Is there a relationship between executive functions and academic success in children with neurofibromatosis type 1?

The present study aimed to compare the executive function (EF) of children with neurofibromatosis type 1 (NF1) to those of typically developing children and to investigate whether those abilities could predict the child's academic success in terms of academic skills and enablers. Twenty-nine children with NF1 and 27 age-and-gender-matched controls (aged 8–16 years) were examined with two tests to measure EF in an ecologically valid manner: the Behavioural Assessment of the Dysexecutive Syndrome in Children (BADS-C) and the parent questionnaire for the Behavior Rating Inventory of Executive Function (BRIEF). In order to evaluate academic success we used the Academic Competence Evaluation Scales (ACES). The performance of the NF1 group was significantly lower on the Water and Key search subtest of the BADS-C and on four scales of the BRIEF: initiate; working memory; plan/organise and organisation of materials. Significant correlations and predictive models via regression analysis were generated for: BADS-C, BRIEF and ACES scores. Based on these findings, children with NF1 have executive dysfunction that partially accounts for their difficulties in academic achievements.     

Do executive function deficits differentiate between children with Attention Deficit Hyperactivity Disorder (ADHD) and ADHD comorbid with Oppositional Defiant Disorder? A cross-cultural study using performance-based tests and the Behavior Rating Inventory of Executive Function

This study examined the differential executive dysfunction of children with attention deficit hyperactivity disorder (ADHD) and those with ADHD and oppositional defiant disorder (ODD) in Han Chinese. A total of 258 children (89 ADHD, 53 ADHD + ODD, 116 controls) completed performance-based executive function tests and had their everyday life executive skills rated by their parents using the Behavior Rating Inventory of Executive Function (BRIEF). Both the ADHD and ADHD + ODD groups performed worse than the controls in the Stroop and Trail-making tests and the BRIEF. The ADHD + ODD group were rated worse than the ADHD group on the BRIEF, but the two groups showed no significant difference in the performance-based tests. These findings suggest Han Chinese children with ADHD display executive dysfunction in performance-based tests and everyday life scenarios, in a similar way to findings in Western counterparts. However, children with ADHD + ODD showed more severe executive dysfunction in everyday life scenarios than those with ADHD only.     

Is there any incremental benefit to conducting neuroimaging and neurocognitive assessments in the diagnosis of ADHD in young children? A machine learning investigation

Given the negative trajectories of early behavior problems associated with ADHD, early diagnosis is considered critical to enable intervention and treatment. To this end, the current investigation employed machine learning to evaluate the relative predictive value of parent/teacher ratings, behavioral and neural measures of executive function (EF) in predicting ADHD in a sample consisting of 162 young children (ages 4–7, mean age 5.55, 82.6 % Hispanic/Latino). Among the target measures, teacher ratings of EF were the most predictive of ADHD. While a more extensive evaluation of neural measures, such as diffusion-weighted imaging, may provide more information as they relate to the underlying cognitive deficits associated with ADHD, the current study indicates that measures of cortical anatomy obtained in research studies, as well cognitive measures of EF often obtained in routine assessments, have little incremental value in differentiating typically developing children from those diagnosed with ADHD. It is important to note that the overlap between some of the EF questions in the BRIEF, and the ADHD symptoms could be enhancing this effect. Thus, future research evaluating the importance of such measures in predicting children’s functional impairment in academic and social areas would provide additional insight into their contributing role in ADHD.     

Executive Functioning in Children with Asperger Syndrome,ADHD-Combined Type,ADHD-Predominately Inattentive Type,and Controls

The purpose of the study was to evaluate neuropsychological and behavioral rating measures of executive functions (EF) in children with two subtypes of ADHD, Asperger syndrome (AS), and controls. Relative to the control group, the clinical groups experienced more difficulty in EF. The AS group showed the most difficulty in emotional control, behavioral regulation, fluid reasoning, and planning compared to the ADHD groups. Number of symptoms of ADHD or AS was found to be significantly related to ratings of difficulty with behavior regulation, metacognition, and general behavioral regulation across the sample. These findings indicate that children with AS or ADHD may have a differing EF profile and thus, may respond differentially to interventions.     

