Executive functions in children with communication impairments, in relation to autistic symptomatology

Annual Research Review: The transdiagnostic revolution in neurodevelopmental disorders

Practitioners frequently use diagnostic criteria to identify children with neurodevelopmental disorders and to guide intervention decisions. These criteria also provide the organising framework for much of the research focussing on these disorders. Study design, recruitment, analysis and theory are largely built on the assumption that diagnostic criteria reflect an underlying reality. However, there is growing concern that this assumption may not be a valid and that an alternative transdiagnostic approach may better serve our understanding of this large heterogeneous population of young people. This review draws on important developments over the past decade that have set the stage for much-needed breakthroughs in understanding neurodevelopmental disorders. We evaluate contemporary approaches to study design and recruitment, review the use of data-driven methods to characterise cognition, behaviour and neurobiology, and consider what alternative transdiagnostic models could mean for children and families. This review concludes that an overreliance on ill-fitting diagnostic criteria is impeding progress towards identifying the barriers that children encounter, understanding underpinning mechanisms and finding the best route to supporting them.

Language and executive functioning in young adults with Down syndrome

BACKGROUND

This study examined the association between executive functioning and language in young adults with Down syndrome (DS).

METHOD

Nineteen young adults with DS (aged 19-24 years) completed standardised measures of overall cognition, vocabulary, verbal fluency and executive function skills.

RESULTS

Friedman's analysis of variance (χ² (3) = 28.15, P < .001) and post hoc comparisons indicated that, on average, participants had a significantly lower overall non-verbal than verbal cognitive age equivalent and lower expressive than receptive vocabulary skills. Using Spearman correlations, performance on a verbal measure of cognition inhibition was significantly negatively related to receptive vocabulary (ρ = -.529, adjusted P = .036) and verbal fluency (ρ = -.608, adjusted P = .022). Attention was significantly positively correlated with receptive (ρ = .698, adjusted-p = .005) and expressive (ρ = .542, adjusted P = .027) vocabulary. Verbal working memory was significantly positively associated with receptive vocabulary (ρ = .585, adjusted P = .022) and verbal fluency (ρ = .737, adjusted P = .003). Finally, visuospatial working memory was significantly associated with receptive vocabulary (ρ = .562, adjusted P = .027).

CONCLUSIONS

Verbal and non-verbal measures of executive functioning skills had important associations with language ability in young adults with DS. Future translational research is needed to investigate causal pathways underlying these relationships. Research should explore if interventions aimed at increasing executive functioning skills (e.g. attention, inhibition and working memory) have the potential to lead to increases in language for young adults with DS.

Node Centrality Measures Identify Relevant Structural MRI Features of Subjects with Autism

Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions characterized by impairments in social interaction and communication and restricted patterns of behavior, interests, and activities. Although the etiopathogenesis of idiopathic ASD has not been fully elucidated, compelling evidence suggests an interaction between genetic liability and environmental factors in producing early alterations of structural and functional brain development that are detectable by magnetic resonance imaging (MRI) at the group level. This work shows the results of a network-based approach to characterize not only variations in the values of the extracted features but also in their mutual relationships that might reflect underlying brain structural differences between autistic subjects and healthy controls. We applied a network-based analysis on sMRI data from the Autism Brain Imaging Data Exchange I (ABIDE-I) database, containing 419 features extracted with FreeSurfer software. Two networks were generated: one from subjects with autistic disorder (AUT) (DSM-IV-TR), and one from typically developing controls (TD), adopting a subsampling strategy to overcome class imbalance (235 AUT, 418 TD). We compared the distribution of several node centrality measures and observed significant inter-class differences in averaged centralities. Moreover, a single-node analysis allowed us to identify the most relevant features that distinguished the groups.

Association between CCC-2 and Structural Language, Pragmatics, Social Cognition, and Executive Functions in Children with Developmental Language Disorder

(1) Background: Developmental Language Disorder (DLD) is diagnosed when the child experiences problems in language with no known underlying biomedical condition and the information required for its correct evaluation must be obtained from different contexts. The Children's Communication Checklist (CCC-2) covers aspects of a child's communication related to structural language and pragmatic skills, which are linked to social cognition or executive functions. The aim of this article is to examine parents' reports using the Spanish version of the CCC-2 questionnaire and its association with different formal assessments related to communication. (2) Methods: 30 children with DLD (3; 10-9 years old) and 39 age-matched (AM) children with typical development were assessed using formal measures of structural language, pragmatics, social cognition, and executive functions. Parents of children with DLD answered the Spanish version of the CCC-2. (3) Results: The performance of children with DLD was lower in all the formal assessments in comparison to AM children. The CCC-2 was significantly correlated with all the direct child assessments, although only formal measures of structural language predicted both the structural language and pragmatics scales of the CCC-2. (4) Conclusions: The CCC-2 answered by parents was consistent with formal assessments in children with DLD, and structural language seemed to be the best predictor of all the subscales.

