A survey of the perceptions and practices of faculty in clinical neuropsychology doctoral training programs: is heterogeneity the norm?

Objective: Doctoral education is a cornerstone in the training of clinical neuropsychologists. However, we know little about perceptions, practices, and needs of the faculty who oversee doctoral training in clinical neuropsychology (CN). Method: Seventy-one faculty from 45 doctoral programs providing CN training completed at least part of a survey assessing characteristics of their programs, current training practices and views, and challenges to CN doctoral training. Results: Over half of CN faculty reported having zero or only one CN colleague. CN faculty reported that the goals of CN doctoral training are research training, clinical training, and acquisition of knowledge and skills reflected in the Houston Conference Guidelines (HCG). CN faculty reported that doctoral trainees obtain more clinical hours than faculty would like and endorsed alternative clinical metrics, including competency-based ratings. CN faculty are divided about the benefits of a required two-year postdoctoral CN fellowship. Conclusions: The HCG states that specialization in CN begins at the doctoral level. CN faculty in doctoral programs are fully immersed in the early development and education of future CN researchers and practitioners. Tensions between clinical and research training in CN at the doctoral level-and student overemphasis on accruing clinical hours-might place CN at risk for failing to make research innovations necessary for our field to evolve and thrive. More CN doctoral faculty are needed to serve as mentors to students, especially for students from backgrounds that have been historically excluded and marginalized. A greater voice from CN doctoral faculty in CN governance is needed.

An Evaluation of the Structure of Attention in Adolescence

This study evaluated the factor structure of attention, considering internal and external attention, and juxtaposed alongside processing speed (PS) and working memory (WM). We expected the hypothesized model to fit better than unitary or method factors. We included 27 measures with 212 Hispanic middle schoolers from Spanish-speaking backgrounds, where a substantial proportion were at risk for learning difficulties. Confirmatory factor analytic models separated factors of PS and WM, but the final model did not align with theoretical predictions; rather only measurement factors emerged. Findings extend and refine our understanding of the structure of attention in adolescents.

PROPERTIES OF A COMBINED MEASURE OF READING AND WRITING: THE ASSESSMENT OF WRITING, SELF-MONITORING, AND READING (AWSM READER)

There is significant overlap between reading and writing, but no known standardized measure assesses these jointly. The goal of the present study is to evaluate the properties of a novel measure, the Assessment of Writing, Self-Monitoring, and Reading (AWSM Reader), that simultaneously evaluates both reading comprehension and writing. In doing so, we evaluate reliability (Cronbach's alpha) and various aspects of construct-related validity, including separate criterion measures of reading and writing, and the AWSM Reader's relations with other variables, including language and executive function (EF), both of which are implicated for both reading and writing. Participants were 377 3rd, 4th, and 5th graders with or at-risk for reading and writing difficulties. Reliability was low for the AWSM Reader reading comprehension (α = .58), but good for writing (α = .75-.80). Criterion-related validity indices revealed moderate correlations with other standardized and commonly used reading and writing measures, r = .47 to .50 (all ps < .001). Additionally, validity data supported the relations of both language and EF to AWSM Reader reading and writing, with EF showing unique prediction in both reading and writing domains. Results provide initial support for the measure per se but stress the difficulty in constructing combined reading and writing measures; directions are given for future work. Results also add to data on the contributions of language and EF to both reading and writing.

Characterization of English and Spanish language proficiency among middle school English learners with reading difficulties

Among bilinguals, language-related variables such as first and second language proficiency and balance may be related to important cognitive and academic outcomes, but approaches to characterizing these variables are inconsistent, particularly among at-risk samples of children. The current study employed comprehensive language assessment of English and Spanish language skills and contrasted various approaches to the characterization of language among at-risk ELs in middle school (N = 161). Specifically, we contrasted variable-centered and person-centered approaches, and convergence between objective and self-report measures. Findings support a two-factor structure of English and Spanish language skills in this population, three profiles of students (balanced, moderately unbalanced-higher Spanish, and very unbalanced-higher English), convergence between variable-centered and person-centered approaches, and mixed support for subjective indices of usage. Results provide a foundation from which to examine the roles of L1 and L2 proficiency as well as balance in important cognitive and academic outcomes in this at-risk and understudied population.

Cognitive predictors of social adjustment in pediatric brain tumor survivors treated with photon versus proton radiation therapy

BACKGROUND

Pediatric brain tumor survivors are at risk for poor social outcomes. It remains unknown whether cognitive sparing with proton radiotherapy (PRT) supports better social outcomes relative to photon radiotherapy (XRT). We hypothesized that survivors treated with PRT would outperform those treated with XRT on measures of cognitive and social outcomes. Further, we hypothesized that cognitive performance would predict survivor social outcomes.

PROCEDURE

Survivors who underwent PRT (n = 38) or XRT (n = 20) participated in a neurocognitive evaluation >1 year post radiotherapy. Group differences in cognitive and social functioning were assessed using analysis of covariance (ANCOVA). Regression analyses examined predictors of peer relations and social skills.

RESULTS

Age at evaluation, radiation dose, tumor diameter, and sex did not differ between groups (all p > .05). XRT participants were younger at diagnosis (XRT M = 5.0 years, PRT M = 7.6 years) and further out from radiotherapy (XRT M = 8.7 years, PRT M = 4.6 years). The XRT group performed worse than the PRT group on measures of processing speed (p = .01) and verbal memory (p < .01); however, social outcomes did not differ by radiation type. The proportion of survivors with impairment in peer relations and social skills exceeded expectation; χ² (1) = 38.67, p < .001; χ² (1) = 5.63, p < .05. Household poverty predicted peer relation difficulties (t = 2.18, p < .05), and verbal memory approached significance (t = -1.99, p = .05). Tumor diameter predicted social skills (t = -2.07, p < .05).

CONCLUSIONS

Regardless of radiation modality, survivors are at risk for social challenges. Deficits in verbal memory may place survivors at particular risk. Results support monitoring of cognitive and social functioning throughout survivorship, as well as consideration of sociodemographic risk factors.

