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Deodhar AV, Bertenthal BI. How attention factors into executive function in preschool children. Front Psychol 2023; 14:1146101. [PMID: 37502749 PMCID: PMC10369189 DOI: 10.3389/fpsyg.2023.1146101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/08/2023] [Indexed: 07/29/2023] Open
Abstract
Executive Function consists of self-regulation processes which underlie our ability to plan, coordinate, and complete goal-directed actions in our daily lives. While attention is widely considered to be central to the emergence and development of executive function during early childhood, it is not clear if it is integral or separable from other executive function processes. Previous studies have not addressed this question satisfactorily because executive function and attention are multidimensional constructs, but they are often studied without differentiating the specific processes that are tested. Moreover, some studies consist of only one task per process, making it difficult to ascertain if the pattern of results is attributable to different processes or more simply to task variance. The main aim of this study was to more fully investigate how attention factored into the underlying structure of executive function in preschool children. Preschool children (n = 137) completed a battery of tasks which included executive function (i.e., response inhibition, working memory) and attentional control (i.e., sustained attention, selective attention) processes; there were two tasks per process. Confirmatory factor analyses (CFA) were conducted to test which of three models fit the data best: (1) a unitary one-factor model with attention loading onto the same factor as other executive function processes, (2) a two-factor model with attention loading onto a separate factor than other executive function processes, or (3) a three-factor model with attention, response inhibition, and working memory as separate factors. Fit indices and model comparisons indicated that the two-factor model fit the data best, suggesting that attentional control and executive function were related, but separable. Although this study is not the first to advocate for a two-factor model during the preschool years, it is the first to suggest that the two factors are attentional control and executive function, not working memory and response inhibition. One important implication of these findings is that a complete assessment of executive function during the preschool years necessitates measuring not only response inhibition and working memory, but attentional control as well.
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Affiliation(s)
- Aditi V. Deodhar
- HANDS in Autism Interdisciplinary Training and Resource Center, Riley Hospital for Children at IU Health, Department of Psychiatry, IU School of Medicine, Indianapolis, IN, United States
| | - Bennett I. Bertenthal
- Developmental Cognitive Neuroscience Lab, Department of Psychological and Brain Sciences, Indiana University-Bloomington, Bloomington, IN, United States
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Child functioning in inclusive preschools: Associations between self-regulation, engagement, prosociality, and hyperactivity. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2023.101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Chen IC, Lee PW, Wang LJ, Chang CH, Lin CH, Ko LW. Incremental Validity of Multi-Method and Multi-Informant Evaluations in the Clinical Diagnosis of Preschool ADHD. J Atten Disord 2022; 26:1293-1303. [PMID: 34949123 DOI: 10.1177/10870547211045739] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study investigated the discriminative validity of various single or combined measurements of electroencephalogram (EEG) data, Conners' Kiddie Continuous Performance Test (K-CPT), and Disruptive Behavior Disorder Rating Scale (DBDRS) to differentiate preschool children with ADHD from those with typical development (TD). METHOD We recruited 70 preschoolers, of whom 38 were diagnosed with ADHD and 32 exhibited TD; all participants underwent the K-CPT and wireless EEG recording in different conditions (rest, slow-rate, and fast-rate task). RESULTS Slow-rate task-related central parietal delta (1-4 Hz) and central alpha (8-13 Hz) and beta (13-30 Hz) powers between groups with ADHD and TD were significantly distinct (p < .05). A combination of DBDRS, K-CPT, and specific EEG data provided the best probability scores (area under curve = 0.926, p < .001) and discriminative validity to identify preschool children with ADHD (overall correct classification rate = 85.71%). CONCLUSIONS Multi-method and multi-informant evaluations should be emphasized in clinical diagnosis of preschool ADHD.
