Multidisciplinary perspectives on attention and the development of self-regulation

Intraindividual variability in post-stroke cognition and its relationship with activities of daily living and social functioning: an ecological momentary assessment approach

INTRODUCTION

Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes.

METHODS

Participants (N = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits. Participants responded to five EMA surveys daily for 14 days to assess cognition. They completed patient-reported measures and neuropsychological assessments during lab visits. Using latent class analysis, we derived four indicators to quantify cognitive variability and identified latent classes among participants. We used ANOVA and Chi-square to test differences between these latent classes in daily activities, social functioning, and neuropsychological performance.

RESULTS

The latent class analysis converged on a three-class model. The moderate and high variability classes demonstrated significantly greater problems in daily activities and social functioning than the low class. They had significantly higher proportions of participants with problems in daily activities and social functioning than the low class. Neuropsychological performance was not statistically different between the three classes, although a trend approaching statistically significant difference was observed in working memory and executive function domains.

DISCUSSION

EMA could capture intraindividual cognitive variability in stroke survivors. It offers a new approach to understanding the impact and mechanism of post-stroke cognitive problems in daily life and identifying individuals benefiting from self-regulation interventions.

Effects of Two Online Mindfulness-Based Interventions for Early Adolescents for Attentional, Emotional, and Behavioral Self-Regulation

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary effects on self-regulation processes in early adolescence. However, programs have typically combined different types of interventions with no understanding of the specific effect of each intervention type on attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs-one focused on classic attentional practices and another focused on the recognition and expression of emotions-on attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental paradigm was used. A sample of 74 children aged between 8 and 12 years old were randomly assigned to three experimental conditions: (1) an MBI with a focus on attentional practices, (2) an MBI with a focus on recognition and expression of emotions, and (3) a control group. The interventions lasted 8 weeks, with a weekly, 1 h online synchronous session plus home practices. Children were evaluated before starting the intervention and at the end of the 8-week period. The assessed outcomes were (1) mindfulness; (2) emotional regulation; (3) attentional regulation, and (4) behavioral regulation. (3) Results: Children who participated in both intervention programs increased their mindfulness and emotional and behavioral regulation scores. Only children who participated in the MBI with a focus on attention showed significant changes in their ability to self-regulate attention. (4) Conclusions: The use of online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills for attention, emotions, and behavior in early adolescence.

Association between physical activity and self-regulation in early childhood: A systematic review

Physical activity and self-regulation are important predictors of pediatric overweight and obesity. Young children (0-5 years) with lower physical activity levels and poorer self-regulation skills are at greater risk for overweight. Despite growing evidence that the two constructs are interrelated, their association remains unclear in young children. This review systematically summarized associations between physical activity and self-regulation in early childhood and explored the directionality of associations. Searches were run in six electronic databases. Forty-seven papers met inclusion criteria. Only three studies investigated all three domains of self-regulation (behavioral, cognitive, and emotional). Overall, findings were inconclusive; studies reported weak to moderate positive associations (n = 17), inverse associations (n = 5), mixed associations (n = 15), null association (n = 2), and negative (n = 1) between physical activity and self-regulation. Compared with the emotional and cognitive domains, physical activity was most consistently positively associated with behavioral self-regulation. Only one study assessed bidirectional associations, reporting a positive association. The three studies that included global self-regulation showed contradicting findings. There is some evidence that physical activity dose and sex potentially confound these associations; however, further research is needed given the paucity of studies. This review highlights the need for more in-depth investigation of the complex association between physical activity and global self-regulation.

Are physical activity and sleep associated with emotional self-regulation in toddlers? a cross-sectional study

BACKGROUND

Toddlerhood (2-3 years) is a crucial period for the development of physical activity, sleep, and emotional self-regulation skills. Although there is growing evidence of positive associations between physical activity, sleep, and emotional self-regulation in school-aged children, the associations in toddlers remain unclear. Thus, this study aimed to examine the association between physical activity, sleep, and emotional self-regulation in toddlers.

METHODS

Baseline data from 1350 toddlers (2.2 ± 0.33 year) from the Let's Grow randomised controlled trial were used. Toddlers' total physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) were assessed via 4 + days of accelerometry and a 3-item parent-report scale. Parent-reported total sleep quantity was calculated using the sum of average night-time sleep and daytime nap durations. Sleep behaviour data including bedtime routine, bedtime resistance, sleep onset-delay, sleep duration, and night waking were collected using relevant subsections from the Child Sleep Habits Questionnaire (CSHQ) and Brief Infant Sleep Questionnaire revised (BISQ-R). A 4-item parent-report scale adapted from the Fast Track Project Child Behaviour Questionnaire was used to assess toddlers' emotional self-regulation. Linear regression models were used, adjusting for child age, sex, and parental education.

RESULTS

Accelerometer-derived TPA, MVPA and parent-reported TPA were not associated with emotional self-regulation. Higher parent-reported MVPA (B = -0.01 CI95 -0.03, -0.003) was associated with poorer emotional self-regulation. Higher sleep duration was associated with better emotional self-regulation (B = 0.06 CI95 0.04, 0.08). The five sleep behaviours assessed were also positively associated with emotional self-regulation (all p < 0.01), with fewer problem sleep behaviours being associated with better emotional self-regulation.

CONCLUSIONS

This cross-sectional study suggests that sleep may be important for emotional self-regulation in toddlers, but the role of physical activity remains unclear. These findings suggest that interventions targeting sleep duration and sleep behaviours during the early toddler years may benefit the positive development of emotional self-regulation skills in this population.

Variability in Cognitive Task Performance in Early Adolescence Is Associated With Stronger Between-Network Anticorrelation and Future Attention Problems

Background

Intraindividual variability (IIV) during cognitive task performance is a key behavioral index of attention and a consistent marker of attention-deficit/hyperactivity disorder. In adults, lower IIV has been associated with anticorrelation between the default mode network (DMN) and dorsal attention network (DAN)-thought to underlie effective allocation of attention. However, whether these behavioral and neural markers of attention are 1) associated with each other and 2) can predict future attention-related deficits has not been examined in a developmental, population-based cohort.

Methods

We examined relationships at the baseline visit between IIV on 3 cognitive tasks, DMN-DAN anticorrelation, and parent-reported attention problems using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,878 participants, ages 9 to 10 years, female = 47.8%). We also investigated whether behavioral and neural markers of attention at baseline predicted attention problems 1, 2, and 3 years later.