Visual attention and reading: A test of their relation across paradigms

Relations of visual attention to reading have long been hypothesized; however, findings in this literature are quite mixed. These relations have been investigated using several different visual attention paradigms and with variable controls for other competing reading-related processes. We extended current knowledge by evaluating four of the key visual attention paradigms used in this research-visual attention span, attention blink, visual search, and visuospatial attention-in a single study. We tested the relations of these to reading in 90 middle schoolers at high risk for reading difficulties while considering their effect in the context of known language predictors. Performance on visual-spatial, visual search, and attentional blink paradigms showed weak nonsignificant relations to reading. Visual attention span tasks showed robust relations to reading even when controlling for language, but only when stimuli were alphanumeric. Although further exploration of visual attention in relation to reading may be warranted, the robustness of this relationship appears to be questionable, particularly beyond methodological factors associated with the measurement of visual attention. Findings extend and refine our understanding of the contribution of attention to reading skill and raise questions about the mechanism by which visual attention is purported to affect reading.

The Not-So-Simple View of Writing in Struggling Readers/Writers

Research suggests that executive function, motivation, transcription, and composition processes are implicated in the writing quality and productivity of children with and without learning difficulties. However, numerous components embedded within these constructs create both conceptual and empirical challenges to the study of written expression. These challenges are reflected in the writing research by way of poor delineation of constructs and insufficient distinction among domain general resources (e.g. working memory) versus processes related to the academic domain of writing (e.g. pre-planning), as well as among lower- (e.g. handwriting) and higher-order (e.g. editing) writing-specific processes. The current study utilizes the Not-so-Simple View of Writing (NSVW) as an organizing framework for examining the relations among multiple components, correlates, and attributes of writing in a sample of struggling readers/writers (n = 402) in grades 3-5. Data were collected on measures of (a) handwriting, spelling, planning, revision, and editing, derived from the Test of Oral Written Language (TOWL-4), (b) executive function derived from the NIH Examiner, and (c) motivation/self-efficacy derived from the Student Contextual Learning Scale. Structural equation modeling was utilized to test direct and indirect relations in the NSVW model. Results showed generally moderate correlations among observed/latent variables and found support for relations among writing-specific processes. Domain-general resources (executive function and motivation/self-efficacy) were related to spelling directly and indirectly to writing. Domain-specific processes (handwriting, spelling, planning, editing, and revision) were related to writing. The results have implications for explicit instruction of writing processes and for future research on empirical models.

Long-term cognitive and academic outcomes among pediatric brain tumor survivors treated with proton versus photon radiotherapy

BACKGROUND

Proton radiotherapy (PRT) may be associated with less neurocognitive risk than photon RT (XRT) for pediatric brain tumor survivors. We compared neurocognitive and academic outcomes in long-term survivors treated with XRT versus PRT.

METHODS

Survivors underwent neurocognitive evaluation >1 year after craniospinal (CSI) or focal PRT or XRT. Groups were compared using separate one-way analyses of covariance for the CSI and focal groups.

RESULTS

PRT (n = 58) and XRT (n = 30) subgroups were similar on gender (66% male), age at RT (median = 6.5 years), age at follow-up (median = 14.6 years), and government assistance status (32%). PRT and XRT focal groups differed on follow-up interval, shunt history, and total RT dose (all p < .05), whereas PRT and XRT CSI groups differed on follow-up interval, baseline neurocognitive performance score, boost volume, and CSI dose (all p < .05). The PRT focal group outperformed the XRT focal group on inhibition/switching (p = .04). The PRT CSI group outperformed the XRT CSI group on inattention/impulsivity (both p < .05). Several clinical variables (i.e., RT dose, boost field, baseline performance) predicted neurocognitive outcomes (all p < .05). The PRT focal group performed comparably to population means on most neurocognitive measures, while both CSI groups performed below expectation on multiple measures. The XRT CSI group was most impaired. All groups fell below expectation on processing speed, fine motor, and academic fluency (most p < .01).

CONCLUSIONS

Findings suggest generally favorable neurocognitive and academic long-term outcomes following focal PRT. Impairment was greatest following CSI regardless of modality. Dosimetry and baseline characteristics are important determinants of outcome alone or in combination with modality.

Executive Functioning with the NIH EXAMINER and Inference Making in Struggling Readers

Executive functioning (EF) is a domain-general process implicated in reading, but there remains lack of clarity within the domain due to varied assessment methods. We investigated the relation of EF (indexed with the NIH EXAMINER) to word reading, reading fluency, and reading comprehension in struggling readers and evaluated the mediational role of inference making for the EF-comprehension link. Analyses revealed an overall effect of EF on reading, with significant differences between fluency and comprehension, and between single word reading and comprehension, but not between fluency and single-word reading. The EF-reading comprehension relation was fully mediated by inference making.

The Role of Reading Anxiety among Struggling Readers in Fourth and Fifth Grade

Cognitive predictors of reading are well known, but less is understood about the roles of "noncognitive" factors, including emotional variables such as anxiety. While math anxiety has been a focus of study, its analogue in the reading literature is understudied. We assessed struggling fourth and fifth graders (n = 272) on reading anxiety in the context of general anxiety, cognitive predictors (working memory, verbal knowledge), and demographics. Regressions tested for unique contributions to three reading outcomes: word reading accuracy, oral reading fluency, and reading comprehension. Reading anxiety and general anxiety correlated moderately (r = .63) but were differentially related to reading. Reading anxiety predicted comprehension when all other predictors were considered, and predicted oral reading fluency until word reading accuracy was added to the model. Results offer a more nuanced understanding of the nature of reading anxiety, and its implications for struggling readers.

The Structure of Processing Speed in Children and its Impact on Reading

The present study had two aims. First, we set out to evaluate the structure of processing speed in children by comparing five alternative models: two conceptual models (a unitary model, a complexity model) and three methodological models (a stimulus material model, an output response model, and a timing modality model). Second, we then used the resulting models to predict multiple types of reading, a highly important developmental outcome, using other well-known predictors as covariates. Participants were 844 children enrolled in third through fifth grade in urban public elementary schools who received 16 measures of processing speed that varied in the above dimensions. A two-factor complexity model that differentiated between simple and complex processing speed was the preferred model and fit the data well. Both types of PS predicted reading fluency, and complex (but not simple) PS predicted single word reading and comprehension. Results offer insight to the structure of processing speed, its relation to closely related concepts (such as executive function), and provide nuance to the understanding of the way processing speed influences reading.