Language and Inhibition: Predictive Relationships in Children With Language Impairment Relative to Typically Developing Peers

Background This study examined predictive relationships between two indices of language-receptive vocabulary and morphological comprehension-and inhibition in children with specific language impairment (SLI) and typically developing (TD) children. Methods Participants included 30 children with SLI and 41 TD age-matched peers (8-12 years). At two time points separated by 1 year, we assessed receptive vocabulary and morphological comprehension via standardized language measures and inhibition via a Flanker task. We used Bayesian model averaging and Bayesian regression analytical techniques. Results Findings indicated predictive relationships between language indices and inhibition reaction time (RT), but not between language indices and inhibition accuracy. For the SLI group, Year 1 inhibition RT predicted Year 2 morphological comprehension. For the TD group, Year 1 morphological comprehension predicted Year 2 inhibition RT. Conclusions This study provides preliminary evidence of a predictive relationship between language and inhibition, but this relationship differed between children with SLI and those with typical development. Findings suggest that inhibition RT played a larger predictive role in later morphological comprehension in children with SLI relative to the other relationships examined. Targeting inhibition skills as a part of language intervention may improve subsequent morphological comprehension. Supplemental Material https://doi.org/10.23641/asha.12014823.

Beyond Broadway: Analysis of Qualitative Characteristics of and Individual Responses to Creatively Able, a Music and Movement Intervention for Children with Autism

Movement in response to music represents one of the natural social environments in which physical activity occurs. The study of music and movement, including dance, requires a careful, holistic consideration of many features, which may include music, physical activity, motor learning, social engagement, emotion, and creativity. The overarching goal of this manuscript is to examine qualitative characteristics of and individual responses to a music and movement intervention (Creatively Able) for children with Autism Spectrum Disorder (ASD). We provide a description of Creatively Able, illustrating how the program design and physical and social environment were informed by children's needs and preferences in order to provide an enriched environment in which to promote multiple systems in children with ASD. Using data from two pilot studies with 20 children with ASD, we illustrate how researchers can use observational research methods to measure important aspects of the social environment (e.g., children's engagement during intervention sessions) as well as engagement of potential underlying behavioral mechanisms (e.g., self-regulation) that might reduce clinical symptoms. We further illustrate how individual responses to intervention (e.g., improvements in behaviors or symptoms) can be studied in physically active interventions. Our pilot study results showed group-level reductions in Stereotyped and Compulsive behaviors of 8% and 4%, respectively; posthoc analysis revealed that there were substantial individual differences in children's responses to the intervention. This research illustrates robust methods that can be applied to intervention research to improve our understanding of important features of interventions that might help promote development in various domains, including executive functions and self-regulation.

Behind the Scenes of Developmental Language Disorder: Time to Call Neuropsychology Back on Stage

Although the Developmental Language Disorder (DLD), also known as Specific Language Impairment in children has been the focus of unceasing scientific attention for decades, the nature and mechanisms of this disorder remain unclear. Most importantly, we still cannot reliably identify children requiring urgent intervention among other ‘late talkers’ at an early age and understand the high prevalence of comorbidity with psychiatric phenomena such as Autism Spectrum Disorder. One of the main reasons for this is the traditional ‘diagnosis-by-exclusion,’ resulting in heterogeneity of the DLD population. This paper proposes an alternative approach to the diagnosis, treatment and research of DLD, claiming that it is these children’s multiple deficits in neuropsychological development, which impede the spontaneous acquisition of their first language. Specifically, this review of the state-of-the-art in DLD research demonstrates deep and systematic interconnections between the speech and other higher cognitive functions developing in early childhood, including perception, attention and executive functions. In the proposed framework, speech is, therefore, considered as one of neuropsychological abilities, and the delay in its development is explained by other neuropsychological deficits, resulting in highly individual clinical profiles. By considering DLD as a complex neuropsychological syndrome, whose successful treatment depends on a holistic approach to diagnosis and intervention, we may significantly increase the efficacy of speech therapy, and also better understand the flexibility of the developing brain, its compensatory mechanisms and hence the comorbidity of DLD with psychiatric symptoms. Implications for using this paradigm in future scientific research are discussed.

Verbal Working Memory as a Longitudinal Mechanism of Vocabulary Problems in Preschoolers with ADHD

Elucidation of early potential risk factors of Attention-Deficit/Hyperactivity Disorder (ADHD) is important to allow for early identification of ADHD and targeted early intervention for children with ADHD. Delayed language skills, particularly poor vocabulary, is an early-developing potential risk factor that is thought to be involved in developmental pathways to ADHD; however, mechanisms explaining the relationship between poor vocabulary skills and ADHD symptoms are unclear and warrant investigation. The present study examines the relationship between poor vocabulary skills and ADHD symptoms by testing cognitive mechanisms, namely verbal working memory (WM), that might account for this link. Participants were 109 young children between the ages of three and six and their primary caregivers. Diagnostic information on ADHD symptoms was available from parents and teachers/daycare providers via standardized rating forms. Vocabulary skills and WM were measured through child performance on laboratory tasks. Mediation analyses found poor verbal working memory significantly partially explained the vocabulary-ADHD association for both parent and teacher-rated ADHD symptoms. Further, effects of verbal WM on the association between poor vocabulary and increased ADHD symptoms largely held at one-year follow-up. Development of early interventions targeting verbal WM may be a promising new direction for early ADHD intervention work.

