Child Neuropsychology最新文献

Children with Neurofibromatosis Type 1 (NF1) experience significant executive dysfunction interfering with outcomes across the lifespan. To date, there have been limited interventions targeting executive function impairments, and even less explored within the NF1 population. The primary purpose of this study was to determine if an existing executive functioning intervention, Unstuck and On Target! (UOT), is a feasible and acceptable intervention for children with NF1. Participants were four children with NF1 (75% male; 75% Caucasian) between the ages of 9 to 12 years and their parents. Participants engaged in 20 weekly group sessions of UOT over the course of five months. Attendance rates and satisfaction ratings were primary outcomes. Attendance was >95% and attrition was null. Parent feedback and satisfaction ratings were overwhelmingly positive. In the first study of its kind, the results suggest that UOT is a feasible and acceptable cognitive intervention for children with NF1. Future development of Phase II/III studies of UOT to examine treatment dose and efficacy is supported.

The majority of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) meet the criteria for at least one comorbid diagnosis. Prior literature has suggested that the assessment of emotion regulation may be helpful in the differential diagnosis of ADHD comorbidity. Thus, a primary goal of this study was to examine the clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) Emotion Regulation Index (ERI) in detecting symptoms commonly comorbid with ADHD (i.e. disruptive and internalizing behaviors). This study also considered the extent to which the ERI may contribute to the overall detection of ADHD and comorbid symptoms, as compared to the BRIEF2 Behavior Regulation Index (BRI) and Cognitive Regulation Index (CRI). Archival data representing 211 male (n = 151) and female (n = 60) children ages 5 to 12 (M = 8.00, SD = 1.63) seen through a university-based ADHD Evaluation Clinic were used. Parent and teacher ratings were analyzed separately. Results revealed that the BRIEF2 ERI reliably detected the presence of ADHD comorbid symptomatology across informants. However, unlike select findings from the BRI and CRI, the ERI and its associated clinical scales did not differentiate between types of comorbidities. Overall, current data suggests that the ERI may make only a small contribution beyond what is already explained by the other two indexes on the BRIEF2 in the assessment of ADHD comorbidity. Nonetheless, from a transdiagnostic perspective, the BRIEF2 ERI clinical scales may provide helpful information for clinicians to help guide assessment and treatment recommendations.

Considering that the early school year are critical for the development of visuoperceptual organization skills, we investigated the effect of stepwise training in perceptual strategies using drawing-based materials on children's perceptual and constructional performance. Forty-four children (24 girls), aged 6.5 to 9 years (M = 7.34; SD = 0.64), were randomly assigned to either the experimental or control group (N = 22 per group). All participants completed the Bender Visual- Motor Gestalt Test - II (a graphomotor test of perceptual organization) and the Block Design test (a measure of constructional ability) before and after the training. The experimental group received the stepwise training on copying of the Rey- Osterrieth Complex Figure, while the control group received drawing materials without any instructions. The study employed a 2 (Group: Experimental, Control; between-subject) × 2 (Phase: Pretest, Posttest; within-subject) design. After controlling for the pretest scores, results showed that the experimental group outperformed the control group on both tasks. No effects of age or gender were detected. We suggest that perceptual organization and planning skills promoted by our training contributed to the enhanced performance. Given the varying degree of similarity between each task and the training materials, we proposed that both near and far transfer of skills acquired through visuoperceptual organization training can occur in children.

Behavioral impairment is comorbid with pediatric medical conditions and impacts academic, social-emotional, and medical outcomes. In prior work, we applied graph-theory analysis to parent-report measures of behavior to derive multidimensional profiles in a multi-site database of children with psychiatric disorders and healthy controls (comprised of participants from Children's National Hospital, Georgetown University, and Kennedy Krieger Institute), and identified three unique profiles characterized by relative weaknesses in (a) metacognition, (b) emotion regulation, and (c) inhibition. In this study, we also found broadly the same behavioral profiles within a large (N = 466) cross-sectional clinical database collected at Children's National Hospital from 2014 to 2018 comprised of children with pediatric medical conditions affecting the central nervous system. A support vector machine (SVM) classification derived from the psychiatric sample was then applied to the medical sample and had high (but not perfect) accuracy, suggesting subtle differences in profile composition between medical and nonmedical populations, particularly within the Inhibit subgroup. These findings lend further support to the existence of three transdiagnostic profiles, representing unique targets for personalized intervention. However, findings also highlight that the etiology of behavior problems (psychiatric versus medical) may matter.

