California Verbal Learning Test-Children Research Articles

Assessing learning and memory among patients with pediatric brain tumor (PBT): a comparison of measures

ABSTRACT Patients with pediatric brain tumor (PBT) can have memory deficits due to tumor location, medical complications, and treatment. The main objective of this study was to investigate whether the California Verbal Learning Test-Children’s Version (CVLT-C; 1994) and briefer Child and Adolescent Memory Profile (ChAMP; 2015) similarly identify such deficits. Seventy-five patients with PBT ages 8–16 ( = 13.1 years, SD = 2.1) were administered the ChAMP or CVLT-C. Rote verbal learning, long-term retrieval, and recognition were analyzed using standardized z-scores. Analyses of differences between measures did not reach statistical significance. Both measures indicated significant downward shifts across free retrieval trials from normative means, with scores approximately 1/3 (ChAMP) to 1/2 (CVLT-C) SD below means across learning and long-term retrieval trials. Scores on recognition trials did not differ significantly from the normative mean. Post-hoc analyses using a subset of the sample who received cranial irradiation (n = 45) similarly found no significant differences between memory measures. Additional post-hoc examination of proportion of participants falling within or below the “below average” range (≤8th percentile) revealed comparable performance between the two measures, whereas the proportion of participants falling at or below 1.5 SDs below the mean on retrieval trials was lower using ChAMP Lists as compared to the CVLT-C. Given the ChAMP is less demanding in terms of time and effort and utilizes more updated and representative normative data, this study supports the ChAMP as a useful tool to evaluate learning and memory within this population.

Frontoparietal and temporal white matter diffusion MRI in children and youth with prenatal alcohol exposure.

Prenatal alcohol exposure (PAE) is associated with brain alterations and neurocognitive deficits, but relationships between brain alterations and neurocognitive deficits remain unclear. Diffusion tensor imaging (DTI) data were obtained from 31 participants with PAE and 31 unexposed controls aged 7-15 years. Mean diffusivity (MD) and fractional anisotropy (FA) were derived from the genu, body, and splenium of the corpus callosum (CC), bilateral cingulum, and inferior and superior longitudinal fasciculus (ILF, SLF). Participants completed language subtests from the NEPSY-II. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning (BRIEF-PR) and verbal learning was assessed using the California Verbal Learning Test-Children's Version (CVLT-C) only in children with PAE. Group differences in diffusion metrics and cognitive scores were tested. Principal component analysis was used to reduce redundancy in cognitive and behavior variables; associations between components and brain measures were then assessed. Children with PAE had lower MD in the right SLF compared with unexposed controls. FA was positively related to age in 6 of 9 tracts and MD negatively related to age in all tracts; there were no significant age-by-group interactions. Participants with PAE scored lower than unexposed peers on the NEPSY-II Comprehension of Instructions and Phonological Processing and above population norms (indicating worse performance) on the BRIEF-PR. Children with PAE had a negative association between a principal component closely associated with Speeded Naming and FA in the left SLF (PAE: p=0.002) and left ILF (PAE: p=0.002); unexposed controls showed no significant associations. We found widespread cognitive difficulties in children with PAE, but relatively limited differences in brain metrics and associations with age. Different brain-cognitive relationships werefound in children with PAE compared with controls. Overall, the results provide additional evidence that PAE may lead to cognitive difficulties and disrupt typical brain-function relationships.

The Impact of Learning and Memory on Performance Validity Tests in a Mixed Clinical Pediatric Population.

This study examined the degree to which verbal and visuospatial memory abilities influence performance validity test (PVT) performance in a mixed clinical pediatric sample. Data from 252 consecutive clinical pediatric cases (Mage=11.23 years, SD=4.02; 61.9% male) seen for outpatient neuropsychological assessment were collected. Measures of learning and memory (e.g., The California Verbal Learning Test-Children's Version; Child and Adolescent Memory Profile [ChAMP]), performance validity (Test of Memory Malingering Trial 1 [TOMM T1]; Wechsler Intelligence Scale for Children-Fifth Edition [WISC-V] or Wechsler Adult Intelligence Scale-Fourth Edition Digit Span indices; ChAMP Overall Validity Index), and intellectual abilities (e.g., WISC-V) were included. Learning/memory abilities were not significantly correlated with TOMM T1 and accounted for relatively little variance in overall TOMM T1 performance (i.e., ≤6%). Conversely, ChAMP Validity Index scores were significantly correlated with verbal and visual learning/memory abilities, and learning/memory accounted for significant variance in PVT performance (12%-26%). Verbal learning/memory performance accounted for 5%-16% of the variance across the Digit Span PVTs. No significant differences in TOMM T1 and Digit Span PVT scores emerged between verbal/visual learning/memory impairment groups. ChAMP validity scores were lower for the visual learning/memory impairment group relative to the nonimpaired group. Findings highlight the utility of including PVTs as standard practice for pediatric populations, particularly when memory is a concern. Consistent with the adult literature, TOMM T1 outperformed other PVTs in its utility even among the diverse clinical sample with/without learning/memory impairment. In contrast, use of Digit Span indices appear to be best suited in the presence of visuospatial (but not verbal) learning/memory concerns. Finally, the ChAMP's embedded validity measure was most strongly impacted by learning/memory performance.