Results

At baseline, greater DMN-DAN anticorrelation was associated with lower IIV across all 3 cognitive tasks (B = 0.22 to 0.25). Older age at baseline was associated with stronger DMN-DAN anticorrelation and lower IIV (B = -0.005 to -0.0004). Weaker DMN-DAN anticorrelation and IIV were cross-sectionally associated with attention problems (B = 1.41 to 7.63). Longitudinally, lower IIV at baseline was associated with less severe attention problems 1 to 3 years later, after accounting for baseline attention problems (B = 0.288 to 0.77).

Conclusions

The results suggest that IIV in early adolescence is associated with worsening attention problems in a representative cohort of U.S. youth. Attention deficits in early adolescence may be important for understanding and predicting future cognitive and clinical outcomes.

Self-regulation and Psychopathology in Young Children

The current study examined concurrent relationships between children's self-regulation, measured behaviorally and by parent-report, and children's internalizing and externalizing symptoms. The aim was to distinguish which components of self-regulation (attention vs. inhibitory control, "hot" vs. "cool" regulation) best predict dimensional symptomatology and clinical disorders in young children. The participants were 120 children, ages 4-8 years old. Results showed that greater parent-reported attention was associated with fewer internalizing and externalizing symptoms. Behaviorally-measured hot inhibitory control related to fewer internalizing symptoms, whereas parent-reported inhibitory control related to fewer externalizing symptoms. Similar patterns emerged for clinical diagnoses, with parent-rated attention most strongly predicting disorders across domains. Results support prior evidence implicating self-regulatory deficits in externalizing problems, while also demonstrating that components of self-regulation are impaired with internalizing symptoms. Further, different sub-components of self-regulation relate to different dimensions of psychopathology in children. Interventions should target these areas in children at-risk for disorders.

Self-Control Measurement Methodologies: An Integrative Approach

The study of self-control occurs in many different types of experimental settings using a wide range of methodologies. In addition, measures of self-control vary in their procedures and operational definitions from simple questionnaires to complex scenarios where individuals must choose to act or not. The present summary draws on trends within the literature using widely accepted measures of self-control. The measures are organized based on established paradigms in the literature and focus on three categories: executive functioning tasks, delay of gratification tasks, and subjective-report surveys. We also include an "additional measures" category to capture measures that do not readily fit in these three categories. Finally, we discuss recent approaches to the scientific exploration of self-control and integrate the categories of measures used here within these approaches. This integration incorporates a wide range of research paradigms and provides direction for future studies.

Associations between Parenting, Temperament-Related Self-Regulation and the Moral Self in Middle Childhood

The moral self is increasingly being debated in research, i.e., what causes children to internalise and evaluate the importance of certain moral values. The aim of the present study is to analyse associations between parental warmth and harsh parenting, temperamental self-regulation (inhibitory control and impulsivity), and the moral self in middle childhood. A total of 194 (n = 52 children with special educational needs in emotional-social development) six- to eleven-year-old children (M_age = 8.53, SD_age = 1.40) and their primary caregivers (M_age = 40.41, SD_age = 5.94) participated in this cross-sectional questionnaire study. Parental warmth and impulsivity were associated with the moral self. Impulsivity mediated the relationship between harsh parenting as well as parental warmth and the moral self. Results are discussed in terms of their relevance to social information processing theory. The importance of parenting and temperamental self-regulation is discussed as implications that may in turn strengthen children's moral selves.

Differential development and trainability of self-regulatory abilities among preschoolers

Self-regulation (SR) as well as self-regulated learning (SRL) show large interindividual variance in preschoolers. This variance may result in differential developmental trajectories. The present study aims to investigate whether a reduction in interindividual differences over time, which could previously be found for preschoolers' SR, is also present for SRL. Furthermore, the present study aims to explore whether preschool SRL training transfers to SR and whether training effects visible in SRL depend on initial performance. A sample of 94 preschoolers participated in this intervention study. Children were assigned to either a training group or to an active control group. Additionally, the sample was divided into high- and low-SRL preschoolers based on pretest SRL performance. Repeated measures ANCOVAs revealed that in the active control group, differences between high- and low-SRL preschoolers decreased over time. The training group showed a greater increase in SRL than the active control group. Training-induced increases did not vary between high- and low-SRL preschoolers. Additionally, increases in SR were identical for training and active control group. Further research on the transferability of preschool SRL training to SR is needed.

The Role of Preschool Dosage and Quality in Children's Self-Regulation Development

The present study examined how the dosage and quality of the federal preschool program "Head Start" (HS) in the US related to children's self-regulation skills in kindergarten. Using Propensity Score Matching and multiple regression (OLS), this study explored how the number of years and hours a week of HS were related to self-regulation among 2,383 children, who entered the program either at 3 or 4 years old. An additional year in HS was significantly positively associated with self-regulation in kindergarten, while the number of hours a week in HS was not. However, the quality of teacher-child interactions moderated the relation between hours a week in HS and self-regulation. Findings contribute to the growing body of evidence about how dosage and quality of early childhood education experiences relate to children's development.

Self-regulation in toddlers and the emergence of pre-academic disparities

A growing body of research has examined how children's self-regulation during early and middle childhood mediates SES disparities in academic achievement. Evidence suggests that these self-regulation skills begin developing even earlier, during the toddler years, but more work is needed examining how different measures of self-regulation relate to key constructs such as socioeconomic status (SES) and toddlers' pre-academic skills. In this online study, we examine multiple approaches to measuring self-regulation using confirmatory factor analyses and assess the extent to which self-regulatory skills help explain SES differences in early math and language skills among a sample of 158 two- and three-year-old children. Self-regulation was assessed through a battery of parent- and examiner-ratings. Children's counting, cardinality, and vocabulary skills were measured online through direct assessments and parent surveys. Two self-regulation factors emerged representing parent-reported and observational measures, and only observational measures of self-regulation mediated associations between SES and children's math and language skills. Parent-reported self-regulation was not uniquely related to SES or children's pre-academic skills, underscoring the need for careful consideration of how self-regulation is measured among toddlers when examining its associations with pre-academic skills.

