Association between ADHD symptoms and inhibition-related brain activity using functional near-infrared spectroscopy (fNIRS)

Attention deficit hyperactivity disorder (ADHD) is associated with deficits in inhibitory functions including interference control, inhibition of prepotent/automatic responses and suppression of already initiated responses. This study used functional near-infrared spectroscopy (fNIRS) to investigate the neural basis of these three forms of inhibition assessed by a recently developed behavioral protocol combining the Stroop-matching/stop-signal task in twenty-five young adults with inattention, impulsivity and/or hyperactivity symptoms. The severity of ADHD symptoms was measured using the Adult ADHD Self-Report Scale (ASRS). The concentration of oxygenated hemoglobin (HbO) was assessed in the dorsolateral prefrontal cortex (DLPFC), inferior frontal gyrus (IFG) and temporoparietal regions (TP) during the Stroop-matching/stop-signal task. Correlations yielded significant associations between ASRS scores and HbO concentration in frontal regions during blocks with stop-signal tasks, namely the right IFG, the left DLPFC and the left IFG. This study revealed that different types of inhibition involve unique frontal and temporoparietal activities and linked frontal dysfunction during the suppression of ongoing responses to the severity of ADHD symptoms.

Evidências de Validade do Teste Informatizado para Avaliação das Funções Executivas

Resumo Funções executivas (FE) referem-se ao conjunto de habilidades que, de forma integrada, coordenam o comportamento e a cognição. Assim, o comprometimento no desenvolvimento das FE está ligado a vários desfechos negativos ao longo da vida. Portanto, a avaliação dessas habilidades na infância é essencial para identificar e prevenir prejuízos na vida adulta. Este estudo teve como objetivo investigar evidências de validade do Teste Informatizado para Avaliação das Funções Executivas (Tafe) pelo critério de idade e pelo padrão de correlação entre medidas do TAFE e outras medidas de FE. Para isso, foi utilizada uma amostra de 51 crianças, entre 4 e 10 anos de idade, matriculadas em uma escola privada na cidade de Goiânia (GO), da pré-escola ao 4º ano do ensino fundamental. Como instrumentos, foram utilizados, além do Tafe, as tarefas de Bloco de Corsi, Teste de Trilhas A e B, Teste de Trilhas Pré-Escolares, Teste de Stroop Pré-Escolares e Subteste Dígitos da Escala Wechsler de Inteligência. Foram conduzidas análises estatísticas Kruskal Wallis para verificar a evidência de validade por relação com idade e análises de correlação não paramétrica de Spearman para avaliar as evidências de validade convergente. O instrumento investigado mostrou-se efetivo para discriminar entre as diferentes faixas etárias, assim, sensível ao desenvolvimento das FE. Os resultados obtidos no Tafe correlacionaram-se aos obtidos em outros testes que também avaliaram FE, mostrando claros padrões de convergência. Logo, as análises dos resultados fornecem evidências de validade ao Tafe, derivadas a partir de diferentes estratégias de investigação.

Análise da inteligibilidade dos textos narrativo e expositivo do Teste Cloze de Compreensão de Leitura

A leitura é uma habilidade fundamental em uma sociedade alfabetizada, sendo essencial também para o desenvolvimento acadêmico. No entanto, no Brasil, os alunos apresentam desempenho em leitura abaixo do esperado, o que torna essencial dispor de instrumentos para avaliar essa competência e planejar ações nesta área. Além dos fatores cognitivos e individuais, questões inerentes ao texto, como gênero e estrutura, também influenciam na leitura. Assim, o objetivo deste estudo foi analisar as características das palavras, a estrutura sintática e os elementos referentes a coesão do Teste Cloze de Compreensão de Leitura (TCCL), comparando suas duas partes, TCCL-N (texto narrativo) e TCCL-E (texto expositivo), por meio do software Coh-Metrix. Os resultados mostram que o TCCL-E é ligeiramente mais complexo que o TCC-N, como sustentado pela literatura, mas também reforçam a necessidade de se considerar os aspectos do leitor a fim de definir a dificuldade do texto.

Executive Functions in the Prediction of Academic Performance in Elementary Education

Abstract The study investigated predictive models of reading and arithmetic based on performance and functional measures of executive functions (EF’s). Ninety-four children (mean age = 6.14y) were evaluated through EF performance tests. Parents and teachers responded to a functional measure of EF. Two years later, children’s reading and arithmetic were evaluated. There were low correlations between EF and later academic performance. For the reading model, inhibition was a relevant variable, with no gain in the prediction with the joint consideration of different EF measures. For arithmetic, attention and delay aversion presented a relevant contribution. When functional measure was considered, the model’s prediction increased. The study indicated skills of interest in identifying children at risk of poor academic performance.

