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.

This study sought to determine the influence of various demographic variables on pass/failure on a pediatric performance validity test, the Memory Validity Profile (MVP) in a mixed clinical sample (n = 393; 62% male, 62% White, median age 11 years). Children who failed the MVP (n = 72, 18%) according to a uniform cutoff of ≤30/32 correct were younger and were more likely to have a special education history than those who passed it (n = 321, 82%). There were no statistically significant group differences on other variables such as sex, race, parental education, history of treatment for ADHD or other psychiatric disorder. Possible false positive findings were relatively most common in children under the age of 10 years and in children who received special education services under the Physical/Other Health Impairment or Speech & Language Impairment qualifications. We conclude that a uniform cutoff for pass/failure on the MVP across any and all ages and diagnostic categories is ill-advised. Instead, we recommend the development of various adjusted cutoffs for this test that maintain 90% specificity at both ends of the age spectrum as well as with different medical or developmental conditions.

Early motor development is a key predictor of development in other skill domains and specific neurodevelopmental disorders, but it is typically measured as achievement of milestones rather than rate of development. To explore the value of the latter approach, this study utilized a novel caregiver report method to examine differences in the developmental trajectory of motor development in term-born compared to preterm-born infants. Caregiver-infant dyads (331 term, 240 preterm) were followed from birth through 12 months (48% female; 6.4% Hispanic; 34.1% Black; 10.3% Mixed or Biracial; and 48.3% White). Longitudinal Item Response Theory (IRT) modeling was used to compare growth trajectories of motor skills between term and preterm infants. The moderating effects of biological sex on group differences also were examined. The main effect for term status was significant. Preterm infants exhibited slower rates of growth in motor ability over the first 12 months compared with term infants. Differences in rate of growth were significant by 6 months of age. In the term group only, females exhibited more rapid growth than males in motor ability. Findings indicate that caregiver report yields reliable estimates of growth in the latent trait of motor ability, with slower rate of growth in infants born preterm. Estimates of latent growth in motor ability may provide more sensitive measures of neurodevelopmental risk and a method to examine response to treatment.

Executive function (EF) impairments are prevalent in survivors of neonatal critical illness such as children born very preterm (VPT) or with complex congenital heart disease (cCHD). This paper aimed to describe EF profiles in school-aged children born VPT or with cCHD and in typically developing peers, to identify child-specific and family-environmental factors associated with these profiles and to explore links to everyday-life outcomes. Data from eight EF tests assessing working memory, inhibition, cognitive flexibility, switching, and planning in n = 529 children aged between 7 and 16 years was subjected into a latent profile analysis. Three EF profiles were identified: The "favorable" profile was defined by mean scores in the normal range (z-scores ≤ -0.5 below the norm; n = 263, 49.7%). The "at-risk" profile's mean scores were 0.5 to 1 SD below the norm (n = 236, 44.6%). The "impaired" profile's mean scores were >1 SD below the norm (n = 30, 5.8%). Children of the two clinical groups were more likely to fall into the at-risk or impaired profile. Irrespective of clinical group, lower socioeconomic status, slower processing speed and poorer fine motor skills were associated with a more impaired profile. In turn, falling into the at-risk or impaired profile was associated with a higher need for educational support, poorer everyday-life EFs and more behavioral problems. Children in the impaired profile reported lower psychosocial quality of life. This study provides evidence for an increased risk of survivors of neonatal critical illness to present with an impaired EF profile that translates into everyday-life difficulties. Long-term monitoring is needed to promote optimal outcome.

Diagnosis of sports-related concussion (SRC) primarily relies on an athlete's self-report of injury and associated symptoms. Social pressures and attitudes surrounding SRC influence athlete reporting behavior. Unfortunately, underreporting of SRC symptoms is an issue among adolescent athletes. Nondisclosure of SRC symptoms may lead to premature return-to-play and potential persistent symptoms. This scoping review summarizes prevailing theories that explain SRC symptom reporting intent and behavior among adolescent athletes. Literature was reviewed following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for Scoping Review guidelines. Inter-rater reliability was calculated at each stage. Thirty-four articles published between 2013-2024 were included. Inter-rater reliability was fair to perfect across all review stages. Of the 16 unique theories described, the Theory of Reasoned Action/Theory of Planned Behavior (TRA/TPB) was the most frequently cited theory explaining SRC symptom reporting behavior. Although the TRA/TPB framework was useful when predicting SRC symptom reporting intent, it did not adequately predict reporting behavior, consistent with the broader health behavior literature which has established that intention is not a good predictor of behavior. In light of these findings, new frameworks must be considered that consider neurodevelopmental, cognitive, and cultural factors, as these may be more useful for understanding SRC symptom reporting behavior in adolescence.