A novel experimental paradigm to evaluate children and adolescents diagnosed with attention-deficit/hyperactivity disorder: Comparison with two standard neuropsychological methods

Introduction: In this study we evaluated a recently developed test, the Ball Search Field Task (BSFT) as a neuropsychological tool for measuring cognitive and behavioral performance of individuals with disorders such as attention-deficit/hyperactivity disorder (ADHD), which are frequently accompanied by cognitive deficits and a lack of behavioral inhibition. The task provides a complementary method of assessment that attempts ecological validity by drawing on challenges faced in real-world situations. In this task, energetic costs and gross sensorimotor feedback are involved, as participants are required to search for targets in a large open area.

Method: We compared performance on the BSFT in a clinical sample of children and adolescents with a diagnosis of ADHD with their scores on two widely used neuropsychological tools, the Tower of London (ToLo) and the Behavior Rating Inventory of Executive Function (BRIEF).

Results: We found no correlations between scores on the BRIEF and those on either the BSFT or ToLo. However, we found moderate correlations between rule violations on ToLo and several BSFT variables, suggesting the capacity of these tests to detect common aspects of executive dysfunction.

Conclusions: These findings, although modest, encourage further study of tasks like the BSFT, which may help assess cognitive dysfunction found in neurodevelopmental disorders such as ADHD in ecologically valid situations.     

Assessment of executive functioning in children and young adults treated for frontal lobe tumours using ecologically valid tests

There is a lack of studies assessing executive functions (EF) using ecologically valid tests in children with frontal lobe lesions. This study aimed to (1) evaluate EF in children, adolescents and young adults treated for childhood frontal lobe tumours, (2) identify factors influencing performance, such as age at diagnosis or type of treatment, and (3) examine correlations between intellectual ability and classical and ecological tests of EF. Twenty-one patients, aged 8–27 years, treated for a childhood benign or malignant frontal lobe tumour, and 42 healthy controls (matched for gender, age and socio-economic status) were assessed using classical tests of EF, and the BADS-C ecological battery. Patients also underwent assessment of intellectual ability and parent and teacher ratings of the BRIEF questionnaire. IQ scores ranged from 45 to 125 (mean FSIQ?=?84) and were lower in case of epilepsy, hydrocephalus and lower parental education. Patients displayed deficits in most, but not all measures of EF. Most classical and ecological measures of EF were strongly correlated to IQ. This study confirms the frequency of EF deficits in this population; it also highlights the utility of ecological measures of EF and some limitations of classical tests of EF in children.     

Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C): An examination of construct validity

Children's success with participating in life depends heavily on intact executive function (EF) skills. The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) was developed to address the need for a standardised ecologically valid test of children's EF performance. This study aimed to establish the construct validity of the BADS-C in relation to socio-demographic parameters. Participants were 208 Israeli children, aged 8–15 years, who were divided into three age groups (8 years to 9 years and 11 months; 10 years to 11 years and 11 months; 12 to 15 years) and tested with the BADS-C. The older age groups achieved significantly better scores than the younger groups. No significant differences were found between genders in any of the BADS-C scores. Similar results were found for familial socio-economic status and parents' education. Construct validity was demonstrated for the BADS-C by providing a profile for different age groups. Additional studies are needed to examine further the validity and reliability of the BADS-C and the relationships between socio-demographic factors and EF.     