The effect of memorizing the quran on cognitive functions

Background: Memorizing the Quran is an education continuing from the early periods of Islamic education until today. Although this education started in the past to protect the Quran, nowadays, it is continuing as a tradition. Aims and Objectives: The main purpose of this study is to investigate the effects of memorizing the Quran on certain cognitive functions of individuals. Materials and Methods: The scope of the study is limited to 18 female and 15 male students who have been studying in the 5th, 6th, and 7th grades of Anatolian Imam Preacher Secondary Schools in different districts of Istanbul. After Demographic Information Questionnaire was used, California Verbal Learning Test children's version, Wechsler Memory Scale revised visual reproduction subtest, Trail Making Test, and Verbal Fluency Test were applied twice to collect data about individuals before and after memorization training. Results: Findings demonstrated that there is a statistically significant difference in verbal learning, visual learning, attention speed, and phonemic and semantic fluency before and after memorization training. Conclusion: In conclusion, memorizing the Quran has positive impacts on verbal and visual memory, attention processes, and lexical and semantic fluency of individuals. It is important with regard to eliminate emptiness in the literature. In future studies, it can be investigated the effects of textual memorization in a foreign language on brain structures and connections.

A-182 Convergent and Divergent Validity of the ChAMP with the CVLT-C and RCFT in Children with Epilepsy

Abstract Objective As new measures of memory become available, clinicians may be cautious to adopt them without evidence supporting their validity. The present study assesses the convergent and divergent validity of the Child and Adolescent Memory Profile (ChAMP), with the California Verbal Learning Test Children’s (CVLT-C) and the Rey Complex Figure Test (RCFT) in children with epilepsy. Method Twenty four clinically referred children (16 female, 8 male, - age = 12.37 years, SD = 2.68) completed the ChAMP, CVLT-C, and RCFT. Pearson correlations assessed the ChAMP’s convergent and divergent validity with the CVLT-C and the RCFT. Base rate of impairment was calculated for scores ≤2nd percentile. Results The ChAMP verbal tasks demonstrated strong relations with CVLT-C (lists; r = 0.678 p = < .001, instructions; r = 0.724 p = < .001 with CVLT-C learning trials and ChAMP lists free recall with CVLT-C long delay r = 0.580 p = .003). The ChAMP visual tasks correlated strongly with the RCFT delay (objects; r = 0.570 p = .004, places; r = 0.619 p = .001, Visual Memory Index; r = 0.657 p = < .001). However, divergent validity was limited as ChAMP Verbal Memory Index correlated with RCFT delay (r = 0.550 p = .005) and ChAMP Visual Memory Index with CVLT-C delay (r = 0.606 p = .002). Eight percent were deemed impaired on ChAMP lists delay similar to the CVLT-C delay (13%), however, ChAMP places delay identified 21% impaired, compared to the RCFT delay (42%). Conclusions ChAMP scores are strongly correlated with older established measures, but identify fewer cases as clinically impaired. This may reflect the more contemporary normative data or the fact that ChAMP tasks are less multifactorial in nature than are the CVLT-C and RCFT.

