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Background: Endovascular clot retrieval (ECR) is known to reduce global disability at 3 months post stroke however limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits between onset and 3 months. Aims: To assess language, swallowing, and cognitive performance following ECR and explore whether impairment severity is correlated with modified Thrombolysis in Cerebral Infarction score (mTICI), stroke severity or quality of life (QoL). Methods: Assessment was completed within 7 days (T1), 1 month (T2) and 3 months (T3) post-stroke. Performance was measured with the Functional Oral Intake Scale (FOIS), Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT A and B) and Brixton Spatial Awareness Test. The Western Aphasia Battery (WAB) was used for left hemisphere stroke. QoL was measured with the Stroke and Aphasia Quality of Life Scale. Results: Twenty-five participants (median 72 years; 64% male) were prospectively recruited following ECR. High reperfusion success (68% mTICI 3) and low stroke severity post ECR (median 24 h NIHSS = 3, IQR 7-18) were noted. At T1, 10 participants presented with aphasia, eight required a modified diet and 20 had impaired cognition. At T3 all had recovered to a normal oral diet, 39% had persistent cognitive impairment and 45% of patients with left hemisphere stroke remained aphasic. Performance on the WAB, FOIS, RBANS and TMT changed significantly over time (all p < 0.05). The severity score at T1 for all measures, excluding TMT B and Brixton, was significantly correlated with 24 h NIHSS. WAB scores at T3 were correlated with QoL (r = 0.618; p = 0.043). Conclusion: This exploratory study found the longitudinal performance of language, swallowing and cognition significantly improved over time and severity in the first-week post-ECR was correlated with 24 h NIHSS rather than the degree of reperfusion.

The financial exploitation (FE) of older adults affects not only victims' finances, but also their health. This preliminary study investigated the impacts of a financial coaching program on the financial, neurocognitive, physical, and emotional health of older adult victims of FE. Twenty older adults residing in a large urban area who had experienced FE were compared at baseline and follow-up with a group of 20 older adult of the same area who were making important financial decisions, but had not experienced FE and did not receive the intervention. At baseline, both groups were similar on demographic variables, but participants who had experienced FE had more health problems, poorer memory and executive functioning, less social support, and greater stress than the comparison group. Six months after financial coaching ended, program participants had significantly less anxiety. Overall, older adult victims of FE showed no significant declines and, in fact, showed some improvement.

The study's goals were: (a) to examine the influence of postsecondary education (PSE) in the form of academic enrichment courses on the cognitive performance of adults with intellectual disability (ID); (b) to examine their attitudes toward the program. The sample included adults who participate in PSE (N = 21; CA = 26-59) and a control group of adults who participate in leisure activities, but not in PSE (N = 28; CA = 25.5-59). The Participation in Cognitively-stimulating Activities Questionnaire (Lifshitz-Vahav et al., 2016) was used. The participants rated their participation in cognitively-stimulating activities during the week. These were grouped into five main activities: table games, watching TV, reading, using technological devices, participating in PSE. A crystallized and fluid tests battery was administered. Semi-structured interviews were conducted to examine the participants' feelings toward the PSE program. Mixed regression with chronological age, etiology, and participation in the five main activities as independent variables indicated that participation in PSE contributed to semantic fluency, homophones and Raven matrices scores. Path analysis suggested that the five main activities predict performance on the crystallized and fluid tests. The opposite model was insufficient. The findings support the compensation age theory and the cognitive activity theory for populations with ID. Theories of motivation (Maslow, 2012; Ryan & Deci, 2020) can serve as explanations for the participants' attitudes toward the program.

Objectives: Health education may improve health in geriatric patients. To evaluate differences between remote and in-person education, the DREAMS ("'D'eveloping a 'R'esearch Participation 'E'nhancement and 'A'dvocacy Training Progra'm' for Diverse 'S'eniors") health seminar series compared in-person and remote learning groups to assess feasibility, satisfaction, adherence, health literacy, and cognitive outcomes. Research Design: Nonrandomized two-arm interventions occurred remotely or in-person. About 130 diverse, older adults (M age: 70.8 ± 9.2 years; in-person n = 95; remote, n = 35) enrolled. Data from 115 completers (In-person n = 80; Remote n = 35) were analyzed for performance outcomes. Feasibility, adherence, and satisfaction benchmarks were evaluated at baseline, immediately post intervention, and 8 weeks post intervention. Adjusting for baseline performances, outcomes on health literacy and cognitive measures were compared between groups after intervention (at posttest and at 8-week follow-up) using adjusted mean differences ([beta] coefficients). Results: Eighty in-person and all remote participants completed at least six modules. Both programs had high satisfaction, feasibility, and strong adherence. After adjusting for demographic covariates and baseline values, cognitive and motor cognitive measures between groups were domain specific (e.g., global cognition, executive function, spatial memory, mental tracking capacity, and cognitive integration). Discussion and Implications: This work explores feasible measures of knowledge acquisition and its link to health literacy and cognitive outcomes. Identifying effective delivery methods may increase involvement in clinical research. Future studies may encourage remote learning for increased accessibility.

