The functional emergence of prefrontally-guided working memory systems in four- to eight-year-old children

Age-related change in executive function: developmental trends and a latent variable analysis

This study examined the developmental trajectories of three frequently postulated executive function (EF) components, Working Memory, Shifting, and Inhibition of responses, and their relation to performance on standard, but complex, neuropsychological EF tasks, the Wisconsin Card Sorting Task (WCST), and the Tower of London (ToL). Participants in four age groups (7-, 11-, 15-, and 21-year olds) carried out nine basic experimental tasks (three tasks for each EF), the WCST, and the ToL. Analyses were done in two steps: (1) analyses of (co)variance to examine developmental trends in individual EF tasks while correcting for basic processing speed, (2) confirmatory factor analysis to extract latent variables from the nine basic EF tasks, and to explain variance in the performance on WCST and ToL, using these latent variables. Analyses of (co)variance revealed a continuation of EF development into adolescence. Confirmatory factor analysis yielded two common factors: Working Memory and Shifting. However, the variables assumed to tap Inhibition proved unrelated. At a latent level, again correcting for basic processing speed, the development of Shifting was seen to continue into adolescence, while Working Memory continued to develop into young-adulthood. Regression analyses revealed that Working Memory contributed most strongly to WCST performance in all age groups. These results suggest that EF component processes develop at different rates, and that it is important to recognize both the unity and diversity of EF component processes in studying the development of EF.

Spatial relational memory in 9-month-old macaque monkeys

This experiment assesses spatial and nonspatial relational memory in freely moving 9-mo-old and adult (11-13-yr-old) macaque monkeys (Macaca mulatta). We tested the use of proximal landmarks, two different objects placed at the center of an open-field arena, as conditional cues allowing monkeys to predict the location of food rewards hidden in one of two sets of three distinct locations. Monkeys were tested in two different conditions: (1) when local visual cues marked the two sets of potentially baited locations, so that monkeys could use both local and spatial information to discriminate these locations from never-baited locations; and (2) when no local visual cues marked the two sets of potentially baited locations, so that monkeys had to rely on a spatial relational representation of the environment to discriminate these locations. No 9-mo-old or adult monkey associated the presence of the proximal landmarks, at the center of the arena, with the presence of food in one set of three distinct locations. All monkeys, however, discriminated the potentially baited locations in the presence of local visual cues, thus providing evidence of visual discrimination learning. More importantly, all 9-mo-old monkeys tested discriminated the potentially baited locations in absence of the local visual cues, thus exhibiting evidence of spatial relational learning. These findings indicate that spatial memory processes characterized by a relational representation of the environment are present as early as 9 mo of age in macaque monkeys.

Everyday cognitive function after craniopharyngioma in childhood

Despite clinical impressions that cognitive complaints are prominent in patients with a history of craniopharyngioma, formal neuropsychologic documentation is inconsistent. This study assessed everyday cognitive complaints and neuropsychologic test performance to evaluate the prevalence of problems and the relationship of these domains to one another in patients treated for craniopharyngioma in childhood or adolescence. Ten patients treated for craniopharyngioma completed measures of everyday cognitive function (Cognitive Failures Questionnaire, Rivermead Behavioural Memory Test) and a battery of standard neuropsychologic tests. The prevalence of problems was ascertained for each measure. Most patients demonstrated significant deficits in everyday memory (Cognitive Failures Questionnaire, 9/10 patients; Rivermead Behavioural Memory Test, 7/10 patients). Scores were within normal limits, however, for intelligence quotient, achievement, attention, verbal memory, and spatial working memory. Processing speed was slow (5/10 patients). Spatial working memory predicted Cognitive Failures Questionnaire (P < 0.07), as did somatic symptoms from the Beck Depression Inventory (P < 0.01), but these associations appeared independent. Adolescents and young adults with treated craniopharyngioma experience deficits in everyday cognitive functions, many involving memory, that are not easily detected by standard neuropsychologic testing. The extent of self-rated cognitive problems is related to spatial working memory and somatic concerns.

Assessment of hot and cool executive function in young children: age-related changes and individual differences

Although executive function (EF) is often considered a domain-general cognitive function, a distinction has been made between the "cool" cognitive aspects of EF more associated with dorsolateral regions of prefrontal cortex and the "hot" affective aspects more associated with ventral and medial regions (Zelazo and Mller, 2002). Assessments of EF in children have focused almost exclusively on cool EF. In this study, EF was assessed in 3- to 5-year-old children using 2 putative measures of cool EF (Self-Ordered Pointing and Dimensional Change Card Sort) and 2 putative measures of hot EF (Children's Gambling Task and Delay of Gratification). Findings confirmed that performance on both types of task develops during the preschool period. However, the measures of hot and cool EF showed different patterns of relations with each other and with measures of general intellectual function and temperament. These differences provide preliminary evidence that hot and cool EF are indeed distinct, and they encourage further research on the development of hot EF.

How do children prepare to react? Imaging maturation of motor preparation and stimulus anticipation by late contingent negative variation

Both the motor system and the frontal executive control system show a late maturation in humans which continues into school-age and even adolescence. We investigated the maturation of preparation processes towards a fast motor reaction in 74 healthy right-handed children aged 6 to 18 years and analyzed the topography of the late component of contingent negative variation (lCNV) in a 64-electrode high density sensor array. While adolescents from about 12 years on showed a bilaterally distributed centro-parietal maximum like adults do, younger children almost completely missed the negativity over the left central area contralaterally to the side of the anticipated movement. The reason, as revealed by current source density, was that only adolescents showed significant evoked activity of the left pre-/primary motor and supplementary/cingulate motor areas, while in contrast both age groups displayed significant current sinks over the right (ipsilateral) centro-temporal area and right posterior parietal cortex. Spatio-temporal source analysis confirmed that negativity over the right posterior parietal area could not be explained by a projection via volume conduction from frontal areas involved in motor preparation but represented an independent component with a different maturational course most likely related to sensory attention. Significant event-related desynchronization of alpha-power over the contralateral sensorimotor cortex was found in the younger age group, indicating that also 6- to 11-year-old children were engaged in motor preparation. Thus, the missing current sink over the contalateral sensorimotor cortex during late CNV in 6- to 11-year-old children might reflect the immaturity of a specific subcomponent of the motor preparation system which is related to evoked (late CNV) but not induced activity (alpha-ERD).