Panayiotopoulos syndrome and Gastaut syndrome are distinct entities in terms of neuropsychological findings

BackgroundAlthough the courses of self-limited focal epilepsies of childhood are considered as benign, a handful of studies suggested that these children may suffer from cognitive problems. Implementing tailor-made educational strategies would aid these children to reach their full potentials. Therefore, it is crucial to understand and differentiate the complete neuropsychological and behavioral profiles of these rather common syndromes. We aimed to examine the distinct cognitive and behavioral profiles of the Panayiotopoulos syndrome (PS) and the Gastaut syndrome (GS), comparatively. MethodTwenty patients with PS, 20 patients with GS, and 20 healthy controls have been recruited. The testing protocol included Wechsler Intelligence Scale for Children-Revised, Conner's Continuous Performance Test, Verbal Fluency Test, Stroop Color and Word Test, Color Trails Test, Tower of London Test, Symbol Digit Modalities Test, California Verbal Learning Test-Children's Version, Rey Complex Figure Test, Benton Face Recognition Test, Benton Judgment of Line Orientation, Peabody Picture Vocabulary Test, Reading and Writing Test, Child Behavior Checklist, Conner's Parent Rating Scale-48, and Behavior Rating Inventory of Executive Function. Demographical, clinical, electrophysiological data, and imaging findings have also been evaluated. ResultsWith regard to intelligence, the patients with PS scored less in all scales compared to the healthy controls. However, only the performance IQ (intelligence quotient) scores differed significantly between the patient groups, with the patients with PS scoring lower than the patients with GS. Verbal memory problems were eminent in both of the patient groups; whereas, visual memory was impaired only in the group with PS. Psychomotor speed was affected in both groups. Reading problems were prominent only in the patients with PS. Writing and arithmetic skills were defective in both patient groups. There were no noteworthy behavioral problems in comparison to healthy subjects. ConclusionUsing neuropsychological profiles, this study demonstrated that the GS and the PS are two distinct entities. Cognitive dysfunction is a more prominent and widespread feature of the patients with PS; whereas, the patients with GS suffer only from milder and isolated cognitive problems.

Acute pediatric traumatic brain injury severity predicts long-term verbal memory performance through suppression by white matter integrity on diffusion tensor imaging.

Mediation analysis was used to investigate the role of white matter integrity in the relationship between injury severity and verbal memory performance in participants with chronic pediatric traumatic brain injury (TBI). DTI tractography was used to measure fractional anisotropy (FA) within the corpus callosum, fornix, cingulum bundles, perforant pathways, and uncinate fasciculi. Injury severity was indexed using Glasgow Coma Scale (GCS) scores obtained at the time of the injury. Verbal memory was measured by performance on the long-delay free recall (LDFR) trial of the California Verbal Learning Test-Children's version. Participants were between the ages of 10-18 and included 21 children with TBI (injured before age 9) and 19 typically-developing children (TDC). Children with TBI showed lower FA across all pathways and poorer LDFR performance relative to TDC. Within the TBI group, mediation analysis revealed neither a significant total effect of GCS on LDFR nor significant direct effects of GCS on LDFR across pathways; however, the indirect effects of GCS on LDFR through FA of the corpus callosum, left perforant pathway, and left uncinate fasciculus were significant and opposite in sign to their respective direct effects. These results suggests that the predictive validity of GCS for LDFR is initially suppressed by the substantial variance accounted for by FA, which is uncorrelated with GCS, and the predictive validity of GCS increases only when FA is considered, and the opposing path is controlled. These findings illustrate the complex associations between acute injury severity, white matter pathways, and verbal memory several years following pediatric TBI.

The relationships between video game experience and cognitive abilities in adolescents.

Objectives: Video games are especially popular among adolescents and young adults as a form of entertainment and the amount of time spent playing video games has increased rapidly. The main objective of this study is to assess the effect of video games on cognitive functions in adolescents.Methods: An exploratory, cross-sectional study was employed to investigate cognitive function in adolescent video game players. Cognitive functions, including memory, attention, and executive functions, were evaluated in 46 adolescents who had been playing video games regularly for at least 1 h per day, 5 days per week, for at least a year, and 31 adolescents (who played video games <5 h per week) using cognitive function assessment tests. Other data, such as demographics, medical information, video game types, and time spent playing video games were collected by questionnaires.Results: No significant difference was detected between the groups in terms of age, gender, IQ levels, and sociodemographic variables. Our findings show that visual memory results were slightly better in the playing group. Moreover, in the group that plays video games regularly, the increase in daily time spent playing games significantly increased the total error value in the Stroop Test and total interference value in California Verbal Learning Test-Children’s Version test. We also found that more time is spent on online games compared with traditional games.Conclusions: In this study, we emphasize the pathological and uncontrolled consumption of video games and the possible consequences of time spent playing games. Our findings indicate the need for more extensive research. Future research should address the various implications of video game play, especially between the potentially positive and negative effects of video games.