Background: The relation between physical activity (PA), motor skills and cognitive function in children is receiving considerable attention. To transition scientific evidence into pedagogical practice, however, we need to further our understanding of which qualitative PA characteristics are best suited to stimulate motor skills and executive functions (EFs) relevant for children to develop their full potential. Purpose: The purpose of this pilot study was to evaluate the effects of cognitively enriched PA on the development of motor skills and core EFs at preschool age, which is still less investigated than middle childhood in exercise and cognition research. Specific objectives were to also provide detailed information on the intervention for replicability and effect sizes for sample size computation for future well-powered studies. Participants and setting: A sample of 36 children (19 girls; 17 boys) aged 3-6 years was divided in two intervention groups allocated to afterschool PA enriched with cognitive challenges or swimming (45-minute sessions twice a week for 12 weeks) and one control group that did not practise any afterschool PA. Methods: Before and after the intervention period, children were assessed for gross and fine motor skills with the Peabody Developmental Motor Scales, 2nd edition (PDMS-2) and for core EFs (working memory, inhibition and cognitive flexibility) with the Forward Word Span Test and Trail Making Test for young children. Intervention effects were explored with two-way Repeated Measures MANOVAs (Group × Time), followed by similar ANOVAs for each dependent variable, planned pairwise comparisons for post-hoc simple effects. Results: Only children assigned to the enriched PA intervention showed significant improvements in "gross" motor skills (p = 0.001, [partial eta-squared] = 0.35) and working memory (p < 0.001, [partial eta-squared] = 0.53) with higher performances at post-test as compared to children assigned to swimming, who showed a marginally significant, less pronounced gross motor improvement, or to the control group, which did not show any improvement. Both intervention groups also showed significant and similar improvements in "fine" motor skills (p = 0.011, [partial eta-squared] = 0.24) but no between-group differences at post-test, as they caught up, reaching the level of the control group at post-test. Conclusions: The results suggest that cognitive enrichment in PA is a viable way to 'fill two needs with one deed' as early as preschool age. The 'two needs' are motor and cognitive development promotion, while the 'one deed' is designed PA that joins physical and cognitive challenges. The results are discussed in the framework of pedagogical approaches to motor and cognitive development promotion through early quality PA experiences and limitations of this pilot study are presented to orient future research.

Acting upon target stimuli from the environment becomes faster when the targets are preceded by a warning (alerting) cue. Accordingly, alerting is often used to support action in safety-critical contexts (e.g., honking to alert others of a traffic situation). Crucially, however, the benefits of alerting for action have been established using laboratory tasks assessing only simple choice reactions. Real-world actions are considerably more complex and mainly consist of sensorimotor sequences of several sub-actions. Therefore, it is still unknown if the benefits of alerting for action transfer from simple choice reactions to such sensorimotor sequences. Here, we investigated how alerting affected performance in a sequential action task derived from the Trail-Making-Test, a well-established neuropsychological test of cognitive action control (Experiment 1). In addition to this task, participants performed a classic alerting paradigm including a simple choice reaction task (Experiment 2). Results showed that alerting sped up responding in both tasks, but in the sequential action task, this benefit was restricted to the first action of a sequence. This was the case, even when multiple actions were performed within a short time (Experiment 3), ruling out that the restriction of alerting to the first action was due to its short-lived nature. Taken together, these findings reveal the existence of an interface between phasic alertness and action control that supports the next action.

Objective: The objective of this study was to identify factors associated with the occurrence and severity of depressive mood states among graduate-level allied health students. Participants: Students (N = 77) completed this study. Methods: Participants completed a series of self-reported surveys measuring moods, lifestyle behaviors, trait mental and physical energy and fatigue, and objective assessments of Trail-Making Test Part-B, and muscle oxygen consumption. Multiple backwards linear regression models were fitted to identify factors associated with depressive mood states. Results: When accounting for all subjects, increased severity of depressive mood states was associated with worse sleep quality (SQ), increased sitting time (ST), and trait physical fatigue (TPF). When examining subjects reporting depressive mood states, increased severity of depressive mood states was associated with worse SQ, increased ST, decreased mental workload on non-school days, and trait physical energy (TPE). Conclusion: Adjustments in lifestyle factors such as sleep, mental workload, and ST, may ameliorate depressive mood states.

This study investigated the utility of four WAIS-IV Digit Span (DS) indices (traditional Reliable Digit Span [RDS], RDS-Working Memory [RDS-WM], RDS-Revised [RDS-R], and DS Age-Corrected Scaled Score [ACSS]) as embedded performance validity tests (PVTs) among a sample of 342 consecutive adults referred for neuropsychological evaluation of ADHD. All DS indices had acceptable classification accuracy (areas under the curve: 0.73-0.76) for detecting invalid performance with optimal cut-scores of RDS [less than or equal to]7 (35% sensitivity/93% specificity), RDS-WM [less than or equal to]7 (56% sensitivity/86% specificity), RDS-R [less than or equal to]12 (48% sensitivity/85% specificity), and ACSS [less than or equal to]7 (46% sensitivity/87% specificity). Although all indices were able to detect invalid performance, DS indices incorporating the more complex working memory trials of the task yielded the best accuracy for identification of invalid test performance among adults referred for ADHD evaluation.

Objective: Theory suggests that impaired executive functioning (EF) might explain several symptoms of autism spectrum disorder (ASD) in children. However, only a few studies have examined the efficacy of EF training for the children using randomized control trial designs, and only two of them found significant benefits of the training. Method: We designed Comprehensive Attention Training System (CATS), and tested this new EF intervention for children with ASD in a small-sampled randomized controlled trial. Twenty-five children with ASD aged six to twelve were randomly assigned to either the CATS or the control training and were assessed pre- and post-training. Results: Relative to the control group, the CATS group improved on EF as measured by the trail-making test, avoiding perseverative errors, and forming conceptual responses in the Wisconsin Card Sorting Task. There were also indications that CATS contributed to long-term communication skills as measured by the Vineland adaptive behavior scales. Conclusions: We report preliminary evidence that the CATS intervention may improve the EF of school-aged children with ASD compared to a control intervention. We discuss the results in terms of their generalizability to other developmental disorders.

