Executive Functioning In School-age Children Research Articles

Test-retest reliability of the N2 event-related potential in school-aged children with autism spectrum disorder (ASD)

ObjectiveThe N2 ERP component is used as a biomeasure of executive function in children with autism spectrum disorder (ASD). The aim of the current study was to evaluate the test-retest reliability of N2 amplitude in this population. MethodsERPs were recorded from 7 to 11-year-old children with ASD during Flanker (n = 21) and Go/Nogo tasks (n = 14) administered at two time points separated by approximately three months. Reliability of the N2 component was examined using intraclass correlation coefficients (ICCs). ResultsReliability for mean N2 amplitude obtained during the Flanker task was moderate (congruent: ICC = 0.542, 95% CI [0.173, 0.782]; incongruent: ICC = 0.629, 95% CI [0.276, 0.831]). Similarly, reliability for the Go/Nogo task ranged from moderate to good (‘go’: ICC = 0.817, 95% CI [0.535, 0.937]; ‘nogo’: ICC = 0.578, 95% CI [0.075, 0.843]). ConclusionsThese findings support the use of N2 amplitude as a biomeasure of executive function in school-aged children with ASD. SignificanceThis research addresses a critical gap in clinical neurophysiology, as an understanding of the stability and reliability of the N2 component is needed in order to differentiate variance explained by repeated measurement versus targeted treatments and interventions.

How executive functions are associated with event-based and time-based prospective memory during childhood

A key developmental task of childhood is to gain autonomy and independence from parents and caregivers. Critical to this individualization process is the development of prospective memory (PM), the capacity to remember to carry out future intentions. In recent studies, children's PM performance has been associated with executive functions (EF). A closer inspection of the literature, however, suggests a differential impact of the three EF (updating, inhibition, and shifting) across different PM task types. The current study examined EF and PM capacities of 212 6- to 11-year-old children, examining for the first time both focal and nonfocal event-based PM tasks as well as a time-based PM task in a single sample. Results show that age-differences did not persist above and beyond age differences in children's executive resources. Specifically, updating predicted children's performance on all PM tasks, inhibition predicted performance on both event-based PM tasks, whereas shifting was specifically deployed by the nonfocal event-based task. Supplementary analyses of the time-based PM task illustrate how children monitor the progression of time and how preparatory processes support PM task performance. In sum, the current study presents the first comprehensive look at the specific role of age and three core EF in school-aged children's PM performance.

Mate Marote: Video Games to Stimulate the Development of Cognitive Processes

Early childhood is a period characterized by the rapid development of several cognitive abilities known as executive functions (EFs), required for all kinds of learning and adaptive behavior. Like other aspects of development, both positive and detrimental environmental conditions can have a potential impact on EF maturation. For instance, an improvement in EF is usually reported when children engage in activities that gradually and systematically challenge them. Mate Marote is a free online platform with videogames inspired in neurocognitive science findings that aim to stimulate the development of EF in school-aged children. In this paper, we present the features of the platform, the games, and some promising results obtained in an experience with first graders in Argentina.

Executive function in school-aged children with cerebral palsy: Relationship with speech and language

Background and AimsAlthough children with cerebral palsy (CP) are at an increased risk for developing speech, language, and executive function (EF) impairments, little is known regarding the relationship among these risk factors. The current study examined how different profiles of speech and language impairment might be associated with impairments in EF skills in school-aged children with CP. Methods and ProceduresForty-seven school-aged children with CP were included. Each child contributed between one and four data points for a total of 87 data points. Children were classified into speech and language profile groups at each data point. EF skills were examined using the Behavior Rating Inventory of Executive Function questionnaire. Outcomes and Results. Compared to a mean of 50 from a normative population of children, mean scores on all measures of EF were significantly elevated for all groups (p<.05). The proportion of children with CP with elevated EF scores was significantly higher for all groups compared to the expected proportion in a normal population of children (p<.05). Conclusions and ImplicationsChildren with CP who do not have impairments in speech or language may be at risk for EF difficulties which may negatively affect social communication, academic performance, and functional independence.