One-Minute PVT: Further Evidence for the Utility of the California Verbal Learning Test—Children’s Version Forced Choice Recognition Trial

To replicate previous research on the forced choice recognition trial for the California Verbal Learning Test—Children’s Version (FCR-C). Classification accuracy of the FCR-C was computed in 178 children referred for neuropsychological assessment to a tertiary care hospital. FCR-C ≤ 14 produced the best combination of sensitivity (.12–.42) and specificity (.88–.96). Unlike some of the criterion performance validity tests (PVTs), base rate of failure on the FCR-C was evenly distributed across age ranges. The FCR-C is a quick and inexpensive PVT, unaffected by cognitive maturation, and highly specific to psychometrically defined invalid performance.

Reductions in Corpus Callosum Volume Partially Mediate Effects of Prenatal Alcohol Exposure on IQ.

Disproportionate volume reductions in the basal ganglia, corpus callosum (CC) and hippocampus have been reported in children with prenatal alcohol exposure (PAE). However, few studies have investigated these reductions in high prevalence communities, such as the Western Cape Province of South Africa, and only one study made use of manual tracing, the gold standard of volumetric analysis. The present study examined the effects of PAE on subcortical neuroanatomy using manual tracing and the relation of volumetric reductions in these regions to IQ and performance on the California Verbal Learning Test-Children's Version (CVLT-C), a list learning task sensitive to PAE. High-resolution T1-weighted images were acquired, using a sequence optimized for morphometric neuroanatomical analysis, on a Siemens 3T Allegra MRI scanner from 71 right-handed, 9- to 11-year-old children [9 fetal alcohol syndrome (FAS), 19 partial FAS (PFAS), 24 non-syndromal heavily exposed (HE) and 19 non-exposed controls]. Frequency of maternal drinking was ascertained prospectively during pregnancy using timeline follow-back interviews. PAE was examined in relation to volumes of the CC and left and right caudate nuclei, nucleus accumbens and hippocampi. All structures were manually traced using Multitracer. Higher levels of PAE were associated with reductions in CC volume after adjustment for TIV. Although the effect of PAE on CC was confounded with smoking and lead exposure, additional analyses showed that it was not accounted for by these exposures. Amongst dysmorphic children, smaller CC was associated with poorer IQ and CVLT-C scores and statistically mediated the effect of PAE on IQ. In addition, higher levels of PAE were associated with bilateral volume reductions in caudate nuclei and hippocampi, effects that remained significant after control for TIV, child sex and age, socioeconomic status, maternal smoking during pregnancy, and childhood lead exposure. These data confirm previous findings showing that PAE is associated with decreases in subcortical volumes and is the first study to show that decreases in callosal volume may play a role in fetal alcohol-related impairment in cognitive function seen in childhood.

Performance validity testing in children and adolescents: A descriptive study comparing direct and embedded measures

ABSTRACTEffort testing is a standard element in adult neuropsychological assessment. Research examining performance validity tests (PVTs) has focused on adults. The purpose of this descriptive study was to examine direct and embedded PVTs in children and adolescents. The Test of Memory Malingering (TOMM), a stand-alone PVT, was compared to two embedded measures of effort: California Verbal Learning Test-Children’s Version/Second Edition (CVLT-C/II) Recognition Discriminability and Reliable Digit Span (RDS). The sample consisted of 119 children and adolescents referred for outpatient assessment. Cut-off scores used for PVTs were based on previous studies. Results revealed 3/119 failures on the TOMM, 14/119 failures on the RDS, and 34/119 failures on the CVLT-C/II. There was a significant difference between failures on the TOMM and the RDS, as well as between failures on the TOMM and the CVLT-C/II and the RDS and the CVLT-C/II. The results of this study demonstrate that PVTs commonly used with adults may require modifications, including adjusted cut-off scores, to be appropriate with children and adolescents. Results of this study also suggest that relying on more than one measure likely provides the most utility.