Previous research has shown that cognitive development is sensitive to socio-economic status (SES) and multilinguistic experiences. However, these effects are difficult to disentangle and SES may modulate the effects of multilingualism. The present study used data from a large cohort of pupils who took part in the Study of Cognition, Adolescents and Mobile Phones (SCAMP) at ages 11-12 (T1) and 13-15 years old (T2). Cognitive measures were derived from tasks of cognitive flexibility, verbal, spatial and visuo-spatial working memory, speech processing and non-verbal reasoning. Using SES information collected through questionnaires (school type, level of deprivation, parental education and occupation), the sample was clustered into high/medium/low SES groups. Comparisons focused on 517 monolingual and 329 multilingual pupils in the high/low SES groups. Having controlled for multiple comparisons, the results indicated a significant beneficial effect of bilingualism in measures of working memory, visuo-spatial processing and non-verbal reasoning. These effects were present in both high and low SES individuals and sustained at both times of development, with a particularly significant improvement of working memory abilities in low SES bilinguals at T2 as compared to monolingual peers. Theoretical and practical implications of these findings are considered and guidance for educators is discussed.

Purpose: The three variants of primary progressive aphasia (PPA) differ in clinical presentation, underlying brain pathology, and clinical course, which stresses the need for early differentiation. However, brief cognitive tests that validly distinguish between all PPA variants are lacking. The Sydney Language Battery (SYDBAT) is a promising screening instrument that can be used as a first step in a comprehensive neuropsychological assessment to distinguish PPA subtypes, but evidence on its validity and reliability is to date limited. In the current study, the validation and diagnostic value of the SYDBAT are described for discriminating PPA subtypes as well as distinguishing PPA from mild cognitive impairment (MCI) or Alzheimer's dementia (AD). Method: Forty-five patients with PPA (13 with semantic PPA, 20 with logopenic PPA, and 12 with nonfluent/agrammatic PPA), 25 MCI patients, 13 AD patients, and 50 cognitively unimpaired controls were included in this study. Both patients and controls completed the SYDBAT-NL (Dutch version). Performance on and predictive ability of the four subtests (i.e., Naming, Word Comprehension, Repetition, and Semantic Association) were assessed. In addition, construct validity and internal consistency were examined. Results: Different SYDBAT performance patterns were found across PPA and non-PPA patient groups. While a discriminant function analysis based on SYDBAT subtest scores could predict PPA subtype with 78% accuracy, it was more difficult to disentangle PPA from non-PPA patients based on SYDBAT scores alone. For assisting in clinical interpretation, simple rules were set up and translated into a diagnostic decision tree for subtyping PPA, which was capable of diagnosing a large proportion of the cases. Satisfying validity and reliability measures were found. Conclusions: The SYDBAT is an easy-to-use and promising screen for assessing single-word language processes, which may contribute to the differential diagnostic process of PPA and the assessment of language impairment in MCI and AD. It can be easily implemented for initial screening of patients in a memory clinic.

Self-derivation of new factual knowledge through integration of separate episodes of learning is one means by which children build knowledge. Content generated in this manner becomes incorporated into the knowledge base and is retained over time; successful self-derivation predicts academic achievement. Yet the component processes on which self-derivation through integration depends are as yet unknown. In parallel studies with 6- and 8-year-olds (N = 41; Experiment 1) and 8- and 10-year-olds (N = 40; Experiment 2), we tested a number of predictors related to other productive processes and learning (reasoning, executive functions, verbal comprehension, and long-term retrieval). Across studies, with different methods, only verbal comprehension, a measure of accumulated semantic knowledge, accounted for unique variance in self-derivation through integration performance. The results indicate that self-derivation through integration of separate episodes relates to accumulation of knowledge and the ability to recruit the knowledge in the service of specific task demands. Implications for cognitive training and transfer are discussed.

This study examines the extent to which iron deficiency in infancy contributes to adverse neurocognitive and educational outcomes in young adulthood directly and indirectly, through its influence on verbal cognition and attention problems in childhood. Young adults (N = 1,000, M age = 21.3 years, 52% female; of Spanish or indigenous descent) from working-class families in Santiago, Chile, completed instruments assessing memory, processing speed, mental flexibility, and educational attainment. Iron status was assessed at ages 6, 12, and 18 months, and verbal intelligence, inattention, and sluggish cognitive tempo (SCT) symptoms were assessed at age 10. Results indicated that young adults who had iron-deficiency in infancy had poor executive control at age 21. Severity of iron deficiency during infancy was associated with lower verbal IQ and more frequent inattention and SCT symptoms in childhood, and with lower educational attainment in young adulthood through its effect on inattention. No additional indirect effects were found. Interventions directed toward improving cognitive and attention deficits linked to early-life iron deficiency appear warranted and could alter the course to adult functioning. Further research on the impact of such interventions would be helpful.

Objective: Determine feasibility of a procedure to identify relationships between preexisting traits and immediate mindfulness meditation (MM) responses in novice college students. Participants: Twenty-four novice college students participated between September 2016 and April 2017. Methods: We measured trait mindfulness, attention and executive function performance, and immediate MM-related changes in self-reported state mindfulness and state anxiety following a 13-min MM. Results: The procedure appeared to be feasible and acceptable to college students. Preliminary findings included increases in state mindfulness and decreases in state anxiety, which appeared to vary by level of trait mindfulness. Better attention performance correlated with greater increases in state mindfulness of body. Conclusion: This pilot study demonstrated feasibility of investigating the relationship between baseline traits and college students' immediate MM responses. Using these methods, future studies can provide a unique examination of MM effects stratified by validated facets of state mindfulness of body and mind.

The present study had two aims. First, we set out to evaluate the structure of processing speed in children by comparing five alternative models: two conceptual models (a unitary model, a complexity model) and three methodological models (a stimulus material model, an output response model, and a timing modality model). Second, we then used the resulting models to predict multiple types of reading, a highly important developmental outcome, using other well-known predictors as covariates. Participants were 844 children enrolled in third through fifth grade in urban public elementary schools who received 16 measures of processing speed that varied in the above dimensions. A two-factor complexity model that differentiated between simple and complex processing speed was the preferred model and fit the data well. Both types of PS predicted reading fluency, and complex (but not simple) PS predicted single word reading and comprehension. Results offer insight to the structure of processing speed, its relation to closely related concepts (such as executive function), and provide nuance to the understanding of the way processing speed influences reading.

