Child Neuropsychology最新文献

Despite improved outcomes with modern antiretroviral therapy (ART), children living with HIV (CLWHIV) may still face significant cognitive deficits. There are no published studies of the neurocognitive and neuroimaging status of CLWHIV in Eastern Europe. This was a cross-sectional study in a pediatric HIV referral center in St Petersburg, Russian Federation. Thirty-seven CLWHIV underwent brain magnetic resonance imaging (MRI) and completed the Wechsler Intelligence Scale for Children, third edition (WISC-III) as part of routine care in 2013-15. WISC-III scores were summarized for full-scale intelligence quotient (FSIQ), performance IQ (PIQ) and performance IQ (PIQ) (all with population mean 100), and for subtests of these scores. Factors associated with MRI abnormalities were assessed using logistic regression. Median [IQR] age at the time of the earlier assessment (either MRI or WISC-III) was 10.5 [8.7-11.9] years, 54% were female, 35/37 (95%) had initiated ART at a median age of 57 [27-93] months. Median WISC-III scores were within the average range: 99 [IQR 91-111, range 62-123] for FSIQ, 97 [IQR 85-111, range 67-129] for VIQ and 101 [IQR 94-106, range 62-129] for PIQ. Thirty-four children (92%) scored below average on at least one subtest score. Of 32 children who underwent MRI, 15 (47%) had at least one abnormality. Older age at ART start was associated with MRI abnormalities (OR 1.37 (95% CI 1.01-1.86), p = 0.05 per year increase). Although median group indexes were within the average range, a high percentage of CLWHIV underperformed in at least one subtest and might benefit from supportive interventions.

This study aimed to examine sex-specific neurodevelopment trajectories and associated factors for providing a reference for sex-specific neurodevelopment assessment and early targeted intervention. We hypothesized: 1) boys and girls have distinct neurodevelopment trajectories, in total or specific domains; 2) maternal and birth factors were associated with neurodevelopment trajectories differently between boys and girls. A retrospective cohort study was performed in children aged <3 years old, and neurodevelopment was assessed by trained medical staff using CNBS-R2016, a validated tool completed based on observation. Group-based trajectory modeling (GBTM) was used to identify the trajectories of neurodevelopment in boys and girls, respectively. Using GBTM, "persistently high - quickly rising," "persistently high - slowly rising," "persistently low - falling" trajectories were documented in girls, and "persistently high - slowly rising," "persistently low - stable" trajectory was revealed in boys. For girls, totally (92.7%) were in the high development trajectories, compared to 52.6% for boys. In the low development trajectories, there was a higher proportion of boys than girls (47.4% vs. 7.3%), although a falling trend was identified for girls. The trajectories for each domain of neurodevelopment also showed sex-dependent variations, with the adaptivity domain primarily driving total development trajectories in girls, and the language domain in boys. In multinomial regression analysis, gravidity and non-breastfeeding were associated with increased risks of having low development trajectories for both boys and girls. Among girls, preterm birth was also associated with low development trajectory. The findings may have implications for sex-specific neurodevelopment screening and interventions during early childhood.