A longitudinal investigation of visual event-related potentials in the first year of life

The goal of the current study was to assess general maturational changes in the ERP in the same sample of infants from 4 to 12 months of age. All participants were tested in two experimental manipulations at each age: a test of facial recognition and one of object recognition. Two sets of analyses were undertaken. First, growth curve modeling with mixed models was used to examine trajectories of development and possible differences in trajectories based on recognition memory (novel versus familiar) and/or stimulus-specific memory (face versus object recognition). Our results suggest that the Pb, Nc and Slow Wave components change significantly in terms of amplitude and latency over the first year of life. Pb amplitude showed a significant non-linear increase over time, whereas Pb latency showed a significant linear decrease over time with a plateau beginning at 10 months. Nc amplitude showed a significant linear decrease over time (i.e. a stronger negative value), whereas Nc latency showed a significant linear decrease over time, with a plateau beginning at 8 months. Second, to relate our findings to those reported in the literature, we examined the effects of memory and stimulus and their combination. Differences between recognition memory and stimulus specific memory were found in the responses to familiar and novel faces and objects for all three components, although the pattern differed across the five ages. These results have implications for future studies that involve the recording of the visual ERP, and point to the advantages of growth curve modeling in examining longitudinal data to account for non-linear development.

Neuropsychological predictors of BOLD response during a spatial working memory task in adolescents: what can performance tell us about fMRI response patterns?

The relationship between standardized neuropsychological test performance and functional magnetic resonance imaging (fMRI) response during cognitive tasks is largely unknown. This exploratory investigation examined the relationship between neuropsychological test performance and fMRI response to a spatial working memory (SWM) task among 49 typically developing adolescents. Participants were administered a variety of neuropsychological tests in the domains of working memory, visuospatial skills, executive functioning, attention, learning and memory, visuomotor skills and processing speed, and language functioning. Neuropsychological domain scores were used to predict fMRI response during a SWM task. Results suggest that in many brain regions, neuropsychological performance negatively predicts fMRI response, suggesting that those teens with better neuropsychological abilities required fewer neural resources to adequately perform the task. This study provides further understanding of how neuropsychological abilities relate to neural activity during fMRI tasks, and provides an important link between neuropsychological and fMRI research.

The development of nonverbal working memory and executive control processes in adolescents

The prefrontal cortex modulates executive control processes and structurally matures throughout adolescence. Consistent with these events, prefrontal functions that demand high levels of executive control may mature later than those that require working memory but decreased control. To test this hypothesis, adolescents (9 to 20 years old) completed nonverbal working memory tasks with varying levels of executive demands. Findings suggest that recall-guided action for single units of spatial information develops until 11 to 12 years. The ability to maintain and manipulate multiple spatial units develops until 13 to 15 years. Strategic self-organization develops until ages 16 to 17 years. Recognition memory did not appear to develop over this age range. Implications for prefrontal cortex organization by level of processing are discussed.

Cognitive control and parsing: Reexamining the role of Broca’s area in sentence comprehension

A century of investigation into the role of the human frontal lobes in complex cognition, including language processing, has revealed several interesting but apparently contradictory findings. In particular, the results of numerous studies suggest that left inferior frontal gyrus (LIFG), which includes Broca's area, plays a direct role in sentence-level syntactic processing. In contrast, other brain-imaging and neuropsychological data indicate that LIFG is crucial for cognitive control--specifically, for overriding highly regularized, automatic processes, even when a task involves syntactically undemanding material (e.g., single words, a list of letters). We provide a unifying account of these findings, which emphasizes the importance of general cognitive control mechanisms for the syntactic processing of sentences. On the basis of a review of the neurocognitive and sentence-processing literatures, we defend the following three hypotheses: (1) LIFG is part of a network of frontal lobe subsystems that are generally responsible for the detection and resolution of incompatible stimulus representations; (2) the role of LIFG in sentence comprehension is to implement reanalysis in the face of misinterpretation; and (3) individual differences in cognitive control abilities in nonsyntactic tasks predict correlated variation in sentence-processing abilities pertaining to the recovery from misinterpretation.

Executive functions after traumatic brain injury in children

There is growing recognition that executive function, the superordinate, managerial capacity for directing more modular abilities, is frequently impaired by traumatic brain injury in children and mediates the neurobehavioral sequelae exhibited by these patients. This review encompasses the definition of specific executive functions, age-related changes in executive functions in typically developing children, and the effects of traumatic brain injury on executive functions. The neural substrate for executive functions is described, including relevant functional brain imaging studies that have implicated mediation by prefrontal and parietal cortex and their circuitry. The vulnerability of the neural substrate for executive function to the pathophysiology of traumatic brain injury is discussed, including focal lesions and diffuse axonal injury. Domains of executive functions covered in this review include the basic processes of working memory and inhibition and more complex processes such as decision making. Other domains of executive function, including motivation, self-regulation, and social cognition are discussed in terms of research methodology, clinical assessment, and findings in children with traumatic brain injury. Proposed approaches to the rehabilitation of executive functions are presented.

Central coherence in typically developing preschoolers: does it cohere and does it relate to mindreading and executive control?

