Executive Function In Children Research Articles

Episodic foresight, episodic memory, and executive functions in children engaged with Child Protective Services: The role of cumulative risk

Previous studies have determined that exposure to risk and adversities may impair children’s cognitive abilities. In particular, children engaged with Child Protective Services (CPS) seem to be at greater risk for enhanced detrimental effects resulting from the cumulative risk factors to which they are exposed. However, little is known about children’s future thinking when they face adverse circumstances, and it is not clear how the associations among episodic foresight abilities, episodic memory, and executive functions work with children under such circumstances. The current study describes the episodic foresight abilities of CPS-involved school-aged children, its association with other cognitive abilities, and how this association is affected by the exposure to cumulative risk and adversity factors. Episodic foresight, episodic memory, executive functions, and a composite of cumulative risk factors were analyzed in a sample of 95 school-aged children engaged with CPS in Portugal. Results suggest the detrimental effect of cumulative risk on the episodic foresight abilities of CPS-involved children. Episodic memory and cognitive flexibility were significant predictors of episodic foresight abilities, and cumulative risk exposure moderated the relation between episodic memory and episodic foresight. The current study provides a better understanding of the influences of multiple adversities on CPS-involved children’s episodic foresight abilities and related cognitive outcomes.

Educational robotics or unplugged coding activities in kindergartens?: Comparison of the effects on pre-school children's computational thinking and executive function skills

This study compares the effects of coding education with educational robot and unplugged coding activities on pre-school students' computational thinking and executive function skills. This study used a pre-test and post-test comparison group quasi-experimental design. The study was conducted in a public kindergarten with 48 pre-school students (24 educational robot- BeeBot® group and 24-unplugged coding group) aged 5-6. The TechCheck-K test was used to measure computational thinking skills, and Executive Functions Battery-Computerized Touch was used to measure executive function skills. The process started with pre-test applications and ended with post-tests after four weeks (16 different sessions) of the implementation in both groups. The study found a statistically significant difference between the computational thinking pre-test and post-test scores of pre-school students in both groups in favor of the post-test. It was determined that there was a statistically significant difference in favor of the educational robot group between the post-test scores of computational thinking skills. In addition, when the findings regarding executive functions were evaluated, there was a statistically significant difference between the pre-test and post-test scores of total executive function in favor of the post-test in both groups. However, it was observed that there was no statistically significant difference between the post-test scores of both groups in terms of total executive function skills scores. In addition, when the post-test scores of pre-school students in two groups were evaluated, it was determined that there was no significant difference in computational thinking and executive function skills according to gender. Consequently, it was determined that coding education with an educational robot was more effective for gaining computational thinking skills than unplugged coding activities for pre-school students. However, it was observed that there was no difference between the two groups in terms of the development of executive function skills in pre-school education.

Staying self-regulated in the classroom: The role of children's executive functions and situational factors.

Self-regulation is crucial for children's learning and development. Several studies have explored children's inter-individual differences in self-regulation, but little is known about sources of intra-individual variation. This study addressed the variability of children's self-regulation across typical classroom situations and how this might be associated with children's executive functions (EFs). The study included 148 children (54.7% girls; Mage = 56.73 months). Self-regulation was assessed with an observational measure in teacher-led and child-led activities within naturalistic classroom settings. Children's EFs were assessed with direct assessments at the start and end of the school year. Linear mixed-effect models showed that children demonstrated higher levels of self-regulation in child-led in comparison with teacher-led activities. Children with higher levels of EFs at the start of the school year showed less variation across teacher-led and child-led activities in comparison with children with lower levels of EFs. Regarding other aspects of the classroom context, neither the group size in which the activity took place nor which school subject it was focused on were associated with children's self-regulation. However, in teacher-led activities the type of interaction involved in the activity and the type of task influenced children's self-regulation. These results suggest that children who start school with higher levels of EFs are more able to adapt to different situations, highlighting the importance of fostering these skills in early childhood. In turn, children with lower levels of EFs may need additional support from teachers to remain self-regulated across different contexts.

