Executive function: Reflection, iterative reprocessing, complexity, and the developing brain

Children's reasoning about the efficiency of others' actions: The development of rational action prediction

The relative efficiency of an action is a central criterion in action control and can be used to predict others' behavior. Yet, it is unclear when the ability to predict on and reason about the efficiency of others' actions develops. In three main and two follow-up studies, 3- to 6-year-old children (n = 242) were confronted with vignettes in which protagonists could take a short (efficient) path or a long path. Children predicted which path the protagonist would take and why the protagonist would take a specific path. The 3-year-olds did not take efficiency into account when making decisions even when there was an explicit goal, the task was simplified and made more salient, and children were questioned after exposure to the agent's action. Four years is a transition age for rational action prediction, and the 5-year-olds reasoned on the efficiency of actions before relying on them to predict others' behavior. Results are discussed within a representational redescription account.

Frontostriatal White Matter Integrity Relations with "Cool" and "Hot" Self-Regulation after Pediatric Traumatic Brain Injury

Traumatic brain injury (TBI) produces microstructural damage to white matter pathways connecting neural structures in pre-frontal and striatal regions involved in self-regulation (SR). Dorsal and ventral frontostriatal pathways have been linked to cognitive ("cool") and emotional ("hot") SR, respectively. We evaluated the relation of frontostriatal pathway fractional anisotropy (FA) 2 months post-TBI on cool and hot SR assessed 7 months post-TBI. Participants were 8-15 years of age, including children with uncomplicated mild TBI (mTBI; n = 24), more severe TBI (complicated-mild, moderate, severe [cms]TBI; n = 60), and typically developing (TD) children (n = 55). Diffusion tensor tractography was used to map frontostriatal pathways. Cool SR included focused and sustained attention performance, and parent-reported attention, whereas hot SR included risk-taking performance and parent-reported emotional control. Multivariate general linear models showed that children with cmsTBI had greater parent-reported cool and hot SR difficulties and lower dorsal and ventral FA than TD children. Focused attention, risk taking, and emotional control correlated with FA of specific dorsal and ventral pathways; however, only the effect of TBI on focused attention was mediated by integrity of dorsal pathways. Results suggest that frontostriatal FA may serve as a biomarker of risk for SR difficulties or to assess response to interventions targeting SR in pediatric TBI and in broader neurodevelopmental populations.

Cognitive and motor function in developmental coordination disorder

AIM

To analyse the development of motor skill and executive function in school-aged children with and without developmental coordination disorder (DCD).

METHOD

Using a longitudinal design, 186 children (86 males, 100 females) aged 6 to 11 years at Time 1 were tested over a 2-year period, 52 of whom were diagnosed with DCD at Time 1 (27 males, 25 females; mean age 8y 5mo, SD 1y 6mo) using DSM-5 criteria. The McCarron Assessment of Neuromuscular Development assessed motor status at Time 1 and at 2-year follow-up (Time 2). Executive function was assessed using a well-validated measure, the Groton Maze Learning Test.

RESULTS

The DCD cohort at Time 1 had moderate incidence of executive function deficit (41%). Most importantly, at a group level, children with persisting DCD (across Times 1 and 2) also showed significantly lower levels of executive function than children with typical motor development at both time points. At an individual level, around 26% of children in this group had persisting executive function deficits relative to normal ranges of performance.

INTERPRETATION

Children with persisting DCD are at significant risk of executive function issues. The combination of motor and cognitive issues as a potential risk factor in the longer-term development of children is discussed.

WHAT THIS PAPER ADDS

Around half of children initially diagnosed with developmental coordination disorder (DCD) had the same diagnosis at 2-year follow-up. 41% of children with DCD have impaired executive function. Children with persisting DCD show poorer executive function than those with typical motor development or remitting DCD.

Does Anxiety Enhance or Hinder Attentional and Impulse Control in Youth With ADHD? An ERP Analysis

Objective: Youth with ADHD and comorbid anxiety (ADHD+ANX) experience increased social and academic impairment compared with youth with ADHD without anxiety (ADHD). Group differences in attentional and impulse control may underlie this increased impairment. Examination of group differences using behavioral measures of attentional and impulse control has yielded inconsistent findings. This study explored group differences using event-related potentials (ERPs), which provide neural information concerning early information processing. Method: ERPs (early frontal positivity [EFP], N2) were collected while youth aged 11 to 17 with ADHD (n = 31) and ADHD+ANX (n = 35) completed a visual and an auditory computer task. Results: Compared with the ADHD group, the ADHD+ANX group exhibited larger N2 amplitudes to no-go stimuli and larger EFP amplitudes to target auditory stimuli, with variable attention allocation to nontarget stimuli. Conclusion: The addition of anxiety to ADHD appears to alter early attentional processing, which may be an important aspect of this comorbidity.

