Measures Of Executive Function Research Articles

Mobile toolbox (MTB) remote measures of executive function and processing speed: development and validation.

The ability to remotely monitor cognitive skills is increasing with the ubiquity of smartphones. The Mobile Toolbox (MTB) is a new measurement system that includes measures assessing Executive Functioning (EF) and Processing Speed (PS): Arrow Matching, Shape-Color Sorting, and Number-Symbol Match. The purpose of this study was to assess their psychometric properties. MTB measures were developed for smartphone administration based on constructs measured in the NIH Toolbox® (NIHTB). Psychometric properties of the resulting measures were evaluated in three studies with participants ages 18 to 90. In Study 1 (N = 92), participants completed MTB measures in the lab and were administered both equivalent NIH TB measures and other external measures of similar cognitive constructs. In Study 2 (N = 1,021), participants completed the equivalent NIHTB measures in the lab and then took the MTB measures on their own, remotely. In Study 3 (N = 168), participants completed MTB measures twice remotely, two weeks apart. All three measures exhibited very high internal consistency and strong test-retest reliability, as well as moderately high correlations with comparable NIHTB tests and moderate correlations with external measures of similar constructs. Phone operating system (iOS vs. Android) had a significant impact on performance for Arrow Matching and Shape-Color Sorting, but no impact on either validity or reliability. Results support the reliability and convergent validity of MTB EF and PS measures for use across the adult lifespan in remote, self-administered designs.

Linking the neural signature of response time variability to Alzheimer's disease pathology and cognitive functioning.

Promising evidence has suggested potential links between mind-wandering and Alzheimer's disease (AD). Yet, older adults with diagnosable neurocognitive disorders show reduced meta-awareness, thus questioning the validity of probe-assessed mind-wandering in older adults. In prior work, we employed response time variability as an objective, albeit indirect, marker of mind-wandering to identify patterns of functional connectivity that predicted mind-wandering. In the current study, we evaluated the association of this connectome-based, mind-wandering model with cerebral spinal fluid (CSF) p-tau/Aβ 42 ratio in 289 older adults from the Alzheimer's Disease NeuroImaging Initiative (ADNI). Moreover, we examined if this model was similarly associated with individual differences in composite measures of global cognition, episodic memory, and executive functioning. Edges from the high response time variability model were significantly associated with CSF p-tau/Aβ ratio. Furthermore, connectivity strength within edges associated with high response time variability was negatively associated with global cognition and episodic memory functioning. This study provides the first empirical support for a link between an objective neuromarker of mind-wandering and AD pathophysiology. Given the observed association between mind-wandering and cognitive functioning in older adults, interventions targeted at reducing mind-wandering, particularly before the onset of AD pathogenesis, may make a significant contribution to the prevention of AD-related cognitive decline.

A 10-min reduction in cerebral blood flow does not alter post-intervention executive function: evidence from lower-body negative pressure.

A single bout of exercise as well as exposure to a hypercapnic environment increases cerebral blood flow (CBF) and is an adaptation linked to a post-intervention executive function (EF) benefit. In the present investigation we sought to determine whether a transient reduction in CBF impairs EF. Accordingly, we employed 10-min -30 mmHg and -50 mmHg lower-body negative pressure (LBNP) interventions as well as a non-LBNP control condition. LBNP was employed because it sequesters blood in the lower legs and safely and reliably decreases CBF. Transcranial Doppler ultrasound was used to measure middle cerebral artery velocity (MCAv) to estimate CBF prior to and during LBNP conditions. As well, assessments of the inhibitory control component of EF (i.e., antipointing) were completed prior to (pre-) and immediately after (i.e., post-) each condition. Antipointing requires that an individual reach mirror-symmetrical to an exogenously presented target and is a task providing the resolution to detect subtle EF changes. Results showed that LBNP produced a 14% reduction in MCAv; however, null hypothesis, equivalence and Bayesian contrasts indicated that antipointing metrics did not vary from pre- to post-intervention, and LBNP-based changes in MCAv magnitude were not reliably correlated with antipointing planning times. Hence, a 10-min reduction in CBF did not impact the efficiency or effectiveness of an inhibitory control measure of EF.

