Executive Function Difficulties Research Articles

Comparing the Executive Function Ability of Autistic and Non-autistic Adolescents with a Manualised Battery of Neuropsychological Tasks.

Performance on a single executive function (EF) task (e.g., a card sorting task) is often taken to represent ability on the underlying subcomponent of EF (e.g., set shifting) without accounting for the non-specific and non-executive skills employed to complete the task. This study used a manualised battery of EF tasks to derive individual task scores and latent EF scores. Seventy-nine adolescents aged between 11 and 19years, including 37 autistic and 42 non-autistic participants, matched on cognitive ability, completed the battery. Autistic adolescents had moderate global EF difficulties and had significantly more difficulties on some individual tasks. However, the samples did not differ on any of the specific individual subcomponents of EF (fluency, cognitive control and working memory).

The longitudinal relationship between fathers' warmth parenting attitude in early childhood, play interaction in early childhood, and executive function difficulty in childhood using a multivariate latent growth model

The longitudinal relationship between fathers' warmth parenting attitude in early childhood, play interaction in early childhood, and executive function difficulty in childhood using a multivariate latent growth model

Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development.

Executive functions are often impaired in autistic people and relate to important outcomes such as mental health, success in school and work, and quality of life. Evaluating executive functions helps autistic people, clinicians, and families identify targets for external supports and skill building. Youth self-report of executive function has not been studied, yet we know that self-report from autistic youth is key to understanding other cognitive/behavioral phenomena in autism such as anxiety, obsessions/compulsions, sensory sensitivities, and repetitive behaviors. We investigated self- and parent-report of executive function problems in 197 autistic youth without intellectual disability (ages 11-18 years), including the magnitude and profiles of executive function problems autistic youth report across subdomains of executive function. We compared autistic self-report with that of 114 youth with attention deficit hyperactivity disorder without intellectual disability and 197 neurotypical youth. We found that autistic youth report significant executive function problems compared to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverged regarding the magnitude of the youth's executive function difficulties, but both identify inflexibility as the most impaired executive function subdomain. Autistic youth and their parents were somewhat more concordant in their report of executive function problems than youth with attention deficit hyperactivity disorder and their parents, but only showed moderate concordance at best. These findings elevate the importance of asking autistic youth directly about their executive functioning when engaging them in assessment and intervention, or researching executive functions in autism.

Executive function as measured by the Behavior Rating Inventory of Executive Function-2: children and adolescents with Williams syndrome.

Difficulties with executive functions (EF) are very common among individuals with Williams syndrome (WS). To characterise the pattern of relative strengths and weaknesses in EF for children and adolescents with WS, we considered the performance of a large sample on the parent version of the Behavior Rating Inventory of Executive Function-2 (BRIEF-2). Associations between distinct components of EF and adaptive behaviour, behaviour problems and intellectual ability were investigated. The concurrent effects of components of behaviour regulation and emotion regulation on attention problems and anxiety problems also were evaluated. Participants were 308 6-17-year-olds with genetically confirmed classic WS deletions. Parent report of EF was measured by the BRIEF-2 questionnaire. Most participants (223/308) completed the Differential Ability Scales-II as a measure of intellectual ability. The parents of these individuals also completed the Child Behavior Checklist and the interview form of the Scales of Independent Behavior-Revised. As a group, the participants evidenced considerable parent-reported EF difficulty. A profile of relative strength and weakness was found at the index level, with performance on both the Behavior Regulation Index and the Emotion Regulation Index significantly better than performance on the Cognitive Regulation Index. Within each index, a statistically significant pattern of relative strength and weakness also was identified. Difficulties with behaviour regulation and emotion regulation were related to both behaviour problems and adaptive behaviour limitations. Higher inflexibility and more difficulty with self-monitoring were associated with lower overall intellectual ability. Difficulty with inhibition was uniquely associated with attention problems, and inflexibility was uniquely associated with anxiety problems. Executive function difficulties are highly prevalent among children and adolescents with WS and are associated with adaptive behaviour limitations, both internalising and externalising behaviour problems and more limited intellectual ability. These results highlight the importance of designing and delivering research-based interventions to improve the EF of children and adolescents with WS.

