Verbal Comprehension Research Articles

Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio

Exposure to metal mixtures may lead to health impacts greater than the effects associated with singular exposures. Two common childhood environmental exposures, manganese (Mn) and lead (Pb), are associated with similar adverse neurodevelopmental effects; however, the effects surrounding concurrent exposure to both metals remain unclear. We study the impact of joint exposure to Mn and Pb on cognitive performance in school-aged children participating in the Communities Actively Researching Exposure Study (CARES) based in East Liverpool, Ohio. Blood Pb levels were measured for each child (geometric mean (GM) = 1.13 μg/dL, range 0.30 μg/dL – 6.64 μg/dL). Mn was measured in participant blood, hair, and toenails with GMs of 10.1 μg/L, 360 ng/g, 0.974 μg/g, respectively. Trained team members administered the Wechsler Intelligence Scale for Children-IV (WISC-IV) to assess intelligence quotient (IQ). The WISC-IV provides scores for Full Scale IQ, Perceptual Reasoning, Processing Speed, Working Memory, and Verbal Comprehension. Interactions between blood Pb and all Mn biomarkers were tested in linear models adjusted for child sex, household income, and serum cotinine. Separate regression models were run for each of the Mn biomarkers. The cohort was comprised of 106 children with a mean age of 8.4 years. Interactions between blood Pb and hair Mn were significant (p < 0.05) for four out of the five IQ domains. The effect of blood Pb on IQ was more pronounced at higher levels of hair and toenail Mn. No significant associations were observed when characterizing the main effect of Mn using blood. Uncovering the health impacts associated with exposure mixtures is critical to understanding the impact of real-life conditions. Our findings suggest that joint exposure to Mn and Pb may produce heightened neurocognitive impacts even at blood Pb levels below the CDC reference concentration of 5 μg/dL.

Thematic and Frequency Analyses of Caregivers’ Report on Communication-related Chief Complaints in Progressive Aphasia

Objectives: Progressive aphasia is a symptom that gradually appears and the caregivers are the ones who first notice the changes of patients’ communication abilities. Therefore, it is necessary to identify and analyze the chief complaints (CCs) reported by caregivers in order to better manage communication problems.Methods: First, communication-related CCs of 44 patients (men:women= 19:25, mean age= 70.5± 10.14) with progressive aphasia were extracted from the electronic medical records (EMRs), and thematic analysis was performed using the NVivo 1.0 program. Consequently, a 45-item interview questionnaire was developed based on the contents of the CCs. Second, a semi-structured interview using the questionnaire was conducted with 9 caregivers (men:women= 2:7, mean age= 56.5±12.82) of patients to verify the questionnaire, and additional thematic and frequency analyses of contents of the interview were performed.Results: Six main themes and 18 subthemes were extracted from the caregivers’ interview. The 6 main themes included ‘verbal expression’, ‘verbal comprehension’, ‘written expression’, ‘written comprehension’, ‘calculation’, and ‘speech’. As for the subthemes, ‘word’, ‘sentence’, ‘linguistic aspect’, ‘reading comprehension’, ‘money management’ and ‘articulation’ were the most frequently reported problems. In addition, the most severely perceived main themes of CCs were ‘verbal expression’, ‘verbal comprehension’, ‘written comprehension’ and ‘speech’.Conclusion: CCs contain crucial information regarding the current status of communication abilities of patients with progressive aphasia. The results of this study may provide information for clinicians and patients/caregivers to understand the nature of communication problems among patients and to direct future planning of the intervention program.

Relationship between Apgar scores and long-term cognitive outcomes in individuals with Down syndrome

This study examined the contribution of the Apgar score at 1 and 5 min after birth to later cognitive functioning in 168 individuals with Down syndrome who were between 6 and 25 years of age at time of cognitive testing. Our results showed that a lower Apgar score at 1 min was related to a worse performance in later cognitive measures of receptive vocabulary, verbal comprehension and production, visual memory and working memory. Results also showed that a lower Apgar score at 5 min was only related to worse later outcomes of verbal comprehension and production and auditory working memory. Our findings suggest a need for future studies investigating how specific perinatal events reflected in the Apgar score are linked to later cognitive functioning in individuals with Down syndrome.

Cognitive and White Matter Microstructure Development in Congenital Hypothyroidism and Familial Thyroid Disorders.