Feasibility and potential benefits of an attention and executive function intervention on metacognition in a mixed pediatric sample

The term "metacognition" describes thinking about a cognitive phenomenon or, more simply put, thinking about thinking . Metacognition involves using knowledge about one's cognitive processes to change behavior, including monitoring and controlling cognition. Metacognition is vital for learning and is often more difficult for children with neurodevelopmental concerns (e.g. Attention Deficit Hyperactivity Disorder [ADHD], Fetal Alcohol Spectrum Disorder [FASD], Autism Spectrum Disorders [ASD]), possibly due to underlying deficits in attention and executive functioning (EF). The present study evaluated a 6- to 8-week cognitive intervention aimed at improving attention and EF and children's metacognitive abilities. Participants included a mixed sample of 50 children ages 6-12 years presenting with attention and/or EF deficits. Children within the active intervention group completed a game-based attention/EF intervention called Caribbean Quest (CQ), which combines process-specific and compensatory approaches to remediate attention and EF. Educational Assistants (EAs) supported children during gameplay by teaching explicit metacognitive strategies. Pre/post assessments included measures of attention and working memory (WM), metacognitive awareness (child, parent, and EA questionnaires), and metacognitive regulation (metacognitive monitoring and control). Results indicated post-intervention gains in WM, metacognitive awareness, and metacognitive regulation (self-monitoring and metacognitive control). These results provide preliminary support for CQ as potentially beneficial in improving aspects of EF and metacognition in children.

A Novel Approach to Measure Executive Functions in Students: An Evaluation of Two Child-Friendly Apps

Interest in measurement of children's executive functions has shown a major increase over the past two decades. The present study evaluates two new apps (EYT and eFun) for measuring executive functions in children. The results of this study show that children (aged 5-8) enjoy executive function assessment in the form of games on an iPad. However, only one executive function, EYT working memory, showed significant positive correlations with several types of grades (e.g., English and maths) in primary school students. New, self-assessed, child-friendly executive function measurement tools have the potential to provide future possibilities for teachers to integrate information on cognitive ability into student learning plans.

Moving beyond Ordinary Factor Analysis in Studies of Personality and Personality Disorder: A Computational Modeling Perspective

Almost all forms of psychopathology, including personality disorders, are arrived at through complex interactions among neurobiological vulnerabilities and environmental risk factors across development. Yet despite increasing recognition of etiological complexity, psychopathology research is still dominated by searches for large main effects causes. This derives in part from reliance on traditional inferential methods, including ordinary factor analysis, regression, ANCOVA, and other techniques that use statistical partialing to isolate unique effects. In principle, some of these methods can accommodate etiological complexity, yet as typically applied they are insensitive to interactive functional dependencies (modulating effects) among etiological influences. Here, we use our developmental model of antisocial and borderline traits to illustrate challenges faced when modeling complex etiological mechanisms of psychopathology. We then consider how computational models, which are rarely used in the personality disorders literature, remedy some of these challenges when combined with hierarchical Bayesian analysis.

Baseline Cognitive Performance Moderates the Effects of Physical Activity on Executive Functions in Children

Findings regarding the effects of regular physical activity on cognition in children have been inconsistent due to a number of demographic factors and experimental considerations. The present study was designed to examine baseline cognitive performance and executive function demands, as possible factors underlying the lack of consensus in the literature, by investigating the moderating role of those factors on the effects of physical activity on cognition. We reanalyzed data from three randomized controlled trials, in which the effects of regular physical activity intervention on cognition were examined using executive function tasks that included at least two task conditions requiring variable executive function demands, with a cumulative total of 292 participants (9–13 years). The results indicate that cognitive improvements resulting from physical activity intervention were greater in children with lower baseline cognitive performance. The main analysis revealed that beneficial effects of physical activity intervention on cognitive performance were generally observed across executive function conditions. However, secondary analyses indicated that these general effects were moderated by baseline performance, with disproportionately greater effects for task conditions with higher executive function demands. These findings suggest that baseline cognitive performance is an individual difference variable that moderates the beneficial effects of physical activity on executive functions.