Hot and cool executive function and theory of mind in children with and without specific learning disorders

Executive function (EF) in specific learning disorders (SLD) has been investigated using mainly cool EF tasks, whilst less is known about hot EF and theory of mind (ToM) in this population. The aim of this study was to examine group differences in hot and cool EF and ToM in school-aged children with SLD relative to typically developing peers. It also attempted to investigate whether EF measures are significant predictors of ToM in SLD and typical development. Cross-sectional data were collected from 135 school-aged children with and without SLD (8–10 years old), tested on measures of cool & hot EF and ToM. Significant group differences were observed in EFs inhibition (p= .04), working memory (p= .04) and delay of gratification (p < .001), as well as ToM mental state/emotion recognition (p = .019). Inhibition and planning contributed to 22% of the explained variance of ToM mental state/emotion recognition, but not false belief overall. Results suggest that cool EF may be a crucial predictor of ToM in children with and without SLD. Finally, stepwise logistic regression analysis identified specific hot EF and ToM measures contributing to group differentiation, specifically delay of gratification (odds ratio=.995, 95% CI [.993–.998]) and mental state/emotion recognition (odds ratio= .89, 95% CI [.796–.995]). This study contributes to our understanding of cognitive deficits and socio-cognitive impairment in children with SLD, which hold promise for informing interventions aimed at addressing these cognitive challenges.

Using semantic verbal fluency to estimate the relative and absolute vocabulary size of bilinguals: An exploratory study of children and adolescents

IntroductionThe full assessment of bilingual children often involves at least one language for which formal vocabulary tests are lacking and which the examiner does not speak. We examined, in a sample of children with typical development (TD), whether a semantic verbal fluency task, typically used in research as a measure of executive function, could be used in the place of a formal vocabulary test to estimate vocabulary knowledge when formal tests are not available. Method113 TD monolingual French speakers and TD bilinguals and with varying degrees of exposure to French, age 6 to 17 years, completed tests of vocabulary knowledge and semantic verbal fluency. A subset of 64 participants spoke French and English and were tested in both languages. Verbal fluency measures calculated using a traditional method which uses specific rules for superordinate categories and for animals of different sex and age and a simplified scoring method which simply counts all words produced, included the total number of words produced in each language, Total Vocabulary and Conceptual Vocabulary measures combining both languages, as well as analyses of lexical composition and word frequency within the study sample. ResultsLinear regressions revealed that the number of words produced predicted vocabulary size in a language-specific way, with slightly stronger predictions made by the simplified scoring method. As expected, bilinguals produced more words and more unique words in their language of greater exposure, while different exposure groups were equivalent in measures combining both languages, including their Total vocabulary and Conceptual vocabulary. Producing unusual words (infrequently produced in the study sample) indicated higher vocabulary scores. ConclusionsThis study supports the use of the verbal fluency task as a quick and simple tool to obtain a rough estimate of vocabulary size in TD monolinguals and bilinguals. This tool shows promise as well in clinical work with other populations, subject to further verification.

A - 23 Interpretation Consideration: Serial Baseline Performances on Core Executive Function Measures in Healthy Youth Athletes

Abstract Purpose Sports participation in youth has demonstrated better core executive function (EF) abilities compared to those who do not participate (Contreras-Osorio et al., 2021). However, previous research has not observed a pattern of improvement across all EF abilities (M√∂hring et al., 2022), indicating EF development in childhood is not linear (Anderson, 2002). The present study compared baseline scores of cognitive flexibility, working memory, and inhibition at two timepoints among youth athletes. Method Data from the Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing (cognitive flexibility), Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index, and Golden Stroop Color-Word Inhibition test were analyzed in a sample of youth athletes (n = 32), aged 8–16 years. Mean age difference between time 1 and 2 was 1.86 years. Paired-samples t-test examined the difference in core EF scores at two timepoints. Results Performance on a measure of inhibition significantly improved over time (p = 0.02; effect size [d] = 0.43). Performances on measures of working memory and cognitive flexibility did not significantly differ over time (p = 0.16 and p = 0.61, respectively). Conclusions Healthy youth athletes performed significantly better only on a measure of inhibition at baseline two than baseline one, suggesting clinicians should anticipate variation in scores when re-examining core EF abilities after two years. Further, clinicians should exercise caution when interpreting variation in baseline scores because it could be due to sports participation. Future research should investigate whether inhibition continues to improve overtime and whether significant changes are observed in other core EFs.

