The Development of Sustained Attention in Children: The Effect of Age and Task Load

Longitudinal relationship between oppositional defiant disorder symptoms and attention-deficit/hyperactivity disorder symptoms in Chinese children: insights from cross-lagged panel network analyses

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common childhood mental disorders, and they have substantial comorbidity. The developmental precursor model has long been widely used to explain the mechanisms of comorbidity between ODD and ADHD, however whether it is equally effective at the symptomatic level is unclear. Therefore, this study aimed to (a) examine the stability of the ODD and ADHD comorbidity network in a longitudinal sample of high-risk children in China; and (b) examine the longitudinal relationship between the ODD and ADHD symptom networks based on a developmental precursor model. Two hundred sixty-three Chinese children aged 6 to 13 years with ODD and/or ADHD were assessed for symptoms of ODD and ADHD in two surveys conducted 1 year apart. We used data from these two time points to construct two cross-sectional networks and a cross-lagged panel network (CLPN) to explore the symptom network for comorbidity of ODD and ADHD. The analysis shows that: (1) the two cross-sectional networks are highly similar in terms of structure, existence of edges, centrality estimates, and the invariance test shows that there is no significant difference between them. The symptoms "follow through", "interrupts/intrudes", "difficulty playing quietly" and "concentration" had the highest expected influence centrality at both time points. (2) Combined with the results of the cross-sectional and cross-lagged networks, we found that "annoy" and "blame" are potential bridge symptoms between the ODD and ADHD symptom networks. The symptom "annoy" forms a reciprocal predictive relationship with "interrupts/intrudes", while "blame" unidirectionally predicts "close attention". In addition, we found that "vindictive" predicted numerous ADHD symptoms, whereas "angry" was predicted by numerous ADHD symptoms. The findings emphasize the broad predictive relationship between ODD and ADHD symptoms with each other, and that ODD symptoms may lead to activation of the ADHD symptom network and vice versa. These findings suggest that the developmental precursor model at the symptom level may partially explain the comorbidity mechanisms of ODD and ADHD, and future studies should further investigate the underlying multiple mechanisms.

An evaluation of computerized attention and executive function measures for use with school age children with neurofibromatosis type 1

The present study investigated the performance of children with neurofibromatosis type 1 on computerized assessments of attention and executive function. Relations to ADHD symptomatology were also examined. Participants included 37 children (20 male) with NF1 (9-13 years; Mage = 11.02). Participants completed the NIH Toolbox Dimensional Change Card Sort, List Sort Working Memory (LSWM), and Flanker tasks, as well as Cogstate Identification and One Back tests. ADHD symptomatology was assessed using the K-SADS. Average performance was significantly different from the normative mean on every measure, except LSWM. The NIH Toolbox Flanker and Cogstate Identification tasks detected the highest proportion of participants with at least mild difficulty, and the Cogstate Identification task detected the highest proportion of participants with severe difficulty. Analyses revealed significant relations with ADHD symptomatology for two NIH toolbox tasks. The various computerized measures of attention and executive function offer different information when working with school age children with NF1. The NIH Flanker may offer the most room for change and offers face validity, which may be beneficial for clinical trials research. However, the LSWM shows most support for relations with behavioral indicators of attention and executive challenges.

Research of visual attention networks in deaf individuals: a systematic review

The impact of deafness on visual attention has been widely discussed in previous research. It has been noted that deficiencies and strengths of previous research can be attributed to temporal or spatial aspects of attention, as well as variations in development and clinical characteristics. Visual attention is categorized into three networks: orienting (exogenous and endogenous), alerting (phasic and tonic), and executive control. This study aims to contribute new neuroscientific evidence supporting this hypothesis. This paper presents a systematic review of the international literature from the past 15 years focused on visual attention in the deaf population. The final review included 24 articles. The function of the orienting network is found to be enhanced in deaf adults and children, primarily observed in native signers without cochlear implants, while endogenous orienting is observed only in the context of gaze cues in children, with no differences found in adults. Results regarding alerting and executive function vary depending on clinical characteristics and paradigms used. Implications for future research on visual attention in the deaf population are discussed.

Impact of Distractors on Sustained Attention and Inhibition in Children With ADHD

OBJECTIVE

This study examines the impact of visual and auditory distractors on attention and inhibition in children with and without ADHD.

METHOD

The study used the MOXO d-CPT child version. The sample consisted of 208 children aged 8 to 12 years, including 64 with ADHD and 144 controls.

RESULTS

Children with ADHD and controls differed in their reaction to distracting stimuli; visual distractors cause a higher decrease in sustained attention and inhibitory control in the ADHD group. Moreover, auditory distractors generate improved performance in the control group but not in the ADHD group. In addition, age-related effects were found in both sustained attention and inhibitory control in all children, regardless of whether the ADHD condition was present.

CONCLUSIONS

The findings indicate that children with ADHD performed poorer compared to controls, and that distractors differently affected the performance of the two groups.

Measuring children's sustained selective attention and working memory: validity of new minimally linguistic tasks

This study introduces visual tasks using nonlinguistic stimuli that measure sustained selective attention (SSA) and working memory (WM), two constructs foundational to learning and associated with developmental disorders in children. Using an argument-based approach to validation, we examine whether each task (a) measures distinct constructs, (b) shows internal consistency, (c) captures a range of performance, and (d) relates to development as indexed by age. Participants included 71 children, ages 4-10, of whom 12 had parental concern for language/learning. The SSA task presented spatial locations within a long and uninteresting task, following the continuous performance task paradigm. The WM task presented paired location sequences of increasing length, incorporating key elements of the n-back and complex span paradigms. Controlling for age, tasks were found to be minimally associated with each other (r = .26), suggesting related but distinct constructs. Internal consistency was high, with split-half reliability of .94 (SSA) and .92 (WM); the stability of these estimates was supported by bootstrapping simulations. Task performance was evenly distributed, with minimal floor or ceiling effects within this age range. Performance was positively related to age (SSA r = .49; WM r = .53). Exploratory correlations with a measure of parental concern were significant for SSA but not WM. The results show that these new tasks can be used to measure children's SSA and WM in a visual domain with minimal linguistic influence. These tasks capture developmental changes in the early school years. Further investigation can examine their utility for classifying children with developmental disorders.

Social influences on alcohol outcome expectancy development from childhood to young adulthood: A narrative review

Purpose of Review

Alcohol outcome expectancies emerge in early childhood, develop throughout adolescence, and predict alcohol outcomes well into adulthood. Social factors shape how expectancies are learned in myriad ways, yet such social learning influences seldom are examined in the context of developmental factors. This review summarized literature on the social origins of alcohol expectancies through vicarious (observational) and experiential (direct) alcohol-related learning from childhood to young adulthood within a social learning framework.

