Brief Report: A Randomized Controlled Trial of a Digital Working Memory Intervention for Preschoolers Displaying ADHD Symptoms

PURPOSE

This study aimed to investigate the effects of a self-paced digital working memory (WM) intervention on preschoolers with ADHD symptoms and explore the relation between WM and time perception (TP) through a randomized controlled trial.

METHOD

Fifty preschoolers between four-to-six years of age (M = 4.93 years) were randomly assigned to three groups: a WM training group (WM; n = 14), a social-emotional (SE) training active control group (n = 15), and a waitlist control group (n = 21). Both the WM and SE groups received fifteen 10-min self-paced digital training sessions over five consecutive weeks.

RESULTS

The digital WM training was effective in improving children's digit span performance compared to the waitlist control group only. Within-group comparisons across two time points indicated a near-significant improvement in numeration and trends of reduced ADHD symptoms and improved TP tasks in the WM group at the post-test, but between-group differences were not observed.

CONCLUSION

The study showed limited effects of the WM training on preschoolers displaying ADHD symptoms. However, the results implied an association between working memory and time perception that awaits further investigation.

An experimental task to measure preschool children's frustration induced by having to wait unexpectedly: The role of sensitivity to delay and culture

The ability to manage frustration induced by having to wait for valued outcomes emerges across childhood and is an important marker of self-regulatory capacity. However, approaches to measure this capacity in preschool children are lacking. In this study, we introduced a new task, the Preschool Delay Frustration Task (P-DeFT), designed specifically to identify children's behavioral and emotional markers of waiting-induced frustration during the imposed wait period and after the release from waiting. We then explored how waiting-induced frustration relates to individual differences in delay sensitivity and whether it differs between two cultural groups thought to have different attitudes toward children's conduct and performance: Hong Kong (HK) and the United Kingdom (UK). A total of 112 preschool children (mean age = 46.22 months) completed the P-DeFT in a quiet laboratory. Each trial had two stages; first, a button press elicited a Go signal; second, this Go signal allowed children to go to a "supermarket" to pick a target toy. On most trials, the Go signal occurred immediately on the first press. On 6 trials, an unexpected/unsignaled 5- or 10-s pre-Go-signal period was imposed. Frustration was indexed by performance (button presses and press duration), behavioral agitation, and negative affect during the pre-Go-signal wait period and the post-Go-signal shopping task. Parents rated their children's delay sensitivity. Waiting-related frustration expressed during both the pre-Go-signal wait period and the post-Go-signal task varied with (a) the length of wait and (b) individual differences in parent-rated delay sensitivity. UK children displayed more negative affect during delay than their HK counterparts, although the relationship between delay sensitivity and frustration was culturally invariant.

Word reading transfer in two distinct languages in reading interventions: How Chinese-English bilingual children with reading difficulties learn to read

PURPOSE

Skills developed from literacy training in L1 are shown to transfer to reading in L2 when both languages involve an alphabetic writing system. However, transfer of literacy skills between a logographic L1 and an alphabetic L2 is less studied. This study examined whether the gain in literacy skills after an 8-week training on 1) Chinese character recognition or 2) English phonics, may generalize across the two languages in Chinese elementary students with reading disabilities.

METHODS

Chinese-speaking students identified with reading difficulties were randomly assigned to the Chinese intervention (Chinese character orthography training), English intervention (English phonics training), and control groups. Their Chinese and English literacy skills were measured before and after the interventions.

RESULTS

Though training on the orthography of Chinese characters significantly improved performance in Chinese word reading and Chinese orthographic awareness, our results did not provide evidence for the generalization of word-decoding skills from L1 Chinese to word reading in L2 English. However, phonics training in L2 English benefitted not only English word reading, but also cross-language word reading in L1 Chinese.

CONCLUSION

We postulated that teaching children analytical skills in decoding words in an alphabetic writing system might likewise benefit their word decoding in a logographic script.

Attention-deficit/hyperactivity disorder (ADHD) in cultural context: Do parents in Hong Kong and the United Kingdom adopt different thresholds when rating symptoms, and if so why?

OBJECTIVES

Attention-deficit/hyperactivity disorder (ADHD) prevalence is similar across world regions. However, because informants' decision thresholds may vary between regions, these similarities may mask regional variations in actual ADHD behaviours. We tested this by comparing the relationship between informant's ratings and children's measured activity in United Kingdom (UK) and Hong Kong (HK) and then explored whether any national differences in endorsement thresholds discovered are linked to cultural variations in parenting factors.

