Working memory and fine motor skills predict early numeracy performance of children with cerebral palsy

Early-life malnutrition role in memory, emotional behavior and motor impairments in early brain lesions with potential for neurodevelopmental disorders: a systematic review with meta-analysis

OBJECTIVES

The present study aims to evaluate the impact of early exposure to brain injury and malnutrition on episodic memory and behavior.

METHODS

For this, a systematic review was carried out in the Medline/Pubmed, Web of Science, Scopus, and LILACS databases with no year or language restrictions.

RESULTS

Initially, 1759 studies were detected. After screening, 53 studies remained to be read in full. The meta-analysis demonstrated that exposure to double insults worsens episodic recognition memory but does not affect spatial memory. Early exposure to low-protein diets has been demonstrated to aggravate locomotor and masticatory sequelae. Furthermore, it reduces the weight of the soleus muscle and the muscle fibers of the masseter and digastric muscles. Early exposure to high-fat diets promotes an increase in oxidative stress and inflammation in the brain, increasing anxiety- and depression-like behavior and reducing locomotion.

DISCUSSION

Epigenetic modifications were noted in the hippocampus, hypothalamus, and prefrontal cortex depending on the type of dietetic exposure in early life. These findings demonstrate the impact of the double insult on regions involved in cognitive and behavioral processes. Additional studies are essential to understand the real impact of the double insults in the critical period.

Association between motor skills and executive function of children with autism spectrum disorder in Taiwan and the United States

Objective

The purpose of this study was to examine the relationship between parent ratings of motor skills and executive function (EF) in children with autism spectrum disorder (ASD) in the United States and Taiwan.

Materials and method

One hundred and seventy-two parents/legal guardians of children (4-6 years and 11 months old) with ASD were recruited from two countries, Taiwan (n = 100) and the United States (n = 72). The parents or guardians of the child with ASD completed a questionnaire including demographic information, child's motor skills (using Children Activity Scale - Parents, ChAS-P), and child's EF (using Childhood Executive Functioning Inventory, CHEXI). A series of hierarchical multiple regressions were conducted to determine whether ChAS-P (total motor score, fine motor skills, and gross motor skill) was associated with CHEXI (total EF score, working memory, and inhibition), after controlling for covariates (i.e., age, gender, race, body mass index, whether children received physical activity or cognitive training, parental education level).

Results

Total motor skills, fine motor skills, and gross motor skills were significantly associated with EF in both working memory and inhibition as rated by parents in both countries (β = 0.21-0.57, p < 0.01), with the exception of a non-significant association between parent-rated total motor skills, fine motor skills, and gross motor skills, and inhibition among Taiwanese children with ASD. In addition, the associations between parent ratings of motor skills (i.e., fine motor and gross motor skills) and EF (i.e., working memory and inhibition) were similar between the two countries.

Conclusion

Positive associations with specific aspects of parent ratings of fine motor and gross motor skills and working memory and inhibition were found in children with ASD from both countries. These findings have implications for future interventions and programs focused on improving early motor skills and EF development for young children with ASD from Taiwan and the United States.

Training arithmetical skills when finger counting and working memory cannot be used: A single case study in a child with cerebral palsy

Children with cerebral palsy (CP) are at greater risk of mathematical learning disabilities due to associated motor and cognitive limitations. However, there is currently little evidence on how to support the development of arithmetic skills within such a specific profile. The aim of this single-case study was to assess the effectiveness of a neuropsychological rehabilitation of arithmetic skills in NG, a 9-year-old boy with CP who experienced math learning disability and cumulated motor and short-term memory impairments. This issue was explored combining multiple-baseline and changing-criterion designs. The intervention consisted of training NG to solve complex additions applying calculation procedures with a tailor-made computation tool. Based on NG's strengths, in accordance with evidence-based practice in psychology, the intervention was the result of a co-construction process involving N, his NG's parents and professionals (therapist and researchers). Results were analyzed by combining graph visual inspections with non-parametric statistics for single-case designs (NAP-scores). Analyses showed a specific improvement in NG's ability to solve complex additions, which maintained for up to 3 weeks after intervention. The training effect did not generalize to his ability to perform mental additions, and to process the symbolic magnitude.