BACKGROUND

Frith and Happé (1994) describe central coherence (CC) as the normal tendency to integrate individual elements into a coherent whole, a cognitive style which varies in the general population. Individuals with autism are at the extreme (weak) end of the continuum of coherence. There has been debate over whether CC is independent from other psychological functions such as theory of mind and executive control.

METHODS

We examined the validity of the CC construct in 76 typically developing 4- and 5-year-old children using four visuospatial coherence tasks. We also investigated the extent to which individual differences in performance on CC measures were associated with individual differences on measures of mindreading and executive functioning (EF).

RESULTS

Unexpectedly, the CC variables were not highly intercorrelated and did not form a single coherence factor. Instead, the results revealed a two-factor structure, one of which corresponded to visuospatial constructional ability. Correlations between the emerging factors of coherence and mindreading ability were weak, even when developmental differences in age and verbal and nonverbal ability were taken into account. In contrast, visuospatial constructional ability was reliably related to measures of EF, whilst correlations between EF and the second CC factor were very weak.

CONCLUSIONS

CC in typically developing preschoolers is not a unitary construct. Whilst there is little relationship between CC and mindreading abilities in these young children, executive control appears to be associated with one aspect of coherence: visuospatial construction.

Predicting individual differences in attention, memory, and planning in first graders from experiences at home, child care, and school

This study adds to the growing literature linking children's experiences in the environment to individual differences in their developing skills in attention, memory, and planning. The authors asked about the extent to which stimulating and sensitive care in the family and in the child-care or school environments would predict these cognitive outcomes. The authors also questioned the primacy of experiences in the first 3 years of life. Data from a sample of 700 first graders whose experiences in the home and in child care or school were evaluated since early infancy revealed that the cumulative quality of the child-rearing environment was related to attention and memory but not to planning and that the quality of the family environment was more strongly associated with outcomes than was the quality of child care and of school. The quality of both children's early (6 through 36 months) and later (54 months and first grade) environments predicted performance on the attention and memory tasks.

White matter development during childhood and adolescence: a cross-sectional diffusion tensor imaging study

Maturation of brain white matter pathways is an important factor in cognitive, behavioral, emotional and motor development during childhood and adolescence. In this study, we investigate white matter maturation as reflected by changes in anisotropy and white matter density with age. Thirty-four children and adolescents aged 6-19 years received diffusion-weighted magnetic resonance imaging scans. Among these, 30 children and adolescents also received high-resolution T1-weighed anatomical scans. A linear regression model was used to correlate fractional anisotropy (FA) values with age on a voxel-by-voxel basis. Within the regions that showed significant FA changes with age, a post hoc analysis was performed to investigate white matter density changes. With increasing age, FA values increased in prefrontal regions, in the internal capsule as well as in basal ganglia and thalamic pathways, the ventral visual pathways, and the corpus callosum. The posterior limb of the internal capsule, intrathalamic connections, and the corpus callosum showed the most significant overlaps between white matter density and FA changes with age. This study demonstrates that during childhood and adolescence, white matter anisotropy changes in brain regions that are important for attention, motor skills, cognitive ability, and memory. This typical developmental trajectory may be altered in individuals with disorders of development, cognition and behavior.

Performance on Cambridge Neuropsychological Test Automated Battery subtests sensitive to frontal lobe function in people with autistic disorder: evidence from the Collaborative Programs of Excellence in Autism network

Recent structural and functional imaging work, as well as neuropathology and neuropsychology studies, provide strong empirical support for the involvement of frontal cortex in autism. The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computer-administered set of neuropsychological tests developed to examine specific components of cognition. Previous studies document the role of frontal cortex in performance of two CANTAB subtests: the Stockings of Cambridge, a planning task, and the Intradimensional/Extradimensional Shift task, a measure of cognitive set shifting. To examine the integrity of frontal functions, these subtests were administered to 79 participants with autism and 70 typical controls recruited from seven universities who are part of the Collaborative Programs of Excellence in Autism network. The two groups were matched on age, sex, and full-scale IQ. Significant group differences were found in performance on both subtests, with the autism group showing deficits in planning efficiency and extradimensional shifting relative to controls. Deficits were found in both lower- and higher-IQ individuals with autism across the age range of 6 to 47 years. Impairment on the CANTAB executive function subtests did not predict autism severity or specific autism symptoms (as measured by the ADI-R and ADOS), but it was correlated with adaptive behavior. If these CANTAB subtests do indeed measure prefrontal function, as suggested by previous research with animals and lesion patients, this adds to the accumulating evidence of frontal involvement in autism and indicates that this brain region should remain an active area of investigation.

Executive functions in children aged 6 to 13: a dimensional and developmental study

A cross-sectional study using 92 children aged 6 to 13 years investigated the dimensionality and the development of executive functioning. The measures were drawn from developmentally relevant conceptualizations of executive functioning and included a go/no-go task, a verbal fluency task, a continuous performance task, a Stroop-like task, a hand movements task, and a digit span task. Analyses revealed 3 dimensions interpreted as Disinhibition, Speed/arousal, and Working memory/Fluency. Age and sex differences were analyzed for the delineated functions, which means that the results may be taken to represent age effects at the level of specific processes within the executive domain rather than on single tests. Age-dependent changes in children's performance on all 3 dimensions were demonstrated, with 3 particularly active stages of maturation: early childhood (6-8 years of age), middle childhood (9-12 years of age), and during early adolescence. Sex differences were only found for the speed/arousal dimension. The results are discussed in terms of 2 developmental executive function frameworks (Barkley, 1997b; Roberts & Pennington, 1996), where inhibition and the interaction between inhibition and working memory, respectively, are seen as key in the development of executive functioning.