The present study investigates if there is a positive effect of the use of concept mapping software on students with Attention Deficit (AD) when learning descriptive writing in the secondary level of education. It also examines what kind of difficulties AD students may have come across during this learning procedure. Sample students were selected and assessed in their use of a combination of distinct educational tools, namely a questionnaire for teachers following the Greek Evaluation Scale (ADHD), the Stroop Test and the Trail Making Test. The students involved in this case study learned by implementing computer-based tools and then answered a number of questions regarding the perceived benefits of technology, accomplishing, in this way, the main purpose of this paper. Results arisen in this case study confirmed that the majority of the students believe they learn better when using computers and that particularly the concept mapping software presents the subject matter in an easier, more interesting and pleasant way, despite some difficulties throughout the learning procedure.

Background: Assessment of intelligence and executive function (EF) is common in complex neuropsychiatric practice. Although previous studies have shown that EF and intelligence are related, it is unknown whether these constructs relate to one another in a similar manner across different ability groups (mild intellectual disability, borderline intellectual disability and normal/high intelligence). This study therefore examines the relation between three EFs (inhibition, shifting and updating) and intelligence in a heterogeneous psychiatric sample. It is hypothesised that the strength of the relation between intelligence and the three EFs decreases when the level of intelligence increases, in accordance with Spearman's Law of Diminishing Returns. Methods: In a cross-sectional, between and within subject design, one of the three intelligence tests (Kaufman Adolescent and Adult Intelligence Test and Wechsler Adult Intelligence Scale--third and fourth editions) and several EF tests (Stroop Colour-Word Test, Trail Making Test and Spatial Working Memory task) were administered to 250 neuropsychiatric inpatients and outpatients (M[subscript age] = 39.8, standard deviation = 14.3, 52.8% male). Based upon their full-scale IQ score, patients were divided into three ability groups (mild intellectual disability, borderline intellectual disability or normal/high intelligence). The relation between EF and intelligence was assessed through analyses of the correlation pattern; groups were compared using analysis of covariance. Results: Analyses showed significant correlations between the constructs of EF and intelligence. A significant interaction effect was found for shifting, with highest correlations in the normal to high intelligence group, but not for inhibition and updating. Conclusions: Results support a specific role for shifting in this EF-intelligence relation. The correlational pattern of updating and intelligence, as well as the differential relation of shifting and intelligence across ability groups, suggests that EF tasks may not measure distinct EFs in lower intellectual ability but rely on cognitive primitives such as processing speed. EF tasks can be considered less valid indicators of EF ability. Implications in terms of the need for development of specific tasks to measure cognition in low intellectual ability are discussed.

Introduction: One of the lines of research that has aroused great interest in recent years has been to determine the role played by certain cognitive abilities in academic performance. This article describes the relationship between executive functions (interference, flexibility and planning) and empathy and their influence on the academic performance of a group of students enrolled in an institute of Basic Vocational Training (BVT). Method: The sample was composed of 80 students between the ages of 15 and 19 years. The instruments used were: STROOP (interference), Trail Making Test (TMT) (flexibility), Tower of Hanoi (planning) and TCAE (Test of Cognitive and Affective Empathy). The academic performance variable was assessed using qualifications obtained in the Social/Language and Science/Technology areas (grades from the different subjects). Pearson correlations and multiple regressions were applied. Results: The results show no significant relation between executive functions and empathy. The level of executive functions explained 15% of the variability in academic performance, while empathy had no significant influence. Discussion and conclusions: This study demonstrates the importance of examining development of executive functions in adolescent BVT students, and determining their influence on academic performance.

"Flow" is the state of full attention to the task at hand. It is typically studied in daily life, as people engage deeply in activities such as art, sports, and leisure, and typically its affective characteristics are emphasized. This research investigates flow in the laboratory, focusing on its cognitive characteristics. Participants completed different versions of the Trail Making test, a measure of executive function, that made parametrically increasing demands on attention. As predicted, more participants were in the flow state when attentional demands were moderate than when they were low or high. This was revealed by conventional survey measures indicating a balance between the perceived challenge of the task and the perceived skill of participants. Critically, this was also evidenced by a new operational measure of time distortion, defined as the difference between people's subjective estimates of their task completion times and the objective, experimenter-recorded times. Participants experienced "downward time distortion"--the feeling of time flying--when attentional demands were moderate. These findings demonstrate for the first time the causal role of attentional demands in inducing the flow state. They set the stage for future studies of flow and time distortion using attention-demanding cognitive tasks, and of the association between time perception and creative thinking.

The goal of this study was to investigate whether single executive function (EF) tests were predictive for learning performance in mainly young and middle-aged adults. The tests measured shifting and updating. Processing speed was also measured. In an observational study, cognitive performance and learning performance were measured objectively in 851 adult students and analyzed using multiple linear regression. EFs and processing speed were measured via cognitive tests. Learning performance was evaluated after 14 months. The results show that updating performance is predictive for learning performance, with a small effect size, while shifting performance was not. This means that a single updating test has predictive value for learning performance acquired over a longer period of time. However, as the effect size is rather small, the test on its own does not serve as a proper selection tool for determining whether a student will be successful or not.

Purpose: To examine the relation between speech recognition and cognitive skills in bimodal cochlear implant (CI) and hearing aid users. Method: Seventeen bimodal CI users (28-74 years) were recruited to the study. Speech recognition tests were carried out in quiet and in noise. The cognitive tests employed included the Reading Span Test and the Trail Making Test (Daneman & Carpenter, 1980; Reitan, 1958, 1992), measuring working memory capacity and processing speed and executive functioning, respectively. Data were analyzed using paired-sample t tests, Pearson correlations, and partial correlations controlling for age. Results: The results indicate that performance on some cognitive tests predicts speech recognition and that bimodal listening generates a significant improvement in speech in quiet compared to unilateral CI listening. However, the current results also suggest that bimodal listening requires different cognitive skills than does unimodal CI listening. This is likely to relate to the relative difficulty of having to integrate 2 different signals and then map the integrated signal to representations stored in the long-term memory. Conclusions: Even though participants obtained speech recognition benefit from bimodal listening, the results suggest that processing bimodal stimuli involves different cognitive skills than does unimodal conditions in quiet. Thus, clinically, it is important to consider this when assessing treatment outcomes.