METHODS

Parents rated the 18 ADHD symptoms in 112 three-to-five-year-old children stratified for ADHD symptom levels (49 girls and 63 boys; 55 from the UK and 57 from HK) and completed some parenting questionnaires. Children's task-related activity was measured using actometers.

RESULTS

In both groups, measured activity was positively correlated with hyperactivity/impulsivity (r = 0.44^HK ; r = 0.41^UK ). While HK children were less active than UK children (p < 0.01), HK parents rated their children as more hyperactive/impulsive and inattentive (ps < 0.05). The lower rating threshold indicated by this pattern in HK parents were explained by their higher child-related stress levels.

CONCLUSIONS

UK and HK parents operated different ADHD symptom endorsement thresholds. The link between these and child-related stress may mark a more general role of cultural pressure for child conformity and school achievement in HK.

Sensitivity Training for Mothers With Premature Infants: A Randomized Controlled Trial

OBJECTIVE

This single-blind parallel design randomized controlled trial evaluated the feasibility and effectiveness of a modified version of the Mother-Infant Transaction Program (MITP) in enhancing Chinese mothers' sensitivity towards their premature infants' physiological and social cues.

METHODS

Sixty mothers of hospitalized premature infants (mean gestational age = 32.1 weeks; SD = 2.8) were randomly assigned to either the MITP group or the treatment-as-usual control group. The intervention group (n = 30) received four sessions of parental sensitivity training adapted from the MITP, delivered by clinical psychologists before the infants were discharged. The control group (n = 30) received standard care provided by the hospitals. Each dyad was assessed at baseline (Time 1), immediately after intervention (Time 2), and when the infants were at the gestation-corrected ages of 3, 6, 9, and 12 months (Times 3-6). Maternal sensitivity, mother-infant interaction quality, parenting stress, postpartum depression, and mother's perception of infant's temperament were measured at Times 1-4, whereas infants' weight gain and developmental performance were assessed at Times 3-6.

RESULTS

The MITP group showed significantly higher maternal sensitivity and better mother-infant interaction quality after completing the training. They also reported less parenting stress and postnatal depression than the control group at Time 2 and subsequent follow-ups. The intervention significantly predicted better weight gain and developmental outcomes in infants across Times 3-6, mediated by maternal wellbeing and interaction quality.

CONCLUSION

 Our results demonstrated the feasibility and effectiveness of this adapted sensitivity training among Chinese mothers with premature infants. [ClinicalTrials.gov NCT04383340].

Early cognitive intervention using mediated learning for preschoolers with developmental delay: A randomized controlled trial

Background

The use of mediated learning in cognitive training has been shown to be effective in enhancing students’ cognitive development. Nonetheless, its effects on language development are less explored.

Aims

This study examined the effects of an early cognitive intervention (Think Bright program) in enhancing the cognitive and language development of Hong Kong preschoolers with developmental delay.

Method

Sixty‐eight children (48 boys and 20 girls; mean age = 58 months) with developmental delay were recruited from preschool rehabilitation centres and randomized to two groups (Think Bright training vs. active control). Each child in the Think Bright group received 12 sessions of 1‐hr individual training on thinking skills over 6 months. The control group received the same amount of training based on the regular training regimen adopted at the rehabilitation centres.

Results

After a 6‐month intervention, the Think Bright group significantly outperformed the control group in language, general cognition, analogical thinking, sequential thinking, and logical reasoning. The Think Bright teachers’ mediation skills significantly improved during the course of intervention and correlated moderately with the improvement in students’ language abilities.

Conclusion

This study has shown promising results on the effectiveness of using mediated learning in early cognitive intervention in enhancing both the cognitive and language development of preschoolers with developmental delay.

Time Perception Deficits in Children and Adolescents with ADHD: A Meta-analysis

OBJECTIVE

Prior studies have reported time perception impairment in children and adolescents with ADHD but the results were inconsistent.

METHOD

The current meta-analysis reviews 27 empirical studies published in English after year 2000 that compared time perception competence among children and adolescents with and without ADHD.