Impact of sleep on executive functioning in school-age children with Down syndrome.

Sleep problems have an impact on executive functioning in the general population. While children with Down syndrome (DS) are at high risk for sleep problems, the impact of these sleep problems on executive functioning in school-age children with DS is less well documented. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports and neuropsychology assessments of executive functioning among school-age children with DS. Thirty school-age children with DS wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Children completed a neuropsychology assessment of their inhibitory control, ability to shift and working memory. Their parents and teachers completed rating scales to assess these same constructs of executive functioning. Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire (CSHQ), but not actigraph-measured sleep period or efficiency, were predictive of parent reports of concerns with inhibitory control, shifting and working memory, and of teacher reports of inhibitory control. No measure of sleep was predictive of executive functioning as measured by the neuropsychology assessment. The study findings corroborate the preliminary literature that parent-reported sleep problems are related to executive functioning in school-age children with DS, particularly in the area of inhibitory control across home and school. These findings have implications for understanding contributing factors to academic performance and school behaviour in school-age children with DS.

Developmental trends of hot and cool executive function in school-aged children with and without autism spectrum disorder: Links with theory of mind.

The development of executive function (EF) in autism spectrum disorder (ASD) has been investigated using only "cool"-cognitive EF tasks while there is limited knowledge regarding the development of "hot"-affective EF. Although cool EF development and its links to theory of mind (ToM) have been widely examined, understanding of the influence of hot EF to ToM mechanisms is minimal. The present study introduced a longitudinal design to examine the developmental changes in cool and hot EF of children with ASD (n = 45) and matched (to age and IQ) controls (n = 37) as well as the impact of EF on ToM development over a school year. For children with ASD, although selective cool (working memory and inhibition) and hot (affective decision making) EF domains presented age-related improvements, they never reached the performance level of the control group. Early cool working memory predicted later ToM in both groups but early hot delay discounting predicted later ToM only in the ASD group. No evidence was found for the reverse pattern (early ToM predicting later EF). These findings suggest that improvements in some EF aspects are evident in school age in ASD and highlight the crucial role that both cool and hot EF play in ToM development.

Attentional control and executive functioning in school-aged children: Linking self-regulation and parenting strategies

Good parenting strategies can shape children’s neurocognitive development, yet little is known about the nature of this relation in school-aged children and whether this association shifts with age. We aimed to investigate the relation between parenting strategies observed during a home visit and children’s performance-based attentional control and executive functioning (N=98, aged 4–8years). Linear and curvilinear regression analyses showed that children of parents who were more supportive, were less intrusive, and asked more open-ended questions displayed better inhibitory control. In addition, children of parents who asked relatively more open-ended than closed-ended questions showed better performance on inhibition, working memory, and cognitive flexibility tasks. Curvilinear relations indicated the presence of an optimal amount of closed-ended and elaborative questions by parents—that is, not too few and not too many—which is linked to increased performance on attentional and inhibitory control in children. Higher parental intrusiveness and more frequent elaborative questioning were associated with decreased inhibitory control in younger children, whereas no such negative associations were present in older children. These results suggest that susceptibility to certain parenting strategies may shift with age. Our findings underscore the importance of adaptive parenting strategies to both the age and needs of school-aged children, which may positively affect their self-regulation skills.

Performance and Ratings Based Measures of Executive Function in School-Aged Children with Down Syndrome

ABSTRACTWe examined performance-based laboratory tasks and ratings-based assessments of executive function (EF) in school-aged children with Down syndrome and mental-age matched peers along with adaptive functioning. Methods. A battery of assessments including EF laboratory tasks was collected. Results. The DS group performed both working memory/inhibition and planning laboratory tasks with significant challenges. Moderate correlations were evident only between some laboratory tasks and ratings-based EF domains. However, ratings-based EF better predicted adaptive function than performance on an EF laboratory-based task. Conclusions. Findings underscore the need to address early and targeted EF intervention in children with DS.