Studies examining the visual and verbal metaphorical comprehension of individuals with non-specific intellectual disability (NSID) are remarkably scarce; to date only one case study examined comprehension of metaphors in an individual with Down syndrome (DS). The current study explored both the understanding of conventional and novel metaphors and the comprehension of visual metaphors in individuals with NSID (aged 15-59, N = 53) and individuals with DS (aged 15-52, N = 50). Both etiology groups showed poor understanding of verbal and visual metaphor comprehension with worse performance on the visual task. However, the comprehension of novel metaphors was significantly higher than the comprehension of conventional ones, in both groups. As expected, individuals with DS understood fewer conventional metaphors than individuals with NSID, probably due to the linguistic deficiency characterizing individuals with DS. These findings were explained in light of the delay in linguistic ability that characterizes individuals with DS as well as the gradual expansion of their mental lexicon with increasing age.

Clinical reasoning requires thoughtful consideration of a variety of factors that contribute to the conceptualization of a case such as the reason for referral, school information, home environment, assessment outcomes, and behavioural observations made during assessments. The purpose of this article is to provide the reader with insight into the clinical reasoning involved in the assessment and intervention planning for an adolescent with oppositional defiant disorder. The reader will be guided through the authors' conceptualization of this case and suggestions for intervention.

The aim of this study was to evaluate the effectiveness of a computer-based executive function (EF) training in children with specific language impairment (SLI). Ten children with SLI, ages 8 to 12 years, completed a 25-session training of visuospatial working memory, inhibition and cognitive flexibility over a 6-week period. Treatment outcome was examined directly after training and at 6 months follow-up by tasks of the three trained EF, tasks of untrained neurocognitive functions (verbal working memory, attention, planning and fluency), and ratings of EF and behavioral problems by parents and teachers. Directly after training, results showed significant improvement on cognitive flexibility and a positive trend for visuospatial storage and inhibition. At 6 months follow-up, the children performed significantly better on tasks of all three trained EFs. Furthermore, the results showed significant improvement on sustained attention, attention control, parent- and teacher-rated attention behavior and parent-rated EF and externalizing behavior with medium effect sizes. The results of this pilot study highlight the importance of a large-scale, randomized controlled trial examining the possible effects of EF training in children with SLI.

This article presents two studies investigating the role of executive functioning in written text comprehension in children and adolescents. In a first study, the involvement of executive functions in reading comprehension performance was examined in normally developing children in fifth grade. Two aspects of text comprehension were differentiated: literal and inferential processes. The results demonstrated that while three aspects of executive functioning (working memory, planning, and inhibition processes) were significantly predictive of the performance on the inferential questions of the comprehension test, these factors did not predict the scores on the literal tasks of the test. In a second experiment, the linguistic and cognitive profiles of children in third/fifth and seventh/ninth grades with a specific reading comprehension deficit were examined. This analysis revealed that the deficits experienced by the less skilled comprehenders in both the linguistic and the executive domains could evolve over time. As a result, linguistic factors do not make it possible to distinguish between good and poor comprehenders among the group of older children, whereas the difficulties relating to executive processing remain stable over development. These findings are discussed in the context of the need to take account of the executive difficulties that characterize less skilled comprehenders of any age, especially for remediation purposes.

Executive functions (EF) can be promoted by classroom interventions. Our study investigated whether (a) an intervention conducted by teachers improves EF in children; (b) there are effects on behaviour and academic achievement; and (c) there are stable benefits in a one-year follow-up. Fifty-eight first-graders, divided into experimental (EG = 28) and control (CG = 30) groups, were assessed in EF, reading and arithmetic tests. Parents and teachers answered EF and behaviour functional scales. The intervention was conducted by teachers in the classroom context. EG children showed greater gains in EF and outperformed controls on reading and arithmetic measures. The EG maintained better performance in the one-year follow-up and showed transfer effect for behaviour measures. The EF intervention may be a useful tool for promoting improved adjustment and academic achievement.

Erikson's (1950) model of adult psychosocial development outlines the significance of successful involvement within one's relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over-75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socioeconomic strata. Eriksonian psychosocial development was coded from men's narrative responses to interviews between the ages of 30-47 (Vaillant & Milofsky, 1980). In late life (ages 75-85) men completed a performance--based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression 3 to 4 decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition, it may be that less successful psychosocial development increases levels of depression making individuals more vulnerable to specific areas of cognitive decline.

Purpose: The purpose of this study was to determine differences in cognition between acute bouts of resistance exercise, aerobic exercise, and a nonexercise control in an untrained youth sample. Method: Ninety-four participants performed 30 min of aerobic exercise, resistance exercise, or nonexercise separated by 7 days each in a randomized crossover design. After each exercise intervention, participants were assessed using 2 cognitive tests. The Dot, Word, and Color elements of the Stroop Test (Victoria version) and Parts A and B of the Trail-Making Test were used to measure cognition. Results: Acute resistance and aerobic exercise resulted in similar improvements over nonexercise in all forms of the Stroop Test. Acute aerobic exercise led to improved performance over nonexercise and resistance exercise in Part B of the Trail-Making Test. Neither exercise intervention showed significant changes in time to complete Part A of the Trail-Making Test. Boys outperformed girls on the Stroop Dot and Color Test following acute aerobic exercise, in the Stroop Dot, Word, and Color Test following acute resistance exercise, and in the Stroop Color Test and Trail-Making Test Part B following nonexercise. Conclusions: Both acute resistance and aerobic exercise increased measures of cognition over a nonexercise control in untrained high school youth. These findings suggest the merits of acute resistance exercise as an alternative or complement to aerobic activity for educators aiming to increase youth physical activity and cognitive function concurrently.