Children with congenital hypothyroidism (CH) are at risk for suboptimal neurodevelopment. To evaluate neurocognitive function and white matter microstructure in children with permanent or transient CH and to correlate these findings with disease severity. A retrospective and prospective observational study was conducted in 39 children with permanent or transient CH, and in 39 healthy children. Cognitive function was assessed by Wechsler Intelligence Scale, Fourth Edition, and by other tests; the white matter microstructure was investigated by 3 Tesla magnetic resonance imaging. Children with permanent CH have lower cognitive scores at a median age of 9.5 years than those with transient CH and controls. An IQ score between 71 and 84 was found in 28.6% of permanent CH and of <70 (P = 0.06) in 10.7%. The Processing Speed Index (PSI; P = 0.004), sustained visual attention (P = 0.02), reading speed (P = 0.0001), written calculations (P = 0.002), and numerical knowledge (P = 0.0001) were significantly lower than controls. Children born to mothers with Hashimoto's thyroiditis have significantly lower IQ values (P = 0.02), Working Memory Index (P = 0.03), and PSI (P = 0.02). Significantly lower IQ and Verbal Comprehension Index values were found in children with a family history of thyroid disorders (P = 0.004 and P = 0.009, respectively). In children with permanent CH, significant correlations between abnormalities in white matter microstructural, clinical, and cognitive measures were documented. These findings indicate that children with CH are at risk of neurocognitive impairment and white matter abnormalities despite timely and adequate treatment. The association between offspring cognitive vulnerability and maternal thyroid disorders requires careful consideration.

Cognitive profile of young children with Williams syndrome.

There is very little research on the cognitive profile of young children with Williams syndrome (WS). The present study utilised the Differential Ability Scales - Second Edition to examine the early cognitive abilities of 22 young children with WS (aged 3.98 to 7.70years, 10 male and 12 female participants). Overall, IQ ranged from 38 (severely impaired) to 81.00 (low average). Consistent with Mervis et al. who looked at an older sample, over half (59.08%) of our young WS sample showed a significant and abnormal weakness in spatial ability relative to verbal ability. Moreover, 81.82% showed a significant and clinically unusual weakness in spatial ability relative to nonverbal reasoning ability. At the subtest level, only 4.55% of our sample showed a significant strength in naming vocabulary compared with verbal comprehension, while 13.64% showed a significant weakness in naming vocabulary relative to verbal comprehension. The results of the present study show cognitive heterogeneity, consistent with the literature on older children and adults with WS. There were variable levels of intellect and variable patterns of cognitive strength and weakness across both index and subtest scores. Findings highlight the need for individual assessment and management of young children with WS but also indicate that for the majority of WS individuals spatial skills are indeed an area of significant and abnormal weakness and should be a focus for early intervention.

Long-term stability of the WISC-Ⅳ in children with autism spectrum disorder

ABSTRACT The present study aimed to investigate the test-retest reliability of the Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) in a sample of 138 children with autism spectrum disorder (ASD) from a child psychiatric clinic in Tokyo, Japan. The stability coefficient of the Full Scale Intelligence Quotient (FSIQ), which is composed of four indices, was very high at .83, while those of the Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI), and Processing Speed Index (PSI) individually were moderate to high, ranging from .62 to .79. Comparisons among three age groups revealed that the coefficients for children aged 5 to 7 years tended to be lower than those for children aged 11 years and older. With respect to relative strengths and weaknesses between index scores, approximately half of children did not exhibit the same trend in the second test. These results revealed that the FSIQ and index scores are stable in the long term in children with ASD aged 11 years and older, and that the PSI and discrepancies in index scores are less stable. Thus, practitioners should take into account ecological information and the test-taking behaviors of children when interpreting WISC-IV results for children with ASD. Abbreviations: ASD: autism spectrum disorder; WISC-IV: wechsler intelligence scale for children – fourth edition; FSIQ: full scale intelligence quotient; VCI: verbal comprehension index; PRI: perceptual reasoning index; WMI: working memory index; PSI: processing speed index

Differences in Neuropsychological Performance between Refugee and Non-Refugee Children in Palestine.