A Comparison of Three Executive Function Batteries in a Preschool-Aged Sample.

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health's Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44-0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children.

Cognitive Profiles in Treatment-Resistant Late-Life Depression and Their Impact on Treatment Outcomes

BackgroundLate-life depression (LLD) is associated with cognitive impairment, but substantial heterogeneity exists among patients. Data on the extent of cognitive impairments are inconclusive, particularly in patients with treatment-resistant depression (TRD). We investigated the cognitive profiles of patients with treatment-resistant versus nonresistant LLD and aimed to identify distinct cognitive subgroups. We also examined whether cognitive subgroups responded differentially to treatment with bilateral repetitive transcranial magnetic stimulation (rTMS). MethodsA total of 165 patients with LLD were divided into treatment-resistant and nonresistant groups and compared with healthy control participants on measures of executive function, information processing speed, verbal learning, and memory. Cluster analysis identified subgroups based on cognitive scores. Demographic and clinical variables, as well as outcomes with bilateral rTMS, were compared between cognitive subgroups. ResultsPatients with LLD, particularly TRD, exhibited significantly worse cognitive performance than healthy controls. A 3-cluster solution was found, including cognitively intact (n = 89), cognitively diminished (n = 29), and impaired memory (n = 47) subgroups. Both the cognitively diminished and impaired memory subgroups had more anxiety symptoms and a higher proportion of patients with TRD than the cognitively intact group, although the latter difference did not survive multiple comparison correction. No significant differences were observed in outcomes to rTMS treatment. ConclusionsPatients with LLD exhibited impairments across cognitive domains, which were more pronounced in TRD. Three cognitive subgroups responded similarly to rTMS treatment, indicating its effectiveness across cognitive profiles, especially when medications are not tolerated. Future research should examine the relationships among cognitive subgroups, cognitive decline, and neurodegeneration.

Cerebrovascular reactivity MRI as a biomarker for cerebral small vessel disease-related cognitive decline: Multi-site validation in the MarkVCID Consortium.

Vascular contributions to cognitive impairment and dementia (VCID) represent a major factor in cognitive decline in older adults. The present study examined the relationship between cerebrovascular reactivity (CVR) measured by magnetic resonance imaging (MRI) and cognitive function in a multi-site study, using a predefined hypothesis. We conducted the study in a total of three analysis sites and 263 subjects. Each site performed an identical CVR MRI procedure using 5% carbon dioxide inhalation. A global cognitive measure of Montreal Cognitive Assessment (MoCA) and an executive function measure of item response theory (IRT) score were used as outcomes. CVR and MoCA were positively associated, and this relationship was reproduced at all analysis sites. CVR was found to be positively associated with executive function. The predefined hypothesis on the association between CVR and a global cognitive score was validated in three independent analysis sites, providing support for CVR as a biomarker in VCID. This study measured a novel functional index of small arteries referred to as cerebrovascular reactivity (CVR). CVR was positively associated with global cognition in older adults. This finding was observed in three independent cohorts at three sites. Our statistical analysis plan was predefined before beginning data collection.

