1
|
Leung WSW, Pei J, Rasmussen C. A working memory intervention for children with prenatal alcohol exposure: Pilot study. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-9. [PMID: 38593749 DOI: 10.1080/21622965.2024.2328672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Cogmed© is a computerized working memory training program designed to improve attention and working memory. We examined the short- and long-term impacts of a 25-session Cogmed© intervention on working memory and other cognitive and learning domains in children with prenatal alcohol exposure (PAE) and typically developing children. Participants included 38 children (4 - 13 years old) from Alberta, Canada in two groups: PAE (n = 20) and typically developing (n = 18). Significant improvements in areas of working memory and attentional control for both the PAE and the typically developing group were reported immediately after intervention completion (short-term impact). The gains on some measures were retained at five-week follow up (long-term impact). Preliminary findings indicate that computerized interventions may positively impact WM and attention control and that these changes may be maintained after a delay period.
Collapse
Affiliation(s)
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| |
Collapse
|
2
|
Hennessy A, Nichols ES, Al-Saoud S, Brossard-Racine M, Duerden EG. Identifying cognitive profiles in children with neurodevelopmental disorders using online cognitive testing. Clin Child Psychol Psychiatry 2024; 29:591-607. [PMID: 38282296 PMCID: PMC10945998 DOI: 10.1177/13591045241228889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Children with neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) tend to exhibit similar deficits in attention and memory ability. Early screening of cognitive deficits in children with NDDs, particularly in preschool children, is fundamental to improving cognitive and academic outcomes. In order to determine cognitive profiles in children with ASD and ADHD, we developed accessible audiovisual instructions for an online battery of 13 cognitive tests. Children ages 4-16 who were diagnosed with ADHD (n = 83), or ASD (n = 37), or who were typically developing children (TD) (n = 86) were recruited. Data were analyzed using a stepwise Discriminant Analysis to determine which cognitive tasks were the strongest discriminators between the diagnostic groups. Results revealed four tasks reflective of working memory, reasoning, and attentional processes, which correctly classified approximately 53-60% of each group. The ADHD group had lower scores on attentional tasks compared to TD, while ASD group had lower scores on reasoning tasks compared to the TD children, and made more attempts across all four tasks. The results from this study stress the need for cognitive screening assessments that include domain-specific items to improve the characterization of executive function deficits and promote academic achievement in all children with NDDs.
Collapse
Affiliation(s)
- Abagail Hennessy
- Applied Psychology, Faculty of Education, Western University, Canada
| | - Emily S Nichols
- Applied Psychology, Faculty of Education, Western University, Canada
- Western Institute for Neuroscience, Western University, Canada
| | - Sarah Al-Saoud
- Applied Psychology, Faculty of Education, Western University, Canada
| | | | - Emma G Duerden
- Applied Psychology, Faculty of Education, Western University, Canada
- Western Institute for Neuroscience, Western University, Canada
- Neuroscience, Schulich School of Medicine and Dentistry, Western University, Canada
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada
| |
Collapse
|
3
|
Hellebrekers DMJ, Wirken JMA, Lionarons JM, van Kuijk SMJ, Klinkenberg S, Vles JSH, Hendriksen JGM. Computerized working memory training in males with Duchenne muscular dystrophy: A single case experimental design study. Neuropsychol Rehabil 2023; 33:1325-1348. [PMID: 35876193 DOI: 10.1080/09602011.2022.2096080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 06/24/2022] [Indexed: 10/16/2022]
Abstract
Learning disabilities (LDs) and working memory problems (WM) are common brain-related comorbidities in Duchenne muscular dystrophy (DMD). Despite growing evidence on the efficacy of computerized WM training in children with LDs, research in DMD is lacking. This exploratory study assessed whether training (1) improves dystrophin-associated WM problems in DMD, (2) effects are present at post-intervention, 3 and 8 months follow-up, and (3) improves problems that arise from their LDs. A single case non-concurrent multiple baseline across patients design evaluated the target behaviour i.e. parental reports of WM problems of four DMD participants with LDs. Additionally, participants completed cognitive tests of verbal and visual WM, academics, attention, processing speed and fluid reasoning. Parents and teachers completed behavioural questionnaires. Testing and questionnaires were administered at baseline, post-intervention (T2), 3 (T3) and 8 (T4) months follow-up. Positive effects on target behaviour were found for three of four participants, but parental bias cannot be ruled out. Short and long-term, near-and far transfer effects were found for verbal and visual WM (T2:n = 2, T3&T4:n = 1), reading (T2:n = 4,T3:n = 3,T4:n = 2), arithmetic (all T:n = 1), processing speed (all T:n = 4) and fluid reasoning (T2:n = 1,T3&T4:n = 2). Behavioural questionnaires displayed minimal changes (T2:n = 1,T3&T4:n = 2). Promising WM training results are shown in DMD that merit further research.
Collapse
Affiliation(s)
- Danique M J Hellebrekers
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jose M A Wirken
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
| | - Judith M Lionarons
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sylvia Klinkenberg
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johan S H Vles
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jos G M Hendriksen
- Centre for Neurological Learning Disabilities, Kempenhaeghe, Heeze, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Dutch Duchenne Centre, Leiden, The Netherlands
| |
Collapse
|
4
|
Marcellus L, Badry D. Infants, children, and youth in foster care with prenatal substance exposure: a synthesis of two scoping reviews. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2023; 69:265-290. [PMID: 37025340 PMCID: PMC10071944 DOI: 10.1080/20473869.2021.1945890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background: Infants, children, and youth in foster care have frequently experienced prenatal substance exposure (PSE), neglect, and maltreatment as well as disruptions in their relationships with families. They also have great capacity for overcoming early adversities. In this synthesis of two previously conducted scoping reviews, we aimed to identify and describe literature that identifies a range of interventions that support the health and development of this population. Methods: This review integrates and extends two previously conducted scoping reviews, one focusing on infants and one focusing on children and youth, to synthesize themes across these developmental stages. The Joanna Briggs Institute scoping review methodology was employed for the current and previous reviews. A three-step search strategy identified published studies in the English language from January 2006 to February 2020. Results: One-hundred and fifty-three sources were included in this review. Four themes were identified: (1) early screening, diagnosis, and intervention; (2) providing theoretically grounded care; (3) supporting parents and foster care providers; and (4) intersectoral collaboration. Conclusion:Infants, children, and youth with PSE are overrepresented in foster care. Child welfare system planning should take a multi-sectoral approach to addressing the cumulative needs of this population and their care providers over developmental ages and stages. Although research remains limited, early screening, diagnosis, and developmentally and fetal alcohol spectrum disorder-informed intersectoral interventions are critical for optimizing outcomes.