The Challenges of Working with Child Abuse and Neglect: Barriers to Disclosure and Intervention, Adverse Outcomes, and Perplexing Presentations

The Challenges of Working with Child Abuse and Neglect: Barriers to Disclosure and Intervention, Adverse Outcomes, and Perplexing Presentations

First-Episode Patients Report Cognitive Difficulties in Executive Functioning 1 Year After Initial Episode of Major Depressive Disorder

Objective: Major Depressive Disorder (MDD) is associated with cognitive impairment in general, and Executive Functioning (EF) in particular, even in remitted phase of the disorder, suggesting residual cognitive symptoms. The aim of the present study was to investigate self-reported EF 1 year after the first episode of MDD and to explore this in relation to depressive mood symptoms, remission and relapse.Method: The study included data from 24 patients and 23 healthy control subjects 1 year after the patients' initial first episode of MDD. All participants completed the Behavior Rating Inventory of Executive Functioning-Adult version (BRIEF-A), a standardized self-report measure of perceived EF in everyday life, measuring nine different EF. Total index scores for metacognitive functions, behavior/emotional regulation functions and a global EF score is also calculated.Results: The patient group in total, independent of symptom status, reported significantly lower EF in all indexes compared to the healthy controls 1 year after the initial episode. However, higher depressive mood symptom load correlated with self-reported difficulties in metacognitive functions and poor global EF scores. Regulatory control of behavior and emotional responses did not show such strong association with mood symptoms, but low self-report scores on this measure was associated with relapse during the first year after the initial episode.Conclusion: First-episode patients report significant lower executive functioning in everyday life compared to individually matched healthy controls, 1 year after onset, independent of symptom load. Residual cognitive symptoms seem to be evident and associated with risk of relapse and should be targeted in treatment and prevention of recurrence in MDD.

Investigating whether a combination of higher CRP and depression is differentially associated with worse executive functioning in a cohort of 43,896 adults

Many depressed individuals experience difficulties in executive functioning that contribute substantially to functional impairment. It is unknown whether a subtype of depression characterized by chronic inflammation is differentially associated with worse executive functioning. This study examined whether the combination of depression and higher C reactive protein (CRP) is differentially associated with worse executive functioning and whether this association is stronger in older adults. This cross-sectional study analyzed data collected from a population-representative sample of 43,896 adults aged 44.13 years (SD = 13.52) who participated in the baseline assessment of the Lifelines cohort study. Multivariate regression models tested whether depressed individuals (established via structured interview) exhibiting higher levels of inflammation (indexed via high-sensitivity CRP assay following an overnight fast) performed worse on a behavioral test of executive functioning. Depression (B = −3.66, 95% CI: −4.82, −2.49, p < .001) and higher log-transformed CRP (B = −0.67, 95% CI: −0.87,-0.47, p < .001) were associated with worse executive functioning, after adjustment for age, sex, educational attainment, body mass index, smoking status, exposure to stressful life events and chronic stressors, sedentary behavior, and number of chronic medical conditions. Depressed individuals with higher log-transformed CRP exhibited differentially poorer executive functioning (B = −1.09, 95% CI: −2.07,-0.11, p < .001). This association did not differ based on age (B = 0.01, 95% CI: −0.08, 0.10, p = .82). Executive functioning is poorer in depressed individuals with higher CRP, even in early adulthood. Interventions that reduce inflammation may improve cognitive functioning in depression.

