Applied Neuropsychology: Child最新文献

Purpose: Literature on children who are deaf or hard of hearing (DHH) suggests overall increased rates of difficulties in emotional/behavioral and adaptive functioning. However, limitations of this literature include the failure to integrate issues unique to the experience of children who are DHH, such as home and school communication modalities and the consistency of modalities across settings.

Method: This study examined de-identified data from a clinical database. Data included caregiver ratings of emotional/behavioral and adaptive functioning in a diverse sample of clinically referred children who are DHH (N = 177). Caregivers also reported home and school communication modalities (e.g., match, partial match, different modalities). We examined mean score differences between our sample and normative samples and compared functioning across subgroups of children with various home-school communication modality combinations.

Results: Consistent with the literature, we found overall increased rates of emotional/behavioral and adaptive functioning concerns on parent rating scales. Emotional/behavioral concerns did not differ among children with spoken language match, sign language match, or partial match communication modalities combinations. Within adaptive functioning, communication and functional academics were significantly lower among children with partial match home-school communication modalities. Adaptive functioning did not differ between spoken language match and sign language match groups.

Conclusions: Our findings suggest possible benefits to adaptive functioning among children who are DHH when home and school communication modalities match, regardless of which modality is used.

The d2, test of attention is one of the most used neuropsychological tests to measure attention in clinical and research settings. To date, no studies have examined neither its convergent and divergent validity in children nor its relationship with academic skills at school age. The aims of the present study were: (1) to examine the convergent and divergent validity of the d2 Test in a non-clinical pediatric population, (2) to explore the relationship between d2 task performance and academic skills (i.e., math, reading and writing abilities) and (3) to develop normative data for Spanish-speaking children (n = 360 8- to 12-year-old children) stratified by age and socioeconomic status (SES). Pearson's correlation and Structural Equation Models (SEM) were used to analyze the d2 Test validity and its relationship with academic skills. A between-subjects factorial MANOVA was used to examine differences among SES (Middle, Low), age (8-10, 11-12), and sex (male, female). Findings revealed a significant relationship between d2 task performance and all attention and executive functions (EF) measures under analysis providing evidence of good convergent validity. Furthermore, SEM results showed that attention has direct effects on math and reading and writing skills. Finally, our study confirms the influence of age and SES on d2 task performance and provides normative data for middle- and low-SES children. These results have important implications for the assessment of attention functions in clinical and research settings in children with typical and atypical development.

This meta-analysis assessed the efficacy of the Cogmed Working Memory Training program in improving near-transfer measures (verbal and visuospatial working memory) and far-transfer measures (attention, executive function, and academic achievement) in school-age children with and without neurological insults or disorders. Relevant studies were searched in databases and clinical trial registries using the keyword Cogmed. Ten published studies and unpublished data from one study met the inclusion criteria. Hedges g was calculated for each outcome measure obtained at pre-intervention, post-intervention, and 3-6 month time points. Analysis compared outcome measures in the control versus experimental groups and examined the role of moderators on treatment effects (control group intervention, intervention environment). Data revealed significant medium-size effects of the Cogmed program in improving verbal and visuospatial working memory post-intervention and for verbal working memory only at the 3-6 month time point. However, the training did not generalize to the far-transfer measures. Analyses indicated that only the type of intervention provided for the control group moderated treatment effects on verbal and visual working memory. Meta-analytic findings suggest that the Cogmed program leads to short-term improvements and in some cases, long-term improvements in working memory in school-age children; however, these effects may not generalize to far-transfer measures.

Parent-related stress represents the level of dysfunction in the parent-child system related to the parents' functioning. The aim of this retrospective pilot study was to assess the degree of stress perceived by mothers and fathers, in the framework of a family-centred approach to rehabilitation.We considered 43 parents of 29 children with cerebral palsy, genetic disorders or brain injury admitted to a neurological rehabilitation center. Parenting stress was assessed with the Parenting Stress Index - Short Form (PSI-SF) self-report questionnaire and a semi-structured investigation of situational stress factors of the family. The cognitive and motor disability of the children were assessed with the Diagnostic and Statistical Manual of Mental Disorders 5(DSM-5) and the Gross Motor Function Classification System-(GMFCS), respectively.The results showed that parental stress is directly correlated with the level of cognitive and behavioral disability and not with motor disability. No significant difference was found in the level of stress perceived by mothers and fathers. The effect of a worsening occupational situation seemed to influence the perception of stress more than a change in the formal relationship of the couple, but neither was statistically significant.

From childhood to adulthood, an individual's ability to estimate and anticipate the timing of events changes continuously. This study investigated the ability of 287 children aged 5-14 years to estimate the duration of prior events and anticipate the timing of future events for determination of the age at which children improve their timing skills. The Luria neuropsychological assessment battery and the Wechsler Intelligence Scale for Children (WISC-IV) were applied to find correlations between timing skills and the development of cognitive functions. The findings demonstrated that retrospective estimation of duration has a zone of proximal development in children between the ages of six to eight; in these children, the accuracy of time assessment significantly improved after receiving the prompt. However, improvement in time estimation was significantly lower in those children who achieved lower results in the attention and memory tests and demonstrated reduced spatial and verbal reasoning skills. The zone of proximal development for the ability to anticipate the timing of future events was demonstrated in children between the ages of nine to eleven years. The improvement of time anticipation was negatively correlated with the number of mistakes made during the dynamic praxis test.

Objectives: The aim of this study to compare the clinic efficacy and effects of osmotic release oral system-methylphenidate and atomoxetine on executive function in children and adolescents with attention deficit hyperactivity disorder by a open-label, prospective, randomized controlled trial.

