Normative data for the letter-cancellation task in school children

Effect of Yoga of Adaptive Yogasana Practice on the Flexibility and Psychomotor Variables in Intellectually Disabled Subjects

Intellectual disability (ID) is a public health challenge affecting communities worldwide. ID is characterized by impaired physical and cognitive functioning and less engaged in physical activities. The objective of this study was to assess the impact of adaptive yoga practices on cognitive and motor abilities in the subjects with ID. Sixty-six subjects with mild and moderate IDs were purposively selected and randomly divided into experimental and control groups, with 33 subjects in each group. One month of adaptive yoga module was provided to the experimental group. To assess the impact of the yoga intervention, Functional Reach Test (FRT), Wall Toss Test (WTT), Finger Tapping Test (FTT), Sit-Reach Test (SRT), and Six Letter Cancellation Test (SLCT) were administered. The experimental group showed a statistically significant improvement with P < 0.05 across all the parameters, whereas the control group could not observe a significant improvement. Based on the results, this study concludes that "one month of adaptive yoga module" delivered impact and helped to improve the dynamic balance, eye-hand coordination, neuro-motor function, spinal flexibility, and selective attention in ID-afflicted subjects.

Effectiveness of intermittent iron and high-dose vitamin A supplementation on cognitive development of school children in southern Ethiopia: a randomized placebo-controlled trial

BACKGROUND

Iron is an essential mineral whose deficiency results in cognitive alteration, impaired emotional behaviors, and altered myelination and neurotransmission. In animal models, it has been shown that vitamin A (VA) could affect cognition.

OBJECTIVES

The study aimed to evaluate the effectiveness of intermittent iron and VA supplementation on cognitive development of schoolchildren, and to assess the interaction between these supplementations.

METHODS

Considering a 2 × 2 factorial design, 504 children were randomly assigned to 1 of the 4 arms: placebo VA and placebo iron supplement; high-dose vitamin VA and placebo iron supplement; iron supplement and placebo VA; and iron and high-dose vitamin VA supplements. Cognitive development was assessed using Raven's Coloured Progressive Matrices, digit span, Tower of London, and visual search tasks.

RESULTS

The mean [± standard deviation (SD)] age of the enrolled children was 9.6 (±1.6) y. One-fifth of the children had iron deficiency or anemia, whereas 2.9%, 3.9%, and 12.1% of children had low iron stores, iron deficiency anemia, and VA deficiency, respectively. Intermittent iron supplementation did not result in any significant improvement of children's cognitive development and had a negative effect on the performance index of the visual search task compared with placebo (-0.17 SD, 95% confidence interval: -0.32, -0.02). Effects were evident among children with stunting, thinness, or children coming from understimulating home environments. High-dose VA supplementation resulted in a significant improvement of digit span z-score with a mean difference of 0.30 SD (95% confidence interval: 0.14, 0.46) compared with placebo VA. VA had a more beneficial impact for girls, children infected with helminths, and those from food secure households.

CONCLUSION

In a population where the prevalence of iron deficiency is low, intermittent iron supplementation did not have any or negative effect on the child's cognitive development outcomes. Conversely, VA supplementation improved the child's working memory.

TRIAL REGISTRATION NUMBER

The study is registered at clinicaltrials.gov as NCT04137354 (https://clinicaltrials.gov/study/NCT04137354).

Validation of the Austin Assessment: A screening tool for cerebral visual impairment related visual issues

Cerebral visual impairment is the most common cause of vision impairment affecting children in the economically developed world with a prevalence rate of approximately 3.4%. Currently there are limited options for screening for cerebral visual impairment, resulting in many children going undiagnosed, especially those that have normal visual acuity. The aim of this research was to validate an iPad App called the Austin Assessment, which was developed as a potential screening tool for cerebral visual impairment related visual issues. The research involved three separate phases: (1) creating a database of normative ranges for children aged 5-18 across the different variables of the Austin Assessment, (2) using the Austin Assessment to screen children aged 5-13 to assess the effectiveness of the Austin Assessment as a screening tool for CVI related visual issues, and (3) conducting specific validation research assessing children using the Austin Assessment and an already validated visual search tool. Each phase used different quantitative research methodologies to help show the effectiveness of the Austin Assessment as a screening tool for cerebral visual impairment related visual issues. From phase one of the research, thresholds were established for three variables of the Austin Assessment for the age groupings of 5-8, 9-12 and 13-18. If a child meets one of these thresholds this indicates further assessment is required to determine if they do in fact have cerebral visual impairment related visual issues. Phase two identified 17 children out of 270 who had clinical findings indicating visual issues; potentially indicative of CVI; investigation into the nature of these visual issues is ongoing. Phase three found that the Austin Assessment has moderate diagnostic value for each age group, with good sensitivity and specificity, making it effective at distinguishing those children who have visual issues from those who have typical vision. Further investigation is needed to confirm this initial validation.