Cognitive Distancing Language in Parent-Child Book Sharing Among Low-Income Mexican American and Chinese American Families: Cultural Group Comparisons and Links to Children’s Executive Functions

ABSTRACT Research Findings: In the context of parent-child book sharing, cultural influences on cognitive distancing language and associations with child executive function (EF) have been understudied. This study examined cultural group similarities/differences in parent and child book-sharing distancing language among preschool-aged dual language learners from low-income Mexican American (MA) and Chinese American (CA) families. We further tested concurrent relations between parent/child distancing language and children’s EF. The sample consisted of 88 children (45 MAs, 43 CAs, age = 38–68 months) enrolled in Head Start preschools and their parents. To assess distancing language, utterances were coded for cognitive demand and classified as referential (low demand), behavioral (moderate demand), or inferential (high demand). Cognitive tasks tapping inhibitory control and cognitive flexibility were used to assess child EF. Results showed parents and children from both cultural groups produced comparable numbers of story-related utterances. MA dyads used higher proportions of parent/child inferential statements and a lower proportion of parent referential questions. The proportions of parent behavioral questions and child behavioral statements were positively related to child cognitive flexibility. Practice or Policy: Findings highlight heterogeneity in parent-child verbal interactions among low-income multilingual families and have implications for promoting preschoolers’ cognitive/language development in diverse populations.

Ambient Air Pollution Exposures and Child Executive Function: A US Multicohort Study.

Executive function, which develops rapidly in childhood, enables problem-solving, focused attention, and planning. Animal models describe executive function decrements associated with ambient air pollution exposure, but epidemiologic studies are limited. We examined associations between early childhood air pollution exposure and school-aged executive function in 1235 children from three US pregnancy cohorts in the ECHO-PATHWAYS Consortium. We derived point-based residential exposures to ambient particulate matter ≤2.5 µm in aerodynamic diameter (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ) at ages 0-4 years from spatiotemporal models with a 2-week resolution. We assessed executive function across three domains, cognitive flexibility, working memory, and inhibitory control, using performance-based measures and calculated a composite score quantifying overall performance. We fitted linear regressions to assess air pollution and child executive function associations, adjusting for sociodemographic characteristics, maternal mental health, and health behaviors, and examined modification by child sex, maternal education, and neighborhood educational opportunity. In the overall sample, we found hypothesized inverse associations in crude but not adjusted models. Modified associations between NO 2 exposure and working memory by neighborhood education opportunity were present ( Pinteraction = 0.05), with inverse associations more pronounced in the "high" and "very high" categories. Associations of interest did not differ by child sex or maternal education. This work contributes to the evolving science regarding early-life environmental exposures and child development. There remains a need for continued exploration in future research endeavors, to elucidate the complex interplay between natural environment and social determinants influencing child neurodevelopment.

Playfulness and Kindergarten Children's Academic Skills: Executive Functions and Creative Thinking Processes as Mediators?

ABSTRACTThis study examined the direct and indirect relationships between playfulness (social and cognitive spontaneity), executive functions, convergent thinking, divergent thinking, and academic skills in Hong Kong Chinese kindergarten children. Participants were 181 second‐year (4 to 5 years) kindergarten children (45.9% boys) and their parents. Parents reported demographic information and children's playfulness and executive functions through a questionnaire. Children were administered behavioral assessments of convergent thinking, divergent thinking, Chinese word reading, and number word comparison at their kindergarten. Results from a path analytic model revealed the mediating roles of convergent and divergent thinking in the relationship between playfulness and number word comparison. In contrast, convergent thinking mediated the link between playfulness and Chinese word reading. Executive functions were positively related to playfulness but unrelated to children's academic skills. The findings suggest that playful children might develop better creative thinking processes, supporting their academic skills. Practically, the findings underscore the importance of play‐based learning in developing children's creativity and academic skills in the early years.

Association of cord blood vitamin D with child neurodevelopment at 7 years of age.