Collapse
Affiliation(s)
| | - Dorothy Badry
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
- Correspondence to: Dorothy Badry, Faculty of Social Work, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
5
|
Betts JL, Eggins E, Chandler‐Mather N, Shelton D, Till H, Harnett P, Dawe S. Interventions for improving executive functions in children with foetal alcohol spectrum disorder (FASD): A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1258. [PMID: 36908848 PMCID: PMC9634003 DOI: 10.1002/cl2.1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background The consequences for children born with birth defects and developmental disabilities encompassed by foetal alcohol spectrum disorder (FASD) are profound, affecting all areas of social, behavioural and cognitive functioning. Given the strong evidence for a core deficit in executive functioning, underpinned by impaired self-regulation skills, there has been a growing focus on the development of interventions that enhance or support the development of executive functions (EFs). Objectives The primary objective of this review is to synthesise the evidence for structured psychological interventions that explicitly aim to improve EF in children. The review also sought to ascertain if the effectiveness of interventions were influenced by characteristics of the intervention, participants or type of EF targeted by the intervention. Search Methods Sixteen databases, 18 grey literature search locations and 9 trial registries were systematically searched to locate eligible studies (up to December 2020). These searches were supplemented with reference harvesting, forward citation searching, hand searches of topic-relevant journals and contact with experts. Selection Criteria Studies were included in the review if they reported on an impact evaluation of a psychological intervention aiming to improve EF in children 3-16 years who either had confirmed prenatal alcohol exposure or a formal diagnosis falling under the umbrella term of FASDs. Eligible study designs included randomised controlled trials (RCTs) and quasi-experimental designs with either no treatment, wait list control or an alternative treatment as a comparison condition. Single-group pre-post designs were also included. Data Collection and Analysis Standard methodological procedures expected by the Campbell Collaboration were used at all stages of this review. Standardised mean differences (SMDs) were used to estimate intervention effects, which were combined with random effects meta-analysis (data permitting). Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB2) and Cochrane Risk of Bias in Non-Randomised Studies-Interventions tool (ROBINS-I). Main Results The systematic search identified 3820 unique records. After title/abstract and full-text screening, 11 eligible studies (reported in 21 eligible documents) were deemed eligible, with a combined 253 participants. Of the 11 studies, 6 were RCTs, 1 was a quasi-experiment and 4 were single-group pre-post intervention designs. All studies were rated as having an overall high or serious risk of bias, with some variation across domains for RCTs. For RCT and quasi-experimental studies, the overall effect of EF interventions on direct and indirect measures of EF generally favoured the experimental condition, but was not statistically significant. There was no difference between intervention and comparison groups on direct measures of auditory attention (k = 3; SMD = 0.06, 95% confidence interval [CI] = -1.06, 1.18), visual attention (k = 2; SMD = 0.90, 95% CI = -1.41, 3.21), cognitive flexibility (k = 2; SMD = 0.23, 95% CI = -0.40, 0.86), attentional inhibition (k = 2; SMD = 0.04, 95% CI = -0.58, 0.65), response inhibition (k = 3; SMD = 0.47, 95% CI = -0.04, 0.99), or verbal working memory (k = 1; d = 0.6827; 95% CI = -0.0196, 1.385). Significant heterogeneity was found across studies on measures of auditory attention and visual attention, but not for measures of cognitive flexibility, attentional inhibition or response inhibition. Available data prohibited further exploration of heterogeneity. There was no statistical difference between intervention and comparison groups on indirect measures of global executive functioning (k = 2; SMD = 0.21, 95% CI = -0.40, 0.82), behavioural regulation (k = 2; SMD = 0.18, 95% CI = -0.43, 0.79), or emotional control (k = 3; SMD = 0.01, 95% CI = -0.33, 0.36). Effect sizes were positive and not significant for meta-cognition (k = 1; SMD = 0.23, 95% CI = -0.72, 1.19), shifting (k = 2; SMD = 0.04, 95% CI = -0.35, 0.43), initiation (k = 1; SMD = 0.04, 95% CI = -0.40, 0.49), monitoring (k = 1; SMD = 0.25, 95% CI = -0.20, 0.70) and organisation of materials (k = 1; SMD = 0.25, 95% CI = -0.19, 0.70). Effect sizes were negative and not statistically different for effortful control (k = 1; SMD = -0.53, 95% CI = -1.50, 0.45), inhibition (k = 2; SMD = -0.08, 95% CI = -0.47, 0.31), working memory (k = 1; SMD = 0.00, 95% CI = -0.45, 0.44), and planning and organisation (k = 1; SMD = -0.10, 95% CI = -0.55, 0.34). No statistically significant heterogeneity was found for any of the syntheses of indirect measures of EF. Based on pre-post single-group designs, there was evidence for small to medium sized improvements in EF based on direct measures (cognitive flexibility, verbal working memory and visual working memory) and indirect measures (behavioural regulation, shifting, inhibition and meta-cognition). However, these results must be interpreted with caution due to high risk of bias. Authors' Conclusions This review found limited and uncertain evidence for the effectiveness of interventions for improving executive functioning in children with FASD across 8 direct and 13 indirect measures of EF. The findings are limited by the small number of high-quality studies that could be synthesised by meta-analysis and the very small sample sizes for the included studies.
Collapse
Affiliation(s)
- Joseph Lee Betts
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| | - Elizabeth Eggins
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| | | | - Doug Shelton
- Child Development ServiceGold Coast Hospital and Health ServiceSouthportAustralia
| | - Haydn Till
- Child Development Service, Gold Coast Hospital and Health ServiceSouthportAustralia
| | - Paul Harnett
- School of Criminology and Criminal JusticeGriffith UniversityMount GravattAustralia
| | - Sharon Dawe
- School of Applied PsychologyGriffith UniversityBrisbaneAustralia
| |
Collapse
|
6
|
Mattson JT, Thorne JC, Kover ST. [Formula: see text]Parental interaction style, child engagement, and emerging executive function in fetal alcohol spectrum disorders (FASD). Child Neuropsychol 2022; 28:853-877. [PMID: 34978272 PMCID: PMC10686097 DOI: 10.1080/09297049.2021.2023122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
Children with fetal alcohol spectrum disorders (FASD) are known to experience cognitive and neurobehavioral difficulties, including in areas of executive function and social skills development. Interventions for these challenges have focused on a number of areas, including parent-based training. Despite the general consensus that specific parenting styles consistent with an "authoritative" - warm but firm - parenting approach may influence behavioral self-regulation, it is not known what specific parental interaction styles are associated with child engagement and emerging executive function in this population. The current study used an observation-based behavioral coding scheme during parent-child play interactions and associated parent report-based executive function measures in children with FASD. Here, we demonstrate that parental interaction styles with increased responsive/child-oriented behavior and parental affect are associated with higher levels of child play engagement, while parental interaction that has increased achievement-orientation is associated with higher levels of emerging executive function in children with FASD. These findings help inform future studies on behavioral targets in parent-based training programs and highlight the importance of considering certain parental interaction styles during parent-child play.
Collapse
Affiliation(s)
- Julia T. Mattson
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - John C. Thorne
- Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| | - Sara T. Kover
- Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| |
Collapse
|
7
|
Brown J, Jonason A, Asp E, McGinn V, Carter MN, Spiller V, Jozan A. Fetal alcohol spectrum disorder and confabulation in psycholegal settings: A beginner's guide for criminal justice, forensic mental health, and legal interviewers. BEHAVIORAL SCIENCES & THE LAW 2022; 40:46-86. [PMID: 34689366 DOI: 10.1002/bsl.2540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) are neurodevelopmental/neurobehavioral conditions caused by prenatal alcohol exposure (PAE). Impairments caused by PAE contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Difficulties include increased susceptibility to confabulation throughout the legal process that, in turn, can contribute to increased rates of poor outcomes including false confessions and wrongful convictions. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. Many professionals in the forensic context are unfamiliar with FASD or related confabulation risk and may unintentionally utilize tactics that intensify impacts of pre-existing impairment. This article serves as a beginner's guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD. Suggestions in this article hold the potential to decrease the risk of confabulation in the criminal justice system and decrease problematic outcomes, such as false confessions and wrongful convictions among individuals with FASD.
Collapse
Affiliation(s)
- Jerrod Brown
- Pathways Counseling Center, Inc., St. Paul, Minnesota, USA
- Concordia University, St. Paul, Minnesota, USA
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
| | - Alec Jonason
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
| | - Erik Asp
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
- Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Valerie McGinn
- The FASD Centre, Auckland, New Zealand
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Megan N Carter
- University of Washington, Seattle, Washington, USA
- Department of Social and Health Services, Special Commitment Center, Steilacoom, Washington, USA
| | | | - Amy Jozan
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
| |
Collapse
|
8
|
Ordenewitz LK, Weinmann T, Schlüter JA, Moder JE, Jung J, Kerber K, Greif-Kohistani N, Heinen F, Landgraf MN. Evidence-based interventions for children and adolescents with fetal alcohol spectrum disorders - A systematic review. Eur J Paediatr Neurol 2021; 33:50-60. [PMID: 34058625 DOI: 10.1016/j.ejpn.2021.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Brain function deficits cause strong negative impacts for the everyday lives of children and adolescents with fetal alcohol spectrum disorders (FASD). Therefore, evidence-based intervention programs that are specifically designed for patients with FASD are needed but still scarce. The aim of the presented article is a systematic literature review of evidence-based intervention strategies for children and adolescents with FASD. MATERIALS AND METHODS A comprehensive systematic literature search was conducted in several relevant databases to identify randomized-controlled intervention studies for children and adolescents with FASD. RESULTS We identified 25 randomized-controlled studies regarding interventions in FASD. Overall, evidence indicating that some therapeutic interventions are effective in children and adolescents with FASD was found. Even though evidence-based interventions rarely lead to improvements of performance into a "normal range", those measures can alleviate negative consequences of prenatal alcohol exposure and relieve daily burdens. CONCLUSION There are only a few randomized-controlled trials regarding therapy research for children and adolescents with FASD. Their results indicate that especially the combination of parent and child sessions present a promising approach for the treatment of FASD. Positive treatment effects of interventions seem to be domain specific, except for interventions regarding self-regulation or social interaction.
Collapse
Affiliation(s)
- Lisa K Ordenewitz
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Julia A Schlüter
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Judith E Moder
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Jessica Jung
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Kerber
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Naschla Greif-Kohistani
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.
| |
Collapse
|
9
|
Moore EM, Glass L, Infante MA, Coles CD, Kable JA, Jones KL, Riley EP, Mattson SN. Cross-Sectional Analysis of Spatial Working Memory Development in Children with Histories of Heavy Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2020; 45:215-223. [PMID: 33190244 DOI: 10.1111/acer.14506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/24/2020] [Accepted: 10/22/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND In children with prenatal alcohol exposure, spatial working memory is affected and brain regions important for spatial working memory performance exhibit atypical neurodevelopment. We therefore hypothesized that children with prenatal alcohol exposure may also have atypical development of spatial working memory ability. METHODS We examined the relation between spatial working memory and age using a cross-sectional developmental trajectory approach in youth with and without histories of heavy prenatal alcohol exposure. The Cambridge Neuropsychological Test Automated Battery Spatial Working Memory subtest was administered to children 5.0 to 16.9 years old. RESULTS While the controls and children with prenatal alcohol exposure showed similar performance at younger ages, larger group differences were observed in older children. This effect was replicated in a separate sample. CONCLUSIONS The atypical brain development that has previously been reported in children with heavy prenatal alcohol exposure may have clinically relevant implications for cognitive development; however, longitudinal cognitive analyses are needed.