The Association between Parenting Behavior and Executive Functioning in Children and Young Adolescents.

Executive functioning (EF) is associated with various aspects of school achievement and cognitive development in children and adolescents. There has been substantial research investigating associations between EF and other factors in young children, such as support processes and parenting, but less research has been conducted about external factors relating to EF in older children and adolescents. Therefore, the present study investigates one possible factor that could correlate with EF in school-age children and adolescents: parenting behavior. The cross-sectional study design gathered data from 169 children in primary schools, middle-schools, and Gymnasien, and their corresponding parents. All children underwent a standardized task to measure EF, the computer-based Erikson Flanker task, which evaluates EF as a function of error rates and response time. A self-report questionnaire was used to assess parenting behavior. Multilevel analysis was implemented to test the effects of parenting behavior on EF in school-age children. The results show significant associations between various parenting behaviors and children's EF: High scores on parental involvement or parental responsibility are associated with low error rates on the Erikson Flanker task, whereas high parental scores on inconsistent discipline are associated with high error rates. These correlations between parenting behavior and EF remained significant despite controlling for child age, maternal education, family income, and baseline performance (i.e., congruent trials on the Erikson Flanker task). No associations were found between parental behavior and reaction time on the Erikson Flanker task. These results indicate the important association between parenting behaviors and EF skills in school-age children, and foster the necessity to inform parents about ways in which they can optimally support their children's cognitive development.

Executive and intellectual functioning in school-aged children with specific language impairment.

Earlier research and clinical practice show that specific language impairment (SLI) is often associated with nonverbal cognitive deficits and weakened skills in executive functions (EFs). Executive deficits may have a remarkable influence on a child's everyday activities in the home and school environments. However, research information is still limited on EFs in school-aged children with SLI, mostly conducted among English- and Dutch-speaking children. To study whether there are differences in EFs between Finnish-speaking children with SLI and typically developing (TD) peers at school age. EFs are compared between the groups with and without controlling for nonverbal intelligence. Parents and teachers of children with SLI (n = 22) and age- and gender-matched TD peers (n = 22) completed The Behavior Rating Inventory of Executive Functions (BRIEF). The mean age of the children was 8,2 years. BRIEF ratings of parents and teachers were compared between the children with SLI and with TD peers by paired analysis using conditional logistic regression models with and without controlling for nonverbal IQ. Intellectual functioning was assessed with the Wechsler Intelligence Scale for Children. Children with SLI had weaker scores in all parent and teacher BRIEF scales compared with TD peers. Statistically significant differences between the groups were found in BRIEF scales Shift, Emotional Control, Initiate, Working Memory, Plan/Organize and Monitor. Differences between the groups were statistically significant also in intellectual functioning. On BRIEF scales some group differences remained statistically significant after controlling for nonverbal IQ. This study provides additional evidence that also Finnish-speaking school-aged children with SLI are at risk of having deficits in EFs in daily life. EFs have been proposed to have an impact on developmental outcomes later in life. In clinical practice it is important to pay attention to EFs in school-aged children with SLI when making diagnostic evaluations and planning interventions for them.

Ecological executive function characteristics and effects of executive function on social adaptive function in school-aged children with epilepsy