Frontostriatal White Matter Integrity Relations with "Cool" and "Hot" Self-Regulation after Pediatric Traumatic Brain Injury

Traumatic brain injury (TBI) produces microstructural damage to white matter pathways connecting neural structures in pre-frontal and striatal regions involved in self-regulation (SR). Dorsal and ventral frontostriatal pathways have been linked to cognitive ("cool") and emotional ("hot") SR, respectively. We evaluated the relation of frontostriatal pathway fractional anisotropy (FA) 2 months post-TBI on cool and hot SR assessed 7 months post-TBI. Participants were 8-15 years of age, including children with uncomplicated mild TBI (mTBI; n = 24), more severe TBI (complicated-mild, moderate, severe [cms]TBI; n = 60), and typically developing (TD) children (n = 55). Diffusion tensor tractography was used to map frontostriatal pathways. Cool SR included focused and sustained attention performance, and parent-reported attention, whereas hot SR included risk-taking performance and parent-reported emotional control. Multivariate general linear models showed that children with cmsTBI had greater parent-reported cool and hot SR difficulties and lower dorsal and ventral FA than TD children. Focused attention, risk taking, and emotional control correlated with FA of specific dorsal and ventral pathways; however, only the effect of TBI on focused attention was mediated by integrity of dorsal pathways. Results suggest that frontostriatal FA may serve as a biomarker of risk for SR difficulties or to assess response to interventions targeting SR in pediatric TBI and in broader neurodevelopmental populations.

Sustained attention and behavioral ratings of attention in struggling readers

Attention is correlated with reading, but the extent to which behavioral ratings and sustained attention relate to reading skills is unclear. We assessed 245 4th and 5th grade struggling readers (mean age = 10.3 years) on behavioral ratings of attention, sustained attention, and reading over a school year. Contributions of behavioral ratings and sustained attention were considered cross-sectionally and longitudinally in the context of other important predictors of reading. Results suggest that sustained measures and behavioral ratings assess distinct, yet overlapping, aspects of attention. Both types of attention accounted for unique variance in comprehension, but not word reading accuracy or fluency, when evaluated cross-sectionally. Results also support the role of behavioral ratings of attention in fluency and in comprehension growth. Findings suggest that multidimensional assessment of attention is useful when considering its relation to reading, and highlights the need to integrate conceptualizations of attention that arise from different theoretical approaches.

A framework for executive function in the late elementary years

OBJECTIVE

Executive function (EF) is a commonly used but difficult to operationalize construct. In this study, we considered EF and related components as they are commonly presented in the neuropsychological literature, as well as the literatures of developmental, educational, and cognitive psychology. These components have not previously been examined simultaneously, particularly with this level of comprehensiveness, and/or at this age range or with this sample size. We expected that the EF components would be separate but related, and that a bifactor model would best represent the data relative to alternative models.

METHOD

We assessed EF with 27 measures in a large sample (N = 846) of late elementary school-age children, many of whom were struggling in reading, and who were demographically diverse. We tested structural models of EF, from unitary models to methodological models, utilizing model-comparison factor analytic techniques. We examined both a common factor as well as a bifactor structure.

RESULTS

Initial models showed strong overlap among several latent EF variables. The final model was a bifactor model with a common EF, and five specific EF factors (working memory-span/manipulation and planning; working memory-updating; generative fluency, self-regulated learning; metacognition).

CONCLUSIONS

Results speak to the commonality and potential separability of EF. These results are discussed in light of prevailing models of EF and how EF might be used for structure/description, prediction, and for identifying its mechanism for relevant outcomes. (PsycINFO Database Record

Executive Function: Association with Multiple Reading Skills

Executive function (EF) is related to reading. However, there is a lack of clarity around (a) the relative contribution of different components of EF to different reading components (word reading, fluency, comprehension), and (b) how EF operates in the context of known strong language predictors (e.g., components of the Simple View of Reading or SVR), and other skills theoretically related to reading (e.g., vocabulary, processing speed) and/or to EF (e.g., short-term memory, motor function). In a large sample of 3rd to 5th graders oversampled for struggling readers, this paper evaluates the impact of EF derived from a bifactor model (Cirino, Ahmed, Miciak, Taylor, Gerst, & Barnes, 2018) in the context of well-known covariates and demographics. Beyond common EF, five specific factors (two related to working memory, and factors of fluency, self-regulated learning, and behavioral inattention/metacognition) were addressed. EF consistently showed a unique contribution to already-strong predictive models for all reading outcomes; for reading comprehension, EF interacted with SVR indices (word reading and listening comprehension). The findings extend and refine our understanding of the contribution of EF to reading skill.

Cognitive, Intervention, and Neuroimaging Perspectives on Executive Function in Children With Reading Disabilities

The role of executive function (EF) in the reading process, and in those with reading difficulties, remains unclear. As members of the Texas Center for Learning Disabilities, we review multiple perspectives regarding EF in reading and then summarize some of our recent studies of struggling and typical readers in grades 3-5. Study 1a found that a bi-factor structure best represented a comprehensive assessment of EF. Study 1b found that cognitive and behavioral measures of EF related independently to math and reading. Study 1c found that EF related to reading, above and beyond other variables, but Study 1d found no evidence that adding an EF training component improved intervention response. Study 1e found that pretest EF abilities did not relate to intervention response. Neuroimaging studies examined EF-related brain activity during both reading and nonlexical EF tasks. In Study 2a, the EF task evoked control activity, but generated no differences between struggling and typical readers. The reading task, however, had group differences in both EF and reading regions. In Study 2b, EF activity during reading at pretest was related to intervention response. Across studies, EF appears involved in the reading process. There is less evidence for general EF predicting or improving intervention outcomes.

Executive Functions and Response to Intervention: Identification of Students Struggling with Reading Comprehension

Inadequate responders demonstrate significant risk for learning disabilities. Previous investigations of the cognitive profiles of inadequate and adequate responders have not included measures of executive functions (EF), which have well-documented associations to reading comprehension. We evaluated EF performance on a common factor comprised of shared variance across tasks as well as five separable EF factors in the context of an intensive reading intervention for struggling fourth graders. To determine if EF performance at pretest is associated with subsequent responder status, we compared EF performance of three subgroups of students: inadequate and adequate responders and typical students not at-risk for reading disabilities. Results of discriminant function analyses and linear regression models comparing groups were largely null; EF performance at pretest demonstrated only small associations with responder status. These results suggest that the assessment of EF may have limited value in predicting which individual students will respond to intensive reading interventions.