Feasibility of a school-based mindfulness program for improving inhibitory skills in children with autism spectrum disorder

BACKGROUND

Executive dysfunction is prevalent in children with autism spectrum disorder (ASD), including prominent difficulties in the two facets of inhibition, as well as with selective attention. School-based mindfulness has been used in typically-developing children to improve executive functioning, though this has not been investigated in children with ASD. Therefore, the purpose of this study was to examine the efficacy of a school-based mindfulness program for improving inhibition (prepotent response inhibition and interference control) and selective attention in children with ASD.

METHOD

Using a quasi-experimental, pre-post design, an eight week school-based mindfulness program (Mindful Schools;https://www.mindfulschools.org/), was administered to students with ASD (n = 27) at a private, not-for-profit school for children with special needs. The Walk/Don't Walk test and the Color-Word Interference test were used to evaluate prepotent response inhibition and interference control, respectively. Selective attention was measured using a cancellation test.

RESULTS

Significant improvements followed the intervention for prepotent response inhibition and interference control (medium effect sizes), as well as for overall selective attention (large effect size).

CONCLUSIONS

The study's findings demonstrate that school-based mindfulness holds promise for increasing specific executive functioning abilities in children with ASD.

Immediate Effect of a Yoga Breathing Practice on Attention and Anxiety in Pre-Teen Children

Pre-teen children face stressors related to their transition from childhood to adolescence, with a simultaneous increase in academic pressure. The present study compared the immediate effects of 18 min of (i) high frequency yoga breathing with (ii) yoga-based breath awareness and (iii) sitting quietly, on (a) attention and (b) anxiety, in 61 pre-teen children (aged between 11 and 12 years; 25 girls). Attention was assessed using a six letter cancellation task and Spielberger’s State Trait Anxiety Inventory STAI-S was used to measure anxiety before and after the three practices, practiced on separate days. Repeated measures ANOVA, followed by Bonferroni adjusted post-hoc analyses showed an increase in total attempts and net scores after high frequency yoga breathing (p < 0.05), while wrong attempts increased after yoga based breath awareness (p < 0.05). Anxiety decreased comparably after all three interventions. The 25 girls in the group had the same trend of results as the whole group with respect to the attention-based cancellation task, while boys showed no, how since change. For both girls and boys, anxiety decreased after all three 18min interventions. The results suggest that high frequency yoga breathing could be a short, useful school based practice to improve attention and reduce anxiety.

Effect of Yoga on Immune Parameters, Cognitive Functions, and Quality of Life among HIV-Positive Children/Adolescents: A Pilot Study

Context:

HIV/AIDS individuals have problems relating to immune system, quality of life (QOL), and cognitive functions (CFs). Yoga is found to be useful in similar conditions. Hardly, any work is reported on yoga for HIV-positive adults/adolescents. Hence, this study is important.

Aim:

The aim of the study is to determine the effect of yoga on immune parameters, CFs, and QOL of HIV-positive children/adolescents.

Settings and Design:

Single-group, pre–post study with 4-month yoga intervention.

Methods:

The study had 18 children from an HIV/AIDS rehabilitation center for children/adolescents. CD4, CD8, CD4/CD8 ratio, and viral loads were studied. CF tests included six letter cancellation test, symbol digit modalities test, digit-span forward backward test, and Stroop tests. QOL was assessed using PedsQL-QOL and fatigue questionnaire. Depression was assessed using CDI2-SR.

Statistical Analysis Used:

t-test and Wilcoxon signed-rank tests, as applicable.

