Executive Difficulties Research Articles

Perinatal complications and executive dysfunction in early-onset schizophrenia

BackgroundThe present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS.MethodsThe participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses.ResultsPerinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls.ConclusionsExposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.

Neuropsychological functioning following surgery for pediatric low-grade glioma: a prospective longitudinal study.

High survival rates have led to an increased emphasis on the functional outcomes of children diagnosed with low-grade glioma. Most outcomes research has focused on risks associated with radiotherapy, but less is known about neuropsychological risks for patients treated with surgery alone. Here, the authors sought to examine the neuropsychological trajectories of children diagnosed with a low-grade glioma and monitored up to 6 years postsurgery. Secondarily, they explored demographic and clinical predictors of neuropsychological performance. The neuropsychological functioning of 32 patients (median age at diagnosis 10.0 years) was prospectively assessed annually for up to 6 years after surgery (median days from surgery at baseline = 72). Tumor location was predominately supratentorial (65.6%). A combination of performance-based and parent-reported measures was used to assess intelligence, memory, executive functioning, and fine motor control in all patients. Binomial tests at the postoperative baseline revealed that the proportion of children falling below the average range (< 16th percentile) was significantly higher than the rate expected among healthy peers on measures of verbal memory, processing speed, executive functioning, and fine motor control (p < 0.05). Even so, linear mixed models indicated that neuropsychological functioning at the postoperative baseline did not significantly change over time for up to 6 years after surgery across all domains. A larger tumor size was associated with a slower reaction time (p < 0.01). A supratentorial tumor location and history of seizures were associated with more parent-reported executive difficulties (p < 0.01). While radiotherapy is a known risk factor for neuropsychological deficits in pediatric brain tumor patients, findings in this study indicate that children treated for low-grade glioma with surgery alone (without radiotherapy or chemotherapy) remain susceptible to difficulties with memory, executive functioning, and motor functioning that persist over time. Over half of the children in the study sample required school support services to address neuropsychological weaknesses. Although low-grade glioma is often conceptualized as a benign tumor, children treated for this lesion require ongoing monitoring and intervention to address neuropsychological weaknesses resulting from the tumor itself as well as the surgery.

Executive functions and attention 7years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de l'Enfant (TGE) cohort.

Severe childhood traumatic brain injury (TBI) leads to long-standing executive function and attention deficits, with negative consequences for participation, academic outcome and independence. This study aimed to assess executive function and attention 7years after severe childhood TBI in comparison with a matched control group and to investigate associated factors. Children (<15years) with severe accidental TBI consecutively admitted in a single trauma center over 3years were included in the Traumatisme Grave de l'Enfant (TGE) prospective longitudinal study. Of the 81children initially included, 65survived. At 7years post-TBI, executive functions and attention were assessed in 27participants (42% of the 65survivors) by using a combination of computerized tasks from the Test of Attentional Performance (TAP) and the Behavioral Rating of Executive Functions (BRIEF) questionnaire. Patients were compared to a group of 27typically developing controls who were matched for sex, age and parental education level. Among the 27participants, mean (SD) age at injury was 7.7 (4.6)years, and mean length of coma 5.6 (4.6) days. Regarding the TAP, the number of errors was significantly higher (P=0.003) and reaction time marginally slower (P=0.08) in the TBI than control group. The BRIEF questionnaire completed by parents indicated significantly more executive difficulties in the TBI than control group (Behavior Regulation Index, P=0.005; Metacognitive index, P=0.02; Global Executive Composite, P=0.012). Correlations between BRIEF and TAP scores did not reach statistical significance. BRIEF total score was correlated moderately with length of coma (r=0.40, P=0.037), and TAP scores were correlated with the Full-Scale Intellectual Quotient (total number of errors: r=-0.48; P=0.01; mean reaction time: r=-0.51; P=0.009). Executive and attention deficits were evident 7years after severe childhood TBI. Computerized tasks and questionnaires provide complementary and non-redundant information. Systematic long-term follow-up should be provided until the transition to adulthood, to assess ongoing development and to implement timely tailored interventions.

Sensory dysregulation in tic disorders is associated with executive dysfunction and comorbidities.