Association of accelerometer measured sedentary behavior patterns with cognitive functions in sedentary office workers: Insights from SMART-STEP study

BACKGROUND: High levels of sedentary behavior in workplaces are currently recognized as an independent risk factor for cognitive dysfunction and poor mental health. However, sedentary patterns vary between workdays and non-workdays, which may influence cognitive functions. OBJECTIVE: The present study aimed to quantify and compare work and nonwork device-measured sedentary time (ST) and its association with cognitive function in Indian office workers. METHODS: In an ongoing randomized controlled trial (SMART-STEP), the baseline data of 136 full-time office workers, including accelerometer-measured sedentary patterns and cognitive functions, were analyzed. The ST was measured using a hip-worn accelerometer (Actigraph wGT3X-BT) for seven days, and executive functions were measured using computer-based tests. Linear regression models were employed to analyze the relationships between ST and executive function measures. RESULTS: The median daily ST of Indian office workers was 11.41 hours. The ST was greater on both workdays (11.43 hrs.) and non-workdays (11.14 hrs.) though different (F = 6.76, p = 0.001, ηp2 = 0.032). Office workers accumulate more prolonged sitting bouts (+21.36 min) during work days than non-workdays. No associations between device-measured ST and executive functions were observed. CONCLUSION: Indian office workers exhibited high ST patterns, especially on workdays. Although lower than workdays, Indian office workers exhibited more ST patterns during non-workdays than did their Western counterparts. Culturally adaptable workplace and leisure time physical activity interventions are needed to address the high ST of Indian office workers.

Exploring the Neuropsychological Correlates of Swallowing Disorders in People with Parkinson's Disease: a Cross-Sectional Study.

Around 80% of persons with Parkinson's disease (PD) present symptoms of dysphagia. Although cognitive impairment may contribute to dysphagia, few studies have investigated the association between the PD neuropsychological profile and objective measures of swallowing dysfunction. Since the swallowing function comprises involuntary but also voluntary actions, we hypothesize that specific measures of attention and executive functions can be underlined in PD-related dysphagia. Therefore, the aim of this study was to extensively investigate the correlation and the relationship between attentive and executive functions and safety/efficiency of pharyngeal phase of swallowing in people with PD. All participants received a fiberoptic endoscopic evaluation of swallowing and were evaluated using the Penetration Aspiration Scale (PAS); the Yale Pharyngeal Residue Severity Rating Scale (IT-YPRSRS), and the Functional Oral Intake Scale (FOIS-IT). Participants also underwent a neuropsychological assessment covering global cognitive status, attention, and frontal executive functions. Correlations and associations between neuropsychological measures and swallowing components were calculated. Twenty-one participants with PD (mean age 69.38 ± 6.58 years, mean disease duration 8.38 ± 5.31 years; mean MDS-UPDRS III 43.95 ± 24.18) completed all evaluations. The most significant correlations were found between attentive functions (i.e., Stroop Time), and executive functions (i.e., Raven's Progressive Matrices, Digit Backward and Semantic Fluency), and FOIS-IT, PAS, and IT-YPRSRS sinuses and valleculae. These associations were not influenced by disease duration. These results suggest that a dysfunction to attentional processes and/or to executive functions can contribute to penetration and the presence of pharyngeal residue in participants with middle-stage PD.

Evaluating the efficacy of cranial electrotherapy stimulation in mitigating anxiety-induced cognitive deficits

Cranial electrotherapy stimulation (CES) is a form of non-invasive brain stimulation (NIBS) that has demonstrated potential to modulate neural activity in a manner that may be conducive to improved cognitive performance. While other forms of NIBS, such as transcranial direct current stimulation (tDCS), have received attention in the field as potential acute cognitive enhancers, CES remains relatively unexplored. The current study aimed to assess the efficacy of CES in improving acute cognitive performance under normal experimental conditions, as well as during sessions of induced situational anxiety (threat of shock or ToS). To study this question, participants completed a cognitive battery assessing processing speed and distinct aspects of executive functioning (working memory, inhibition, and task switching) in two separate sessions in which they received active and sham CES. Participants were randomly assigned to between subject groups of either situational anxiety (ToS) or control condition (no ToS). We predicted that active CES would improve performance on assessments of executive functioning (working memory, inhibition, and task switching) relative to sham CES under ToS. We did not find any significant effects of ToS, CES, or an interaction between ToS and CES for any measures of executive functioning or processing speed. These findings suggest that a single dose of CES does not enhance executive functioning or processing speed under normal conditions or during ToS.