Brain activity in struggling readers before intervention relates to future reading gains

Neural markers for reading-related changes in response to intervention could inform intervention plans by serving as a potential index of the malleability of the reading network in struggling readers. Of particular interest is the role of brain activation outside the reading network, especially in executive control networks important for reading comprehension. However, it is unclear whether any intervention-related executive control changes in the brain are specific to reading tasks or reflect more domain general changes. Brain changes associated with reading gains over time were compared for a sentence comprehension task as well as for a non-lexical executive control task (a behavioral inhibition task) in upper-elementary struggling readers, and in grade-matched non-struggling readers. Functional MRI scans were conducted before and after 16 weeks of reading intervention. Participants were grouped as improvers and non-improvers based on the consistency and size of post-intervention gains across multiple post-test measures. Engagement of the right fusiform during the reading task, both before and after intervention, was related to gains from remediation. Additionally, pre-intervention activation in regions that are part of the default-mode network (precuneus) and the fronto-parietal network (right posterior middle temporal gyrus) separated improvers and non-improvers from non-struggling readers. None of these differences were observed during the non-lexical inhibitory control task, indicating that the brain changes seen related to intervention outcome in struggling readers were specific to the reading process.

Control Engagement During Sentence and Inhibition fMRI Tasks in Children With Reading Difficulties

Recent reading research implicates executive control regions as sites of difference in struggling readers. However, as studies often employ only reading or language tasks, the extent of deviation in control engagement in children with reading difficulties is not known. The current study investigated activation in reading and executive control brain regions during both a sentence comprehension task and a nonlexical inhibitory control task in third-fifth grade children with and without reading difficulties. We employed both categorical (group-based) and individual difference approaches to relate reading ability to brain activity. During sentence comprehension, struggling readers had less activation in the left posterior temporal cortex, previously implicated in language, semantic, and reading research. Greater negative activity (relative to fixation) during sentence comprehension in a left inferior parietal region from the executive control literature correlated with poorer reading ability. Greater comprehension scores were associated with less dorsal anterior cingulate activity during the sentence comprehension task. Unlike the sentence task, there were no significant differences between struggling and nonstruggling readers for the nonlexical inhibitory control task. Thus, differences in executive control engagement were largely specific to reading, rather than a general control deficit across tasks in children with reading difficulties, informing future intervention research.

Longitudinal Predictors of the Overlap between Reading and Math Skills

The predictors of developing reading skill are well known, and there is increasing coherence around predictors of developing math as well. These achievement skills share strong relations. Less knowledge is available regarding the extent to which predictors overlap and predict one another, particularly longitudinally, and across different types of reading and math. We followed kindergarten students (n = 193) for one year, evaluating a range of relevant predictor skills in kindergarten, and a range of relevant achievement outcomes (core, fluency, complex) of reading and math in grade 1. Few predictors differentially predicted math versus reading with some exception (phonological awareness and rapid naming for reading; counting knowledge for math). The pattern was more similar for core and fluency outcomes relative to complex ones. A small set of predictors accounted for much of the overlap among math and reading outcomes, regardless of type (core, fluency, or complex). Results have the potential to inform the development of early screening tools to consider both achievement domains simultaneously, and support the importance of following students identified as at-risk in one domain for their performance in both domains.

Maternal gene-micronutrient interactions related to one-carbon metabolism and the risk of myelomeningocele among offspring

BACKGROUND

Few studies have evaluated interactions between maternal genetic variation in 5,10-methylenetetrahydrofolate reductase (MTHFR) and micronutrient intake on the risk of myelomeningocele (MM) in offspring. Therefore, we sought to determine if the role of maternal MTHFR C677T and A1298C on MM risk is altered by maternal intake of micronutrients related to one-carbon metabolism.

METHODS

The study consisted of 220 MM case-parent trios recruited from 1996 to 2006. A dietary questionnaire was used to obtain information on maternal dietary intake on eight micronutrients including folate and cobalamin. TaqMan assays were used to generate MTHFR C677T and A1298C genotypes. Log-linear models were used to evaluate the joint effects of maternal genotype and micronutrient intake dichotomized as at or above versus below the United States Recommended Dietary Allowance (US RDA) on MM.

RESULTS

There was little evidence to suggest maternal MTHFR genotypes interacted with micronutrient intake to influence the risk of MM. For instance, the effect of MTHFR 677T was similar for mothers with cobalamin intake below US RDA (relative risk [RR] = 0.97) versus at or above US RDA cobalamin intake (RR = 0.81, interaction p = 0.87). However, some differences were noted. For example, the effect of MTHFR 1298C appeared to be different between those mothers below US RDA folate intake (RR = 0.98) versus those at or above US RDA folate intake (RR = 0.68), but the interaction was not statistically significant (interaction p = 0.27).

CONCLUSION

There did not appear to be strong effects of maternal micronutrient intake on the role of maternal genetic polymorphisms in MTHFR C677T and A1298C on MM risk. Birth Defects Research 109:99-105, 2017. © 2016 Wiley Periodicals, Inc.

A Cognitive Dimensional Approach to Understanding Shared and Unique Contributions to Reading, Math, and Attention Skills

Disorders of reading, math, and attention frequently co-occur in children. However, it is not yet clear which cognitive factors contribute to comorbidities among multiple disorders and which uniquely relate to one, especially because they have rarely been studied as a triad. Thus, the present study considers how reading, math, and attention relate to phonological awareness, numerosity, working memory, and processing speed, all implicated as either unique or shared correlates of these disorders. In response to findings that the attributes of all three disorders exist on a continuum rather than representing qualitatively different groups, this study employed a dimensional approach. Furthermore, we used both timed and untimed academic variables in addition to attention and activity level variables. The results supported the role of working memory and phonological awareness in the overlap among reading, math, and attention, with a limited role of processing speed. Numerosity was related to the comorbidity between math and attention. The results from timed variables and activity level were similar to those from untimed and attention variables, although activity level was less strongly related to cognitive and academic/attention variables. These findings have implications for understanding cognitive deficits that contribute to comorbid reading disability, math disability, and/or attention-deficit/hyperactivity disorder.