A systematic review and meta-analysis of associations between self-regulation and morality in preschool and elementary school children

The importance of self-regulatory skills for the socio-emotional competencies of children is being researched and discussed extensively. However, in order to make a clear statement about the impact of self-regulation on children’s morality, a systematic review of the literature is urgently needed. The aim of this systematic review and meta-analysis is to analyze associations between self-regulation and morality of preschool and elementary school children. In this context, distinctions among different definitions and operationalizations of self-regulation and morality are considered. Search terms were entered in the bibliographic databases PsycINFO, Scopus and Web of Science. To meet the inclusion criterion, studies needed to report empirical associations between self-regulation and morality in children of preschool and elementary school age. Furthermore, the studies should report primary data and be published in English in a peer-reviewed journal. Studies with secondary or summarized data, special populations or with certain designs were excluded. A total of 37 studies were included in the narrative synthesis. 35 of these studies were included in the meta-analysis. The narrative synthesis showed that different definitions and operationalizations were used for both self-regulation and morality. There also seems to be no consensus regarding the association between the constructs. Meta-analysis results revealed a small positive combined effect between self-regulation and morality, especially between temperament-related self-regulation and moral behavior and moral emotions. In order to gain a better understanding of the effects of self-regulation on morality, longitudinal research and further research addressing different forms of these constructs are essential.

Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum

BACKGROUND

The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent-infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic.

METHODS

As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables.

RESULTS

Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs.

LIMITATIONS

Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis.

CONCLUSIONS

The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.

Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders

The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.

Sociomoral Temperament: A Mediator Between Wellbeing and Social Outcomes in Young Children

Social outcomes, such as empathy, conscience, and behavioral self-regulation, might require a baseline of psychological wellbeing. According to Triune Ethics Metatheory (TEM), early experience influences the neuropsychology underlying a child's orientation toward the social and moral world. Theoretically, a child's wellbeing, fostered through early caregiving, promotes sociomoral temperaments that correspond to the child's experience, such as social approach or withdrawal in face-to-face situations. These temperaments may represent an individual's default sociomoral perspective on the world. We hypothesized that sociomoral temperament emerges as a function of wellbeing and would be related to social outcomes measured by moral socialization and self-regulation. Further, we hypothesized that sociomoral temperament would mediate the relationship between wellbeing and social outcomes. To investigate, we collected items reflective of sociomoral temperament, asking mothers from two countries (USA: n = 525; China: n = 379) to report on their 3- to 5-year-old children. They also reported on their child's wellbeing (anxiety, depression, happiness) and social outcomes, including moral socialization (concern after wrong doing, internalized conduct and empathy) and behavioral self-regulation (inhibitory control and misbehavior). As expected, correlations identified connections between wellbeing, sociomoral temperament, and social outcomes. Mediation analyses demonstrated that sociomoral temperament mediated relations between wellbeing and social outcomes in both samples, though in slightly different patterns. Fostering early wellbeing may influence social outcomes through a child's developing sociomoral temperament.

Relationships between Coerced Sexting and Differentiation of Self: An Exploration of Protective Factors

Pressure to send sexually explicit messages, or ‘sexting coercion’ is associated with adverse mental health outcomes and sexual risk behaviors. This study explores Differentiation of Self (DoS) as a potential protective factor to reduce susceptibility to sexting coercion. A convenience sample of 399 Australian participants, aged 18 to 21 years (Mage = 19.63; SD = 1.14, 68.2% women) completed an online survey measuring sexting behaviors and DoS. Women were four times more likely to send willing unwanted sexts, and seven times more likely to engage in coerced unwanted sexting than men. Participants with low DoS were four times more likely to engage in coerced unwanted sexting. DoS significantly mediated the relationship between gender and coerced unwanted sexting. Results support the proposal of a sexting coercion typology encompassing discrete sub-types of sexting coercion. Results also indicate DoS may operate as a protective factor for young people in Australia, reducing compliance with sexting when coerced.

Frequent follow-up of suicidal youth assessed in the emergency room: Long-term trajectory and predictors of suicidality

Suicide was the second‑leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome of a cohort of suicidal adolescents, many also suffering from BPD and having undergone some form of treatment, to identify baseline factors which could inform intervention that would minimize suicidality 4 years post-discharge.

METHODS

We conducted a prospective longitudinal study of suicidality at twelve points (four assessment occasions) for 286 suicidal youth presenting to a pediatric ER, most suffering from BPD, with 36 suicide ratings from baseline to 2-, 6- and 48-month follow-up evaluations. We examined the trajectory and predictors of persisting suicidality.

RESULTS

Suicidality rapidly decreased within 2 months post-ER-discharge, subsequently remaining low throughout 48 months. Baseline functioning, female sex, stressful life events and BPD impulsiveness were most predictive of persisting suicidality at 48-month follow-up.

CONCLUSION

Most suicidal youth, many meeting BPD criteria, no longer feel suicidal 2 months after ER discharge. Management of participants' baseline poor functioning stressful life events and the impulsiveness component of BPD specifically in females could impact suicidality 4 years later, and guide treatment options. The absence of the BPD cognitive and affective subscales as predictors of suicidality at 4-year follow-up may reflect treatment received. Further investigation of treatment effects is warranted and under way.

Early regulatory problems and parenting: life-long risk, vulnerability or susceptibility for attention, internalizing and externalizing outcomes?

Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems, RPs) predict increased risk for self-regulation difficulties. Sensitive parenting may protect children from trajectories of dysregulation. Considering self-regulation from a life-course perspective, are children with early multiple and/or persistent RPs affected similarly by parenting as those without (main effects model, ME), or are they more vulnerable (diathesis-stress, DIA-S), or more susceptible (differential susceptibility theory, DST) to variations in sensitive parenting at age 6 years? Participants (N = 302) were studied prospectively from birth to 28 years. RPs were assessed from 5 to 56 months. Sensitive parenting was observed at 6 years. Attention regulation was observed at 8 and 28 years. Internalizing and externalizing problems were rated by parents at 8 years, and by adults at 28 years. Confirmatory-comparative modelling tested whether associations of sensitive parenting with outcomes at 8 and 28 years among individuals with early multiple and/or persistent RPs (n = 74) versus those without (n = 228) were best explained by ME, DIA-S, or DST models. Best fitting models differed according to age at assessment. For childhood attention regulation, the statistically parsimonious DIA-S provided the best fit to the data. At age 28, two additive main effects (ME, RP group and sensitive parenting) fit best. DIA-S and ME explained internalizing and externalizing problems. Using a comprehensive life-span approach, DIA-S and ME models but not DST explained how early RPs and sensitive parenting predicted attention, internalizing, and externalizing outcomes. Individuals with early RPs are vulnerable to insensitive parenting.