Fine motor skills and finger gnosia contribute to preschool children's numerical competencies

Facets of fine motor skills (FMS) and finger gnosia have been reported to predict young children's numerical competencies, possibly by affecting early finger counting experiences. Furthermore, neuronal connections between areas involved in finger motor movement, finger gnosia, and numerical processing have been posited. In this study, FMS and finger gnosia were investigated as predictors for preschool children's performance in numerical tasks. Preschool children (N = 153) completed FMS tasks measuring finger agility and finger dexterity as well as a non-motor finger gnosia task. Furthermore, children completed numerical tasks that involved finger use (i.e., finger counting and finger montring), and tasks that did not (i.e., picture-aided calculation and number line estimation). To control for possible confounding influences of domain general skills, we included measures of reasoning and spatial working memory. We found associations between FMS and both finger counting and calculation, but not finger montring. In contrast, finger gnosia was only associated with finger montring, but not finger counting and calculation. Surprisingly, there were no associations between FMS or finger gnosia with number line estimation. Findings highlight that the relationship between finger gnosia, FMS, and numerical skills is specific to task requirements. Possible implications are discussed.

From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy

Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.

Numerical cognition in children with cerebral palsy

Children with Cerebral Palsy (CP) often perform poorly in mathematics. It is not yet clear to what extent mathematics difficulties in this clinical condition are similar to those observed in developmental dyscalculia. To better elucidate this issue, we conducted an exploratory cross-sectional study with a sample of children and adolescents with congenital brain injuries and educational history of problems in Mathematics. Fifty students aged 7-15 years, of both genders (28 males) participated in the study, 31 with typical development (TD) and 19 of whom diagnosed with spastic CP. Nine had hemiplegia and ten diplegia. Assessment procedures included a neuropsychological battery covering numerical cognition (ZAREKI-R) and working memory (AWMA) skills, and a computerized task for comparing non-symbolic magnitudes as a measure of number sense. Despite average intelligence coefficient, participants with CP underperformed the TD in five of the 12 ZAREKI-R subtests, as well as in the number sense and working memory tasks. scores were lower among hemiplegic children compared to diplegic, numerical cognition was impaired in all CP group, unveiling a dyscalculia secondary to neurodevelopmental impairments. Therefore, we can consider that mathematical learning difficulties in CP as being heterogeneous and associated with the immaturity of neuropsychological functions, with consequences for the development of numerical cognition.

Putting a Finger on Numerical Development - Reviewing the Contributions of Kindergarten Finger Gnosis and Fine Motor Skills to Numerical Abilities

The well-documented association between fingers and numbers is not only based on the observation that most children use their fingers for counting and initial calculation, but also on extensive behavioral and neuro-functional evidence. In this article, we critically review developmental studies evaluating the association between finger sensorimotor skills (i.e., finger gnosis and fine motor skills) and numerical abilities. In sum, reviewed studies were found to provide evidential value and indicated that both finger gnosis and fine motor skills predict measures of counting, number system knowledge, number magnitude processing, and calculation ability. Therefore, specific and unique contributions of both finger gnosis and fine motor skills to the development of numerical skills seem to be substantiated. Through critical consideration of the reviewed evidence, we suggest that the association of finger gnosis and fine motor skills with numerical abilities may emerge from a combination of functional and redeployment mechanisms, in which the early use of finger-based numerical strategies during childhood might be the developmental process by which number representations become intertwined with the finger sensorimotor system, which carries an innate predisposition for said association to unfold. Further research is nonetheless necessary to clarify the causal mechanisms underlying this association.

Cognitive functioning in children with cerebral palsy

Children with cerebral palsy (CP) have an increased risk of cognitive impairments. This narrative review of the literature discusses assessment of cognition in children with CP, presents the most salient characteristics of cognitive functioning pertaining to each subtype, and discusses the relationships between brain injury, functioning, and intervention from a developmental perspective. A search for original studies of cognitive functioning in children with different subtypes of CP was performed. The search resulted in 81 unique hits. There were few studies with a representative sample of children with CP where all participants were individually assessed. Cognitive functioning in children with the most severe motor impairments were often assumed and not assessed. Furthermore, there was a confounding of IQ below 70 and intellectual disability, possibly leading to an overestimation of the prevalence of intellectual disability. Longitudinal neuropsychological studies, including also very young children and those with the most severe speech and motor impairments, as well as intervention studies, are called for. WHAT THIS PAPER ADDS: Few studies have assessed cognition in a representative sample of children with cerebral palsy. Cognition in children with severe motor impairment is often assumed, not assessed. Lack of assessment may lead to overestimating the prevalence of intellectual disability. Lowered cognitive functioning in older children highlights the need for longitudinal studies.