'MusiMath' and 'Academic Music' - Two music-based intervention programs for fractions learning in fourth grade students

Music and mathematics require abstract thinking and using symbolic notations. Controversy exists regarding transfer from musical training to math achievements. The current study examined the effect of two integrated intervention programs representing holistic versus acoustic approaches, on fraction knowledge. Three classes of fourth graders attended 12 lessons on fractions: One class attended the 'MusiMath' holistic program (n = 30) focusing on rhythm within the melody. Another class attended the 'Academic Music' acoustic program (Courey et al., Educ Stud Math 81:251, 2012) (n = 25) which uses rhythm only. The third class received regular fraction lessons (comparison group, n = 22). Students in both music programs learned to write musical notes and perform rhythmic patterns through clapping and drumming as part of their fraction lessons. They worked toward adding musical notes to produce a number (fraction), and created addition/subtraction problems with musical notes. The music programs used a 4/4 time signature with whole, half, quarter and eighth notes. In the math lessons, the students learned the analogy between musical durations and 1 2 , 1 4 , 1 8 fractions, but also practiced fractions other than 1 2 , 1 4 , 1 8 . Music and math were assessed before, immediately following, and 3- and 6-months post-intervention. Pre- to post-intervention analyses indicated that only the 'MusiMath' group showed greater transfer to intervention-trained and untrained fractions than the comparison group. The 'Academic Music' group showed a trend on trained fractions. Although both music groups outperformed the comparison group 3- and 6-months post-intervention on trained fractions, only the 'MusiMath' group demonstrated greater gains in untrained fractions. Gains were more evident in trained than in untrained fractions. A video abstract of this article can be viewed at https://youtu.be/uJ_KWWDO624.

Measurement of Executive Functioning and High Intellectual Ability in Childhood: A Comparative Meta-Analysis

From a neuroconstructivist approach and a developmental model of high intellectual ability (HIA), it is argued that the management of intellectual resources through executive functioning (EF) is one of the factors influencing the expression of high potential. The main objective is to determine the effectiveness of measures of executive functioning used comparing schoolchildren with HIA and those of average intelligence. A meta-analysis was carried out on a selection of 17 studies for a total sample of 1518 children with either HIA or an average level of intelligence. Pooled estimates of effect size revealed a significant difference favoring the HIA individuals in the two components of EF related with WM verbal (d = 1.015), and WM visual-spatial (d = 0.709). Other components did not show significant differences: inhibition (d = −0.014), flexibility (d = 0.068), and planification (d = −0.038). The empirical heterogeneity was very high. It is concluded that these instruments show a degree of measurement impurity, which condition their validity and reliability, and that schoolchildren with HIA display better executive functioning in the components of verbal and visual-spatial working memory.

RDoC and Psychopathology among Youth: Misplaced Assumptions and an Agenda for Future Research

Now over 10 years old, the Research Domain Criteria (RDoC) has gained impressive traction in the adult psychopathology literature, but enthusiasm among child and adolescent psychopathologists lags somewhat behind. We consider possible reasons why RDoC has not been embraced fully in the child and adolescent literatures. We emphasize common, interrelated, and sometimes outdated assumptions that impede scientific progress that RDoC could facilitate. Traditionally, child and adolescent psychopathologists have used behavioral syndromes as gold standards against which biological markers are validated, even though behavioral syndromes are often measured with less precision; sought to identify large main effects of single biological functions on single behavioral syndromes, thereby ignoring (even if implicitly) the overwhelming etiological complexity of psychopathology; expected 1:1 correspondencies between biological functions and behaviors, despite evidence that core biological systems subserving behavior are functionally interdependent (i.e., modulate one another); and failed to consider neurobiological mechanisms of homotypic and heterotypic comorbidity and continuity. Using examples from our work, we show how a developmental, RDoC-informed approach to externalizing behavior enriches our understanding of psychopathology. We also provide an agenda for future research, which includes calls to (1) adopt neural-systems-first approaches over disorder-first approaches when studying psychopathology, (2) eschew biological reductionism by integrating environmental risk mediators into our etiopathophysiological models, (3) integrate neural vulnerabilities into the empirical latent structure of psychopathology, and (4) replace null hypothesis significance testing with computational approaches that accommodate etiological complexity by evaluating functional dependencies among RDoC constructs, including positive valence systems (approach), negative valence systems (avoidance), and arousal/regulatory systems (self-regulation).

Mapping Mind-Brain Development: Towards a Comprehensive Theory

The relations between the developing mind and developing brain are explored. We outline a theory of intellectual development postulating that the mind comprises four systems of processes (domain-specific, attention and working memory, reasoning, and cognizance) developing in four cycles (episodic, realistic, rule-based, and principle-based representations, emerging at birth, 2, 6, and 11 years, respectively), with two phases in each. Changes in reasoning relate to processing efficiency in the first phase and working memory in the second phase. Awareness of mental processes is recycled with the changes in each cycle and drives their integration into the representational unit of the next cycle. Brain research shows that each type of processes is served by specialized brain networks. Domain-specific processes are rooted in sensory cortices; working memory processes are mainly rooted in hippocampal, parietal, and prefrontal cortices; abstraction and alignment processes are rooted in parietal, frontal, and prefrontal and medial cortices. Information entering these networks is available to awareness processes. Brain networks change along the four cycles, in precision, connectivity, and brain rhythms. Principles of mind-brain interaction are discussed.