Self-regulation in the pre-adolescent brain

Self-regulation refers to the ability to monitor and modulate emotions, behavior, and cognition, which in turn allows us to achieve goals and adapt to ever changing circumstances. This trait develops from early infancy well into adulthood, and features both low-level executive functions such as reactive inhibition, as well as higher level executive functions such as proactive inhibition. Development of self-regulation is linked to brain maturation in adolescence and adulthood. However, how self-regulation in daily life relates to brain functioning in pre-adolescent children is not known. To this aim, we have analyzed data from 640 children aged 8–11, who performed a stop-signal anticipation task combined with functional magnetic resonance imaging, in addition to questionnaire data on self-regulation. We find that pre-adolescent boys and girls who display higher levels of self-regulation, are better able to employ proactive inhibitory control strategies, exhibit stronger frontal activation and more functional coupling between cortical and subcortical areas of the brain. Furthermore, we demonstrate that pre-adolescent children show significant activation in areas of the brain that were previously only associated with reactive and proactive inhibition in adults and adolescents. Thus, already in pre-adolescent children, frontal-striatal brain areas are active during self-regulatory behavior.

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Children with higher levels of self-regulation employ more proactive inhibition.

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During proactive inhibition, children aged 8–11 show activation in frontal-cortical areas.

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Children higher in self-regulation exhibit more cortical-subcortical coupling.

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Children aged 8–11 show similar brain activation as adults during inhibition.

The effects of home visiting on mother-child interactions: Evidence from a randomized trial using dynamic micro-level data

BACKGROUND

Home visiting programs constitute an important policy to support vulnerable families with young children. One of their principal aims is to improve infant-parent relationships, so a key measure of their effectiveness is based on observational measures of parent-children interactions. In the present study we provide novel evidence on the effectiveness of home visiting programs in improving mother-child interactions within a randomized controlled trial (RCT) of the Pro Kind program. A major goal of the Pro Kind program is to promote child development by strengthening the intuitive parenting skills of mothers. On this basis, the following research question is addressed in this paper: What is the impact of the Pro Kind home visitation program on the quality of mother-child interaction?

METHODS

A randomly chosen subsample of the original sample was selected to participate on video recordings. This subsample of 109 mother-child dyads was videotaped during a 3-min typical play situation at the participants' homes when the child was aged 25 months. We use a novel micro-coding system which allows us to examine how the intervention affected the dynamic feedback responses of both mothers and children in three key measures of behavior: orientation, positive contingency, and negative/lack of contingency. The analysis was conducted using a set of static probit models and dynamic cross-lagged panel probit models for each measure.

RESULTS

The intervention significantly improved the interactions between girls and their mothers, by increasing the prevalence of orientation and positive contingency (and reducing that of negative/lack of contingency). This was achieved by increasing both the persistence of positive behaviors and also the probability of switching from negative to positive behaviors in the treatment group. Mixed impacts were detected for boys.

CONCLUSIONS

Overall, it can be said that the Pro Kind program has a positive impact on the quality of mother-daughter interaction. However, our findings might also influence the design and delivery of home visiting programs, to the extent that they suggest that more attention has to be devoted to the interactions between boys and their mothers. Furthermore, the results show the importance of careful dynamic modelling of interactions data from videotaped observations to have a more complete understanding of the effectiveness of home visiting programs.

Eye contact effect: The role of vagal regulation and reactivity, and self-regulation of attention

Eye contact is a crucial aspect of social interactions that may enhance an individual’s cognitive performance (i.e. the eye contact effect) or hinder it (i.e. face-to-face interference effect). In this paper, I focus on the influence of eye contact on cognitive performance in tasks engaging executive functions. I present a hypothesis as to why some individuals benefit from eye contact while others do not. I propose that the relations between eye contact and executive functioning are modulated by an individual’s autonomic regulation and reactivity and self-regulation of attention. In particular, I propose that individuals with more optimal autonomic regulation and reactivity, and more effective self-regulation of attention benefit from eye contact. Individuals who are less well regulated and over- or under-reactive and who do not employ effective strategies of self-regulation of attention may not benefit from eye contact and may perform better when eye contact is absent. I present some studies that justify the proposed hypothesis and point to a method that could be employed to test them. This approach could help to better understand the complex mechanisms underlying the individual differences in participant’s cognitive performance during tasks engaging executive functions.

Sleep and self-regulation in early childhood

What is the role of sleep in children's behavioral, emotional, and cognitive regulation? This chapter considers theoretical and conceptual links between sleep and self-regulation, with special attention to sleep and self-regulation in early childhood. We selectively review the growing body of research on associations between sleep and self-regulation, mentioning some methodological issues. We also consider how child characteristics and sociocontextual factors may interact with sleep in the development of self-regulation in early childhood. We provide some relevant empirical examples from our own research.

Helping Families of Infants With Persistent Crying and Sleep Problems in a Day-Clinic

Excessive crying and sleep problems affect up to 30% of infants and often coexist. Although usually benign and self-limiting, persistent crying, and sleep problems exceeding 6 months of age need attention as they may impair the mental health of the infant and its family. The source and the impact of these persistent regulatory problems is often not restricted to the infant, but extends to the parents and the parent-infant relationship. Clinical practice needs interdisciplinary and multi-method interventions focusing beyond regulatory problems of the infant but also on parental self-regulation and parent's co-regulatory responses toward the infant. Treating clinicians may encounter limitations of home-visits, outpatient, and pediatric residential settings when working with families in distress. We describe an infant mental health day-clinic treatment, drawing attention to this viable future direction. It offers a therapeutic climate based on forming a triangle of co-regulation between clinician, parent and infant to first help the parent and the infant settle down. This stress reduction restores parent-infant connectedness and parental learning and reflecting capacity. Clinicians then use established therapeutic modalities to support parental self- and co-regulatory skills which is important for the development of self-regulation in the infant. Experience with this treatment program suggests that a day-clinic setting facilitates interdisciplinary and integrative multi-method intervention, infant and parental stress reduction and integration of parental self- and co-regulatory skills in daily family life, improving overall outcomes. This perspective warrants further investigation.