The Flexibility Scale: Development and Preliminary Validation of a Cognitive Flexibility Measure in Children with Autism Spectrum Disorders

Flexibility is a key component of executive function, and is related to everyday functioning and adult outcomes. However, existing informant reports do not densely sample cognitive aspects of flexibility; the Flexibility Scale (FS) was developed to address this gap. This study investigates the validity of the FS in 221 youth with ASD and 57 typically developing children. Exploratory factor analysis indicates a five-factor scale: Routines/rituals, transitions/change, special interests, social flexibility, and generativity. The FS demonstrated convergent and divergent validity with comparative domains of function in other measures, save for the Generativity factor. The FS discriminated participants with ASD and controls. Thus, this study suggests the FS may be a viable, comprehensive measure of flexibility in everyday settings.

Is interference control in children with specific language impairment similar to that of children with autistic spectrum disorder?

AIMS

The purpose of the study was to examine resistance to proactive interference, which is strongly associated with working memory (WM) performance and language processing, in children with specific language impairment (SLI), with autism spectrum disorder (ASD), and with typical development (TD).

METHODS

Sixty children (eight to ten years; matched in age and nonverbal IQ) participated in the study. Resistance to proactive interference was measured using a verbal conflict paradigm.

RESULTS

Children with SLI and ASD show a deficit in resistance to proactive interference compared to their TD peers, but the source of the problem appears to be different for the two clinical groups. The interference problem exhibited by the children with SLI is related to a more complex deficit involving different cognitive-linguistic functions, whereas the children with ASD show a specific problem in cognitive flexibility.

IMPLICATIONS

The theoretical implications are that poor resistance to interference may be caused by weaknesses in different WM functions, such as a deficit in updating or responses based on familiarity rather than recollection. The clinical implications are that children with SLI and ASD show distinct patterns of performance; therefore they need different types of intervention to strengthen their resistance to proactive interference.

Differentiating Autism from Typical Development: Preliminary Findings of Greek Versions of a Pragmatic Language and Social Communication Questionnaire

OBJECTIVE

A social pragmatic communication disorder is one of the primary characteristics of children with autism. Although several measures of pragmatics and social communication exist, many are not comprehensive, do not examine the quality of interactions across contexts and interlocutors, and cannot be easily administered and interpreted. The aim of this article is to report on preliminary data collected using the Greek version of comprehensive social communication and pragmatic language questionnaires completed by parents and teachers interacting with young children in different contexts.

METHODS

A Greek translation of the social communication and pragmatic language questionnaires was administered to parents and teachers of 31 children diagnosed with autism and of 51 typically developing children aged 3.0-6.0 years. Analysis and Results: The performance on the Greek versions of the social communication and pragmatic language questionnaires of typically developing children was compared with the performance of the children with autism using a series of independent t tests. Descriptive statistics were used to summarize participant characteristics and performances on the measure. Preliminary results showed that significant differences with moderate effect sizes were found between groups on 63% of the 30 test items.

CONCLUSIONS

The performance of children on questionnaires may lead to the development of easily administered and interpretable assessments for differentiating children with pragmatics and social communication impairments, such as children with autism, from typically developing children.

Executive Functions in Children With Specific Language Impairment: A Meta-Analysis

PURPOSE

Mounting evidence demonstrates deficits in children with specific language impairment (SLI) beyond the linguistic domain. Using meta-analysis, this study examined differences in children with and without SLI on tasks measuring inhibition and cognitive flexibility.

METHOD

Databases were searched for articles comparing children (4-14 years) with and without SLI on behavioral measures of inhibition or cognitive flexibility. Weighted average effect size was calculated using multilevel modeling to measure potential group differences.

RESULTS

The analysis included 46 studies. Of those, 34 included inhibitory control measures and 22 included cognitive flexibility tasks. Children with SLI performed below same-aged peers on both inhibitory control tasks (g = -.56) and cognitive flexibility tasks (g = -.27). Moderator analyses showed no effect of linguistic task demands, participant age, or severity of language impairment on the degree of difference between children with SLI and controls on measures of inhibitory control.

CONCLUSION

Reliable differences between children with and without SLI were found on inhibition and cognitive flexibility tasks. A moderate group effect was found for inhibition tasks, but there was only a small effect for cognitive flexibility tasks. Results of moderator analyses suggest that these deficits are present throughout development despite task demands or severity of linguistic impairment.

Exekutive Funktionen und psychopathologische Symptome bei Kindern mit Spezifischer Sprachentwicklungsstörung

Zusammenfassung. Eine Inanspruchnahmepopulation von Kindern mit Spezifischer Sprachentwicklungsstörung (SSES) im Alter von sechs bis neun Jahren (n = 47) wurde in Hinblick auf nonverbale Intelligenz, Sprache, exekutive Funktionen (EF) und psychopathologische Symptome (CBCL) untersucht und mit einer Kontrollgruppe (n = 53) ohne Entwicklungsstörungen verglichen. EF-Defizite wurden signifikant häufiger bei Kindern mit SSES (53 %) als bei Kindern der Kontrollgruppe (19 %) gefunden, diese Unterschiede erwiesen sich als unabhängig von der nonverbalen Intelligenz. EF-Defizite korrelierten mit erhöhtem Risiko für psychopathologische Symptome, insbesondere bei Kindern mit SSES. Das Ergebnis latenter Klassenanalysen weist auf zwei unterschiedliche Teilgruppen von Kindern mit Sprachdefiziten hin, wobei nur eine davon gehäuft EF-Defizite sowie psychopathologische Symptome zeigt, analog zu zwei weiteren Teilgruppen ohne Sprachdefizite. Implikationen dieser Ergebnisse für die Diagnostik werden im Beitrag diskutiert.