More than 20?years ago, Minshew and colleagues proposed the Complex Information Processing model of autism in which the impairment is characterized as a generalized deficit involving multiple modalities and cognitive domains that depend on distributed cortical systems responsible for higher order abilities. Subsequent behavioral work revealed a related dissociation between concept formation and concept identification in autism suggesting the lack of an underlying organizational structure to manage increases in processing loads. The results of a recent study supported the impact of this relative weakness in conceptual reasoning on adaptive functioning in children and adults with autism. In this study, we provide further evidence of the difficulty relatively able older adolescents and adults with autism have with conceptual reasoning and provide evidence that this characterizes their difference from age- and ability-matched controls with typical development better than their differences in language. For verbal adults with autism, language may serve as a bootstrap or compensatory mechanism for learning but cannot overcome an inherent weakness in concept formation that makes information processing challenging as task demands increase.

Background: Previous studies suggest that children with Down's syndrome (DS), a genetically based neurodevelopmental disorder, demonstrate motor problems and cognitive deficits. The first aim of this study was to examine motor skills and executive functions (EFs) in school-age children with DS. The second aim was to investigate the relationship between these two performance domains. Methods: The Test of Gross Motor Development (TGMD-2), the Movement Assessment Battery Children-2 checklist (MABC2-checklist) and the Trail-Making Test for young children (Trails-P) were used to assess motor and cognitive performances of 18 children (11 boys, 7 girls) with DS aged between 7 and 11 years (9.06?±?0.96) and an age- and sex-matched sample of 18 typically developing (TD) children (11 boys, 7 girls; 8.99?±?0.93). Results: Individuals with DS showed the expected difficulties in attentional control, response suppression and distraction, as well as in locomotor and object control skills, as indicated by poorer performance than TD individuals. Motor performance (bottom-up as well as top-down measures) and EF correlated positively, with regard to the group with DS only though. In the most complex task (distraction), the children of the DS group achieving lower locomotor scores showed lower efficacy scores on the Trails-P. Additionally, strong relationships were found for the perspective of teachers on all sections of the MABC2-Checklist and EF. Conclusion: The findings from this study suggest that children with DS are not only impaired in higher-order EF, but showing also deficits in locomotor and object control skills. This study stresses the importance of early interventions facilitating cognitive abilities and motor skills.

Background: A novel exercise modality termed Assisted Cycling Therapy (ACT) has been used successfully in patients with Parkinson's disease, but its effects in adolescents with autism spectrum disorder (ASD) have not been investigated. Method: The aim was to examine the acute effects of 2 modes of exercise on cognitive and motor functioning in adolescents with ASD. Participants (N = 10) randomly completed 3 interventions on nonconsecutive days. The interventions were (a) voluntary cycling (VC), in which participants cycled at their self-selected pedalling rate; (b) ACT, in which the participants' voluntary pedalling rates were augmented with a motor to ensure the maintenance of 80 rpm; and (c) no cycling (NC), in which the participants sat and watched a video. Results: Participants' inhibition improved significantly and improvements in cognitive planning and set-switching approached significance after a single session of ACT; however, no improvements in inhibition, cognitive planning, or set-switching were observed following the VC or NC sessions. Exercise perception improved after the VC session but did not change after the ACT or NC sessions. Conclusions: ACT appears to benefit cortical structures in adolescents with ASD, but a chronic intervention may be necessary to improve exercise perception and self-efficacy.

Adolescence is a developmental period characterized by intense changes, which impact the interaction between individuals and their environments. Moral reasoning (MR) is an important skill during adolescence because it guides social decisions between right and wrong. Identifying the cognitive underpinnings of MR is essential to understanding the development of this function. The aim of this study was to explore predictors of MR in typically developing adolescents (n = 92, 33 males, M = 16.3 years, SD = 2.2 years) and the specific contribution of higher order cognitive processing using an innovative visual MR assessment tool and measures of executive functioning and intelligence. MR maturity was correlated with four executive functions (cognitive flexibility, feedback utilization, conceptual reasoning, verbal fluency) and was predicted by four variables: age, intelligence, nonverbal flexibility and verbal fluency. Overall, these results contribute to a better understanding of MR during adolescence and highlight the importance of using innovative tools to measure social cognition.

The current study tested 2 models of inhibition in 45 children with language impairment and 45 children with normally developing language; children were aged 7 to 12 years. Of interest was whether a model of inhibition as a mental-control process (i.e., executive function) or as a mental resource would more accurately reflect the relations among mental-attentional (M) capacity, inhibition, updating, shifting, and language competence. Children completed measures of M-capacity (in the verbal and nonverbal domains), inhibition, updating, shifting, and language. Path analyses showed the data provided a poor fit to the model of inhibition as a mental-control process but a good fit to the model of inhibition as a mental resource. Results are consistent with the theory of constructive operators and suggest inhibition is a mental resource rather than a mental-control process.

Research Findings: The current article explores the relationship between teachers' perceptions of child behavior problems and preschool teacher job stress, as well as the possibility that teachers' executive functions moderate this relationship. Data came from 69 preschool teachers in 31 early childhood classrooms in 4 Head Start centers and were collected using Web-based surveys and Web-based direct assessment tasks. Multilevel models revealed that higher levels of teachers' perceptions of child behavior problems were associated with higher levels of teacher job stress and that higher teacher executive function skills were related to lower job stress. However, findings did not yield evidence for teacher executive functions as a statistical moderator. Practice or Policy: Many early childhood teachers do not receive sufficient training for handling children's challenging behaviors. Child behavior problems increase a teacher's workload and consequently may contribute to feelings of stress. However, teachers' executive function abilities may enable them to use effective, cognitive-based behavior management and instructional strategies during interactions with students, which may reduce stress. Providing teachers with training on managing challenging behaviors and enhancing executive functions may reduce their stress and facilitate their use of effective classroom practices, which is important for children's school readiness skills and teachers' health.