Heterogeneity in brain functional changes of cognitive processing in ADHD across age: A systematic review of task-based fMRI studies

This review aims to establish the cognitive processing of patients with attention-deficit hyperactive disorder (ADHD) across age. Functional magnetic resonance imaging (fMRI) studies on children and adult populations were conducted, thus delineating deficits that could have been maintained and ameliorated across age. This allowed for the examination of the correlation between patterns of brain activation and the corresponding development of functional heterogeneity in ADHD. A systematic literature search of fMRI studies on ADHD was conducted using the PubMed and Scopus electronic databases based on PRISMA guidelines. References and citations were verified in Scopus database. The present study has identified 14 studies on children, 16 studies on adults, and one study on both populations of ADHD consisting of 1371 participants. Functional heterogeneity is present in ADHD across age, which can manifest either as different brain activation patterns, intra-subject variability, or both. This is shown in the increased role of the frontal regions and the specialized network in adults with ADHD from inefficient non-specific activation in childhood. Functional heterogeneity may manifest when delayed maturation is insufficient to normalize frontal lobe functions.

The Roles of Physical Activity, Exercise, and Fitness in Promoting Resilience During Adolescence: Effects on Mental Well-Being and Brain Development

Adolescence is a critical yet vulnerable period for developing behaviors important for mental well-being. The existing literature suggests that physical activity (PA), exercise, and aerobic fitness promote well-being and reduce risk of mental health problems. In this review, we focus on PA, exercise, and fitness as modifiable resilience factors that may help promote self-regulation via strengthening of top-down control of bottom-up processes in the brain, thereby acting as a buffer against mental health problems during this period of vulnerability. First, we briefly review the link between PA, exercise, and aerobic fitness with mental well-being and reduced mental health problems in adolescence. Then we present how impairments in self-regulation, which involves top-down control to modulate bottom-up processes, are common across a wide range of mental health disorders. Finally, we use the extant neuroimaging literature to highlight how neural systems underlying top-down control continue to develop across adolescence, and propose that PA, exercise, and aerobic fitness may facilitate resilience through strengthening individual brain regions as well as large-scale neural circuits to improve emotional and behavioral regulation. Future neuroimaging studies assessing the effects of PA, exercise, and aerobic fitness at various developmental stages in each sex and studies considering the characteristics (e.g., frequency, intensity, type) and social context of PA and exercise are vital to better understand both macro- and microscale mechanisms by which these behaviors and attributes may facilitate mental health resilience during adolescent development.

Towards an integrated account of the development of self-regulation from a neurocognitive perspective: A framework for current and future longitudinal multi-modal investigations

Self-regulation is the ability to monitor and modulate emotions, behaviour, and cognition in order to adapt to changing circumstances. Developing adequate self-regulation is associated with better social coping and higher educational achievement later in life; poor self-regulation has been linked to a variety of detrimental developmental outcomes. Here, we focus on the development of neurocognitive processes essential for self-regulation. We outline a conceptual framework emphasizing that this is inherently an integrated, dynamic process involving interactions between brain maturation, child characteristics (genetic makeup, temperament, and pre- and perinatal factors) and environmental factors (family characteristics, parents and siblings, peers, and broader societal influences including media development). We introduce the Consortium of Individual Development (CID), which combines a series of integrated large-scale, multi-modal, longitudinal studies to take essential steps towards the ultimate goal of understanding and supporting this process.

The association of infant crying, feeding, and sleeping problems and inhibitory control with attention regulation at school age

Regulatory problems in infancy and toddlerhood have previously been associated with an increased risk of developing attention problems in childhood. We hypothesized that early regulatory problems are associated with attention problems via reduced inhibitory control. This prospective study assessed 1,459 children from birth to 8 years. Crying, feeding, and sleeping problems were assessed at 5 and 20 months via parent interviews and neurological examinations. At 20 months, inhibitory control was tested with a behavioral (snack delay) task. Attention regulation was assessed at 6 and 8 years using multiple instruments and informants. Detrimental effects of crying, feeding, and sleeping problems on attention regulation were partly mediated by children's ability to inhibit unwanted behaviors (β = -0.04, p = 0.013). Accounting for cognition diminished this indirect effect (β = -0.01, p = 0.209). Instead, the effects of crying, feeding, and sleeping problems on attention regulation were fully mediated by children's cognitive functioning (β = -0.10, p < 0.001). These results support that inhibitory control abilities partly mediate effects of crying, feeding, and sleeping problems. However, these effects may be accounted for by children's general cognitive abilities. Early regulatory problems may set infants on a course of under control of behavior into school age, and such trajectories are highly associated with general cognitive development.

Controlling Parenting Behaviors in Parents of Children Born Preterm: A Meta-Analysis

OBJECTIVE

This meta-analysis tested whether parents of preterm-born children differ from parents of full-term-born children regarding controlling parenting.

METHODS

Databases of PubMed, Scopus, Web of Science, Open Access Theses and Dissertations, and Elton B. Stephens Company were searched for cross-sectional and prospective longitudinal studies examining controlling parenting in preterm-born children.

RESULTS

The meta-analysis included 27 independent data sets, derived from 34 studies, with a total of 8053 participants-3265 preterm and 4788 full-term children. Parents of children born preterm were more controlling than parents of children born full-term (Hedges' g = 0.29; 95% confidence interval: 0.19-0.39; z = 5.48; p < 0.001). Heterogeneity analysis indicated significant variation in effects between studies (Q = 148.46, p < 0.001), but the effects were not moderated by gestational age, birth weight, child age, child gender, parental education, type of parenting assessment method (observational vs parental self-report), parenting dimension measured (behaviors vs attitudes), type of controlling parenting (intrusiveness vs others), study design (cross-sectional vs longitudinal), year of publication, or geographical setting of the studies (America vs Europe).

CONCLUSION

Findings suggest that parents of children born preterm are at higher risk for engaging in controlling parenting strategies, stressing the importance of psychosocial follow-up support for these parents.

Autonomic Nervous System Is Related to Inhibitory and Control Function Through Functional Inter-Region Connectivities of OFC in Major Depression

OBJECTIVE

To investigate the mechanism of interactions between autonomic nervous system (ANS) and cognitive function in Major depression (MD) with Magnetoencephalography (MEG) measurements.