Collapse
Affiliation(s)
- Eileen M Moore
- From the, Department of Psychology, (EMM, LG, MAI, EPR, SNM), Center for Behavioral Teratology, San Diego State University, San Diego, California
| | - Leila Glass
- From the, Department of Psychology, (EMM, LG, MAI, EPR, SNM), Center for Behavioral Teratology, San Diego State University, San Diego, California.,Los Angeles Semel Institute for Neuroscience and Human Behavior, (LG), University of California, Los Angeles, California
| | - M Alejandra Infante
- From the, Department of Psychology, (EMM, LG, MAI, EPR, SNM), Center for Behavioral Teratology, San Diego State University, San Diego, California.,Department of Psychiatry, (MAI), University of California, San Diego, San Diego, La Jolla, California
| | - Claire D Coles
- Department of Psychiatry and Behavioral Sciences, (CDC), Emory University School of Medicine, Atlanta, Georgia.,Department of Pediatrics, (CDC, JAK), Emory University School of Medicine, Atlanta, Georgia
| | - Julie A Kable
- Department of Pediatrics, (CDC, JAK), Emory University School of Medicine, Atlanta, Georgia
| | - Kenneth L Jones
- Department of Pediatrics, (KLJ), School of Medicine, University of California, San Diego, La Jolla, California
| | - Edward P Riley
- From the, Department of Psychology, (EMM, LG, MAI, EPR, SNM), Center for Behavioral Teratology, San Diego State University, San Diego, California
| | - Sarah N Mattson
- From the, Department of Psychology, (EMM, LG, MAI, EPR, SNM), Center for Behavioral Teratology, San Diego State University, San Diego, California
| | | |
Collapse
|
10
|
Kapasi A, Pei J, Kryska K, Joly V, Gill K, Thompson-Hodgetts S, McLachlan K, Andrew G, Rasmussen C. Exploring Self-Regulation Strategy Use in Adolescents with FASD. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2020. [DOI: 10.1080/19411243.2020.1822260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Aamena Kapasi
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Kathryn Kryska
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Vannesa Joly
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Kamaldeep Gill
- Department of Rehabilitation Sciences, University of British Colombia, Vancouver, Canada
| | | | | | - Gail Andrew
- Glenrose Rehabilitation Hospital Edmonton, PAE Clinic, Edmonton, AB, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| |
Collapse
|
11
|
Passmore HM, Mutch RC, Watkins R, Burns S, Hall G, Urquhart J, Carapetis J, Bower C. Reframe the Behaviour: Evaluation of a training intervention to increase capacity in managing detained youth with fetal alcohol spectrum disorder and neurodevelopmental impairments. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2020; 28:382-407. [PMID: 35530127 PMCID: PMC9067986 DOI: 10.1080/13218719.2020.1780643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The first study to investigate the prevalence of fetal alcohol spectrum disorder (FASD) within an Australian juvenile detention centre has identified the highest known prevalence of FASD among a justice-involved population worldwide. However, there has been limited investigation into the capacity of the custodial workforce to identify and manage young people in Australian detention centres with FASD or other neurodevelopmental impairment (NDI), and no published interventions aiming to develop environments appropriate for those with FASD in justice settings. Using the Template for Intervention Description and Replication checklist, this study describes the conception, implementation and evaluation of a training intervention aiming to upskill the custodial workforce in the management of youth with FASD and NDI; 117 staff participated in the intervention, and 109 completed pre- and post-intervention surveys. Improvements were seen across almost all knowledge and attitude items, and the intervention was considered highly necessary, appropriate and valuable by the workforce.
Collapse
Affiliation(s)
- Hayley M. Passmore
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Raewyn C. Mutch
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
- Department of Health Western Australia, Child and Adolescent Health Service, Perth, WA, Australia
| | - Rochelle Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Sharyn Burns
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Guy Hall
- School of Law, Murdoch University, Perth, WA, Australia
| | | | - Jonathan Carapetis
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| |
Collapse
|
12
|
Macoun SJ, Pyne S, MacSween J, Lewis J, Sheehan J. Feasibility and potential benefits of an attention and executive function intervention on metacognition in a mixed pediatric sample. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:240-252. [PMID: 32701379 DOI: 10.1080/21622965.2020.1794867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The term "metacognition" describes thinking about a cognitive phenomenon or, more simply put, thinking about thinking . Metacognition involves using knowledge about one's cognitive processes to change behavior, including monitoring and controlling cognition. Metacognition is vital for learning and is often more difficult for children with neurodevelopmental concerns (e.g. Attention Deficit Hyperactivity Disorder [ADHD], Fetal Alcohol Spectrum Disorder [FASD], Autism Spectrum Disorders [ASD]), possibly due to underlying deficits in attention and executive functioning (EF). The present study evaluated a 6- to 8-week cognitive intervention aimed at improving attention and EF and children's metacognitive abilities. Participants included a mixed sample of 50 children ages 6-12 years presenting with attention and/or EF deficits. Children within the active intervention group completed a game-based attention/EF intervention called Caribbean Quest (CQ), which combines process-specific and compensatory approaches to remediate attention and EF. Educational Assistants (EAs) supported children during gameplay by teaching explicit metacognitive strategies. Pre/post assessments included measures of attention and working memory (WM), metacognitive awareness (child, parent, and EA questionnaires), and metacognitive regulation (metacognitive monitoring and control). Results indicated post-intervention gains in WM, metacognitive awareness, and metacognitive regulation (self-monitoring and metacognitive control). These results provide preliminary support for CQ as potentially beneficial in improving aspects of EF and metacognition in children.
Collapse
Affiliation(s)
- Sarah J Macoun
- Psychology Department, University of Victoria, Victoria, British Columbia, Canada
| | - Sarah Pyne
- Psychology Department, University of Victoria, Victoria, British Columbia, Canada
| | - Jennifer MacSween
- Psychology Department, University of Victoria, Victoria, British Columbia, Canada
| | - Jessica Lewis
- Psychology Department, University of Victoria, Victoria, British Columbia, Canada
| | - John Sheehan
- Psychology Department, University of Victoria, Victoria, British Columbia, Canada
| |
Collapse
|
13
|
Adebiyi BO, Mukumbang FC, Erasmus C. The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122244. [PMID: 31242673 PMCID: PMC6617245 DOI: 10.3390/ijerph16122244] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 11/16/2022]
Abstract
The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions.
Collapse
Affiliation(s)
- Babatope O Adebiyi
- School of Public Health, University of the Western Cape, Cape Town 8001, South Africa.
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Cape Town 8001, South Africa.
| | - Charlene Erasmus
- Child and Family Studies, University of the Western Cape, Cape Town 8001, South Africa.
| |
Collapse
|
14
|
Betts J, Dawe S, Eggins E, Shelton D, Till H, Harnett P, Chandler‐Mather N. PROTOCOL: Interventions for improving executive functions in children with Fetal Alcohol Spectrum Disorder: Systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1009. [PMID: 37131471 PMCID: PMC8533799 DOI: 10.1002/cl2.1009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Joseph Betts
- School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
| | - Sharon Dawe
- School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
| | - Elizabeth Eggins
- School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
| | - Doug Shelton
- Gold Coast University HospitalSouthportAustralia
| | - Haydn Till
- Gold Coast Hospital and Health ServiceSouthportAustralia
| | - Paul Harnett
- School of Applied PsychologyGriffith UniversityBrisbaneQueenslandAustralia
| | | |
Collapse
|
15
|
Benyakorn S, Calub CA, Riley SJ, Schneider A, Iosif AM, Solomon M, Hessl D, Schweitzer JB. Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study. JMIR Ment Health 2018; 5:e40. [PMID: 29802090 PMCID: PMC5993974 DOI: 10.2196/mental.9564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/01/2018] [Accepted: 03/03/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. OBJECTIVE The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. METHODS A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. RESULTS Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child's response. CONCLUSIONS Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics.
Collapse
Affiliation(s)
- Songpoom Benyakorn
- Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhonnayok, Thailand.,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Catrina A Calub
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Steven J Riley
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Andrea Schneider
- MIND Institute, University of California, Davis, Sacramento, CA, United States.,Department of Pediatrics, University of California, Davis, Sacramento, CA, United States
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - David Hessl
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States.,MIND Institute, University of California, Davis, Sacramento, CA, United States
| |
Collapse
|
16
|
Zhang H, Chang L, Chen X, Ma L, Zhou R. Working Memory Updating Training Improves Mathematics Performance in Middle School Students With Learning Difficulties. Front Hum Neurosci 2018; 12:154. [PMID: 29740298 PMCID: PMC5928151 DOI: 10.3389/fnhum.2018.00154] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 04/05/2018] [Indexed: 12/02/2022] Open
Abstract
Working memory (WM) deficit is considered the key cause of learning difficulties (LDs). Studies have shown that WM is plastic and thus can be improved through training. This positive effect is transferable to fluid intelligence and academic performance. This study investigated whether WM updating ability and academic performance in children with LDs could be improved through WM updating training and explored the effects of this training on the children’s brain activity. We used a running memory task lasting approximately 40 min per day for 28 days to train a group of 23 children with LDs (TLDs group). We also selected two control groups of 22 children with LDs (CLDs group) and 20 children without LDs (normal control [NC] group). The behavioral results of a pretest indicated that WM updating ability and academic performance in the TLDs and CLDs groups were significantly lower than those in the NC group before training. Compared with the CLDs group, the TLDs group exhibited significant performance improvement in a 2-back WM task, as well as in mathematical ability. Event-related potentials (ERPs) results suggested that the amplitudes of N160 (representative of visual recognition) and P300 (representative of updating processing, which is a valid index for updating WM) in the TLDs and CLDs groups were markedly lower than those in the NC group before training. In the TLDs group, these two components increased considerably after training, approaching levels similar to those in the NC group. The results of this study suggest that WM updating training can improve WM updating ability in children with LDs and the training effect can transfer to mathematical performance in such children. Furthermore, the participants’ brain activity levels can exhibit positive changes. This article provides experimental evidence that WM updating training could mitigate the symptoms of LDs to a certain degree.