Tics are conceptualized as a sensorimotor phenomenon with a premonitory urge typically described by patients. As observed in other neurodevelopmental disorders, we have observed sensory dysregulation symptoms, such as tactile hypersensitivity to clothing, in children with tic disorders; however, formal clinical research in this area is limited. To define the presence of sensory dysregulation symptoms in tic disorders, and their clinical associations. Prevalence of sensory dysregulation in 102 children with tic disorders was compared to 61 age- and sex-matched healthy controls. Sensory dysregulation, executive function, and quality of life data were obtained through the Short Sensory Profile-2, Sensory Profile-2, Sensory Processing Measure, Behaviour Rating Inventory of Executive Function-2, and Strength and Difficulties Questionnaire and Pediatric Quality of Life Inventory. Tics were assessed with the Yale Global Tic Severity Scale. Children with tics, in the presence of comorbidity, had elevated sensory dysregulation compared to healthy controls (P < 0.001). There was a positive correlation between sensory dysregulation and global executive difficulties in children with tics and comorbidity (n = 87; rho = 0.716; P < 0.001) and a negative correlation of sensory dysregulation with quality of life (n = 87; rho = -0.595; P < 0.001). In children with tics, there was an association between sensory dysregulation and number of comorbidities (P < 0.001). In the presence of comorbidity, children with tic disorders have broad sensory dysregulation symptoms beyond the premonitory urge. There was a statistically significant association between sensory dysregulation and executive function difficulties and the presence of neurodevelopmental and psychiatric comorbidity. Sensory dysregulation can be considered neurodevelopmental symptoms, providing insight into the neurobiology of tics and opportunities for therapeutic intervention. © 2019 International Parkinson and Movement Disorder Society.

Caregiver ratings of executive functions among foster children in middle childhood: Associations with early adversity and school adjustment

Children in foster care often present difficulties related to executive functions, such as poor school adjustment and impulsivity. Despite their importance, few studies have analyzed executive functions in foster children, especially beyond preschool age. This study sought to analyze the executive functions of a sample of 43 Spanish foster children aged between five and nine years (M = 7.51, SD = 1.29), using a caregiver-reported questionnaire. We also explored the relationship between executive functions, early adversity variables, and teacher-reported school adjustment. Results indicate that participants experienced more executive function-related difficulties than the measure's standardization sample in almost all areas, particularly in behavioral regulation, although they were found to have age-appropriate executive function levels in some areas, such as monitoring and organization of materials. Prenatal substance exposure was associated with poorer planning/organization skills, whereas other early adversity variables showed no statistically significant associations with executive functions. A higher level of difficulty in inhibitory control and other areas were associated with poorer school adjustment as reported by teachers. The results of our study point to an important presence of executive function difficulties in foster children in middle childhood, a finding which highlights the need for early intervention efforts targeting these skills among this population.

Auditory, Phonological, and Semantic Factors in the Recovery From Wernicke’s Aphasia Poststroke: Predictive Value and Implications for Rehabilitation

Background. Understanding the factors that influence language recovery in aphasia is important for improving prognosis and treatment. Chronic comprehension impairments in Wernicke’s aphasia (WA) are associated with impairments in auditory and phonological processing, compounded by semantic and executive difficulties. This study investigated whether the recovery of auditory, phonological, semantic, or executive factors underpins the recovery from WA comprehension impairments by charting changes in the neuropsychological profile from the subacute to the chronic phase. Method. This study used a prospective, longitudinal observational design. Twelve WA participants with superior temporal lobe lesions were recruited 2 months post–stroke onset (2 MPO). Language comprehension was measured alongside a neuropsychological profile of auditory, phonological, and semantic processing and phonological short-term memory and nonverbal reasoning at 3 poststroke time points: 2.5, 5, and 9 MPO. Results. Language comprehension displayed a strong and consistent recovery between 2.5 and 9 MPO. Improvements were also seen for slow auditory temporal processing, phonological short-term memory, and semantic processing but not for rapid auditory temporal, spectrotemporal, and phonological processing. Despite their lack of improvement, rapid auditory temporal processing at 2.5 MPO and phonological processing at 5 MPO predicated comprehension outcomes at 9 MPO. Conclusions. These results indicate that recovery of language comprehension in WA can be predicted from fixed auditory processing in the subacute stage. This suggests that speech comprehension recovery in WA results from reorganization of the remaining language comprehension network to enable the residual speech signal to be processed more efficiently, rather than partial recovery of underlying auditory, phonological, or semantic processing abilities.