METHODS

Participants with MD (n = 20), and Health controls (HCs, n = 18) were completed MEG measurements during the performance of a go/no-go task. Heart rate variability (HRV) indices (SDANN, and RMSSD) were derived from the raw MEG data. The correlation analysis of the HRV and functional connectivities in different brain regions was conducted by Pearson's r in two groups.

RESULTS

The go/no-go task performances of HCs were better than MD patients; HRV indices were lower in the MD group. Under the no-go task, a brain MEG functional connectivity analysis based on the seed regions of the orbitofrontal cortex (OFC) displayed increased functional inter-region connectivity networks of OFC in MD group. HRV indices were correlated with different functional inter-region connectivity networks of OFC in two groups, respectively.

CONCLUSION

ANS is related to inhibitory and control function through functional inter-region connectivity networks of OFC in MD. These findings have important implications for the understanding pathophysiology of MD, and MEG may provide an image-guided tool for interventions.

Early adolescent brain markers of late adolescent academic functioning

Academic performance in adolescence strongly influences adult prospects. Intelligence quotient (IQ) has historically been considered a strong predictor of academic performance. Less objectively explored have been morphometric features. We analyzed brain MRI morphometry metrics in early adolescence (age 12-14 years) as quantitative predictors of academic performance over high school using a naïve Bayesian classifier approach with n = 170 subjects. Based on the mean GPA, subjects were divided into high (GPA ≥3.54; n = 87) and low (GPA <3.54; n = 83) academic performers. Covariance analysis was performed to look at the influence of subject demographics. We examined predictive features from the 343 available regions (surface areas, cortical thickness, and subcortical volumes) and applied 4 algorithms for selection and reduction of attributes using Weka. Cortical thickness measures performed better than surface areas or subcortical volumes as predictors of academic performance. We identified 15 cortical thickness regions most predictive of academic performance, three of which have not been described in the literature predictive of academic performance. These were in the left hemisphere fusiform, bilateral insula, and left hemisphere paracentral regions. Prediction had a sensitivity of 0.65 and specificity of 0.73 with independent validation. Follow-up independent t-test analyses between high and low academic achievers on 10 of 15 regions showed between-group significance at the p < 0.05 level. High achievers demonstrated thicker cortices than low achievers. These newly identified regions may help pinpoint new targets for further study in understanding the developing adolescent brain in the classroom setting.

Heart rate variability as a biomarker in health and affective disorders: A perspective on neuroimaging studies

The dynamic embodiment of psychological processes is evident in the association of health outcomes, behavioural traits and psychological functioning with Heart Rate Variability (HRV). The dominant high-frequency component of HRV is an index of the central neural control of heart rhythm, mediated via the parasympathetic vagus nerve. HRV provides a potential objective measure of action policies for the adaptive and predictive allostatic regulation of homeostasis within the cardiovascular system. In its support, a network of brain regions (referred to as the 'central autonomic network') maps internal state, and controls autonomic responses. This network includes regions of prefrontal cortex, anterior cingulate cortex, insula, amygdala, periaqueductal grey, pons and medulla. Human neuroimaging studies of neural activation and functional connectivity broadly endorse this architecture, and its link with cardiac regulation at rest and dysregulation in clinical states that include affective disorders. In this review, we appraise neuroimaging research and related evidence for HRV as an informative marker of autonomic integration with affect and cognition, taking a perspective on function and organisation. We consider evidence for the utility of HRV as a metric to inform targeted interventions to improve autonomic and affective dysregulation, and suggest research questions for further investigation.

An Applied Contextual Model for Promoting Self-Regulation Enactment Across Development: Implications for Prevention, Public Health and Future Research

This theoretical paper presents a public health approach for promoting self-regulation across development that is based in cross-disciplinary theory and research. The self-regulation promotion model includes three key approaches that are each dependent on the relationship that children and youth have with caregivers: teaching self-regulation skills, building supportive environments, and providing co-regulation. This model extends the science of self-regulation insofar as it: (1) focuses on promoting wellbeing (not only reducing risks) across domains of functioning, (2) addresses self-regulation intervention across childhood and through young adulthood, (3) integrates multiple theories and applies them to intervention in meaningful ways, and (4) identifies specific strategies that can be used in natural developmental contexts and that address the social ecological environment as well as the individual child. We describe seven key principles that support the model including a description of self-regulation processes and implications for promoting self-regulation at each developmental stage. We end with broad implications for intervention, highlighting the relevance of the self-regulation promotion model for practitioners, policy makers, and prevention researchers.

The relationship between attention deficit hyperactivity disorder, bipolarity and mixed features in major depressive patients: Evidence from the BRIDGE-II-Mix Study

OBJECTIVE

This study primarily focused on the relationship between comorbid attention deficit-hyperactivity disorder (ADHD), mixed features and bipolarity in major depressive patients.

METHODS

The sample comprised 2777 patients with Major Depressive Episode (MDE) enrolled in a multicentre, multinational study originally designed to assess different definitions of mixed depression. Socio-demographic, familial and clinical characteristics were compared in patients with (ADHD + ) and without (ADHD-) comorbid ADHD.

RESULTS

Sixty-one patients (2.2%) met criteria for ADHD. ADHD was associated with a higher number of (hypo)manic symptoms during depression. Mixed depression was more represented in ADHD + patients than in ADHD- using both DSM-5 and experimental criteria. Differences were maintained after removing overlapping symptoms between (hypo)mania and ADHD. ADHD in MDE was also associated with a variety of clinical and course features such as onset before the age of 20, first-degree family history of (hypo)mania, past history of antidepressant-induced (hypo)manic switches, higher number of depressive and affective episodes, atypical depressive features, higher rates of bipolarity specifier, psychiatric comorbidities with eating, anxiety and borderline personality disorders.

LIMITATIONS

The study was primarily designed to address mixed features in ADHD, with slightly reduced sensitivity to the diagnosis of ADHD. Other possible diagnostic biases due to heterogeneity of participating clinicians.

CONCLUSIONS

In a sample of major depressive patients, the comorbid diagnosis of current ADHD is associated with bipolar diathesis, mixed features, multiple psychiatric comorbidity and a more unstable course. Further prospective studies are necessary to confirm the possible mediating role of temperamental mood instability and emotional dysregulation in such a complex clinical presentation.