White matter microstructure integrity in relation to reading proficiency☆

Components of reading proficiency such asaccuracy, fluency, and comprehension require the successful coordination of numerous, yet distinct, cortical regions. Underlying white matter tracts allow for communication among these regions. This study utilized unique residualized tract - based spatial statistics methodology to identify the relations of white matter microstructure integrity to three components of reading proficiency in 49 school - aged children with typically developing phonological decoding skills and 27 readers with poor decoders. Results indicated that measures of white matter integrity were differentially associated with components of reading proficiency. In both typical and poor decoders, reading comprehension correlated with measures of integrity of the right uncinate fasciculus; reading comprehension was also related to the left inferior longitudinal fasciculus in poor decoders. Also in poor decoders, word reading fluency was related to the right uncinate and left inferior fronto - occipital fasciculi. Word reading was unrelated to white matter integrity in either group. These findings expand our knowledge of the association between white matter integrity and different elements of reading proficiency.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

[Formula: see text]Cognitive and behavioral rating measures of executive function as predictors of academic outcomes in children

Interrelations of two measurement methods (cognitive versus behavioral ratings) for executive function (EF) were examined and related to reading comprehension and math calculations in fourth and fifth grade students (n = 93) in the context of a diverse urban student population. Relations among measures within four EF processes (working memory, planning, inhibition and shifting) were modest; relations to academics were stronger. EF measures contributed to both academic outcomes even in the context of relevant covariates (age, language and educational program). Working memory was particularly important for reading comprehension across measurement type. Cognitive measures from all EF processes, particularly inhibition and planning, and behavioral ratings of working memory were important for math.

Cognitive control and associated neural correlates in adults with spina bifida myelomeningocele

OBJECTIVE

Accelerated aging can occur in adult survivors of neurodevelopmental disorders, but has been narrowly studied in spina bifida myelomeningocele (SBM). Since discrete aspects of cognitive control and related neural network macrostructure deteriorate in normal aging, the specificity and trajectory of cognition and neuropathology incurred across adulthood in SBM were examined.

METHOD

Adults (N = 120) with and without SBM completed working memory span and manipulation tasks, and an inhibitory control task. A subset (n = 53) underwent structural MRI. Effects of group, age, and their interaction on performance and select gray matter volumes were examined.

RESULTS

Adults with SBM had significantly poorer working memory accuracy and overall inhibitory control performance than typical peers. Age negatively predicted inhibitory control. Group × Age significantly interacted on span accuracy; advanced age related to diminished performance in typical adults, but not in adults with SBM. SBM related to disproportionately enlarged cortical and putamen and reduced hippocampus volumes. Group × Age significantly interacted on cortical, but not subcortical gray matter volumes. Dorsolateral prefrontal, hippocampus, and putamen volumes negatively correlated with cognitive performance.

CONCLUSIONS

Supporting previous literature, current findings elucidated a profile of executive impairment in SBM that was maintained in a parallel maturational trajectory to typical aging. Accelerated aging in cognitive control or subcortical gray matter was not supported in SBM. However, reductions in anterior and posterior cortical regions were exacerbated in older adults with SBM compared with typical peers. Overall results supported persistent anomalous neurodevelopmental maturation across the life span in SBM that related to diminished cognitive control. (PsycINFO Database Record

Executive Function, Self-Regulated Learning, and Reading Comprehension: A Training Study

The goal of this study was to evaluate the extent to which training that emphasizes the process of executive function (EF) and self-regulated learning (SRL) would result in increased reading comprehension; we also evaluated interrelationships of EF, SRL, and reading. We report an experiment ( N = 75 fourth graders) that contrasted two researcher-implemented conditions (text-based reading [TB] and text-based reading plus executive function [TB+EF]) to a control. We also evaluated relationships among measures of SRL, EF, and reading. Both the TB and TB+EF groups outperformed the control group for proximal text comprehension (where the topic was similar to that covered in training) and background knowledge related to it, but the two researcher-led groups performed similarly. There were no significant differences for less proximal text, and again similar performance for both TB and TB+EF. Correlations among measures were weak in general, although the pattern was similar to that found in the extant literature. The findings speak to the difficulty in separating these components from those of strong instruction more generally. The relationships of these constructs to reading comprehension will likely be enhanced by more sensitive measurement of EF and reading comprehension, particularly where tied to active treatment components.

The role of cognitive processes, foundational math skill, and calculation accuracy and fluency in word-problem solving versus prealgebraic knowledge

The purpose of this study was to examine child-level pathways in development of prealgebraic knowledge versus word-problem solving, while evaluating the contribution of calculation accuracy and fluency as mediators of foundational skills/processes. Children (n = 962; mean 7.60 years) were assessed on general cognitive processes and early calculation, word-problem, and number knowledge at start of Grade 2; calculation accuracy and calculation fluency at end of Grade 2; and prealgebraic knowledge and word-problem solving at end of Grade 4. Important similarities in pathways were identified, but path analysis also indicated that language comprehension is more critical for later word-problem solving than prealgebraic knowledge. We conclude that pathways in development of these forms of 4th-grade mathematics performance are more alike than different, but demonstrate the need to fine-tune instruction for strands of the mathematics curriculum in ways that address individual students' foundational mathematics skills or cognitive processes. (PsycINFO Database Record

The Woodcock Reading Mastery Test

This study examined the magnitude of differences in standard scores, convergent validity, and concurrent validity when an individual’s performance was gauged using the revised and the normative update (Woodcock, 1998) editions of the Woodcock Reading Mastery Test in which the actual test items remained identical but norms have been updated. From three metropolitan areas, 899 first to third grade students referred by their teachers for a reading intervention program participated. Results showed the inverse Flynn effect, indicating systematic inflation averaging 5 to 9 standard score points, regardless of gender, IQ, city site, or ethnicity, when calculated using the updated norms. Inflation was greater at lower raw score levels. Implications for using the updated norms for identifying children with reading disabilities and changing norms during an ongoing study are discussed.