Exercise is Effortful: Executive Functions Predict Strenuous Exercise in the Past Week

Abstract Purpose Executive functions (EF) are a dynamic collection of complex cognitive processes governing volitional, goal-directed behaviour. EFs are particularly susceptible to environmental influences such as exercise or concussion. Exercise improves EF but it is unclear if having good EF improves exercise engagement habits. Expanding upon a previously derived higher-order, four-factor screener for executive behaviour problems (Duggan et al., 2018), we extracted a common EF factor using a bifactor structure and examined if self-reported executive difficulties predict weekly engagement in strenuous exercise. We also examined if a history of concussion affects self-ratings of executive difficulties. Methods 197 university students (Mean age=20.46; 79% female) completed the BASC-2-COL and self-report of concussion history and past 7-day exercise habits. An a-priori bifactor model of executive behaviour was established using CFA. Using SEM, the bifactor latent executive function was used to predict past 7-day exercise. Concussion history was used to predict variations in the bifactor executive function. Results Bifactor fit indices were not optimal but generally adequate (CFI=.897; TLI=.868; RMSEA=.037). Latent bifactor EF was predictive of past week strenuous exercise (p=.046). Concussion history was not predictive of EF problems (p=.296). Conclusion Results suggest that latent EF predicts recent strenuous exercise engagement. Baseline EF should be accounted for when examining the positive effects of exercise. Having a history of one or more concussions did not appear to influence current self-report of behavioral EF problems.

Intervenção Neuropsicológica com Crianças e Adolescentes – Uma Revisão da Literatura

Este artigo teve como objetivo realizar uma revisão literária sobre os estudos científicos publicados nos últimos dez anos em reabilitação/intervenção neuropsicológica com crianças e adolescentes, buscando identificar como os programas com abordagens voltadas para as dificuldades acadêmicas e executivas se articulam com as demandas familiares e escolares. As principais bases de dados utilizadas foram PubMed, SciELO e Redalyc. Dentre os 89 artigos encontrados, dez foram selecionados por englobarem métodos para o ensino de estratégias que facilitassem a aprendizagem escolar e os comportamentos adaptativos. Os resultados dos estudos sugerem que a intervenção neuropsicológica em crianças e adolescentes promove o desenvolvimento de habilidades cognitivas e dos processos de aquisição de linguagem. Entretanto, em face da distância entre o contexto clínico de intervenção e o educacional, mais estudos precisam ser promovidos em busca de um olhar mais integrado sobre esses espaços de promoção de desenvolvimento.

Parental Occupation Executive Training (POET): An Efficient Innovative Intervention for Young Children with Attention Deficit Hyperactive Disorder

Background: The American Academy of Pediatrics strongly recommends first-line treatment of preschool aged children with attention deficit hyperactivity disorder (ADHD) be parent- or teacher-administered behavior therapy.Aim: To assess the efficacy of Parental Occupation Executive Training (POET), a new intervention for young children with ADHD symptomatology.Materials and Methods: We implemented a controlled, counterbalanced design with a study and comparison group (72 children with mean age of 5.42 years identified as having ADHD symptomatology. using the DSM-IV and Conners Parents and Teachers Rating Scales). Intervention included parental-training sessions focused on children's occupational goals and capitalized on the assumed relationship between daily activities and executive functions. We evaluated achievement with the Canadian Occupational Performance Measure (COPM), Behavioral Rating Inventory of Executive Functions, and a questionnaire we developed related to parental knowledge and skills.Results: Executive functions and preselected daily functions significantly improved following the POET intervention. Parent perceptions related to their knowledge of their children's executive difficulties and appropriate management strategies changed significantly following the intervention, and significantly correlated with the COPM scores.Conclusions: A short-term parental training program, the POET improved daily functioning of young children with ADHD symptomatology by focusing on their parents' ability to cope with the children's executive delays.

Eveningness is associated with greater subjective cognitive impairment in individuals with self-reported symptoms of unipolar depression