Long-term neuropsychological outcomes of very low birth weight: associations with early risks for periventricular brain insults

Few follow-up studies of children with very low birth weight (VLBW, <1,500 g) have examined neuropsychological sequelae at later ages or neonatal risks as predictors of these outcomes. The present study assessed cognitive skills at mean age 16 years in 48 participants with <750 g birth weight, 47 with 750-1,499 g birth weight, and 52 term-born controls. Our major objectives were to delineate the long-term cognitive consequences of VLBW, and to determine if risks for periventricular brain insults accounted for variations in outcomes. Analysis revealed poorer outcomes for the <750 g group than for term-born controls on nearly all measures, with specific impairments in visual-motor skills, spatial memory, and executive function. Predictors of outcome for participants with VLBW included lower birth weight, lower weight for gestational age, and a longer period of oxygen requirement for chronic lung disease. The longer-term consequences of VLBW are consistent with expectations based on early brain pathology and suggest limitations to functional plasticity.

Endocrine disruption and cognitive function in adolescent female rhesus monkeys

Female rhesus monkeys (n=8/group) received daily oral doses of exogenous estrogen [diethylstilbestrol (DES), 0.5 mg/kg, methoxychlor (MXC), 25 or 50 mg/kg] for 6 months before and after the anticipated age of menarche. Behavior was assessed during and for 9 months after dosing. Visual discrimination performance (simultaneous nonmatch-to-sample with trial-unique stimuli) conducted during dosing demonstrated delayed improvement and poorer performance in the MXC50 group, with some similar effects in the DES group. Visual recognition memory, assessed with delays of < or = 3 s, was not apparently affected. Spatial working memory, assessed after dosing, also showed acquisition deficits and possible working memory difficulties in the MXC50 group. Spontaneous motor activity, monitored at 6-month intervals, was not affected by treatment. Late peak latencies of the auditory brainstem response (ABR) were shorter in the DES group 6 months after treatment, suggesting long-term effects on brain. The study suggests that some aspects of brain function can be modified by exposure to exogenous estrogen during pubertal development. Although DES is a more potent estrogen, the high-dose MXC group was more affected behaviorally. Differential effects of the two agents at the estrogen receptor subtypes (ER alpha and ER beta) may be relevant to the differential behavioral outcomes.

Posterior brain ERP patterns related to the go/no-go task in children

Event-related potentials (ERPs) and performance correlates of inhibition of responses to no-go stimuli were investigated in 6-12-year-old children and young adults. The percent of correct responses to go stimuli was high and similar in both groups; the percent of false alarm errors to no-go was significantly higher in children. Effective inhibition of responses to no-go stimuli was elucidated by a negative component of ERPs, the frontal-central N2, with peak latency 230-430 ms after stimulus onset. In adults, N2 was larger to no-go than to go stimuli, regardless of stimulus frequency. This effect was more prominent in tasks with high (25% no-gos and 75% gos), than with low (75% no-gos and 25% gos) inhibitory demand. In children, the parietal N2 was generally larger to rare than to frequent stimuli, and it was more specifically related to inhibition. The analysis of the relationship of no-go N2 to the inhibitory content of stimuli, probability of stimuli, and the contextual task difficulty suggests that child/adult differences in behavioral responses and ERPs may be related to both the immaturity of the fronto-parietal cortical-cortical network and to different task strategies.

Methylphenidate restores visual memory, but not working memory function in attention deficit-hyperkinetic disorder

RATIONALE

Dysfunction of executive neuropsychological performance, mediated by the prefrontal cortex, has been the central focus of recent attention deficit/ hyperkinetic disorder (AD-HKD) research. The role of other potential neuropsychological "risk factors", such as recognition memory, remains understudied. Further, the impact of methylphenidate (MPH) on key neuropsychological processes in AD-HKD remains poorly understood.

OBJECTIVES

To compare the performance of boys with AD-HKD on a spatial working memory (SWM) task and on two non-working memory tasks [a simultaneous and delayed matching-to-sample task (DMtS) and a pattern-recognition task] with that of healthy boys, and to investigate the impact of acute and chronic MPH on performance of these tasks.

METHODS

Baseline performance of 75 stimulant-naive boys with AD-HKD was compared with that of 70 healthy boys. The AD-HKD boys were then re-tested following the administration of acute and chronic challenges with MPH (0.3 mg/kg and 0.6 mg/kg) under randomised double-blind placebo controlled conditions.

RESULTS

Compared with healthy boys, the AD-HKD boys demonstrated performance deficits on all neuropsychological tasks. A single dose of MPH restored performance on the DMtS task but had no impact on the SWM or pattern-recognition tasks. Chronic MPH administration did not alter performance on the SWM task but did improve performance on both the pattern-recognition and DMtS tasks. However, the acute restorative effect of MPH on DMtS diminished with repeated administration.

CONCLUSIONS

Our results suggest that current conceptualisations of the neuropsychological basis of AD-HKD and the proposed therapeutic mechanisms of MPH require broadening.

Maturation of Cognitive Processes From Late Childhood to Adulthood

To characterize cognitive maturation through adolescence, processing speed, voluntary response suppression, and spatial working memory were measured in 8- to 30-year-old (N = 245) healthy participants using oculomotor tasks. Development progressed with a steep initial improvement in performance followed by stabilization in adolescence. Adult-level mature performance began at approximately 15, 14, and 19 years of age for processing speed, response inhibition, and working memory, respectively. Although processes developed independently, processing speed influenced the development of working memory whereas the development of response suppression and working memory were interdependent. These results indicate that processing speed, voluntary response suppression, and working memory mature through late childhood and into adolescence. How brain maturation specific to adolescence may support cognitive maturation is discussed.