Recent Findings

Young children primarily endorse negative expectancies, which decline rapidly with age amidst escalations in positive expectancies across adolescence. Parents and peers can contribute to vicarious learning about alcohol and facilitate experiential learning in different ways and to varying degrees across development. Media and social media, which children are increasingly exposed to as they mature, often depict alcohol-outcome relations that may further contribute to expectancy development in later adolescence and young adulthood.

Summary

Social influences on alcohol expectancy learning are complex and change over time, although this dynamic complexity typically is not depicted in extant literature. Developmentally-informed research capturing co-occurring shifts in social influences and alcohol expectancies is needed.

Impaired neurocognitive functioning 3 months following diagnosis of high-risk acute lymphoblastic leukemia: A report from the Children's Oncology Group

PURPOSE

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer diagnosis. Cognitive late effects develop in 20%-40% of ALL survivors, but the course of declines is unclear. The aim of this paper is to characterize cognitive functioning, and its association with patient-reported outcomes, early in treatment.

PATIENTS AND METHODS

A total of 483 children with high-risk ALL, aged 6-12 years at diagnosis, consented to the neurocognitive study embedded in a prospective therapeutic trial, Children's Oncology Group (COG) AALL1131. A computerized neurocognitive battery (Cogstate) was administered 3 months post diagnosis assessing reaction time, visual attention, working memory, visual learning, and executive functioning. Parent-reported executive functioning and patient-reported physical symptoms were also collected.

RESULTS

Data from 390 participants (mean age at diagnosis = 9.2 years, 55.4% male) were obtained. Relatively few patients reported pain (16.0%) or nausea (22.6%), but a majority (68.5%) reported feeling at least some fatigue at testing. Mean Cogstate Z-scores were within normal limits across tasks; however, rates of impairment (Z-scores ≤ -1.5) for reaction time, working memory, visual learning, and visual attention were all higher than expected compared to the standardization sample. Patients reporting fatigue were significantly more likely to have impaired reaction time and visual attention compared to those reporting no fatigue.

CONCLUSION

Findings support feasibility of computerized cognitive assessments and suggest higher-than-expected rates of impaired cognitive performance early during treatment for pediatric ALL, notably within 3 months of diagnosis, suggesting intervention efforts may be indicated. These results also highlight acute factors that may impact reliability of "baseline" assessments conducted soon after diagnosis.

Consensus-Based Evaluation of Outcome Measures in Pediatric Stroke Care: A Toolkit

Following a pediatric stroke, outcome measures selected for monitoring functional recovery and development vary widely. We sought to develop a toolkit of outcome measures that are currently available to clinicians, possess strong psychometric properties, and are feasible for use within clinical settings. A multidisciplinary group of clinicians and scientists from the International Pediatric Stroke Organization comprehensively reviewed the quality of measures in multiple domains described in pediatric stroke populations including global performance, motor and cognitive function, language, quality of life, and behavior and adaptive functioning. The quality of each measure was evaluated using guidelines focused on responsiveness and sensitivity, reliability, validity, feasibility, and predictive utility. A total of 48 outcome measures were included and were rated by experts based on the available evidence within the literature supporting the strengths of their psychometric properties and practical use. Only three measures were found to be validated for use in pediatric stroke: the Pediatric Stroke Outcome Measure, the Pediatric Stroke Recurrence and Recovery Questionnaire, and the Pediatric Stroke Quality of Life Measure. However, multiple additional measures were deemed to have good psychometric properties and acceptable utility for assessing pediatric stroke outcomes. Strengths and weaknesses of commonly used measures including feasibility are highlighted to guide evidence-based and practicable outcome measure selection. Improving the coherence of outcome assessment will facilitate comparison of studies and enhance research and clinical care in children with stroke. Further work is urgently needed to close the gap and validate measures across all clinically significant domains in the pediatric stroke population.

Relationships among age, socioeconomic status, and distractibility in preschoolers as assessed by the Competitive Attention Test

In children, the ability to attend to relevant auditory information and ignore distracting information is crucial for learning and educational achievement. Distractibility, the propensity to pay attention to irrelevant information, depends on multiple components of cognition (voluntary attention orienting, sustained attention, distraction resulting from the capture of attention by a distractor, phasic arousal, impulsivity, and motor control) that may mature at different ages. Here, we used the Competitive Attention Test (CAT) to measure these components in children aged 3 to 5 years. Our goal was to characterize changes in the efficiency of attention during the preschool period and to determine whether distractibility varies as a function of socioeconomic status (SES). All 3-year-olds (n = 14) and some 4- and 5-year-olds (n = 21) needed to be excluded from the sample due to noncompliance with instructions, suggesting that the CAT might not be suitable for children with poorly developed skills in sustained attention. Among 4- and 5-year-olds who completed the CAT (n = 71), sustained attention improved with age, whereas voluntary attention orienting remained immature. Independent of age, task-irrelevant sounds induced distraction, phasic arousal, and impulsivity. There was no relationship between SES and children's distraction. Finally, children from lower SES backgrounds showed reduced sustained attention abilities and increased impulsivity. Taken together, these findings suggest that distractibility is still developing during the preschool period and is likely to vary depending on the SES background of a child's family.

Re-visiting the 'mysterious myth of attention deficit': A systematic review of the recent evidence

Based on the inclusive and methodologically rigorous framework provided by Ed Zigler's developmental approach, we previously challenged what we called, 'the mysterious myth of attention deficit', the fallacy of attention as a universal deficit among persons with intellectual disability (ID). In this latest update, we conducted a systematic review of studies of essential components of attention among persons with ID published in the interim since the last iteration of the mysterious myth narrative was submitted for publication approximately a decade ago. We searched the databases PubMed and PsycINFO for English-language peer-reviewed studies published from 1 January 2011 through 5 February 2021. In keeping with the developmental approach, the two essential methodological criteria were that the groups of persons with ID were aetiologically homogeneous and that the comparisons with persons with average IQs (or with available norms) were based on an appropriate index of developmental level, or mental age. Stringent use of these criteria for inclusion served to control for bias in article selection. Articles were then categorised based on aetiological group studied and component of visual attention. Based on these criteria, 18 articles were selected for inclusion out of the 2837 that were identified. The included studies involved 547 participants: 201 participants with Down syndrome, 214 participants with Williams syndrome and 132 participants with fragile X syndrome. The findings from these articles call attention to the complexities and nuances in understanding attentional functioning across homogeneous aetiological groups and highlight that functioning must be considered in relation to aetiology; factors associated with the individual, such as developmental level, motivation, styles and biases; and factors associated with both the task, such as context, focus, social and emotional implications, and levels of environmental complexity.

