Deficits In Children Research Articles

Sensitivity of the Test of Memory and Learning to Attention and Memory Deficits in Children with ADHD

Children with attention deficit hyperactivity disorder (ADHD) exhibit a number of cognitive deficits. The current study compared patterns of attention, learning, and memory impairment on the Test of Memory and Learning (TOMAL) between 80 children with ADHD and 80 normal comparisons who were matched for age and gender. Results demonstrated that children with ADHD performed significantly worse than matched controls on the Attention/Concentration Index and the Sequential Recall Index. ROC analysis indicated that these two indexes had good classification accuracy with AUCs of.76 and.77 respectively. There were also group differences on the other index scores except the Associative Recall Index. Factor analysis of the ADHD sample extracted five factors, including an Attention factor that significantly correlated with performance on nonverbal memory tasks. Significant correlations between the TOMAL Index scores and tests of intelligence and visuomotor integration supported the convergent and discriminant validity of the test. These results provide support for the criterion validity of the TOMAL in assessing neurocognitive deficits in children with ADHD.

Intellectual Deficits in Children with ADHD Beyond Central Executive and Non-Executive Functions

This study aimed to specify the deficit in intellectual ability in children with attention deficit hyperactivity disorder (ADHD), by studying the mediating role of impairments in central executive function (EF)-related components (working memory, inhibition, sustained attention) and non-EFs (short-term memory and processing speed). Two hundred and thirty children aged 8-11 years from a population-based sample were assigned to either the ADHD group, the clinical comparison group, or the normal comparison group. The results showed that children with ADHD had poorer fluid and crystallized intelligence, relative to both comparison groups. Further, regarding fluid intelligence, these deficits were not fully mediated by, but rather went beyond, poorer functioning on the studied EF-related components and non-EFs. We tentatively interpret these fluid deficits in children with ADHD as representing deficiencies in a general intellectual resource reflecting executive attentional processes. Concerning crystallized ability, in contrast, the deficit signified impairment in the studied cognitive functions, as indicated by the significant full mediation effect.

Adenotonsillectomy and Neurocognitive Deficits in Children with Sleep Disordered Breathing

BackgroundSleep Disordered Breathing (SDB) is a common childhood disorder that encompasses a range of sleep-related upper airway obstruction. Children with SDB demonstrate significant neurocognitive deficits. Adenotonsillectomy is the first line of treatment for SDB and whilst this improves respiratory disturbance, it remains to be established whether neurocognitive gains also result.MethodsA total of 44 healthy snoring children aged 3–12 years awaiting adenotonsillectomy (SDB group), and 48 age and gender matched non-snoring controls from the general community, completed the study. All children underwent polysomnography and neurocognitive assessment at baseline and after a 6-month follow-up (after surgery in the snoring group). Our primary aim was to determine whether neurocognitive deficits in snoring children were significantly improved following adenotonsillectomy.ResultsWide ranging neurocognitive deficits were found at baseline in SDB children compared to controls, most notably a 10 point IQ difference (P<.001) and similar deficits in language and executive function. Whilst adenotonsillectomy improved respiratory parameters and snoring frequency at 6 months post surgery, neurocognitive performance did not improve relative to controls.ConclusionAdenotonsillectomy successfully treated the respiratory effects of SDB in children. However, neurocognitive deficits did not improve 6-months post-operatively.

There are Multiple Contributors to the Verbal Short-Term Memory Deficit in Children with Developmental Reading Disabilities

Prior research has put forth at least four possible contributors to the verbal short-term memory (VSTM) deficit in children with developmental reading disabilities (RD): poor phonological awareness that affects phonological coding into VSTM, a less effective phonological store, slow articulation rate, and fewer/poorer quality long-term memory (LTM) representations. This project is among the first to test the four suppositions in one study. Participants included 18 children with RD and 18 controls. VSTM was assessed using Baddeley's model of the phonological loop. Findings suggest all four suppositions are correct, depending upon the type of material utilized. Children with RD performed comparably to controls in VSTM for common words but worse for less frequent words and nonwords. Furthermore, only articulation rate predicted VSTM for common words, whereas Verbal IQ and articulation rate predicted VSTM for less frequent words, and phonological awareness and articulation rate predicted VSTM for nonwords. Overall, findings suggest that the mechanism(s) used to code and store items by their meaning is intact in RD, and the deficit in VSTM for less frequent words may be a result of fewer/poorer quality LTM representations for these words. In contrast, phonological awareness and the phonological store are impaired, affecting VSTM for items that are coded phonetically. Slow articulation rate likely affects VSTM for most material when present. When assessing reading performance, VSTM predicted decoding skill but not word identification after controlling Verbal IQ and phonological awareness. Thus, VSTM likely contributes to reading ability when words are novel and must be decoded.