Behavioral regulation as a predictor of response to Children's Friendship Training in children with fetal alcohol spectrum disorders

Children with fetal alcohol spectrum disorders (FASDs) evidence an array of structural brain abnormalities and neurocognitive deficits. Furthermore, previous research suggests that deficits in executive functioning (EF) may be associated with significant difficulties in the formation of positive peer relationships in this population. The purpose of the current study was to examine the role of EF as a predictor of treatment response to a controlled social skills intervention for children with FASDs. A total of 100 children between the ages of 6 and 12 received Children's Friendship Training (CFT). Prior to treatment, parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF). Treatment outcome was measured using parent report on the Social Skills Rating System (SSRS). The results demonstrated that behavioral regulation as measured on the BRIEF predicted the effectiveness of CFT for children with FASDs, regardless of general intellectual functioning. Specifically, the ability to control impulses, solve problems flexibly, and monitor emotional responses significantly predicted improvement in social skills and reduction in problem behaviors following CFT.     

Differences in Parent and Teacher Rating of Everyday Executive Function in Pediatric Brain Tumor Survivors

We aimed to compare executive function (EF) outcomes in pediatric brain tumor (BT) survivors compared with healthy children (HC) across multiple settings. This retrospective cross-sectional study of BT survivors and age- and gender-matched HC analyzed scale patterns of parent and teacher ratings of EF (Behavior Ratings of Executive Function; BRIEF). We also analyzed relationships between groups and raters (parent/teacher) and clinical elevations across EF domains on the BRIEF. Group differences in aspects of EF emerged from parent ratings in working memory (WM), while significant interactions from teacher ratings emerged on nearly all EF scales. Parents reported impaired cognitive/behavioral flexibility in the BT group four times more than parents of HC. Teachers rated survivors significantly more poorly as a group on the majority of EF domains, and indicated clinical impairment in cognitive/behavioral flexibility, emotional regulation, self-starting/initiation, WM, and planning and organization (P/O) four to ten times more often than the teachers of HC. Overall, teacher ratings of EF impairment in pediatric BT survivors were significantly greater than parent ratings, who reported far fewer EF problems. Possible explanations for inter-rater discrepancies include potential reporting bias/response shift in parents and/or differences in EF demands across settings.     

Gender differences in a clinic-referred sample of Taiwanese attention-deficit/hyperactivity disorder children

The purpose of this study was to examine gender differences within a clinic-referred sample of 6-11-year-old Taiwanese children with attention-deficit/hyperactivity disorder (ADHD)- combined subtype. The subjects were 21 girls with a diagnosis of ADHD from the 4th edition of the Diagnostic and Statistical Manual and 21 age-matched boys with ADHD. Comparisons were made of behavioral ratings, cognitive profiles, and vigilance/attention assessments between these two groups. The results found ADHD girls and ADHD boys to be statistically indistinguishable on nearly all measures except the subtests of block design (P = 0.016), the discrepancy between Performance Intelligence Quotient and Verbal Intelligence Quotient (P = 0.019), and the discrepancy between fluid and crystallized IQ (P = 0.041). In the study samples, ADHD girls and ADHD boys were strikingly similar on a wide range of measures. ADHD boys and girls in clinics may be expected to show more similarities than differences in treatment needs. However, these results should be interpreted with caution since data were only from clinic-referred samples.     

Reliability and validity of the Executive Function and Occupational Routines Scale (EFORTS)

Sustainable daily routines during childhood are important both for children and their parents. Although their affective completion requires well developed executive functions (EF), this issue has not been studied until now. The current study examined the reliability and validity of the Executive Functions and Occupational Routines Scale – EFORTS (developed in Hebrew) which measures children's executive control in their daily routines. Internal consistency and construct and convergent validity were examined by applying the EFORTS and the Behavior Rating Inventory of Executive Functions/preschool version (BRIEF/P) to 261 children (129 boys, 132 girls) between the ages 3 and 10 (mean = 6.1, SD = 1.43). The findings indicate that the EFORTS is a reliable and valid tool for examining children's executive control in three occupational daily routines, focusing specifically on metacognitive manifestations of EF. These findings suggest that the EFORTS can be a useful tool to assess children with EF deficits, and may serve targeting intervention programs toward the accomplishment of daily occupational goals.     