Little fast, little slow, should I stay or should I go? Adapting cognitive control to local-global temporal prediction across typical development

Adaptive cognitive control (CC), the ability to adjust goal-directed behavior according to changing environmental demand, can be instantiated bottom-up by implicit knowledge, including temporal predictability of task-relevant events. In S1-S2 tasks, either local (trial-by-trial hazard expectation) or global (block-by-block expectation) temporal information can induce prediction, allowing for proactive action control. Recent developmental evidence showed that adaptive CC based on global temporal prediction emerges earlier than when it is based on the local one only. However, very little is known about how children learn to dynamically adjust behavior on the fly according to changing global predictive information. Addressing this issue is nevertheless crucial to unravel the mechanisms underlying adaptive CC flexibility. Here we used a modified version of the Dynamic Temporal Prediction task to investigate how typically developing younger (6-8 years) and older children (9-11 years), adolescents (12-15 years) and adults (21-31 years) use global prediction to shape adaptive CC over time. Specifically, the short-long percentage of S2 preparatory intervals was manipulated list-wide to create a slow-fast-slow-fast fixed block sequence and test how efficiently the response speed adapted accordingly. Overall, results revealed that in all groups behavioral performance is successfully adjusted as a function of global prediction in the late phase of the task (block 3 to 4). Remarkably, only adolescents and adults exhibit an early adaptation of adaptive CC (block 1 to 2), while children younger than 11 show sluggish ability in inferring implicit changes in global predictive rules. This age-related dissociation suggests that, although being present from an early age, adaptive CC based on global predictive information needs more developmental space to become flexible in an efficient way. In the light of a neuroconstructivist approach, we suggest that bottom-up driven implicit flexibility may represent a key prerequisite for the development of efficient explicit cognitive control.

Development of categorical speech perception in Mandarin-speaking children and adolescents

Although children develop categorical speech perception at a very young age, the maturation process remains unclear. A cross-sectional study in Mandarin-speaking 4-, 6-, and 10-year-old children, 14-year-old adolescents, and adults (n = 104, 56 males, all Asians from mainland China) was conducted to investigate the development of categorical perception of four Mandarin phonemic contrasts: lexical tone contrast Tone 1-2, vowel contrast /u/-/i/, consonant aspiration contrast /p/-/p^h /, and consonant formant transition contrast /p/-/t/. The results indicated that different types of phonemic contrasts, and even the identification and discrimination of the same phonemic contrast, matured asynchronously. The observation that tone and vowel perception are achieved earlier than consonant perception supports the phonological saliency hypothesis.

The Temporal Memory Sequence Test (TMST) in children: Validity test performance in clinically referred children

Validity evaluation is fundamental in neuropsychological assessment in adults, with increasing interest among pediatric neuropsychologists. Although some measures exist, given time constraints placed on clinicians, and children's limited sustained attention, development of less time-consuming measures is beneficial. We explored the use of the Temporal Memory Sequence Test (TMST), a new performance validity test, in clinically referred children. One minor adaptation included reading the instructions and labels to non-fluent readers. Participants were 68 consecutive clinically referred children and adolescents, aged 6-18 years, with neurological (n = 46) or behavioral (n = 22) difficulties. Applying the adult cutoff, 83.8% passed the TMST. Age, gender, and diagnosis did not differ between children passing the TMST cutoff and those who failed it. Classification accuracy calculated against three embedded measures of performance validity (Wechsler scale Digit Span, Coding, and Processing Speed Index) indicated specificity over 90% (Digit Span: 94%, Coding: 96%, Processing Speed Index: 92%) and sensitivity between 30 and 33%. For individuals without Intellectual Disability (ID), 90.9% passed the TMST, and intelligence did not predict success. Thus, the use of the TMST with the adult cutoff was supported in children without ID, offering an additional validity measure for clinically referred children.

Development of visual attention control in early childhood: Associations with temperament and home environment

Endogenous visual attention orienting is early available from infancy. It shows a steady development during the preschool period towards monitoring and managing executive attention to optimize the interplay between environmental contingencies and internal goals. The current study aims at understanding this transition from basic forms of endogenous control of visual orienting towards the engagement of executive attention, as well as their association with individual differences in temperament and home environment. A total of 150 children between 2 and 4 years of age were evaluated in a Visual Sequence Learning task, measuring visual anticipations in easy (context-free) and complex (context-dependent) stimuli transitions. Results showed age to be a predictor of a reduction in exogenous attention, as well as increased abilities to attempt to anticipate and to correctly anticipate in complex transitions. Home chaos predicted more complex correct anticipations, suggesting that the exposure to more unpredictable environments could benefit learning in context-dependent settings. Finally, temperamental surgency was found to be positively related to sustained attention in the task. Results are informative of age differences in visual attention control during toddlerhood and early childhood, and their association with temperament and home environment.

Personal Values and Sustained Attention as Predictors of Children's Helping Behavior in Middle Childhood

OBJECTIVE

This study tested the effect of personal values (motivation) and sustained attention (cognitive ability) on children's helping behavior.

METHOD

Children (N = 162, age range 8-9 years, mean = 8.81, SD =.43) completed value ranking and go/no-go tasks, and their helping behavior was examined.

RESULTS

Children who valued self-transcendence over self-enhancement helped more than others. Surprisingly, children's lack of sustained attention was associated with more helping among those who valued self-transcendence over self-enhancement or openness-to-change over conservation values. Valuing both self-transcendence and openness-to-change was also associated with more helping.

CONCLUSIONS

Children are more likely to help others if they value self-transcendence and openness to change. Notably, children's tendency to act upon these values may be facilitated (rather than obstructed by) low attention skills.

Application of the Scale for Assessment and Rating of Ataxia in toddlers

INTRODUCTION

In young children with early onset ataxia (EOA), quantitative rating of ataxia by the Scale for Assessment and Rating of Ataxia (SARA) is longitudinally influenced by the physiological age effect on motor coordination. To enable longitudinal quantitative interpretation of ataxia by SARA in children with EOA, the EPNS ataxia working group has previously determined SARA-scores in typically developing children (4-16 years of age). In toddlers, this information is still lacking. We therefore aimed to investigate the feasibility and reliability of SARA-scores in typically developing toddlers.

METHODS

In 57 typically developing toddlers (2-4 years), we aimed to determine the: 1. feasibility of SARA-scores, 2. age-related pre-requisites to obtain SARA-scores in toddlers over all domains, 3. SARA-score reliability, 4. mathematical age connection of SARA-scores in toddlers and older children.

RESULTS

In typically developing toddlers, the feasibility of SARA is strongly age-dependent (p < .000). After computing compensations for two age-related, unfeasible and therefore un-assessable kinetic subtasks and after allowing the videotaping of non-kinetic SARA sub-task performances at home, the SARA was fully reliably assessable in all (n = 57) toddlers (ICC = 0.732). From two to 16 years of age, SARA-scores were mathematically represented by one continuous, exponentially decreasing trend line approaching the adult-optimum at 16 years of age.

