Balance-based Attentive Rehabilitation of Attention Networks (BARAN) improves executive functions and ameliorates behavioral symptoms in children with ADHD

Cross-Sectional Study on the Effect of Bilingualism, Age, Gender, and Family Income on Executive Function Development in a Sample of Lebanese School-Aged Children

This study investigates executive functions (EFs) and selected developmental factors in 120 children aged 6-11 years. By examining inhibition, working memory, and cognitive flexibility, the research evaluates the potential influences of age, gender, bilingualism, and family income on these EF skills. Tests adapted to Lebanese Arabic were used to assess EFs. Results indicate a linear development of inhibition, working memory, and flexibility with age. Gender differences were observed, affecting verbal and visuospatial working memory as well as flexibility. Bilingualism positively impacts EFs, with early bilinguals outperforming late bilinguals. Family income, however, shows no significant effect on EFs.

Inhibitory Control Training Improves Cold but Not Warm Cognition in Typically Developing Preschoolers

Inhibitory control, as a fundamental executive function, has been found to be associated with a range of cognitive processes. In this study, our objective was to enhance inhibitory control through a targeted training program and assess its impact on attention, executive function, delay discounting and risky decision making. Thirty-two typically-developing children (age mean 6.89 ± 0.32 years) were recruited in a random clinical trial design in two equal intervention and active control groups. Go/No-Go, Flanker, continuous performance, delay discounting, and balloon analogue risk tasks were used for assessment in three baseline, post- intervention, and 3-months follow-up sessions. The intervention group received the program for attentive rehabilitation of inhibition and selective attention (PARISA) and the active control group participated in a story telling class, both in 12 sessions. The results of the study indicate significant improvements in sustained attention, interference control, and prepotent inhibition among participants in the intervention group. However, there were no significant changes observed in delay discounting and risky decision making. These findings suggest that the inhibitory control training primarily enhances aspects of cold cognition and attentional processes. However, the observed improvements did not extend to reward processing or warm cognition.

A Comparison between the Effectiveness of computerized Cognitive Rehabilitation Training and transcranial Direct Current Stimulation on Dialysis Patients' Executive Functions

Purpose

Executive function impairments are among the most common dialysis side effects. The present study aims to compare the efficiency of transcranial Direct Current Stimulation (tDCS) with computerized Cognitive Rehabilitation Training (cCRT) on dialysis patients' executive functions.

Research method

The present study, a quasi-experimental effort, adopted a pre-test/post-test method that included a control (sham) group.

Design

The study sample consisted of 30 participants, selected through the convenience sampling method, and categorized into three groups of cCRT, tDCS, and sham participants. The cCRT participants were asked to complete 8 tasks in Captain's Log MindPower Builder software. The tDCS participants were treated with a 0.06 mA/cm2 current with the anodal electrode on F3 and the cathodal electrode on Fp2. For the sham participants, the electrodes were put on the same regions but there was no current stimulation. The treatment lasted for 10 sessions carried out every other day.

Results

The results of MANCOVA showed no significant difference between the sham group and the cCRT group in any of the executive function items. . However, between the sham group and the tDCS group was detected a significant difference in spatial working memory (p \< 0.05) and a marginally significant in cognitive flexibility (p = 0.091). No significant difference was reported between cCRT and tDCS groups in any item.

Conclusion

According to the findings of the study, given the efficacy of tDCS on spatial working memory and cognitive flexibility for dialysis patients, it can be used to improve these skills.

The impact of time perception remediation on cold and hot executive functions and behavioral symptoms in children with ADHD

Children with ADHD struggle with impaired time management, indicating premature and temporally inadequate behavioral style. This study aimed to evaluate the impact of time perception remediation on hot and cold executive functions (EFs) and behavioral symptoms in children with ADHD. In this pilot study, an RCT design was employed to investigate the effects of the intervention on children with ADHD. The participants were assigned to either the control group (n = 15) or the intervention group (n = 13). The intervention group receive 10-12 sessions of program for attentive remediation of time perception (PART). Time perception, N-back, Wisconsin card sorting, Go/No-Go, balloon analog risk, Iowa gambling tasks, and Conner's parental rating scale were used for the assessment in three baseline, post-intervention, and follow-up sessions. Repeated measures ANOVAs were used for analysis. The results suggest improved time perception and risky decision making in intervention group. Working memory, inhibitory control, and cognitive flexibility did not improve after intervention. The behavioral symptoms ameliorated after intervention. Time perception is trainable in children with ADHD. This training effect transfers to hot EFs and behavioral symptoms, but not cold EFs. A cognitive model has been proposed based on the results of this studies and other cognitive training studies.