Cognitive and emotional components of frontal lobe functioning in childhood and adolescence

Frontal lobe functions include a range of cognitive, emotional, and social abilities that enable goal-directed behavior. Although a number of studies have plotted the development of frontal lobe functions in childhood, few have extended into the adolescent years. There is also little information on which cognitive and emotional components of frontal functioning may be correlated. The aims of this study were to identify and compare age effects on different components of frontal functioning in childhood and adolescence and to examine whether abstract reasoning skills were associated with levels of emotional intelligence and social sensitivity. Twenty children (ages 9-18) were recruited from the local community for a study of normal adolescent brain development. All subjects were free of psychiatric or developmental disorders, as determined by a structured interview. Subjects completed a comprehensive neuropsychological test battery, as well as self-report measures of social sensitivity (anxiety) and emotional intelligence. Significant age effects were found for measures of abstract reasoning, response inhibition, and attentional set shifting. Levels of social anxiety increased moderately with age, although not significantly at this sample size. Abstract reasoning skills correlated positively with levels of social anxiety but not emotional intelligence. The pattern of results suggests differential developmental trajectories across various cognitive and emotional domains of frontal lobe functioning in childhood and adolescence. Increased abstract reasoning ability may be associated with increased vulnerability to social anxiety during this period.

Executive Functions Following Traumatic Brain Injury in Young Children: A Preliminary Analysis

To examine executive processes in young children with traumatic brain injury (TBI), we evaluated performance of 44 children who sustained moderate-to-severe TBI prior to age 6 and to 39 comparison children on delayed response (DR), stationary boxes, and spatial reversal (SR) tasks. The tasks have different requirements for holding mental representations in working memory (WM) over a delay, inhibiting prepotent responses, and shifting response set. Age at the time of testing was divided into 10- to 35- and 36- to 85-month ranges. In relation to the community comparison group, children with moderate-to-severe TBI scored significantly lower on indexes of WM/inhibitory control (IC) on DR and stationary boxes tasks. On the latter task, the Age x Group interaction indicated that performance efficiency was significantly reduced in the older children with TBI relative to the older comparison group; performance was similar in younger children irrespective of injury status. The TBI and comparison groups did not differ on the SR task, suggesting that shifting response set was not significantly altered by TBI. In both the TBI and comparison groups, performance improved with age on the DR and stationary boxes tasks. Age at testing was not significantly related to scores on the SR task. The rate of acquisition of working memory (WM) and IC increases steeply during preschool years, but the abilities involved in shifting response set show less increase across age groups (Espy, Kaufmann, & Glisky, 2001; Luciana & Nelson, 1998). The findings of our study are consistent with the rapid development hypothesis, which predicts that skills in a rapid stage of development will be vulnerable to disruption by brain injury.

Impaired Neuropsychological Functioning in Lead-Exposed Children

Neuropsychological functions were assessed in 174 children participating in a longitudinal study of low-level lead exposure. At age 5 1/2 years, children were administered the Working Memory and Planning Battery of the Cambridge Neuropsychological Testing Automated Battery. Measures of sociodemographic characteristics of the family, prenatal and perinatal risk, quality of caregiving and crowding in the home, and maternal and child intelligence were used as covariates to test the hypothesis that children with higher lifetime average blood lead concentrations would perform more poorly on tests of working memory, attentional flexibility, and planning and problem solving. The lifetime average blood lead level in this sample was 7.2 micrograms per deciliter (mug/dL; range: 0-20 mug/dL). Children with greater exposure performed more poorly on tests of executive processes. In both bivariate and multivariate analyses, children with higher lifetime average blood lead concentrations showed impaired performance on the tests of spatial working memory, spatial memory span, intradimensional and extradimensional shifts, and an analog of the Tower of London task. Many of the significant associations remained after controlling for children's intelligence test scores, in addition to the other covariates. These findings indicate that the effects of pediatric lead exposure are not restricted to global indexes of general intellectual functioning, and executive processes may be at particular risk of lead-induced neurotoxicity.

Development of "hot" executive function: the children's gambling task

Development of affective decision-making was studied in 48 children at two ages (3 and 4 years) using a simplified version of the Iowa Gambling Task (). On each of 50 trials, children chose from 1 of 2 decks of cards that, when turned, displayed happy and sad faces, corresponding to rewards (candies) won and lost, respectively. Cards in 1 deck offered more rewards per trial, but were disadvantageous across trials due to occasional large losses; cards in the other deck offered fewer rewards per trial, but were advantageous overall. On later trials, 4-year-olds made more advantageous choices than 3-year-olds, and 4-year-olds made more advantageous choices than would be expected by chance, whereas 3-year-olds made more disadvantageous choices than would be expected by chance. These findings, which were especially pronounced for girls, indicate that affective decision-making develops rapidly during the preschool period, possibly reflecting the growth of neural systems involving orbitofrontal cortex.

Development of orbitofrontal function: current themes and future directions

In recent years, an exciting thrust in the developmental research literature has been the focus on "executive" functions (EF). However, the emphasis has been on the more purely cognitive aspects of EF operative in abstract reasoning and problem solving-aspects associated mainly with dorsolateral frontal regions. Although the literature on adult neuropsychology has seen an emerging and growing interest in the study of processes more related to orbitofrontal cortex (OFC), including emotion and personality, research on the development of EF has lagged behind. This special issue of Brain and Cognition is intended to redress this imbalance by bringing together researchers who are studying the nature and development of orbitofrontal function from a wide variety of perspectives.