Collapse
Affiliation(s)
- Hongxia Zhang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Lei Chang
- Department of Psychology, University of Macau, Macau, China
| | - Xiaoying Chen
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Liang Ma
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, China
| |
Collapse
|
17
|
Palermo E, Laut J, Nov O, Cappa P, Porfiri M. Spatial memory training in a citizen science context. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Bebko JM, Rhee T, Ncube BL, Dahary H. Effectiveness and Retention of Teaching Memory Strategy Use to Children With Autism Spectrum Disorder. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2017. [DOI: 10.1177/0829573517699332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although low levels of memory strategy use have been found in children with autism spectrum disorders (ASDs), few studies have explored the effectiveness of interventions for improving strategy use with this population. In two studies, we examined the short- and longer term effectiveness of rehearsal strategy training. In Study 1, children with ASD made strong gains during a focused teaching session, but rehearsal strategy use was not well maintained after training. In Study 2, we increased training with multiple individualized sessions. Longer term maintenance of gains occurred, demonstrating the possibility of successfully teaching and generalizing of strategy use, findings that have important implications for classroom and intervention contexts with children with ASD.
Collapse
|
19
|
Abstract
This grand rounds manuscript reviews important considerations in developing case conceptualizations for individuals with a history of prenatal alcohol exposure. This case study provides an introduction to fetal alcohol spectrum disorders, diagnostic issues, a detailed description of the individual's history, presenting symptoms, neuropsychological test results, and an integrated summary. We describe a 9-year old girl diagnosed with a fetal alcohol spectrum disorder (FASD): Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). This patient is a composite of a prototypical child who participated as part of a research project at the Center for Behavioral Teratology who was subsequently seen at an outpatient child psychiatry facility.
Collapse
Affiliation(s)
- Leila Glass
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, CA 92120
| | - Sarah N Mattson
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, CA 92120
| |
Collapse
|
20
|
Petrenko CLM, Alto ME. Interventions in fetal alcohol spectrum disorders: An international perspective. Eur J Med Genet 2017; 60:79-91. [PMID: 27742482 PMCID: PMC5205562 DOI: 10.1016/j.ejmg.2016.10.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 10/03/2016] [Accepted: 10/11/2016] [Indexed: 12/21/2022]
Abstract
Fetal alcohol spectrum disorders (FASD) are present across countries and cultures, with prevalence rates threatening to rise in the coming years. In order to support children and families with FASD around the world, researchers must work to disseminate and implement evidence-based interventions. However, each cultural context presents unique elements and barriers to the implementation process. This review considers the challenges of addressing FASD in an international context. It summarizes existing FASD interventions that have empirical support in the domains of parenting and education, attention and self-regulation, adaptive functioning, and nutrition and medication. It then outlines cultural barriers pertaining to FASD that may impede the implementation process and makes suggestions for using purveyors as cultural liaisons between researchers and local stakeholders. The review concludes with recommendations for moving forward with international dissemination and implementation of FASD interventions.
Collapse
|
21
|
Germanaud D, Toutain S. Exposition prénatale à l’alcool et troubles causés par l’alcoolisation fœtale. ACTA ACUST UNITED AC 2017. [DOI: 10.3917/cont.046.0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
22
|
Clerc J, Courbois Y. Evidence of a Phonological Similarity Effect After Rehearsal Training in Adolescents With Intellectual Disability. JOURNAL OF COGNITIVE EDUCATION AND PSYCHOLOGY 2017. [DOI: 10.1891/1945-8959.16.2.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A phonological similarity effect (PSE) in adolescents with an intellectual disability (ID) has previously been shown with auditory stimuli, but studies using visual stimuli are scarce. In the case of visually presented items, PSE requires verbal recoding before it appears. Using visual items, we trained 15 participants with ID to use rehearsal strategies. Another group of 13 participants took part in nonstrategic training. In both groups, PSE was tested before and after training. Participants in the strategy-training group, who showed no PSE at pretest, began to show such an effect during the training stage and maintained it until posttest as was observed through microgenetic analysis. Participants with ID showing no PSE with visual material can thus be trained to show this effect through extensive use of cumulative rehearsal. Such training would lead them to recode items verbally, which in turn would make phonological similarities more salient and lead to a PSE.
Collapse
|
23
|
Everts R, Mürner-Lavanchy I, Schroth G, Steinlin M. Neural change following different memory training approaches in very preterm born children - A pilot study. Dev Neurorehabil 2017; 20:14-24. [PMID: 25905646 DOI: 10.3109/17518423.2015.1027010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE There is mixed evidence regarding neural change following cognitive training. Brain activation increase, decrease, or a combination of both may occur. We investigated training-induced neural change using two different memory training approaches. METHODS Very preterm born children (aged 7-12 years) were randomly allocated to a memory strategy training, an intensive working memory practice or a waiting control group. Before and immediately after the trainings and the waiting period, brain activation during a visual working memory task was measured using fMRI and cognitive performance was assessed. RESULTS Following both memory trainings, there was a significant decrease of fronto-parietal brain activation and a significant increase of memory performance. In the control group, no neural or performance change occurred after the waiting period. CONCLUSION These pilot data point towards a training-related decrease of brain activation, independent of the training approach. Our data highlight the high training-induced plasticity of the child's brain during development.
Collapse
Affiliation(s)
- Regula Everts
- a Division of Neuropediatrics , Development and Rehabilitation, Children's University Hospital , Inselspital , Bern , Switzerland.,b Institute of Diagnostic and Interventional Neuroradiology, University Hospital , Inselspital , Bern , Switzerland.,c Centre for Cognition, Learning and Memory, University of Bern , Bern , Switzerland , and
| | - Ines Mürner-Lavanchy
- b Institute of Diagnostic and Interventional Neuroradiology, University Hospital , Inselspital , Bern , Switzerland.,c Centre for Cognition, Learning and Memory, University of Bern , Bern , Switzerland , and.,d Institute of Psychology, University of Bern , Bern , Switzerland
| | - Gerhard Schroth
- b Institute of Diagnostic and Interventional Neuroradiology, University Hospital , Inselspital , Bern , Switzerland
| | - Maja Steinlin
- a Division of Neuropediatrics , Development and Rehabilitation, Children's University Hospital , Inselspital , Bern , Switzerland.,c Centre for Cognition, Learning and Memory, University of Bern , Bern , Switzerland , and
| |
Collapse
|
24
|
Pei J, Tremblay M, McNeil A, Poole N, McFarlane A. Neuropsychological Aspects of Prevention and Intervention for FASD in Canada. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2016. [DOI: 10.1007/s40817-016-0020-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
du Plooy CP, Malcolm-Smith S, Adnams CM, Stein DJ, Donald KA. The Effects of Prenatal Alcohol Exposure on Episodic Memory Functioning: A Systematic Review: Table 1. Arch Clin Neuropsychol 2016; 31:710-726. [DOI: 10.1093/arclin/acw067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 01/04/2023] Open
|
26
|
Lee CSC, Pei J, Andrew G, A Kerns K, Rasmussen C. Effects of working memory training on children born preterm. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:281-296. [PMID: 27259472 DOI: 10.1080/21622965.2016.1161513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Researchers have reported benefits of working memory training in various populations, however, the training gains in preterm population is still inadequately studied. This study aimed to investigate the transfer and lasting effects of an online working memory training program on a group of preterm children aged between 4 and 6 years (mean gestational age = 28.3 weeks; mean birth weight = 1153 grams). Children were asked to perform the Cogmed JM at home for approximately 15 minutes a day, 5 days a week for 5 weeks. Their nontrained working memory and attention were assessed pre-training, post-training, and at 5-week follow-up. Parent ratings on children's executive functions were obtained at the three time points. Results revealed that significant improvements in verbal working memory was emerging in preterm children at 5-week follow-up, while significant gains in visuospatial working memory was found post-training and at 5-week follow-up in age-matched term-born children. These results indicated that working memory training has benefits on preterm children; however, the gains are different from those observed in term-born children. No significant differences in attention and parent-rated EF were found in either group across time. The possible explanations for the training benefits observed in preterm children were discussed.