Methods: The study was performed by 95 cases between ages 6 and 12 years who were diagnosed as attention-deficit/hyperactivity disorder (ADHD) and also 40 control individuals. In this study, Conners' Teacher Rating Scale (CTRS) was used in order to evaluate the efficacy of the treatment. Executive functions were assessed by the performance-based neuropsychological tests and ecological behavioral rating scales. Stroop test, cancellation test, and serial digit learning test were applied to performance based neuropsychological tests. Behavior Rating Inventory of Executive Function tests (BRIEFs) were used as behavioral assessment scales.

Results: Among the ADHD groups, a reduction of over 40% in the CTRS subtest scores used to evaluate the efficacy of the treatment was considered to be an improvement, and no significant difference was found for both drugs. Both Osmotic Release Oral System-Methylphenidate Hydrochloride (OROS-MPH) and atomoxetine (ATX) significantly improved scores in neuropsychological tests.

Conclusion: Atomoxetine and OROS-MPH treatments have shown similar efficacy in clinical recovery and improvement on executive functions. However, disturbances in executive functions observed in children with ADHD are persistent despite treatment, when compared with the control group.

North African countries such as Morocco are scarcely the focus of neuropsychological studies, although the role of culture in cognition processes is widely recognized. Currently, studies on flexibility and planning skills in the Moroccan context are still lacking and there are no adapted tools to assess these functions in the country. In this scenario, this study aimed to adapt the Child Executive Functions Battery (CEF-B) tasks and the playing cards task of the Behavioral Assessment of the Dysexecutive Syndrome for Children (BADS-C) to Morocco and provide preliminary normative data on the development of flexibility and planning. In addition, this study proposed to examine the effects of gender, parents' education level and multilingualism on executive development. To this end, six tasks of the CEF-B were adapted through a translation and back-translation process and administered to 115 children aged 7-12 years. Results showed that the adopted procedure was sufficient for the cross-cultural adaptation of the tasks. Analyses showed a continuous increase with age on executive performance in most of the variables. However, gender and parents' level of education showed mostly non-significant effects. On the other hand, a significant effect of multilingualism was found on the two analyzed functions, with better results for multilingual children if compared to their bilingual peers. In general, results suggest that the identified pattern of development is consistent with international studies. Although normative data on executive functions are still lacking in Morocco, this unprecedented study will help better understand their development in this context.

The purpose of this study was to compare athletes with high and low resilience scores on concussion outcomes, and identify significant predictors associated with protracted recovery (>30 days). Forty-five adolescent and young adult athletes (28 males; aged 15.13 ± 2.74; range of 11-22) were diagnosed with an SRC within 14 days of injury (M = 4.9 days) and grouped as high or low resilience based on score on the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Primary dependent measures included days to full clearance, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Depression Anxiety and Stress Scale-21 (DASS-21), and Vestibular/Ocular Motor Screening (VOMS). The low resilience group (n = 22) had a longer recovery (36.0 ± 27.6 vs 17.8 ± 11.2 days), endorsed more mood symptoms (PCSS Affective cluster; 3.8 ± 0.8 vs 0.9 ± 0.7), and were more likely to have VOMS scores above cut off (p = 0.01-0.02), compared to those with high psychological resilience (n = 23). Logistic regression found low resilience scores was the only significant predictor for protracted recovery among injury characteristics and risk factors. Psychological resilience is a critical factor associated with recovery time following sport-related concussions. Low resilience was also associated with other poor clinical outcomes, greater subjective symptom report, more severe vestibular dysfunction, and elevated levels of mood symptoms following injury.

Our study aims were to identify the frequency of continued play following sport-related concussion (SRC), defined as continuing athletic activity on the same day following a suspected SRC, characteristics associated with continued play, and whether continued play was associated with worse outcomes. A prospective study of participants ages 13-18 years diagnosed with SRC at a pediatric sports medicine clinic over a 4-year period was conducted. A comparison was performed between athletes who reported continued play following SRC (PLAY) and those who did not (NO PLAY). Of 441 participants, 231 (52.4%) were in the PLAY group. The PLAY group recalled less severe balance problems from the day of injury (p = 0.02), but reported greater symptoms of trouble falling asleep, concentrating, and remembering at their initial clinic visit (p < 0.05). There was no difference in recovery time between groups. Greater symptom severity score at the initial clinic visit and longer time to presentation were associated with prolonged recovery in both groups (p < 0.01). In conclusion, more than half of the athletes in this sample continued to play on the same day following SRC. Our results indicate the need for a heightened focus on education and additional efforts to reduce continued play following SRC in adolescents.

Many patients that experience a concussion have impairing symptoms that persist beyond typical recovery timeframes. Concussion symptoms often remit within a month, but persisting impairments are difficult to characterize and attribute to concussion given the poorly defined diagnostic criteria of post-concussion syndrome and inadequate understanding of the cognitive symptoms associated with this condition. The current study aims to clarify the cognitive profiles of school-aged concussion patients (n = 21; N = 36; 64% male) that have persisting symptoms to improve the clinical identification methods for this condition. Logistic regression was used to explore the importance of cognitive processing speed and working memory for identifying patients with persisting concussion symptoms (PCS). Additional exploratory analyses were conducted to clarify cognitive domains that may be impacted by having PCS. Findings indicate processing speed and working memory abilities alone are not adequate to identify patients with PCS. Further, measures of processing speed, fluid reasoning, working memory, and long-term retrieval together were found to be necessary to identify those who had a prior concussion with PCS. These findings indicate clinical neuropsychological batteries must include measures of these four cognitive domains when assessing school-aged patients with chronic symptoms that extend beyond three months following injury.