Evidence against poor semantic encoding in individuals with autism

This article tests the hypothesis that individuals with autism poorly encode verbal information to the semantic level of processing, instead paying greater attention to phonological attributes. Participants undertook a novel explicit verbal recall task. Twenty children with autism were compared with 20 matched typically developing children. On each trial, 20 words were presented individually on a computer screen. Half of the items were related through having either a common semantic theme, or a common phonological feature. Following a filler task, the participants were presented with a cue and asked to recall items consistent with the cue. No differences between the autism and comparison groups were found in either the semantic or the phonological condition. A follow-up comparison revealed that the participants with autism showed comparable levels of recall to an additional group of children matched in chronological age. The findings do not support the idea of a developmental delay in semantic encoding in children with autism.

Continuous Performance Tasks: Not Just About Sustaining Attention

PURPOSE

Continuous performance tasks (CPTs) are used to measure individual differences in sustained attention. Many different stimuli have been used as response targets without consideration of their impact on task performance. Here, we compared CPT performance in typically developing adults and children to assess the role of stimulus processing on error rates and reaction times.

METHOD

Participants completed a CPT that was based on response to infrequent targets, while monitoring and withholding responses to regular nontargets. Performance on 3 stimulus conditions was compared: visual letters (X and O), their auditory analogs, and auditory pure tones.

RESULTS

Adults showed no difference in error propensity across the 3 conditions but had slower reaction times for auditory stimuli. Children had slower overall reaction times. They responded most quickly to the visual target and most slowly to the tone target. They also made more errors in the tone condition than in either the visual or the auditory spoken CPT conditions.

CONCLUSIONS

The results suggest error propensity and reaction time variations on CPTs cannot solely be interpreted as evidence of inattention. They also reflect stimulus-specific influences that must be considered when testing hypotheses about modality-specific deficits in sustained attention in populations with different developmental disorders.

Executive functioning in autism spectrum disorders: influence of task and sample characteristics and relation to symptom severity

Impaired executive functioning (EF) has been proposed to underlie symptoms of autism spectrum disorders (ASD). However, insight in the EF profile of ASD individuals is hampered due to task impurity and inconsistent findings. To elucidate these inconsistencies, we investigated the influence of task and sample characteristics on EF in ASD, with an extended test battery designed to reduce task impurity. Additionally, we studied the relation between EF and ASD symptoms. EF (inhibition, cognitive flexibility, generativity, working memory and planning) was measured in open-ended versus structured assessment situations, while controlling for possible confounding EF and non-EF variables. The performance of 50 individuals with ASD was compared with that of 50 age, gender and IQ matched typically developing (TD) individuals. The effects of group (ASD versus TD), age (children versus adolescents) and gender were examined, as well as the correlation between age, IQ, ASD symptoms and EF. Individuals with ASD showed impairments in all EF domains, but deficits were more pronounced in open-ended compared to structured settings. Group differences did not depend on gender and only occasionally on participants' age. This suggests that inconsistencies between studies largely result from differences in task characteristics and less from differences in the investigated sample features. However, age and IQ strongly correlated with EF, indicating that group differences in these factors should be controlled for when studying EF. Finally, EF correlated with both social and non-social ASD symptoms, but further research is needed to clarify the nature of this relationship.

Executive functioning in preschoolers with specific language impairment

The pathogenesis of Specific Language Impairment (SLI) is still largely beyond our understanding. In this review, a neuropsychological perspective on language impairments in SLI is taken, focusing specifically on executive functioning (EF) in preschoolers (age range: 2.6-6.1 years) with SLI. Based on the studies described in this review, it can be concluded that similar to school-aged children with SLI, preschoolers with SLI show difficulties in working memory, inhibition and shifting, as revealed by both performance based measures and behavioral ratings. It seems plausible that a complex, reciprocal relationship exists between language and EF throughout development. Future research is needed to examine if, and if yes how, language and EF interact in SLI. Broad neuropsychological assessment in which both language and EF are taken into account may contribute to early detection of SLI. This in turn can lead to early and tailored treatment of children with (suspected) SLI aimed not only at stimulating language development but also at strengthening EF.

Cognitive set shifting deficits and their relationship to repetitive behaviors in autism spectrum disorder

The neurocognitive impairments associated with restricted and repetitive behaviors (RRBs) in autism spectrum disorder (ASD) are not yet clear. Prior studies indicate that individuals with ASD show reduced cognitive flexibility, which could reflect difficulty shifting from a previously learned response pattern or a failure to maintain a new response set. We examined different error types on a test of set-shifting completed by 60 individuals with ASD and 55 age- and nonverbal IQ-matched controls. Individuals with ASD were able to initially shift sets, but they exhibited difficulty maintaining new response sets. Difficulty with set maintenance was related to increased severity of RRBs. General difficulty maintaining new response sets and a heightened tendency to revert to old preferences may contribute to RRBs.