Collapse
Affiliation(s)
- Clara S C Lee
- a Educational Psychology, University of Alberta , Edmonton , Alberta , Canada
| | - Jacqueline Pei
- a Educational Psychology, University of Alberta , Edmonton , Alberta , Canada
| | - Gail Andrew
- b Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
| | - Kimberly A Kerns
- c Psychology, University of Victoria , Victoria , British Colombia , Canada
| | - Carmen Rasmussen
- d Glenrose Rehabilitation Hospital, Pediatrics , Edmonton , Alberta , Canada
| |
Collapse
|
27
|
Kerns KA, Macoun S, MacSween J, Pei J, Hutchison M. Attention and working memory training: A feasibility study in children with neurodevelopmental disorders. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:120-137. [PMID: 27049769 DOI: 10.1080/21622965.2015.1109513] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study investigated the efficacy of a game-based process specific intervention for improving attention and working memory in children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD). The Caribbean Quest (CQ) is a 'serious game' that consists of five hierarchically structured tasks, delivered in an adaptive format, targeting different aspects of attention and/or working memory. In addition to game play, the intervention incorporates metacognitive strategies provided by trained educational assistants (EAs), to facilitate generalization and far transfer to academic and daily skills. EAs delivered the intervention to children (ages 6-13) during their regular school day, providing children with instruction in metacognitive strategies to improve game play, with participants completing approximately 12 hours of training over an 8 to 12 school week period. Pre- and post-test analyses revealed significant improvement on measures of working memory and attention, including reduced distractibility and improved divided attention skills. Additionally, children showed significant gains in performance on an academic measure of reading fluency, suggesting that training-related gains in attention and working memory transferred to classroom performance. Exit interviews with EAs revealed that the intervention was easily delivered within the school day, that children enjoyed the intervention, and that children transferred metacognitive strategies learned in game play into the classroom. Preliminary results support this game-based process specific intervention as a potentially effective treatment and useful tool for supporting cognitive improvements in children with FASD or ASD, when delivered as part of an overall treatment plan.
Collapse
Affiliation(s)
- Kimberly A Kerns
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Sarah Macoun
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Jenny MacSween
- a Department of Psychology , University of Victoria , Victoria , British Columbia , Canada
| | - Jacqueline Pei
- b Department of Educational Psychology , University of Alberta , Edmonton , Alberta , Canada
| | - Marnie Hutchison
- b Department of Educational Psychology , University of Alberta , Edmonton , Alberta , Canada
| |
Collapse
|
28
|
Kable JA, O'Connor MJ, Olson HC, Paley B, Mattson SN, Anderson SM, Riley EP. Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): Proposed DSM-5 Diagnosis. Child Psychiatry Hum Dev 2016. [PMID: 26202432 DOI: 10.1007/s10578-015-0566-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Over the past 40 years, a significant body of animal and human research has documented the teratogenic effects of prenatal alcohol exposure (PAE). Neurobehavioral Disorder associated with PAE is proposed as a new clarifying term, intended to encompass the neurodevelopmental and mental health symptoms associated with PAE. Defining this disorder is a necessary step to adequately characterize these symptoms and allow clinical assessment not possible using existing physically-based diagnostic schemes. Without appropriate diagnostic guidelines, affected individuals are frequently misdiagnosed and treated inappropriately (often to their considerable detriment) by mental health, educational, and criminal justice systems. Three core areas of deficits identified from the available research, including neurocognitive, self-regulation, and adaptive functioning impairments, are discussed and information regarding associated features and disorders, prevalence, course, familial patterns, differential diagnosis, and treatment of the proposed disorder are also provided.
Collapse
Affiliation(s)
- Julie A Kable
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, GA, 30329, USA.
| | - Mary J O'Connor
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Heather Carmichael Olson
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Blair Paley
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Sarah N Mattson
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, 92120, USA
| | - Sally M Anderson
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MA, USA
| | - Edward P Riley
- Department of Psychology, Center for Behavioral Teratology, San Diego State University, San Diego, CA, 92120, USA
| |
Collapse
|
29
|
Lee SJ, Ha JW, Koo MM, Hwang YM, Pyun SB. Delayed Non-word Repetition according to Rehearsal Conditions in 6- to 7-Year-Old Children. COMMUNICATION SCIENCES & DISORDERS 2016. [DOI: 10.12963/csd.16291] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
30
|
Demily C, Rigard C, Peyroux E, Chesnoy-Servanin G, Morel A, Franck N. «Cognitus & Moi»: A Computer-Based Cognitive Remediation Program for Children with Intellectual Disability. Front Psychiatry 2016; 7:10. [PMID: 26869942 PMCID: PMC4737901 DOI: 10.3389/fpsyt.2016.00010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/18/2016] [Indexed: 11/13/2022] Open
Abstract
Attentional, visuospatial, and social cognition deficits have a negative impact on children's adaptative and social competences and, as a result, on their ability to achieve a normal functioning and behavior. Until now and despite the frequency of those deficits, there is a lack of children's specific cognitive remediation tools specifically dedicated to attentional and visuospatial areas. The «Cognitus & Moi» program involves a variety of exercises in a paper and/or pencil (n = 30) or a computerized format (n = 29) and a strategy coaching approach. Each module of «Cognitus & Moi» targets a single impaired cognitive area, within the limits of cognitive domains' overlapping. The little cartoon character named Cognitus, who illustrates the program, is supposed to be very friendly and kind toward children. Cognitus will accompany them throughout the program for an effective and positive reinforcement. The main goal of «Cognitus & Moi» is to adjust to children's difficulties in daily life. Moreover, since the cognitive remediation benefit is complex to apply in daily life, the program is based on a metacognitive strategy. After a complete neuropsychological assessment and a psychoeducational session (with the child and the parents), 16 1-h-sessions of cognitive remediation with the therapist are proposed. Each session is composed of three parts: (1) computerized tasks focusing on specific attentional or visuospatial components (20 min). The attentional module targets hearing, visual, and divided attention. A double attention task is also proposed. The visuospatial module targets eye tracking and gaze direction, spatial orientation, visuospatial memory and construction, and mental imagery; (2) pen and paper tasks focusing on the same processes (20 min) and a facial emotion recognition task; (3) a proposal of a home-based task (during 20 min). Weekly, specific attentional and visuospatial home tasks are proposed to the child and analyzed with the parents and the therapist. Indeed, home exercises are useful to promote the transfer of strategies to daily life and their subsequent automation. The heterogeneity of cognitive deficits in intellectual deficiency necessitates an individualized cognitive remediation therapy. In this regard, «Cognitus & Moi» seems to be a promising tool.
Collapse
Affiliation(s)
- Caroline Demily
- GénoPsy, Center for the Diagnosis and Management of Genetic Psychiatric Disorders, CH Le Vinatier, Bron, France; UMR 5229, EDR-Psy, Center of Cognitive Neuroscience, CNRS, University Lyon 1, Lyon, France
| | - Caroline Rigard
- GénoPsy, Center for the Diagnosis and Management of Genetic Psychiatric Disorders, CH Le Vinatier, Bron, France; UMR 5229, EDR-Psy, Center of Cognitive Neuroscience, CNRS, University Lyon 1, Lyon, France
| | - Elodie Peyroux
- GénoPsy, Center for the Diagnosis and Management of Genetic Psychiatric Disorders, CH Le Vinatier, Bron, France; UMR 5229, EDR-Psy, Center of Cognitive Neuroscience, CNRS, University Lyon 1, Lyon, France; Centre référent lyonnais en réhabilitation psychosociale et en remédiation cognitive (CL3R), CH Le Vinatier, Bron, France
| | | | - Aurore Morel
- GénoPsy, Center for the Diagnosis and Management of Genetic Psychiatric Disorders, CH Le Vinatier, Bron, France; UMR 5229, EDR-Psy, Center of Cognitive Neuroscience, CNRS, University Lyon 1, Lyon, France
| | - Nicolas Franck
- UMR 5229, EDR-Psy, Center of Cognitive Neuroscience, CNRS, University Lyon 1, Lyon, France; Centre référent lyonnais en réhabilitation psychosociale et en remédiation cognitive (CL3R), CH Le Vinatier, Bron, France
| |
Collapse
|
31
|
Reid N, Dawe S, Shelton D, Harnett P, Warner J, Armstrong E, LeGros K, O'Callaghan F. Systematic Review of Fetal Alcohol Spectrum Disorder Interventions Across the Life Span. Alcohol Clin Exp Res 2015; 39:2283-95. [DOI: 10.1111/acer.12903] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/09/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Natasha Reid
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Brisbane Queensland Australia
| | - Sharon Dawe
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Brisbane Queensland Australia
- Australian Centre for Child Protection; University of South Australia; Adelaide South Australia Australia
| | - Douglas Shelton
- Community Child Health; Gold Coast Hospital & Health Service; Gold Coast Queensland Australia
| | - Paul Harnett
- School of Psychology; University of Queensland; Brisbane Queensland Australia
| | - Judith Warner
- Community Child Health; Gold Coast Hospital & Health Service; Gold Coast Queensland Australia
| | - Eleanor Armstrong
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Brisbane Queensland Australia
| | - Kim LeGros
- Community Child Health; Gold Coast Hospital & Health Service; Gold Coast Queensland Australia
| | - Frances O'Callaghan
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| |
Collapse
|
32
|
Kable JA, Coles CD, Keen CL, Uriu-Adams JY, Jones KL, Yevtushok L, Kulikovsky Y, Wertelecki W, Pedersen TL, Chambers CD. The impact of micronutrient supplementation in alcohol-exposed pregnancies on information processing skills in Ukrainian infants. Alcohol 2015; 49:647-56. [PMID: 26493109 PMCID: PMC4636447 DOI: 10.1016/j.alcohol.2015.08.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 12/24/2022]
Abstract
The potential of micronutrients to ameliorate the impact of prenatal alcohol exposure (PAE) was explored in a clinical trial conducted in Ukraine. Cardiac orienting responses (ORs) during a habituation/dishabituation learning paradigm were obtained from 6 to 12 month-olds to assess neurophysiological encoding and memory. Women who differed in prenatal alcohol use were recruited during pregnancy and assigned to a group (No study-provided supplements, multivitamin/mineral supplement, or multivitamin/mineral supplement plus choline supplement). Heart rate was collected for 30 s prior to stimulus onset and 12 s post-stimulus onset. Difference values (∆HR) for the first 3 trials of each condition were aggregated for analysis. Gestational blood samples were collected to assess maternal nutritional status and changes as a function of the intervention. Choline supplementation resulted in a greater ∆HR on the visual habituation trials for all infants and for the infants with no PAE on the dishabituation trials. The latency of the response was reduced in both conditions for all infants whose mothers received choline supplementation. Change in gestational choline level was positively related to ∆HR during habituation trials and levels of one choline metabolite, dimethylglycine (DMG), predicted ∆HR during habituation trials and latency of responses. A trend was found between DMG and ∆HR on the dishabituation trials and latency of the response. Supplementation did not affect ORs to auditory stimuli. Choline supplementation when administered together with routinely recommended multivitamin/mineral prenatal supplements during pregnancy may provide a beneficial impact to basic learning mechanisms involved in encoding and memory of environmental events in alcohol-exposed pregnancies as well as non- or low alcohol-exposed pregnancies. Changes in maternal nutrient status suggested that one mechanism by which choline supplementation may positively impact brain development is through prevention of fetal alcohol-related depletion of DMG, a metabolic nutrient that can protect against overproduction of glycine, during critical periods of neurogenesis.
