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Dakopolos A, Condy E, Smith E, Harvey D, Kaat AJ, Coleman J, Riley K, Berry-Kravis E, Hessl D. Developmental associations between cognition and adaptive behavior in intellectual and developmental disability. J Neurodev Disord 2024; 16:31. [PMID: 38872099 PMCID: PMC11177479 DOI: 10.1186/s11689-024-09542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/03/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living, commonly referred to as adaptive behavior (DSM-5). Although cross-sectional associations between intelligence or cognition and adaptive behavior have been reported in IDD populations, no study to date has examined whether developmental changes in cognition contribute to or track with changes in adaptive behavior. The present study sought to examine associations of longitudinal developmental change in domains of cognition (NIH Toolbox Cognition Battery, NIHTB-CB) and adaptive behavior domains (Vineland Adaptive Behavior Scales-3; VABS-3) including Socialization, Communication, and Daily Living Skills (DLS) over a two year period in a large sample of children, adolescents and young adults with IDD. METHODS Three groups were recruited, including those with fragile X syndrome, Down syndrome, and other/idiopathic intellectual disability. Eligible participants (n = 263) included those who were between 6 and 26 years (mage = 15.52, sd = 5.17) at Visit 1, and who had a diagnosis of, or suspected intellectual disability (ID), including borderline ID, with a mental age of at least 3.0 years. Participants were given cognitive and adaptive behavior assessments at two time points over a two year period (m = 2.45 years, range = 1.27 to 5.56 years). In order to examine the association of developmental change between cognitive and adaptive behavior domains, bivariate latent change score (BLCS) models were fit to compare change in the three cognitive domains measured by the NIHTB-CB (Fluid Cognition, Crystallized Cognition, Total Cognition) and the three adaptive behavior domains measured by the VABS-3 (Communication, DLS, and Socialization). RESULTS Over a two year period, change in cognition (both Crystallized and Total Composites) was significantly and positively associated with change in daily living skills. Also, baseline cognition level predicted growth in adaptive behavior, however baseline adaptive behavior did not predict growth in cognition in any model. CONCLUSIONS The present study demonstrated that developmental changes in cognition and adaptive behavior are associated in children and young adults with IDD, indicating the potential for cross-domain effects of intervention. Notably, improvements in DLS emerged as a primary area of adaptive behavior that positively related to improvements in cognition. This work provides evidence for the clinical, "real life" meaningfulness of changes in cognition detected by the NIHTB-CB in IDD, and provides empirical support for the NIHTB-CB as a fit-for-purpose performance-based outcome measure for this population.
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Affiliation(s)
- Andrew Dakopolos
- UC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Emma Condy
- Hofstra University, 1000 Hempstead Tpke, Hempstead, NY, 11549, USA
| | - Elizabeth Smith
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, UC Davis, Medical Sciences 1C, One Shields Avenue, Davis, CA, 95616, USA
| | - Aaron J Kaat
- Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave Suite 2700, Chicago, IL, 60611, USA
| | - Jeanine Coleman
- Regis University, 3333 Regis Boulevard, Denver, CO, 80221, USA
| | - Karen Riley
- Slippery Rock University of Pennsylvania, 104 Maltby Ave, Slippery Rock, PA, 16057, USA
| | | | - David Hessl
- UC Davis MIND Institute and Department of Psychiatry and Behavioral Sciences, 2825 50th Street, Sacramento, CA, 95817, USA.
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Eng CM, Tsegai-Moore A, Fisher AV. Incorporating Evidence-Based Gamification and Machine Learning to Assess Preschool Executive Function: A Feasibility Study. Brain Sci 2024; 14:451. [PMID: 38790430 PMCID: PMC11119088 DOI: 10.3390/brainsci14050451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/17/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
Computerized assessments and digital games have become more prevalent in childhood, necessitating a systematic investigation of the effects of gamified executive function assessments on performance and engagement. This study examined the feasibility of incorporating gamification and a machine learning algorithm that adapts task difficulty to individual children's performance into a traditional executive function task (i.e., Flanker Task) with children ages 3-5. The results demonstrated that performance on a gamified version of the Flanker Task was associated with performance on the traditional version of the task and standardized academic achievement outcomes. Furthermore, gamification grounded in learning science and developmental psychology theories applied to a traditional executive function measure increased children's task enjoyment while preserving psychometric properties of the Flanker Task. Overall, this feasibility study indicates that gamification and adaptive machine learning algorithms can be successfully incorporated into executive function assessments with young children to increase enjoyment and reduce data loss with developmentally appropriate and intentional practices.