Truncal Ataxia, Hypotonia, and Motor Delay With Isolated Rhombencephalosynapsis

We report on a 16-month-old girl with developmental motor delay, microcephaly, and mild truncal ataxia who was revealed to have rhombencephalosynapsis on magnetic resonance imaging. The child was nonsyndromic and exhibited normal cognitive and social abilities for her age, despite neuroimaging findings. As this case demonstrates, motor skills in children with isolated rhombencephalosynapsis may be relatively mildly affected, and cognition may be normal despite the presence of a major central nervous system anomaly. Neuroimaging may be helpful in defining the nature of a child's deficits at an early age, particularly when associated with microcephaly and abnormalities on neurologic examination.

Differences in Neurophysiological Markers of Inhibitory and Temporal Processing Deficits in Children and Adults with ADHD

We compared ADHD-related temporal processing and response inhibition deficits in children and adults using event-related potentials (ERPs) during cued continuous performance tasks (CPT, O-X-version, plus a more demanding flanker version). ERP markers of temporal processing (Cue CNV) and inhibition (NoGo P300) were obtained in matched groups of children (32 with ADHD, mean age 11.2 years, and 31 controls, mean age 11.1 years) and adults (22 ADHD, mean age 42.7 years, and 22 controls, mean age 44.0 years). ERP markers and performance reflected both age and ADHD status. Performance was poorer, and Cue CNV and NoGo P300 were weaker in ADHD children and adults compared to their matched controls. ADHD-related ERP differences in children were more prominent at posterior scalp sites but more pronounced at anterior scalp sites in adults, paralleling the prominent topographic changes of both ERP markers with development. The fact that differences in the same test and the same processing period appear in both children and adults, but that they present in different aspects of performance and different scalp topographies, leads to the conclusion that some ADHD-related deficits persist into adulthood despite alterations of their qualitative aspects.

A Two-Year Longitudinal Study of Persistent Lean Tissue Deficits in Children With Crohn's Disease

Deficits in lean body mass have been reported in cross-sectional studies of children with Crohn's disease, but no longitudinal data exist from diagnosis. We observed the effects of Crohn's disease on body composition and bone mineral content (BMC), beginning at diagnosis and followed prospectively for 2 years. The study was conducted at 2 tertiary care centers for pediatric inflammatory bowel diseases. At diagnosis we recorded age, weight, height, levels of serum interleukin-6 and insulin-like growth factor-1, sexual maturation stage, disease activity, z scores for body mass index (BMI), fat-free mass (FFM), and bone mineral content (BMC). z Scores were adjusted for height and age, when appropriate. Measurements were made yearly in patients with Crohn's disease (n = 42) but only at the start of the study in controls (n = 81). BMI and FFM z scores were significantly reduced at the time of diagnosis in children with Crohn's disease, compared with controls. During the 2-year study period, the BMI z scores normalized in patients with Crohn's disease, but the FFM z scores did not increase significantly. The BMC z scores increased significantly, but they were still lower than control values after 2 years. Changes in BMC during a period of 2 years were associated with increases in FFM (R(2) = 0.318, P < .01). The correction of BMI that is associated with clinical improvement in children with Crohn's disease 2 years after diagnosis results from gains in fat mass. Significant FFM deficits might hamper normal acquisition of bone mass in children with Crohn's disease because of a lack of mechanical strain.

Brainstem Timing Deficits in Children with Learning Impairment May Result from Corticofugal Origins

A substantial proportion of children with language-based learning problems [learning disabilities (LD)] display abnormal encoding of speech at rostral levels of the auditory brainstem (i.e. midbrain) as measured by the auditory brainstem response (ABR). Of interest here is whether these timing deficits originate at the rostral brainstem or whether they reflect deficient sensory encoding at lower levels of the auditory pathway. We describe the early brainstem response to speech (waves I and III) in typically developing 8- to 12-year-old children and children with LD. We then focus on the early brainstem responses in children with LD found to show abnormal components of the rostral speech-evoked ABR (waves V and A). We found that wave I was not reliably evoked using our speech stimulus and recording parameters in either typically developing children or those with LD. Wave III was reliably evoked in the large majority of subjects in both groups and its timing did not differ between them. These data are consistent with the view that the auditory deficits in the majority of LD children with abnormal speech-evoked ABR originate from corticofugal modulation of subcortical activity.