Predicting ADHD Symptoms in Adolescence from Early Childhood Temperament Traits

Extreme levels of certain temperament traits can be early markers of different developmental pathways of attention-deficit/hyperactivity disorder (ADHD). However, the long-term utility of using these traits as predictors of ADHD is not fully known. This study includes 64 male adolescents (M age = 13.5), who have been followed since birth as part of a longitudinal study. The primary aim was to test effortful control (EC), activity level, and anger, measured in early childhood - both with mother's reports and laboratory assessments -as predictors of ADHD symptoms in adolescence. Further, we investigated the specificity of this prediction to the different ADHD symptom domains. The results demonstrated that early temperament dimensions of EC and activity level were predictive of ADHD symptoms about 10 years later, when the participants reached adolescence. Moreover, activity level showed specificity only to hyperactivity-impulsivity symptoms whereas EC was a predictor of the two symptom domains. Anger had a predictive correlation with ADHD symptoms; however, it did not have a unique predictive contribution. These results emphasize the relevance of EC and activity level in the developmental course of ADHD. Identification of early risk factors can lead to more efficient design and implementation of intervention programs.

Correlations of Internet Addiction Severity With Reinforcement Sensitivity and Frustration Intolerance in Adolescents With Attention-Deficit/Hyperactivity Disorder: The Moderating Effect of Medications

Background: Deviations in reinforcement sensitivity and frustration-related reactions have been proposed as components of the biopsychosocial mechanisms, which explained the high vulnerability to internet addiction (IA) among individuals with attention-deficit/hyperactivity disorder (ADHD). There is currently limited knowledge on the relationship of IA symptoms with reinforcement sensitivity and frustration intolerance, as well as factors moderating those correlations in this population. Objective: The aims of this study were (1) to examine the associations of IA symptoms severity with reinforcement sensitivity and frustration intolerance and (2) identify the moderators of these associations among adolescents diagnosed with ADHD in Taiwan. Methods: A total of 300 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their levels of IA severity, reinforcement sensitivity, and frustration intolerance were assessed using the Chen Internet Addiction Scale, behavioral inhibition system (BIS) and behavioral approach system (BAS), and Frustration Discomfort Scale, respectively. The associations of IA severity with reinforcement sensitivity and frustration intolerance were examined using multiple regression analysis. Possible moderators, including medications for ADHD, were tested using the standard criteria. Results: Higher fun seeking on the BAS (p = .003) and higher frustration intolerance (p = .003) were associated with more severe IA symptoms. Receiving medication for treating ADHD moderated the association between fun seeking on the BAS and severity of IA symptoms. Conclusion: Fun seeking on the BAS and frustration intolerance should be considered as targets in prevention and intervention programs for IA among adolescents with ADHD.

Effects of mindfulness training on regulatory and academic abilities in preadolescents: Results from a pilot study

Regulatory abilities such as self-regulation and stress regulation are key predictors of essential developmental outcomes, including intellectual and socioemotional milestones as well as academic achievement. Preadolescence has been proposed as a period that is crucial for training these abilities. The present pilot study investigated the effects of mindfulness training on preadolescents‘ regulatory abilities and school-related outcomes. A group of 34 fifth graders received either mindfulness training (experimental group), Marburg Concentration Training (alternative treatment group), or no treatment (passive control group) and were monitored over a four-month intervention period. Regulatory abilities were assessed first, with two self-report questionnaires that operationalized impulsivity and coping with stress, respectively. Second, physical stress regulation was examined on the basis of diurnal cortisol as well as salivary α-amylase (sAA) profiles. Finally, school-related outcomes were measured with a paperpencil based performance test of verbal memory. Results show that impulsivity increased in all groups over time, whereas there were no significant training effects on self-reported coping with stress. Both training groups showed more adaptive physiological stress regulation in terms of steeper diurnal cortisol slopes and marginally less pronounced sAA awakening responses, however, with respect to physiological measures, no data of the passive control group are available. With respect to school-related outcomes, the results indicate a slight superiority regarding verbal memory for the mindfulness training group compared to the Marburg Concentration Training group.

From Character Strengths to Children's Well-Being: Development and Validation of the Character Strengths Inventory for Elementary School Children

Although research on character strengths has flourished in recent years, the paucity of suitable quantitative instruments for the assessment of children’s character strengths limits the study of character development in childhood. The Character Strengths Inventory for Children (CSI-C) is a new self-report character inventory for children that was designed for easy administration directly to elementary school-aged children. The CSI-C provides an evaluation of 24 character strengths defined in Peterson and Seligman’s Values in Action Classification of Strengths. Data from two samples of 2,061 Israeli children aged 7–12 support the constructs of the instrument. Principal component analysis and confirmatory factor analysis of the 96 CSI-C items revealed preliminary evidence for a hierarchical structure with 24 lower factors nested within four higher-order latent factors: interpersonal, transcendence, intellectual, and temperance strengths. Children’s interpersonal and temperance strengths were negatively associated with mental health difficulties, and their temperance and transcendence strengths were positively associated with subjective well-being. The intellectual and temperance strengths were correlated with children’s school functioning and grit. The potential uses of the CSI-C in research and practice are discussed.

Emotion dysregulation in attention-deficit/hyperactivity disorder and borderline personality disorder

There is ongoing debate on the overlap between Attention-Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD), particularly regarding emotion dysregulation (ED). In this paper, we present a narrative review of the available evidence on the association of these two disorders from several standpoints. First, we discuss the unique and shared diagnostic criteria for ADHD and BPD, focusing particularly on ED. We consider the methodology of ecological momentary assessment and discuss why this approach could be an alternative and more accurate way to qualitatively distinguish between ADHD and BPD. We summarise key findings on the genetic and environmental risk factors for ADHD and BPD and the extent to which there are shared or unique aetiological and neurobiological risk factors. Finally, we discuss the clinical relevance of considering both disorders in the assessment of patients presenting with trait-like behavioural syndromes, distinguishing the two conditions and implications for treatment.