The Emergence of Collaborative Brain Function: fMRI Studies of the Development of Response Inhibition

Adolescence marks the beginning of adult-level cognitive control of behavior supported by the brain maturation processes of synaptic pruning and myelination. Cognitive development studies on adolescence indicate that this period is characterized by improvements in the performance of existing abilities including speed and capacity of information processing and the ability to have consistent cognitive control of behavior. Although adolescents can behave at adult levels in some ways, brain imaging studies indicate that the functional organization of brain systems that support higher-cognitive processes are not fully mature. Synaptic pruning allows for more efficient local computations, enhancing the ability of discrete brain regions to support high-level cognitive control of behavior including working memory. Myelination increases the speed of neuronal transmission supporting the collaboration of a widely distributed circuitry, integrating regions that support top-down cognitive control of behavior. Functional brain imaging methods allow for the characterization of the relationship between cognitive development and brain maturation as we can map progressions in the establishment of distributed brain circuitry and its relation to enhanced cognitive control of behavior. We present a review on the maturation (as distinct from "development" in emphasizing the transition to maturity and stabilization) of response inhibition, brain structure, and brain function through adolescence. We also propose a model for brain-behavior maturation that allows for the qualitative changes in cognitive processes that occur during adolescence.

Methylphenidate improves working memory and set-shifting in AD/HD: relationships to baseline memory capacity

OBJECTIVE

Catecholamine stimulant drugs are highly efficacious treatments for attention deficit/ hyperactivity disorders (AD/HD). Catecholamine modulation in humans influences performance of numerous cognitive tasks, including tests of attention and working memory (WM). Clear delineation of the effects of methylphenidate upon such cognitive functions in AD/HD would enhance understanding of the effects of drug treatment.

METHOD

Here we present a double-blind, placebo-controlled study of the cognitive effects of an acute dose of methylphenidate (c. .5 mg/kg) in 14 boys aged 10.86 (+/- 1.19) years meeting criteria for DSM-IV AD/HD. Current behaviour was ascertained using Conners' teacher and parent self-report questionnaires and IQ was tested using sub-tests from WISC-III-UK. Tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were selected to assess visuo-spatial recognition memory, spatial WM, planning, visual-search and attentional-set shifting.

RESULTS

Methylphenidate improved spatial WM, attentional-set shifting and visual-search task performance. Correlational analyses suggested possible relationships between WM capacity and spatial WM performance improvement. Also, poor performance on the attentional-set shifting task on placebo was associated with increased errors on the spatial WM task on placebo.

CONCLUSIONS

Methylphenidate may selectively improve both underlying cognitive difficulties in tasks dependent on intact fronto-striatal structures, and clinical symptoms of AD/HD. Pre-treatment measures may have some predictive value in determining individual differences in drug response.

Changes in Working Memory After Traumatic Brain Injury in Children

The impact of traumatic brain injury (TBI) on working memory (WM) was studied in 144 children (79 with mild, 23 with moderate, and 42 with severe injuries) who underwent magnetic resonance imaging (MRI) at 3 months and were tested at baseline and at 3, 6, 12, and 24 months postinjury. An n-back WM task for letter identity was administered with memory load ranging from 1- to 3-back and a 0-back condition. A TBI Severity x Quadratic Tune interaction showed that net percentage correct (correct detections of targets minus false alarms) was significantly lower in severe than in mild TBI groups. The Left Frontal Lesions x Age interaction approached significance. Mechanisms mediating late decline in WM and the effects of left frontal lesions are discussed.

Developmental Change in Feedback Processing as Reflected by Phasic Heart Rate Changes

Heart rate was recorded from 3 age groups (8-10, 12, and 20-26 years) while they performed a probabilistic learning task. Stimuli had to be sorted by pressing a left versus right key, followed by positive or negative feedback. Adult heart rate slowed following negative feedback when stimuli were consistently mapped onto the left or right key (response-dependent condition) but not when responses to stimuli were always followed by negative feedback (uninformative condition). Young children's heart rate showed slowing following both response-dependent and uninformative negative feedback. These findings suggest that the ability to assess the relevance of performance feedback improves with age, resulting in improved adjustment to dynamical changes in the task environment.

Gambling as an Executive Function Task

The Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) was investigated in relation to fluid intelligence and two conventional executive function tasks: letter fluency and the Wisconsin Card Sorting Test. Fifty-one children aged 8-10 years and a heterogeneous group of 40 adults served as participants. Adults outperformed children on all measures except one; this was the number of good cards selected in the IGT. Intercorrelations among executive function tasks were low. The number of good cards in the IGT appeared to be lower than in previous studies. Reasons for poor performance are discussed. The IGT may possess some shortcomings, which should be investigated in future studies. In clinical usage, the IGT may best serve as a complementary tool to the executive functions test battery.

Attention deficit hyperactivity disorder, combined type: better executive function performance with longer-term psychostimulant medication

OBJECTIVE

Executive function deficits are evident in primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT) and are possibly improved by longer-term psychostimulant medication. In contrast, a substantial subgroup of children with ADHD-CT become symptomatic despite longer-term psychostimulant medication use. We investigated the hypothesis that better executive function performance is associated with the use of longer-term psychostimulant medication in primary school-age children with ADHD-CT who are again symptomatic of ADHD-CT, despite its use.

METHOD

A cross-sectional study of 40 primary school-age psychostimulant medication-naïve children with ADHD-CT, 26 with symptomatic ADHD-CT and treated with psychostimulant medication, and 26 control children without ADHD-CT was conducted. Nonverbal tasks of executive function were compared across the three groups.

RESULTS

The longer-term psychostimulant medication-treated group had a better executive function performance, despite being symptomatic for ADHD-CT, than the psychostimulant medication-naïve group.

CONCLUSION

Improved executive function may be a marker of psychostimulant medication effect in children with ADHD-CT treated in the longer term. This improvement may not correlate with that of the ADHD-CT symptoms. Longitudinal studies are required.