Verbal and Nonverbal Memory in Hemispherectomy: Lateralization Effects

AbstractHemispherectomy is a routine surgery performed for children with intractable seizures and often in the midst of a life-threatening emergency such as status epilepticus. As the following article will demonstrate, studies of neurocognitive outcome in general, and memory in specific, following hemispherectomy are mixed, although findings tend to indicate stronger lateralization of verbal memory. This is often demonstrated by loss of verbal memory following left hemispherectomy, although there are few studies focusing solely on hemispherectomy and neurocognitive outcome. We examined data from 25 patients who participated in the University of California, Los Angeles (UCLA) Pediatric Epilepsy Surgery Program (right hemisphere = 7; left hemisphere = 18). The California Verbal Learning Test-Children's Version was used as a verbal memory correlate, and the doors visual recall was used as a correlate of nonverbal memory. Based on a review of the literature, we hypothesized that (1) verbal memory would be significantly different between hemispheres with higher scores in the remaining left hemisphere; (2) nonverbal memory would be significantly different between hemispheres with higher scores in the remaining right hemisphere. Exploratory analyses were also undertaken. Implications for lateralization, medical factors, and plasticity are discussed.

Correlates of verbal learning and memory after pediatric traumatic brain injury

ABSTRACTThis study examined the role of injury-related variables, socioeconomic disadvantage, and preexisting conditions on verbal learning and memory in a sample of children with traumatic brain injury (TBI). We also explored the mediating effect of processing speed and working memory. One hundred children aged 7–16 years (M = 13.46, SD = 2.78) completed a neuropsychological assessment between 1–12 months post injury. Hierarchical multiple regression analyses were conducted on domains comprising the four-factor model of the California Verbal Learning Test–Children’s Version (CVLT–C). Results revealed independent associations between injury severity as well as parental education on learning efficiency and delayed recall, while injury severity alone accounted for inaccurate recall. Working memory and prior special education placement were predictive of the attention factor of the CVLT–C. Additionally, Sobel tests showed that working memory mediated the effect of prior special education on learning efficiency (Z = 2.90, p < 0.01) and delayed recall (Z = 2.82, p < 0.01). Working memory was unrelated to injury severity. No evidence for a mediating effect of processing speed was found. The findings emphasize the importance of considering the impact of socioeconomic disadvantage and pre-injury conditions in addition to injury-related factors on outcomes of TBI.

Sex-specific associations of testosterone with prefrontal-hippocampal development and executive function

Testosterone is thought to play a crucial role in mediating sexual differentiation of brain structures. Examinations of the cognitive effects of testosterone have also shown beneficial and potentially sex-specific effects on executive function and mnemonic processes. Yet these findings remain limited by an incomplete understanding of the critical timing and brain regions most affected by testosterone, the lack of documented links between testosterone-related structural brain changes and cognition, and the difficulty in distinguishing the effects of testosterone from those of related sex steroids such as of estradiol and dehydroepiandrosterone (DHEA). Here we examined associations between testosterone, cortico-hippocampal structural covariance, executive function (Behavior Rating Inventory of Executive Function) and verbal memory (California Verbal Learning Test-Children’s Version), in a longitudinal sample of typically developing children and adolescents 6–22 yo, controlling for the effects of estradiol, DHEA, pubertal stage, collection time, age, handedness, and total brain volume. We found prefrontal-hippocampal covariance to vary as a function of testosterone levels, but only in boys. Boys also showed a specific association between positive prefrontal-hippocampal covariance (as seen at higher testosterone levels) and lower performance on specific components of executive function (monitoring the action process and flexibly shifting between actions). We also found the association between testosterone and a specific aspect of executive function (monitoring) to be significantly mediated by prefrontal-hippocampal structural covariance. There were no significant associations between testosterone-related cortico-hippocampal covariance and verbal memory. Taken together, these findings highlight the developmental importance of testosterone in supporting sexual differentiation of the brain and sex-specific executive function.

Children and adolescents’ performance on a medium-length/nonsemantic word-list test

ABSTRACTWord-list learning tasks are among the most important and frequently used tests for declarative memory evaluation. For example, the California Verbal Learning Test-Children’s Version (CVLT-C) and Rey Auditory Verbal Learning Test provide important information about different cognitive-neuropsychological processes. However, the impact of test length (i.e., number of words) and semantic organization (i.e., type of words) on children’s and adolescents’ memory performance remains to be clarified, especially during this developmental stage. To explore whether a medium-length non-semantically organized test can produce the typical curvilinear performance that semantically organized tests produce, reflecting executive control, we studied and compared the cognitive performance of normal children and adolescents by utilizing mathematical modeling. The model is based on the first-order system transfer function and has been successfully applied to learning curves for the CVLT-C (15 words, semantically organized paradigm). Results indicate that learning nine semantically unrelated words produces typical curvilinear (executive function) performance in children and younger adolescents and that performance could be effectively analyzed with the mathematical model. This indicates that the exponential increase (curvilinear performance) of correctly learned words does not solely depend on semantic and/or length features. This type of test controls semantic and length effects and may represent complementary tools for executive function evaluation in clinical populations in which semantic and/or length processing are affected.