Neuropsychological studies on refugee children are scarce, but there are even less in the case of Palestinian children. This work aims to study the neuropsychological performance of Palestinian refugee children in Palestine compared to other Palestinian children living outside refugee camps. A comprehensive Neuropsychological battery was administrated to 584 Palestinian school children (464 refugees and 120 non-refugees) aged 6, 7, and 8 years old. Results showed that non-refugee children outperformed refugee children in sustained attention, verbal comprehension, verbal memory, and visual memory. This study is the first to have performed a comprehensive neuropsychological assessment, based on a standardized and validated battery with the Palestinian refugee children. It supports professionals in their evaluation of neurodevelopment and neuropsychological alterations in refugee and non-refugee children in Palestine.

Association of General Cognitive Functions with Gaming Use in Young Adults: A Comparison among Excessive Gamers, Regular Gamers and Non-Gamers.

This study aimed to examine the relationship of general cognitive function with gaming use, and to identify elements of intelligence predicting increased gaming use. In total, 160 young adults participated in this study. Two clinical groups (n = 97) were defined: excessive gaming users diagnosed with internet gaming disorder (IGD) (n = 64) and the high-risk users (n = 33). The control group (n = 63) was also divided into regular gamers (n = 14) and non-gamers (n = 49). Participants completed the Wechsler Adult Intelligence Scale-IV and self-reported questionnaires regarding IGD severity and gaming hours. The IGD group had significantly lower Full Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), and Processing Speed Index (PSI) scores, compared with regular gamers and non-gamers. The IGD group also exhibited lower Working Memory Index (WMI) scores, compared with non-gamers. The high-risk group demonstrated significantly lower PSI score, compared with non-gamers. Furthermore FSIQ, VCI, WMI, and PSI scores were significant predictors of gaming hours in the IGD group. For the high-risk group, FSIQ, WMI, and VCI scores were negatively associated with gaming hours. Our study demonstrates the need to address the importance of enhancing working memory and verbal ability, thus, preventing the development of gaming addiction among individuals at high-risk gamers.

DNA methylation at GRIN2B partially mediates the association between prenatal bisphenol F exposure and cognitive functions in 7-year-old children in the SELMA study.

Accumulating evidence suggests that prenatal chemical exposure triggers epigenetic modifications that could influence health outcomes later in life. In this study, we investigated whether DNA methylation (DNAm) levels at the glutamate ionotropic receptor NMDA type subunit 2B (GRIN2B) gene underlies the association between prenatal exposure to an endocrine disrupting chemical (EDC), bisphenol F (BPF), and lower cognitive functions in 7-year-old children. Data from 799 children participating in the Swedish Environmental Longitudinal Mother and child Asthma and allergy (SELMA) pregnancy cohort was analyzed. Prenatal BPF exposure was assessed by measuring BPF levels in maternal urine. At age 7, DNAm of three CpG sites in a regulatory region of the GRIN2B gene was analyzed from buccal swabs using bisulfite-Pyrosequencing. Cognitive functions, including full-scale IQ and four subscales, were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV). Associations between prenatal BPF exposure and GRIN2B DNAm, as well as between GRIN2B DNAm and cognitive functions, were determined using regression models adjusted for potential confounders. Generalized structural equation models (gSEM) were used to evaluate if GRIN2B DNAm mediates the association between prenatal BPF exposure and cognitive functions at 7years of age. Prenatal BPF exposure was positively associated with GRIN2B DNAm levels at the third CpG site (CpG3), while CpG3 methylation was inversely associated with cognitive test scores. Mediation analyses showed that CpG3 methylation exerted 6-9% of the association between BPF exposure and full-scale IQ, as well as verbal comprehension and perceptual reasoning in boys, while not significant in girls. This study is the first to identify locus-specific DNAm as a mediating factor underlying an epidemiological association between prenatal EDC exposure and cognitive functions in childhood. It also confirms previous findings, that GRIN2B DNAm is responsive to environmental exposures.

ADHD Symptomatology, Executive Function and Cognitive Performance Differences between Family Foster Care and Control Group in ADHD-Diagnosed Children.