When words lead to solutions: executive function deficits in preschool children with specific language impairment

Several studies indicate that school-age children with specific language impairment (SLI) have difficulties with tasks that rely on executive functions. Whether executive function deficits in children with SLI emerge during preschool age remains unclear. Our aim was to fill this gap by investigating executive function performances in two age groups of preschoolers with and without SLI. Children with SLI (N=60; young: 53.6±5.3 months; old: 65.4±3.8 months) and age-matched control children (N=58) were tested for problem-representation ability, using the Flexible Item Selection Task (FIST), rule-use skills, using a Stroop-like Day-Night test (D/N), and planning skills, using the Tower of London test (TOL). Older children performed better than younger children did across tasks. Children with SLI had poorer performance, compared to typically developing children, on measures of problem representation, planning skills, and use of rules. Our results clearly indicate that executive function impairment is evident during the preschool period. Although old children with SLI performed better than young children with SLI, their performances were still poor, compared to those of control peers. These findings suggest that children with SLI have altered executive functioning at 53.6 months.

Differences in the performance of children with specific language impairment and their typically developing peers on nonverbal cognitive tests: a meta-analysis

PURPOSE

This study used meta-analysis to investigate the difference in nonverbal cognitive test performance of children with specific language impairment (SLI) and their typically developing (TD) peers.

METHOD

The meta-analysis included studies (a) that were published between 1995 and 2012 of children with SLI who were age matched (and not nonverbal cognitive matched) to TD peers and given a norm-referenced nonverbal cognitive test and (b) that reported sufficient data for an effect size analysis. Multilevel modeling was used to examine the performance of children with SLI relative to their typically developing, age-matched peers on nonverbal IQ tests.

RESULTS

Across 138 samples from 131 studies, on average children with SLI scored 0.69 standard deviations below their TD peers on nonverbal cognitive tests after adjusting for the differences in the tests used, the low-boundary cutoff scores, the age of the participants, and whether studies matched the two groups on socioeconomic status.

DISCUSSION

The lower performance of children with SLI relative to TD children on nonverbal IQ tests has theoretical implications for the characterization of SLI and clinical and political implications regarding how nonverbal cognitive tests are used and interpreted for children with this disorder.

Vocabulary gain among children with language disorders: contributions of children's behavior regulation and emotionally supportive environments

PURPOSE

Behavior regulation is a positive predictor of language outcomes for children with typically developing language skills, and children with language disorders are at greater risk for difficulties with behavior regulation. This study investigated the unique role of behavior regulation on vocabulary gain for children receiving language therapy in the public schools as well as the unique and moderating influence of emotional support within therapy sessions on outcomes.

METHOD

A total of 121 kindergarten and 1st-grade students with language disorders, nested within 42 speech-language pathologists (SLPs), participated in the study. Direct child measures, indirect child measures, and therapy session videotapes were used for all analyses.

RESULTS

Hierarchical linear modeling indicated a positive association between children's behavior regulation and vocabulary gain. The emotional support of therapy sessions was not a significant predictor of vocabulary gain.

CONCLUSIONS

Results from this study suggest that children's behavior regulation is a significant predictor of vocabulary gain for children with language disorders; children with higher behavior regulation gain more over the academic year than do peers with lower behavior regulation. Findings highlight the importance of SLPs considering children's behavior regulation when planning and implementing therapy.

Limitations in social anticipation are independent of imaginative and Theory of Mind abilities in children with autism but not in typically developing children

Anticipating future interactions is characteristic of our everyday social experiences, yet has received limited empirical attention. Little is known about how children with autism spectrum disorder, known for their limitations in social interactive skills, engage in social anticipation. We asked children with autism spectrum disorder and their typically developing counterparts to consider an interaction with another person in the near future. Our results suggest that children with autism spectrum disorder and typically developing children performed similarly when anticipating the age, gender, and possible questions of another person, but children with autism spectrum disorder struggled more to anticipate what they would say in response to an anticipated interaction. Furthermore, such responses were robustly associated with imaginative capacities in typically developing children but not children with autism spectrum disorder. Our findings suggest that the cognitive mechanisms of social anticipation may differ between these groups.

The role of executive functions in the pragmatic skills of children age 4-5

Several studies suggest that pragmatic skills (PS) (i.e., social communication) deficits may be linked to executive dysfunction (i.e., cognitive processes required for the regulation of new and complex behaviors) in patients with frontal brain injuries. If impairment of executive functions (EF) causes PS deficits in otherwise healthy adults, could this mean that EF are necessary for the normal functioning of PS, even more so than cognitive maturation? If so, children with highly developed EF should exhibit higher levels of PS. This study aimed to examine the link between EF and PS among normally developing children. A secondary goal was to compare this relationship to that between intellectual quotient (IQ) and PS in order to determine which predictor explained the most variance. Participants were 70 French-speaking preschool children (3;10–5;7 years old). The PS coding system, an observational tool developed for this study, was used to codify the children's PS during a semi-structured conversation with a research assistant. Five types of EF processes were evaluated: self-control, inhibition, flexibility, working memory and planning. IQ was estimated by tallying the scores on a receptive vocabulary test and a visuoconstructive abilities test. The results of the test of differences between correlation coefficients suggest that EF contributed significantly more than IQ to the PS exhibited by preschoolers during conversation. More specifically, higher inhibition skills were correlated with a decrease in talkativeness and assertiveness. EF also appeared to foster quality of speech by promoting the ability to produce fluid utterances, free of unnecessary repetition or hesitation. Moreover, children with a high working memory capacity were more likely to formulate contingent answers and produce utterances that could be clearly understood by the interlocutor. Overall, these findings help us better understand how EF may assist children in everyday social interactions.