Longitudinal Effects of Media Usage by Early School-age Children and Maternal Parenting Stress on School Adjustment: Mediating Effect of Executive Function Difficulty

This study examined the longitudinal effects of media usage by early school-age children and of maternal parenting stress on children’s school adjustment. The study focused on the mediating effect of executive function difficulty. Longitudinal data to examine the hypothetical model were drawn from the eighth (2015) through tenth (2017) waves of the Panel Study of Korean Children (PSKC) collected by the Korea Institute of Child Care and Education (KICCE). A total of 581 children (293 boys and 288 girls) and their mothers were included. Confirmatory factor analysis, structural equation model, and bootstrapping analysis were applied using SPSS 25.0 and Amos 26.0. The results are as follows. First, no significant correlation was found between early school-age children’s media usage and maternal parenting stress. Second, neither media usage by early school-age children nor maternal parenting stress were found to directly affect children’s school adjustment. Third, media usage by early school-age children and maternal parenting stress were shown to indirectly affect children’s school adjustment via executive function difficulties. In other words, higher levels of media usage by early school-age children and maternal parenting stress during the first grade lead to greater executive function difficulties after a year, which, in turn, lead to a lower level of school adjustment in the third grade. This study indicates the need to develop practical support for the psychological wellbeing of mothers while they are performing their role as a parent and for children in maintaining suitable levels of media usage during early childhood.

Phase II study of exercise and low-dose ibuprofen for cancer-related cognitive impairment (CRCI) during chemotherapy.

12016 Background: CRCI is a debilitating consequence of cancer and its treatment, including difficulties in attention, memory, and executive function. Though CRCI can develop during the course of chemotherapy, interventions targeting CRCI during chemotherapy have not been investigated. Inflammation contributes to CRCI and thus reducing inflammation may ameliorate CRCI. Using a biobehavioral approach, we investigated 2 promising interventions that reduce inflammation: exercise and low-dose ibuprofen. Methods: This is a Phase II RCT with a 2:2 factorial design. Eligible participants were patients with cancer receiving chemotherapy who self-reported cognitive difficulties. Participants were stratified by disease type (breast cancer; gastrointestinal cancer; other) and were randomized to 1 of 4 groups for 6 weeks: exercise alone (+ placebo), ibuprofen alone, exercise + ibuprofen, or placebo only. The exercise intervention, delivered by an exercise physiologist, was Exercise for Cancer Patients (EXCAP), an individually tailored, home-based prescription of walking and resistance band training. Ibuprofen/placebo was over-encapsulated for blinding; 200mg was taken 2 times per day. Participants completed 7 cognitive assessments probing attention, memory, and executive function including the Trail Making Test (TMT) and self-report (FACT-Cog) at baseline and post-intervention. ANCOVA, controlling for baseline, assessed overall Arm effects at post-intervention. Results: Of the 110 who consented to the study, 86 participants (mean age=54; 88% female; 76% breast cancer, 21% GI; 73% Stage I-III) completed baseline assessments and were randomized to one of four study arms. Ninety percent (78/86) of those completed post-intervention. Average pill compliance across all 4 groups was balanced and averaged 90.8%. Participants in the exercise and exercise + ibuprofen arms increased 2,414 and 1,073 steps respectively compared to those in placebo and ibuprofen arms increased only 464 and 412 steps respectively from pre- to post-intervention. No study-related adverse events occurred. Intent to treat ANCOVA analyses revealed a significant improvement in attention (TMT) in exercise alone compared to placebo (21.57 seconds better; p=0.003), ibuprofen alone compared to placebo (11.27 seconds better; p=0.0475), and trend for exercise + ibuprofen (7.98 seconds better; p=0.122). Those participating in both exercise arms exhibited significant improvements in the FACT-Cog Comments from Others subdomain (p&lt;0.05). Conclusions: Exercise and low-dose ibuprofen during chemotherapy improved attention in patients with cancer receiving chemotherapy. Exercise improved self-reported cognitive functioning. These results suggest possible treatment options for ameliorating CRCI during chemotherapy. Phase III trials are needed to confirm these findings. K07CA16888; DP2CA195765. Clinical trial information: NCT01238120.