Daily functioning profile of children with attention deficit hyperactive disorder: A pilot study using an ecological assessment

Children with attention-deficit hyperactivity disorder (ADHD) often present with activities of daily living (ADL) performance deficits. This study aimed to compare the performance characteristics of children with ADHD to those of controls based on the Do-Eat assessment tool, and to establish the tool's validity. Participants were 23 children with ADHD and 24 matched controls, aged 6–9?years. In addition to the Do-Eat, the Children Activity Scale–Parent (ChAS-P) and the Behavioral Rating Inventory of Executive Function (BRIEF) were used to measure sensorimotor abilities and executive function (EF). Significant differences were found in the Do-Eat scores between children with ADHD and controls. Significant moderate correlations were found between the Do-Eat sensorimotor scores, the ChAS-P and the BRIEF scores in the ADHD group. Significant correlations were found between performance on the Do-Eat and the ChAS-P questionnaire scores, verifying the tool's ecological validity. A single discriminant function described primarily by four Do-Eat variables, correctly classified 95.5% of the study participants into their respective study groups, establishing the tool's predictive validity within this population. These preliminary findings indicate that the Do–Eat may serve as a reliable and valid tool that provides insight into the daily functioning characteristics of children with ADHD. However, further research on larger samples is indicated.     

Executive functions in 7-year-old children of parents with schizophrenia or bipolar disorder compared with controls: The Danish High Risk and Resilience Study—VIA 7, a population-based cohort study

Cognitive impairments are strongly associated with schizophrenia (SZ) and bipolar disorder (BP) with executive functions (EF) impairments as a likely key feature. Studies of everyday behavior rated EF in young children at familial high risk of SZ (FHR-SZ) are scarce and, to our knowledge, non-existent in young children at familial high risk of BP (FHR-BP). We aimed to compare everyday behavior-rated EF of FHR-SZ, FHR-BP, and control children. A nationwide population-based cohort of 522 7-year-old children with parents diagnosed with either SZ (N = 202) or BP (N = 120) and matched controls (N = 200) were recruited using the Danish national registries. The children’s EF were assessed with the Behavior Rating Inventory of Executive Functions questionnaire rated by primary caregivers and teachers. According to primary caregiver assessments, FHR-SZ children displayed widespread EF impairments and had an odds ratio of 3.7 (2.0–6.9) of having clinically significant global EF impairments compared to controls. FHR-BP children were most severely impaired regarding EF related to emotional control and had an odds ratio of 2.5 (1.2–5.1) of clinically significant global EF impairments compared to controls. Teacher assessments were overall comparable to primary caregiver assessments but teachers rated more difficulties in the FHR-SZ group than primary caregivers. Already at age 7, children with a parental history of SZ or BP displayed significant impairments of EF in everyday-life situations. FHR-SZ children displayed widespread significant impairments of EF, whereas FHR-BP children were most severely impaired on emotional control. Clinicians should be aware of potential EF impairments in FHR children.

     

Executive function impairments in children with attention-deficit hyperactivity disorder: do they differ between school and home environments?

OBJECTIVE: The primary purpose of this study was to compare parent and teacher reports of executive function (EF), as measured by the Behavior Rating Inventory of Executive Function (BRIEF), on a sample of children who had been diagnosed with attention-deficit hyperactivity disorder (ADHD). If differences were found, the secondary purpose was to explore these differences by determining which of the 8 BRIEF scales, each representing a different EF, would best predict symptoms of ADHD by the 2 proxy reporters. METHOD: We performed a secondary data analysis on the assessment information pertaining to 240 children, aged 5 to 15 years, accessing services at an urban Toronto psychiatric program specializing in ADHD. We compared parent and teacher ratings and applied logistical binary regressions to predict the probability of a child's meeting the criteria for clinically significant inattention and hyperactivity-impulsivity on the ADHD Rating Scale-IV. RESULTS: As expected, teachers reported more variety and severity of EF impairments than did parents. In addition, teachers used inhibition, organization of materials, and planning and organizing as predictors of ADHD symptoms, whereas parents relied predominantly on inhibition, working memory, and planning and organizing as the risk factors. CONCLUSION: Consistent with the current theory, EF impairments, particularly in inhibition, appear to underlie the behavioural manifestation of ADHD. However, parents and teachers do not always agree when reporting EF impairments at home and in school. Thus information from both types of informants is essential for understanding and treating children with this disorder.     