Working Memory Deficits in Children With Specific Learning Disorders

This article examines working memory functioning in children with specific developmental disorders of scholastic skills as defined by ICD-10. Ninety-seven second to fourth graders with a minimum IQ of 80 are compared using a 2 x 2 factorial (dyscalculia vs. no dyscalculia; dyslexia vs. no dyslexia) design. An extensive test battery assesses the three subcomponents of working memory described by Baddeley (1986): phonological loop, visual-spatial sketchpad, and central executive. Children with dyscalculia show deficits in visual-spatial memory; children with dyslexia show deficits in phonological and central executive functioning. When controlling for the influence of the phonological loop on the performance of the central executive, however, the effect is no longer significant. Although children with both reading and arithmetic disorders are consistently outperformed by all other groups, there is no significant interaction between the factors dyscalculia and dyslexia.

Cognitive subtypes of dyslexia.

Different theories conceptualise dyslexia as either a phonological, attentional, auditory, magnocellular, or automatisation deficit. Such heterogeneity suggests the existence of yet unrecognised subtypes of dyslexics suffering from distinguishable deficits. The purpose of the study was to identify cognitive subtypes of dyslexia. Out of 642 children screened for reading ability 49 dyslexics and 48 controls were tested for phonological awareness, auditory discrimination, motion detection, visual attention, and rhythm imitation. A combined cluster and discriminant analysis approach revealed three clusters of dyslexics with different cognitive deficits. Compared to reading-unimpaired children cluster no. 1 had worse phonological awareness; cluster no. 2 had higher attentional costs; cluster no. 3 performed worse in the phonological, auditory, and magnocellular tasks. These results indicate that dyslexia may result from distinct cognitive impairments. As a consequence, prevention and remediation programmes should be specifically targeted for the individual child's deficit pattern.

Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder

Research has revealed facial emotion labeling deficits in children and adolescents with bipolar disorder. To assess whether such impairments may be an endophenotype for bipolar disorder, the authors examined facial emotion identification proficiency in children who were at risk for bipolar disorder because they had a first-degree relative with the illness. The facial expressions subtests of the Diagnostic Analysis of Nonverbal Accuracy scale were administered to 52 patients with bipolar disorder, 24 at-risk youths, and 78 control subjects, all 4-18 years of age. Compared with the control group, both the bipolar and at-risk groups made more errors identifying facial emotions. The number of errors did not differ significantly between the bipolar and at-risk groups. Deficits in facial emotion labeling may be a risk marker for bipolar disorder. Further study is needed to determine the neural mechanisms involved, as well as to explore other emotional processing impairments in youths at risk for bipolar disorder and to identify genetic associations.

Frequency and Severity of Visual Sensory and Motor Deficits in Children with Cerebral Palsy: Gross Motor Function Classification Scale

Cerebral palsy (CP) is a permanent, nonprogressive disorder of movement and posture due to a lesion of the fetal or infant brain. The goal was to determine whether children with different severities of CP, as defined using the Gross Motor Function Classification System (GMFCS), had different degrees or types of visual dysfunction. An observational, cross-sectional-design study was conducted by using neurologic and masked ophthalmic measurements on a representative cohort of 50 children with CP. Mean age was 5.6 years (range, 2-19.5 years); mean gestational age was 31 weeks. The likelihood of debilitating visual deficits was greater in children with higher GMFCS scores, independent of gestational age. Children with level 5 disease (most severe) were at greatest risk for high myopia, absence of binocular fusion, dyskinetic strabismus, severe gaze dysfunction, and optic neuropathy or cerebral visual impairment (CVI). These deficits were rare or absent in children with the mildest disease, level 1. When categorized by anatomic or physiologic CP subtype, diplegic and spastic children were more often hyperopic and esotropic, but had the highest prevalence of fusion and stereopsis. In contrast, children with quadriplegic and mixed CP (dyskinetic, athetoid, hypotonic, and ataxic) more often had high myopia, CVI, dyskinetic strabismus, and gaze dysfunction. Visual deficits differ in children who have mild versus severe CP. Children with GMFCS level 1 to 2 have sensorimotor deficits resembling those of neurologically normal children with strabismus and amblyopia; children at level 3 to 5 have more severe deficits, not observed in neurologically normal children.