Physical Exercise and Executive Function in the Pediatric Overweight and Obesity Population: A Systematic Review Protocol.

Executive function is often altered in overweight/obese children and adolescents, which has a negative impact on their learning and daily life. Furthermore, research has shown the benefits of physical exercise in improving cognitive performance. This protocol aims to define in a detailed and structured manner the procedures that will be conducted for the development of a systematic review of the literature aimed at evaluating the effects of physical exercise on the executive functions of children and adolescents (≤18 years) with overweight/obesity in comparison with peers in control groups. The Web of Science, PubMed, Scopus, and EBSCO databases will be searched for longitudinal studies that have at least one experimental and one control group using pre- and post-intervention measures of executive function, including working memory, inhibition, and cognitive flexibility in the pediatric population who are overweight or obese. The risk of bias and certainty of evidence will be assessed using Cochrane RoB2 and GRADE, respectively. Furthermore, Der Simonian-Laird's random effects model will be employed for meta-analyses. The effect sizes will be calculated with 95% confidence intervals, and p values < 0.05 indicate statistical significance for each dimension of executive function in the different groups before and after the intervention. The results of this review may be useful for education and health professionals to design treatment plans for overweight/obese children and adolescents, offering potential benefits related to the learning and cognitive abilities of this population. PROSPERO registration number: CRD42023391420.

Association of Prenatal Exposure to Antiseizure Medications With Creative and Executive Function at Age 4.5 Years.

Neurodevelopmental effects of fetal antiseizure medication (ASM) exposure on creativity and executive functions are poorly understood. We previously found fetal valproate exposure to adversely affect measures of creativity and executive functions. In this study, we examine fetal exposure of newer ASMs on these functions in children of women with epilepsy (WWE) compared with children of healthy women (HW). The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational cohort study of WWE and HW enrolled in pregnancy and their offsprings. This report examines blindly assessed creativity and executive functions in 4.5-year-old children of WWE vs HW. In addition, exposure-dependent ASM effects during the third trimester were examined in children of WWE, using a ratio of maximum observed ASM concentrations and ratio of defined daily dose (ratio DDD). For polytherapy, ratios were summed across ASMs. Linear regression models adjusted for multiple potential confounding factors were conducted for all analyses. The primary outcome for 4.5-year-old children was the Torrance Test of Creative Thinking-Figural Creativity Index. Secondary outcomes included the Global Executive Composite Score from the Behavior Rating Inventory of Executive Function-Preschool Version and subscales and other indexes of both measures. The primary analysis included 251 children of WWE and 73 of HW. No differences in creativity or executive function were found between children of WWE vs HW. No ASM exposure-dependent effects were found for the creativity measures, but exposure-dependent effects for executive function were present for ratio ASM concentration and ratio DDD. Our findings at 4.5 years show no differences in creative thinking between children of WWE vs HW (-3.2 [-9.0 to 2.7], p = 0.286) or associations with fetal exposure to ASMs (-2.6 [-11.0 to 5.7], p = 0.530). Secondary analyses revealed fetal exposure-dependent effects for executive function in children of WWE (7.0 [2.9-11.2], p = 0.001), which are most marked for levetiracetam (12.9 [4.2-21.6], p = 0.004). Our findings suggest that even for relatively safe ASMs, dosing needs to be adjusted to concentrations that prevent seizures, but balance risks to the fetus that high concentrations may pose. The study is registered at ClinicalTrials.gov as NCT01730170.