Sequence matters: patterns in task-based clinical reasoning

Background

The cognitive pathways that lead to an accurate diagnosis and efficient management plan can touch on various clinical reasoning tasks (1). These tasks can be employed at any point during the clinical reasoning process and though the four distinct categories of framing, diagnosis, management, and reflection provide some insight into how these tasks map onto clinical reasoning, much is still unknown about the task-based clinical reasoning process. For example, when and how are these tasks typically used? And more importantly, do these clinical reasoning task processes evolve when patient encounters become complex and/or challenging (i.e. with contextual factors)?

Methods

We examine these questions through the lens of situated cognition, context specificity, and cognitive load theory. Sixty think-aloud transcripts from 30 physicians who participated in two separate cases – one with a contextual factor and one without – were coded for 26 clinical reasoning tasks (1). These tasks were organized temporally, i.e. when they emerged in their think-aloud process. Frequencies of each of the 26 tasks were aggregated, categorized, and visualized in order to analyze task category sequences.

Results

We found that (a) as expected, clinical tasks follow a general sequence, (b) contextual factors can distort this emerging sequence, and (c) the presence of contextual factors prompts more experienced physicians to clinically reason similar to that of less experienced physicians.

Conclusions

These findings add to the existing literature on context specificity in clinical reasoning and can be used to strengthen teaching and assessment of clinical reasoning.

The effect of task difficulty on feedback processing in children

The study evaluated the effect of task difficulty on feedback processing as measured by the feedback related event related potentials (ERPs) in 7-11-years-old children. Children completed two declarative learning tasks that differed in the number of object-name pairs they were required to learn, deeming the task with twice as many pairs as more difficult. EEG was recorded during the tasks, and event related potentials time-locked to the feedback presentation were analyzed. Additionally, Accuracy was measured in test block at the end of each task. Behaviorally, children achieved better accuracy on the easy task than on the difficult task. In line with previous findings in adults, the FRN was not found sensitive to task difficulty. However, a feedback-related P300 and a fronto-central positivity that followed the FRN were found sensitive to task difficulty such that their amplitudes were larger in the easy task. This pattern is opposite to that reported previously in adults and may reflect the effect of motivation on attention allocation in children.

Brief Stress Reduction Strategies Associated with Better Behavioral Climate in a Crisis Nursery: A Pilot Study

Approximately 3.5 million children in the United States were reported to Child Protective Services in 2016. Effective, developmentally-informed programs are critically necessary to support under-resourced families at risk of child abuse. This study implemented a module of mindfulness-based stress reduction strategies in partnership with a community organization whose goal is to keep families together while reducing the risk of child abuse by providing short-term (3-day) overnight crisis care for birth through 6-year-olds. Group-level assessment of child behaviors was used to assess child functioning at the program level. Children's Services staff were trained in brief stress reduction strategies, with the intention that they be used with the children regularly throughout the day to help the children be emotionally calm and behaviorally regulated. Ordinal logistic regressions suggested that, over the six months preceding implementation (April - September 2017) compared to six months following completion of implementation (February - July 2018), the introduction of stress-reduction strategies was associated with significantly increased self-regulatory behavior and coping skills, but not decreased aggressive behavior. Additionally, staff frequently (approximately 65% of the time) endorsed the strategies as being effective. Though the evidence is preliminary, the unique context of the crisis nursery coupled with the measurement of program-level outcomes furthers our understanding of the scalable impact mindfulness-based stress reduction strategies can have with children experiencing chronic stress and/or trauma in a very hard-to-reach population. Implementation challenges are discussed, as are the implications of stress reduction strategies as a useful, efficient method to improve self-regulation in children experiencing adversity.

Executive Function and Psychopathology: A Neurodevelopmental Perspective

Executive function (EF) skills are neurocognitive skills that support the reflective, top-down coordination and control of other brain functions, and there is neural and behavioral evidence for a continuum from more "cool" EF skills activated in emotionally neutral contexts to more "hot" EF skills needed for the reversal of motivationally significant tendencies. Difficulties in EF are transdiagnostic indicators of atypical development. A neurodevelopmental model traces the pathway from adverse childhood experiences and stress to disruption of the development of neural systems supporting reflection and EF skills to an increased risk for general features of psychopathology. Research indicates that EF skills can be cultivated through scaffolded training and are a promising target for therapeutic and preventive intervention. Intervention efficacy can be enhanced by mitigating disruptive bottom-up influences such as stress, training both hot and cool EF skills, and adding a reflective, metacognitive component to promote far transfer of trained skills.