Collapse
Affiliation(s)
- J A Kable
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, USA; Department of Pediatrics, Emory University School of Medicine, USA.
| | - C D Coles
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, USA; Department of Pediatrics, Emory University School of Medicine, USA
| | - C L Keen
- Department of Nutrition, University of California, Davis, USA
| | - J Y Uriu-Adams
- Department of Nutrition, University of California, Davis, USA
| | - K L Jones
- Department of Pediatrics, University of California, San Diego, USA
| | - L Yevtushok
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne Province, Ukraine
| | - Y Kulikovsky
- OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne Province, Ukraine
| | - W Wertelecki
- Department of Pediatrics, University of California, San Diego, USA; Department of Medical Genetics, University of South Alabama, USA
| | - T L Pedersen
- United States Department of Agriculture, Agricultural Research Service (ARS), Western Human Nutrition Research Center, Davis, CA, USA
| | - C D Chambers
- Department of Pediatrics, University of California, San Diego, USA; Department of Family Medicine and Public Health, University of California, San Diego, USA
| |
Collapse
|
33
|
Glass L, Graham DM, Akshoomoff N, Mattson SN. Cognitive factors contributing to spelling performance in children with prenatal alcohol exposure. Neuropsychology 2015; 29:817-28. [PMID: 25643217 PMCID: PMC4522410 DOI: 10.1037/neu0000185] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Heavy prenatal alcohol exposure is associated with impaired school functioning. Spelling performance has not been comprehensively evaluated. We examined whether children with heavy prenatal alcohol exposure demonstrate deficits in spelling and related abilities, including reading, and tested whether there are unique underlying mechanisms for observed deficits in this population. METHOD Ninety-six school-age children made up 2 groups: children with heavy prenatal alcohol exposure (AE, n = 49) and control children (CON, n = 47). Children completed select subtests from the Wechsler Individual Achievement Test-Second Edition and the NEPSY-II. Group differences and relations between spelling and theoretically related cognitive variables were evaluated using multivariate analysis of variance and Pearson correlations. Hierarchical regression analyses were used to assess contributions of group membership and cognitive variables to spelling performance. The specificity of these deficits and underlying mechanisms was tested by examining the relations between reading ability, group membership, and cognitive variables. RESULTS Groups differed significantly on all variables. Group membership and phonological processing significantly contributed to spelling performance, whereas for reading, group membership and all cognitive variables contributed significantly. For both reading and spelling, group × working memory interactions revealed that working memory contributed independently only for alcohol-exposed children. CONCLUSION Alcohol-exposed children demonstrated a unique pattern of spelling deficits. The relation of working memory to spelling and reading was specific to the AE group, suggesting that if prenatal alcohol exposure is known or suspected, working memory ability should be considered in the development and implementation of explicit instruction.
Collapse
Affiliation(s)
- Leila Glass
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, California
| | - Diana M. Graham
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, California
| | - Natacha Akshoomoff
- Department of Psychiatry and Center for Human Development, University of California, San Diego, California
| | - Sarah N. Mattson
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, California
| |
Collapse
|
34
|
Orsolini M, Melogno S, Latini N, Penge R, Conforti S. Treating verbal working memory in a boy with intellectual disability. Front Psychol 2015; 6:1091. [PMID: 26284014 PMCID: PMC4519672 DOI: 10.3389/fpsyg.2015.01091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/15/2015] [Indexed: 11/29/2022] Open
Abstract
The present case study investigates the effects of a cognitive training of verbal working memory that was proposed for Davide, a 14-year-old boy diagnosed with mild intellectual disability. The program stimulated attention, inhibition, switching, and the ability to engage either in verbal dual tasks or in producing inferences after the content of a short passage had been encoded in episodic memory. Key elements in our program included (1) core training of target cognitive mechanisms; (2) guided practice emphasizing concrete strategies to engage in exercises; and (3) a variable amount of adult support. The study explored whether such a complex program produced "near transfer" effects on an untrained dual task assessing verbal working memory and whether effects on this and other target cognitive mechanisms (i.e., attention, inhibition, and switching) were long-lasting and produced "far transfer" effects on cognitive flexibility. The effects of the intervention program were investigated with a research design consisting of four subsequent phases lasting 8 or 10 weeks, each preceded and followed by testing. There was a control condition (phase 1) in which the boy received, at home, a stimulation focused on the visuospatial domain. Subsequently, there were three experimental training phases, in which stimulation in the verbal domain was first focused on attention and inhibition (phase 2a), then on switching and simple working memory tasks (phase 2b), then on complex working memory tasks (phase 3). A battery of neuropsychological tests was administered before and after each training phase and 7 months after the conclusion of the intervention. The main finding was that Davide changed from being incapable of addressing the dual task request of the listening span test in the initial assessment to performing close to the normal limits of a 13-year-old boy in the follow-up assessment with this test, when he was 15 years old.
Collapse
Affiliation(s)
- Margherita Orsolini
- Dipartimento di Psicologia dei Processi di Sviluppo e Socializzazione, Sapienza Università di RomaRoma, Italy
| | - Sergio Melogno
- Dipartimento di Pediatria e Neuropsichiatria Infantile, Sapienza Università di RomaRoma, Italy
| | - Nausica Latini
- Dipartimento di Psicologia dei Processi di Sviluppo e Socializzazione, Sapienza Università di RomaRoma, Italy
| | - Roberta Penge
- Dipartimento di Pediatria e Neuropsichiatria Infantile, Sapienza Università di RomaRoma, Italy
| | - Sara Conforti
- Dipartimento di Psicologia, Sapienza Università di RomaRoma, Italy
| |
Collapse
|
35
|
Cassanelli PM, Cladouchos ML, Fernández Macedo G, Sifonios L, Giaccardi LI, Gutiérrez ML, Gravielle MC, Wikinski S. Working memory training triggers delayed chromatin remodeling in the mouse corticostriatothalamic circuit. Prog Neuropsychopharmacol Biol Psychiatry 2015; 60:93-103. [PMID: 25724761 DOI: 10.1016/j.pnpbp.2015.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/05/2015] [Accepted: 02/16/2015] [Indexed: 01/10/2023]
Abstract
Working memory is a cognitive function serving goal-oriented behavior. In the last decade, working memory training has been shown to improve performance and its efficacy for the treatment of several neuropsychiatric disorders has begun to be examined. Neuroimaging studies have contributed to elucidate the brain areas involved but little is known about the underlying cellular events. A growing body of evidence has provided a link between working memory and relatively long-lasting epigenetic changes. However, the effects elicited by working memory training at the epigenetic level remain unknown. In this study we establish an animal model of working memory training and explore the changes in histone H3 acetylation (H3K9,14Ac) and histone H3 dimethylation on lysine 27 (H3K27Me2) triggered by the procedure in the brain regions of the corticostriatothalamic circuit (prelimbic/infralimbic cortex (PrL/IL), dorsomedial striatum (DMSt) and dorsomedial thalamus (DMTh)). Mice trained on a spontaneous alternation task showed improved alternation scores when tested with a retention interval that disrupts the performance of untrained animals. We then determined the involvement of the brain areas of the corticostriatothalamic circuit in working memory training by measuring the marker of neuronal activation c-fos. We observed increased c-fos levels in PrL/IL and DMSt in trained mice 90min after training. These animals also presented lower immunoreactivity for H3K9,14Ac in DMSt 24h but not 90min after the procedure. Increases in H3K27Me2, a repressive chromatin mark, were found in the DMSt and DMTh 24h after the task. Altogether, we present a mouse model to study the cellular underpinnings of working memory training and provide evidence indicating delayed chromatin remodeling towards repression triggered by the procedure.