RESULTS

Results from 1620 participants with ADHD and 1249 healthy controls showed significant timing deficits in ADHD. Children/adolescents with ADHD perceived time less accurately (Hedges' g > 0.40), less precisely (Hedges' g = 0.66) and had higher tendency to overestimate time than their healthy counterparts. Moderator analyses indicated that the discrepancy of time perception between groups was not affected by the type of timing tasks nor the modality of stimuli used in the tasks. Nonetheless, results were moderated by age and gender.

CONCLUSION

These findings may update current understanding of the underlying neuropsychological deficits in ADHD and provide insight for future research in clinical assessments and treatments for ADHD.

Tuning in to kids: A randomized controlled trial of an emotion coaching parenting program for Chinese parents in Hong Kong

Tuning in to Kids (TIK) is a parenting program that focuses on emotion coaching and is evidenced to be effective in Western populations. This study used a randomized controlled trial to examine the intervention effects of TIK on Chinese parents of low to middle socioeconomic status in Hong Kong. One hundred four parents (99 mothers and five fathers; M_age in years = 37.92) of preschoolers aged 3-6 years were randomly assigned to the experimental (n = 54) or waitlist control group (n = 50). Parent and child outcomes were assessed at baseline (Time 1), immediately after the 6-week intervention (Time 2), and 6 weeks postintervention (Time 3), using the Alabama Parenting Questionnaire, Coping with Children's Negative Emotions Scale, Parenting Stress Index-Short Form, and Emotion Regulation Checklist. The experimental group reported significant reductions in punitive parenting and parenting stress at Time 2, and these effects were maintained at Time 3. Delayed improvements in parents' use of expressive encouragement and children's emotion lability/negativity were observed at Time 3 in the experimental group. The immediate intervention effects were replicated in the waitlist control group at Time 3 after they attended the training. This study represented one of the few randomized controlled trials of TIK conducted in a non-Western sample. Our results corroborated the findings of prior studies of TIK and provided preliminary support for its effectiveness across different cultural contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Autism spectrum disorder screening in Chinese-language preschools

This study examined the reliability and validity of the 13-item Classroom Observation Scale as used by teachers and non-clinically trained observers to identify children who more likely than their peers to have autism spectrum disorder in less-resourced preschools. A total of 534 children (ages 2;10 to 4;5, Mean = 3;8) from nine Chinese-language preschools serving families from lower-middle to middle socioeconomic backgrounds in Hong Kong were observed in their first preschool year using the Classroom Observation Scale. The 75 screen-positive children and 55 randomly selected typically developing peers were clinically assessed for autism spectrum disorder 1 year later. The Classroom Observation Scale as used by teachers and non-clinically trained researchers helped to identify preschoolers who were later diagnosed with autism spectrum disorder with odds ratios of 3.11 and 8.66, respectively. This study provided further evidence on the versatility and ecological validity of the Classroom Observation Scale for use by preschool teachers and observers with little or no clinical training in the early identification of children with autism spectrum disorder in community settings.

Acceptance of outgroup members in schools: Developmental trends and roles of perceived norm of prejudice and teacher support

BACKGROUND

Schools around the world are increasingly diverse in ethnicity. Given the importance of peer acceptance in children's well-being and development, it is a pressing concern for educators to promote intergroup acceptance in schools.

AIMS

First, to examine the developmental trends of acceptance of outgroup members in both the ethnic minority and majority students. Second, to investigate how outgroup acceptance is subject to the interplay between perceived norm of prejudice, a risk factor in the macrosystem, and teacher support, a protective factor in the microsystem.

SAMPLE

The participants were 3,723 students (ethnic majority: 61%; boys: 51.9%; mean age: 13.7) at Grade 2, 5, 8, and 11 from 24 schools in Hong Kong.

METHODS

The students were asked to complete a battery of questionnaires regarding their willingness to accept outgroup members in schools, perceived societal norm of prejudice against ethnic minority group, and teacher support they received in schools.

RESULTS

It was found that ethnic minority students accepted outgroup members more than ethnic majority students accepted them. The difference was primarily driven by the low outgroup acceptance of ethnic majority students in Grades 2 and 5. The results of multi-level analysis revealed that outgroup acceptance was associated negatively with perceived norm of prejudice but positively with teacher support. The negative association between outgroup acceptance and perceived norm of prejudice was attenuated in schools with supportive culture.