Associations Among Body Mass Index, Cortical Thickness, and Executive Function in Children

IMPORTANCE

A total of 25.7 million children in the United States are classified as overweight or obese. Obesity is associated with deficits in executive function, which may contribute to poor dietary decision-making. Less is known about the associations between being overweight or obese and brain development.

OBJECTIVE

To examine whether body mass index (BMI) is associated with thickness of the cerebral cortex and whether cortical thickness mediates the association between BMI and executive function in children.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, cortical thickness maps were derived from T1-weighted structural magnetic resonance images of a large, diverse sample of 9 and 10-year-old children from 21 US sites. List sorting, flanker, matrix reasoning, and Wisconsin card sorting tasks were used to assess executive function.

MAIN OUTCOMES AND MEASURES

A 10-fold nested cross-validation general linear model was used to assess mean cortical thickness from BMI across cortical brain regions. Associations between BMI and executive function were explored with Pearson partial correlations. Mediation analysis examined whether mean prefrontal cortex thickness mediated the association between BMI and executive function.

RESULTS

Among 3190 individuals (mean [SD] age, 10.0 [0.61] years; 1627 [51.0%] male), those with higher BMI exhibited lower cortical thickness. Eighteen cortical regions were significantly inversely associated with BMI. The greatest correlations were observed in the prefrontal cortex. The BMI was inversely correlated with dimensional card sorting (r = -0.088, P < .001), list sorting (r = -0.061, P < .003), and matrix reasoning (r = -0.095, P < .001) but not the flanker task. Mean prefrontal cortex thickness mediated the association between BMI and list sorting (mean [SE] indirect effect, 0.014 [0.008]; 95% CI, 0.001-0.031) but not the matrix reasoning or card sorting task.

CONCLUSIONS AND RELEVANCE

These results suggest that BMI is associated with prefrontal cortex development and diminished executive functions, such as working memory.

The Specific Impact of Apolipoprotein E Epsilon 2 on Cognition and Brain Function in Cognitively Normal Elders and Mild Cognitive Impairment Patients

Variants in the apolipoprotein E (APOE) gene play an important role in the development of Alzheimer’s disease (AD). Specifically, the APOE ε4 allele is an established genetic risk factor for AD, while the APOE ε2 allele is a protective factor against AD. However, the mechanism underlying this impact of APOE genotype on the pathogenesis of AD remain unclear. This study sought to investigate the influence of APOE genotype on cognition and neuroimaging features in cognitively normal (CN) elderly individuals and patients with mild cognitive impairment (MCI). A total of 177 participants were selected from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, including 101 MCI patients and 76 CN individuals. A 2 × 3 (consisting of two groups and three APOE genotypes) analysis of covariance was carried out to measure the influences of diagnosis and APOE genotype on cognition and brain features, assessed based on global functional connectivity density (gFCD) and hippocampal volume. In addition, a mediation analysis was carried out to investigate the indirect influence of neuroimaging features on the relationship between APOE genotype and cognitive performance in the MCI group. This analysis revealed that APOE genotype had an influence on brain function in the bilateral precentral gyrus, right thalamus, and posterior cingulate cortex (PCC). In addition, an interactive influence between diagnosis and APOE genotype was found on general cognition, immediate memory, executive function, hippocampal volume, and gFCD in the right dorsolateral prefrontal cortex and medial prefrontal cortex (MPFC). Finally, this mediation analysis revealed that hippocampal volume and gFCD in the thalamus may mediate the relationship between APOE genotype and cognitive performance in the MCI group. Taken together, our findings provide novel insights into the neural mechanisms underlying the genetically guided pathogenic mechanisms of AD.

The role of executive functions in kindergarteners' persistent and non-persistent behaviour

The aim of the study was to examine whether cognitive skills are related to persistence. Thus, children's (N = 157, mean age: 5.9 years) persistent and non-persistent behaviours (i.e., cheating and off-task) were assessed in an unsolvable task. Additionally, we assessed children's executive functions and temperament. Analysis for persistence showed that cognitive inhibition and cognitive flexibility predicted children's persistent behaviour, beyond age and temperament. Analyses for non-persistent behaviours revealed that temperament and weak executive functions predicted cheating, while age predicted off-task behaviour. Statement of contribution What is already known on this subject? So far, persistence has been conceptualized as a temperamental sub-dimension of self-regulation. What does this study add? A child's persistence depends not only on temperament but also on cognitive inhibition and cognitive flexibility. There are qualitative differences between the two non-persistent behaviours cheating and off-task. While cheating is related to weaker cognitive skills, off-task behaviour seems mainly age-related.