Alternative Treatments to Pharmacological Therapy in Pediatric Populations With Attention-Deficit/Hyperactivity Disorder (ADHD): A Scoping Review

In recent years, there has been an increase in the prevalence of the diagnosis of attention-deficit/hyperactivity disorder (ADHD), a cognitive and behavioral disorder in which individuals present with inattention and impulsivity, in the pediatric population. With an increase in diagnoses, there is also increasing concern regarding overdiagnosis and overtreatment with medications for ADHD. The objective of this study was to map out and compile the recent literature pertaining to alternative therapies (e.g., physical activity, diet, mindfulness, and computer-based interventions) for children and adolescents diagnosed with ADHD in an attempt to reduce or replace the use of pharmacological therapy. This scoping review searched articles from multiple databases (PubMed, ScienceDirect, Web of Science, Directory of Open Access Journals, Scopus, and CINAHL). Using search terms "children with ADHD," "alternative treatment," and "cognitive behavioral therapy," articles were identified that were specific to the research question. The inclusion criteria were patients under the age of 18 with a previous diagnosis of ADHD, no other comorbid illnesses, alternative treatments, and was limited to studies published between 2012 and 2022. After removing duplicates, screening for eligibility criteria, and conducting a critical appraisal of the articles, 16 articles were retained for the final review. The main alternative therapeutic domains that emerged were (1) physical activity, (2) diet, (3) mindfulness, (4) computer-based interventions, and (5) miscellaneous interventions. Seven articles assessed the effect of physical activity on executive and cognitive function in children and adolescents with ADHD. Most findings showed improvement with increased physical activity. Two articles explored the effect of diet on the improvement of ADHD symptoms and reported a positive impact. The two articles that evaluated the effects of mindfulness on ADHD symptoms reported a reduction in ADHD symptoms. Two studies evaluated the use of computer-based interventions as an adjunct treatment in children and adolescents with ADHD; improvements in symptoms were reported. One study each evaluated interventions based on music and nerve stimulation. These showed an improvement in attention, memory, and executive function. With the increasing prevalence of ADHD diagnosis in children and adolescents, alternative and/or adjunctive treatments may be a viable and valuable alternative to pharmaceutical interventions. The findings from this review suggest that multiple non-pharmacological interventions effectively reduce symptoms of ADHD in children and adolescents, including diet, exercise, mindfulness, computer-based interventions, music, and nerve stimulation. While there are implications for alternatives to be used in the future, more research is warranted using larger samples with controlled trials.

Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease

Background: Children with attention-deficit hyperactivity disorder (ADHD) struggle with impaired attention, leading to impaired executive function and behavioral symptoms. In this study, we aimed to evaluate the effect of attention training on executive functions and behavioral symptoms in children with ADHD, in a tele-cognitive-rehabilitation setting. Methods: Thirty children (mean age: 9.93 ± 1.68 years, 21 boys) with ADHD were randomly assigned to 2 equal groups of attention training and active control group. Attentive Rehabilitation and Improvement of Attention (ARIA) and a class of storytelling were used for intervention in two groups, in an online platform. Continuous performance test, one-back test, Wisconsin card sorting test (WCST), Conner's parent rating scale, and behavioral rating inventory of executive function (BRIEF) were used for assessment in three-baseline, postintervention, and follow-up sessions. Repeated measures analysis of variances were used for analysis. Results: ARIA leads to significant improvement in omission error (P < 0.001), commission error (P = 0.006), and response time (P = 0.005) of continuous performance test, cluster (P = 0.001), but not preservation error (P = 0.110) of WCST, accuracy of NBT (P = 0.004) and the score of Conner's parent rating scale (P < 0.001) and BRIEF (P < 0.001). These results indicate improved attention and executive functions, amelioration of ADHD symptoms, and improved behavioral performance. Conclusion: This study suggests that attention can be trained through tele-cognitive rehabilitation using a remediation program in children with ADHD. The effectiveness of this training can be confirmed by examining the transfer of training effects to other untrained cognitive domains, executive functions, symptoms of ADHD, and behavioral performance.

Remediation of theory of mind in children with autism spectrum disorders: Effectiveness and transferability of training effects to behavioral symptoms

BACKGROUND

Children with autism spectrum disorders (ASD) struggle with impaired theory of mind. We aimed to evaluate the effect of remediation of theory of mind on theory of mind, face perception, and behavioral symptoms in children with ASD.

METHODS

Thirty children with ASD were randomly assigned to two equal groups of theory of mind training and active control group. Attentive remediation of theory of mind (ARTOM) and story-telling sessions were used for intervention in the groups. Theory of mind and facial emotion recognition tests as well as Gilliam autism rating scale (GARS) were used for assessment in three baseline, post-intervention, and follow-up sessions. Repeated measures ANOVAs were used for analysis.

RESULTS

The results showed improvement in facial emotion recognition and theory of mind in intervention group. The behavioral symptoms, measured by GARS, were ameliorated in the intervention group. The training effects lasted until follow-up session.

CONCLUSIONS

The results suggest remediation of basic components of theory of mind, without direct intervention on theory of mind, improves theory of mind skill. The results also suggest that the remediation of basic components of theory of mind improves social and communicational performance and ameliorates stereotypes symptoms in children with ASD.

The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD)

This study aimed to evaluate the effect of working memory training on executive functions and behavioral symptoms in children with ADHD. Thirty children with ADHD were randomly assigned to active control or Active Memory Intervention (AMIN) group. Executive functions and rating scales were used for assessment in three baseline, post-intervention, and 1-month follow-up sessions. The results show AMIN improves working memory and inhibitory control as well as ameliorates ADHD symptoms at home and school. Working memory training is beneficial and transferable intervention in children with ADHD.