Neuropsychological test scores, academic performance, and developmental disorders in Spanish-speaking children

Neurodevelopmental assessments used to measure preschoolers' cognitive development in Latin America: a systematic review

OBJECTIVE

The objective of this study was to systematically review the standardized neurodevelopmental assessments used to study preschool-aged children's cognitive development in Spanish-speaking Latin America.

METHODS

The authors systematically searched PubMed, PsycINFO, and ERIC databases for peer-reviewed articles from Spanish-speaking Latin American countries. Articles were included if they measured cognitive development among children aged 2-6 years using at least one standardized assessment tool; 97 articles were included and reviewed in accordance with PRISMA guidelines to assess their use of these tools.

RESULTS

Ninety-seven studies across 13 countries used a total of 41 assessments to measure cognitive development; most widely used were the Wechsler intelligence scales (n = 46/97), particularly the Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children (n = 23 and 29, respectively). Other common assessments included the McCarthy Scales of Children's Abilities (n = 9), Raven's Progressive Matrices (n = 9), Child Neuropsychological Assessment (n = 8), and Peabody Picture Vocabulary Test (n = 7). In regions where normative data for a given assessment were unpublished, authors commonly used norms from the United States, Mexico, or Spain or did not report standard scores in their analyses.

CONCLUSIONS

The wide range of tools used in these studies presents a challenge for generalizing results when measuring the neurodevelopment of Latin American preschool-aged children. The low availability of normative data for specific regions reveals concerns if some tools are culturally and linguistically appropriate even when Spanish is a common language, particularly in low-resource settings. Future work to forge greater consistency in the use of validated measures, clarity in reporting research methods, and publication of regional normative data would benefit the field.

Mirror movements and callosal dysgenesis in a family with a DCC mutation: Neuropsychological and neuroimaging outcomes

Corpus callosum dysgenesis is a congenital abnormality whereby the corpus callosum fails to develop normally, and has been associated with a range of neuropsychological outcomes. One specific finding in some individuals with corpus callosum dysgenesis is "congenital mirror movement disorder", which is the presence of involuntary movements on one side of the body that mimic voluntary movements of the other side. Mirror movements have also been associated with mutations in the deleted in colorectal carcinoma (DCC) gene. The current study aims to comprehensively document the neuropsychological outcomes and neuroanatomical mapping of a family (a mother, daughter and son) with known DCC mutations. All three family members experience mirror movements, and the son additionally has partial agenesis of the corpus callosum (pACC). All family members underwent extensive neuropsychological testing, spanning general intellectual functioning, memory, language, literacy, numeracy, psychomotor speed, visuospatial perception, praxis and motor functioning, executive functioning, attention, verbal/nonverbal fluency, and social cognition. The mother and daughter had impaired memory for faces, and reduced spontaneous speech, and the daughter demonstrated scattered impairments in attention and executive functioning, but their neuropsychological abilities were largely within normal limits. By contrast, the son showed areas of significant impairment across multiple domains including reduced psychomotor speed, fine motor dexterity and general intellectual functioning, and he was profoundly impaired across areas of executive functioning and attention. Reductions in his verbal/non-verbal fluency, with relatively intact core language, resembled dynamic frontal aphasia. His relative strengths included aspects of memory and he demonstrated largely sound theory of mind. Neuroimaging revealed an asymmetric sigmoid bundle in the son, connecting, via the callosal remnant, the left frontal cortex with contralateral parieto-occipital cortex. Overall, this study documents a range of neuropsychological and neuroanatomical outcomes within one family with DCC mutations and mirror movements, including one with more severe consequences and pACC.

Cross-validation and initial investigation of two abbreviated methods of the finger tapping test

The Finger Tapping Test (FTT) is a widely utilized measure to assess lateralized motor speed and dexterity. The current study sought to cross-validate an abbreviated version of the FTT (i.e., M of Trials 3-5) and to evaluate a novel abbreviated method (i.e., M of three trials within five taps of each other; "3 within 5") to examine their respective effectiveness as a predictor of full-score performance based on a traditional administration procedure. The results showed that the abbreviated methods accurately predicted the full-test score, and any statistically significant differences that emerged were small based on effect size analysis and unlikely to be clinically meaningful. These findings were consistent across genders, among older adults, and among individuals displaying significant inter-trial tapping variability and thus requiring lengthier administration time. Classification accuracy statistics for the detection of impairment and performance validity status were high for both abbreviated methods. The results support two valid options for shortening the duration of the FTT. Both methods, used independently or in combination, are compatible with traditional administration procedures.

Effects of age and sex on outcomes of the Q-Motor speeded finger tapping and grasping and lifting tests-findings from the population-based BiDirect Study

Background

Q-Motor is a suite of motor tests originally designed to assess motor symptoms in Huntington's disease. Among others, Q-Motor encompasses a finger tapping task and a grasping and lifting task. To date, there are no systematic investigations regarding effects of variables which may affect the performance in specific Q-Motor tests per se, and normative Q-Motor data based on a large population-based sample are not yet available.

