Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis

Game-based cognitive training and its impact on executive functions and math performance: A randomized controlled trial

Executive functions (EFs) are the focus of interventions aimed at their development and subsequent improvement of indirectly trained skills such as academic performance. Therefore, the objective of this study was to evaluate the presence of near-transfer effects (EFs improvement) and far-transfer effects (mathematics improvement) of the Cucca Curiosa intervention in Brazilian children aged 7 to 10 years, with 28 participants per age group. This stratified trial included 112 children randomly assigned to the experimental group (EG) or control group (CG). Child Brief Neuropsychological Assessment Battery  (NEUPSILIN-Inf), Five-Digit Test (FDT), Day-Night Stroop task, and Mathematics Test (TEMA) were administered at pretest and posttest levels. The EG participated in the 1-week Cucca Curiosa program, consisting of five sessions (averaging 13 min, with a maximum of 26 min), whereas the CG remained in passive waiting. Data analysis revealed that the intervention significantly improved children's executive and mathematics performance in the short term. The mediation analysis identified that EFs are essential mediators that explain how the intervention improves mathematical performance, reinforcing the importance of focusing on the development of EFs as a strategy to improve academic performance. Further studies are necessary to assess long-term effects, transfer to other skills, and potential benefits in reducing psychopathological symptoms.

Health-related quality of life of children with developmental disabilities in Singapore and associated factors: A broad-based examination

The study investigates the health-related quality of life (HRQoL) of elementary-aged children with developmental disabilities in Singapore, focusing on the influences of individual and family factors. Data from 113 students from special education schools was examined, with data collected from parents, teachers, and direct assessments of the children. The Pediatric Quality of Life Inventory (PedsQL) was used to measure HRQoL across four domains: physical, emotional, social, and school functioning. Results showed that children with developmental disabilities generally experience lower HRQoL compared to typically developing peers, with the social functioning domain presenting the greatest challenges. Executive functioning difficulties emerged as the most significant predictor of overall HRQoL, affecting all domains, particularly social and school functioning. Parental psychological well-being was also significantly associated with children's emotional functioning, highlighting the broader influence of family factors on children's well-being. This study contributes to the literature by examining a broad-based sample in a multicultural Asian context. Results underscores the importance of addressing both child-specific challenges, such as executive functioning, and family-centered interventions to improve parental mental wellbeing. In the pursuit of positive quality of life for children with developmental disabilities across multiple domains, this study's findings highlight the need for a multi-component approach. Limitations and future directions, including the use of proxy reports and the need for culturally relevant interventions, are discussed.

Dynamic Mathematical Processing Through Symbolic, Situational, and Verbal Representations

In this paper, we discuss symbolic, situational, and verbal mathematical processing. These three modes of processing are conducted by the mediums of symbolic, situational, and verbal mathematical representations. While symbolic processing is a suppressive-oriented mechanism, situational one is receptive-oriented and reliant on sensorimotor features of elements in the context of mathematical representation. Verbal processing is a linguistic-oriented mechanism that is supported by semantic networks. We suggest that these three mechanisms can be dynamically employed at the same time to process a mathematical idea or problem. We call this high-level process as dynamic cross-type representational transformation. Dynamic cross-type representational transformation is a mode of thought that enables the individual to dynamically shift between various types of mathematical representations and to employ a larger part of cognitive capacity and brain's networks. Finally, we conclude that this dynamic process can be regarded as one specific part of executive functions.

Safety and feasibility of home-based transcranial alternating current stimulation in youths with 22q11.2 deletion syndrome

Neurodevelopmental disorders such as attention deficit and/or hyperactivity disorder (ADHD) and schizophrenia are characterized by core impairment in executive functions (EF). Despite the development of various behavioral interventions to enhance EF, the evidence is still scarce. Alternatively, non-invasive brain stimulation tools such as transcranial alternating current stimulation (tACS) has emerged as a potential strategy to alleviate cognitive deficits. Previous studies have demonstrated the safety, feasibility, and efficacy of one single tACS session in different clinical populations. However, the effects of tACS appear limited and need to be sustained to be considered an effective cognitive neurorehabilitation tool. Recent studies have used home-based, repeated tACS sessions in individuals with neurodegenerative diseases. To our knowledge, the safety and feasibility of such an intensive protocol remains to be tested in a younger population with neurodevelopmental disorders. Using a randomized double-blind sham-controlled design, we administered home-based, repeated tACS sessions to seven individuals aged 14-25 with 22q11.2 deletion syndrome (22q11.2DS), which confers an increased risk for neurodevelopmental disorders. We aimed to assess the safety, tolerability, and feasibility of tACS. Findings from this ongoing clinical trial revealed a favorable safety profile, with frequent yet transient and mainly mild adverse effects. The intervention proved to be feasible, shown by very high adherence rates and positive user experiences. Future studies should therefore investigate whether prolonged exposure to tACS can lead to long-lasting cognitive outcomes.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05664412.

Unraveling the spectrum: overlap, distinctions, and nuances of ADHD and ASD in children

This review explores the clinical presentation of similarities and differences in Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). This paper investigates the deficits in executive function, social function, and emotional intelligence that are seen in both conditions and how the presence of both conditions can exacerbate these deficiencies. Understanding the clinical presentations in these domains is critical to refine diagnostic methods and treatments and improve outcomes for those affected by these neurodevelopmental disorders. The similarities in clinical presentation between ADHD and ASD present a significant diagnostic challenge, with individuals often exhibiting similar behaviors and difficulty navigating the complexities that encompass reacting to their environment. Further research is paramount in gaining more knowledge of the disorders and challenges faced by these individuals, especially those with the presence of both conditions.