BackgroundEveningness is associated with depression diagnosis and increased depressive symptom severity. Time-of-day preference has been linked with differences in cognitive function in the general population, with cognitive difficulties being a major factor in psychosocial impairment in depression. We therefore investigated the impact of time-of-day preference and self-reported depressed state on subjective cognitive function. MethodsParticipants over the age of 18 with a self-reported history of depression completed an online questionnaire. They provided demographic and mental health information, and completed self-report scales assessing depression symptoms, time-of-day preference, and cognition. Participants were classified as “currently” or “previously depressed” based on self-reported symptoms, and as having a morning, neither, or evening time-of-day preference. ResultsA total of 804 participants reporting a history of unipolar depression were included. Currently-depressed participants reported more cognitive difficulties in all areas measured. Evening types reported more complex attentional and retrospective memory difficulties than neither types, and reported more executive and prospective memory difficulties than both neither and morning types. There was an additive effect of mood state and time-of-day preference, with self-reported depressed evening types reporting the most cognitive problems. LimitationsDepression history, time-of-day preference, and cognitive function were assessed using unsupervised self-report measures. Time-of-day preference does not necessarily reflect the physiological circadian system. ConclusionsBoth depressed state and evening preference were individually associated with subjective cognitive complaints in people with a self-reported history of unipolar depression. The additive effect of poor mood and eveningness is important given the high prevalence of eveningness in depression. Assessment of time-of-day preference could help to identify those susceptible to cognitive symptoms, and inform treatment.

Driver safety in patients with primary brain tumors.

Operating a motor vehicle involves multiple cognitive and sensorimotor faculties. Neurological conditions pose driving risk, but this has not been examined in patients with primary brain tumors. Sixty-four patients with primary brain tumors (32 left hemisphere; 69% glioblastoma) completed the Cognitive Behavioral Driver's Inventory (CBDI). A subset also completed broader cognitive testing. Patient characteristics, CBDI measures, and broader neuropsychological test scores were compared between Passing and Nonpassing groups. Follow-up logistic regression analyses identified patient characteristics and CBDI measures predictive of Pass/Nonpass outcome. Point-biserial correlations determined associations between neuropsychological tests and CBDI outcome. Sixty-nine percent of patients were classified as passing the CBDI. Nonpassing patients were older and more likely to have WHO grade IV and temporal lobe tumors. Age was the most salient predictor of CBDI performance. CBDI measures of speeded visual search and set-shifting, speeded response inhibition, vigilance and freedom from distractibility, and basic visual scanning speed were predictive of Pass/Nonpass outcome. Neuropsychological tests of memory in particular, but also speeded visual scanning and discrimination, executive function, basic visual attention, visuoconstruction, and manual dexterity (dominant hand), were associated with CBDI outcome. A sizeable proportion of patients with primary brain tumors appear at risk of driving difficulty, particularly those with higher-grade tumors and of older age. Memory, visual attention, and executive difficulties appear to contribute most to driving safety risk as determined by the CBDI. These results highlight the importance of driving safety screening in this population.

Participation seven years after severe childhood traumatic brain injury

Purpose: Participation in home, school and community activities is considered as the ultimate aim of rehabilitation. The aims of this study were to examine participation seven years post-severe childhood traumatic brain injury and factors associated with participation.Materials and methods: Participants were enrolled in the Traumatisme Grave de l’Enfant (Severe Childhood Injury) cohort study following severe accidental childhood traumatic brain injury. Participation seven years post-injury, was examined using parent- and self-report forms of the Child and Adolescent Scale of Participation among 37 patients [62% males, mean age 15.4 years (SD = 4.4), mean length of coma 6.68 days (SD = 4.96)] and 33 matched controls.Results: Parent reports indicated significantly lower participation among patients compared to controls, but the self-reports did not. In the traumatic brain injury group, parent-reported participation was variable, with 22% of the patients clearly showing greater restrictions than controls. Participation restrictions were significantly associated with injury severity, poor functional outcome one-year post-injury, executive and behavioral difficulties and higher fatigue levels seven years post-injury, but not with pre-injury nor family factors.Conclusions: Several years after severe childhood traumatic brain injury, participation appears to depend more on injury-related factors than on environmental factors. In self-reports assessments of participation, it could be difficult for children and adolescents to distinguish capacity from performance.Implications for rehabilitationParticipation outcomes were highly variable in a sample of patients who sustained severe childhood traumatic brain injury.Participation should be assessed systematically following severe traumatic brain injury, both initially but also in the long-term, ideally using a combination of self- and proxy-report measures.Among patients with severe injuries, the influence of initial brain injury severity markers on participation seems much stronger than that of social/family environment factors.Children’s and adolescents’ self-reported participation assessed with the Child and Adolescent Scale of Participation may be difficult to interpret.

Self-assessment of executive function and lateralization of brain pathology: What does the DEX-S profile show?