Development of a Program based on Goal Management Training for Adolescents with Executive Dysfunctions Complaints

This study aimed to develop a program based on Goal Management Training (GMT) and to investigate its effectiveness on executive functions, through formal instruments and an ecological task. Participants were 25 adolescents with complaints of executive dysfunctions. They underwent neuropsychological assessment of working memory, inhibitory control, cognitive flexibility, planning, and intellectual ability. Participants also took part in a cooking activity and were evaluated for errors per action, of omission, activity performance time, recipe consultation. After, they were randomly allocated to an active control group (CG), which underwent psychoeducation sessions, and an experimental group (EG), stimulated through GMT in eight sessions. Then participants underwent another assessment and follow-up after 4 weeks. In post-intervention analyses, results showed an improvement in executive functions in EG, in the working memory measurement and time of the ecological activity (g = 1.78 and .93, respectively), IQ (g = -1.01), reasoning (g = -.89), flexibility (g = -1.21), and inhibition (g = -3.11). In follow-up evaluation, large-size effects were observed on flexibility (g = -2.95), inhibition (g = -5.78) and execution time of the ecological activity (g = .98). Significant interactions between assessment Time x Group revealed EG gains in IQ, scores in reasoning and flexibility. EG also had longer execution time in flexibility and inhibition tests. That is, EG had greater scores and probably was less impulsive in these tests. Furthermore, EG decreased the number of verifications and the time in the ecological task, that is, had a more efficient performance. Results suggest the intervention can be as instrument to promote executive function.

Development and Content Validity of IFERA-II for Adults

Abstract Considering the importance of the functional assessment, a scale was developed to evaluate Executive Functions (EFs), State Regulation (SR) and Delay Aversion (DA) in adults, based on a children’s scale, and evidence of content validity was investigated. In Phase 1, items from the children’s version were adapted to generate the Inventory of Difficulties in Executive Functions, Regulation and Delay Aversion for Adults (IFERA-II), with 28 items of EFs (inhibition, working memory and flexibility), RS and DA. Analysis by judges verified the representativeness of the contents of the items. After adaptations, 18 adult participants responded to the IFERA-II and were interviewed regarding comprehension, need for examples and clarity of vocabulary. A new revision led to the preliminary version of the IFERA-II, the psychometric properties of which should be investigated.

Mental Health, Cognition and Academic Performance in the 1st Year of Elementary Education

Abstract The study investigated 1) relationships and explanatory models of mental health indicators from cognitive abilities and 2) relationships between mental health indicators and academic performance one year later. Participants were 86 children, students of the 1st year of Elementary Education, evaluated in intelligence, inhibitory control (IC) and language. Parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ). One year later, the children were re-evaluated in word recognition (WR) and arithmetic. The IC measures were related and could explain up to 21.9% of the variance in the SDQ indices completed by parents and teachers. The SDQ indices completed by teachers were related to WR and arithmetic performances, predicting up to 16.3% of the variance in school performance measures the following year. There was no IC mediation effect on the models generated. The findings suggest an interaction between specific cognitive skills, mental health indicators and academic performance.

Prediction of Reading and Writing in Elementary Education through Early Childhood Education

Abstract The study investigated the predictive role of executive functions, language, initial reading and writing abilities, teacher’s perception of the students’ difficulties and family characteristics, evaluated in Early Childhood Education (ECE) (Jardim I and Jardim II), in relation to reading and writing performance in the first year of Elementary Education. A total of 71 children were monitored in a longitudinal manner from ECE up to the first year, and evaluated in Oral Language (OL), Executive Functions (EF), initial Reading and Writing skills in ECE and, in the first year, evaluated by means of Reading and Writing tests. Parents provided information on socioeconomic status (SES) and teachers indicated children with difficulties. After the data imputation process, regression tree analysis showed that OL skills and initials skills of reading and writing in ECE explained a mean of 43% of the reading variability in the first year. For writing, the models also included performances in EF, income, father’s age and indication of difficulty by the teacher in ECE, explaining a mean of 78% of the variability in writing in the first year. The results allowed identifying abilities and variables that can be considered precursors of subsequent performances in Elementary Education, providing guidance for actions of early identification and intervention.