CONCLUSION

In toddlers, SARA-scores are reliably assessable, by using two age-compensations and allowing the videotaping of SARA-performances partly at home. In children with EOA, these data enable longitudinal quantification and interpretation of quantitative ataxia-scores by SARA from 2 years of age throughout childhood.

The influence of methylphenidate on sustained attention in paediatric acquired brain injury: a meta-analytical review

Impairment in sustained attention is a common consequence of childhood Acquired Brain Injury (ABI). Whilst methylphenidate provides promise in enhancing "attention" as a unitary construct, little work has explored its effectiveness upon individual attentional domains. The current systematic review and meta-analysis evaluates the utility of methylphenidate on sustained attentional performance across childhood ABI groups. Five databases (PsycINFO, MEDLINE, Embase, Scopus & Cochrane Library) were searched for relevant articles from their inception to March 2022. A purpose-developed evaluation tool was used to assess each study's research quality (QuEST:MAP). Nine of the 1600 identified articles were included within this review (n = 259). Meta-analytical findings reported an overall significant benefit of methylphenidate on sustained attention in childhood ABI (g = -0.33, 95% CI: -0.62 to -0.04). Associated summary effect sizes were relatively small, particularly when adjusting for outlier cases. Subgroup analyses identified a significantly greater benefit of methylphenidate in clinical subgroups with comorbid ADHD diagnoses (p < .01). The current evidence base is characterized by small-scale clinical trials with variable research quality and low generalizability. Further robust research is needed to quantify methylphenidate utility upon individual attentional domains in larger and more representative ABI samples.

Effectiveness of Virtual Reality on Attention Training for Elementary School Students

This study is aimed at investigating the effectiveness of virtual reality (VR) on attention training for elementary school students. A pre-test and post-test design of the quasi-experimental method was adopted and 66 third and fourth graders from an elementary school in Hsinchu, Taiwan were used as experimental subjects, divided into a control group and experimental group. The former used the computerized Attention Process Training (APT) system and the latter used the proposed VR system for attention training, both for two weeks. The attention scale for elementary school children was used to evaluate the participant’s attention before and after training, including the dimensions of focused attention, sustained attention, selective attention, alternating attention, and divided attention. A questionnaire survey was conducted to measure the learning anxiety and cognitive load during the training process. The experimental results indicated: (1) The overall attention was significantly improved after the training process for both groups, and the VR system was more effective than the computerized APT in improving children’s attention. (2) The questionnaire results showed that the experimental group had lower learning anxiety and cognitive load than the control group. According to the experimental results, VR training is more effective in improving the attention of participants while reducing their learning anxiety and cognitive load. Therefore, it is a useful tool for attention training in elementary schools.

Normierung der Testbatterie COGBAT bei Jugendlichen im Alter von 12 bis 15 Jahren

Zusammenfassung: Das Jugendalter stellt eine wichtige Phase in der Entwicklung der Verarbeitungsgeschwindigkeit, der Aufmerksamkeit, des Gedächtnisses und der exekutiven Funktionen dar. Im Rahmen einer Normierungsstudie der kognitiven Basistestung (COGBAT) für das Jugendalter wurden Testwerte bei n = 269 Jugendlichen im Alter von 12 bis 15 Jahren erhoben und mit den Normen der Altersgruppe der 16- bis 30-Jährigen verglichen. Zusätzlich wurde überprüft, inwiefern sich diese Testergebnisse in der subjektiven Einschätzung zur Leistungsfähigkeit (FLei) und Psychopathologie (SDQ) abbilden lassen. Im Jugendalter zeigte sich ein starker Zuwachs in der kognitiven Flexibilität, der Verarbeitungs- und Reaktionsgeschwindigkeit sowie der Inhibitions- und Planungsfähigkeit. Ein bedeutsamer Geschlechtsunterschied fand sich in der Inhibition, mit stärkeren Leistungen bei Mädchen als bei Jungen. Zwischen den Testergebnissen und den subjektiven Einschätzungen zeigten sich keine Zusammenhänge.

Popular interventions to enhance sustained attention in children and adolescents: A critical systematic review

There are a myriad of interventions promoting activities designed to help enhance sustained attention in children and adolescents. In this systematic review, we critically evaluate the evidence behind three popular sustained attention training approaches - cognitive attention training, meditation, and physical activity. Seven databases were searched in addition to secondary searches. Cognitive attention training, meditation training or physical activity intervention studies aimed at improving sustained attention (randomised-controlled or non-randomised-controlled designs) in samples of children and adolescents (3-18 years) were included. We screened 3437 unique articles. Thirty-seven studies satisfied inclusion criteria. In general, cognitive attention training (n = 14) did not reliably improve sustained attention. Physical activity (n = 15) and meditation interventions (n = 8) demonstrated somewhat more potential in enhancing sustained attention, but these effects should be considered preliminary and need to be replicated with greater methodological rigour. Cognitive attention training demonstrated very limited transfer to other aspects of attention. Notably, mindfulness training had rather consistent positive effects on selective attention. Across all three intervention types, there was very weak evidence for transfer to other aspects of cognition, behaviour, and academic achievement. The paper concludes with methodological recommendations for future studies to strengthen the evidence base.

Salivary Cortisol and Sustained Auditory Attention in Children with and without Cleft Lip and Palate

Introduction Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress.

Objectives To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients.

Methods In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n = 69) and the control group (CG; n = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation.

Results The median level of salivary cortisol was of 0.03615 µl/dL and 0.18000 µl/dL respectively for the EG and CG, with a significant difference between the groups (p = 0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00).

Conclusion All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.

The development of selective stopping: Qualitative and quantitative changes from childhood to early adulthood

Although progress has been made in elucidating the behavioral and neural development of global stopping across the lifespan, little is known about the development of selective stopping. This more complex form of inhibitory control is required in real-world situations where ongoing responses must be inhibited to certain stimuli but not others, and can be assessed in laboratory settings using a stimulus selective stopping task. Here we used this task to investigate the qualitative and quantitative developmental changes in selective stopping in a large-scale cross-sectional study with three different age groups (children, preadolescents, and young adults). We found that the ability to stop a response selectively to some stimuli (i.e., use a selective strategy) rather than non-selectively to all presented stimuli (i.e., use a global, non-selective strategy) is fully mature by early preadolescence, and remains stable afterwards at least until young adulthood. By contrast, the efficiency or speed of stopping (indexed by a shorter stop-signal reaction time or SSRT) continues to mature throughout adolescence until young adulthood, both for global and selective implementations of stopping. We also provide some preliminary findings regarding which other task variables beyond the strategy and SSRT predicted age group status. Premature responding (an index of "waiting impulsivity") and post-ignore slowing (an index of cognitive control) were among the most relevant predictors in discriminating between developmental age groups. Although present results need to be confirmed and extended in longitudinal studies, they provide new insights into the development of a relevant form of inhibitory control.