Children in foster care have a high prevalence of attention deficit and hyperactivity disorder (ADHD) diagnosis, together with other difficulties in inattentive/hyperactive behaviors, executive and cognitive processes. Early exposure to adversity is a risk factor for developing ADHD via neurodevelopmental pathways. The goal of this research is (a) to study the cognitive and executive performance and inattentive/hyperactive behavior of ADHD-diagnosed children living in foster families in Spain, and (b) to analyze the role of placement variables in their performance. The sample was composed of 102 ADHD-diagnosed children aged 6- to 12-years-old, divided into two groups: 59 children living with non-relative foster families and 43 children not involved with protection services. Children’s executive function–inhibition, working memory, flexibility, attention, intellectual capacity, verbal comprehension, perceptive reasoning, working memory and processing speed were assessed using objective testing measures. At the same time, parents and teachers reported on children’s inattentive, hyperactive and impulsive behaviors. Children in foster care obtained lower scores in the general ability index than the control group after controlling the age at assessment. However, no differences were found in executive processes. Regarding placement factors, children with shorter exposure to adversities in their birth families and more time in foster care showed better executive performance. Professionals should consider the placement history of children in foster care and its influence on their symptomatology and cognitive capacities.

Theory of Mind Ability and Socioeconomic Status, a Study of Street-Connected Children and Adolescents in Ecuador

Family socioeconomic status (SES) is closely associated with cognitive ability in children and adolescents. However, most of the research has come from high-income countries. There is only limited research on ‘street children’, who represent an aspect of low-SES particularly associated with low- and middle-income counties. The current research in Quito, Ecuador, compared a group of street-connected youth with a not street-connected control group on two different measures of theory of mind ability and verbal comprehension. Initial analysis revealed that the street-connected sample scored significantly below the level of the control sample for verbal comprehension. For the main analysis, street-connected youth were matched to control participants for age, sex, and verbal comprehension scores. The street-connected sample was found to perform significantly below the control sample on both measures of theory of mind. Furthermore, worse performance appeared to be linked to severity of symptoms of post-traumatic stress disorder (PTSD) within the street-connected sample. In conclusion, the association of relatively poor verbal comprehension with street-connectedness is consistent with existing research from high-income countries on SES gradients and cognitive development. In contrast, theory of mind ability, a core aspect of social cognition, may be particularly linked to the street-connectedness form of low SES that exists in many low- and middle-income countries.

Expanded Exploration of the Auditory Naming Test in Patients with Dementia.

Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions. To delineate characteristics of auditory naming most likely to reveal anomia in patients with dementia, and possibly improve diagnostic utility, we evaluated a large sample of patients referred with memory impairment complaints. Patients with dementia (N = 733) or other cognitive impairments and normal individuals (N = 69) were evaluated for frequency of impairment on variables of the Auditory Naming Test (ANT) of Hamberger & Seidel versus the Boston Naming Test (BNT). Naming impairment occurred more frequently using the ANT total score (φ= 0.41) or ANT tip-of-the tongue score (TOT; φ= 0.19) but not ANT mean response time compared to the BNT in patients with dementia (p < 0.001). Significantly more patients were impaired on ANT variables than on the BNT in Alzheimer's disease (AD), vascular dementia (VaD), mixed AD/VaD, and multiple domain mild cognitive impairment (mMCI) but not in other dementias or amnestic MCI (aMCI). This differential performance of patients on auditory versus visual naming tasks was most pronounced in older, well-educated, male patients with the least cognitive impairment. Impaired verbal comprehension was not contributory. Inclusion of an ANT index score increased sensitivity in the dementia sample (92%). Poor specificity (41%) may be secondary to the inherent limitation of using the BNT as a control variable. The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.

Reciprocal burden: Adults with drug-resistant epilepsy reflect upon informal caregiver support

PurposeTo explore how a sample of people with uncontrolled seizures describe their experiences of receiving informal supportive care. MethodsUsing constructivist grounded theory, in-person, semi-structured interviews were conducted in 35 adults with drug-resistant epilepsy. These 20 (57%) women and 15 (43%) men were aged 18–68 years (mean= 35.6 years), with a range of verbal comprehension scores. The majority, 28 (80%) lived in nuclear family settings. ResultsUnpredictable seizures disrupted personal autonomy and generated unique challenges for everyday life. While supportive care was deemed necessary to survival, subjective reflections around the implications of care-receiving and caregiving, were ultimately experienced as mutually burdensome. Four dynamic and interactive dimensions revealed a mirrored, interactive perspective of what it meant to be a care-recipient: assuming responsibility; protecting and supervising; acknowledging reliance and setting boundaries. Care-recipience was not one-sided, but included actively hiding personal struggles as a way to shield the caregiver from the emotional and physical demands of caregiving. Relationship dynamics between caregivers and care-recipients played a major role in treatment decision-making. A clinically useful Theory of Reciprocal Burden resulted from our study. ConclusionsThis study adds an explanatory dimension to the concept of illness burden from the perspective of care-recipients. Relationship dynamics play a key role in patient-centered epilepsy care, with clinical implications for guiding supportive caregiving, fostering independence and promoting self-management strategies.