Collapse
Affiliation(s)
- Pablo Martín Cassanelli
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Laura Cladouchos
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Georgina Fernández Macedo
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Sifonios
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Inés Giaccardi
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - María Laura Gutiérrez
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - María Clara Gravielle
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Wikinski
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina; 1ª Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
36
|
Schaffer Y, Geva R. Memory outcomes following cognitive interventions in children with neurological deficits: A review with a focus on under-studied populations. Neuropsychol Rehabil 2015; 26:286-317. [PMID: 25730385 DOI: 10.1080/09602011.2015.1016537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given the primary role of memory in children's learning and well-being, the aim of this review was to examine the outcomes of memory remediation interventions in children with neurological deficits as a function of the affected memory system and intervention method. Fifty-seven studies that evaluated the outcome of memory interventions in children were identified. Thirty-four studies met the inclusion criteria, and were included in a systematic review. Diverse rehabilitation methods for improving explicit and implicit memory in children were reviewed. The analysis indicates that teaching restoration strategies may improve, and result in the generalisation of, semantic memory and working memory performance in children older than 7 years with mild to moderate memory deficits. Factors such as longer protocols, emotional support, and personal feedback contribute to intervention efficacy. In addition, the use of compensation aids seems to be highly effective in prospective memory tasks. Finally, the review unveiled a lack of studies with young children and the absence of group interventions. These findings point to the importance of future evidence-based intervention protocols in these areas.
Collapse
Affiliation(s)
- Yael Schaffer
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
| | - Ronny Geva
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
| |
Collapse
|
37
|
Ethanol, Neurodevelopment, Infant and Child Health (ENRICH) prospective cohort: Study design considerations. ACTA ACUST UNITED AC 2015; 2. [PMID: 26491726 PMCID: PMC4610372 DOI: 10.12715/apr.2015.2.10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND While intervention is the leading factor in reducing long-term disabilities in children with fetal alcohol spectrum disorder (FASD), early identification of children affected by prenatal alcohol exposure (PAE) remains challenging. Deficits in higher-order cognitive domains (e.g. executive function) might be more specific to FASD than global neurodevelopmental tests, yet these functions are not developed in very young children. Measures of early sensorimotor development may provide early indications of atypical brain development during the first two years of life. METHODS This paper describes the novel methodology of the Ethanol, Neurodevelopment, Infant and Child Health (ENRICH) prospective cohort study of 120 maternal-infant pairs with a goal to identify early indices of functional brain impairment associated with PAE. The cohort is established by recruiting women early in pregnancy and classifying them into one of three study groups: patients on opioid-maintenance therapy who consume alcohol during pregnancy (Group 1), patients on opioid-maintenance therapy who abstain from alcohol during pregnancy (Group 2), and healthy controls (Group 3). After the initial prenatal assessment (Visit 1), patients are followed to Visit 2 occurring at delivery, and two comprehensive assessments of children at six (Visit 3) and 20 months (Visit 4) of age. ENRICH recruitment started in November 2013 and 87 women were recruited during the first year. During Year 1, the biospecimen (maternal whole blood, serum, urine, dry blood spots of a newborn) collection rate was 100% at Visit 1, and 97.6% for those who completed Visit 2. DISCUSSION The tiered screening approach, evaluation of confounders, neurocognitive and magneto-/electro-encephalography (MEG/EEG) outcomes, and ethical considerations are discussed.
Collapse
|
38
|
Abstract
Prenatal alcohol exposure (PAE) is one of the most prevalent and modifiable risk factors for somatic, behavioral, and neurological abnormalities. Affected individuals exhibit a wide range of such features referred to as fetal alcohol spectrum disorders (FASD). These are characterized by a more or less specific pattern of minor facial dysmorphic features, growth deficiency and central nervous system symptoms. Nevertheless, whereas the diagnosis of the full-blown fetal alcohol syndrome does not pose a major challenge, only a tentative diagnosis of FASD can be reached if only mild features are present and/or maternal alcohol consumption during pregnancy cannot be verified. The respective disorders have lifelong implications. The teratogenic mechanisms induced by PAE can lead to various additional somatic findings and structural abnormalities of cerebrum and cerebellum. At the functional level, cognition, motor coordination, attention, language development, executive functions, memory, social perception and emotion processing are impaired to a variable extent. The long-term development is characterized by disruption and failure in many domains; an age-adequate independency is frequently not achieved. In addition to primary prevention, individual therapeutic interventions and tertiary prevention are warranted; provision of extensive education to affected subjects and their caregivers is crucial. Protective environments are often required to prevent negative consequences such as delinquency, indebtedness or experience of physical/sexual abuse.
Collapse
|
39
|
Koren G, Zelner I, Nash K, Koren G. Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions. Curr Opin Psychiatry 2014; 27:98-104. [PMID: 24445400 DOI: 10.1097/yco.0000000000000038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Since the first description of the foetal damage of alcohol in 1967, numerous studies have outlined different aspects of neurodevelopmental dysfunction, adversely affecting the lives of children worldwide. Although the cause of the syndrome is sorted out, the pathogenesis of brain damage is far from being clear. In contrast to children exhibiting the full facial dysmorphology, who are relatively easy to diagnose, in those presenting only with alcohol-related neurodevelopmental damage diagnosis is much more challenging due to poor specificity of the brain dysfunction. Hence, identifying the neurodevelopmental phenotype of foetal alcohol spectrum disorder (FASD) is a major challenge. RECENT FINDINGS Recently, a behavioural phenotype of FASD has been described and validated using items from the Child Behaviour Checklist. This tool has high sensitivity and specificity in separating children with FASD from those with ADHD and from healthy controls. In parallel, a number of intervention studies show promise in improving the abilities of children and adolescents with the syndrome to cope with daily tasks and improve their quality of life. SUMMARY The neurobehavioural screening test can facilitate screening for FASD and is an official screening tool in the FASD toolkit of the Public Health Agency of Canada. Promising new interventions may attenuate the long-term outcome of these children.
Collapse
Affiliation(s)
- Gideon Koren
- aMotherisk Program, Division of Clinical Pharmacology-Toxicology, Department of Pediatrics bDepartment of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
40
|
Di Pietro NC, Illes J. Disparities in Canadian indigenous health research on neurodevelopmental disorders. J Dev Behav Pediatr 2014; 35:74-81. [PMID: 24356498 DOI: 10.1097/dbp.0000000000000002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To map the landscape of research on autism (ASD), cerebral palsy (CP), and fetal alcohol spectrum disorder (FASD) in Canadian Aboriginal children. METHOD The authors used a detailed search strategy to identify and access publications on ASD, CP, and FASD involving Canadian Aboriginal children, families, and communities from online databases. They analyzed these materials for the type of research, stated objectives, methodologies, and the level of engagement of Aboriginal Peoples. RESULTS The authors found a total of 52 reports published since 1981 relevant to Aboriginal children. Of these, 51 focused exclusively on FASD. They also found a near-complete failure to acknowledge community involvement in research decisions or dissemination of results in any of the publications. CONCLUSIONS The focus on FASD in Aboriginal children and the absence of research on the other 2 major childhood disorders are at odds with rates of these disorders across Canadian children. The authors argue that this trend violates fundamental principles ensuring equitable representation of all children regardless of background in research and access to benefits of research in health care and perpetuates stigma in an already marginalized population.
Collapse
Affiliation(s)
- Nina C Di Pietro
- *National Core for Neuroethics, Division of Neurology, Faculty of Medicine; and †NeuroDevNet, Inc., University of British Columbia, Vancouver, Canada
| | | |
Collapse
|
41
|
Zhao X, Zhou R, Fu L. Working memory updating function training influenced brain activity. PLoS One 2013; 8:e71063. [PMID: 24015182 PMCID: PMC3754993 DOI: 10.1371/journal.pone.0071063] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/25/2013] [Indexed: 11/18/2022] Open
Abstract
Recent studies demonstrated that working memory could be improved by training. We recruited healthy adult participants and used adaptive running working memory training tasks with a double-blind design, combined with the event-related potentials (ERPs) approach, to explore the influence of updating function training on brain activity. Participants in the training group underwent training for 20 days. Compared with the control group, the training group's accuracy (ACC) in the two-back working memory task had no significant differences after training, but reaction time (RT) was reduced significantly. Besides, the amplitudes of N160 and P300 increased significantly whereas that of P200 decreased significantly. The results suggest that training could have improved the participants' capacity on both inhibitory and updating.