When Preschoolers Interact with an Educational Robot, Does Robot Feedback Influence Engagement?

In this paper, we examine to what degree children of 3–4 years old engage with a task and with a social robot during a second-language tutoring lesson. We specifically investigated whether children’s task engagement and robot engagement were influenced by three different feedback types by the robot: adult-like feedback, peer-like feedback and no feedback. Additionally, we investigated the relation between children’s eye gaze fixations and their task engagement and robot engagement. Fifty-eight Dutch children participated in an English counting task with a social robot and physical blocks. We found that, overall, children in the three conditions showed similar task engagement and robot engagement; however, within each condition, they showed large individual differences. Additionally, regression analyses revealed that there is a relation between children’s eye-gaze direction and engagement. Our findings showed that although eye gaze plays a significant role in measuring engagement and can be used to model children’s task engagement and robot engagement, it does not account for the full concept and engagement still comprises more than just eye gaze.

Short-Term Exposure to Nature and Benefits for Students’ Cognitive Performance: a Review

There is growing interest recently in the outdoor environment surrounding schools where students spent time during breaks, in-school activities, and after-school programs. Several reviews have examined the impact of long-term exposures to nearby nature on students’ academic achievement, but none has focused on the effects of short-term contacts with nature on students’ cognitive performance. The aim of this review is to understand the context in which short-term passive exposures to greenness occur, how cognitive performance is measured, and the conditions under which cognitive benefits emerge at various educational levels. We reviewed 14 studies in the extant literature that report investigations involving students at different educational levels, from elementary school to university, in a short exposure to nature lasting from 10 to 90 min during a study day. The review shows that in 12 out of the 14 studies, across educational levels, cognitive benefits emerge in terms of directed attention restoration from mental fatigue due to contact with nature. A no-cost opportunity to sustain students’ cognition is a break in a green environment after mentally demanding activities.

Designing Virtual, Moderated Studies of Early Childhood Development

With increased public access to the Internet and digital tools, web-based research has gained prevalence over the past decades. However, digital adaptations for developmental research involving children have received relatively little attention. In 2020, as the COVID-19 pandemic led to reduced social contact, causing many developmental university research laboratories to close, the scientific community began to investigate online research methods that would allow continued work. Limited resources and documentation of factors that are essential for developmental research (e.g., caregiver involvement, informed assent, controlling environmental distractions at home for children) make the transition from in-person to online research especially difficult for developmental scientists. Recognizing this, we aim to contribute to the field by describing three separate moderated virtual behavioral assessments in children ranging from 4 to 13years of age that were highly successful. The three studies encompass speech production, speech perception, and reading fluency. However varied the domains we chose, the different age groups targeted by each study and different methodological approaches, the success of our virtual adaptations shared certain commonalities with regard to how to achieve informed consent, how to plan parental involvement, how to design studies that attract and hold children's attention and valid data collection procedures. Our combined work suggests principles for future facilitation of online developmental work. Considerations derived from these studies can serve as documented points of departure that inform and encourage additional virtual adaptations in this field.

Sustained Attention Deficits in Adults With Juvenile-Onset Type 1 Diabetes Mellitus

OBJECTIVE

This study aimed to investigate whether patients with juvenile-onset type 1 diabetes mellitus (T1DM) have poorer sustained attention than their counterparts with adult-onset T1DM, and whether there is a relationship between diabetes-related variables and sustained attention.

METHODS

This study included 76 participants with juvenile-onset T1DM, 68 participants with adult-onset T1DM, and 85 healthy controls (HCs). All participants completed the Sustained Attention to Response Task, Beck Depression Inventory-II, and the Chinese version of the Wechsler Adult Intelligence Scale.

RESULTS

The juvenile-onset group showed more omission errors (p = .007) than the adult-onset group and shorter reaction time (p = .005) than HCs, whereas the adult-onset group showed no significant differences compared with HCs. Hierarchical linear regression analysis revealed that the age of onset was associated with omission errors in T1DM participants (β = -0.275, t = -2.002, p = .047). In the juvenile-onset group, the omission error rate were associated with the history of severe hypoglycemia (β = 0.225, t = 1.996, p = .050), whereas reaction time was associated with the age of onset (β = -0.251, t = -2.271, p = .026). Fasting blood glucose levels were significantly associated with reaction time in both the juvenile-onset and adult-onset groups (β = -0.236, t = -2.117, p = .038, and β = 0.259, t = 2.041, p = .046, respectively).

CONCLUSIONS

Adults with juvenile-onset T1DM have sustained attention deficits in contrast to their adult-onset counterparts, suggesting that the disease adversely affects the developing brain. Both the history of severe hypoglycemia and fasting blood glucose levels are factors associated with sustained attention impairment. Early diagnosis and treatment in juvenile patients are required to prevent the detrimental effects of diabetes.

Mental fatigue delays visual search behaviour in young cyclists when negotiating complex traffic situations: A study in virtual reality

INTRODUCTION

Mental fatigue has been shown to negatively affect motor and sport performance. To date, however, no research focused on assessing the effects of mental fatigue on hazard perception in young cyclists who are highly vulnerable in traffic, especially after school. Therefore, the purpose of this study was to examine the influence of induced mental fatigue on hazard perception and anticipation in young cyclists using a novel Virtual Reality bicycle simulator.

METHODS

In this randomised, counterbalanced, cross-over investigation, forty-eight young cyclists cycled through a Virtual Environment (VE) in which they were confronted with eight simple and six complex traffic situations. Simple traffic situations are considered events including only one other actor can cause a dangerous situation while complex traffic situations include multiple actors than contribute to the dangerous situation. Half of the children were mentally fatigued using the Stroop colour-word task while the other half immediately started the VR hazard perception test. On the second test occasion, one month later, the other half of the group was mentally fatigued.

RESULTS

The results demonstrate that mentally fatigued cyclists fixated the relevant areas of interest (AOIs) in the simple and complex later and showed delayed response times for the complex hazards. Mental fatigue, however, did not alter the speed with which participants cycled through the virtual environment and did not change the hazard perception score.

CONCLUSION

To our knowledge, this was the first study to investigate the effect of mental fatigue in young cyclists with an innovative VR hazard perception simulator. Due to increased mental fatigue, young cyclists might have experienced more episodes of fatigue-related mind-wandering and a deterioration of selective attention for the task at hand. This resulted in a less thorough visual inspection of the scene and delayed braking responses.