Results:

The study included 18 children/adolescents. There was improvement in general health of the participants. There was statistically significant increase in CD4 cells counts (p = 0.039) and significant decrease in viral load (p = 0.041). CD4/CD8 ratio moved to normal range. QOL significantly improved. CFs had mixed results with improved psychomotor performance (PP) and reduced executive functions.

Conclusions:

There was improvement in general health and immune parameters. While depression increased, QOL improved. CFs showed mixed results with improved PP and reduced executive functions.

Effect of Add-On Yoga on Cognitive Functions among Substance Abusers in a Residential Therapeutic Center: Randomized Comparative Study

Background

Chronic vulnerability characterizes substance abuse disorder with consequent relapse. The process of abstinence depends on cognitive recovery. Hence, behavioral intervention should account for cognitive dimension of substance abusers. Recent studies highlight yoga-based intervention as a promising add-on therapy for treating and preventing addictive behaviors.

Purpose

The study aimed to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing cognitive functions, compared with physical exercise to newly admitted substance abusers seeking an inpatient treatment program.

Methods

The study was a single-blind, randomized, comparative design that included 96 male participants, between 18 and 40 years in a residential rehabilitation treatment unit. Partakers in the yoga or physical exercise group received supervised daily training for 12 weeks, in addition to standard rehabilitation treatment. Raters blind to the study assessed the patients on digit span task, cancellation test, and Stroop tests at the baseline and following 12 weeks of intervention.

Results

A significant enhancement in digit forward (yoga - p < 0.0005, d = 0.81; exercise - p < 0.0005, d = 0.73), digit backward (yoga - p < 0.0005, d = 0.88; exercise - p < 0.0005, d = 0.58), and letter cancellation test scores (yoga - p < 0.0005, d = 1.31; exercise - p < 0.0005, d = 1.4) were observed in both the yoga and the exercise groups. Stroop word and color task scores were seen significantly higher following yoga (p < 0.005, d = 0.74; p < 0.005, d = 1.13) and exercise (p < 0.0005, d = 0.62; p < 0.0005, d = 0.61). Furthermore, Stroop color-word test showed significant enhancement after yoga (p < 0.0005, d = 1.10) and exercise (p < 0.0005, d = 0.42), with degree of variation higher in the yoga group.

Conclusion

Our results suggest that the add-on yoga or exercise-based intervention show enhancement of cognitive functions. These findings provide the utility of yoga and exercise-based intervention in improving cognitive functions among substance abusers. Furthermore, rigorous trials are needed to explore the potential long-term effects of these procedures.

Novice Readers: The Role of Focused, Selective, Distributed and Alternating Attention at the First Year of the Academic Curriculum

The ability to read depends on different cognitive skills. This study investigated the role of the main components of attention (selective attention, focused attention, distributed attention, and alternating attention) on the different dimensions of reading skills in novice readers. Participants were 288 Italian children, who attended the first year of primary school. Attention and reading skills (reading "comprehension," "accuracy," and "speed") were measured. Different components of attention influence each dimension of reading. Moreover, both the correctness and rapidity at which attention operates play a pivotal role in learning to read. Interestingly, selective attention is involved in all dimensions of reading. These findings may have educational and practical relevance. The early assessment of attention might favor the development of new strategies of intervention in dyslexic children and in children at risk of developing learning difficulties.

Influence of Yoga-Based Personality Development Program on Psychomotor Performance and Self-efficacy in School Children

Selective attention and efficacy are important components of scholastic performance in school children. While attempts are being made to introduce new methods to improve academic performance either as part of curricular or extracurricular activities in schools, the success rates are minimal. Hence, this study assessed the effect of yoga-based intervention on psychomotor performance and self-efficacy in school children. Two hundred ten school children with ages ranging from 11 to 16 years (mean age ± SD; 13.7 ± 0.8 years) satisfying the inclusion and exclusion criteria were recruited for the 10-day yogä program. An equal number of age-matched participants (n = 210; mean ± SD; 13.1 ± 0.8 years) were selected for the control group. Participants were assessed for attention and performance at the beginning and end of 10 days using trail making task (TMT) A and B, and self-efficacy questionnaire. The yoga group showed higher self-efficacy and improved performance after 10 days of yoga intervention. The performance in TMT-A and -B of the yoga group showed a significantly higher number of attempts with a reduction in time taken to complete the task and a number of wrong attempts compared with control group. Results suggest that yoga practice enhances self-efficacy and processing speed with fine motor coordination, visual-motor integration, visual perception, planning ability, and cognitive performance.