Collapse
Affiliation(s)
- Xin Zhao
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Renlai Zhou
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
| | - Li Fu
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, China
| |
Collapse
|
42
|
Schreiber W, St. Cyr S, Jablonski S, Hunt P, Klintsova A, Stanton M. Effects of exercise and environmental complexity on deficits in trace and contextual fear conditioning produced by neonatal alcohol exposure in rats. Dev Psychobiol 2013; 55:483-95. [PMID: 22644967 PMCID: PMC4134880 DOI: 10.1002/dev.21052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 05/02/2012] [Indexed: 12/23/2022]
Abstract
In rodents, voluntary exercise and environmental complexity increases hippocampal neurogenesis and reverses spatial learning and long-term potentiation deficits in animals prenatally exposed to alcohol. The present experiment extended these findings to neonatal alcohol exposure and to delay, trace, and contextual fear conditioning. Rats were administered either 5.25 g/kg/day alcohol via gastric intubation or received sham-intubations (SI) between Postnatal Day (PD) 4 and 9 followed by either free access to a running wheel on PD 30-41 and housing in a complex environment on PD 42-72 (wheel-running plus environmental complexity; WREC) or conventional social housing (SHSH) from PD 30 to 72. Adult rats (PD 80 ± 5) received 5 trials/day of a 10-s flashing-light conditioned stimulus (CS) paired with .8 mA footshock either immediately (delay conditioning) or after a 10-s trace interval (trace conditioning) for 2 days. Neonatal alcohol exposure impaired context and trace conditioning, but not short-delay conditioning. The WREC intervention did not reverse these deficits, despite increasing context-related freezing in ethanol-exposed and SI animals.
Collapse
Affiliation(s)
- W.B. Schreiber
- Department of Psychology, University of Delaware, Newark, DE 19716
| | - S.A. St. Cyr
- Department of Psychology, University of Delaware, Newark, DE 19716
| | - S.A. Jablonski
- Department of Psychology, University of Delaware, Newark, DE 19716
| | - P.S. Hunt
- Department of Psychology, College of William & Mary, Williamsburg, VA 23187
| | - A.Y. Klintsova
- Department of Psychology, University of Delaware, Newark, DE 19716
| | - M.E. Stanton
- Department of Psychology, University of Delaware, Newark, DE 19716
| |
Collapse
|
43
|
Alloway TP, Bibile V, Lau G. Computerized working memory training: Can it lead to gains in cognitive skills in students? COMPUTERS IN HUMAN BEHAVIOR 2013. [DOI: 10.1016/j.chb.2012.10.023] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
44
|
Davis KM, Gagnier KR, Moore TE, Todorow M. Cognitive aspects of fetal alcohol spectrum disorder. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2012; 4:81-92. [DOI: 10.1002/wcs.1202] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
45
|
Pei J, Job J, Kully-Martens K, Rasmussen C. Executive function and memory in children with Fetal Alcohol Spectrum Disorder. Child Neuropsychol 2011; 17:290-309. [PMID: 21718218 DOI: 10.1080/09297049.2010.544650] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A complex relation exists between memory and executive functioning (EF), particularly when learning and recalling multifaceted or extensive information ( Moscovitch & Winocur, 2002 ). A common instrument for evaluating this relationship is the Rey-Osterrieth Complex Figure (ROCF; Rey, 1941 ; Osterrieth, 1944 ). The ROCF has proved particularly useful in pediatric research; however, little research has been conducted among children with Fetal Alcohol Spectrum Disorders (FASD). Seventy children (35 FASD, 35 control), aged 6 to 12 years, were tested using the ROCF. All participants with FASD had received a diagnosis according to the Canadian guidelines for FASD ( Chudley et al., 2005 ) using the 4-digit diagnostic code ( Astley, 2004 ). Significant group differences were revealed with children with FASD demonstrating substantial difficulties in organization, accuracy, and memory. Among children with FASD, a distinctive profile emerged, lending support to the argument that children with FASD experience deficits in EF and memory throughout their development. Information from the present study will not only help to improve understanding of functioning in this population but also provide insight into how to deal with EF and memory deficits in terms of testing, treatment, and intervention.
Collapse
Affiliation(s)
- Jacqueline Pei
- Department of Educational Psychology, University of Alberta , Edmonton, Canada
| | | | | | | |
Collapse
|
46
|
Does working memory training work? The promise and challenges of enhancing cognition by training working memory. Psychon Bull Rev 2011; 18:46-60. [PMID: 21327348 DOI: 10.3758/s13423-010-0034-0] [Citation(s) in RCA: 385] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A growing body of literature shows that one's working memory (WM) capacity can be expanded through targeted training. Given the established relationship between WM and higher cognition, these successful training studies have led to speculation that WM training may yield broad cognitive benefits. This review considers the current state of the emerging WM training literature, and details both its successes and limitations. We identify two distinct approaches to WM training, strategy training and core training, and highlight both the theoretical and practical motivations that guide each approach. Training-related increases in WM capacity have been successfully demonstrated across a wide range of subject populations, but different training techniques seem to produce differential impacts upon the broader landscape of cognitive abilities. In particular, core WM training studies seem to produce more far-reaching transfer effects, likely because they target domain-general mechanisms of WM. The results of individual studies encourage optimism regarding the value of WM training as a tool for general cognitive enhancement. However, we discuss several limitations that should be addressed before the field endorses the value of this approach.
Collapse
|
47
|
Kodituwakku PW, Kodituwakku EL. From research to practice: an integrative framework for the development of interventions for children with fetal alcohol spectrum disorders. Neuropsychol Rev 2011; 21:204-23. [PMID: 21544706 DOI: 10.1007/s11065-011-9170-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 04/24/2011] [Indexed: 01/06/2023]
Abstract
Since fetal alcohol syndrome was first described over 35 years ago, considerable progress has been made in the delineation of the neurocognitive profile in children with prenatal alcohol exposure. Preclinical investigators have made impressive strides in elucidating the mechanisms of alcohol teratogenesis and in testing the effectiveness of pharmacological agents and dietary supplementation in the amelioration of alcohol-induced deficits. Despite these advances, only limited progress has been made in the development of evidence-based comprehensive interventions for functional impairment in alcohol-exposed children. Having performed a search in PubMed and PsycINFO using key words, interventions, treatment, fetal alcohol syndrome, prenatal alcohol exposure, and fetal alcohol spectrum disorders, we found only 12 papers on empirically-based interventions. Only two of these interventions had been replicated and none met the criteria of "well-established," as defined by Chambless and Hollon (Journal of Consulting and Clinical Psychology 66(1):7-18, 1998). There has been only limited cross-fertilization of ideas between preclinical and clinical research with regard to the development of interventions. Therefore, we propose a framework that allows integrating data from preclinical and clinical investigations to develop comprehensive intervention programs for children with fetal alcohol spectrum disorders. This framework underscores the importance of multi-level evaluations and interventions.
Collapse
|
48
|
|
49
|
A neurodevelopmental framework for the development of interventions for children with fetal alcohol spectrum disorders. Alcohol 2010; 44:717-28. [PMID: 20036485 DOI: 10.1016/j.alcohol.2009.10.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 10/08/2009] [Accepted: 10/13/2009] [Indexed: 01/24/2023]
Abstract
Despite considerable data published on cognitive and behavioral disabilities in children with fetal alcohol spectrum disorders (FASD), relatively little information is available on behavioral or pharmacological interventions for alcohol-affected children. The main goals of this article, therefore, are to summarize published intervention studies of FASD and to present a neurodevelopmental framework, based on recent findings from a number of disciplines, for designing new therapies for alcohol-affected children. This framework assumes a neuroconstructionist view, which posits that reciprocal interactions between neural activity and the brain's hardware lead to the progressive formation of intra- and interregional neural connections. In this view, behavioral interventions can be conceptualized as a series of guided experiences that are designed to produce neural activation. Based on evidence from cognitive neuroscience, it is hypothesized that specific interventions targeting executive attention and self-regulation may produce greater generalizable results than those aimed at domain-specific skills in children with FASD. In view of reciprocal interactions between environmental effects and neural structures, the proposed framework suggests that the maximum effects of interventions can eventually be achieved by optimally combining behavioral methods and cognition-enhancing drugs.
Collapse
|
50
|
Montgomery JW, Magimairaj BM, Finney MC. Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010; 19:78-94. [PMID: 19948760 DOI: 10.1044/1058-0360(2009/09-0028)] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Children with specific language impairment (SLI) demonstrate significant language impairments despite normal-range hearing and nonverbal IQ. Many of these children also show marked deficits in working memory (WM) abilities. However, the theoretical and clinical characterization of the association between WM and language limitations in SLI is still sparse. Our understanding of this association would benefit greatly from an updated and thorough review of the literature. METHOD We review the newest developments in these areas from both a theoretical and clinical perspective. Our intent is to provide researchers and practicing clinicians (a) a conceptual framework within which the association between WM and language limitations of children with SLI can be understood and (b) potentially helpful suggestions for assessing and treating the memory-language difficulties of children with SLI. CONCLUSIONS In the past 10 years, important new theoretical insights into the range and nature of WM deficits and relation between these limitations and the language difficulties in SLI have occurred. New, robust diagnostic assessment tools and computerized treatment methods designed to enhance children's WM functioning have also been developed. The assessment, diagnosis, and treatment of the language difficulties in SLI should consider the potential influence of WM.
Collapse
|