Selective Inhibitory Control in Middle Childhood

The main aim of this study was to investigate the development of selective inhibitory control in middle childhood, a critical period for the maturation of inhibition-related processes. To this end, 64 children aged 6–7 and 56 children aged 10–11 performed a stimulus-selective stop-signal task, which allowed us to estimate not only the efficiency of response inhibition (the stop-signal reaction time or SSRT), but also the strategy adopted by participants to achieve task demands. We found that the adoption of a non-selective (global) strategy characterized by stopping indiscriminately to all stimuli decreased in older children, so that most of them were able to interrupt their ongoing responses selectively at the end of middle childhood. Moreover, compared to younger children, older children were more efficient in their ability to cancel an initiated response (indexed by a shorter SSRT), regardless of which strategy they used. Additionally, we found improvements in other forms of impulsivity, such as the control of premature responding (waiting impulsivity), and attentional-related processes, such as intra-individual variability and distractibility. The present results suggest that middle childhood represents a milestone in the development of crucial aspects of inhibitory control, including selective stopping.

Responses to Navon tasks differ across development and between tasks with differing attentional demands

Navon hierarchical stimuli are designed to measure responses to the global level (grouped local elements, e.g. a forest) and the local level (individuated local elements, e.g. trees) of a visual scene. Cross-sectional evidence suggests that there are developmental changes in global and local processing. We examined global and local processing in 135 typically developing children in Year 1 (aged 5-6 year), Year 3 (aged 7-8 years), and Year 5 (aged 9-10 years). Participants completed a range of Navon tasks, each with different attentional demands. The design of the Navon stimuli remained constant across the tasks, ensuring that any task-related differences were not due to stimulus characteristics. Sixty children from Years 1 and 3 repeated the testing session two years later. Linear mixed model analyses combined longitudinal and cross-sectional data to assess developmental changes and the influence of attentional task demands on responses. The results revealed differing patterns of global and local processing responses according to Year group and attentional task demands. We found some evidence of developmental change in responses from a relatively more local advantage to a relatively more global advantage, which is consistent with the literature. However, the age at which this transition occurred varied across the tasks. We conclude that responses to hierarchical Navon stimuli are modulated by attentional task characteristics which mask any underlying global or local processing advantage.

Why Are Children So Distractible? Development of Attention and Motor Control From Childhood to Adulthood

Distractibility is the propensity to behaviorally react to irrelevant information. Although children are more distractible the younger they are, the precise contribution of attentional and motor components to distractibility and their developmental trajectories have not been characterized yet. We used a new behavioral paradigm to identify the developmental dynamics of components contributing to distractibility in a large cohort of French participants balanced, between age groups, in gender and socioeconomic status (N = 352; age: 6-25). Results reveal that each measure of these components, namely voluntary attention, distraction, impulsivity, and motor control, present a distinct maturational timeline. In young children, increased distractibility is mostly the result of reduced sustained attention capacities and enhanced distraction, whereas in teenagers, it is the result of decreased motor control and increased impulsivity.

Is 10 Better than 1? The Effect of Speaker Variability on Children's Cross-situational Word Learning

The current study examined the effect of speaker variability on children's cross-situational word learning (XSWL). The study also examined the role of bilingual experience and sustained attention. Forty English monolingual children and 40 Spanish-English bilingual children ages 4-7 completed a XSWL task in a Single Speaker Condition and a Multiple Speaker Condition. Results indicated that speaker variability neither facilitated nor hindered XSWL. While monolingual children outperformed bilingual children, speaker-variability effects did not fluctuate across the two language groups. Notably, exposure to multiple speakers facilitated XSWL in children with poorer sustained attention skills, suggesting that variability in the input may be especially useful to children with poorer cognitive processing abilities.

Cortical responses to letters and ambiguous speech vary with reading skills in dyslexic and typically reading children

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Text recalibrates ambiguous speech perception in children with and without dyslexia.

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Dyslexia and poorer reading skills are linked to reduced left fusiform activation.

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Poorer letter-speech sound matching is linked to higher superior temporal activation.

One of the proposed issues underlying reading difficulties in dyslexia is insufficiently automatized letter-speech sound associations. In the current fMRI experiment, we employ text-based recalibration to investigate letter-speech sound mappings in 8–10 year-old children with and without dyslexia. Here an ambiguous speech sound /a?a/ midway between /aba/ and /ada/ is combined with disambiguating “aba” or “ada” text causing a perceptual shift of the ambiguous /a?a/ sound towards the text (recalibration). This perceptual shift has been found to be reduced in adults but not in children with dyslexia compared to typical readers. Our fMRI results show significantly reduced activation in the left fusiform in dyslexic compared to typical readers, despite comparable behavioural performance. Furthermore, enhanced audio-visual activation within this region was linked to better reading and phonological skills. In contrast, higher activation in bilateral superior temporal cortex was associated with lower letter-speech sound identification fluency. These findings reflect individual differences during the early stages of reading development with reduced recruitment of the left fusiform in dyslexic readers together with an increased involvement of the superior temporal cortex in children with less automatized letter-speech sound associations.

Developmental change in the nature of attention allocation in a dual task

Younger children have more difficulty in sharing attention between two concurrent tasks than do older participants, but in addition to this developmental change, we documented changes in the nature of attention sharing. We studied children 6-8 and 10-14 years old and college students (in all, 104 women and 76 men; 3% Hispanic, 3% Black or African American, 3% Asian, 7% multiracial, and 84% White). On each dual-task trial, the participant received an array of colored squares to be retained for a subsequent probe recognition test and then an easy or more difficult signal requiring a quick response (a speeded task, clicking a key on the same side of the screen as the signal or the opposite side). Finally, each trial ended with the presentation of the array item recognition probe and the participant's response to it. In our youngest age group (6-8 years), array memory was often displaced by the speeded task performed under load, especially when it was the opposite-side task, but speeded-task accuracies were unaffected by the presence of an array memory load. In contrast, in older participants (10-14 years and college students), the memory load was maintained better, with some cost to the speeded task. With maturity, participants were better able to adopt a proactive stance in which not only present processing demands but also upcoming demands were taken into account, allowing them to balance the demands of the two tasks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Developing attention in typical children related to disabilities

We define attention by three basic functions. The first is obtaining and maintaining the alert state. The second is orienting overtly or covertly to sensory stimuli. The third is selection among competing responses. These three functions correspond to three separable brain networks. Control of the alert state develops in infancy but continues to change till adulthood. During childhood, the orienting network provides a means of controlling affective responses, e.g., by looking away from negative events and toward positive or novel events. The executive network mediates between competing voluntary responses by resolving conflicts. Executive control improves rapidly over the first 7 years of life. Autistic spectrum disorders and attention deficit hyperactivity disorder are two disorders that have been shown to involve deficits in attention networks. We examine connections between developing attention networks and these disorders.