Social cognition and executive functioning in multiple sclerosis: A cluster-analytic approach.

Multiple sclerosis (MS) is associated with deficits in social cognition, the process underlying social interaction and cognitive function. However, the relationships between executive impairment and social cognition remain unclear in MS. Previous studies exclusively focused on group comparisons between healthy controls and patients with MS, treating the latter as a homogeneous population. The variability of socio- and neurocognitive profiles in this pathology therefore remains underexplored. In the present study, we used a cluster analytic approach to explore the heterogeneity of executive and social cognition skills in MS. A total of 106 patients with MS were compared with 53 healthy matched controls on executive (e.g., working memory) and social cognition (facial emotion recognition and theory of mind) performances. A cluster analysis was then performed, focusing on the MS sample, to explore the presence of differential patterns of interaction between executive and social cognition difficulties and their links to sociodemographic, clinical and cognitive variables. We identified three distinct functional profiles: patients with no executive or social cognition deficits (Cluster 1); patients with difficulties in facial emotion recognition and theory of mind and, to a lesser extent, executive functioning (Cluster 2); and patients with executive functioning difficulties only (Cluster 3). Clinical characteristics (disease duration, disability, fatigue) did not differ between clusters. CONCLUSIONS: These results suggest that there are qualitative differences in the social cognition and executive difficulties that are commonly found among patients with MS. If replicated, the identification of these profiles in clinical practice could allow for more individualized rehabilitation.

Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism.

Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n = 217) from the Pathways in ASD longitudinal study was analyzed. The Children's Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (mean = 3.5 years). Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points (7.8-11.8 years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (mean = 6.7 years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b = 2.07, p < 0.04), but conversely associated with lower BRI difficulties at 7.7 years (b = -4.14, p = 0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b = 7.78, p < 0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b = 3.15, p = 0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b = -0.60, p = 0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate.

Executive function as a mechanism linking socioeconomic status to internalizing and externalizing psychopathology in children and adolescents

IntroductionThe association between low socioeconomic status (SES) in childhood and increased risk for psychopathology is well established, but the mechanisms explaining this relationship are poorly understood. Here, we investigate the potential role of difficulties in executive functioning (EF) as a mechanism linking childhood and adolescent SES with externalizing and internalizing psychopathology. MethodsWe examined whether difficulties with EF mediated the association between SES and externalizing and internalizing psychopathology in two cross-sectional samples of children and adolescents (Study 1: N = 94, ages 6–18, 51.1% male; Study 2: N = 259, ages 8–16, 54.1% male) from diverse SES backgrounds in the United States. EF was measured through behavioral tasks and parent-reported behavioral regulation (BR). ResultsIn both samples, children and adolescents from lower SES families were more likely to experience both externalizing and internalizing psychopathology than youth from more advantaged backgrounds and exhibited greater EF difficulties – they had lower performance on a task measuring inhibitory control and lower parent-rated BR. Reduced inhibitory control and BR, in turn, were associated with higher externalizing and internalizing psychopathology. In Study 1, difficulties with BR mediated the association of low-SES with both externalizing and internalizing psychopathology. In Study 2, low inhibitory control mediated the association between low-SES and externalizing psychopathology. These findings largely persisted after adjusting for exposure to violence, a form of adversity that is common in children from low-SES backgrounds. ConclusionsThese findings suggest that reduced EF may be an underlying mechanism through which low-SES confers risk for psychopathology in children and adolescents.