Aberrant cortico-thalamic structural connectivity in premature-born adults

Premature birth is associated with alterations in brain structure, particularly in white matter. Among white matter, alterations in cortico-thalamic connections are present in premature-born infants, and they have been suggested both to last until adulthood and to contribute to impaired cognitive functions. To test these hypotheses, 70 very premature-born adults and 67 full-term controls underwent cognitive testing and diffusion-weighted imaging. Each cortical hemisphere was parcellated into six lobes, from which probabilistic tractography was performed to the thalamus. Connection probability was chosen as metric of structural connectivity. We found increased cortico-thalamic connection probability between left prefrontal cortices and left medio-dorsal thalamus and reduced connection probability between bilateral temporal cortices and bilateral anterior thalami in very premature-born adults. Aberrant prefronto- and temporo-thalamic connection probabilities were correlated with birth weight and days on ventilation, respectively, supporting the suggestion that these connectivity changes relate with the degree of prematurity. Moreover, an increase in left prefronto-thalamic connection probability also correlated with lower verbal comprehension index indicating its relevance for verbal cognition. Together, our results demonstrate that cortico-thalamic structural connectivity is aberrant in premature-born adults, with these changes being linked with impairments in verbal cognitive abilities. Due to corresponding findings in infants, data suggest aberrant development of cortico-thalamic connectivity after premature birth with lasting effects into adulthood.

Psychometric Properties of WISC-IV Verbal Scales: A Study of Students in China Who Are Blind

Introduction: Numerous studies have investigated the use of Wechsler tests on individuals with visual impairments. However, few studies have examined the utilization of the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) for such individuals. This study investigated the reliability and validity of the WISC-IV Verbal Scales’ (i.e., the Verbal Comprehension Index [VCI] and the Working Memory Index [WMI]) scores for children with blindness in China. Methods: One hundred children with blindness were assessed using the Chinese version of the WISC-IV Verbal and Nonverbal Cognitive Development Scales. Results: The results of this study generally support the internal consistency reliability and validity of WISC-IV Verbal Scale scores for Chinese children who are blind. The split-half reliability coefficients ranged from .79 to .97, while Cronbach’s alpha or KR-20 (KR-20 is a measure of internal consistency reliability for measures with dichotomous choices) reliability coefficients ranged from .83 to .97. In terms of construct validity through exploratory factor analysis, the subtests of the WISC-IV Verbal Scale were confirmed to belong to VCI or the WMI as intended by the original structure of the WISC-IV. The convergent validity showed that the VCI and WMI scores were moderately and positively correlated with the Nonverbal Cognitive Development Scale. Discussion: The WISC-IV VCI and WMI were found to be valuable instruments for assessing the cognitive abilities of students in China with blindness. Finally, the limitations and significance of the study were also discussed. Implications for practitioners: The WISC-IV Verbal Scales may be used to assess the cognitive abilities of the numerous students in China who are blind and may be used as one of many tests to provide reference information for educational placement, educational planning, employment, and project evaluation.

Preconception micronutrient supplementation positively affects child intellectual functioning at 6 y of age: A randomized controlled trial in Vietnam