Maternal Language and Child Vocabulary Mediate Relations Between Socioeconomic Status and Executive Function During Early Childhood

This article examined longitudinal relations among socioeconomic risk, maternal language input, child vocabulary, and child executive function (EF) in a large sample (N = 1,009) recruited for a prospective longitudinal study. Two measures of maternal language input derived from a parent-child picture book task, vocabulary diversity (VOCD), and language complexity, showed variation by socioeconomic risk at child ages 15, 24, and 36 months. Maternal VOCD at child age 24 months and maternal language complexity at child age 36 months mediated the relation between socioeconomic risk and 48-month child EF, independent of parenting sensitivity. Moreover, 36-month child vocabulary mediated the relation between maternal language input and child EF. These findings provide novel evidence about mechanisms linking socioeconomic risk and child executive function.

The Planning of Difficulty Curves in an Exergame for Inhibitory Control Stimulation in a School Intervention Program: A Pilot Study

Apollo & Rosetta is an Exergame developed for Inhibitory Control stimulation in Elementary School children. This works’ goal has been to demonstrate the behavior of the difficulty curves planned for seven activities (minigames) ingame, as well as their correspondence with the variables collected during a pilot neuropsychological intervention. Seven students participated in the study and played the minigames 1528 times during the 3-month intervention. Each of the minigames had a difficulty curve computed with the goal of keeping the players in the state of Flow. The curves were designed in cycles which grow throughout levels (Normal Level) to a peak (Peak Level), followed by a rest period (Rest Level). The pilot study encompassed three different analyses: (1) Exploratory performance analysis with Spearman correlation, which indicated a positive and significant general correlation between performance and level difficulty; (2) Success exploratory analysis, which showed that as the stages progressed, the success rate increased, even if the level difficulty also increased; (3) Analysis of the factors which influenced performance, through Mixed Effects Logistic Regression and the Backward method. This analysis demonstrated that the odds ratio for overcoming challenges between Normal levels was 0.71 [0.59;0.86] times lower than Rest Level (p-value = 0.000), whereas in Peak levels it was 0.62 [0.47;0.83] times lower than Rest level values (p-value = 0.001). These data confirm the overall planned behavior of the difficulty curves.

The association between executive functioning and parental stress and psychological distress is mediated by parental reflective functioning in mothers with substance use disorder

Mothers with a substance use disorder (SUD) have been found to exhibit heightened experience of stress and deficits in executive functioning (EF) and in parental reflective functioning (PRF). Although experiences of stress, EF and PRF are important for caregiving capacities; no studies have explored associations between the phenomena in mothers with SUD. This study aimed to examine the association between EF (working memory, inhibition, and cognitive flexibility) and different forms of stress (parental stress, general life stress, and psychological distress) in 43 mothers with SUD with infants. We further aimed to investigate whether PRF had a mediating function between EF and the experience of stress. The mothers completed self-report questionnaires regarding experiences of different types of stress, and we also used neuropsychological tests to assess EF and a semistructured interview to assess PRF. Results identified problems in EF were associated with higher parental stress and psychological distress but not with general life stress. Cognitive flexibility contributed uniquely to variance in parental stress, whereas working memory was a unique contributor to variance in psychological distress. PRF had a mediating function between EF and parental stress and between EF and psychological distress. Findings highlight the importance of considering individual differences in PRF when targeting EF in interventions trying to reduce the experience of parental stress and psychological distress in mothers with SUD.

Developing, mature, and unique functions of the child's brain in reading and mathematics

Cognitive development research shows that children use basic "child-unique" strategies for reading and mathematics. This suggests that children's neural processes will differ qualitatively from those of adults during this developmental period. The goals of the current study were to 1) establish whether a within-subjects neural dissociation between reading and mathematics exists in early childhood as it does in adulthood, and 2) use a novel, developmental intersubject correlation method to test for "child-unique", developing, and adult-like patterns of neural activation within those networks. Across multiple tasks, children's reading and mathematics activity converged in prefrontal cortex, but dissociated in temporal and parietal cortices, showing similarities to the adult pattern of dissociation. "Child-unique" patterns of neural activity were observed in multiple regions, including the anterior temporal lobe and inferior frontal gyri, and showed "child-unique" profiles of functional connectivity to prefrontal cortex. This provides a new demonstration that "children are not just little adults" - the developing brain is not only quantitatively different from adults, it is also qualitatively different.