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Affiliation(s)
- Cassondra M. Eng
- Department of Psychiatry & Behavioral Sciences, Stanford University, 1520 Page Mill Road Stanford, Stanford, CA 94304, USA
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, 335I Baker Hall, Pittsburgh, PA 15213, USA;
| | - Aria Tsegai-Moore
- Department of Psychology, Columbia University, 406 Schermerhorn Hall, 1190 Amsterdam Avenue, New York, NY 10027, USA;
| | - Anna V. Fisher
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, 335I Baker Hall, Pittsburgh, PA 15213, USA;
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Dakopolos A, Condy E, Smith E, Harvey D, Kaat AJ, Coleman J, Riley K, Berry-Kravis E, Hessl D. Developmental Associations between Cognition and Adaptive Behavior in Intellectual and Developmental Disability. RESEARCH SQUARE 2024:rs.3.rs-3684708. [PMID: 38260292 PMCID: PMC10802716 DOI: 10.21203/rs.3.rs-3684708/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living (DSM-5). Individuals with IDD often present with an intellectual disability in addition to a developmental disability such as autism or Down syndrome. Those with IDD may present with deficits in intellectual functioning as well as adaptive functioning that interfere with independence and living skills. The present study sought to examine associations of longitudinal developmental change in domains of cognition (NIH Toolbox Cognition Battery, NIHTB-CB) and adaptive behavior domains (Vineland Adaptive Behavior Scales-3; VABS-3) including Socialization, Communication, and Daily Living Skills (DLS) over a two-year period. Methods Eligible participants for this multisite longitudinal study included those who were between 6 and 26 years at Visit 1, and who had a diagnosis of, or suspected intellectual disability (ID), including borderline ID. Three groups were recruited, including those with fragile X syndrome, Down syndrome, and other/idiopathic intellectual disability. In order to examine the association of developmental change between cognitive and adaptive behavior domains, bivariate latent change score (BLCS) models were fit to compare change in the three cognitive domains measured by the NIHTB-CB (Fluid, Crystallized, Composite) and the three adaptive behavior domains measured by the VABS-3 (Communication, DLS, and Socialization). Results Over a two-year period, change in cognition (both Crystalized and Composite) was significantly and positively associated with change in daily living skills. Also, baseline cognition level predicted growth in adaptive behavior, however baseline adaptive behavior did not predict growth in cognition in any model. Conclusions The present study demonstrated that developmental improvements in cognition and adaptive behavior are associated in children and young adults with IDD, indicating the potential for cross-domain effects of intervention. Notably, improvements in Daily Living Skills on the VABS-3 emerged as a primary area of adaptive behavior that positively related to improvements in cognition. This work provides evidence for the clinical, "real life" meaningfulness of the NIHTB-CB in IDD, and important empirical support for the NIHTB-CB as a fit-for-purpose performance-based outcome measure for this population.
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Affiliation(s)
| | | | - Elizabeth Smith
- Cincinnati Children's Hospital Medical Center Burnet Campus: Cincinnati Children's Hospital Medical Center
| | | | - Aaron J Kaat
- Northwestern University Feinberg School of Medicine
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Distefano R, Palmer AR, Kalstabakken AW, Hillyer CK, Seiwert MJ, Zelazo PD, Carlson SM, Masten AS. Predictive Validity of the NIH Toolbox Executive Function Measures with Developmental Extensions from Early Childhood to Third Grade Achievement. Dev Neuropsychol 2023; 48:373-386. [PMID: 38044631 DOI: 10.1080/87565641.2023.2286353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/16/2023] [Indexed: 12/05/2023]
Abstract
The National Institutes of Health Toolbox includes two executive function measures: the Dimensional Change Card Sort (DCCS) and the Flanker Inhibitory Control and Attention Test. Developmental extension (Dext) versions were created with easier levels for younger and more disadvantaged children. Although research on early (E-Prime) and later (iPad) versions of the Dext measures demonstrated their short-term validity, this study investigated their longer-term predictive validity. Participants included 402 children (Mage = 55.02 months) who completed the DCCS-Dext and Flanker-Dext (E-Prime) during early childhood screening and achievement tests in the third grade. Both measures significantly predicted math and reading scores among diverse groups of children.