The role of fetal vitamin D [25-hydroxyvitamin D (25(OH)D)], one of the nuclear steroid transcription regulators, and brain development is unclear. We previously found a weak but persistent association between cord blood 25(OH)D and child language abilities at 18 months and 4 years of age, but no association with cognition or behaviour. The aim of this study was to investigate the association between cord blood 25(OH)D and a range of neurodevelopmental outcomes in these same children at 7 years of age. Cord blood samples from 250 Australian mother-child pairs were analysed for 25(OH)D by mass spectroscopy. Children underwent tests of cognition, language, academic abilities and executive functions with a trained assessor at 7 years of age. Caregivers completed questionnaires to rate their child's behaviour and executive functioning in the home environment. Associations between standardised 25(OH)D and outcomes were assessed using regression models, taking into account possible social and demographic confounders. Standardised 25(OH)D in cord blood was not associated with any test or parent-rated scores. Nor was there any association with the risk of having a poor test or parent-rated score. Likewise, cord blood 25(OH)D categorised as <25, 25-50 and >50 nmol/L was not associated with test scores or parent-rated scores. There was no evidence that cord blood vitamin D concentration or deficiency was associated with cognition, language, academic abilities, executive functioning or behaviour at 7 years of age.

Effect of aerobic exercise on the improvement of executive function in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis.

Aerobic exercise (AE) interventions are beginning to be used as an emerging adjunctive treatment modality in the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD). However, to date, there is no substantial evidence to support the improved effects of aerobic exercise intervention in children with ADHD aged 6-12 years. This study aims to investigate the effect of aerobic exercise therapy on executive function in children with attention deficit hyperactivity disorder aged 6-12 years. We conducted a systematic review and meta-analysis using PubMed and Web of Science. The cut-off date was June 1, 2023. The aim was to assess the impact of aerobic exercise interventions on children with ADHD and all randomized controlled trials eligible for aerobic exercise interventions for children with ADHD were included. Nine randomized controlled trials were screened for eligibility for systematic evaluation, and the nine studies were assessed for risk of bias using the PEDro score and the GRADE Quality of Evidence Evaluation System for quality grading of outcome indicators. After testing for heterogeneity, a random-effects model was selected for analysis. Finally, meta-analyses and regression analyses were performed on the core functions (inhibitory control, cognitive flexibility, and working memory) and subgroups of the nine studies on executive function using Revman 5.4 and Stata 16.0. The risk of bias evaluation showed a mean PEDro score of 7.78, and of the nine studies, two were rated as having excellent methodological quality, while the remaining seven had a good level of evidence, and the GRADE evidence evaluation showed that the outcome indicators were all of moderate quality. Inhibitory control [SMD = 0.83,95% CI (0.37-1.29), Z = 3.51, p = 0.0005], cognitive flexibility [SMD = 0.65,95% CI (0.37-0.93), Z = 4.58, p < 0.00001], and working memory [SMD = 0.48,95% CI (0.02-0.95), Z = 2.03, p = 0.04] were statistically significant, with effect sizes of moderate or higher; furthermore, in subgroup analyses type of intervention, duration, intensity, and medication use had different effects on inhibitory control and cognitive flexibility, and the combined IC, CF statistic found that a single category of aerobic exercise ( β = 0.867, p < 0.001), moderate intensity ( β = 0.928, p < 0.001), 6-12 weeks (β = 0.804, p < 0.001), 60-90 min ( β = 0.894, p < 0.001), and the use of medication ( β = 1.202, p = 0.002) were better for overall improvement in EF. Aerobic exercise therapy significantly improved executive functioning in children with ADHD, showing above moderate effect sizes especially in inhibitory control, cognitive flexibility, and working memory. Aerobic exercise therapy can be used as a reference in improving executive function in children with ADHD, but given the limitations of this study, it should be used with caution when applied in clinical settings.

INHIBITORY CONTROL IN CHILDREN WITH ATTENTİON DEFİCİT AND HYPERACTİVİTY DİSORDER

The article talks about inhibitory control, which is one of the executive functions in children with ADHD. These children always have impaired executive functions. However, executive dysfunction does not always mean ADHD. Evaluation of executive functions can help diagnose this neurodevelopmental disorder. One of the most common executive function deficits associated with ADHD is problems with inhibitory control. They find it difficult to control inappropriate or impulsive behavior, external interference, and therefore have trouble concentrating. Inhibition plays an important role in successful behavior, requiring the suppression of extraneous interference to focus attention, the ignoring of irrelevant cues to recall stored information, and the suppression of habitual responses to adaptive decision making. Impaired response inhibition directly affects four executive functions: working memory, self-regulation, language internalization, and restructuring. This, in turn, leads to difficulties with complex movements and goal-directed behavior, especially those related to motor control, verbal fluency, and syntax. Given the influence of inhibitory control on ADHD, the author argues that training that enhances inhibition may improve ADHD symptoms. A number of studies in this area have demonstrated the effectiveness of trainings designed to enhance inhibitory control.