Understanding social cognition in children with cerebral palsy: exploring the relationship with executive functions and the intervention outcomes in a randomized controlled trial

Children with Cerebral Palsy (CP) experience Social Cognition (SC) difficulties, which could be related to executive functioning. While motor interventions are common, there is limited knowledge about the impact of cognitive interventions on SC in this population. This study examined the relationship between SC and Executive Function (EF) skills and the effectiveness of an EF intervention that included some SC tasks for improving SC in children with CP. SC and EF domains were assessed in 60 participants with CP (30 females; 8-12 years). The relationship between SC and EF baseline scores was analyzed by bivariate correlations and contingency tables. Participants were matched by age, sex, motor ability, and intelligence quotient and randomized into intervention or control groups. The intervention group underwent a 12-week home-based computerized EF intervention. Analysis of covariance was used to examine differences in SC components between groups at post-intervention and 9 months after. Significant positive correlations were found between the SC and EF scores. The frequencies of impaired and average scores in SC were distributed similarly to the impaired and average scores in EFs. The intervention group showed significant improvements in Affect Recognition performance post-intervention, which were maintained at the follow-up assessment, with a moderate effect size. Long-term improvements in Theory of Mind were observed 9 months after.

CONCLUSIONS

This study highlights the association between SC and EFs. A home-based computerized cognitive intervention program improves SC in children with CP. Including SC tasks in EF interventions may lead to positive short- and long-term effects for children with CP.

CLINICAL TRIAL REGISTRATION

NCT04025749 retrospectively registered on 19 July 2019.

WHAT IS KNOWN

• Executive functions and social cognition are associated with social and community participation in people with cerebral palsy. • A home-based computerized cognitive intervention can improve the executive functioning of children with cerebral palsy.

WHAT IS NEW

• Social cognition performance is related to core and higher-order executive functions. • A home-based computerized executive function intervention, including social cognition tasks, has positive short- and long-term effects on social cognition skills in children with cerebral palsy.

Executive functions as predictors of learning prerequisites in preschool: A longitudinal study

INTRODUCTION

This study focuses on 'learning prerequisites', cognitive and non-cognitive skills crucial for school success, often measured in preschoolers. Executive Functions (EF), like inhibition and cognitive flexibility, are vital among these prerequisites. While EF's role in early literacy and numeracy is acknowledged, some components are often overlooked.

OBJECTIVE

The study aims to longitudinally explore the link between EF, assessed at the beginning of the preschool year and the learning prerequites, measured at the end of the same preschool year.

METHOD AND RESULTS

Evaluating 70 preschoolers (62.30 months, SD 4.55), results showed that certain EF measures predicted performance in literacy and numeracy tasks. Specifically, response inhibition predicted rhyme and syllable recognition, series completion, and cognitive flexibility predicted rhyme recognition. Moreover, EF, particularly response inhibition, correlated with overall metaphonology and pre-math abilities.

CONCLUSION

The findings suggest the importance of integrating EF enhancement in early educational interventions, aiding in selecting and optimizing EF skills crucial for later academic success.

Semantic fluency in 3-6 years old preschoolers: which executive functions?

Semantic Fluency (SF) increases with age, along with the lexicon and the strategies to access it. Among the cognitive processes involved in controlling lexical access, Executive Functions (EF) play an essential role. Nevertheless, which EF, namely inhibition, working memory, and cognitive flexibility, are specifically tapped by SF during preschool years, when these basic EF components are developing and differentiating, is still unknown. The study had a two-fold aim: 1. to analyze in preschoolers the role of EF basic components on SF; 2. to investigate if EF mediated the effect of age on SF. A total of 296 typically developing preschoolers (M age = 57.86; SD = 9.91; month range = 33-74) were assessed with an SF task and EF tasks measuring the main EF basic components. Results showed that during preschool, response inhibition, working memory, and cognitive flexibility were significant predictors of SF, explaining 27% of its variance. Moreover, the effect of age on the SF task performance correlated with the improvement of these EF components. This study supports the importance of considering cognitive control processes in 3-6 year-old preschoolers as they underline important competencies for the child's development, such as the ability to quickly access vocabulary.

Effects of Physical Activity on Cognition, Behavior, and Motor Skills in Youth with Autism Spectrum Disorder: A Systematic Review of Intervention Studies

The aim of this paper was to analyze the acute and chronic effects of physical activity (PA) on cognition, behavior, and motor skill in youth with autism spectrum disorder (ASD), taking into account potential confounders. In addition, it was intended to elaborate a guide of educational applications with strategies for PA use. Studies were identified in four databases from January 2010 to June 2023. A total of 19 interventional studies met the inclusion criteria. PA programs ranged from two weeks to one year in duration, with a frequency of one to five sessions per week. More than 58% of the studies showed positive effects of PA on cognition, and 45.5% on behavior and motor skill. Moderate-vigorous PA for 15-30 min has shown acute effects on cognition, general behavior, and stereotypic/repetitive behaviors in youth with ASD. A total of 9 out of 14 studies showed chronic effects on general behavior and stereotypic behaviors, and only 6 on motor skills.