Neurocognitive performance of children with higher functioning autism spectrum disorders on the NEPSY-II

This study examined patterns of strengths and weaknesses in the neurocognitive performance of children with higher functioning autism spectrum disorder (ASD). The participants were 30 children with higher functioning ASD ranging from 6 to 11 years, and 60 typically developing (TD) children, who were matched with the children with higher functioning ASD in terms of age, gender, and maternal education. The TD children were drawn from the Finnish standardization sample for the NEPSY-II. The cognitive abilities of the children with higher functioning ASD were assessed with the WISC-III, and the neurocognitive performance of the children with higher functioning ASD and TD children on the NEPSY-II was compared. The children with higher functioning ASD were found to have strengths in verbal reasoning skills with respect to the population mean and weaknesses in set-shifting, verbal fluency, and narrative memory in comparison with the TD children. Minor weaknesses were also observed in facial memory and fine and visuomotor skills.

Working memory performance and executive function behaviors in young children with SLI

The present study compared the performances of young children with specific language impairment (SLI) to that of typically developing (TD) children on cognitive measures of working memory (WM) and behavioral ratings of executive functions (EF). The Automated Working Memory Assessment was administered to 58 children with SLI and 58 TD children aged 4 and 5 years. Additionally, parents completed the Behavior Rating Inventory of Executive Function - Preschool Version. The results showed the SLI group to perform significantly worse than the TD group on both cognitive and behavioral measures of WM. The deficits in WM performance were not restricted to the verbal domain, but also affected visuospatial WM. The deficits in EF behaviors included problems with inhibition, shifting, emotional control, and planning/organization. The patterns of associations between WM performance and EF behaviors differed for the SLI versus TD groups. WM performance significantly discriminated between young children with SLI and TD, with 89% of the children classified correctly. The data indicate domain general impairments in WM and problems in EF behaviors in young children with SLI. Attention should thus be paid to WM - both verbal and visuospatial - and EF in clinical practice. Implications for assessment and remediation were discussed.

When words fail us: insights into language processing from developmental and acquired disorders

Acquired disorders of language represent loss of previously acquired skills, usually with relatively specific impairments. In children with developmental disorders of language, we may also see selective impairment in some skills; but in this case, the acquisition of language or literacy is affected from the outset. Because systems for processing spoken and written language change as they develop, we should beware of drawing too close a parallel between developmental and acquired disorders. Nevertheless, comparisons between the two may yield new insights. A key feature of connectionist models simulating acquired disorders is the interaction of components of language processing with each other and with other cognitive domains. This kind of model might help make sense of patterns of comorbidity in developmental disorders. Meanwhile, the study of developmental disorders emphasizes learning and change in underlying representations, allowing us to study how heterogeneity in cognitive profile may relate not just to neurobiology but also to experience. Children with persistent language difficulties pose challenges both to our efforts at intervention and to theories of learning of written and spoken language. Future attention to learning in individuals with developmental and acquired disorders could be of both theoretical and applied value.

Inhibition in autism: children with autism have difficulty inhibiting irrelevant distractors but not prepotent responses

Resistance to distractor inhibition tasks have previously revealed impairments in children with autism. However, on the classic Stroop task and other prepotent response tasks, children with autism show intact inhibition. These data may reflect a distinction between prepotent response and resistance to distractor inhibition. The current study investigated this possibility using tasks that systematically manipulated inhibitory load. Findings showed that children with autism performed comparably to typically developing and learning disabled controls on a prepotent response inhibition stop-signal task but showed significant inhibitory impairment on a modified flanker resistence to distractor inhibition task. Although the results are clearly consistent with the suggestion that autism is associated with a specific deficit in resistance to distractor inhibition, they may in fact be related to an increased perceptual capacity in autism.

Verbal mediation of cognition in children with specific language impairment

Private speech (PS) and inner speech (IS) are thought to be functionally important for children's and adults' cognition, but they have not been studied systematically in children with specific language impairment (SLI). Participants were 21 children with SLI (7-11 years, expressive or receptive verbal IQ ≤ 75, nonverbal IQ ≥ 84) and 21 age- and nonverbal IQ-matched controls. Participants completed three sets of Tower of London problems: one with no dual task (PS condition), one with articulatory suppression, and one while foot tapping (control condition). Participants also completed a digit span task. There was no group difference in the susceptibility of Tower of London performance to articulatory suppression, but the PS of the SLI group was less internalized than that of the controls on both tasks. The findings suggest that children with SLI experience a significant delay in the development of PS/IS, but that their PS/IS is effective for Tower of London performance in middle childhood. Findings are discussed with reference to the interpretation of the nonlinguistic deficits associated with SLI, and in terms of clinical implications.