Relationships between Sensory Processing and Executive Functions in Children with Combined ASD and ADHD Compared to Typically Developing and Single Disorder Groups.

Sensory Profile 2 (SP-2) and Behavior Rating Inventory of Executive Function 2 (BRIEF-2) were measured in 120 school-aged children. The results of the above scales were compared across these four groups, and correlation and regression analyses between BRIEF2 and SP2 were conducted. Our research revealed varying levels of atypical sensory processing and executive function anomalies across the three neurodevelopmental disorder groups compared to the TD group. The ASD+ADHD group showed particularly significant differences. The heightened emotional problems observed in ASD+ADHD children may be associated with more prominent atypical sensory processing. Variance analysis of inhibitory function revealed differences between ASD+ADHD and ADHD children, suggesting distinct etiological mechanisms for attention issues between ASD+ADHD and ADHD. ASD+ADHD represents a phenotype distinct from both ASD and ADHD. Special consideration should be given to interventions for children with ASD+ADHD. The results of this study may offer a new perspective on understanding the occurrence of ASD+ADHD and potential individualized intervention methods.

A Study of the Effect of Interactive Physical Activity on Executive Function in Children with Autism

To explore the impact of interactive physical activity on executive function of children with autism through interactive physical activity teaching, and to verify the effective improvement of executive function of children with autism through interactive physical activity intervention. Four autistic children aged 8-10 were divided into the experimental group and the control group by literature review, interview, observation and experiment methods. Two children in the experimental group received 90 minutes of interactive physical activity once a week for 12 weeks. Through the working memory, inhibition ability, cognitive flexibility test indicators, the intervention subjects were pretested and post tested for 8 times. The working memory test scores of autistic children in the experimental group increased from 3.50-3.75 before intervention to 6.00-6.25 after intervention, and the inhibitory ability test scores increased from 2.75 before intervention to 5.00-5.75 after intervention, while the cognitive flexibility test scores did not change significantly. The total score of executive function test increased from 8.25-9.25 before intervention to 13.50-14.00 after intervention. Interactive physical activity has positive effects on working memory and inhibition in executive function of autistic children, but it has no effect on cognitive flexibility. Interactive physical activity should be based on the differences of children with autism and the fun of roller skating combined with the concept of interactive physical activity, targeted intervention for children with autism.

The Effects of Physical Activity Interventions on Children's Perception: A Systematic Review and Meta-Analysis.

Perception is an essential component of children's psychological development, which is foundational to children's ability to understand and adapt to their external environment. Perception is also a crucial tool for understand and navigating one's surroundings, enabling children to identify objects and react appropriately to settings or situations. Substantial evidence indicates that engaging in physical activity is beneficial for the development of children's perceptual abilities, as the two are closely intertwined. Still, more research is necessary to gain a full understanding of the impact of physical activity on children's perception. To further identify and quantify the effects of physical activity on a number of specific perceptions in children. Systematic review and meta-analysis. Searches were performed using five online databases (i.e., PubMed, SPORTDiscus, PsycINFO, Web of Science, and Cochrane Library) for articles published up to and including June 2023 to identify eligible citations. A total of 12 randomized controlled trials, encompassing 1,761 children under the age of 12, were analyzed. Overall, physical activity as an intervention showed a notable effect on the development of children's perceptions. The meta-analysis indicated that participating in physical activity for 30 minutes around, daily, had a greater impact on children's visual perception and executive functioning than on their motor perception, body perception, and global self-worth (SMD = 1.33, 95% CI: 0.75, 1.91, p < 0.001). The effects of physical activity on children's perception performance varied by participant characteristics, with physical activity having better effects on body perception and overall self-worth in children who were obese or overweight. Furthermore, physical activity can also enhance executive function and attention in children with developmental coordination disorders. The effects of physical activity on children's perception performance varied according to the intervention time, with different activity durations resulting in different perception performances. Therefore, parents and educators must prioritize an appropriate length of physical activity time for children to ensure their optimal growth and development. Registration and protocol CRD42023441119.