Patterns of verbal long-term and working memory performance reveal deficits in strategic processing in children with frontal infarcts related to sickle cell disease

Frontal brain regions are thought to mediate strategic processes that facilitate memory. We hypothesized that children with frontal cerebral infarcts related to sickle cell disease (SCD) would exhibit impairments in long-term and working memory as a result of disruptions in strategic processing. Word-list learning and digit span tasks were used to assess verbal memory and strategic processing in 21 children with SCD without infarcts (controls) and in 10 children with SCD with frontal infarcts. On the word-list learning task, children with frontal infarcts performed more poorly in terms of learning and free recall, although recognition and cued recall were adequate; this pattern suggested intact encoding and storage with impaired retrieval. Children with frontal infarcts performed more poorly on backward digit span, although forward digit span was adequate; this pattern suggested intact maintenance with impaired manipulation of information in working memory. Overall, these findings support the notion that disruptions in strategic processing contribute to memory impairments in children with frontal infarcts.

The Nine Box Maze Test: A measure of spatial memory development in children

This study investigates the development of visuo-spatial memory in school-aged children, as measured by the Nine Box Maze Test Child Version (NBMT-CV). This task, originally developed for adults by, utilises an allocentric framework to assess the complexities of spatial memory. Sixty children participated in this study (aged 5-12 years), which also involved administration of traditional 'non-verbal' memory tests. Results indicate that visuo-spatial memory develops across childhood and that the NBMT-CV taps distinct skills compared to other 'non-verbal' memory tasks. The theoretical, assessment and developmental issues raised by these findings are discussed.

Motor function under lower and higher controlled processing demands in early and continuously treated phenylketonuria

This study examined motor control in 61 early and continuously treated patients with phenylketonuria (PKU) and 69 control participants, aged 7 to 14 years. The pursuit task demanded concurrent planning and execution of unpredictable movements, whereas the tracking task required a highly automated circular movement that could be planned in advance. PKU patients showed significantly poorer motor control in both tasks compared with control participants. Deficits were particularly observed for younger patients (age < 11 years). Differences between control participants and PKU patients were significantly greater in the pursuit task compared with the tracking task, indicating more serious deficits when a higher level of controlled processing is required. Correlations with historical phenylalanine levels indicated a later maturation of the level of control required by the pursuit task compared with the tracking task.

Practitioner review: computerized assessment of neuropsychological function in children: clinical and research applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB)

BACKGROUND

Computers have been used for a number of years in neuropsychological assessment to facilitate the scoring, interpretation, and administration of a variety of commonly used tests. There has been recent interest in applying computerized technology to pediatric neuropsychological assessment, which poses unique demands based on the need to interpret performance relative to the child's developmental level.

FINDINGS

However, pediatric neuropsychologists have tended to implement computers in the scoring, but not administration, of tests. This trend is changing based on the work of experimental neuropsychologists who frequently combine data obtained from test batteries with lesion or neuroimaging data allowing descriptions of brain-behavior relations to be made with increasing confidence. One such battery is the Cambridge Neuropsychological Testing Automated Battery (CANTAB), and current studies in which the CANTAB has been used to measure executive functions in children are reviewed.

CONCLUSIONS

Computerized batteries of this type can record aspects of performance that are difficult for psychometrists to achieve, and these may reflect activity in developing neural networks with more sensitivity than can be achieved with traditional tests. However, before computerized test administration becomes a routine part of pediatric neuropsychological assessment, several obstacles must be overcome. Despite these limitations, it is concluded that computerized assessment can improve the field by facilitating the collection of normative and clinical data.

Assessment of neuropsychological function through use of the Cambridge Neuropsychological Testing Automated Battery: performance in 4- to 12-year-old children

In this article, children's performance on subtasks from the Cambridge Neuropsychological Testing Automated Battery (CANTAB) is described. Two samples were recruited, one of which included children who spoke English as a second language. Children in this group also completed subtests from the Wechsler Intelligence Scale for Children-Third Revision (WISC-III). Despite the fact that ESL children scored over 1 SD below the norm on the WISC-III Vocabulary subtest, there were no CANTAB performance distinctions between primary versus secondary English-language speakers. In addition, several aspects of CANTAB performance were significantly correlated with verbal and nonverbal IQ. When developmental trends were examined, findings indicated that several aspects of frontal lobe function (memory span, working memory, and planning skills) are not functionally mature, by the age of 12 years. Implications for use of the CANTAB in clinical studies are discussed.

The importance of head growth patterns in predicting the cognitive abilities and literacy skills of small-for-gestational-age children

This study evaluated the effects of head growth compromise beginning in utero and continuing, in some cases, through the first 9 months of life on the cognitive and literacy skills of school-age small-for-gestational-age (SGA) children. Seventy-one SGA children, aged 7 to 9 years (gestational ages, 24-41 weeks) and 16 full-term appropriate-for-gestational-age control children of comparable socioeconomic backgrounds and age at testing completed tests assessing intelligence, receptive language, working memory, problem solving, visual-motor integration, phonological awareness, reading, and spelling. SGA children were subdivided into head-growth pattern groups based on their head circumference at birth and at 9 months postterm. Analyses showed that SGA children with poor prenatal and postnatal head growth had the worst outcomes, followed by those with prenatal brain compromise, but good postnatal head growth. SGA children with preserved head growth in utero as well as good head growth after birth demonstrated the best outcomes, although spelling skills were deficient relative to full-term peers. The Verbal and Full Scale IQ ratings of the SGA children who had experienced brain compromise in utero declined significantly from 5 to 8 years of age. We conclude that mild intrauterine growth retardation (IUGR) has a minimal effect on the development of cognitive or academic abilities, providing that brain growth in utero is not affected. IUGR that slows brain growth in utero impairs the acquisition of some cognitive and academic abilities, even when followed by good catch-up head growth after birth, whereas poor brain growth in utero followed by little or no catch-up head growth results in widespread impairments. Findings highlight the limits to brain plasticity and emphasize the importance of optimal prenatal and postnatal brain growth.