Iranian Normative Data for the Trail-Making Test Stratified by Age, Gender, and Education

Purpose: Executive functions and attention are often impaired in neurological, medical, and psychiatric disorders. This study aimed to, in addition to collecting Iranian normative data, examine whether the demographic variables are associated with performance in one of the most widely used neuropsychological tools to measure cognitive status. Materials and Methods: The present study as part of the Iranian Brain Imaging Database (IBID) was implemented on three hundred medically and cognitively healthy people aged 20 to 70. Each decade consisted of 60 participants and the gender proportion was equal in each decade. Five decades of age (20 to 70 years old) and scores obtained in the Trail Making Test (TMT; defined in terms of two scores of the completion time of its two parts A and B) were the independent and dependent variables, respectively. Results: According to correlation coefficients, age and education had a significant negative and positive association with both parts A and B (p=0.01), respectively, with no significant association between gender and TMT scores (p&gt;0.05). According to multivariate analysis of variance, the interaction of age, gender, and education did not lead to a significant difference in the TMT scores (p=0.309). Tukey's post hoc test showed that participants under 40 took significantly less time to complete TMT-A than those over 50, while in TMT-B, participants under 30 years completed in a shorter time than those over 30 years old (p&lt;0.01). Conclusion: Our findings indicate that age and education have a significant association with the performance of the Iranian healthy population in the well-known measure of executive function and attention, and it is necessary to interpret TMT scores using normative data gathered in regional settings.

Socio-emotional behavior, learning, and the distinct contributions of Executive Functions in primary graders

Socio-emotional school behavior and learning are both fundamental aspects of children’s development influenced by cognitive control processes named Executive Functions (EF). Yet, research on school-age children has often focused on the relationship between EF and learning skills overlooking that of EF and school behavior, which has usually been examined among preschoolers. The current study investigated the contribution of EF in both school behavior and learning in school-age children. One hundred forty-six III–V graders were assessed using text comprehension and EF tasks and evaluated by teachers-rated inventories on behavioral difficulties and EF within the school context. The results suggested a different involvement of direct and indirect EF measures in the two domains considered: controlling for socioeconomic level and age, an EF direct measure, predicted reading comprehension whereas teacher-reported EF related to both behavior and text comprehension. The results contribute to defining the role of cognitive control processes on school behavior and learning in school-age children.

Perinatal influences on academic achievement and the developing brain: a scoping systematic review.

In this PRISMA-compliant systematic review, we identify and synthesize the findings of research in which neuroimaging and assessments of achievement have been used to examine the relationships among aspects of developmental programming, neurodevelopment, and achievement in reading and mathematics. Forty-seven studies met inclusion criteria. The majority examined the impact of prematurity (n = 32) and prenatal alcohol exposure (n = 13). Several prematurity studies reported a positive correlation between white-matter integrity of callosal fibers and executive functioning and/or achievement, and white matter properties were consistently associated with cognitive and academic performance in preterm and full-term children. Volumetric studies reported positive associations between academic and cognitive abilities and white and gray matter volume in regions such as the insula, putamen, and prefrontal lobes. Functional MRI studies demonstrated increased right-hemispheric language processing among preterm children. Altered activation of the frontoparietal network related to numerical abilities was also reported. Prenatal alcohol exposure studies reported alterations in white matter microstructure linked to deficits in cognitive functioning and academic achievement, including mathematics, reading, and vocabulary skills. Volumetric studies reported reductions in cerebral, cerebellar, and subcortical gray matter volumes associated with decreased scores on measures of executive functioning, attention, working memory, and academic performance. Functional MRI studies demonstrated broad, diffuse activation, reduced activation in canonical regions, and increased activation in non-canonical regions during numeric tasks. A preponderance of studies linked prematurity and prenatal alcohol exposure to altered neurodevelopmental processes and suboptimal academic achievement. Limitations and recommendations for future research are discussed. Identifier: DOI 10.17605/OSF.IO/ZAN67.

A digital intervention to support childhood cognition after the COVID-19 pandemic: a pilot trial