Construção e validação de instrumento para avaliar conhecimentos de universitários sobre transtorno específico da aprendizagem

O Transtorno Específico da Aprendizagem (TEAp) caracteriza-se por dificuldades persistentes para desenvolver habilidades acadêmicas de leitura, escrita e/ou matemática, sendo fundamental que professores conheçam suas características. O estudo teve como objetivos construir um questionário que avalia conhecimentos sobre TEAp e verificar suas propriedades psicométricas, mediante estudo piloto com estudantes de pedagogia ingressantes e concluintes. Participaram 178 estudantes, entre 18 e 54 anos, de três instituições de ensino superior particulares. Resultados revelaram índice adequado de consistência interna (Alfa de Cronbach = 0,738). Houve maior conhecimento sobre TEAp dos estudantes concluintes em relação aos ingressantes, porém com resultados baixos em alguns itens. Também houve diferença significativa entre as instituições. Não houve associação dos fatores idade, ano, renda e situação de trabalho, com o nível de conhecimento. Além de contribuir com a criação do questionário, os resultados sinalizam a necessidade de incluir disciplinas sobre TEAp na grade curricular dos cursos de pedagogia.

Program for the Neuropsychological Stimulation of Cognition in Students: Impact, Effectiveness, and Transfer Effects on Student Cognitive Performance

Despite the crucial role played by the executive functions (EF) to cognitive, emotional, and social development of children before and during school years, little attention has been given to construct and analyze the efficacy of programs that intend to develop them. The program of neuropsychological stimulation of cognition in students: emphasis on EF, or PENcE (an acronym from its original name in Portuguese, Programa de Estimulação Neuropsicológica da Cognição em Escolares: ênfase nas Funções Executivas), is an early and preventive intervention program for school-aged children, and implemented at school three times a week for 5 months. The PENcE was structured in four modules, each focusing on a different executive component: organization and planning, inhibitory control, working memory, and cognitive flexibility. The objectives of this study were to verify the effectiveness of the PENcE among elementary school children and to investigate whether there are transfer effects to other executive, cognitive, and academic abilities. The sample consisted of 113 children attending 3rd or 4th grade at two public elementary schools. Eight classes participated in the study, divided into two groups: an experimental group (EG) (four classes; n = 64), which received the intervention, and a control group (CG) (four classes; n = 49), which continued their regular school activities. The EF and academic skills of both participant groups were evaluated before and after the intervention. The EG showed significantly greater improvements in inhibitory control, working memory, and abstract planning relative to the CG, with a small to medium effect size. There were transfer effects to other cognitive and academic abilities. These findings suggest the PENcE may be a useful method of improving EF and could benefit both school-aged children and education professionals.

Phonological awareness and early reading and writing abilities in early childhood education: preliminary normative data

ABSTRACT Objective: to provide preliminary normative data for the Reading and Writing Test by type of school, and normative data for the Phonological Awareness Test by Oral Production for private schools and update their normative data available for public schools, all of which are for children in the final year of early childhood education. Methods: 267 children, in the age range of 5 years, and typical development. Identification Questionnaire for Parents, Phonological Awareness Test by Oral Production and Reading and Writing Test were used. The means of performance in the tests of the present sample were compared with the existing normative data to justify normative data provision and updating. Results: Student’s t-test revealed that the private school children outperformed those of the public schools in all measures, reinforcing the need for specific standards, according to the type of school. There were strong to very strong relationships among the variables evaluated, demonstrating a marked association between phonological awareness and initial reading and writing abilities. The Wilcoxon test revealed significant differences between the performance of the children of the present study, from both private and public schools, and the data from the Phonological Awareness Test by Oral Production standardization sample, suggesting the need to update the Phonological Awareness Test by Oral Production standards. Finally, the new normative data were presented. Conclusion: the need to make available and update the test standards used, according to the type of school, was confirmed. Further studies are necessary to expand the data presented to other age groups.