Atomoxetine improves communication in a girl with semantic-pragmatic disorder

This report describes the case of an ADHD girl (hereafter referred to as K) with semantic-pragmatic disorder, she was treated with atomoxetine. K was a 9-year-old girl. She had difficulty understanding words or sentences, finding words, and producing sentences. K also displayed symptoms of severe inattentiveness. K was diagnosed with DSM-IV-defined(1) ADHD, predominantly the inattentive type. Her communication impairment was considered symptomatic of semantic-pragmatic disorder. K was started on atomoxetine, the dose was increased to 50 mg/day (dosage based on weight: 1.8 mg/kg). Her communication activities were improved a few weeks after atomoxetine 50 mg/day was administered. She was unable to organize information pertaining to words, and so could not use words in expressive language. These problems were mitigated through the administration of atomoxetine. Further prospective studies are needed to better understand the therapeutic effects of atomoxetine in patients with semantic-pragmatic disorder.

Short-term and working memory skills in primary school-aged children with specific language impairment and children with pragmatic language impairment: phonological, linguistic and visuo-spatial aspects

BACKGROUND

Children with specific language impairment (CwSLI) are consistently reported to have short-term memory (STM) and working memory (WM) difficulties.

AIM

To compare STM and WM abilities in CwSLI with children with pragmatic language impairment (CwPLI).

METHODS & PROCEDURES

Primary school-aged CwSLI (n= 12) and CwPLI (n= 23) were assessed on measures of STM and WM.

OUTCOMES & RESULTS

CwPLI had significantly higher scores than CwSLI on STM tasks, and this difference could not be accounted for by differences in receptive language ability. There were no between-group differences for WM tasks. The majority of CwSLI and a significant proportion of CwPLI scored in the impaired range on each of the memory measures. In contrast, some CwPLI scored within the normal range.

CONCLUSIONS & IMPLICATIONS

CwPLI present with a different profile of STM but not WM ability to CwSLI. Clinical implications are discussed.

Are executive control functions related to autism symptoms in high-functioning children?

BACKGROUND

Linking autism symptoms to cognitive abilities can expand phenotypic descriptions and facilitate investigations into the etiology and treatment of this multiplex disorder. Executive dysfunction is one of several potential cognitive phenotypes in autism.

METHOD

Archival clinical data on 89 children diagnosed with Autism Spectrum Disorders and administered a large neuropsychological battery were evaluated for relationships between executive functioning and autism symptoms.

RESULTS

Significant relationships between both laboratory tasks and behavior rating scales of executive functions and autism symptoms were identified. Multiple regression analyses revealed that measures of semantic fluency, divided auditory attention, and behavioral regulation were significantly correlated with autism symptoms, even after accounting for the variance from correlated "nuisance variables," such as vocabulary and age.

CONCLUSIONS

Executive dysfunction is related to all three clusters of behavioral symptoms in Autism Spectrum Disorders.

Exploring language profiles for children with ADHD and children with asperger syndrome

OBJECTIVE

The aims of the present study was to investigate communication impairments in a Norwegian sample of children with ADHD and children with Asperger syndrome (AS) and to explore whether children with ADHD can be differentiated from children with AS in terms of their language profiles on the Norwegian adaptation of the Children's Communication Checklist Second Edition (CCC-2).

METHOD

The CCC-2 was completed by the parents, and altogether, 77 children aged between 6 and 15 years participated in the study.

RESULTS

Communication impairments were as common in a group of children with ADHD as in a group of children with AS. Although a similar pattern appeared on most CCC-2 scales, children with ADHD and children with AS could be distinguished from each other in terms of their language profiles on the subscales assessing stereotyped language and nonverbal communication.

CONCLUSION

Language abilities should be taken into account when standard assessments of ADHD and AS are performed and before therapies are initiated.

Auditory word recognition of nouns and verbs in children with Specific Language Impairment (SLI)

Nouns are fundamentally different from verbs semantically and syntactically, since verbs can specify one, two, or three nominal arguments. In this study, 25 children with Specific Language Impairment (age 5;3-8;2 years) and 50 typically developing children (3;3-8;2 years) participated in an eye-tracking experiment of spoken language comprehension to compare the dynamics of spoken word recognition for nouns and verbs in Spanish. Listeners' eye movements were recorded as they searched an array of pictures in response to hearing a noun or verb. Results showed significant an animacy effect before the word was finished as images that contain more animate entities attracted their looks which suggest an underdevelopment suppression mechanisms inhibition. Moreover, after word finished all the groups showed differences between nouns and verbs. They were faster in recognizing nouns than verbs and one-argument were recognized faster than two- and three-verb arguments whereas. Children with SLI were slower that their controls and especially in the recognition of three-argument verbs. We suggest that this was due to an incomplete argument structure representation that affects processing times.

LEARNING OUTCOMES

(1) As a result of this activity, the participant will be able to describe the differences between adults and children with and without SLI in spoken word recognition of nouns and verbs. (2) As a result of this activity, the participant will be able to describe the animacy effect.

Executive functioning in children with specific language impairment

BACKGROUND

A limited range of evidence suggests that children with specific language impairment (SLI) have difficulties with higher order thinking and reasoning skills (executive functioning, EF). This study involved a comprehensive investigation of EF in this population taking into account the contributions of age, nonverbal IQ and verbal ability.