Phonological Spelling and Reading Deficits in Children With Spelling Disabilities

Spelling errors in the Wide Range Achievement Test were analyzed for 77 pairs of children, each of which included one older child with spelling disability (SD) and one spelling-level-matched younger child with normal spelling ability from the Colorado Learning Disabilities Research Center database. Spelling error analysis consisted of a percent graphotactic-accuracy (GA) score based on syllable position and existence in English, and a phonological accuracy score (PA). The SD group scored significantly worse in the PA measure and nonsignificantly better than controls on the GA measure. The Group × Measure interaction was significant. Spelling matched pairs had very similar scores for word recognition and orthographic coding, but the SD group exhibited significant deficits in reading measures of phonological decoding and in language measures of phonological awareness.

Maternal Thyroid Autoantibodies during the Third Trimester and Hearing Deficits in Children: An Epidemiologic Assessment

Elevated maternal thyroid autoantibodies during pregnancy are linked to infertility, miscarriage, and neurodevelopmental deficits such as in cognitive function. It has not been established whether autoantibodies to thyroid peroxidase are associated with sensorineural hearing loss (SNHL). The authors tested stored third-trimester maternal serum specimens of 1,736 children for thyroid peroxidase autoantibodies (TPOaAb) by using an enzyme-linked immunosorbent assay technique. The children participated at the Baltimore, Maryland, site of the Collaborative Perinatal Project, which enrolled pregnant women in 1959-1965. An audiology examination was administered to the children at 8 years of age and was used to identify cases of SNHL. Compared with 4.3% of the other children, 22.7% of the children whose mothers had elevated TPOaAb (> or =62.5 IU/ml) had SNHL. The difference was significant after controlling for maternal race, age, and hypothyroidism (exact prevalence odds ratio = 7.5, 95% confidence interval: 2.4, 23.3). When a lower cutoff of TPOaAb > or =31.25 IU/ml was used, there continued to be an association with SNHL (exact prevalence odds ratio = 5.7, 95% confidence interval: 2.1, 15.6). The direction and magnitude of the association were similar when an alternative case definition of SNHL was used. These data suggest that antenatal exposure to maternal TPOaAb during the third trimester of pregnancy is associated with impaired auditory development.

The Stability of Inhibitory and Working Memory Deficits in Children and Adolescents Who are Children of Parents With Schizophrenia

Cognitive deficits are a central feature of schizophrenia and occur in first-degree relatives of schizophrenic probands, even in the absence of psychotic symptoms. A number of cognitive domains have been implicated including measures of response inhibition and working memory. While the stability of cognitive deficits has been demonstrated in individuals with schizophrenia, stability of deficits has not been explored in first-degree relatives. This report focuses on 25 children (ages 6-15 years), all with at least one schizophrenic parent. The children were assessed twice, utilizing inhibitory and working memory tasks, with a mean 2.6 years between visits. Stop reaction time (a measure of motor inhibition) and performance on a counting span task (a measure of verbal working memory) were borderline to mildly impaired (compared with a typically developing comparison group) at both visits with similar effect sizes (stopping task time 1, effect size = 0.46, time 2 effect size = 0.50; counting span time 1 effect size = 0.53, time 2 effect size = 0.42). For these 2 tasks, individual age-adjusted scores also correlated across both time points (r = 0.41-0.76) suggesting that individual children maintained deficits across time. As etiologically driven strategies are developed for the cognitive deficits of schizophrenia, expansion of these treatments to relatives who share the cognitive but not the psychotic symptoms may be worth exploring.

Obesidade e baixa estatura: estado nutricional de indivíduos da mesma família

Chronic undernourishment in infancy and obesity associated with short stature in the adult phase may have common determining biological and socio-environmental factors. This study with a view to contributing to the understanding of this relationship has as objective the verification of how children and parents distribution of nutritional conditions in pauperized families takes place and what the factors of a social, environmental and biological nature involvedare. It was studied 214 children aged 6 months to 5 years and 293 children and adolescents aged 6 to 18 years, belonging to pauper families earning monthly incomes less than US 70,living in two rural municipalities of the State of São Paulo, Brazil. Maternal schooling, number of rooms in the dwelling, age bellow 24 months, problems at birth and low stature of the mother especially when associated with obesity and, were all associated with the height deficitin children up to five years of age. The association of father’s height was weak. Conversely to the children of less then five years of age, the children of six year or over and adolescents were more clearly subject to the adverse socio-environmental and family conditions. Type of dwelling,number of individuals by dwelling, father’s absence and alcohol abuser in the family, lowstature of the mother associated with obesity were strongly related to the height deficit. Lowstature of the father was associated with the stature deficit, in this group...