Objective

We investigated effects of age and sex on five selected Q-Motor outcomes representing the two core Q-Motor tasks speeded finger tapping and grasping and lifting in a community sample of middle-aged to elderly adults. Furthermore, we explored effects of the potentially mediating variables educational attainment, alcohol consumption, smoking status, and depressive symptoms. Moreover, we explored inter-examiner variability. Finally, we compared the findings to findings for the Purdue Pegboard test.

Methods

Based on a sample of 726 community-dwelling adults and using multiple (Gaussian) regression analysis, we modeled the motor outcomes using age, sex, years in full-time education, depressive symptoms in the past seven days, alcohol consumption in the past seven days, and smoking status as explanatory variables.

Results

With regard to the Q-Motor tests, we found that more advanced age was associated with reduced tapping speed, male sex was associated with increased tapping speed and less irregularity, female sex was associated with less involuntary movement, more years of education were associated with increased tapping speed and less involuntary movement, never smoking was associated with less involuntary movement compared to current smoking, and more alcohol consumed was associated with more involuntary movement.

Conclusion

The present results show specific effects of age and sex on Q-Motor finger tapping and grasping and lifting performance. In addition, besides effects of education, there also were specific effects of smoking status and alcohol consumption. Importantly, the present study provides normative Q-Motor data based on a large population-based sample. Overall, the results are in favor of the feasibility and validity of Q-Motor finger tapping and grasping and lifting for large observational studies. Due to their low task-complexity and lack of placebo effects, Q-Motor tests may generate additional value in particular with regard to clinical conditions such as Huntington's or Parkinson's disease.

Pediatric Co-Norms for Finger Tapping, Grip Strength, and Grooved Pegboard in a Community Sample

OBJECTIVE

Motor tests, including Finger-Tapping Test, Grooved Pegboard Test, and Grip Strength Test, are frequently used by neuropsychologists when assessing pediatric populations. Many of the norms available for these measures are outdated, have not been co-normed, and have samples with limited diversity. This study aims to provide updated, co-norms for three commonly used motor tasks with a diverse population.

METHOD

Participants (n = 476; age range 6-14) were recruited from community settings to complete each of the three motor tests.

RESULTS

Results demonstrate generally improved performance across ages with no significant difference between performance of males and females on the Grooved Pegboard Test or the Finger Tapping Test. The only significant findings were on the Grip Strength Test where 12-14-year-old boys demonstrated stronger performance on the dominant hand.

CONCLUSION

This study provides updated and co-normed data on frequently used motor tasks with a diverse pediatric sample, which are useful for clinicians.

Halstead Category Test sensitivity to neurocognitive deficits in prenatal alcohol exposed and cognitively impaired children

Objective: The Halstead Category Test (HCT) has been demonstrated to be sensitive to executive dysfunction in adults and children. Children with a history of significant prenatal alcohol exposure (PAE) typically show deficits in executive functions in such areas as abstract reasoning, concept formation abilities, and cognitive flexibility. However, earlier research has not taken into account the demographic variables of age, sex, and ethnicity.Methods: Three groups of psychiatrically hospitalized children ages 9-17 years were included: Children with a history of PAE (n = 295); children with cognitive impairment but no suspected history of PAE (n = 201); and children without suspected cognitive impairment (n = 317). All children completed a series of neuropsychological tests including the HCT and the Wechsler Intelligence Scale for Children-IV (WISC-IV).Results: Children with a history of PAE and cognitively impaired children with no history of PAE produced significantly more HCT errors across all ages than the cognitively unimpaired group. There were no significant effects of ethnicity or gender. Age and Working Memory Index were negatively correlated with HCT errors.Conclusion: The findings support the use of the HCT as a sensitive measure of executive functions in both PAE and non-PAE cognitively impaired children with no evidence of gender and ethnic bias. Use of the HCT is indicated in future research to measure improvement in executive functioning among children with a history of PAE facilitated by education, rehabilitation, and other forms of training and treatment.

Clustering of neuropsychological traits of preschoolers

Neuropsychological tests (targeting cognitive, linguistic, motor, and executive abilities) are grouped in neuropsychological domains that are thought to be stable through adulthood. However, this assumption does not always hold true, particularly during young children's early developmental phase. Here, we explored how the neuropsychological profile of typical Spanish-speaking preschoolers varied and consolidated with age. We recruited 643 monolingual Latin-American children from Mexico, Colombia, and Guatemala, with ages spanning from 30 to 71 months of age, and applied a novel neuropsychological examination which combined a total of 52 tests covering five classical neuropsychological domains: receptive, expressive, attention/memory, processing, and executive functions. These tests' scores uncovered a correlational structure across neuropsychological functions that could not be explained by chance. Notably, these correlations' overall strength, but not their interdependence across domains, dramatically increased with age. Moreover, by applying conventional clustering techniques to classify the experimental data, we found a stable representation of two clusters of children with distinctive traits, with cultural factors contributing to this classification scheme. We also found that the tasks were well organized in a network of abilities, where nodes with highest highest interconnectedness were those that required multimodal processing. These results contribute to our understanding of children's 'normal' development and could help identify how failure in particular functions forecasts the emergence of neurodevelopmental disorders. Our analytic methods might become useful to characterize individual differences and improve educational practices and interventions.