Microcephaly and other Zika virus related events: the impact on children, families and health teams

The present study aimed to present an overview of recent national and international research on the Zika virus (ZIKV), as well as to explore possible action plans focused on children, their families and the health teams involved.Therefore, the study proposes the implementation of tracking systems in order to identify, describe and characterize the potential correlates of prenatal exposure to ZIKV, divided into three lines of action: 1. Diagnostic and etiological evaluation as well as screening of developmental problems in children confirmed or suspected of prenatal ZIKV infection. 2. Investigation of the emotional impact, quality of life, coping strategies and support network of the affected children and their families. 3. Training of multidisciplinary teams to conduct assessments and intervention programs throughout these children's development, especially in the first three years of life. In conclusion, the recent ZIKV outbreak in Brazil and several other Latin American countries places a significant burden on the health care systems: to understand the real meaning of a potential new teratogen; to unravel the pathogenic mechanisms of ZIKV, particularly in a prevention perspective; and to recognize the broad spectrum of clinical manifestations in order to devise intervention programs.

Program of neuropsychological stimulation of cognition in students: Emphasis on executive functions - development and evidence of content validity

Objective

The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF) in Elementary School children within the school environment.

Methods

The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI) was calculated.

Results

Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process.

Conclusion

The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.

Childhood Executive Functioning Inventory: Adaptação e Propriedades Psicométricas da Versão Brasileira

Resumo O objetivo do estudo foi traduzir, adaptar e investigar propriedades psicométricas da Childhood Executive Functioning Inventory (CHEXI) em uma amostra de crianças brasileiras. Após tradução, adaptação transcultural, retrotradução e equivalência semântica, realizada por juízes da área, a versão brasileira da CHEXI foi respondida por pais e professores de 408 crianças, idades entre 4 e 7 anos, também avaliadas com a Escala de Maturidade Mental Colúmbia e SNAP-IV. Elevados índices de consistência interna foram encontrados. A análise fatorial exploratória gerou dois fatores para a versão brasileira: um fator mais geral de funções executivas e um específico de inibição. As pontuações nas subescalas de planejamento, regulação e, marginalmente, memória de trabalho da CHEXI explicaram de modo significativo o indicador de desatenção da SNAP-IV, enquanto a pontuação na subescala de inibição explicou o indicador de hiperatividade/impulsividade. Os resultados fornecem bons parâmetros psicométricos para a CHEXI, além de contribuir para a realização de estudos com funções executivas e indicadores de TDAH no país.

Relacionamento entre Filhos e Pais não Residentes, Representação de Apego e Desempenho de Escrita

Considerando que o apego interfere no desenvolvimento cognitivo pesquisou-se a relação entre filhos epais não residentes, representação de apego, desempenho em escrita. Participaram 43 estudantes doEnsino Fundamental que não residiam com o pai. Utilizou-se para a coleta de dados: teste do desenho dafamília e avaliação das dificuldades de aprendizagem na escrita.Os resultados revelaram que o aumentodos sinais ansiosos/ inseguros correspondeu ao maior número de erros na escrita; quanto menor o tempode não residência pai/filho, maior o número de erros na escrita. Os participantes que se relacionam com opai tiveram melhor desempenho na escrita. Conclui-se que, tanto a representação de apego quanto arelação entre filhos e pais não residentes influenciam o desempenho na escrita.

Avaliação da consciência fonológica na síndrome de Williams

Resumo: OBJETIVOS: avaliar o desempenho de crianças e adolescentes com Síndrome de Williams em tarefas de consciência fonológica e analisar esse desempenho em função da idade, escolaridade e indicadores de habilidade intelectual. MÉTODOS: vinte e duas crianças e adolescentes (11 meninos e 11 meninas) com idades entre 7 e 18 anos realizaram os subtestes cubos e vocabulário das Escala Wechsler de Inteligência para estimativa de habilidades intelectuais e responderam a Prova de Consciência Fonológica por produção oral. RESULTADOS: os participantes obtiveram valores do quociente de inteligência estimado compatível com rebaixamento intelectual. Nas habilidades de consciência fonológica os resultados mostraram que os participantes com a síndrome obtiveram desempenho rebaixado em nove dos dez subtestes da prova de consciência fonológica em relação à pontuação padronizada em função da idade, assim como do nível escolar. Não foram encontradas correlações significantes entre consciência fonológica, indicadores de habilidade intelectual, idade e escolaridade. CONCLUSÃO: os resultados corroboram os encontrados em pesquisas internacionais sugerindo rebaixamento em consciência fonológica na Síndrome de Williams. Dada a relevância desses achados é necessário incluir programas de estimulação contínua, inclusive com intervenções precoces dirigidas a crianças com Síndrome de Williams em idade pré-escolar, adequação de métodos de ensino e de currículo adaptado.