Attention-Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo Dimensions in Relation to Executive Functioning in Adolescents with ADHD

Previous research has failed to find a consistent relation between Sluggish Cognitive Tempo (SCT) and executive function (EF) in youth with Attention-Deficit/Hyperactivity Disorder (ADHD) when laboratory-based neuropsychological tasks of EF are used, whereas recent research with youth and adults suggests a significant relation between SCT and ratings of EF. The purpose of this study was to examine ADHD dimensions and SCT symptoms in relation to ratings of EF in adolescents with ADHD. Fifty-two adolescents (ages 12–16; 70 % male) participated in this study. Parents and teachers completed validated measures of SCT, ADHD symptoms, and EF in daily life. Adolescents’ intelligence and academic achievement were also assessed. ADHD and SCT symptoms were significantly correlated with ratings of EF. Regression analyses demonstrated that, as hypothesized, ADHD hyperactive-impulsive symptoms were strongly associated with behavioral regulation EF deficits, with ADHD inattentive and SCT symptoms unrelated to behavioral regulation EF when hyperactive-impulsivity symptoms were included in the model. The parent-reported SCT Slow scale measuring motivation, initiative, and apathy predicted both parent- and teacher-reported metacognitive EF deficits above and beyond youth characteristics and ADHD symptoms. In contrast, teacher-reported ADHD inattention was most clearly associated with teacher-reported metacognitive EF deficits. This study provides preliminary evidence for the importance of SCT symptoms in relation to metacognitive EF deficits among adolescents with ADHD and the need to further investigate the overlap and distinctiveness of SCT/ADHD. Further research is needed to replicate and extend these findings.     

Behavioral Regulation as a Predictor of Response to Children's Friendship Training in Children with Fetal Alcohol Spectrum Disorders

Children with fetal alcohol spectrum disorders (FASDs) evidence an array of structural brain abnormalities and neurocognitive deficits. Furthermore, previous research suggests that deficits in executive functioning (EF) may be associated with significant difficulties in the formation of positive peer relationships in this population. The purpose of the current study was to examine the role of EF as a predictor of treatment response to a controlled social skills intervention for children with FASDs. A total of 100 children between the ages of 6 and 12 received Children's Friendship Training (CFT). Prior to treatment, parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF). Treatment outcome was measured using parent report on the Social Skills Rating System (SSRS). The results demonstrated that behavioral regulation as measured on the BRIEF predicted the effectiveness of CFT for children with FASDs, regardless of general intellectual functioning. Specifically, the ability to control impulses, solve problems flexibly, and monitor emotional responses significantly predicted improvement in social skills and reduction in problem behaviors following CFT.     

Age Related Differences of Executive Functioning Problems in Everyday Life of Children and Adolescents in the Autism Spectrum

Numerous studies investigated executive functioning (EF) problems in people with autism spectrum disorders (ASD) using laboratory EF tasks. As laboratory task performances often differ from real life observations, the current study focused on EF in everyday life of 118 children and adolescents with ASD (6–18 years). We investigated age-related and individual differences in EF problems as reported by parents on the Behavioral Rating Inventory Executive Functions (BRIEF: Gioia et al. in Behavior rating inventory of executive function. Psychological Assessment Resources, Odesse 2000), and examined the association with autism severity. Inhibition problems were mostly found in the youngest group (6- to 8-year-olds), whereas problems with planning where more evident for 12- to 14-year-olds as compared to 9- to 11-year-olds. In a subsample of participants meeting the ADOS ASD cut-off criteria the age related differences in planning were absent, while problems with cognitive flexibility were less apparent in 15- to 18-year-olds, compared to 9- to 11-, and 12- to 14-year olds. EF problems surpassing the clinical cutoff were only observed in 20 % (planning) to 51 % (cognitive flexibility) of the children and adolescents, and no relation was found with ASD symptom severity. This underlines the heterogeneous nature of ASD.     