Cognitive control and episodic memory in adolescents with autism spectrum disorders

IntroductionTo further investigate manifestations of episodic memory impairments in adolescents, we examined the role of encoding on recognition of stimuli in conditions designed to emphasize their item-specific versus relational characteristics in a group of 12–18 year olds with autism spectrum disorders (ASD). We also examined how strategic learning and memory processes, verbal abilities, attention, and age were associated with recognition in this group. Materials and methodTwenty two high functioning adolescents with ASD (mean age=15 years; SD=1.8; range=12.2–17.9), and 26 age, gender, and IQ-matched adolescents with typical development (TYP) (mean age=14.7 years; SD=1.9; range=12.3–17.8) completed the Relational and Item-Specific Encoding task (RiSE), the California Verbal Learning Test-Children's Version (CVLT-C), the Wechsler Abbreviated Scales of Intelligence, and the Connors' Parent Rating Scale-Revised. Univariate statistical analyses were performed. ResultsThe ASD group showed poorer performance on strategic memory assessed by the CVLT-C. Surprisingly, on the RiSE, ASD showed poorer discriminability for objects encoded in item-specific versus relational encoding conditions and were more impaired in familiarity (after relational encoding) than in recollection. ASD also did not show the hypothesized association between item and associative recognition and CVLT-C performance found in TYP. Instead, in the ASD group recognition was associated with increased age. ConclusionsFindings from the RiSE task demonstrated that adolescents with ASD do not always exhibit impaired memory for relational information as commonly believed. Instead, memory was worse when cognitive control demands were high, when encoding focused on specific item features, and when familiarity was used to retrieve relational information. Recognition also was better in older participants. This suggests that learning and memory deficits in adolescents with ASD, may not be due primarily to failed relational binding processes in the hippocampus but, rather to disrupted strategic memory and familiarity processes associated with the prefrontal and perirhinal cortices. These findings demonstrate the importance and utility of using well-validated cognitive neuroscience tasks and of considering the ages of participants when comparing the neural underpinnings of different memory processes in both typical and atypical populations.

Verbal learning and memory impairment in children with fetal alcohol spectrum disorders.

Previous studies using the California Verbal Learning Test-Children's Version (CVLT-C) to examine effects of heavy prenatal alcohol exposure on verbal learning and memory have reported impaired information acquisition (i.e., encoding), rather than retrieval, as the primary mechanism underlying learning and memory impairment. We administered the CVLT-C to 2 independent cohorts to determine whether (i) effects on encoding are also seen at moderate exposure levels, using both categorical (diagnostic/exposure group) and continuous exposure measures; (ii) these deficits are specific or secondary to alcohol-related impairment in IQ; (iii) effects on retrieval can be detected over and above effects on initial encoding; and (iv) effects on learning are attributable to less efficient learning strategy use. We administered the CVLT-C and Wechsler Intelligence Scale for Children to 151 Cape Town heavy and nonexposed children (M=10.3years), and 291 Detroit adolescents recruited to over-represent moderate-to-heavy prenatal alcohol exposure (M=14.4years). Effects on encoding in the heavily exposed Cape Town cohort and on retrieval in both cohorts were significant after adjustment for IQ. Although effects on retrieval were no longer significant in Cape Town after control for initial encoding, effects on recognition memory continued to be evident in Detroit. Children with full or partial fetal alcohol syndrome were less able to use the semantic cluster encoding strategy implicit in the CVLT-C. Effects on verbal learning were seen primarily in the more heavily exposed Cape Town cohort; effects on recall and recognition memory were also seen at moderate exposure levels in Detroit. These effects were not attributable to alcohol-related impairment in overall intellectual competence. The finding that effects on retention continued to be evident after statistical adjustment for initial encoding in Detroit suggests that a fetal alcohol-related deficit in retrieval is not secondary to a failure to encode the initial information. These data confirm that this impairment in initial learning is mediated, in part, by failure to use the semantic cluster learning strategy.