To explore the characteristics of ecological executive function in school-aged children with idiopathic or probably symptomatic epilepsy and examine the effects of executive function on social adaptive function. A total of 51 school-aged children with idiopathic or probably symptomatic epilepsy aged 5-12 years at our hospital and 37 normal ones of the same gender, age and educational level were included. The differences in ecological executive function and social adaptive function were compared between the two groups with the Behavior Rating Inventory of Executive Function (BRIEF) and Child Adaptive Behavior Scale, the Pearson's correlation test and multiple stepwise linear regression were used to explore the impact of executive function on social adaptive function. The scores of school-aged children with idiopathic or probably symptomatic epilepsy in global executive composite (GEC), behavioral regulation index (BRI) and metacognition index (MI) of BRIEF ((62±12), (58±13) and (63±12), respectively) were significantly higher than those of the control group ((47±7), (44±6) and (48±8), respectively))(P<0.01). The scores of school-aged children with idiopathic or probably symptomatic epilepsy in adaptive behavior quotient (ADQ), independence, cognition, self-control ((86±22), (32±17), (49±14), (41±16), respectively) were significantly lower than those of the control group ((120±12), (59±14), (59±7) and (68±10), respectively))(P<0.01). Pearson's correlation test showed that the scores of BRIEF, such as GEC, BRI, MI, inhibition, emotional control, monitoring, initiation and working memory had significantly negative correlations with the score of ADQ, independence, self-control ((r=-0.313--0.741, P<0.05)). Also, GEC, inhibition, MI, initiation, working memory, plan, organization and monitoring had significantly negative correlations with the score of cognition ((r=-0.335--0.437, P<0.05)); Multiple stepwise linear regression analysis showed that BRI, inhibition and working memory were closely related with the social adaptive function of school-aged children with idiopathic or probably symptomatic epilepsy. School-aged children with idiopathic or probably symptomatic epilepsy may have significantly ecological executive function impairment and social adaptive function reduction. The aspects of BRI, inhibition and working memory in ecological executive function are significantly related with social adaptive function in school-aged children with epilepsy.

The effectiveness of racket-sport intervention on visual perception and executive functions in children with mild intellectual disabilities and borderline intellectual functioning.

BackgroundThis study aimed to investigate the effects of table tennis training (TTT) versus standard occupational therapy (SOT) on visual perception and executive functions in school-age children with mild intellectual disabilities and borderline intellectual functioning.Subjects and methodsChildren (n=91) were randomly assigned to intervention with either SOT (n=46, 20 females, mean age =10.9±3.9 years) or TTT (n=45, 21 females, mean age =10.6±3.6 years), while another 41 (18 females, mean age =10.7±4.0 years) served as controls. Both the SOT and TTT programs were administered 60 minutes per session, three times a week, for 16 weeks. The Test of Visual Perceptual Skill–third edition (TVPS-3) was used to evaluate visual perception, and executive functions were assessed by the Wisconsin Card Sorting Test 64-card version (WCST-64) and the Stroop test.ResultsAt postintervention, the two intervention groups significantly outperformed the control group on all measures of visual perception and executive functions. Participants in the TTT group had significantly greater before–after changes on all measures of the TVPS-3, WCST-64, and the Stroop test compared to the SOT and controls.ConclusionTable tennis could be considered a therapy option while treating cognitive/perceptual problems in children with mild intellectual disabilities and borderline intellectual functioning. Implications for clinical professionals and recommendations for further research are discussed.

Assessment of Executive Functions in School-Aged Children: Challenges and Solutions for the SLP

The assessment of executive function (EF) deficits in school-aged children has become an area of increased interest and need for speech-language pathologists (SLPs) working in educational settings. Various challenges exist that complicate the assessment of executive dysfunction (EDF) in students, among them the fact that EDF is present within a heterogeneous mix of developmental disorders. The resulting communication, behavioral, and academic problems addressed by the SLP, educators, and parents are frequently an interwoven mix of language disorders, social disorders, learning disorders, and/or mental health disorders—each of which is known to present with EDF. Furthermore, there is no one specific profile of EDF. The SLP must evaluate for each student's individual EF profile, while also taking into account foundations of language or social cognition. Questionnaires, informal observations, standardized rating scales, and standardized EF tests are available that can provide diagnostic insight for SLPs working with students who display EDF.