Aggressive behaviours in adolescence often originate in early development. This study tested three longitudinal pathways starting in early childhood, in a sample of 325 Belgian participants (162 girls) assessed every 1 or 2 years from birth through age 14. Structural equation models supported the "mother early dissatisfaction" pathway toward adolescent aggression, but neither the "cognitive functioning" nor the "early aggressive behaviour" pathway gained clear support. Mother's early dissatisfaction with her child was the starting point of a series of negative perceptions of the child, which predicted physical and social aggression in adolescence. Children's cognitive functioning and early aggression level were weakly correlated with mother's perceptions. This finding suggests that explaining normative development to parents may improve mothers' perceptions of their early experience as a mother, of their child, and of their subsequent interactions, which may reduce their child's future aggressive behaviours. (Contains 2 figures and 2 tables.)

This investigation is an initial examination of possible enhancement of executive function through a dual-language (50:50) education model. The ethnically diverse, low-income sample of 120 children from Grades K, 2, and 4 consisted of approximately equal numbers of children enrolled in dual-language and traditional classrooms. Dual-language students in Grades 2 and 4 performed better on a measure from the Trail Making Task requiring inhibition and rule-switching. The results indicate that the established benefits of bilingual exposure can be generalized across SES and ethnicity and can be acquired within the context of elementary school programs.

The Comprehensive Trail Making Test (CTMT) is a relatively new version of the Trail Making Test that has a number of appealing features, including a large normative sample that allows raw scores to be converted to standard "T" scores adjusted for age. Preliminary validity information suggests that CTMT scores are sensitive to brain injury and demonstrate expected correlations with other neuropsychological tests, although the evidence also suggests that the factor structure of the CTMT may differ in children with brain dysfunction in comparison to the standardization sample. The present study addresses this matter by conducting a confirmatory factor analysis (CFA) of the CTMT in 382 children and adolescents. Of the 382, 191 were diagnosed with various forms of brain dysfunction, including 140 who had sustained a traumatic brain injury. The other 191 participants were healthy controls who were individually matched on age and gender to the clinical group with brain dysfunction. Results of the CFA indicated that for the clinical group, a 2-factor model composed of Simple Sequencing and Complex Sequencing/Shifting factors provided the best fit for the data. Although these 2 factors were also identified in the controls, differences in pattern of loadings were present. Results suggest that the presence of brain dysfunction may alter the factor structure of the CTMT in children and adolescents. (Contains 3 tables and 1 figure.)

The sensitivity of the Trail Making Test to brain damage has been well-established over many years, making it one of the most commonly used tests in clinical neuropsychological evaluations. The current study examined the validity of scores from a newer version of the Trail Making Test, the Comprehensive Trail Making Test (CTMT), in children and adolescents with traumatic brain injury (TBI). Participants included 242 children and adolescents, 121 with sustained TBI and 121 normal control participants, who were matched to the individuals with TBI on age and sex. Receiver operating characteristic analysis indicated that the CTMT composite index provided the best overall classification, with a correct classification rate of 79%. Differences between the TBI and control groups remained stable across age. These findings indicate that the CTMT is sensitive to TBI and overall demonstrates classification rates that are comparable with some other versions of the Trail Making Test. Whether the CTMT will exhibit similar classification accuracy in adults with TBI and for other neurological disorders awaits further investigation. (Contains 2 figures and 3 tables.)

Disadvantageous decision making is cited as one of the premier problems in childhood development, underlying risky behavior and causing adolescents to make poor choices that could prove detrimental later in life. However, there are relatively few studies looking at the development of decision making in children and adolescents, and fewer still comparing it with the performance trajectories of more typically developing cognitive functions. In the current study, we measured the affective decision-making abilities of children and adolescents 8- to 17-years-old using the Iowa Gambling Task (IGT; Bechara, 2007) in conjunction with a battery of established cognitive neuropsychological assessments. In contrast to the typical linear development of executive functions, affective decision-making abilities progressed in a J-shaped curve. Younger, more developmentally naive children performed better on the IGT than older, early-adolescent individuals, with performance becoming advantageous again toward the end of the teenage years. This trajectory is thought to coincide with asymmetric neural development in early adolescents, with relatively overactive striatal regions creating impulsive reward-driven responses that may go unchecked by the slower developing inhibitive frontal cortex. This trajectory is in stark contrast with the linear development of memory, speed of processing, and other cognitive abilities over the ages. (Contains 3 tables and 1 figure.)

To explore the predictive value of cognitive and coping resources for problem- and emotion-focused coping with age, we collected data from community-dwelling adults between 20 and 90 years old. We hypothesized that age, perceived stress, self-efficacy, working-memory capacity, and mental flexibility were predictors of coping. We collected data using French versions of the Perceived Stress Scale, General Self-Efficacy Scale, and Way of Coping Checklist. Cognitive assessments comprised the WAIS III digit-span subtest and the Trail Making Test parts A and B. In multivariate analyses, neither working-memory nor mental-flexibility deficit predicted problem-focused coping. "Age" was found to predict only problem-focused coping. "Self-efficacy" predicted problem-focused coping, and "perceived stress" predicted emotion-focused coping. Our results confirmed that use of an emotion-focused coping style would not significantly change with age. Problem-focused coping increases with age and depends primarily on participants' confidence in their ability to successfully solve problems (i.e., self-efficacy).