ADHD and executive functioning deficits in OCD youths who hoard

Hoarding is common among youth with obsessive compulsive disorder (OCD), with up to 26% of OCD youth exhibiting hoarding symptoms. Recent evidence from adult hoarding and OCD cohorts suggests that hoarding symptoms are associated with executive functioning deficits similar to those observed in subjects with attention deficit hyperactivity disorder (ADHD). However, while hoarding behavior often onsets during childhood, there is little information about executive function deficits and ADHD in affected children and adolescents.The study sample included 431 youths (ages 6–17 years) diagnosed with OCD who participated in the OCD Collaborative Genetics Study and the OCD Collaborative Genetics Association Study and completed a series of clinician-administered and parent report assessments, including diagnostic interviews and measures of executive functioning (Behavior Rating Inventory of Executive Functioning; BRIEF) and hoarding severity (Hoarding Rating Scale-Interview; HRS-I).113 youths (26%) had clinically significant levels of hoarding compulsions. Youths with and without hoarding differed significantly on most executive functioning subdomains and composite indices as measured by the parent-rated BRIEF. Groups did not differ in the frequency of full DSM-IV ADHD diagnoses; however, the hoarding group had significantly greater number of inattention and hyperactivity symptoms compared to the non-hoarding group. In multivariate models, we found that overall BRIEF scores were related to hoarding severity, adjusting for age, gender and ADHD symptoms.These findings suggest an association between hoarding and executive functioning deficits in youths with OCD, and assessing executive functioning may be important for investigating the etiology and treatment of children and adolescents with hoarding and OCD.     

Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C©)

ABSTRACT

Objectives: The Jansari assessment of Executive Functions for Children (JEF-C^©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C^© in children and adolescents with acquired brain injury (ABI).

Methods: Twenty-nine patients with ABI aged 10–18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C^©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire.

Results: The JEF-C^© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach’s alpha?=?0.62 and significant intercorrelations between individual JEF-C^© constructs). Patients performed significantly worse than controls on most of the JEF-C^© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C^© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C^© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables.

Conclusion: JEF-C^© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.     

Parent ratings of working memory are uniquely related to performance-based measures of secondary memory but not primary memory

Introduction: Existing evidence suggests that performance- and rating-based measures of working memory (WM) correlate poorly. Although some researchers have interpreted this evidence as suggesting that these measures may be assessing distinct cognitive constructs, another possibility is that rating-based measures are related to some but not all theoretically motivated performance-based measures. The current study distinguished between performance-based measures of primary memory (PM) and secondary memory (SM), and examined the relation between each of these components of WM and parent-ratings on the WM subscale of the Behavior Rating Inventory of Executive Function (BRIEF–WM). Because SM and BRIEF–WM scores have both been associated with group differences in attention-deficit/hyperactivity disorder (ADHD), it was hypothesized that SM scores would be uniquely related to parent-rated BRIEF–WM scores.

Method: Participants were a sample of 77 adolescents with and without an ADHD diagnosis, aged 11 to 15 years, from a midwestern school district. Participant scores on verbal and spatial immediate free recall tasks were used to estimate both PM and SM capacities. Partial correlation analyses were used to evaluate the extent to which estimates of PM and SM were uniquely related parent-rated BRIEF–WM scores.

Results: Both verbal and spatial SM scores were significantly related to parent-rated BRIEF–WM scores, when corresponding PM scores were controlled. Higher verbal and spatial SM scores were associated with less frequent parent-report of WM-related failures in their child’s everyday life. However, neither verbal nor spatial PM scores significantly related to parent-rated BRIEF–WM scores, when corresponding SM scores were controlled.

Conclusion: The current study suggested that previously observed low correlations between performance- and rating-based measures of WM may result from use of performance-based WM measures that do not capture the unique contributions of PM and SM components of WM.