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Affiliation(s)
- I-Chun Chen
- National Yang Ming Chiao Tung University, Hsinchu.,Ton Yen General Hospital, Hsinchu
| | | | - Liang-Jen Wang
- Chang Gung Memorial Hospital, Kaohsiung.,Chang Gung University, Taoyuan
| | | | | | - Li-Wei Ko
- National Yang Ming Chiao Tung University, Hsinchu
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Merkt J, Siniatchkin M, Petermann F. Neuropsychological Measures in the Diagnosis of ADHD in Preschool: Can Developmental Research Inform Diagnostic Practice? J Atten Disord 2020; 24:1588-1604. [PMID: 27006414 DOI: 10.1177/1087054716629741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The diagnosis of ADHD in preschool is challenging. Behavioral ratings are less reliable, but the value of neuropsychological tests in the diagnosis of ADHD has been debated. Method: This article provides an overview of neuropsychological measures utilized in preschoolers with ADHD (3-5 years). In addition, the manuscript discusses the extent to which these measures have been tested for their diagnostic capacity. Results: The diagnostic utility of computerized continuous performance tests and working memory subtests from IQ-batteries has been demonstrated in a number of studies by assessing their psychometric properties, sensitivity, and specificity. However, findings from developmental and basic research attempting to describe risk factors that explain variance in ADHD show the most consistent associations of ADHD with measures of delay aversion. Conclusion: Results from developmental research could benefit studies that improve ADHD diagnosis at the individual level. It might be helpful to consider testing as a structured situation for behavioral observation by the clinician.
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Affiliation(s)
- Julia Merkt
- Helmut-Schmidt-University, Hamburg, Germany.,Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
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Riley EA, Owora A. Relationship Between Physiologically Measured Attention and Behavioral Task Engagement in Persons With Chronic Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1430-1445. [PMID: 32324437 DOI: 10.1044/2020_jslhr-19-00016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Persons with aphasia (PWAs) have been shown to have impaired attention skills that may interfere with their ability to successfully participate in speech and language therapy. Fluctuations in attention can be detected using physiological measures such as electroencephalography (EEG), but these measures can be impractical for clinical use. The primary purpose of this study was to investigate observable behavioral signs of attention as a means of measuring within-session fluctuations in attention by comparing behavioral ratings to physiological changes. Other aims were to understand the relationship between observable behaviors and task performance and to determine whether syntactic complexity influences behavioral attention. Method Ten PWAs and 10 neurologically healthy adults underwent a sentence-reading task with 45 active and 45 passive sentences while video/audio and EEG data were recorded continuously. EEG data for each trial were classified into one of four levels of attention using a classification algorithm (Berka et al., 2004), and video/audio data were scored for accuracy and behavioral engagement by two trained speech-language pathologist students using a behavioral rating scale of inattention (Whyte et al., 1996). Results Results showed that behavioral engagement was significantly correlated with task performance, with higher engagement scores associated with fewer errors. Behavioral engagement did not differ based on syntactic complexity for either group, but PWAs had significantly lower behavioral engagement scores when they were in lower/distracted states of physiologically measured vigilant attention. Conclusion Behavioral observation may provide an alternative means of detecting clinically significant lapses in attention during aphasia therapy.
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Affiliation(s)
- Ellyn A Riley
- Aphasia Lab, Department of Communication Sciences and Disorders, College of Arts & Sciences, Syracuse University, NY
| | - Arthur Owora
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington
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Does Preschool Self-Regulation Predict Later Behavior Problems in General or Specific Problem Behaviors? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1491-1502. [PMID: 28130704 DOI: 10.1007/s10802-016-0260-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Findings from prior research have consistently indicated significant associations between self-regulation and externalizing behaviors. Significant associations have also been reported between children's language skills and both externalizing behaviors and self-regulation. Few studies to date, however, have examined these relations longitudinally, simultaneously, or with respect to unique clusters of externalizing problems. The current study examined the influence of preschool self-regulation on general and specific externalizing behavior problems in early elementary school and whether these relations were independent of associations between language, self-regulation, and externalizing behaviors in a sample of 815 children (44% female). Additionally, given a general pattern of sex differences in the presentations of externalizing behavior problems, self-regulation, and language skills, sex differences for these associations were examined. Results indicated unique relations of preschool self-regulation and language with both general externalizing behavior problems and specific problems of inattention. In general, self-regulation was a stronger longitudinal correlate of externalizing behavior for boys than it was for girls, and language was a stronger longitudinal predictor of hyperactive/impulsive behavior for girls than it was for boys.
