Writing abilities and the role of working memory in children with symptoms of attention deficit and hyperactivity disorder

Do learning disabilities in reading, spelling and numeracy have common underlying factors? Evidence from Arabic-speaking children sample

We examined the role of phonemic awareness [PA], rapid naming [RAN], and verbal short-term memory [VSTM], phonological verbal fluency (PVF) along with literacy related skills (letter naming and orthographic knowledge) in reading, spelling, and numeracy performances. The study was carried out on a sample that consists of 245 native Arabic children of grade 1 and 2. The results showed a significant effect of Group on PA, RAN, VSTM, PVF, and letter naming and orthographic knowledge. There is also a comorbidity effect on PA and orthographic knowledge. The regression analysis indicated that PA and orthographic knowledge are the strongest predictors of the three academic outcomes, whereas VSTM, PVF and RAN displayed less predictive relationships with reading, spelling and numeracy. The results suggest that there are a number of underpinning factors that are linked to PA and orthographic knowledge, which are also accounted for a comorbidity condition between literacy and numeracy.

Is There a Deficit in Product and Process of Handwriting in Children with Attention Deficit Hyperactivity Disorder? A Systematic Review and Recommendations for Future Research

Handwriting abnormalities in children with attention deficit hyperactivity disorder (ADHD) have sometimes been reported both (i) at the product level (i.e., quality/legibility of the written trace and speed of writing) and (ii) at the process level (i.e., dynamic and kinematic features, such as on-paper and in-air durations, pen pressure and velocity peaks, etc.). Conversely, other works have failed to reveal any differences between ADHD and typically developing children. The question of the presence and nature of handwriting deficits in ADHD remains open and merits an in-depth examination. The aim of this systematic review was, therefore, to identify studies that have investigated the product and/or process of handwriting in children with ADHD compared to typically developing individuals. This review was conducted and reported in accordance with the PRISMA statement. A literature search was carried out using three electronic databases. The methodological quality of the studies was systematically assessed using the Critical Appraisal Skills Program (CASP) criteria. Twenty-one articles were identified. Of these, 17 described handwriting quality/legibility, 12 focused on speed and 14 analyzed the handwriting process. All the studies (100%) with satisfactory methodology procedures reported an impaired product and process in children with ADHD, while 25% evidenced a difference in the speed of production. Most importantly, the studies differed widely in their methodological approaches. Substantial gaps remain, particularly with regard to ascertaining comorbidities, ADHD subtypes and the medical status of the included children. The lack of overall homogeneity in the samples calls for higher quality studies. We conclude with recommendations for further studies.

The effect of working memory updating training on the Chinese writing ability of primary school students

Objective

This study aimed to explore the effects of working memory updating training on primary school students' writing ability and performance.

Methods

A total of 46 fourth-grade Chinese primary school students were recruited; their performance in the Chinese character N-back training task, the Writing Ability Questionnaire, and a time-limited writing task was assessed.

Results

The paired-sample t-test revealed that working memory updating training significantly improved the experimental group's working memory level. After training, a repeated measures ANOVA revealed that the experimental group's performance on the Writing Ability Questionnaire improved and was higher than that of the control group. In the time-limited writing task, independent-sample t-tests revealed that the experimental group's writing fluency increased and was higher than that of the control group, while the latter's grammatical accuracy and complexity decreased and were lower than those of the former.

Conclusion

Working memory updating training can be used as auxiliary cognitive training to improve primary school students' working memory level, thereby promoting their writing development.

Cognitive and White Matter Microstructure Development in Congenital Hypothyroidism and Familial Thyroid Disorders

CONTEXT

Children with congenital hypothyroidism (CH) are at risk for suboptimal neurodevelopment.

OBJECTIVES

To evaluate neurocognitive function and white matter microstructure in children with permanent or transient CH and to correlate these findings with disease severity.