The DEX-S Questionnaire is a tool often used in the self-report of executive difficulties. Numerous data demonstrate that the result of the DEX-S do not differentiate between healthy and clinical groups or people with different characteristics of brain pathology. Limited research taking into account lateralization of damage also did not provide the conclusive data. There were no relationships between the DEX-S result and the results of tasks evaluating cognitive function, including executive functions. There is an ongoing discussion on the clinical and ecological value of the DEX-S. In the face of inconclusive data, the own study was undertaken. The objective was: (1) to compare the overall result and the DEX-S profile of healthy people and people with brain pathology including the lateralization of brain pathology; and (2) determining the relationships between the result of the DEX-S and the level of selected cognitive competences. 115 people were enrolled in the study, including people without brain pathology (C; N = 74), people with damage to the left hemisphere (LH; N = 6), people with damage to the right hemisphere (RH, N = 12) and people with damage to both hemispheres (BH, N = 23). In the research the DEX-S, WAIS subtests: Vocabulary, Digit span forward and backwards, the MoCA test and the Affect Scale from the ProCog Questionnaire were applied. The DEX-S overall result did not differentiate the groups. However, the RH and BH groups obtained the highest average scores and the LP group - the lowest. There were intergroup differences in the results of only a few DEX-S items. Patients with right and both hemispheres pathology reported a significantly higher level of difficulties in attention, greater susceptibility to distractors, deficits in planning, sequential operation and problem solving. The RH group performed poorer in tasks involving cognitive functions in comparison to other patients. All clinical groups differed from healthy persons in terms of results of tests/tasks evaluating selected cognitive functions. There were positive correlations between the DEX-S score and sense of anxiety, no association with age, and incidental correlations with the results of cognitive tasks in each research group. The results suggest that mechanisms of sense of executive deficits depend on lateralization of pathology. The higher sense of executive deficits in people with right hemisphere pathology may be due to the efficiency of delayed memory, and may reflect an adequate self-assessment of own competence. The low DEX-S result of the group with the left hemisphere pathology may result from reduced, despite the absence of aphasia, language /semantic skills and not from the lack of insight into executive deficits.

Executive Functioning in the Dystrophinopathies and the Relation to Underlying Mutation Position.

The aim of this study was to investigate executive skills in children with dystrophinopathy and to examine the association between executive functions and dystrophin gene mutation position. Fifty boys with dystrophinopathy (mean age, 11 years 0 months; ages range, 5 to 17 years) completed measures of intellectual functioning (IF), working memory and executive functioning [including Digit Span (working memory) and measures from the NIH Toolbox (selective attention/inhibitory control, set shifting, working memory, and processing speed)]. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF). Mutation positions were categorized into three groups (upstream exon 30, 31-62, and downstream exon 63). Paired-samples t tests compared performance on executive measures to IF, and a one-way (three-group) multivariate analysis of covariance compared cognitive performance with mutation location controlling for motor functioning. Mean performance on all executive measures was significantly lower than IF. Parents were also more likely to rate their child with dystrophinopathy as having clinically significant executive difficulties on the Shift, Emotional Control, and Behavior Regulation indices of the BRIEF. Mutation analyses resulted in small groups limiting power to detect subtle differences. Those with a downstream mutation position had significantly poorer performance on IF and Total Digit Span, but not on other measures of executive function including behavior. Individuals with dystrophinopathy have executive skill deficits, but they are not generally associated with more distal mutations. (JINS, 2019, 25, 146-155).

Cognitive Profile of Children With Intracranial Germ Cell Tumor According to Tumor Location.

The purpose of this study was to evaluate the long-term cognitive sequelae and to describe the neuropsychological profile of patients with intracranial germ cell tumors according to tumor location (pineal or suprasellar site). Forty-five children treated at Gustave Roussy between 1991 and 2010 were assessed with neuropsychological tests to measure IQ, memory, visuospatial, motor, and executive skills at a mean delay of 4.2 years after diagnosis. All patients have received chemotherapy associated with surgery in 17 cases. Thirty-nine patients received, radiotherapy (focal 27, focal plus ventricles 8, craniospinal 4). Twenty-three patients had 2 IQ assessments with a mean delay of 4.1 years between the first and second. Full scale IQ was preserved, with higher verbal IQ than other IQ indexes. Visuospatial, fine-motor, and executive difficulties were present in a significant proportion of patients. Visuospatial and fine-motor deficits were significantly associated with oculomotor difficulties, more present in the pineal than in the suprasellar group. No cognitive decline was observed between the first and the second IQ assessment. Overall cognitive abilities were preserved in children treated for central nervous system germ cell tumor.