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Celeste PM, Esteban VP, Mariana L, María José GB, Florencia B, Christy E, Isabel LM, Guillermo A. Continuous performance test in children with intellectual disability and attention deficit hyperactivity disorder. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 8:246-252. [DOI: 10.1080/21622965.2018.1434077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Puga María Celeste
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Vaucheret Paz Esteban
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Leist Mariana
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Baliarda Florencia
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ekonen Christy
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Lascombes María Isabel
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Agosta Guillermo
- Department of Child Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Grane VA, Endestad T, Pinto AF, Solbakk AK. Attentional control and subjective executive function in treatment-naive adults with Attention Deficit Hyperactivity Disorder. PLoS One 2014; 9:e115227. [PMID: 25545156 PMCID: PMC4278892 DOI: 10.1371/journal.pone.0115227] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/20/2014] [Indexed: 11/19/2022] Open
Abstract
We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD.
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Affiliation(s)
- Venke Arntsberg Grane
- Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Tor Endestad
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Anne-Kristin Solbakk
- Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
- Department of Neurosurgery, Division of Surgery and Clinical Neuroscience, Oslo University Hospital—Rikshospitalet, Oslo, Norway
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Guy J, Rogers M, Cornish K. Age-related changes in visual and auditory sustained attention in preschool-aged children. Child Neuropsychol 2013; 19:601-14. [DOI: 10.1080/09297049.2012.710321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bexkens A, Van der Molen MW, Collot d'Escury-Koenigs AML, Huizenga HM. Interference control in adolescents with mild-to-borderline intellectual disabilities and/or behavior disorders. Child Neuropsychol 2013; 20:398-414. [PMID: 23755963 DOI: 10.1080/09297049.2013.799643] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate interference control in adolescents with Mild to Borderline Intellectual Disability (MBID) by addressing two key questions. First, as MBID is often associated with comorbid behavior disorders (BD), we investigated whether MBID and BD both affect interference control. Second, we studied whether interference control deficits are associated to problems in everyday executive functioning. Four groups of adolescents with and without MBID and/or BD performed the Eriksen flanker task, requiring participants to respond to a central target while ignoring interfering flanking stimuli. Their teachers rated behavior on the Behavior Rating Inventory Executive Function (BRIEF). We found pronounced effects of MBID but not BD on flanker interference control. In contrast, we observed pronounced effects of BD, but not MBID, on the BRIEF. In addition, flanker interference scores and BRIEF scores did not correlate. These results are taken to suggest that adolescents with MBID are characterized by deficits in interference control that do not become manifest in ratings of everyday executive functioning. In contrast, adolescents with BD are not characterized by deficits in interference control but do show elevated ratings of deficits in everyday executive function.
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Affiliation(s)
- Anika Bexkens
- a Department of Psychology , University of Amsterdam , Amsterdam , Netherlands
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Mahone EM, Schneider HE. Assessment of attention in preschoolers. Neuropsychol Rev 2012; 22:361-83. [PMID: 23090646 PMCID: PMC3511648 DOI: 10.1007/s11065-012-9217-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
Abstract
In the past two decades, there has been an increased interest in the assessment and treatment of preschool children presenting with concerns about attention problems. This article reviews the research and clinical literature involving assessment of attention and related skills in the preschool years. While inattention among preschoolers is common, symptoms alone do not necessarily indicate a disorder, and most often represent a normal variation in typical preschool child development. Thus, accurate identification of "disordered" attention in preschoolers can be challenging, and development of appropriate, norm-referenced tests of attention for preschoolers is also difficult. The current review suggests that comprehensive assessment of attention and related functions in the preschool child should include thorough review of the child's history, planned observations, and formal psychometric testing. The three primary methods of psychometric assessment that have been used to characterize attentional functioning in preschool children include performance-based tests, structured caregiver interviews, and rating scales (parent, teacher, and clinician). Among performance-based methods for measurement of attention in the preschool years, tests have been developed to assess sustained attention, selective (focused) attention, span of attention (encoding/manipulation), and (top-down) controlled attention--including freedom from distractibility and set shifting. Many of these tests remain experimental in nature, and review of published methods yields relatively few commercially available, nationally normed tests of attention for preschoolers, and an overall dearth of reliability and validity studies on the available measures.
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Affiliation(s)
- E M Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD 21231, USA.
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Schoemaker K, Mulder H, Deković M, Matthys W. Executive Functions in Preschool Children with Externalizing Behavior Problems: A Meta-Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:457-71. [PMID: 23054130 DOI: 10.1007/s10802-012-9684-x] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kim Schoemaker
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands.
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