Association between outdoor light at night exposure and executive function in Chinese children

BackgroundRecent evidences highlight the potential impact of outdoor Light at Night (LAN) on executive function. However, few studies have investigated the association between outdoor LAN exposure and executive function. MethodsWe employed data from 48,502 Chinese children aged 5–12 years in a cross-sectional study conducted in Guangdong province during 2020–2021, to examine the association between outdoor LAN and executive function assessed using the validated parent-completed Behavior Rating Inventory of Executive Function. We assessed children's outdoor LAN exposure using the night-time satellite images based on the residential addresses. We used generalized linear mixed models to estimate the association between outdoor LAN exposure and executive function scores and executive dysfunction. ResultsAfter adjusting for potential covariates, higher quintiles of outdoor LAN exposure were associated with poorer executive function. Compared to the lowest quintile (Q1), all higher quintiles of exposure showed a significant increased global executive composite (GEC) score with β (95% confidence intervals, CI) of 0.58 (0.28, 0.88) in Q2, 0.59 (0.28, 0.9) in Q3, 0.85 (0.54, 1.16) in Q4, and 0.76 (0.43, 1.09) in Q5. Higher quintiles of exposure were also associated with higher risks for GEC dysfunction with odd ratios (ORs) (95% CI) of 1.34 (1.18, 1.52) in Q2, 1.40 (1.24, 1.59) in Q3, 1.40 (1.23, 1.59) in Q4, and 1.39 (1.22, 1.58) in Q5. And stronger associations were observed in children aged 10–12 years. ConclusionsOur study suggested that high outdoor LAN exposure was associated with poor executive function in children. These findings suggested that future studies should determine whether interventions to reduce outdoor LAN exposure can have a positive effect on executive function.

Patterns of cognitive and social-emotional parental stimulation practices among Ghanaian kindergarteners

Across geographically diverse samples, engagement in stimulating activities with young children is considered an important element of parenting that promotes cognitive, behavioral, and social-emotional development. Indicators of stimulation activities are often summed, based on the assumption that more stimulation is better and that different stimulating activities are equivalent. Instead, this study takes a household-centered analytic approach, applying latent class analysis to detect patterns of parental stimulation practices across six activities. We then examine predictors of the resultant latent classes and their implications for children's school readiness among a sample of Ghanaian kindergarteners (N = 2,117; Mage = 5.2 years; 51% male). Results support a 4-class solution that represents (i) Highly Stimulating; (ii) Social-emotionally Stimulating; (iii) Playful; and (iv) Playful and Academically Stimulating households. Multiple child and family characteristics differentially predict latent class membership, although class membership did not differentially predict children's literacy, numeracy, executive function, or social-emotional skills. Findings suggest that all combinations of parental stimulation are equivalently promotive of children's school-related skills and help reify a strengths-based perspective. The results deepen our understanding of the different configurations of parental stimulation and suggest that a tailored approach to parenting programs may be beneficial. Programs can build on activities that parents already do (e.g., social-emotional) to encourage increased stimulation in other areas (e.g., academic).

Feasibility and acceptability of a parent‐toddler programme to support the development of executive functions in children at elevated likelihood of autism or ADHD: Pilot findings

AbstractThis study reports feasibility, fidelity and acceptability of a pilot of START; a 12‐week parent‐toddler, group‐based, neurodiversity‐affirming programme aiming to support executive function development in toddlers at elevated likelihood of autism or ADHD. After 4 days' training, community early years practitioner pairs delivered START to 13 UK families with a toddler showing elevated autistic traits, or with a parent or sibling with autism or ADHD, in groups of 6 and 7. Sessions were audio‐recorded and rated by practitioners and researchers regarding the extent to which programme and session aims were met. Practitioners' reflections on strengths and challenges in session delivery, adaptations to the session plan and researchers' observations from the audio recordings were probed in weekly debrief calls, and one‐to‐one interviews at programme end‐point. Recruitment and retention were monitored. Parent participants were asked to complete a feedback questionnaire after each session. Results show recruitment to the programme is feasible, but a large minority of parents experience barriers to regular attendance, which is a challenge for achieving exposure targets. Practitioners delivered the programme to a high quality and at least partially met programme and session‐specific aims in every session. The most significant barrier to fully meeting session aims was families' late arrival. Parents reported regularly engaging with the suggested activities at home and found the sessions useful, although not all parents responded each week. Overall, the results of this small‐scale pilot indicate START is feasible and acceptable as a parent‐mediated programme to support toddlers at elevated likelihood of autism or ADHD to thrive.