ABSTRACTBackgroundAlthough there is growing evidence on the role of preconception nutrition for birth outcomes, very few studies have evaluated the long-term effects of nutrition interventions during the preconception period on offspring cognitive outcomes.ObjectiveWe evaluate the impact of preconception weekly multiple micronutrients (MMs) or iron and folic acid (IFA) supplementation compared with folic acid (FA) alone on offspring intellectual functioning at age 6–7 y.MethodsWe followed 1599 offspring born to women who participated in a double-blinded randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements containing either 2800 μg FA only, 60 mg iron and 2800 μg FA, or MMs (15 micronutrients including IFA) from baseline until conception, followed by daily prenatal IFA supplements until delivery. We used the Wechsler Intelligence Scale for Children to measure full-scale IQ (FSIQ) and 4 related domains of intellectual functioning [Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI), and Processing Speed Index (PSI) scores] at 6–7 y. Group comparisons were done using ANOVA tests for all children and the subgroup born to women who consumed the supplements ≥26 wk before conception (per-protocol analyses).ResultsThe final sample with data at 6–7 y (n = 1321) was similar for baseline maternal and offspring birth characteristics and age at follow-up by treatment group. Compared with the offspring in the FA group, those in the MM group had higher FSIQ (β = 1.7; 95% CI: 0.1, 3.3), WMI (β = 1.7; 95% CI: 0.2, 3.2), and PSI (β = 2.5; 95% CI: 0.9, 4.1). Similar findings were observed in the per-protocol analyses. There were no significant differences by treatment group for VCI and PRI.ConclusionsPreconception supplementation with MMs improved certain domains of intellectual functioning at age 6–7 y compared with FA. These findings suggest the potential for preconception micronutrient interventions to have long-term benefits for offspring cognition.

Assessment of inference-making in children using comprehension questions and story retelling: Effect of text modality and a story presentation format.

Reading and listening comprehension are essential for accessing the school curriculum. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) and integrating information with background knowledge (global coherence). We require appropriate methods to assess comprehension and inference-making in order to identify areas of difficulty and provide appropriate support. Typically developing children's ability to generate local and global coherence inferences was assessed. The effect of text modality (reading and listening comprehension) and presentation format (stories presented in segmented and whole story format) was explored using two comprehension measures (question answering and story retell). The main aims were to determine whether there were advantages for reading or listening comprehension and for segmented or whole text presentation. Typically developing children in Year 3 (n = 33) and Year 5 (n = 40) either read or listened to short stories. Their ability to generate global and local coherence inferences was assessed in two ways: answers to inference-tapping questions and story retelling (scored for inclusion of necessary inferences). Stories were presented in either a whole format (all questions after the story) or a segmented format (questions asked at specific points during story presentation); the retelling was always after the complete story and questions had been presented. For both comprehension measures, there was developmental progression between age groups and a benefit for the reading modality. Scores were higher for global coherence than local coherence inferences, but the effect was significant only for the question-answering responses, not retells. For retells there was a benefit in presenting the text as a whole compared with the segmented format, but this effect was not present for the comprehension questions. There was a significant interaction between inference type and modality for both comprehension measures (question answering and story retell): for the local coherence inferences scores were significantly greater in the reading compared with the listening modality, but performance on the global coherence inferences did not differ significantly between modalities. Clinicians, teachers and other professionals should consider the modality and presentation format for comprehension tasks to utilize areas of strength and support areas of difficulty. Oral presentation may result in poorer comprehension relative to written presentation in general, and may particularly affect local integrative processing. These findings have important implications for the development of appropriate assessments as well as for supporting children with comprehension difficulties. What this paper adds What is already known on the subject Reading and listening comprehension are critical for accessing the school curriculum and educational success. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) as well as integrating information with background knowledge (global coherence). Children have an awareness of the need to generate coherence inferences, but not all children will generate sufficient coherence inferences for adequate comprehension during text presentation. Existing assessment tools measure comprehension by asking questions after story presentation. This provides an overall indication of comprehension or inference-making ability and can identify children with comprehension or language and communication difficulties. What this paper adds to existing knowledge The study compared coherence inference-making in two presentation conditions: whole format (all questions after the story) or segmented format (questions asked at specific points during story presentation). Children (aged 7-10 years) were assessed in the reading or listening modality. Two comprehension measures were used (inference-tapping questions and story retell). There was developmental progression and a benefit for the reading modality for both comprehension measures. Scores were higher for global coherence than local coherence inferences for the comprehension questions. There was a benefit in presenting the text as a whole compared with the segmented format for story retells. What are the potential or actual clinical implications of this work? The results are important for clinicians and other professionals assessing and supporting comprehension skills. The results suggest that the modality and presentation format of comprehension tasks should be considered to utilize areas of strength and support areas of difficulty. The optimum form of input and structure may depend on a child's individual profile and the skill being assessed or supported. Targeted questions may identify a child's potential to generate an inference. This may assist identification of children who may require more targeted or specialist intervention. The reading modality may provide a means of support for development of verbal comprehension.