Semantic, Executive, and Visuospatial Abilities in Mathematical Reasoning of Referred College Students

Semantic retrieval (SR) and executive-procedural (EP), but not visuospatial (VS) skills, have been found to be uniquely predictive of mathematical calculation skills in a sample of clinically referred college students. This study set out to cross-validate these results in an independent sample of clinically referred college students (N = 337) as well as extend them by examination of the contributions of these cognitive domains to math reasoning skills. Results indicate that these cognitive domains were able to predict 30% of the variance in calculation skills and 50% of the variance in math reasoning; however, in both cases, only the domains of semantic retrieval and visuospatial skill contributed uniquely. Differences between studies, and the lack of unique contribution of the EP domain to either type of math skill, may be due to measurement and sampling differences, the degree of shared relations among domains, and the choice of measures that represent the EP domain. Implications and future directions are explored.

Gray matter integrity within regions of the dorsolateral prefrontal cortical-subcortical network predicts executive function and fine motor dexterity in spina bifida

OBJECTIVES

This study examined microstructural properties of cortical and subcortical gray matter components of the dorsolateral prefrontal (DLPFC) cortical-subcortical circuit in relation to parent-rated executive function and fine motor dexterity performance in youth with spina bifida myelomeningocele (SBM). Aberrant gray matter integrity of the DLPFC, basal ganglia nuclei, and thalamus were hypothesized to differentially relate to neurobehavioral outcomes.

METHODS

Forty-nine youth between 8 and 18 years (M = 12.34) old with SBM underwent a 3T MRI including diffusion tensor imaging. Neurobehavioral measures of parent-rated executive function and fine motor dexterity were obtained from a standardized neuropsychological evaluation. Relations among indices of gray matter microstructural integrity (mean diffusivity [MD], fractional anisotropy [FA], cortical thickness) and neurobehavior were examined using 3 correlational methods to enhance reliability of brain-behavior relations.

RESULTS

In SBM, higher FA values in the caudate were associated with poorer behavioral regulation. Higher FA values in the putamen and greater DLPFC thickness were both associated with poorer fine motor dexterity.

CONCLUSION

Behavioral regulation and FA in the caudate related to behavioral inhibition in SBM. Similarly, associations between fine motor dexterity and indices of gray matter integrity in the putamen and DLPFC support fronto-striatal involvement in motor control in SBM. Examination of these neurobehavioral correlates revealed a pattern of attenuated behavioral impairments when gray matter structure was more similar to that of typically developing youth. (PsycINFO Database Record

Cognitive and numerosity predictors of mathematical skills in middle school

There is a strong research base on the underlying concomitants of early developing math skills. Fewer studies have focused on later developing skills. Here, we focused on direct and indirect contributions of cognitive measures (e.g., language, spatial skills, working memory) and numerosity measures, as well as arithmetic proficiency, on key outcomes of fraction performance, proportional reasoning, and broad mathematics achievement at sixth grade (N=162) via path analysis. We expected a hierarchy of skill development, with predominantly indirect effects of cognitive factors via number and arithmetic. Results controlling for age showed that the combination of cognitive, number, and arithmetic variables cumulatively accounted for 38% to 44% of the variance in fractions, proportional reasoning, and broad mathematics. There was consistency across outcomes, with more proximal skills providing direct effects and with the effects of cognitive skills being mediated by number and by more proximal skills. Results support a hierarchical progression from domain-general cognitive processes through numerosity and arithmetic skills to proportional reasoning to broad mathematics achievement.

Plasticity of Interhemispheric Temporal Lobe White Matter Pathways Due to Early Disruption of Corpus Callosum Development in Spina Bifida

Spina bifida myelomeningocele (SBM) is commonly associated with anomalous development of the corpus callosum (CC) because of congenital partial hypogenesis and hydrocephalus-related hypoplasia. It represents a model disorder to examine the effects of early disruption of CC neurodevelopment and the plasticity of interhemispheric white matter connections. Diffusion tensor imaging was acquired on 76 individuals with SBM and 27 typically developing individuals, aged 8-36 years. Probabilistic tractography was used to isolate the interhemispheric connections between the posterior superior temporal lobes, which typically traverse the posterior third of the CC. Early disruption of CC development resulted in restructuring of interhemispheric connections through alternate commissures, particularly the anterior commissure (AC). These rerouted fibers were present in people with SBM and both CC hypoplasia and hypogenesis. In addition, microstructural integrity was reduced in the interhemispheric temporal tract in people with SBM, indexed by lower fractional anisotropy, axial diffusivity, and higher radial diffusivity. Interhemispheric temporal tract volume was positively correlated with total volume of the CC, such that more severe underdevelopment of the CC was associated with fewer connections between the posterior temporal lobes. Therefore, both the macrostructure and microstructure of this interhemispheric tract were reduced, presumably as a result of more extensive CC malformation. The current findings suggest that early disruption in CC development reroutes interhemispheric temporal fibers through both the AC and more anterior sections of the CC in support of persistent hypotheses that the AC may serve a compensatory function in atypical CC development.

Do Processing Patterns of Strengths and Weaknesses Predict Differential Treatment Response?

OBJECTIVE

No previous empirical study has investigated whether the LD identification decisions of proposed methods to operationalize processing strengths and weaknesses (PSW) approaches for LD identification are associated with differential treatment response. We investigated whether the identification decisions of the concordance/discordance model (C/DM; Hale & Fiorello, 2004) and Cross Battery Assessment approach (XBA method; Flanagan, Ortiz, & Alfonso, 2007) were consistent and whether they predicted intervention response beyond that accounted for by pretest performance on measures of reading.

METHOD

Psychoeducational assessments were administered at pretest to 203 4^th graders with low reading comprehension and individual results were utilized to identify students who met LD criteria according to the C/DM and XBA methods and students who did not. Resulting group status permitted an investigation of agreement for identification methods and whether group status at pretest (LD or not LD) was associated with differential treatment response to an intensive reading intervention.

RESULTS

The LD identification decisions of the XBA and C/DM demonstrated poor agreement with one another (κ = -.10). Comparisons of posttest performance for students who met LD criteria and those who did not meet were largely null, with small effect sizes across all measures.

CONCLUSIONS

LD status, as identified through the C/DM and XBA approaches, was not associated with differential treatment response and did not contribute educationally meaningful information about how students would respond to intensive reading intervention. These results do not support the value of cognitive assessment utilized in this way as part of the LD identification process.