Sex chromosome aneuploidies are associated with a wide range of neurodevelopmental outcomes, and notably, confer risk for cognitive impairments with varying degrees of severity. Yet, to date, few studies have compared multiple cognitive outcomes between different sex chromosome aneuploidy karyotypes, and it remains unclear how cognitive variation is linked to other elements of functioning. Leveraging high-dimensional data from a large battery of standardized neurocognitive tasks, we systematically characterize cognition across domains among 167 individuals with sex chromosome aneuploidy (n = 102 XXY/Klinefelter syndrome, n = 65 XYY) aged 5-25 years. These profiles of cognition are then compared between sex chromosome aneuploidy groups and related to measures of adaptive functioning, caregiver strain, and psychopathology. Age-normed scores and z-scores describe the cognitive performance across fifteen scales within XXY/Klinefelter syndrome and XYY syndrome relative to instrument-provided population norms. These profiles are compared between groups, revealing an overall intensification of impairment among the XYY group versus the XXY/Klinefelter syndrome group. The relationships between cognitive scores and adaptive functioning are found to be largely congruent between groups, while we find heterogeneity in the relative coupling of cognitive scores and psychopathology. This multidimensional characterization and comparison of cognitive abilities in XXY/Klinefelter syndrome and XYY syndrome contributes to our understanding of X- versus Y-chromosome dosage effects on neurodevelopment, with the potential to inform karyotype-specific targeting of assessment and intervention that may have unique impacts on functioning.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder, with childhood onset (cSLE) impacting 15-20% of all individuals with SLE. Cognitive dysfunction, including difficulties with executive functioning (EF), affects 30-70% of individuals with cSLE. EF describes cognitive processes that support goal-directed behavior and contributes to capacity for disease self-management and quality of life. Standardized questionnaires provide clinically valuable information about parental observations and adolescent's self-awareness, however, agreement between adolescent and parent ratings is not yet well understood in cSLE. Thirty-six adolescent-parent dyads completed the Behavior Inventory of Executive Function, Second Edition (BRIEF-2). Intraclass correlation coefficients (ICCs) indicated moderate agreement among most indices and subscales, with the exception of the Emotional Regulation Index and Shift subscale. However, mean T-score comparisons showed that adolescents rated themselves as having significantly greater difficulties compared to parent report on the Global Executive Composite, Behavioral Regulation Index, and Cognitive Regulation Index and the Inhibit, Emotional Control, Working Memory and Planning/Organization subscales. Our findings demonstrate that alongside parental report, considering the adolescent's own perspective of their cognitive functioning is an essential part of assessing EF in cSLE.

Although the psychological impact of stroke on children and adults is well known, there is still limited knowledge about its impact on adolescents. This retrospective study examined the prevalence of emotional and behavioral problems in 33 adolescents following childhood arterial ischemic stroke (AIS; age at stroke: M = 10.4 years, SD = 4.13, range = 1-15; time since stroke: M = 3.9 years, SD = 3.2, range = 0.27-12) administering the CBCL questionnaire to adolescents and their parents. Results indicate elevated psychological problems reported by both adolescents and their parents, with clinical or subclinical scores in Total problems observed in 33% of cases compared to the expected 9.8%. These difficulties include both emotional (49% observed) and behavioral (30% observed) issues and reduced Total competences. In addition, a discrepancy emerged between what parents and adolescents reported, with parents reporting lower internalizing problems than their children. Clinical impairment in the Total Competences subscale was significantly associated with anterior circulation lesions and poor functional outcomes measured by PSOM. In addition, externalizing problems were related to anterior circulation lesions. No other significant associations were observed. Results suggest that routinely including psychological assessment in the clinical follow-up of these patients, considering both the parents and the adolescent's perspective, is necessary to promptly identify individuals who may need psychological support.

Early interventions to enhance executive function (EF) have received growing attention; however, evidence of their effectiveness remains limited. To address this gap, we systematically reviewed and meta-analyzed studies evaluating such interventions in typically developing children aged 3 to 6 years. A database search conducted through January 2025 identified 35 eligible studies (randomized and non-randomized), including 2,367 participants in intervention groups and 1,928 in controls. Interventions comprised 27 cognitive-based, 7 multimodal, and 1 physical activity program. Seventeen randomized trials were included in the meta-analysis, examining inhibitory control, nonverbal working memory, and verbal working memory. Results showed small positive effects on verbal working memory (d = 0.13; I² = 18%) and inhibitory control (d = 0.10; I² = 88%), and an almost null effect on nonverbal working memory (d = 0.02; I² = 86%). Although modest in magnitude, these patterns suggest domain-specific gains that may hold developmental relevance in preschool populations. The small effect sizes likely reflect the brief duration, methodological heterogeneity, and limited statistical power of the included studies, which were primarily conducted in non-clinical samples. Overall, these findings provide cautious yet informative evidence on the potential benefits of early EF interventions and underscore the need for larger, methodologically rigorous studies to identify which approaches yield consistent and meaningful improvements in early executive functioning.

This study investigates sex differences in demographic and injury-related characteristics, along with recovery patterns, in children with mild traumatic brain injury (mTBI) who failed at least one Performance Validity Test (PVT). A retrospective analysis of 186 patients (8-18 years old; 65.1% females) from a specialty concussion clinic with non-credible effort on PVTs was conducted. Data on demographics, injury-related characteristics, symptoms, as well as recovery patterns, were analyzed. There were significant sex differences in age at injury, pre-injury academic status, ADHD prevalence, physical activity levels, and post-injury emotional symptoms. Girls exhibited longer recovery times, had more clinical visits, and received different provider recommendations. This study revealed significant sex differences between boys and girls with mTBI and non-credible effort on PVTs. These findings underscore the need for sex-informed approaches in pediatric mTBI management and highlight areas for future research.