The Localization and Lateralization of Memory Deficits in Children with Temporal Lobe Epilepsy

It is often reported that children with temporal lobe epilepsy (TLE) experience nonlateralized memory impairments. However, many of these studies have been exploratory and not based on memory theory. Further, differences between mesial and lateral subgroups have not been adequately examined. This study aimed to discern more specific patterns of memory impairment in children with TLE. Forty-three children (5-16 years) with lesional TLE participated. Subjects were categorized in terms of lesion laterality (left, n = 21; right, n = 22) and intratemporal location (mesial, n = 31; lateral, n = 12). Verbal and nonverbal memory tasks were administered that reflected associative, allocentric and recognition paradigms. Facial recognition was poorer in right TLE (p = 0.03). There were no differences between left and right groups on any other memory task, even when comparisons were restricted to cases with mesial involvement. Irrespective of laterality, clear differences were observed between mesial and lateral lesion subgroups (arbitrary associative learning, p = 0.01; complex figure recall, p = 0.03). The lateral lesion subgroup displayed intact memory function relative to normative standards. Memory is more frequently impaired in children with mesial as opposed to lateral TLE. Tasks with an associative component discriminated between these subgroups, supporting an associative model of hippocampal function. With the exception of facial recognition, memory deficits were not lateralized. Therefore, the nature of memory impairment experienced by children with TLE cannot be extrapolated from adult models.

Social Skills and Executive Function Deficits in Children With the 22q11 Deletion Syndrome

The 22q11 Deletion Syndrome (22q11DS) is among the most frequent gene deletion disorders, occurring once in every 6,000 live births. Descriptive reports have suggested marked social differences in affected children. Empirical studies are needed to verify possible social skills deficits among children with 22q11DS, and also to examine possible associations between their frequently reported executive function deficits and social anomalies. Fifty-two parents of affected children (n = 52) and participating control siblings (n = 26) completed the Social Skills Rating System (SSRS) and Behavior Inventory of Executive Function (BRIEF). When compared with control siblings, children with 22q11DS had significantly lower SSRS ratings for Cooperation, Assertion, Responsibility, and Self-Control. Affected children had significantly higher BRIEF ratings for Initiation, Planning, Working Memory, and Monitoring. In affected children, global Social Skill was negatively correlated with BRIEF Global Composite scores. Initiation and Monitoring significantly predicted Social Skill. Children with 22q11DS have marked differences in social skill development which are associated with executive dysfunction.

Identifying New Symptoms for Diagnosing ADHD in Adulthood

The current symptom list for ADHD in the DSM–IV (American Psychiatric Association, 2000) was developed on children and was only field tested using children (Lahey, Applegate, McBurnett, Biederman, Greenhill et al., 1994; Spitzer, Davies, & Barkley, 1989). The utility of extending that list to adults with ADHD is therefore an open question. This article addresses the important issue of whether or not better symptoms could be identified for the adult stage of this disorder than those 18 childhood symptoms currently represented in the DSM–IV.

Story Comprehension and Academic Deficits in Children With Attention Deficit Hyperactivity Disorder: What Is the Connection?

Based on the reliable findings that children with attention deficit hyperactivity disorder (ADHD) have both attentional and academic difficulties, it is assumed that the attentional deficit contributes to the academic problems. In this article, existing support for a link between the attentional and academic difficulties experienced by children with ADHD is reviewed, and questions for future research are identified. This article goes beyond a discussion of visual attention problems to an investigation of the more complex processing deficits that may contribute to academic difficulties. It is suggested that current interventions for children with ADHD that focus on decreasing disruptive behavior and increasing simple attention to tasks may not address deficits in story comprehension skills such as those required for many school tasks. This article draws from the educational literature to explore possibilities for creating academic interventions that are more effective at remedying the story comprehension deficits experienced by children with ADHD.