A randomized controlled trial to examine the effect of two teaching methods on preschool children's language and communication, executive functions, socioemotional comprehension, and early math skills

BACKGROUND

During the preschool years, children's development of skills like language and communication, executive functions, and socioemotional comprehension undergo dramatic development. Still, our knowledge of how these skills are enhanced is limited. The preschool contexts constitute a well-suited arena for investigating these skills and hold the potential for giving children an equal opportunity preparing for the school years to come. The present study compared two pedagogical methods in the Swedish preschool context as to their effect on language and communication, executive functions, socioemotional comprehension, and early math. The study targeted children in the age span four-to-six-year-old, with an additional focus on these children's backgrounds in terms of socioeconomic status, age, gender, number of languages, time spent at preschool, and preschool start. An additional goal of the study was to add to prior research by aiming at disentangling the relationship between the investigated variables.

METHOD

The study constitutes a randomized controlled trial including 18 preschools and 29 preschool units, with a total of 431 children, and 98 teachers. The interventions lasted for 6 weeks, preceded by pre-testing and followed by post-testing of the children. Randomization was conducted on the level of preschool unit, to either of the two interventions or to control. The interventions consisted of a socioemotional and material learning paradigm (SEMLA) and a digitally implemented attention and math training paradigm (DIL). The preschools were further evaluated with ECERS-3. The main analysis was a series of univariate mixed regression models, where the nested structure of individuals, preschool units and preschools were modeled using random variables.

RESULTS

The result of the intervention shows that neither of the two intervention paradigms had measurable effects on the targeted skills. However, there were results as to the follow-up questions, such as executive functions predicting all other variables (language and communication, socioemotional comprehension, and math). Background variables were related to each other in patterns congruent with earlier findings, such as socioeconomic status predicting outcome measures across the board. The results are discussed in relation to intervention fidelity, length of intervention, preschool quality, and the impact of background variables on children's developmental trajectories and life prospects.

Accounting for complexity in medical education: a model of adaptive behaviour in medicine

CONTEXT

Medicine is practised in complex systems. Physicians engage in clinical and operational problems that are dynamic and lack full transparency. As a consequence, the behaviour of medical systems and diseases is often unpredictable. Medical science has equipped physicians with powerful tools to favourably impact health, but a reductionist approach alone is insufficient to optimally address the complex challenges posed by illness and public health. Concepts from complexity science, such as continuous quality improvement and teamwork, strive to fill the gap between biomedical knowledge and the realities of practice. However, the superficial treatment of these systems-thinking concepts in medical education has distorted their implementation and undermined their impact. 'Systems thinking' has been conflated with 'systematic thinking'; concepts which are adaptive in nature are being taught as standardised, reductionist tools.

METHODS

Using concepts from complexity science, the history of science and psychology, this problem is outlined and a theoretical model of professional development is proposed.

RESULTS

This model proposes that complex problem solving and adaptive behaviour, not technical expertise, are distinguishing features of professionalism.

DISCUSSION

The impact of this model on our understanding of physician autonomy, professionalism, teamwork and continuous quality improvement is discussed. This model has significant implications for the structure and content of medical education. Strategies for enhancing medical training, including interventions in recruitment, the curriculum and evaluation, are reviewed. Such adjustments would prepare trainees to more effectively utilise biomedical knowledge and tools in the complex high-stakes reality of medical practice.

A Dynamic Multi-Reduction Algorithm for Brain Functional Connection Pathways Analysis

Revealing brain functional connection pathways is of great significance in understanding the cognitive mechanism of the brain. In this paper, we present a novel rough set based dynamic multi-reduction algorithm (DMRA) to analyze brain functional connection pathways. First, a binary discernibility matrix is introduced to obtain a reduction, and a reduction equivalence theorem is proposed and proved to verify the feasibility of reduction algorithm. Based on this idea, we propose a dynamic single-reduction algorithm (DSRA) to obtain a seed reduction, in which two dynamical acceleration mechanisms are presented to reduce the size of the binary discernibility matrix dynamically. Then, the dynamic multi-reduction algorithm is proposed, and multi-reductions can be obtained by replacing the non-core attributes in seed reduction. Comparative performance experiments were carried out on the UCI datasets to illustrate the superiority of DMRA in execution time and classification accuracy. A memory cognitive experiment was designed and three brain functional connection pathways were successfully obtained from brain functional Magnetic Resonance Imaging (fMRI) by employing the proposed DMRA. The theoretical and empirical results both illustrate the potentials of DMRA for brain functional connection pathways analysis.

Expressive Vocabulary Predicts Nonverbal Executive Function: A 2-year Longitudinal Study of Deaf and Hearing Children

Numerous studies suggest an association between language and executive function (EF), but evidence of a developmental relationship remains inconclusive. Data were collected from 75 deaf/hard-of-hearing (DHH) children and 82 hearing age-matched controls. Children were 6-11 years old at first time of testing and completed a battery of nonverbal EF tasks and a test of expressive vocabulary. These tasks were completed again 2 years later. Both groups improved their scores on all tasks over this period. DHH children performed significantly less well than hearing peers on some EF tasks and the vocabulary test at both time points. Cross-lagged panel models showed that vocabulary at Time 1 predicted change in EF scores for both DHH and hearing children but not the reverse.