Longitudinal Trajectories of Sustained Attention Development in Children and Adolescents with ADHD

The present study characterizes changes in sustained attention ability over ages 9-14, and whether longitudinal trajectories of attention development differ between persistent ADHD, remitted ADHD and control groups. The Sustained Attention to Response Task (SART) was administered to 120 children with ADHD and 123 controls on three occasions between ages 9 and 14. Trajectories of sustained attention development, indicated by changes in SART performance (standard deviation of response time [SDRT], omission errors, and ex-Gaussian parameters sigma and tau), were examined using generalized additive mixed models. For all measures there was a significant main effect of age; response time variability and number of omission errors improved linearly as children aged. However, children with ADHD had significantly greater SDRT, tau and omission errors than controls across waves. There were no significant group differences in sigma, indicating that the greater overall response time variability (SDRT) observed in ADHD was likely driven by more intermittent long responses (larger tau). Trajectories of sustained attention performance did not differ between children with persistent ADHD or ADHD in remission. Longitudinal trajectories of sustained attention development are comparable between ADHD and controls, however children with ADHD (regardless of remission status) display a performance deficit equivalent to typical controls 1-3 years younger. Findings highlight the need for continued clinical support for children in remission from ADHD and provide support for tau as an endophenotype of ADHD.

The Low-Frequency Fluctuation of Trial-by-Trial Frontal Theta Activity and Its Correlation With Reaction-Time Variability in Sustained Attention

Reaction-time variability is a critical index of sustained attention. However, researchers still lack effective measures to establish the association between neurophysiological activity and this behavioral variability. Here, the present study recorded reaction time (RT) and cortical electroencephalogram (EEG) in healthy subjects when they continuously performed an alternative responding task. The frontal theta activity and reaction-time variability were examined trial by trial using the measures of standard deviation (SD) in the time domain and amplitude of low-frequency fluctuation (ALFF) in the frequency domain. Our results showed that the SD of reaction-time variability did not have any correlation with the SD of trial-by-trial frontal theta activity, and the ALFF of reaction-time variability has a significant correlation with the ALFF of trial-by-trial frontal theta activity in 0.01–0.027 Hz. These results suggested the methodological significance of ALFF in establishing the association between neurophysiological activity and reaction-time variability. Furthermore, these findings also support the low-frequency fluctuation as a potential feature of sustained attention.

Implementation of an attention training programme with a sample of children who have sustained traumatic brain injuries in South Africa: A pilot study

This pilot study evaluated the feasibility of implementing an attention-training programme for children who have sustained moderate-to-severe traumatic brain injuries (TBIs) in a South African context. We compared the performance on the programme of children with TBI (TBI Intervention Group) to children who had been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD Intervention Group), a TBI Art group and a TBI No-intervention Group (n=5 in each group) in this preliminary study. Children in the two Intervention Groups participated in the "Pay Attention!" programme for 45 minutes twice a week for 12 weeks. All children were aged 6-8 years and underwent neuropsychological testing pre- and post-intervention. Behavioural data were collected from parents. Children in the ADHD Intervention Group showed individual clinically significant attentional improvements on measures of the Conners' Continuous Performance Test II using the Reliable Change Index (≥ 2.58 SD). Despite mixed results, the pilot study demonstrates that implementing a cognitive rehabilitation programme in South Africa is feasible and necessary, despite limited infrastructure and access to resources.

Impact of Intrathecal Triple Therapy Versus Intrathecal Methotrexate on Disease-Free Survival for High-Risk B-Lymphoblastic Leukemia: Children's Oncology Group Study AALL1131

PURPOSE

The high-risk stratum of Children's Oncology Group Study AALL1131 was designed to test the hypothesis that postinduction CNS prophylaxis with intrathecal triple therapy (ITT) including methotrexate, hydrocortisone, and cytarabine would improve the postinduction 5-year disease-free survival (DFS) compared with intrathecal methotrexate (IT MTX), when given on a modified augmented Berlin-Frankfurt-Münster backbone.

PATIENTS AND METHODS

Children with newly diagnosed National Cancer Institute (NCI) high-risk B-cell acute lymphoblastic leukemia (HR B-ALL) or NCI standard-risk B-ALL with defined minimal residual disease thresholds during induction were randomly assigned to receive postinduction IT MTX or ITT. Patients with CNS3-status disease were not eligible. Postinduction IT therapy was given for a total of 21 to 26 doses. Neurocognitive assessments were performed during therapy and during 1 year off therapy.

RESULTS

Random assignment was closed to accrual in March 2018 after a futility boundary had been crossed, concluding that ITT could not be shown to be superior to IT MTX. The 5-year postinduction DFS and overall survival rates (± SE) of children randomly assigned to IT MTX versus ITT were 93.2% ± 2.1% v 90.6% ± 2.3% (P = .85), and 96.3% ± 1.5% v 96.7% ± 1.4% (P = .77), respectively. There were no differences in the cumulative incidence of isolated bone marrow relapse, isolated CNS relapse, or combined bone marrow and CNS relapse rates, or in toxicities observed for patients receiving IT MTX compared with ITT. There were no significant differences in neurocognitive outcomes for patients receiving IT MTX compared with ITT.

CONCLUSION

Postinduction CNS prophylaxis with ITT did not improve 5-year DFS for children with HR B-ALL. The standard of care for CNS prophylaxis for children with B-ALL and no overt CNS involvement remains IT MTX.

Technical Report: Repeatability of Contrast Sensitivity Test in Children

Contrast sensitivity (CS) in children is not routinely measured in the clinical setting, although CS losses have been found in amblyopic and premature children. Thus simple visual acuity measurements do not completely assess their quality of vision. To evaluate contrast sensitivity in children, a reliable and easy test, sampling the entire spatial frequency range, is necessary.

PURPOSE

This study aimed to evaluate the repeatability and normal range of the contrast sensitivity function measured using the Topcon CC-100 instrument, in children aged between 4 and 9 years, for use as a diagnostic tool.

METHODS

Contrast sensitivity was measured in 25 children, 11 boys and 14 girls, with normal or corrected-to-normal visual acuity, normal binocular function, and stereopsis. Two measurements were performed, 3 months apart, with a Topcon CC-100 device using achromatic sinusoidal gratings of 1.5, 3, 6, 12, and 18 cycles per degree (cpd) with random orientation in a circular window with sharp edges.

RESULTS

The normal range in the first visit is wider than in the second. Coefficients of variation are better for the middle-range spatial frequencies (6.6 and 7.8% at 3 and 6 cpd, respectively) and worst at 18 cpd (18.2%), with intermediate values at 1.5 cpd (11.3%) and 12 cpd (13.7%), and better for older than for younger children. No significant sex differences were found (P > .05, Mann-Whitney U test).