Fine motor and executive functioning skills predict maths and spelling skills at the start of kindergarten: a compensatory account (La motricidad fina y las funciones ejecutivas predicen las competencias en matemáticas y lengua escrita al comienzo de la etapa preescolar: una propuesta compensatoria)

ABSTRACT Research shows that executive functions (EF) and fine motor skills (FMS) contribute to early academic skills, possibly in overlapping ways. We examine whether and how EF and FMS interact in the concurrent prediction of maths, reading and spelling skills at the start of kindergarten. Structural Equation Modelling (SEM) on data from 1248 five-year-olds supports a compensatory account of EF and FMS in contributing towards maths and spelling skills. Controlling for socio-economic status, age, time spent in kindergarten and intelligence, the influence of EF on spelling achievement was larger for children with poorer compared to better FMS, and vice versa; FMS significantly predicted maths achievement only in children with high but not low EF, and vice versa. Identifying EF or FMS difficulties at or before the start of kindergarten may be important. Different approaches to intervention involving EF and FMS may be appropriate for maths versus spelling skills. We suggest for early childhood curricula to enhance opportunities for FMS development, especially for children who enter kindergarten with poor FMS.

The role of distinct executive functions on adaptive behavior in children and adolescents with Down syndrome

ABSTRACT Difficulties in executive function are a relatively well-characterized feature of the neuropsychological profile in Down syndrome (DS), yet the impact of these challenges on aspects of daily functioning remain poorly understood. We examined the role of specific executive functions on domains of adaptive behavior in children and adolescents with DS. Participants included 68 children and adolescents with DS between 6–17 years old (mean chronological age = 12.56 years; SD = 3.22) and their caregivers. Parent reported executive function skills were measured using the BRIEF-2 and adaptive behavior was measured using the Vineland Adaptive Behavior Scales-III. Results identified working memory as a significant predictor of Communication, Daily Living, and Socialization skills, and Shifting significantly predicted Daily Living and Socialization. Findings demonstrate the relation between executive functions and adaptive behavior and highlight the effects of working memory on aspects of daily functioning for individuals with DS.

Longitudinal Effects of Fathers’ Rearing Involvement During Early Childhood on First Graders’ School Adjustment: Mediating Role of Executive Function Difficulties

Objectives The purpose of this study was to examine longitudinal effects of father involvement in child-reaering during early childhood on first graders’ school adjustment, focusing on the mediating role of executive function difficulties. By doing so, the present study attempted to investigate the importance of fathers’ involvement in childcare during early childhood. Methods This study used the 4th, 5th, and 8th data sets from the Panel Study on Korean Children. A total of 1,711 data were analyzed. Descriptive statistics analysis, Pearson correlation analysis, structural equation modeling analysis, and bootstrapping were conducted. Results Fathers’ rearing involvement during early childhood was found to have a positive effect on first graders’ school adjustment by reducing levels in the children’s executive function difficulties, with socioeconomic status and children’s gender being considered as a confounder. However, fathers’ rearing involvement during early childhood did not have a direct effect on first graders’ school adjustment. Conclusion The present study suggests that fathers’ rearing involvement in early childhood is important for first graders’ cognitive development and school adjustment in the long term. This study is meaningful in that it did not simply reveal the longitudinal influences of fathers’ rearing involvement on children’s elementary school adjustment, but also explained these influences through the development of children’s executive skills. Keywords: fathers’ rearing involvement, school adjustment, executive function difficulty, first grade, Panel Study on Korean Children

The Effect of Mother’s Perceived Parenting Behaviors on School Adjustment Through Executive Function Difficulty and Anxiety of Children: A Longitudinal Study Using the Auto-Regressive Cross-Lagged Model

The Effect of Mother’s Perceived Parenting Behaviors on School Adjustment Through Executive Function Difficulty and Anxiety of Children: A Longitudinal Study Using the Auto-Regressive Cross-Lagged Model

Analysis on the Structural Relationship Between Second-Graders’ Prosocial Behavior, Mother-Child Interaction, Executive Function Difficulty, and Language Ability

Analysis on the Structural Relationship Between Second-Graders’ Prosocial Behavior, Mother-Child Interaction, Executive Function Difficulty, and Language Ability

The dimensionality of the Behavior Rating Inventory of Executive Function, Second Edition in a clinical sample