The Rey Auditory Verbal Learning Test (RAVLT) is a widely used neuropsychological tool developed for assessing various aspects of verbal memory. We present a RAVLT version for Russian-speaking children, developed in digital form with two sets of materials. The current study aimed to investigate whether the two versions of the Russian RAVLT are equivalent in terms of psycholinguistic characteristics and whether participants perform comparably on them. Second, we computed the norms based on a large cohort of Russian-speaking children (n = 239) aged 5-18 years using a multivariate regression-based approach. Results demonstrated that the two test versions can be used interchangeably for memory assessment in children. Moreover, we determined the cutoff scores for performance on the nine raw trial scores and five composite scores (total learning, learning rate, retroactive interference, retention, and retrieval efficiency scores). Only age, but not sex or test version, modulated test performance. The new Russian RAVLT for children can be used by clinicians and researchers to detect memory impairments in the Russian-speaking pediatric population.

Learning and memory are crucial neuropsychological skills, linked with the development of play, adaptive skills, and academic functioning. Children and adolescents with critical congenital heart disease (cCHD) are at risk for a range of neurodevelopmental difficulties. Here, we examine visual and verbal learning and memory skills in a school-age sample of children and adolescents with cCHD, and explore how medical, neuropsychological, and social variables predict school-age learning and memory. This is a retrospective observational study of 189 patients with cCHD (age 5-18 years) who attended a neuropsychological evaluation through the Cardiac Neurodevelopmental Program. Results demonstrate that on average, children and adolescents with cCHD show relatively poorer performance on tasks of visual learning and memory and list learning and memory, skills with a higher executive burden, whereas there are no differences in story learning and memory compared to normative samples. Working memory is identified as the most consistent predictor of learning and memory. Medical variables also contribute to learning and memory at school age, whereas social determinants of health are less closely linked. These findings demonstrate the importance of considering downstream effects of core aspects of attention and executive functioning skills on other neurodevelopmental abilities.

Children born very preterm (VP, <32 gestational weeks and/or birth weight ≤1500 g) are at risk for difficulties in language and reading. It is unclear whether early language is predictive for later reading skills in this population. We aimed to investigate the predictive value of language at 2;0 for reading at 11;0 in children born VP. The study comprised 115 Finnish-speaking children born VP. At 2;0, language skills were assessed with the Finnish long-form of the MacArthur-Bates Communicative Development Inventory. At 11;0, reading fluency and reading comprehension were evaluated using the Finnish Primary School Reading Test. The language variables explained 32%-33% of the variance in reading comprehension at 11;0. No clear associations between early language and reading fluency were found. Early language had high specificity but low sensitivity for identifying weak reading comprehension at 11;0. The findings provide support for the continuum between early language and later reading comprehension in children born VP. Evaluating language skills at 2;0 provides important predictive insight into later reading comprehension. Validated parental-report instruments offer valuable data on the language skills of children born preterm at this age. It is recommended to include these tools in the clinical follow-up of very preterm children.