Intervention for executive functions in attention deficit and hyperactivity disorder

This study aimed to investigate if an executive functions (EF) intervention could promote these skills in individuals with attention deficit and hyperactivity disorder (ADHD). Eighteen children and adolescents, 7-13 years old, divided into experimental (EG, N = 8) and control (CG, N = 10) groups, were assessed in the Block Design and Vocabulary subtests of the WISC III and seven tests of EF. Parents answered two scales, measuring EF and inattention and hyperactivity signs. EG children participated in a program to promote EF in twice-weekly group sessions of one hour each. After 8 months of intervention, groups were assessed again. ANCOVA, controlling for age, intelligence quotient and pretest performance, revealed gains in attention/inhibition and auditory working memory measures for the EG. No effect was found for scales or measures of more complex EF. Results are not conclusive, but they illustrate some promising data about EF interventions in children and adolescents with ADHD.

The FAS fluency test in Brazilian children and teenagers: executive demands and the effects of age and gender

The FAS Verbal Fluency Test is widely used in neuropsychological clinical services and research. This study investigated the contributions of different executive functions, age and gender to FAS test performance in a sample of children and teenagers divided into two groups: G1 comprised 263 children aged 6-10 years, and G2 comprised 150 teenagers aged 10-14 years. All participants were assessed using the Cancellation Attention Test, the Auditory Working Memory Test, the Visual Working Memory Test, the Semantic Generation Test, and the Trail Making Test, in addition to the FAS test. For G1, age, auditory working memory and shifting were predictors of FAS performance. For G2, gender, auditory working memory, shifting and inhibition comprised the FAS explanatory model. The study contributed to our understanding of which are the best predictor variables for the FAS test in a Brazilian sample and how executive demands change with age.

Translation, adaptation, and preliminary validation of the Brazilian version of the Behavior Problems Inventory (BPI-01)

Introduction: Children with atypical development often present behavior problems that impair their psychosocial adaptation. Objective: To describe the cultural adaptation to Brazilian Portuguese of the Behavior Problems Inventory (BPI-01), as well as preliminary indicators of instrument reliability and validity. Methods: The process involved translation, back-translation, and cultural adaptation of the instrument. Psychometric properties (reliability and validity) were assessed comparing scores obtained with the BPI-01, the Wechsler Intelligence Scales for Children and Adults, the Child Behavior Checklist for Ages 6-18 (CBCL/6-18), and the Autism Screening Questionnaire (ASQ). The sample comprised 60 children (30 typically developing and 30 atypically developing). Results: The cultural adaptation process was considered adequate. Internal consistency of the BPI-01 was satisfactory, with a Cronbach's alpha of 0.65 for the self-injurious behavior scale, 0.82 for stereotyped behaviors, and 0.91 for aggressive/destructive behaviors. Considering a mean frequency of 0.5, the receiver operating characteristic (ROC) curve revealed 80% sensitivity and 3% specificity in the stereotyped behavior scale, 50 and 10% in aggressive/destructive behaviors, and 76 and 6% in self-injurious behaviors, respectively. Low-to-moderate correlations were observed between BPI-01, ASQ, and CBCL/6-18 scores. Conclusion: BPI-01 showed good psychometric properties, with satisfactory preliminary indicators of reliability, convergent validity, and sensitivity for the diagnosis of atypical development.

Estudo fatorial dos componentes da leitura: velocidade, compreensão e reconhecimento de palavras

Modelos de processamento de informação têm identificado diferentes processos envolvidos na leitura, incluindo reconhecimento de palavras, compreensão e velocidade, podendo o reconhecimento ocorrer por três diferentes estratégias, logográfica, alfabética e ortográfica. De modo a identificar tais componentes na leitura, foram avaliados 443 estudantes da 1ª à 4ª série do ensino fundamental, em testes de reconhecimento de palavras, compreensão oral/auditiva, compreensão de leitura, processamento ortográfico e velocidade de leitura. Foi conduzida análise fatorial por componentes principais e rotação oblimin, derivando quatro fatores. O fator 1 incluiu reconhecimento de palavras familiares e compreensão linguística oral e escrita; o fator 2 compreendeu as estratégias logográfica e alfabética de reconhecimento de palavras; o fator 3, a estratégia ortográfica; e o fator 4 referiu-se à velocidade leitora. Os achados, bastante próximos ao esperado teoricamente, podem auxiliar na compreensão dos processos cognitivos envolvidos na leitura de crianças no início do ensino fundamental.