The parent-report Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is a widely used pediatric neuropsychological measure. Unfortunately, despite meaningful changes from its predecessor, few studies have examined its internal factor structure (now with Behavioral Regulation [BRI], Emotion Regulation [ERI], and Cognitive Regulation [CRI]), and no available literature has investigated higher order models for the BRIEF-2. This study sought to address this shortcoming in the literature by investigating and reporting on the dimensionality of the parent-report BRIEF-2 in a clinical sample. Two hundred and two (202) pediatric neuropsychology examinees (M age = 9.90; 68% males) with complete data for the parent-report BRIEF-2 were included. Descriptive results revealed generally elevated scores across BRIEF-2 scales (Global Executive Composite M T = 70.16). Exploratory factor analyses suggested two factors (CRI and BRI/ERI) should be extracted, and that higher order models should be considered. Confirmatory factor analyses suggested that a direct hierarchical/bifactor two-factor structure (which was more parsimonious than the theoretical three-factor model) provided the best fit, with a bulk of the variance explained by the general GEC factor. The BRIEF-2 may be best interpreted at the overall level, with relatively less weight given to the index variables, particularly within clinical samples with high levels of reported executive functioning difficulties. Implications of these findings, limitations of the present study, and appropriate directions for future inquiry were discussed.

Screening of Developmental Difficulties during the Transition to Primary School.

The five-to-fifteen (FTF) questionnaire is a screening tool completed by parents that is able to distinguish developmental disorders in children aged 5 to 15 years old. The current study aimed to characterize the developmental difficulties by gender and school age (kindergarten and first grade) of children in their transition to primary school, using the Spanish-language version of the FTF questionnaire. The participants were 541 parents of typically developed children from kindergarten and first grade in public schools in Chile. Developmental difficulties were revealed, showing that boys displayed significantly more difficulties in their social skills when compared to girls, and that kindergartners displayed significantly more developmental difficulties than first graders. The children’s developmental difficulties in executive functions, social skills, and emotional/behavioral problems exhibited interactions between gender and school age. The findings were discussed in terms of current conceptualizations of both executive functions and self-regulatory processes. These processes and functions are configured early in development, are gradually consolidated over the course of school age, and can be strengthened or weakened by conditions experienced in childhood. Early screening of developmental difficulties from the parents’ perspective would facilitate early detection of problems, as early as in kindergarten, and considering the normal adaptable development of children.

The relationship between executive dysfunctions and quality of life of children and youth with psychiatric disorders

Introduction The high cognitive abilities named executive functions (EF) are responsible for emotional regulation and for goal-oriented behavior. EF are frequently disrupted in anxiety disorders and negatively affect daily function and quality of life (QoL). Nevertheless, EF evaluation is usually performed in the laboratory using neuro-psychological assessments that refer to specific components (such as working memory, inhibition), but lacks a comprehensive profile of EF and the expressions in real life context.ObjectivesTo elaborate the knowledge about EF in daily life of children/youth with psychiatric disorders, by comparing their EF to those of healthy controls, using an ecological measure that imitates daily life scenarios; To examine the relationship between EF and QoL in the study group.MethodsParticipants were 49 children and youth aged 8-18 years: 25 subjects with psychiatric (mainly anxiety) disorders and 24 healthy controls. The children’s parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL) to profile emotional difficulties; The Behavior Rating Inventory of Executive Functions (BRIEF) which examines EF components related to meta-cognition and behavioral regulation; and the Pediatric Quality of Life Inventory (Peds-QoL).ResultsThe study group had more EF difficulties [reduced behavioral regulation (F=31.81; p&lt;.001) and metacognition (F=26.25; p&lt;.001)], and lower QoL. In the study group, EF difficulties correlated with reduced physical, emotional, social, and school-related QoL.ConclusionsEF should be evaluated in children/youth with psychiatric disorders, by ecological evaluation that reflect the difficulties in daily life. This may focus intervention on child’s specific needs and improve the outcomes in terms of better function, development and QoL.