Inhibitory control and temporal perception in cerebral palsy

Prepotent response inhibition and temporal perception abilities were explored in a sample of individuals with cerebral palsy relative to typically developing peers. The extent to which inhibitory control difficulties might affect temporal processing was also investigated. For this purpose, two inhibitory control tasks and two duration estimation tasks were given to the groups of cerebral palsy and typically developing children. Results showed inhibition and temporal perception problems in the group with cerebral palsy. A relationship was found between inhibition and temporal estimation performances, which indicates that inhibitory control contributes, at least partially, to acquisition of the temporal processing ability.

Effects of extreme prematurity and kindergarten neuropsychological skills on early academic progress

OBJECTIVE

The study was designed to investigate the effect of extreme prematurity on growth in academic achievement across the early school years and the validity of kindergarten neuropsychological skills as predictors of achievement.

METHOD

A 2001-2003 birth cohort of 145 extremely preterm/extremely low birth weight (EPT/ELBW) children from a single medical center, along with 111 normal birth weight (NBW) classmate controls, were recruited during their first year in kindergarten and followed annually across the next 2 years in school. Mixed model analysis was conducted to compare the groups on growth in achievement across years and examine kindergarten neuropsychological skills as predictors of growth.

RESULTS

The EPT/ELBW group scored significantly below NBW controls on all achievement tests across years and had higher rates of special education placement and grade repetition. Despite limited catch-up of the EPT/ELBW group to the NBW controls in spelling, group differences were generally stable. Differences in spelling and mathematics achievement remained significant when controlling for global intelligence or excluding children who had intellectual or neurosensory impairments or repeated a grade. Higher scores on kindergarten tests of multiple neuropsychological ability domains predicted higher achievement levels and steeper growth in achievement.

CONCLUSIONS

The findings document persistent academic weaknesses in EPT/ELBW children across the early school years. Results point to the need for preschool interventions to enhance academic readiness and suggest that neuropsychological skills assessed in kindergarten are useful in identifying individual differences in early learning progress. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The impact of group occupational therapy using a cueing system on executive function of preschool-aged children with brain lesions

[Purpose] This study investigates the effects of group occupational therapy using a cueing system on the executive function of preschool-aged children with brain lesions. [Subjects and Methods] Six preschool-aged children with brain lesions participated in this study. A 24-session occupational therapy program (1 session/week, 50 minutes/session) designed based on a cueing system was administered to examine the changes in the participants’ executive function. The behavior rating inventory of executive function-preschool (BRIEF-P) was used to check the magnitude of improvement of executive functions after therapy. [Results] A Wilcoxon signed rank test revealed that occupational therapy significantly improved all domains, indices, and the global executive composite in the BRIEF-P. [Conclusion] The occupational therapy intervention incorporating a type of cognitive behavioral approach known as the cueing system may assist improving executive functions in preschool-aged children with brain lesions

SUPERVISED PHYSICAL TRAINING IMPROVES FINE MOTOR SKILLS OF 5-YEAR-OLD CHILDREN

ABSTRACT Introduction: Fine motor skills are important for children not only in the activities of daily living, but also for learning activities. In the present study, the effects of supervised physical training were investigated in normal children. Objective: To evaluate the effects of supervised training by combining full-body exercise and the eye-hand coordination activities to improve fine motor skills in a group of five-year-old normal children. Methods: Fifty-two children were selected and randomized in exercise and control groups. The exercise group participated in three 30-minute training sessions per week for 24 weeks. Results: The fine motor skills and hand grip strength of the exercise group were significantly increased, while there was no significant change in the control group during the experimental period. Conclusion: The results indicate that the current exercise training program is effective and can be applied to 5-year-old normal children to improve their fine motor skills. In addition, this program has simple physical activities that are appropriate to the physical and mental level of child development. The 30-minute training session would be easily implemented in the kindergarten program. Level of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.