Effects of a Multitier Support System on Calculation, Word Problem, and Prealgebraic Performance Among At-Risk Learners

The focus of the present study was enhancing word-problem and calculation achievement in ways that support pre-algebraic thinking among 2^nd-grade students at risk for mathematics difficulty. Intervention relied on a multi-tier support system (i.e., responsiveness-to-intervention or RTI) in which at-risk students participate in general classroom instruction and receive supplementary small-group tutoring. Participants were 265 students in 110 classrooms in 25 schools. Teachers were randomly assigned to 3 conditions: calculation RTI, word-problem RTI, and business-as-usual control. Intervention lasted 17 weeks. Multilevel modeling indicated that calculation RTI improved calculation but not word-problem outcomes; word-problem RTI enhanced proximal word-problem outcomes as well as performance on some calculation outcomes; and word-problem RTI provided a stronger route than calculation RTI to pre-algebraic knowledge.

Neurocognitive predictors of mathematical processing in school-aged children with spina bifida and their typically developing peers: Attention, working memory, and fine motor skills

OBJECTIVE

Math and attention are related in neurobiological and behavioral models of mathematical cognition. This study employed model-driven assessments of attention and math in children with spina bifida myelomeningocele (SBM), who have known math difficulties and specific attentional deficits, to more directly examine putative relations between attention and mathematical processing. The relation of other domain general abilities and math was also investigated.

METHOD

Participants were 9.5-year-old children with SBM (n = 44) and typically developing children (n = 50). Participants were administered experimental exact and approximate arithmetic tasks, and standardized measures of math fluency and calculation. Cognitive measures included the Attention Network Test (ANT), and standardized measures of fine motor skills, verbal working memory (WM), and visual-spatial WM.

RESULTS

Children with SBM performed similarly to peers on exact arithmetic, but more poorly on approximate and standardized arithmetic measures. On the ANT, children with SBM differed from controls on orienting attention, but not on alerting and executive attention. Multiple mediation models showed that fine motor skills and verbal WM mediated the relation of group to approximate arithmetic; fine motor skills and visual-spatial WM mediated the relation of group to math fluency; and verbal and visual-spatial WM mediated the relation of group to math calculation. Attention was not a significant mediator of the effects of group for any aspect of math in this study.

CONCLUSION

Results are discussed with reference to models of attention, WM, and mathematical cognition.

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

OBJECT

No previous reports exist that have evaluated the relationships of white matter (WM) integrity with the number of shunt revisions, ventricular volume after shunting, and cognition in medically stable children who have spina bifida and hydrocephalus (SBH). The authors hypothesized that enlarged ventricles and a greater number of shunt revisions decrease WM integrity in children.

METHODS

In total, 80 children (mean age 13.7 years) who had SBH underwent MRI and IQ testing. Probabilistic diffusion tractography was performed to determine mean diffusion tensor imaging (DTI) metrics along the frontal and parietal tectocortical pathways. The DTI metrics were evaluated for significant correlation with a composite IQ measure and with the total number of shunt revisions and the total lateral ventricular volume obtained through semiautomated parcellation of T1-weighted MRI scans.

RESULTS

An enlargement in total lateral ventricle volume and an increase in the number of shunt revisions were both associated with higher fractional anisotropy (FA) and with lower radial diffusivity (RD) along both frontal and parietal tectocortical pathways. Children who had not undergone a shunt revision had on average a greater lateral ventricle volume and higher FA and lower RD along frontal and parietal pathways than those who had undergone multiple shunt revisions. The mean DTI metrics along parietal pathways predicted IQ scores, but intellectual ability was not significantly correlated with ventricular volume or with the number of lifetime shunt revisions.

CONCLUSIONS

Significant changes in DTI metrics were observed as a function of ventricular volume. An increased lateral ventricle volume was associated with elevated FA and decreased RD. Given that the participants were medically stable at the time of the MRI examination, the results suggested that those who have enlarged ventricles show a DTI pattern consistent with axonal compression due to increased intracranial pressure (ICP) in attenuated hydrocephalus. Although limited by a cross-sectional design, the study's findings suggest that DTI metrics may serve as sensitive indicators for chronic, mild hydrocephalus in the absence of overt clinical symptoms due to increased ICP. Having enlarged ventricles and undergoing multiple shunt revisions did not affect intellectual ability in children with SBH.

Attention in spina bifida myelomeningocele: Relations with brain volume and integrity

This study investigated the relations of tectal volume and superior parietal cortex, as well as alterations in tectocortical white matter connectivity, with the orienting and executive control attention networks in individuals with spina bifida myelomeningocele (SBM). Probabilistic diffusion tractography and quantification of tectal and superior parietal cortical volume were performed on 74 individuals aged 8–29 with SBM and a history of hydrocephalus. Behavioral assessments measured posterior (covert orienting) and anterior (conflict resolution, attentional control) attention network functions. Reduced tectal volume was associated with slower covert orienting; reduced superior parietal cortical volume was associated with slower conflict resolution; and increased axial diffusivity and radial diffusivity along both frontal and parietal tectocortical pathways were associated with reduced attentional control. Results suggest that components of both the orienting and executive control attention networks are impaired in SBM. Neuroanatomical disruption to the orienting network appears more robust and a direct consequence of characteristic midbrain dysmorphology; whereas, executive control difficulties may emerge from parietal cortical anomalies and reduced frontal and parietal cortical–subcortical white matter pathways susceptible to the pathophysiological effects of congenital hydrocephalus.

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We use robust correlations to model structure–function relations.

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We use a large sample of individuals with spina bifida myelomeningocele.

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Reduced tectal volume is associated with slower covert orienting.

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Reduced superior parietal cortical volume is associated with slower conflict resolution.

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Tectocortical pathways are associated with reduced attentional control.

Cognitive and mathematical profiles for different forms of learning difficulties

The purpose of this study was to compare subgroups of students with various forms of learning difficulties (< 25th percentile) on cognitive and mathematics characteristics. Students with mathematics difficulty (MD, n = 105), reading difficulty (RD, n = 65), both (MDRD, n = 87), or neither (NoLD, n = 403) were evaluated on an array of cognitive measures (e.g., working memory and language) and on mathematics measures of foundational numerical competencies, computation, and problem solving. Results revealed expected level differences among groups in both domains: NoLD outperformed RD, and MD outperformed MDRD. Profile differences were noted among pairs of subgroups on cognitive measures. On mathematics measures, profile differences were noted between RD and other subgroups, but not between MD and MDRD subgroups. The most discriminating cognitive measures were processing speed and language; the most discriminating mathematics measures depended on the subgroups being compared. Results were further evaluated according to more severe (< 10th percentile) criteria for MD and RD, which generally affected level differences more than the profile patterns. Results have implications for understanding comorbid MD and RD and for conceptualizing core deficits in MD.