Elevated airborne manganese and low executive function in school-aged children in Brazil

Exposure to airborne manganese (Mn) has been associated with neurotoxic effects, including motor and cognitive deficits. The main deficits related to excessive exposure to Mn are predominantly the dysfunction of fronto-striatal and dopaminergic circuits observed in animal experimental studies, which are involved in attention, working memory and motor function. The present study aims to assess the association between elevated Mn exposure and performance on executive function and attention neuropsychological tests in children living in two communities near a ferro-manganese alloy plant. Seventy children aged between 7 and 12 years with no history of neurologic disease and an estimated IQ >68 (Vocabulary and Block Design subtests) that had lived near the iron-Mn production alloy plant for at least 1.5 years were included. Participants were assessed for cognitive functioning with neuropsychological measures for sustained attention (Test of Visual Attention – TAVIS-3R), cognitive flexibility (WCST), and verbal and visual working memory (WISC-III Digit Span subtest and Corsi Block). Manganese hair (MnH) levels were used as a biomarker of exposure. Mean scores among study participants were lower than general population norms/averages for block design, digit span, reaction time and commission errors. The median MnH level was 11.48 (range 0.52–55.74) μg/g, and no difference between sexes was observed. Spearman's correlation analysis showed a significant inverse correlation between MnH levels and estimated IQ (rho=−0.448, p=0.0001), Vocabulary (rho=−0.272, p=0.02), Block Design (rho=−0.485, p=0.00002) and Digit Span (rho=−0.410, p=0.0004). Multiple regression analyses detected inverse associations between log MnH and scores on estimated IQ (β=−9.67; 95%CI=−16.97 to −2.37), Block Design (β=−2.50; 95%CI=−3.91 to −1.10) and Digit Span Total (β=−2.59; 95%CI=−4.13 to −1.05) standardized scores and the number of correct answers in forward and backward Digit Span methods, after adjusting for covariates (β=−1.32=95%CI=−2.23 to −0.40; β=−1.09 95%CI=−2.02 to −0.16, respectively). The results suggest that airborne Mn exposure may be associated with lower IQ and neuropsychological performance in tests of executive function of inhibition responses, strategic visual formation and verbal working memory. Executive function is dependent on the fronto-striatal circuit, which may be disrupted by Mn accumulation in the brain.

Primary hypertension and neurocognitive and executive functioning in school-age children

Data on neurocognitive function in hypertensive children are limited. In this review, we summarize recent preliminary, early studies that suggest that children with elevated blood pressure demonstrate evidence of worse performance on direct neurocognitive testing, as well as evidence of executive dysfunction based on parent ratings, compared with matched normotensive comparison groups. Furthermore, hypertensive children may have increased prevalence of learning disabilities as well as a blunted cerebrovascular reactivity compared with normotensive controls. Larger, prospective studies are needed to confirm and further explore these emerging but preliminary findings.

Relationship between motor and executive functioning in school-age children with pervasive developmental disorder not otherwise specified

This study examines the motor skills and executive functioning (EF) of 28 children diagnosed with pervasive developmental disorder-not otherwise specified (PDD-NOS; mean age: 10 years 6 months, range: 7–12 years; 19 boys, 9 girls) in comparison with age- and gender-matched typically developing children. The potential relationship between motor performance and EF in children with PDD-NOS is investigated as well. The children's motor skills were evaluated with the Movement ABC. EF, in terms of planning ability, strategic decision making, and problem solving, was gauged with the Tower of London (TOL) task. Compared with their typically developing peers, the children with PDD-NOS scored poor on the Movement ABC (p<0.01) and the TOL (p<0.05). They had significantly more definite motor problems than the normative sample of the Movement ABC: 43% (manual dexterity, p<0.001), 25% (ball skills, p<0.001), and 25% (balance skills, p<0.001). There were significant inverse relationships between manual dexterity and the TOL score (r=−0.46, p<0.01), and balance and the TOL score (r=−0.41, p<0.05), indicating that children with a better performance on the manual dexterity subtest and the balance subtest had a better TOL score than children with a worse performance. Children with PDD-NOS have inferior motor skills, and these deficits are interrelated with planning ability, strategic decision making, and problem solving.