The ability to follow nonverbal social cues is impaired in several disorders. Our aim was to collect normative data for the first psychometric test (TooN) that assesses this skill in children. The normative sample consisted of 339 typically developing children aged 6 to 10. TooN is a computerized tool that includes 120 trials in which children must press a button as soon as possible when an object appears on the right or left side of the screen. Each object is preceded by a video of a model gazing and/or pointing to the side where the object appears (i.e. congruent condition) or the opposite side (i.e. incongruent condition). Linear regression analyses were conducted for reaction times (RTs) and for gaze and pointing cuing effects (i.e. the difference between RTs in incongruent and congruent conditions). Regression analyses showed that age, sex and parental education significantly predicted RTs. Age and sex, but not parental education, were significant predictors of gaze cuing effects. However, age was the only significant predictor of pointing cuing effects. Based on these analyses, we provided the equations to calculate the z-scores for RTs and cuing effects. Accuracy scores, stratified by age and/or sex, are reported as percentiles. Based on the performances of typically developing children, we present the normative data of a new psychometric tool designed to assess nonverbal social cue-following. This tool can be valuable for evaluating children with neurodevelopmental disorders. To support this claim, its validity should be tested across various clinical populations.

Neurocognitive sequelae are common late complications in childhood cancer survivors (CCS), impacting quality of life, yet no validated Korean tool exists to screen neurocognitive function effectively. Korean CCS (N = 638) and their siblings (N = 218) were included from a cohort study of Korean CCS at three major hospitals in South Korea. To determine the underlying structure of K-NCQ, exploratory factor analysis and confirmatory factor analysis were performed. Pearson's correlations were used to evaluate concurrent and convergent validity. We also explored known-group validity of K-NCQ by comparing the score of K-NCQ across the four risk stratified groups. The mean age of the study participants was 17.5 ± 4.7 years at the time of the survey and 8.8 ± 5.2 years at the time of cancer diagnosis. Exploratory factor analysis supported the five-factor structure within the original four-domains (factor 2 and factor 5 can be incorporated under emotional regulation domain), and confirmatory factor analysis supported the five-factor structure, excluding one item with cross-loadings (item 8) within the original four domains, demonstrating a sufficient level of goodness-of-fit indices (comparative fit index = 0.926, root mean square error of approximation = 0.045). The K-NCQ demonstrated high internal consistency (α = 0.91 for the total scale and α = 0.74-0.89 for each subdomain). Moderate correlations were found between K-NCQ domains and subscales of other questionnaires and tests for cognitive function. Our study demonstrated the validity of K-NCQ, thus supporting that K-NCQ is a useful tool to assess the neurocognitive function in Korean CCS in clinical settings.

We examine the role that medical history and social determinants of health play in predicting school-age intellectual (IQ) and executive functioning (EF) in children with critical congenital heart disease (cCHD). This is a retrospective observational study of 197 patients with cCHD (age 5-18 years) who attended a neuropsychological evaluation through the Cardiac Neurodevelopmental Program. Medical history and social determinants of health (SDOH), measured by the Childhood Opportunity Index (COI 3.0), were obtained via chart review. COI was a significant predictor of school-age IQ and EF. Seizure history and genetic condition were predictors of IQ; inclusion of COI improved the model, predicting an additional 14% of the variance. The Education subdomain of COI, reflecting neighborhood-level educational resources, drove this effect. Aortic obstruction and seizure history were significant predictors of parent-reported EF; inclusion of COI provided modest improvement. Only COI was identified as a predictor of performance-based EF. Social determinants of health are important predictors of school-age functioning in children with cCHD, and efforts to promote positive neurodevelopmental outcomes in this population must consider SDOH. IQ at school-age is related to neighborhood educational resources. This suggests that enhancing educational opportunities in patients with cCHD in lower-resourced communities may promote positive neurodevelopment and reduce disparities.