Working memory and inhibitory control in early childhood: Contributions from physiology, temperament, and language

This study examined the cognitive skills of working memory and inhibitory control (WMIC) in relation to physiological functioning, temperament, and language in early childhood. WMIC skills were assessed in twenty-five 4 1/2-year-old children using the day--night Stroop-like task and the yes--no task; each task required the child to remember two rules and to inhibit a dominant response. Electroencephalogram (EEG) and heart period (HP) were recorded during baseline and WMIC tasks. An increase in 6- to 9-Hz EEG power from baseline to task was found for the medial frontal region. In addition, a decrease in HP (i.e., an increase in heart rate) was found from baseline to task. Associations were found between performance on the WMIC tasks and scales of the Children's Behavioral Questionnaire (CBQ) related to the effortful control of behavior. The Peabody Picture Vocabulary Test-III (PPVT-III) distinguished between high and low WMIC performance. Results of a discriminant function analysis indicated that physiology, temperament, and language were able to correctly predict 90% of WMIC performance.

The neuropsychology of Down syndrome: evidence for hippocampal dysfunction

This study tested prefrontal and hippocampal functions in a sample of 28 school-aged (M = 14.7 years, SD = 2.7) individuals with Down syndrome (DS) compared with 28 (M = 4.9 years, SD = .75) typically developing children individually matched on mental age (MA). Both neuropsychological domains were tested with multiple behavioral measures. Benchmark measures of verbal and spatial function demonstrated that this DS sample was similar to others in the literature. The main finding was a significant Group x Domain interaction effect indicating differential hippocampal dysfunction in the group with DS. However, there was a moderate partial correlation (r = .54, controlling for chronological age) between hippocampal and prefrontal composite scores in the DS group, and both composites contributed unique variance to the prediction of MA and adaptive behavior in that group. In sum, these results indicate a particular weakness in hippocampal functions in DS in the context of overall cognitive dysfunction. It is interesting that these results are similar to what has been found in a mouse model of DS. Such a model will make it easier to understand the neurobiological mechanisms that lead to the development of hippocampal dysfunction in DS.

Audiospatial and visuospatial working memory in 6-13 year old school children

The neural processes subserving working memory, and brain structures underlying this system, continue to develop during childhood. We investigated the effects of age and gender on audiospatial and visuospatial working memory in a nonclinical sample of school-aged children using n-back tasks. The results showed that auditory and visual working memory performance improves with age, suggesting functional maturation of underlying cognitive processes and brain areas. The gender differences found in the performance of working memory tasks suggest a larger degree of immaturity in boys than girls at the age period of 6-10 yr. The differences observed between the mastering of auditory and visual working memory tasks may indicate that visual working memory reaches functional maturity earlier than the corresponding auditory system.

Raising the ceiling: the Tower of London--extended version

The Tower of London (TOL) is a neuropsychological test used to assess problem-solving and planning skills. Clinically, the measure has demonstrated sensitivity in discriminating between performance among individuals with varying severity of closed head injury (CHI). However, ceiling effects have been demonstrated with preadolescent and adolescent CHI samples. An extended version of the Tower of London (TOL-E) was devised to minimize these ceiling effects. In this study we examined the performance of 26 normal children between the ages of 7 and 16 years on the TOL-E. Significant complexity and age effects suggest that the TOL-E contributes a significant level of complexity relative to the original TOL across all age groups. This finding has implications for the measure's ability to detect the development of planning and problem solving in normal children as well as to differentiate between impaired and nonimpaired samples.

Short-term dietary interventions in children and adolescents with treated phenylketonuria: effects on neuropsychological outcome of a well-controlled population

This study addressed two questions: is there an effect of dietary interventions that induce relatively small changes in phenylalanine (Phe) concentration on neuropsychological outcome of early- and continuously treated phenylketonuria (PKU) patients, and are there differences in effects for PKU children and adolescents? To answer the first question, the effect of a short-term dietary intervention (1-2 weeks) was compared for patients whose Phe concentrations increased vs those whose Phe concentrations decreased. Controls were tested twice to control for learning effects. To answer the second question, the effect of dietary interventions was examined in younger patients (aged 7-10 years) and older patients (aged 11-14 years). The effect of dietary interventions was determined with three neuropsychological tasks: one requiring sustained attention; a second demanding maintenance in working memory; and a third in which complex operations were performed in working memory. Relatively small fluctuations in Phe concentration were found to influence neuropsychological task performance of PKU patients. Patients whose Phe concentrations decreased at the second assessment showed generally more improvement than controls. Patients whose Phe concentrations had increased showed minimal improvement or deterioration of task performance. The strongest effects were observed when sustained attention and manipulation of working memory content were required. There were some indications of a greater sensitivity of younger patients to fluctuations in Phe concentration.

Maturation of brain function associated with response inhibition

OBJECTIVE

To investigate the developmental trajectory of response inhibition and, more specifically, whether there is a dissociation of function in the prefrontal cortex over the course of development of executive function and associated response inhibition abilities.

METHOD

Nineteen typically developing subjects, ranging in age from 8 to 20, performed a Go/NoGo task while behavioral and functional magnetic resonance imaging (fMRI) data were collected.

RESULTS

All subjects performed the task with few errors of omission and commission. No relationship between accuracy and age emerged, but the ability to inhibit responses significantly improved with age. Analyses of fMRI data revealed a positive correlation between activation and age in the left inferior frontal gyrus/insula/orbitofrontal gyrus, and a negative correlation between activation and age in the left middle/superior frontal gyri.

CONCLUSION

These data provide the first evidence of dissociable processes occurring in the prefrontal cortex during development of executive functions associated with response inhibition: (1) Younger subjects activate more extensively than older subjects in discrete regions of the prefrontal cortex, presumably due to increased demands and inefficient recruitment of brain regions subserving executive functions including working memory. (2) Older subjects show increasingly focal activation in specific regions thought to play a more critical role in response inhibition.