CONCLUSIONS

The results point to the need of early intervention and the importance of cultivating school culture with strong social emotional support.

Dimensional structure of the BRIEF2 and its relations with ADHD symptoms and task performance on executive functions in Chinese children

This study examined the dimensional structure of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in a Chinese sample of children with attention-deficit/hyperactivity disorder (ADHD)-related concerns and the correlations of the BRIEF2 with the children's ADHD symptoms and their performance on executive function (EF) tasks. Participants were 339 Chinese children aged 6-15 (M = 9.18 years, SD = 2.33; boys: 78.2%) recruited from 35 schools in Hong Kong. The results from confirmatory factor analyses revealed the best fit for a three-factor nine-scale model compared to a two-factor or single-factor model. Significant correlations were found between the BRIEF2 parent and teacher forms for the Behavioral Regulation Index and Cognitive Regulation Index, but not for the Emotion Regulation Index. Associations between performance on an EF task and the rating of the corresponding subscale on the BRIEF2 purportedly measuring the same EF construct were not consistently observed. Lastly, the BRIEF2 showed good convergent validity with the ratings of ADHD symptoms on the Swanson, Nolan, and Pelham Rating Scale Version IV (SNAP-IV). This study provided plausibly the first evidence on the dimensional structure of the BRIEF2 Parent and Teacher Forms in an Asian sample and confirmed the factorial validity of the Chinese version of the BRIEF2.

Brief Report: A Randomized Controlled Trial of the Effects of RECALL (Reading to Engage Children with Autism in Language and Learning) for Preschoolers with Autism Spectrum Disorder

This study investigated the effects of a parent-implemented dialogic reading approach-Reading to Engage Children with Autism in Language and Learning (RECALL)-on the engagement in reading and inference-making ability for preschoolers with autism spectrum disorder (ASD). Thirty-one preschoolers (mean age = 5.90 years, SD = 0.69; 26 boys, 5 girls) were randomly assigned to a treatment or control group. Six weeks of RECALL significantly enhanced story comprehension, emotion knowledge, and reading engagement among preschoolers in the treatment group. This might be the first randomized controlled trial testing the effects of RECALL on children with ASD. Our findings suggest that additional instructional support such as the application of a prompting hierarchy during dialogic reading might help children with ASD reap greater benefits from shared book reading.

The Moderating Effect of Mindfulness on the Mediated Relation Between Critical Thinking and Psychological Distress via Cognitive Distortions Among Adolescents

Critical thinking has been widely regarded as an indispensable cognitive skill in the 21st century. However, its associations with the affective aspects of psychological functioning are not well understood. This study explored the interrelations between trait mindfulness, critical thinking, cognitive distortions, and psychological distress using a moderated mediation model. The sample comprised 287 senior secondary school students (57% male and 43% female) aged 14–19 from a local secondary school in Hong Kong. The results revealed that high critical thinking was significantly associated with high levels of psychological distress when mindful awareness was low among adolescents. Trait mindfulness was found to moderate the indirect effects of critical thinking on psychological distress via cognitive distortions as the mediator. Specifically, in low trait mindfulness conditions, critical thinking was found to associate positively with cognitive distortions and psychological distress. Such associations were not observed in high trait mindfulness conditions. The findings reveal that though critical thinking has positive associations with cognitive functioning, its associations with affective well-being might be negative. The results also suggest that mindfulness might play an important role in preventing the possible psychological distress associated with critical thinking. Educational implications relating to the fostering of critical thinking and mindful awareness are discussed.

Learning How to Make Friends for Chinese Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial of the Hong Kong Chinese Version of the PEERS® Intervention

This study examined the treatment efficacy of PEERS® (Program for the Education and Enrichment of Relational Skills) among Chinese adolescents with autism spectrum disorder (ASD) in Hong Kong. The original PEERS® manual was translated into Chinese, and cultural adjustments were made according to a survey among 209 local adolescents in the general population. 72 high-functioning adolescents with ASD were randomly assigned to a treatment or waitlist control group. The 14-week parent-assisted training significantly improved social skills knowledge and social functioning, and also reduced autistic mannerisms. Treatment outcomes were maintained for 3 months after training and replicated in the control group after delayed treatment. The present study represents one of the few randomized controlled trials on PEERS® conducted outside North America.