Waiting for a treat. Studying behaviors related to self-regulation in 18- and 24-month-olds

The ability to delay gratification - conceived as an early expression of self-regulation - develops in the second half of the second year of life. We used inductive methodology to identify different behaviors and set of behaviors performed by children while waiting for a treat. We asked which sets are more effective when it comes to successfully delaying gratification and how all observed sets change during toddler age. 130 children were tested twice - at 18 and at 24 months - using a Snack Delay Task. We observed 20 different behaviors and distinguished 4 sets of behaviors. The most important and effective set for delaying gratification in 18 and in 24 month olds was the set called Attention and Movements. We concluded that growth in the ability to delay gratification resulted from increased ability to overcome temptation by using an active strategy mainly based on attention.

Assessment: The Newborn

Neonatal neurobehavioral assessment has become a standardized component of clinical care provided to newborn infants, guiding neonatal clinical care and subsequent access to early interventions and services. Links between neonatal assessment and neurosensory and motor impairments in high-risk infants have been relatively well established. In contrast, the extent to which newborn neurobehavioral assessment might also facilitate the early identification of infants susceptible to socioemotional impairments in early childhood is less well documented. This review examines longitudinal links between the neonatal neurobehavioral assessment, temperament, and socioemotional outcomes in early childhood.

Commentary: On the importance of looking at nonlinearity and developmental effects - a reflection on Flom et al. (2017)

By examining both linear and curvilinear associations between mental development and activity level, the study by Flom et al. (Journal of Child Psychology and Psychiatry, 2017) highlights the importance of going beyond linear associations in psychological fields of research. Results from Flom et al. (Journal of Child Psychology and Psychiatry, 2017) also raise interesting questions for future research. First, studies should look at variables that may explain the associations between activity level and mental development, such as self-regulation and attention. Second, longitudinal changes in the strength of the association between activity level and mental development should be examined to determine when this association is at its strongest. Finally, longitudinal research looking at bidirectional effects is needed to confirm the direction of the associations between activity level and mental development. Answers to these questions will allow the identification of the best targets and developmental periods for interventions to take place.

Heart rate variability indices as bio-markers of top-down self-regulatory mechanisms: A meta-analytic review

Theoretical perspectives posit that heart-rate variability (HRV) reflects self-regulatory capacity and therefore can be employed as a bio-marker of top-down self-regulation (the ability to regulate behavioral, cognitive, and emotional processes). However, existing findings of relations between self-regulation and HRV indices are mixed. To clarify the nature of such relations, we conducted a meta-analysis of 123 studies (N=14,347) reporting relations between HRV indices and aspects of top-down self-regulation (e.g., executive functioning, emotion regulation, effortful control). A significant, albeit small, effect was observed (r=0.09) such that greater HRV was related to better top-down self-regulation. Differences in relations were negligible across aspects of self-regulation, self-regulation measurement methods, HRV computational techniques, at-risk compared with healthy samples, and the context of HRV measurement. Stronger relations were observed in older relative to younger samples and in published compared to unpublished studies. These findings generally support the notion that HRV indices can tentatively be employed as bio-markers of top-down self-regulation. Conceptual and theoretical implications, and critical gaps in current knowledge to be addressed by future work, are discussed.

Evidence-Based Multifactorial Assessment of Preschool-Age Children Who Stutter

This review summarizes extant findings supporting multifactorial models of stuttering within the context of preschool-age stuttering assessment. Evidence is given for a number of speech-language and associated factors/domains to consider when evaluating young children who stutter. Selected factors are presented in two parts: (1) Caregiver Interview and (2) Direct Child Assessment. Factors addressed during caregiver interviews include: gender, time since and age at stuttering onset, family history of stuttering, caregivers' perception/concerns about stuttering, and temperament. Factors addressed during direct child assessments include: stuttering behaviors, speech-associated attitudes/awareness, and speech rate, as well as speech sound and language development. Interactions/relations among factors are noted, showing their combined effects and contributions to childhood stuttering. Additionally, suggested clinical applications are provided wherever appropriate. Such evidence and practical applications bridge the gap between theory and clinical practice, thus advancing the abilities of speech-language pathologists to conduct well-informed, comprehensive stuttering evaluations.

Does the development of executive functioning in infants born preterm benefit from maternal directiveness?

OBJECTIVE

Problems in early development of executive functioning may underlie the vulnerability and individual variability of infants born preterm for behavioral and learning problems. Parenting behaviors may aggravate or temper this increased risk for dysfunction. This study assessed how maternal parenting behaviors predict individual differences in early development of executive functioning in infants born preterm, and whether this varies with infant temperament, i.e., self-regulation.

METHODS

Participants were 76 infants born preterm (≤36weeks' gestation and <2500g birth weight) and their mothers. Maternal sensitive responsiveness and directiveness were observed during a mother-infant interaction situation at 7, 10 and 14months corrected age. At the same ages, executive functioning was measured using the A-not-B task. An infant self-regulation questionnaire (IBQ-R) was completed by mothers at 7months.

RESULTS

After controlling for perinatal risk factors, Multivariate Latent Growth Modeling showed that consistently higher levels of maternal directiveness predicted a stronger increase in A-not-B performance, which did not vary with infant self-regulation. No relationship between maternal sensitive responsiveness and development in A-not-B performance in infants born preterm was found.

CONCLUSIONS

These results suggest that preterm infants' early executive functioning development in the first year of life may benefit from a more and consistent directive approach by their mothers. These findings have important implications for early intervention programs aimed at facilitating preterm infants' development.

Dissociable Response Inhibition in Children With Tourette's Syndrome Compared With Children With ADHD

OBJECTIVE

This study investigates whether performance in a verbal response task (Color-Word Interference Test [CWIT]) and a motor response task (Conners' Continuous Performance Test [CCPT]) discriminates children with Tourette's Syndrome (TS), ADHD, and typically developing children (TDC).

METHOD

Nineteen children with TS, 79 with ADHD, and 50 with TDC participated (8-17 years).

RESULTS

Children with TS committed significantly fewer errors in the verbal response task than those with ADHD. Moreover, children with TS but without ADHD performed better than TDC. Errors in motor task and speed of response did not distinguish between groups. A cautious tendency of response correlated positively with rates of tics in children with TS.

CONCLUSION

Children with TS were superior in inhibiting a prepotent verbal response; however, comorbidity with ADHD in those children negatively influenced performance. Results support the hypothesis that levels of inhibitory control distinguish children with TS, ADHD, and TDC.