Cognition in children with cerebral palsy (CP) is often affected. How cognition differs by functional level and subtype is not clear, and the effects of adapted response modes need investigation. In this study, the aims were to investigate how many psychologists reported that interpreters and/or augmentative and alternative communication (AAC) were used, how many assessments were adapted, if there were clinical characteristics associated with whom had been assessed, and to delineate scores from the Wechsler scales with CP by sex, subtype, gross motor function (GMFCS), manual abilities (MACS), and communication level (CFCS). This was a Swedish register study that included two cohorts of children with CP. Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III/IV) and Wechsler Intelligence Scale for Children (WISC-IV/V) served as dependent variables. Descriptive statistics, logistic regression, and multiple regressions were performed. Interpreters and AAC were used in 5% and 13% of the assessments, respectively. Adapted assessments were associated with lower verbal intelligence (VIQ), performance intelligence (PIQ), and full-scale intelligence (FSIQ) mean scores. Assessment practices were associated with GMFCS, MACS, and subtype. Age was negatively associated with PIQ and FSIQ. Children with spastic unilateral CP scored higher than children with ataxic CP on VIQ, PIQ, and FSIQ. Mean scores were significantly different across MACS levels. Children with less affected gross motor, manual, and communication functioning and those with spastic CP were more likely to be assessed. Irrespective of subtype, GMFCS, MACS, and CFCS levels, the ranges of scores were wide, highlighting the great heterogeneity of cognition in this population.

Extant literature has found attention and academic achievement to be related throughout development. Surprisingly, there are few comprehensive meta-analytic studies of the size of this effect. Therefore, the present study evaluates the relation between ADHD symptomatology (i.e., ratings of inattention and/or hyperactivity/impulsivity) and academic achievement, over 106 studies and 450 effect sizes, with moderators assessing: study design type; symptomatology type; academic domain and subskills; rater type; gender; and age. Included studies had: students from Kindergarten to undergraduate level; an ADHD group or ADHD symptomatology rating measure; an academic achievement measure; and effect size availability. Effect sizes were converted to pooled correlations, r. The pooled correlation for behavioral attention and academic achievement was r = -.25 (95% CI: -0.29, -0.22; p < .001). Meta-regression analyses significantly differed for the moderators of symptomatology type (inattention r = -.30, hyperactivity/impulsivity r = -.13), and rater (parent r = -.19, teacher r = -.34). No significant differences were found for the other moderators. Post-hoc analyses found that higher academic complexity (e.g., combined reading comprehension, written expression, math word problems) was more related to ADHD symptomatology than lower academic complexity (e.g., combined decoding, spelling, math computation), β = -.10, t =-3.21, p < .01, 95% CI [-.17, -.04]. Overall, this meta-analysis quantified and systematized the significant negative relation between behavioral attention and academic achievement using scientifically rigorous methodology. Findings highlight the importance of ratings specifically of inattention, particularly by teachers, for academic achievement.

Attention-Deficit/Hyperactivity Disorder (ADHD) is frequently linked to functional impairments and deficits in executive functioning. This study investigated inter-relationships between executive functions and functional impairments among children with ADHD from a network analysis perspective to identify key domains for targeted intervention research. Children with ADHD, diagnosed using a semi-structured interview, were recruited from a pediatric hospital in China. Executive functions were assessed using the Behavior Rating Inventory of Executive Function - Parent Form (BRIEF). Functional impairments were measured using the Weiss Functional Impairment Scale-Parent Form (WFIRS-P). Network analysis was performed to examine interactions between executive functions and functional impairments, identifying central and bridge nodes through Expected Influence (EI) and bridge EI indices. Of the 225 participating children with ADHD, functional impairments ranged from 0.4% (95% CI: [0.0%, 1.3%]) for risky behavior to 15.1% (95% CI: [10.4%, 19.8%]) for self-concept. Network analysis revealed executive functions of "Monitoring" (EI = 1.11) and "Planning" (EI = 1.07) had the highest centrality values and were the most influential domains in the network model. The most influential bridge nodes linking executive function and functional impairment communities were impairments related to "Family" (bridge EI = 0.41) and the executive function, "Inhibition" (bridge EI = 0.38). This study highlighted the most influential central and bridge domains within a network model of executive functions and functional impairments among children with ADHD. Findings provide plausible hypotheses for risk factors and targeted interventions. Future research should use longitudinal designs and objective assessments to evaluate our findings further.