shifting tasks of increasing difficulty level, three age groups were compared with respect to their AF skills.Results show a developmental factor underlying AF, with different levels of this form becoming more and more complex with age, ranging from a rudimentary visual form to a complex representational form of flexibility. Overall, few perseverative errors occurred and they decreased with age. Results are discussed from a developmental and neuropsychological perspective.