What does the Detroit tests of learning abilities, fifth edition measure? Revelations from a hierarchical exploratory factor analysis

AbstractThis study examined the factor structure of the Detroit Tests of Learning Abilities, Fifth Edition (DTLA‐5) using principal axis factoring, multiple factor extraction criteria, and the Schmid–Leiman orthogonalization procedures not utilized by test publishers. Results suggest that the publisher's six‐factor structure model was over factored. Although there is support for five group factors and a hierarchical general factor that correspond with some of the test's most reliable composites, there was no evidence warranting a distinction between the test's hypothesized Reasoning Abilities and Processing Abilities domains or separation of Acquired Knowledge and Verbal Comprehension subdomains. Some test users may prefer to interpret the four DTLA‐5 subdomains that correspond to some of our basic findings in a profile indicating intra‐individual strengths and weaknesses. Based on our hierarchical factor analysis and omega statistics, we believe that the DTLA‐5 should be interpreted as a measure of psychometric g and not used to examine intra‐individual strengths and weaknesses for most test‐takers.

WAIS-IV short form applied to a mixed neurological Swedish clinical sample

The Wechsler Adult Intelligence Scale, fourth version (WAIS-IV), is a frequently used instrument for neuropsychological assessment. The aim was to assess the degree of conformity between the Scandinavian adaptation of the WAIS-IV and a short form of this scale (SF) in a mixed sample of neurological diagnoses. The SF comprised Block Design, Similarities, Digit Span, Arithmetic, Information, Digit Symbol (in the WAIS-IV named Coding), and Picture Completion, the latter here replaced by Matrix Reasoning. The sample consisted of 150 patients and included multiple sclerosis (n = 27), brain tumor (n = 15), traumatic brain injury (n = 60) and vascular brain damage (n = 48). There was a lack of congruence between the WAIS-IV and the SF in the entire sample, revealing selectively significantly higher scores for the SF on Full Scale IQ (FSIQ) and Processing Speed Index (PSI). On a diagnostic group level, the discrepancies were as follows: in the traumatic brain injury group on FSIQ, Verbal Comprehension Index (VCI) and PSI, in the vascular damage group the FSIQ was significantly higher on SF compared to the WAIS-IV. Since the results revealed several mismatches between the SF and the WAIS-IV, except for the MS and traumatic brain tumor group, there is a lack of interchangeability between these two sets of tests. Thus, generally the SF cannot be recommended as a substitute for the WAIS-IV in this type of mixed Swedish neurological sample. The small sample sizes make the generalizability of this study limited.

Long-term cognitive outcome after radiosurgery in epileptic hypothalamic hamartomas and review of the literature.

Epileptic patients with hypothalamic hamartoma (HH) frequently present cognitive impairments. Surgical techniques aiming at HH can be very efficient for epilepsy relief and cognitive improvement but are also demonstrated to carry a significant risk of additional reduction in memory function in these already disabled patients. Gamma knife radiosurgery (GKS) offers an efficient minimally invasive procedure. We evaluated the effect of stereotactic radiosurgery on cognitive outcome. We designed a prospective single-center case series study. Thirty-nine epileptic patients (median age = 17 years, range = 4-50) with HH underwent preoperative and postoperative testing of intelligence quotient (IQ; all patients), including a working memory component, and other memory function testing (for patients≥16years old). All patients were prospectively evaluated and underwent complete presurgical and postsurgical clinical, electrophysiological, endocrinal, and visual assessments. In all patients, the postoperative assessment was performed at least 3years after radiosurgery. We explored what variables correlate with cognitive outcome. Literature review was done for other surgical techniques and their risks for cognitive complications after surgery. No decline was observed in intellectual ability (including working memory) after GKS, and no memory decline was seen in adults. We observed significant improvement (>1 SD in z-score) in working memory index (46%) and processing speed index (35%), as well as improvement in full-scale IQ (24%), verbal comprehension index (11%), perceptual organization index (21%), verbal learning (20%), and visual learning (33%). Before GKS, the probability of seizure cessation was higher in patients with higher cognitive performance. After GKS, the cognitive improvement was significantly higher in the seizure-free patients compared to the non-seizure-free patients. We found clear cognitive improvement in a high percentage of patients but importantly no significant decline in intellectual ability (including working memory) and no decline in memory in adult patients 3 years after GKS. GKS compares favorably to the other surgical techniques in terms of cognitive outcome, with similar seizure freedom.