Assessment of Executive Functions in Preschool Children With Sickle Cell Anemia.

Children with sickle cell anemia (SCA) are commonly reported to experience executive dysfunction. However, the development of executive function (EF) in preschool-age children without stroke in this patient population has not been investigated so it is unclear when and how these deficits emerge. This case-control study examines the feasibility of assessing the early development of executive functioning in 22 preschool children years with SCA in the domains of processing speed, working memory, attention, inhibitory control, and cognitive flexibility, as well as everyday function, in comparison to matched control children. A pattern of potential deficits in early emerging executive skills was observed in the domains of inhibitory control and cognitive flexibility. Parents reported no differences for everyday EF and no significant differences were observed for working memory and processing speed. Results suggest that deficits in everyday executive difficulties, working memory, and processing speed, as commonly reported for older children with SCA, may not yet have emerged at this early developmental stage, despite specific deficits in cognitive flexibility and inhibitory control on behavioral measures. The feasibility of using available executive measures with preschool age children to characterize the development of early EF skills is discussed. (JINS, 2018, 24, 949-954).

O11. Impact of Adverse Childhood Experiences on Behavioral and Neural Markers of Executive Function in Menopausal Women

Many healthy women with no history of cognitive dysfunction experience subjective executive difficulties during menopause. We hypothesized that adverse childhood experiences (ACE) increase the risk of executive dysfunction during menopause via alterations in monoaminergic neurotransmission.

Subjective executive difficulties – a study using the Dysexecutive Questionnaire

Subjective executive difficulties – a study using the Dysexecutive Questionnaire

A Neuropsychological Profile for Agenesis of the Corpus Callosum? Cognitive, Academic, Executive, Social, and Behavioral Functioning in School-Age Children.

Agenesis of the corpus callosum (AgCC), characterized by developmental absence of the corpus callosum, is one of the most common congenital brain malformations. To date, there are limited data on the neuropsychological consequences of AgCC and factors that modulate different outcomes, especially in children. This study aimed to describe general intellectual, academic, executive, social and behavioral functioning in a cohort of school-aged children presenting for clinical services to a hospital and diagnosed with AgCC. The influences of age, social risk and neurological factors were examined. Twenty-eight school-aged children (8 to 17 years) diagnosed with AgCC completed tests of general intelligence (IQ) and academic functioning. Executive, social and behavioral functioning in daily life, and social risk, were estimated from parent and teacher rated questionnaires. MRI findings reviewed by a pediatric neurologist confirmed diagnosis and identified brain characteristics. Clinical details including the presence of epilepsy and diagnosed genetic condition were obtained from medical records. In our cohort, ~50% of children experienced general intellectual, academic, executive, social and/or behavioral difficulties and ~20% were functioning at a level comparable to typically developing children. Social risk was important for understanding variability in neuropsychological outcomes. Brain anomalies and complete AgCC were associated with lower mathematics performance and poorer executive functioning. This is the first comprehensive report of general intellectual, academic, executive social and behavioral consequences of AgCC in school-aged children. The findings have important clinical implications, suggesting that support to families and targeted intervention could promote positive neuropsychological functioning in children with AgCC who come to clinical attention. (JINS, 2018, 24, 445-455).

Insights in Developmental Coordination Disorder.

Developmental Coordination Disorder (DCD) is a neurological impairment occurring in nearly 6% of general population, and sometimes mimics other developmental disorders like Attention Deficit Hyperactivity Disorder (ADHD) or, in the most severe cases, intellectual deficiency. To review the general portrait of DCD, the physiology, the clinical assessments, and to provide an overview of functional studies on the subject. We finally report some proposed DCD managements which vary depending on the manifestation of the disorder and on the goals of the therapy. DCD can be stated as a sum of fine motor, perceptual visual and executive difficulties, emerging during childhood brain development and lasting throughout adulthood. Even if DCD can be isolated from other co-morbidities in certain individuals, it is still difficult to categorize it in delimited subclasses of characteristics, e.g. problems of vision or language. The findings in functional imaging also diverge in locating the cerebral deficit for a given motor task. Finding a single explanation seems difficult as many cerebral regions are associated with DCD and many clinical aspects are involved, but, further studies could explore genetic (or epigenetic) explanation for the prevalence of DCD in population.