Transactional Linkages Between Parenting Behaviors and Child Executive Functions and Self-Regulation from Early Childhood to Adolescence.

Research on the development of executive functions (EFs) and self-regulation (SR) has focused heavily on the early childhood years, when these abilities first emerge. Less is known in comparison about how these abilities develop through adolescence, and how contextual factors, such as parenting, influence their development in later years. Using longitudinal data from the Study of Early Child Care and Youth Development (SECCYD), we used random intercept cross-lagged panel modeling (RI-CLPM) to examine the bidirectional linkages between three parenting behaviors (i.e., autonomy support, supportive presence, hostility), child EFs (i.e., working memory, inhibitory control) and child SR outcomes, from early childhood to adolescence. Parenting in early childhood was significantly associated with change in child EFs from early to middle childhood, but not from middle childhood to adolescence. Specifically, greater autonomy support in early childhood was associated with stronger child working memory and inhibitory control in middle childhood; greater supportive presence in early childhood was associated with stronger child working memory in middle childhood; and higher rates of hostility in early childhood were associated with weaker child inhibitory skills in middle childhood. Reciprocal effects of child EF and SR on parenting were also observed. Specifically, stronger child inhibitory control in early childhood was associated with less hostility in middle childhood, and stronger child self-regulation in middle childhood was associated with greater supportive presence in adolescence. Accounting for lagged and stability effects, there was significant residual covariance between parenting behaviors and child SR in adolescence, suggesting that parenting continues to be associated with the development of SR skills through adolescence. Understanding reciprocal linkages between parenting and child EF/SR through adolescence is critical in developing targeted parenting interventions beyond early childhood to improve children's outcomes.

Mind the Gap: Executive Function Is Associated with the Discrepancy Between Cognitive and Adaptive Functioning in Autistic Children Without Cognitive Delay.

Adaptive functioning is central to autistic individuals' independence and well-being. However, autism spectrum disorder (ASD) is associated with poor adaptive functioning, even in the absence of cognitive delays or deficits. This study examined how age and executive function associate with adaptive functioning-particularly the gap between cognitive and adaptive functioning. We addressed our research questions separately for a school-age (N = 101 ages 7-12) cohort and a preschool (N = 48 ages 2 and 4) cohort of autistic children without cognitive delays. Both cohorts of parents reported on their children's adaptive and executive functioning skills. The difference between adaptive and cognitive skills was computed for each participant. For each cohort, we evaluated whether adaptive skills decline with age. Next, we measured, in each cohort, whether children's executive function corresponded with this gap between their adaptive and cognitive skills. Adaptive functioning did not decline relative to cognitive ability in the younger cohort, but the gap was present in the school-age cohort. Yet, reduced executive function consistently corresponded with a greater cognitive-adaptive gap in socialization domains for both preschool and school-age children. Targeting EF, specifically emotional control, during preschool years may support both adaptive functioning and social connectedness for autistic children without cognitive delays.

Assessment of Executive Functions in Children with Sensorineural Hearing Loss and in Children with Specific Language Impairment: Preliminary Reports.

Executive functions (EFs) are related abilities, associated with the frontal lobes functions, that allow individuals to modify behavioral patterns when they become unsatisfactory. The aim of this study was to assess EFs in children with sensorineural hearing loss (SNHL) and in children with "specific language impairment" (SLI), compared with a control group of children with normal development, to identify specific skill deficits. Three groups of preschool children aged between 2 and 6 years were assessed: 19 children with normal hearing, cognitive, and language development, 10 children with SNHL, and 20 children with SLI. The FE-PS 2-6 Battery was used for the assessment of preschool EFs, supplemented with the Modified Bell Test for the analysis of selective attention. Statistically significant differences were found between the two experimental groups and the control one, regarding the investigated skills. Children with SNHL showed a clear deficit in flexibility, whereas children with SLI had greater problems in self-regulation and management of waiting for gratification. Selective attention was found to be deficient in all three groups, with no statistically significant differences. This study shows that the skills investigated were found to be deficient in both SNHL and SLI patients. It is essential to start targeted exercises based on specific deficient skills as part of the rehabilitation program. It is of great importance to understand the consequences of EF deficit in preschool children to achieve an accurate diagnosis and carry out customized rehabilitation programs.