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Affiliation(s)
- Rebecca Distefano
- Teachers College, Columbia University, New York, NY, USA
- Department of Psychology, Roger Williams University, Bristol, Rhode Island, USA
| | - Alyssa R Palmer
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Amanda W Kalstabakken
- Department of Pediatrics, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | | | | | - Philip David Zelazo
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Stephanie M Carlson
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ann S Masten
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Borairi S, Ozdemir B, Jenkins J, Shah PS, Kingdom J, Ganea P. A follow up investigation of placental pathology, responsive parenting, and preschool children's executive functioning and language development. Child Neuropsychol 2023:1-18. [PMID: 37811813 DOI: 10.1080/09297049.2023.2264535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Despite documented effects linking underlying placental diseases and neurological impairments in children, little is known about the long-term effects of placental pathology on children's neurocognitive outcomes. In addition, maternal responsivity, known to positively influence early postnatal cognitive development, may act to protect children from putative adverse effects of placental pathology. The current study is a follow up of medically healthy, term born, preschool age children, born with placental pathology. A sample of 118 children (45 comparison children with normal placental findings, 73 born with placental pathology) were followed when children were 3-4 years old. In comparison to children born to mothers with normal placentas, placental pathology was associated with poorer performance in the executive function involving cognitive flexibility, but not inhibitory control or receptive language. Maternal responsivity was observed to be marginally protective on the impact of placental pathology risk on cognitive flexibility, but this was not seen for either inhibitory control or receptive language.
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Affiliation(s)
- Sahar Borairi
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Begum Ozdemir
- Department of Psychology, Maltepe University, Maltepe, Turkey
| | - Jennifer Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - John Kingdom
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Patricia Ganea
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
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Schipper L, Bartke N, Marintcheva-Petrova M, Schoen S, Vandenplas Y, Hokken-Koelega ACS. Infant formula containing large, milk phospholipid-coated lipid droplets and dairy lipids affects cognitive performance at school age. Front Nutr 2023; 10:1215199. [PMID: 37731397 PMCID: PMC10508340 DOI: 10.3389/fnut.2023.1215199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Background Breastfeeding has been positively associated with infant and child neurocognitive development and function. Contributing to this effect may be differences between human milk and infant formula in the milk lipid composition and milk fat globule structure. Objective To evaluate the effects of an infant formula mimicking human milk lipid composition and milk fat globule structure on childhood cognitive performance. Methods In a randomized, controlled trial, healthy term infants received until 4 months of age either a Standard infant formula (n = 108) or a Concept infant formula (n = 115) with large, milk phospholipid coated lipid droplets and containing dairy lipids. A breastfed reference group (n = 88) was included. Erythrocyte fatty acid composition was determined at 3 months of age. Neurocognitive function was assessed as exploratory follow-up outcome at 3, 4, and 5 years of age using the Flanker test, Dimensional Change Card Sort (DCCS) test and Picture Sequence Memory test from the National Institutes of Health Toolbox Cognition Battery. Mann-Whitney U test and Fisher exact test were used to compare groups. Results Erythrocyte omega-6 to -3 long-chain polyunsaturated fatty acid ratio appeared to be lower in the Concept compared to the Standard group (P = 0.025). At age 5, only the Concept group was comparable to the Breastfed group in the highest reached levels on the Flanker test, and the DCCS computed score was higher in the Concept compared to the Standard group (P = 0.021). Conclusion These outcomes suggest that exposure to an infant formula mimicking human milk lipid composition and milk fat globule structure positively affects child neurocognitive development. Underlying mechanisms may include a different omega-3 fatty acid status during the first months of life. Clinical trial registration https://onderzoekmetmensen.nl/en/trial/28614, identifier NTR3683 and NTR5538.
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Affiliation(s)
| | - Nana Bartke
- Danone Nutricia Research, Utrecht, Netherlands
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