Effect of Structured and Unstructured Physical Activity Training on Cognitive Functions in Adolescents - A Randomized Control Trial

BACKGROUND

Regular physical activity in children and adolescents promotes not only their physical health but also improves their cognition. Paper and pencil Neurocognitive tests (NCT) are commonly used to assess the various cognitive domains of a person and can be used as simple tests to assess improvements, if any, in the cognitive abilities of growing adolescents who practice regular physical activity.

AIM

To study the effect of six months of structured and unstructured physical activity on cognitive functions in adolescents.

MATERIALS AND METHODS

We recruited 439 healthy adolescent volunteers in the age group of 12 to 17 years (boys 250, girls 189) from a residential school (Jawahar Navodaya Vidyalaya, Pondicherry). The following paper and pencil neuropsychological cognitive tests were administered: Two Target Letter Cancellation test, Trail Making test A and B, Ruff Figural Fluency test (RFFT). These participants were then divided into Structured Physical Activity (SPA: n=219; boys 117, girls 102) and Unstructured Physical Activity (USPA: n=220; boys 119, girls 101) groups based on age and gender block randomization method. Six-month intervention was successfully completed by 347 participants only (SPA group: n= 136; boys 77, girls 59; USPA group: n = 139; boys 75, girls 64) and the tests were repeated.

STATISTICAL ANALYSIS

The data were recorded and statistically analysed by per-protocol analysis method, using the Statistical Package for Social Sciences (SPSS), version 19.

RESULTS

After six months of intervention, both SPA and USPA group participants showed significant improvements in all the tested neurocognitive parameters. On inter-group comparison, participants in SPA group showed significantly better improvements.

CONCLUSION

Physical activity training in adolescents is more beneficial when structured as per WHO guidelines, probably due to higher cognitive loading.

Study the effect of age and gender related differences on common paper and pencil neurocognitive tests in adolescents

BACKGROUND

Neurocognitive tests are routinely used to assess cognitive domains in the adolescents for assessing cognitive deficits and for therapeutic interventions. Now they are being used to assess their mental abilities in athletics too.

AIM

To study the effect of age and gender differences on routinely used common paper and pencil neuro-cognitive tests in adolescents and present the trends of normative data of Indian adolescent population.

SETTINGS AND DESIGN

Present study was conducted as a joint collaboration between Department of Physiology and Jawahar Navodaya school, Puducherry, India.

MATERIALS AND METHODS

Four hundred and thirty nine adolescents in the age group of 12 to 17 y (M = 250, F= 189) were selected in the present study after meeting the inclusion and exclusion criteria. Subjects were administered commonly used paper and pencil neuropsychological tests in the following order: Two Target Letter Cancellation test, Trail Making test A and B, Ruff Figural Fluency test (RFFT).

STATISTICAL ANALYSIS

We divided the students based on their age into six groups - from age 12-17. Neurocognitive parameters were compared between these age groups using one-way-ANOVA with Bonferroni post-hoc test. Only the p-values for one, two and three year difference were considered. The same analysis was repeated for each gender separately. We compared males and females from the entire sample using unpaired t test. We then repeated the same test to compare males and females in each age group separately. Pearsons correlation was done to find correlation between the neurocognitive test parameters using the entire sample size. Then the correlation was done again after adjusting for age. All the statistical analysis was done using Statistical package for social sciences (SPSS) version 19.

RESULTS

Year wise normative data has been presented for all the age groups from 12 y onwards to 17 y. The results showed a consistent improvement in performance on the tested neuro-psychological tests with increasing age in adolescents. Overall gender comparison showed significantly better RFFT performance in males than females, with a non-significant difference in other tested parameters. However, no such difference was observed when the comparison was made within each age group.

CONCLUSION

Improvement in the tests as a function of age may represent ongoing neuro-maturational process. Overall gender comparison from 12 to 17 y demonstrates that males performed better on nonverbal fluency task and strategic analysis suggesting difference in cognitive growth patterns but changes are so slow and gradual that no significant difference was observed at each intra-age group gender comparison. Baseline testing should be at least repeated once in two years.