No evidence for effects of Turkish immigrant children's bilingualism on executive functions

Recent research has increasingly questioned the bilingual advantage for executive functions (EF). We used structural equation modeling in a large sample of Turkish immigrant and German monolingual children (N = 337; aged 5–15 years) to test associations between bilingualism and EF. Our data showed no significant group differences between Turkish immigrant and German children’s EF skills while taking into account maternal education, child gender, age, and working memory (i.e., digit span backwards). Moreover, neither Turkish immigrant children’s proficiency in either language nor their home language environment predicted EF. Our findings offer important new evidence in light of the ongoing debate about the existence of a bilingual advantage for EF.

Maternal emotional support but not cognitive support during problem-solving predicts increases in cognitive flexibility in early childhood

Cognitive flexibility is a sophisticated form of executive functions that predicts a range of adaptive outcomes; however, little is known about which caregiving behaviors predict the rapid improvements in children’s cognitive flexibility during early childhood. This study examined whether ordinary variations in mothers’ provision of emotional and cognitive support during problem-solving predict children’s cognitive flexibility and tested whether children’s cognitive flexibility predicts caregiving behaviors across time. Two hundred and seventy-eight children and their caregivers (96% mothers) participated in laboratory visits when children were in preschool, kindergarten, and first grade. At each visit, cognitive flexibility was measured via a computerized version of the Dimensional Change Card Sort task and mothers’ behaviors were observed during a semi-structured problem-solving board game task. Results from autoregressive cross-lagged structural regression analyses indicated that mothers’ emotional support predicted greater child cognitive flexibility from preschool to kindergarten, and from kindergarten to first grade, after accounting for the stability in these constructs over time and controlling for the influence of maternal education, and child age and minority status. Mothers’ cognitive support did not predict child cognitive flexibility over time. Child cognitive flexibility did not lead to changes in caregiving behaviors over time. Findings suggest that mothers’ provision of emotional support during problem-solving may be an important proximal mechanism that contributes to children’s cognitive flexibility across early childhood.

Differential inter-trial effects in the visual search of children, adolescents, and young adults

We examined the age-related variation in one type of inter-trial effect of visual search, the distractor previewing effect (DPE), in affectively neutral and affectively charged contexts. In Experiment 1, children, adolescents, and young adults were faster to identify the shape of a color target when the color of the current distractors had already been previewed than when the target had been previewed in the preceding target-absent trial, indicative of a color-based DPE. The results revealed a greater DPE in children than in adolescents and young adults, but it can be attributed to children's slower RTs than the other two groups. In Experiment 2, children, adolescents, and young adults were instructed to respond to a schematic face that was different from the other two faces. Young adults were faster in searching for a threatening face among friendly ones when they had previewed a target-absent display consisting of friendly faces than that of threatening faces, indicating an emotional DPE. By contrast, children showed a reversed DPE under the same condition, whereas adolescents showed no DPE. Taken together, these results suggested that the three age groups were all able to create an inhibitory attentional bias on the basis of trial history in affectively neutral context, whereas children and adolescents were not able to create such an inhibitory attentional bias in affectively charged contexts in the same way as adults did. These findings implied that the development of attentional inhibition abilities in affectively charged contexts might be delayed compared to those in affectively neutral contexts.

Competitive achievement may be predicted by executive functions in junior tennis players: An 18-month follow-up study

This study evaluates whether high levels of executive function predict competition results 18 months later in junior tennis players. Forty junior tennis players (20 girls, 20 boys; 9-15 years old) who regularly participate in prefecture tennis tournaments were recruited. All participants underwent executive function evaluations (the Design Fluency Task) in July 2015 and their prefecture junior rankings in August 2015 and February 2017 were recorded. As a result, after controlling for age and gender, the future ranking (February 2017) was significantly predicted by performance in the Design Fluency Task (β = -.30, p = .02; ΔR² = .08), whereas the prediction for August 2015 rank as the baseline was not significant (β = -.19, p = .17; ΔR² = .03). After controlling for age, gender, and ranking in the baseline, the change in ranking was significantly predicted by performance in the Design Fluency Task (β = -.14, p = .02; ΔR² = .02). This suggests that childhood executive function may play a significant role in success later in life. This study highlights how executive function predicts future success in a specific sport; as such, supporting the development of executive function may contribute to higher competition results.