A Neurodevelopmental Approach to Understanding Memory Processes Among Intellectually Gifted Youth With Attention-Deficit Hyperactivity Disorder

Intellectual giftedness is associated with strong strategic verbal memory while attention-deficit hyperactivity disorder (ADHD) is associated with strategic verbal memory deficits; however, no previous research has explored how this contradiction manifests in gifted populations with diagnoses of ADHD. The purpose of this study was to explore strategic verbal memory processes among intellectually gifted youth with and without ADHD to provide clarification regarding this specific aspect of neuropsychological functioning within this population. One hundred twenty-five youth completed neuropsychological evaluations including the Wechsler Intelligence Scale for Children-Fourth Edition and California Verbal Learning Test-Children’s Version (CVLT-C). Results revealed significant differences between groups, with intellectually gifted youth with ADHD achieving lower T scores on CVLT-C Trials 1 through 5 compared with intellectually gifted youth without ADHD, and intellectually gifted youth with ADHD achieving higher T scores than youth of average intellectual abilities with ADHD. Additionally, repeated-measures analysis of variance revealed a main effect improvement among gifted youth with ADHD in short-delay recall when provided with organizational cues. Findings revealed new evidence about the role of twice exceptionality (specifically intellectual giftedness and ADHD) in strategic verbal memory and have important implications for parents, educators, psychologists and neuropsychologists, and other mental health professionals working with this population.

Memory and Health-Related Quality of Life in Severe Pediatric Epilepsy

The purpose of this paper was to investigate the contributions of sociodemographic, neurologic, and neuropsychological variables to health-related quality of life (HRQoL) in children with epilepsy and high seizure burden. Focus was placed on the relationship between memory and HRQoL, which has not been previously investigated. Ninety children with epilepsy receiving clinical care at a tertiary-level children's hospital were retrospectively identified. Primary assessment measures were verbal memory (California Verbal Learning Test-Children's Version) and HRQoL. Other neuropsychological variables included intellectual function, executive function, emotional and behavioral function, and adaptive function. Sociodemographic and neurologic variables were extracted from chart review. No significant correlations were found between HRQoL and sociodemographic or neurologic variables. Moderate correlations were found between neuropsychological variables and HRQoL. Emotional function (Child Behavior Checklist) and verbal memory (California Verbal Learning Test-Children's Version) emerged as significant predictor variables of HRQoL. Low verbal memory was associated with a twofold risk of low HRQoL, emotional and behavioral difficulty with a 10-fold risk, and the combination of emotional and behavioral difficulty and low verbal memory with a 17-fold risk. Verbal memory and emotional and behavioral difficulty are associated with increased risk of low HRQoL, even when other important variables are considered in children with high seizure burden. The results reinforce the importance of neuropsychological assessment in clinical care in pediatric epilepsy and suggest important areas of focus for psychological intervention.

Learning and Memory Following Conformal Radiation Therapy for Pediatric Craniopharyngioma and Low-Grade Glioma

The primary objective of this study was to examine whether children with low-grade glioma (LGG) or craniopharyngioma had impaired learning and memory after conformal radiation therapy (CRT). A secondary objective was to determine whether children who received chemotherapy before CRT, a treatment often used to delay radiation therapy in younger children with LGG, received any protective benefit with respect to learning. Learning and memory in 57 children with LGG and 44 children with craniopharyngioma were assessed with the California Verbal Learning Test-Children's Version and the Visual-Auditory Learning tests. Learning measures were administered before CRT, 6 months later, and then yearly for a total of 5 years. No decline in learning scores after CRT was observed when patients were grouped by diagnosis. For children with LGG, chemotherapy before CRT did not provide a protective effect on learning. Multiple regression analyses, which accounted for age and tumor volume and location, found that children treated with chemotherapy before CRT were at greater risk of decline on learning measures than those treated with CRT alone. Variables predictive of learning and memory decline included hydrocephalus, shunt insertion, younger age at time of treatment, female gender, and pre-CRT chemotherapy. This study did not reveal any impairment or decline in learning after CRT in overall aggregate learning scores. However, several important variables were found to have a significant effect on neurocognitive outcome. Specifically, chemotherapy before CRT was predictive of worse outcome on verbal learning in LGG patients. In addition, hydrocephalus and shunt insertion in craniopharyngioma were found to be predictive of worse neurocognitive outcome, suggesting a more aggressive natural history for those patients.