The Trail-Making Test (TMT) is a widely used neuropsychological measure that assesses visuomotor abilities and cognitive flexibility. For the TMT-A condition participants are required to locate and connect numbers (i.e. 1-2-3...) while in the TMT-B condition participants perform the set-shifting task of locating and connecting numbers and letters (i.e. 1-A-2-B...). The TMT-B condition has shown impairments in many clinical populations, particularly schizophrenia patients, but the neurobiological underpinning of the task can be difficult to discern given pragmatic obstacles in adapting the task for neuroimaging. In a behavioural testing experiment we demonstrated a close correspondence between performance on the standard TMT and a novel, computer programmed adaptation of the TMT (pcTMT). The pcTMT was designed for functional magnetic resonance imaging (fMRI) administration and neuroimaging data for this task were obtained in. A whole brain analysis revealed significantly greater activation during the pcTMT-B relative to the pcTMT-A in right inferior/middle frontal cortices, right precentral gyrus, left angular gyrus/left middle temporal gyrus. These results identify the regions that most likely underlie cognitive flexibility during the TMT and are candidate regions underlying the impairment of groups with poor set-shifting abilities. (Contains 8 figures and 1 table.)

This paper is aimed at depicting the quality of functions of some of the aspects of attention in children with mild intellectual disabilities and their influence on the mastering of arithmetic operations, including addition and subtraction. The sample used in this study encompasses 60 pupils, both males and females. The criteria used in the selection of examinees included the IQ level of the students which ranged from 50 - 69, calendar age from 12 to 14 years, school age which involved the inclusion of pupils attending grades five to seven of primary school in Serbia. To evaluate the quality of attention in our study we used the Trail Making Test form A and the Double Letter Cancellation Test, whilst a Criterion-referenced test was used to evaluate how well the specified body of knowledge, in this case arithmetic operations i.e. addition and subtraction were learned by the pupils. The implications of the study pertain to the proposal of implementing specific, creative activities and exercise during play, concrete contents, demonstration, experiments and teaching resources susceptible for teaching arithmetic. (Contains 4 tables.)

Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to "indirect" informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes "direct" neuropsychological or academic assessment data to determine treatment efficacy. Documenting "cool" executive-working memory (EWM) and "hot" self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type (n = 33)/hyperactive-impulsive type (n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed. (Contains 2 figures and 1 table.)

Because of ongoing neuromaturation, youth with chronic alcohol/substance use disorders (AUD/SUD) are at risk for cognitive decrements during young adulthood. We prospectively examined cognition over 10 years based on AUD/SUD history. Youth (N = 51) with no AUD/SUD history (n = 14), persisting AUD/SUD (n = 18), or remitted AUD/SUD (n = 19) were followed over 10 years with neuropsychological assessments. Groups were compared at baseline and 10-year follow-up. Both AUD/SUD groups declined in visuospatial construction at year 10 (p = 0.001). Further, cumulative alcohol use (p less than 0.01) and drug withdrawal (p less than 0.05) predicted year-10 visuospatial function. Alcohol use predicted verbal learning/memory (p less than 0.05), while stimulant use predicted visual learning/memory (p = 0.01). More recent substance use predicted poorer executive function (p less than 0.05). In conclusion, heavy alcohol and other substance use from adolescence through young adulthood may produce cognitive disadvantages, including visuospatial and memory decline. Youth with heavy, chronic alcohol use and/or drug withdrawal symptoms may be at particular risk. (Contains 3 tables and 1 figure.)

Children with nonverbal learning disabilities (NVLD) have been found to be worse at recognizing facial expressions than children with verbal learning disabilities (LD) and without LD. However, little research has been done with adolescents. In addition, expressing and understanding facial expressions is yet to be studied among adolescents with LD subtypes. This study examined abilities of adolescents with NVLD, with general learning disabilities (GLD), and without LD to recognize, express, and understand facial expressions of emotion. Adolescents were grouped into those with NVLD, with GLD, and without LD using the "Wechsler Intelligence Scale for Children-Third Edition" (short form) and "Wide Range Achievement Test-Third Edition." The adolescents completed neuropsychological, recognition, expression, and understanding measures. It is intriguing that the GLD group was significantly less accurate at recognizing and understanding facial expressions compared with the NVLD and NLD groups, who did not differ. Implications are explored with regard to the need to consider possible deficits in recognition and understanding of emotion in adolescents with LD in schools. (Contains 1 table and 2 figures.)

Objective: Few studies have examined the psychological benefits of physical activity in children with ADHD who may be at higher risk for mood and anxiety problems. This study explores the relationship between participation in physical activity and emotional functioning in children with ADHD. Method: Scores on parent-reported measures of mood and behavior were retrospectively compared among a group of 65 children (ages 6 to 14) diagnosed with ADHD based on their amount of sport participation. A total of 32 children diagnosed with a learning disorder (LD) were used as a comparison group. Results: Children with ADHD who participated in three or more sports displayed significantly fewer anxiety or depression symptoms than did those who participated in fewer than three sports. These differences were not evident among children with LDs. Conclusion: Results suggest that active sport participation may be associated with a reduced expression of anxiety or depression symptoms in children with ADHD. (Contains 3 tables and 2 figures.)

The construct validity of three variants of the Trail Making Test was investigated using 162 undergraduate psychology students. During a 3-week period, the Trail Making Test of the Delis-Kaplan Executive Function System, Comprehensive Trail Making Test, and Connections Task were administered in six possible orders. Using confirmatory factor analysis, a two-factor (sequencing, shifting) model was identified as the best fitting model for the data as an alternative to unitary and three-factor (sequencing, shifting, scanning) models. The two-factor structure was invariant across groups. A latent means structural analysis yielded no differences between the factor means for each of the groups, which indicates the absence of order effects and supports the interchangeable use of the three tests. The study proposes the use of alternate, equivalent tasks to help eliminate the effects of practice associated with serial assessment and should be replicated in a clinical sample. (Contains 5 tables, 1 figure, and 1 note.)

Results of correlation studies of 141 adult epileptics' scores on the Background Interference Procedure (BIP) indicated that the BIP often does not agree with abnormal neurological diagnoses but often does agree with psychiatric diagnoses of Organic Brain Syndrome (OBS). Suggests that future BIP validity studies include a behavioral measure of OBS as criterion. (Author/BL)