CONCLUSIONS

Repeatability measured by the coefficient of variation is better for the middle frequency range (3 and 6 cpd) than for low (1.5 cpd) and high frequencies (12 and 18 cpd). The variability of the differences between the first and second measurements suggests that the participants were not able to maintain a stable response criterion. The test seems to be subject to a learning effect, and the standard normality range may not be adequate for children.

The SLC6A3 gene polymorphism is related to the development of attentional functions but not to ADHD

Neuropharmacological and human clinical studies have suggested that the brain dopaminergic system is substantively involved in normal and pathological phenotypes of attention. Dopamine transporter gene (SLC6A3) was proposed as a candidate gene for Attention-Deficit/Hyperactivity Disorder (ADHD). We investigated the effect of the SLC6A3 variants on cognitive performance in ADHD and healthy children and teenagers. Participants completed cognitive tasks measuring attentional switching, selective and sustained attention, and effectiveness of alerting, orienting and executive attention. We estimated the effects of 40 bp variable number of tandem repeat (VNTR) polymorphism located in the 3' untranslated region (3' UTR) (9-repeat vs 10-repeat allele) of the SLC6A3 gene, ADHD diagnosis, age, and their interactions as predictors of cognitive performance. ADHD children demonstrated deficits in most of the examined attention processes, persistent within the examined age range (9-16 years). No significant effects were observed for the interaction of ADHD and the SLC6A3 polymorphism, but the results revealed a significant main effect of SLC6A3 genotype in the entire research sample. Subjects carrying 9R allele performed the switching task significantly worse in comparison to children with 10R/10R or 10R/11R genotype. SLC6A3 polymorphism moderated age-related improvements in orienting and attentional switching. Results suggest that SLC6A3 genotype influence these attentional/cognitive functions which deficits are not the key symptoms in ADHD.

Narrative comprehension and engagement with e-books vs. paper-books in autism spectrum condition

BACKGROUND AND AIMS

Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension.

METHOD

Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children's behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure).

RESULTS

Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group.

CONCLUSION

Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children.Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.

Detection and Attention for Auditory, Visual, and Audiovisual Speech in Children with Hearing Loss

OBJECTIVES

Efficient multisensory speech detection is critical for children who must quickly detect/encode a rapid stream of speech to participate in conversations and have access to the audiovisual cues that underpin speech and language development, yet multisensory speech detection remains understudied in children with hearing loss (CHL). This research assessed detection, along with vigilant/goal-directed attention, for multisensory versus unisensory speech in CHL versus children with normal hearing (CNH).

DESIGN

Participants were 60 CHL who used hearing aids and communicated successfully aurally/orally and 60 age-matched CNH. Simple response times determined how quickly children could detect a preidentified easy-to-hear stimulus (70 dB SPL, utterance "buh" presented in auditory only [A], visual only [V], or audiovisual [AV] modes). The V mode formed two facial conditions: static versus dynamic face. Faster detection for multisensory (AV) than unisensory (A or V) input indicates multisensory facilitation. We assessed mean responses and faster versus slower responses (defined by first versus third quartiles of response-time distributions), which were respectively conceptualized as: faster responses (first quartile) reflect efficient detection with efficient vigilant/goal-directed attention and slower responses (third quartile) reflect less efficient detection associated with attentional lapses. Finally, we studied associations between these results and personal characteristics of CHL.

RESULTS

Unisensory A versus V modes: Both groups showed better detection and attention for A than V input. The A input more readily captured children's attention and minimized attentional lapses, which supports A-bound processing even by CHL who were processing low fidelity A input. CNH and CHL did not differ in ability to detect A input at conversational speech level. Multisensory AV versus A modes: Both groups showed better detection and attention for AV than A input. The advantage for AV input was facial effect (both static and dynamic faces), a pattern suggesting that communication is a social interaction that is more than just words. Attention did not differ between groups; detection was faster in CHL than CNH for AV input, but not for A input. Associations between personal characteristics/degree of hearing loss of CHL and results: CHL with greatest deficits in detection of V input had poorest word recognition skills and CHL with greatest reduction of attentional lapses from AV input had poorest vocabulary skills. Both outcomes are consistent with the idea that CHL who are processing low fidelity A input depend disproportionately on V and AV input to learn to identify words and associate them with concepts. As CHL aged, attention to V input improved. Degree of HL did not influence results.

CONCLUSIONS

Understanding speech-a daily challenge for CHL-is a complex task that demands efficient detection of and attention to AV speech cues. Our results support the clinical importance of multisensory approaches to understand and advance spoken communication by CHL.

Children's perception of visual and auditory ambiguity and its link to executive functions and creativity

The phenomenon of perceptual bistability provides insights into aspects of perceptual processing not normally accessible to everyday experience. However, most experiments have been conducted in adults, and it is not clear to what extent key aspects of perceptual switching change through development. The current research examined the ability of 6-, 8-, and 10-year-old children (N = 66) to switch between competing percepts of ambiguous visual and auditory stimuli and links between switching rate, executive functions, and creativity. The numbers of switches participants reported in two visual tasks (ambiguous figure and ambiguous structure from motion) and two auditory tasks (verbal transformation and auditory streaming) were measured in three 60-s blocks. In addition, inhibitory control was measured with a Stroop task, set shifting was measured with a verbal fluency task, and creativity was measured with a divergent thinking task. The numbers of perceptual switches increased in all four tasks from 6 to 10 years of age but differed across tasks in that they were higher in the verbal transformation and ambigous structure-from-motion tasks than in the ambigous figure and auditory streaming tasks for all age groups. Although perceptual switching rates differed across tasks, there were predictive relationships between switching rates in some tasks. However, little evidence for the influence of central processes on perceptual switching was found. Overall, the results support the notion that perceptual switching is largely modality and task specific and that this property is already evident when perceptual switching emerges.

Developmental Trajectories of Attention in Normal Korean Population

Objectives

This study aimed to investigate the trajectory of change of diverse attention and working memory in Koreans from 4 to 40 years of age.

Methods

The data of 912 subjects from 4 to 15 years of age obtained from a previous standardization study of the computerized comprehensive attention test were merged with the newly obtained data of 150 subjects aged 16 to 40 years from this study. We evaluated the various kinds of attention, in which each subtest had five indicators. Working memory, with parameters such as number of correct responses and span, was also measured.

Results

Our findings indicated that attention developed as age increased, and it decreased or was maintained after a certain age. Selective and sustained attention developed rapidly in children and adolescents, until mid-teens or 20 s when it ceased development. Divided attention, however, developed up to approximately age 20. In addition, working memory developed until mid-teens or 20 s.

Conclusion

We presented the standardized data on diverse kinds of attention and working memory in children, adolescents, and adults in Korea. We could recognize any patterns of change in attention and working memory with increasing age.