DESIGN, PARTICIPANTS AND METHODS

A retrospective and prospective observational study was conducted in 39 children with permanent or transient CH, and in 39 healthy children. Cognitive function was assessed by Wechsler Intelligence Scale, Fourth Edition, and by other tests; the white matter microstructure was investigated by 3 Tesla magnetic resonance imaging.

RESULTS

Children with permanent CH have lower cognitive scores at a median age of 9.5 years than those with transient CH and controls. An IQ score between 71 and 84 was found in 28.6% of permanent CH and of <70 (P = 0.06) in 10.7%. The Processing Speed Index (PSI; P = 0.004), sustained visual attention (P = 0.02), reading speed (P = 0.0001), written calculations (P = 0.002), and numerical knowledge (P = 0.0001) were significantly lower than controls. Children born to mothers with Hashimoto's thyroiditis have significantly lower IQ values (P = 0.02), Working Memory Index (P = 0.03), and PSI (P = 0.02). Significantly lower IQ and Verbal Comprehension Index values were found in children with a family history of thyroid disorders (P = 0.004 and P = 0.009, respectively). In children with permanent CH, significant correlations between abnormalities in white matter microstructural, clinical, and cognitive measures were documented.

CONCLUSIONS

These findings indicate that children with CH are at risk of neurocognitive impairment and white matter abnormalities despite timely and adequate treatment. The association between offspring cognitive vulnerability and maternal thyroid disorders requires careful consideration.

Inattention Symptoms are Predictors of Neuropsychological Functioning in Children from 3rd and 4th Grades

Symptoms of inattention and hyperactivity/impulsivity, arranged along a continuum, are commonly associated with neuropsychological and academic deficits, even in the general population. The aim of this study is to analyze how Attention Deficit Hyperactivity Disorder (ADHD) symptoms are associated with the performance in neuropsychological and academic abilities (phonological processing, processing speed/automatic attention, executive functions, reading, and spelling) in school-age children. The sample consisted of 216 children from 3^rd and 4^th grades (M = 8.94 years old, SD =.71) from public elementary schools of two Brazilian capitals. Pearson correlation and Multiple Linear Regression analysis were performed. Inattention symptoms were the only predictors of performance in phonological processing (phoneme suppression and rapid automatized naming of letters), processing speed/automatic attention, executive functions, such as inhibitory control and cognitive flexibility, and reading fluency. Beta values ranged from .14 to .27, and the largest value was related to an inhibitory control task. Inattention, and not hyperactivity/impulsivity symptoms, seems to affect neuropsychological functions even in non-clinical diagnosed children. Contributions and future directions are discussed.

Cognitive Profiles of Developmental Dysgraphia

Developmental dysgraphia is a disorder of writing/spelling skills, closely related to developmental dyslexia. For developmental dyslexia, profiles with a focus on phonological, attentional, visual or auditory deficits have recently been established. Unlike for developmental dyslexia, however, there are only few studies about dysgraphia, in particular about the variability of its causes. Research has demonstrated high similarity between developmental dyslexia and dysgraphia. Thus, the aim of the study was to investigate cognitive deficits as potential predictors of dysgraphia, analogously to those for dyslexia, in order to identify dysgraphia profiles, depending on the particular underlying disorder. Different tests were carried out with 3rd and 4th grade school children to assess their spelling abilities, tapping into phonological processing, auditory sound discrimination, visual attention and visual magnocellular functions as well as reading. A group of 45 children with developmental dysgraphia was compared to a control group. The results showed that besides phonological processing abilities, auditory skills and visual magnocellular functions affected spelling ability, too. Consequently, by means of a two-step cluster analysis, the group of dysgraphic children could be split into two distinct clusters, one with auditory deficits and the other with deficits in visual magnocellular functions. Visual attention was also related to spelling disabilities, but had no characteristic distinguishing effect for the two clusters. Together, these findings demonstrate that a more fine-grained diagnostic view on developmental dysgraphia, which takes the underlying cognitive profiles into account, might be advantageous for optimizing the outcome of individuum-centered intervention programs.