METHODS

Ten separate measures of EF were assessed in 160 children: 41 had SLI; 31 had low language/cognitive functioning but did not fulfil the criteria for SLI (low language functioning or LLF); and 88 were typically developing with no language difficulties. Group differences in performance were assessed after controlling for age, nonverbal IQ and verbal ability in a series of regression analyses.

RESULTS

Children with SLI and LLF had significantly lower performance than typical children on 6 of the 10 EF tasks once age and nonverbal IQ had been controlled (verbal and nonverbal executive-loaded working memory, verbal and nonverbal fluency, nonverbal inhibition and nonverbal planning). Performance on these EF tasks remained lower for those in the SLI group even when verbal IQ was entered in the regressions.

CONCLUSIONS

Children with language impairments showed marked difficulties on a range of EF tasks. These difficulties were present even when adjustments were made for their verbal abilities.

Verbal problem-solving in autism spectrum disorders: a problem of plan construction?

Children with autism spectrum disorders (ASD) adopt less efficient strategies than typically developing controls (TD) on verbal problem-solving tests such as the Twenty Questions Task. This study examined the hypotheses that this can be explained by differences in (i) planning processes or (ii) selective attention. Twenty-two children with ASD and 21 TD controls matched for age (M(age) = 13:7) and cognitive ability (M(FSIQ) = 96.42) were tested on an adapted version of Twenty Questions and two planning tasks. ASD participants could recognize effective questions as well as TD participants on a forced-choice question discrimination task, but were observed to construct plans that were significantly less efficient. ASD performance was also specifically reduced when items could not be physically removed from the testing array, although this effect could be ameliorated by keeping a written record of participant questions during search. These findings indicate that ASD participants are sensitive to the within-task executive demands of Twenty Questions, but that their inefficiency in strategy relates to planning processes and question selection pretask. The implications for understanding ASD problem-solving skills and their impact on everyday functioning are discussed.

Perfil funcional de comunicação e desempenho sócio-cognitivo de adolescentes autistas institucionalizados

OBJETIVO: o objetivo dessa pesquisa foi descrever as características funcionais da comunicação de adolescentes autistas institucionalizados, ao longo de um período de aproximadamente seis meses, nos aspectos de: número de atos comunicativos por minuto, proporção de interpessoalidade da comunicação e proporção de utilização dos meios comunicativos gestual, vocal e verbal assim como descrever as características do desempenho sócio-cognitivo dos sujeitos ao longo desse período. MÉTODOS: foram sujeitos dessa pesquisa oito adolescentes autistas institucionalizados que foram avaliados durante seis meses quanto ao perfil funcional de comunicação e ao desempenho sócio-cognitivo. Os dados obtidos foram submetidos à análise estatística não paramétrica. RESULTADOS: foi observada evolução quanto ao número de atos comunicativos por minuto e à proporção de funções comunicativas interpessoais, mas não foi observada evolução significativa quanto aos aspectos sócio-cognitivos. CONCLUSÃO: foi possível observar evolução na linguagem em adolescentes autistas institucionalizados num período de tempo de seis meses, mas não foi possível identificar correlações com o desempenho sócio-cognitivo.

The episodic buffer in children with intellectual disabilities: an exploratory study

Performance on three verbal measures (story recall, paired associated learning, category fluency) designed to assess the integration of long-term semantic and linguistic knowledge, phonological working memory and executive resources within the proposed 'episodic buffer' of working memory (Baddeley, 2007) was assessed in children with intellectual disabilities (ID). It was hypothesised that children with ID would show equivalent performance to typically developing children of the same mental age. This prediction was based on the hypothesis that, despite poorer phonological short-term memory than mental age matched peers, those with ID may benefit from more elaborate long-term memory representations, because of greater life experience. Children with ID were as able as mental age matched peers to remember stories, associate pairs of words together and generate appropriate items in a category fluency task. Performance did not, however, reach chronological age level on any of the tasks. The results suggest children with ID perform at mental age level on verbal 'episodic buffer' tasks, which require integration of information from difference sources, supporting a 'delayed' rather than 'different' view of their development.

Videogames and Young People with Developmental Disorders

Young people with developmental disorders experience difficulties with many cognitive and perceptual tasks, and often suffer social impairments. Yet, like typical youth, many appear to enjoy playing videogames. This review considers the appeal of videogames to individuals with autism spectrum disorders, attention deficit hyperactivity disorder, and specific language impairment. It examines how they respond to the various challenges that play entails with particular reference to sensory, cognitive, and social dimensions. It is argued that research into how these young people engage voluntarily with this dynamic and challenging medium offers great potential to extend our empirical and theoretical understanding of the disorders. Many gaps in our current knowledge are identified and several additional themes for possible future research are proposed.

The Assessment of Executive Functioning in Children

BACKGROUND

  Executive functioning is increasingly seen as incorporating several component sub-skills and clinical assessments should reflect this complexity.

METHOD

  Tools for assessing executive functioning in children are reviewed within five key areas, across verbal and visuospatial abilities, with emphasis on batteries of tests.

RESULTS

  There are many appropriate tests for children, although the choice is more limited for those under the age of 8 years.

CONCLUSIONS

  Whilst there are several batteries of executive functioning suitable for children, clinicians may prefer to cherry-pick from a broader range of measures that assess specific components of executive functioning.