Difficulties in executive functioning (EF) can result in impulsivity, forgetfulness, and inattention. Children living in remote/regional communities are particularly at risk of impairment in these cognitive skills due to reduced educational engagement and poorer access to interventions. This vulnerability has been exacerbated by the COVID-19 pandemic and strategies are needed to mitigate long-term negative impacts on EF. Here we propose a pilot trial investigating the benefits, feasibility, and acceptability of a school-based EF intervention for primary school students (6–8 years) living in regional, developmentally vulnerable, and socio-economically disadvantaged communities. Students were randomised to a digital intervention or teaching as usual, for 7 weeks. Children completed measures of EF and parents/educators completed ratings of everyday EF and social/emotional wellbeing at pre-intervention, post-intervention, and 3-month follow-up. Change in EFs (primary outcome), everyday EF, and social/emotional wellbeing (secondary outcomes) from pre- to post-intervention and pre-intervention to 3-month follow-up were examined. Feasibility and acceptability of the intervention was assessed through educator feedback and intervention adherence.Protocol Registration: The stage 1 protocol for this Registered Report was accepted in principle on 20 April 2023. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/WT3S2. The approved Stage 1 protocol is available here: https://osf.io/kzfwn.

Validity of the MoCA as a cognitive screening tool in epilepsy: Are there implications for global care and research?

This study evaluated the diagnostic performance of a widely available cognitive screener, the Montreal cognitive assessment (MoCA), to detect cognitive impairment in older patients (age ≥ 55) with epilepsy residing in the US, using the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) as the gold standard. Fifty older adults with focal epilepsy completed the MoCA and neuropsychological measures of memory, language, executive function, and processing speed/attention. The IC-CoDE taxonomy divided participants into IC-CoDE Impaired and Intact groups. Sensitivity and specificity across several MoCA cutoffs were examined. Spearman correlations examined relationships between the MoCA total score and clinical and demographic variables and MoCA domain scores and individual neuropsychological tests. IC-CoDE impaired patients demonstrated significantly lower scores on the MoCA total, visuospatial/executive, naming, language, delayed recall, and orientation domain scores (Cohen's d range: 0.336-2.77). The recommended MoCA cutoff score < 26 had an overall accuracy of 72%, 88.2% sensitivity, and 63.6% specificity. A MoCA cutoff score < 24 yielded optimal sensitivity (70.6%) and specificity (78.8%), with overall accuracy of 76%. Higher MoCA total scores were associated with greater years of education (p = 0.016) and fewer antiseizure medications (p = 0.049). The MoCA memory domain was associated with several standardized measures of memory, MoCA language domain with category fluency, and MoCA abstraction domain with letter fluency. This study provides initial validation of the MoCA as a useful screening tool for older adults with epilepsy that can be used to identify patients who may benefit from comprehensive neuropsychological testing. Further, we demonstrate that a lower cutoff (i.e., <24) better captures cognitive impairment in older adults with epilepsy than the generally recommended cutoff and provides evidence for construct overlap between MoCA domains and standard neuropsychological tests. Critically, similar efforts in other regions of the world are needed. The Montreal cognitive assessment (MoCA) can be a helpful tool to screen for cognitive impairment in older adults with epilepsy. We recommend that adults 55 or older with epilepsy who score less than 24 on the MoCA are referred to a neuropsychologist for a comprehensive evaluation to assess any changes in cognitive abilities and mood.

Preschool Children’s Science Learning: Instructional Approaches and Individual Differences

ABSTRACT Research Findings: Early science skills predict later science achievement, and persistent achievement gaps in science appear as early as preschool. The current study compared the effectiveness of different instructional approaches for teaching preschoolers about sinking and floating and examined individual differences in learning. Typically developing 4–5-year-olds (N = 93; 47% female) were randomly assigned to an Explicit Instruction, Discovery Learning, or No-Instruction Control condition. A pre-posttest design was used to measure change in children’s knowledge of sinking and floating using an assessment created for the current study. Participants also completed measures of executive function and non-verbal and verbal IQ. Children in the Explicit Instruction condition learned more than children in the other two groups. Additionally, individual differences in age, socioeconomic status, IQ, and executive function predicted learning, although only age and SES were uniquely predictive when all variables were included in the model. Lastly, children’s sinking and floating pretest scores significantly interacted with instructional condition to predict learning. Among children in the Discovery Learning condition, those with more prior knowledge gained more after instruction than children with less prior knowledge. Practice or Policy: These findings highlight the importance of considering how learner characteristics might influence the effectiveness of different instructional approaches.