Benign rolandic epileptiform discharges are associated with mood and behavior problems

Children with benign rolandic epilepsy (BRE) experience elevated rates of cognitive, behavioral, and affective problems. Frequent epileptiform spike discharges may impair behavioral functioning. To elucidate this relationship, we evaluated associations between the EEG spike frequency index (SI) and parental ratings of psychosocial adjustment and executive functioning in school-aged children with EEGs typical of BRE. Twenty-one children (6–12years) participated. Parents completed validated questionnaires at a median of 5months (range: 1–8) after a routine outpatient EEG. The EEG SI was calculated for wakefulness and sleep. The strength of association between the SI and behavioral variables was evaluated by simple and multivariate correlation. Higher awake and sleep SIs were associated with more symptoms of depression (P<0.001), aggression and conduct problems (P<0.01). Higher sleep SI was associated with executive dysfunction and anxiety (P<0.05). Symptoms of hyperactivity and inattention had no correlation. Increased epileptiform activity in children with BRE may predict higher rates of mood and behavioral problems.

The Lexical Stroop Sort (LSS) picture-word task: A computerized task for assessing the relationship between language and executive functioning in school-aged children

The relationship between language development and executive function (EF) in children is not well understood. The Lexical Stroop Sort (LSS) task is a computerized EF task created for the purpose of examining the relationship between school-aged children's oral language development and EF. To validate this new measure, a diverse sample of school-aged children completed standardized oral language assessments, the LSS task, and the widely used Dimensional Change Card Sort (DCCS; Zelazo, 2006) task. Both EF tasks require children to sort stimuli into categories based on predetermined rules. While the DCCS largely relies on visual stimuli, the LSS employs children's phonological loop to access their semantic knowledge base. Accuracy and reaction times were recorded for both tasks. Children's scores on the LSS task were correlated with their scores on the DCCS task, and a similar pattern of relationships emerged between children's vocabulary and the two EF tasks, thus providing convergent validity for the LSS. However, children's phonological awareness was associated with their scores on the LSS, but not with those on the DCCS. In addition, a mediation model was used to elucidate the predictive relationship between phonological awareness and children's performance on the LSS task, with children's vocabulary fully mediating this relationship. The use of this newly created and validated LSS task with different populations, such as preschoolers and bilinguals, is also discussed.

Relationships between executive functions tasks in late childhood.

Executive functions (EF) is a general term that refers to cognitive processes designed to organize and adapt human behavior in situations that require planning and decision making, problem solving, initiation and inhibition of actions, and adapting to changes. Among the main components of executive processes, we can emphasize the ability to inhibit and to present cognitive flexibility due to changes. Understanding the relationships among the various components of EF in adults and children has been a focus in the literature. However, these processes are complex and multiple. The present study sought to determine whether correlations exist among performances measured by different tools used to evaluate EF in school-age children. The sample comprised 59 children aged 8 to 12 years attending public schools. Participants were assessed using verbal fluency tasks and narrative discourse with the Montreal Battery of Evaluation of Communication-MAC Battery, random-number generation, the Hayling Test, the Bells Test, and the n-back test. Correlation analyses were performed using Pearson's correlation coefficient. The results suggested a closer relationship among some components of the evaluation of EF, especially among tasks that assess inhibition and cognitive flexibility.

Theoretical and statistical derivation of a screener for the behavioral assessment of executive functions in children.

The problem of valid measurement of psychological constructs remains an impediment to scientific progress, and the measurement of executive functions is not an exception. This study examined the statistical and theoretical derivation of a behavioral screener for the estimation of executive functions in children from the well-established Behavior Assessment System for Children (BASC). The original national standardization sample of the BASC-Teacher Rating Scales for children ages 6 through 11 was used (N = 2,165). Moderate-to-high internal consistency was obtained within each factor (.80-.89). A panel of experts was used for content validity examination. A confirmatory factor analysis model with 25 items loading on 4 latent factors (behavioral control, emotional control, attentional control, and problem solving) was developed, and its statistical properties were examined. The multidimensional model demonstrated adequate fit, and it was deemed invariant after configural, metric, and scalar measurement invariance tests across sex and age. Given its strong psychometric properties, with further tests of item validity, this instrument promises future clinical and research utility for the screening of executive functions in school-age children.