The NIH Toolbox is used extensively in various research settings, including clinical trials, observational studies, and longitudinal studies. Its validity and reliability have been systematically appraised only in adults. The current study systematically evaluated the validity and reliability of the NIH Toolbox for assessing neurocognitive, motor and emotional-behavioral functioning in children. Based on 22 studies including over 60,000 participants, sufficient evidence was found for the validity and reliability of most tests in the Cognition Battery and Motor Battery. However, there was insufficient evidence to assess the validity and reliability of the Emotion Battery. Thus, this review supports the use of the NIH Toolbox Cognition and Motor Batteries in assessing neurocognitive functioning in 3-17-year-olds.

Persisting symptoms after concussion (PSaC) affect up to 30% of children, adolescents, and young adults beyond 1 month post-injury, posing challenges in clinical care. This retrospective study examined 54 patients referred for neuropsychological evaluation due to PSaC, exploring factors contributing to symptom persistence. Results showed that 75.9% of patients experienced symptoms attributable to non-concussion factors, with 90.7% lacking evidence-based care post-injury. Pre-existing conditions, including migraines, anxiety, depression, and other psychiatric disorders, correlated with symptom burden. Linear regression models indicated that these psychiatric factors and the absence of evidence-based recommendations predicted symptom severity [R² = .314, p = .002], with other psychiatric disorders showing a significant effect [β = 2.28, p = .008]. History of any psychiatric disorder predicted current symptom count [R² = .121, p = .010]. Logistic regression identified migraines (Nagelkerke R² = .389, p = .000) and depression (Nagelkerke R² = .124, p = .033) as predictors of non-concussion etiology. Anxiety, depression, migraines, psychiatric disorders, and lack of evidence-based care predicted non-concussion symptoms (Nagelkerke R² = .575, p = .000). These findings highlight the importance of holistic, individualized care in concussion. Early neuropsychological involvement may improve diagnosis, reduce iatrogenic effects, and optimize recovery through tailored evidence-based interventions.

Previous research estimated a prevalence of 3.4% Cerebral Visual Impairment (CVI)-related visual problems within primary school children, potentially compromising students' performance. This study aimed to clarify how CVI-related visual difficulties relate to academic performance in standardized achievement tests. As part of the Luxembourg school monitoring programme, 1129 first graders (mean age of 7 years) participated in three competence tests (mathematics, early literacy and listening comprehension) and in student and parent questionnaires (background information). The same children took part in a CVI-related visual difficulties screening (Evaluation of Visuo-Attentional abilities battery, optometric and orthoptic measures). The sample was divided post-screening into 38 children with potential CVI-related visual difficulties (18 females, 20 males, mean age 7y, range 6-8y) and 890 typically developing (TD) children (445 females, 430 males, 15 missing, mean age 7y, range 5-10y). Compared to the TD sample children with CVI-related visual difficulties significantly underperformed in early literacy and mathematics, but not in listening comprehension, even when controlling for background characteristics known to influence performance (gender, socio-economic status, migration background, parental education, home language, age). The results confirm the association of CVI-related visual difficulties with learning processes already at primary school level and emphasize the need to implement a systematic screening for CVI-related visual difficulties, as early as possible within the school path, to ensure adequate measures are employed to aid students at risk.

The current study investigated the relationship between adverse childhood experiences (ACEs), post-traumatic stress disorder (PTSD) symptoms, within-network resting-state functional connectivity (rs-FC), and alcohol use during adolescence using functional magnetic resonance imaging (fMRI) data from the National Consortium on Alcohol and Neurodevelopment in Adolescence study (NCANDA; N = 687). Significant rs-FC differences emerged that linked participant ACEs, PTSD symptoms, and alcohol use problems. Participants with ACEs compared to those without had diminished rs-FC within the default mode, salience, and medial frontoparietal networks (p ≤ 0.005). Further reduction in rs-FC within the default mode and medial frontoparietal networks (p ≤ 0.005) was found when PTSD symptoms were present in addition to ACEs. Findings suggest that PTSD symptoms are associated with lower within network rs-FC beyond exposure to ACEs, and some of these rs-FC changes were associated with worsened alcohol use problems (i.e. withdrawal symptoms). These findings highlight the importance of addressing PTSD symptoms in adolescents with a history of ACEs as it may mitigate problematic changes in brain connectivity and reduce the risk of developing alcohol use problems.

Fetal inflammation, typically measured indirectly through prenatal maternal cytokine markers, has been shown to impact early childhood executive functions (EFs), which are central to later cognitive and life outcomes. Here, we assessed the impact of prenatal inflammation on EF developmental trajectories using direct placenta histopathology measures in 131 mothers who predominantly self-identified as Black (90.8% Black; 0.8% Asian American, 1.5% biracial, 0.8% Latinx, 3.1% White, 3.1% Missing). We found that placental measures of inflammation were associated with limited gain in EF development from 3 to 5 years old. In follow up analyses, we addressed whether screening questionnaires in infancy might aid in classification of infants as higher risk for subsequent EF problems. We found that parent responses to the Ages & Stages Questionnaire and the Infant/Toddler Sensory Profile at 12 months predict the development of EF abilities in children exposed to chronic inflammation. These findings open promising opportunities for early screening of children at risk for poor executive functioning in children exposed to prenatal inflammation.