General ability and specific cognitive functions are lower in children with epilepsy after perinatal ischemic stroke

IntroductionEpilepsy develops in one third of children after perinatal stroke. Both epilepsy and stroke may be risk factors for impaired cognitive abilities. How the development of epilepsy is related to the cognitive profile of children with perinatal stroke is still unclear. The aim of the study was to evaluate general and specific cognitive functions in children with epilepsy and children without epilepsy after perinatal ischemic stroke.MethodsThe study group consisted of 51 children with perinatal ischemic stroke confirmed by magnetic resonance imaging: 27 (53%) children with arterial ischemic stroke and 24 (47%) with periventricular venous infarction. Magnetic resonance imaging and electroencephalography were performed in all patients after the neonatal period. Epilepsy was diagnosed if the child had at least two unprovoked seizures occurring &amp;gt;24 h apart or one unprovoked seizure with a high recurrence risk. Cognitive assessments were performed using the Kaufman Assessment Battery for Children, Second Edition, at the age of ≥7 years. General ability (Fluid Crystallized Index, Mental Processing Index, Non-verbal Index) and specific cognitive functions (sequential processing, simultaneous processing, learning, planning, knowledge) were evaluated.ResultsAt the median age of 19.3 years (interquartile range 14.0–22) at the time of follow-up for epilepsy, 14 (27.5%) patients had developed epilepsy, and 37 (72.5%) patients were without epilepsy. All general cognitive ability scores were lower in children with epilepsy compared to children without epilepsy. Among specific cognitive functions, simultaneous processing, planning, and knowledge were lower in children with epilepsy compared to children without epilepsy: simultaneous processing mean [78.5, 95% CI: [69.8, 87.2], vs. 96.9, 95% CI [90, 103.9], p = 0.0018]; planning mean [82.5, 95% CI: [73, 92], vs. 96.2, 95% CI: [88.7, 103.6], p = 0.026]; knowledge median (25th, 75th percentile): 80.5 (75, 87) vs. 92 (84, 108), p = 0.023.ConclusionChildren with epilepsy after perinatal ischemic stroke have lower general cognitive abilities compared to children without epilepsy. The profile of the subscales indicates lower verbal abilities and executive functions in children with epilepsy. Children with post-stroke epilepsy need targeted cognitive monitoring for early aimed rehabilitation and for establishing an adapted learning environment.

Executive function performance in children and adolescent patients with narcolepsy type 1

ObjectiveThe executive function profile in patients with narcolepsy type 1 (NT1) has been mentioned; however, limited research exists on children and adolescent patients with NT1.This study aims to assess executive function in children and adolescent patients with NT1 in China, examine potential influencing factors and evaluate the short-term treatment effect on executive function. Methods53 NT1 patients (36 males, age 12.2 ± 3.4 years) and 37 healthy controls (23 males, age 12.2 ± 2.5 years) underwent self-reported measures assessing subjective sleepiness, depression, anxiety and sleep quality. A comprehensive neuropsychological test was administered to assess executive function domains, including processing speed, inhibitory control, cognitive flexibility and working memory. These assessments were repeated in NT1 patients after three-day regular drug treatment. ResultsNT1 patients exhibited higher levels of excessive daytime sleepiness, depression, anxiety, and poor sleep quality compared to healthy controls. Patients showed impaired processing speed, inhibitory control and cognitive flexibility (p < 0.05), whereas working memory was unaffected (p > 0.05). Regression analysis revealed that parameters from sleep monitoring, such as sleep efficiency and sleep latency, were correlated with executive function performance after controlling for age, gender, and education years. The short-term treatment led to improvements in inhibitory control, cognitive flexibility, and working memory. ConclusionThe findings showed that executive function was impaired among children and adolescent patients with NT1, which was associated with objective sleep parameters. Furthermore, this study emphasizes the necessity of neuropsychological assessments and early interventions among children and adolescent NT1 patients.