Prospective and episodic memory in relation to hippocampal volume in adults with spina bifida myelomeningocele

The present study examined prospective and episodic memory in relation to age, functional independence, and hippocampal volume in younger to middle-aged adults with spina bifida myelomeningocele (SBM) and typically developing (TD) adults. Prospective and episodic memory, as well as hippocampal volume, was reduced in adults with SBM relative to TD adults. Neither memory performance nor hippocampal volume showed greater decrements in older adults. Lower hippocampal volume was associated with reduced prospective memory in adults with SBM, and this relation was specific to the hippocampus and not to a contrast structure, the amygdala. Prospective memory mediated the relation between hippocampal volume and functional independence in adults with SBM. The results add to emerging evidence for reduced memory function in adults with SBM and provide quantitative evidence for compromised hippocampal macrostructure as a neural correlate of reduced memory in this population.

Anatomical and diffusion MRI of deep gray matter in pediatric spina bifida

Individuals with spina bifida myelomeningocele (SBM) exhibit brain abnormalities in cortical thickness, white matter integrity, and cerebellar structure. Little is known about deep gray matter macro- and microstructure in this population. The current study utilized volumetric and diffusion-weighted MRI techniques to examine gray matter volume and microstructure in several subcortical structures: basal ganglia nuclei, thalamus, hippocampus, and amygdala. Sixty-six children and adolescents (ages 8–18; M = 12.0, SD = 2.73) with SBM and typically developing (TD) controls underwent T₁- and diffusion-weighted neuroimaging. Microstructural results indicated that hippocampal volume was disproportionately reduced, whereas the putamen volume was enlarged in the group with SBM. Microstructural analyses indicated increased mean diffusivity (MD) and fractional anisotropy (FA) in the gray matter of most examined structures (i.e., thalamus, caudate, hippocampus), with the putamen exhibiting a unique pattern of decreased MD and increased FA. These results provide further support that SBM differentially disrupts brain regions whereby some structures are volumetrically normal whereas others are reduced or enlarged. In the hippocampus, volumetric reduction coupled with increased MD may imply reduced cellular density and aberrant organization. Alternatively, the enlarged volume and significantly reduced MD in the putamen suggest increased density.

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Spina bifida resulted in reduced hippocampal and enlarged putamen volumes.

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Spina bifida resulted in reduced MD and increased FA in the putamen.

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Periventricular regions were differentiated by increased MD and FA in spina bifida.

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Spina bifida resulted in greater FA for all regions, except the hippocampus.

Does Calculation or Word-Problem Instruction Provide A Stronger Route to Pre-Algebraic Knowledge?

The focus of this study was connections among 3 aspects of mathematical cognition at 2^nd grade: calculations, word problems, and pre-algebraic knowledge. We extended the literature, which is dominated by correlational work, by examining whether intervention conducted on calculations or word problems contributes to improved performance in the other domain and whether intervention in either or both domains contributes to pre-algebraic knowledge. Participants were 1102 children in 127 2^nd-grade classrooms in 25 schools. Teachers were randomly assigned to 3 conditions: calculation intervention, word-problem intervention, and business-as-usual control. Intervention, which lasted 17 weeks, was designed to provide research-based linkages between arithmetic calculations or arithmetic word problems (depending on condition) to pre-algebraic knowledge. Multilevel modeling suggested calculation intervention improved calculation but not word-problem outcomes; word-problem intervention enhanced word-problem but not calculation outcomes; and word-problem intervention provided a stronger route than calculation intervention to pre-algebraic knowledge.

Examination of frontal and parietal tectocortical attention pathways in spina bifida meningomyelocele using probabilistic diffusion tractography

Abnormalities of the midbrain tectum are common but variable malformations in spina bifida meningomyelocele (SBM) and have been linked to neuropsychological deficits in attention orienting. The degree to which variations in tectum structure influence white matter (WM) connectivity to cortical regions is unknown. To assess the relationship of tectal structure and connectivity to frontal and parietal cortical regions, probabilistic diffusion tractography was performed on 106 individuals (80 SBM, 26 typically developing [TD]) to isolate anterior versus posterior tectocortical WM pathways. Results showed that those with SBM exhibited significantly reduced tectal volume, along with decreased fractional anisotropy (FA) in posterior but not anterior tectocortical WM pathways when compared with TD individuals. The group with SBM also showed greater within-subject discrepancies between frontal and parietal WM integrity compared with the TD group. Of those with SBM, qualitative classification of tectal beaking based on radiological review was associated with increased axial diffusivity across both anterior and posterior tectocortical pathways, relative to individuals with SBM and a normal appearing tectum. These results support previous volumetric findings of greater impairment to posterior versus anterior brain regions in SBM, and quantifiably relate tectal volume, tectocortical WM integrity, and tectal malformations in this population.

Prediction and stability of mathematics skill and difficulty

The present study evaluated the stability of math learning difficulties over a 2-year period and investigated several factors that might influence this stability (categorical vs. continuous change, liberal vs. conservative cut point, broad vs. specific math assessment); the prediction of math performance over time and by performance level was also evaluated. Participants were 144 students initially identified as having a math difficulty (MD) or no learning difficulty according to low achievement criteria in the spring of Grade 3 or Grade 4. Students were reassessed 2 years later. For both measure types, a similar proportion of students changed whether assessed categorically or continuously. However, categorical change was heavily dependent on distance from the cut point and so more common for MD, who started closer to the cut point; reliable change index change was more similar across groups. There were few differences with regard to severity level of MD on continuous metrics or in terms of prediction. Final math performance on a broad computation measure was predicted by behavioral inattention and working memory while considering initial performance; for a specific fluency measure, working memory was not uniquely related, and behavioral inattention more variably related to final performance, again while considering initial performance.