Demographically-adjusted norms for the Grooved Pegboard and Finger Tapping tests in Spanish-speaking adults: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project

OBJECTIVE

We developed demographically-corrected norms for Spanish-speakers from the U.S.-Mexico border regions of California and Arizona on two tests of motor skills - the Grooved Pegboard Test (Pegboard) and Finger Tapping Test (Tapping) - as part of a larger normative effort.

METHOD

Participants were native Spanish-speakers from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project (Pegboard: N = 254; Tapping: N = 183; age: 19-60 years; education: 0-20 years; 59% women). We examined the association of demographics (age, education and gender) with raw scores. Raw test scores were then converted to demographically-corrected T-scores via fractional polynomial equations. We also examined rates of impairment (T-score < 40) based on the current norms and on previously published norms for English-speaking non-Hispanic Whites and Blacks.

RESULTS

Having more years of education was associated with better raw test score performance on both tests (p < .001), and increased age was associated with worse performance on Pegboard (p < .001). Men outperformed women on Tapping, and older age was associated with lower raw scores in men only on the Tapping non-dominant hand trial (p = .02). The normed T-scores were confirmed to be normally distributed and free from demographic influences, and resulted in expected rates of impairment. Applying existing norms for English-speaking non-Hispanic Whites and Blacks to the raw scores of Spanish-speakers generally yielded lower than expected impairment rates (2-13%), with one exception: non-dominant Pegboard, for which non-Hispanic White norms overestimated impairment (23%).

CONCLUSIONS

Present findings underscore the importance of appropriate, population-specific normative data, even for tests of motor ability.

Factors associated with motor dexterity on the grooved pegboard test in a Lebanese sample

The Grooved Pegboard Test (GPT) is a cognitive test used to assess patients' manual dexterity, rapid visual-motor coordination and psychomotor speed. Studies have shown that performance on the GPT is associated to cognitive functions and examinee's demographics; however, none of which involved Arab populations. The present study aims to explore motor dexterity as measured by the GPT and its relationship to intellectual abilities, age, gender and education in a sample of Lebanese individuals. We reviewed the charts of 330 patients who were administered the GPT as part of larger cognitive batteries in an outpatient diagnostic center in Beirut, Lebanon between September 2013 and September 2016. Results from this sample suggest that a higher Full Scale IQ, and an older age contribute to a better performance on the GPT, whereas gender and grade level are not significant predictors of performance. Results also show a significant difference between the performance of patients diagnosed with a Developmental Coordination Disorder and patients with no neurodevelopmental diagnosis.

Demographically adjusted normative data for the Halstead category test in a Spanish-speaking adult population: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS)

OBJECTIVE

The present study aimed to develop norms applicable to Spanish-speakers living in the United States (U.S.)- Mexico border region for the Halstead Category Test (HCT), a test of executive function.

METHODS

Healthy native Spanish-speakers (N = 252; Age: range 19-60 years, M = 37.28, SD = 10.24; Education: range 0-20 years; M = 10.65, SD = 4.33; 58.33% women) living in the U.S.-Mexico border region of California and Arizona completed the HCT as part of a comprehensive neuropsychological test battery. The univariable and interactive effects of demographic variables on HCT raw scores were examined. Total scores were normed using fractional polynomial equations, controlling for age, education, and gender. T-scores were also computed for HCT scores of the current Spanish-speaking normative sample using published, demographically-adjusted norms for English-speaking non-Hispanic Whites and Blacks. Impairment rates (T-Scores < 40) were calculated using published and current norms.

RESULTS

Age was significantly associated with increased number of errors, and education and male gender were associated with decreased number of HCT errors (total raw scores). Applying norms developed for English-speaking non-Hispanic Whites and Blacks resulted in overestimation of impairment rates in the current sample (impairment: 48% with White norms and 27% with Black norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using non-Hispanic Black norms were comparable to those based on newly developed norms.

CONCLUSION

The present study presents norms for the HCT in a sample of U.S. Spanish-speakers, providing an important tool for identifying executive dysfunction in this population.

Low level arsenic exposure, B-vitamins, and achievement among Uruguayan school children

OBJECTIVES

Millions of children globally, including the U.S., are exposed to low levels of arsenic from water and food. Arsenic is a known neurotoxicant at high levels but its effects at lower exposure levels are understudied. Arsenic methylation capacity, influenced by B-vitamin intake and status, potentially influences arsenic toxicity. In a cross-secitonal study of 5-8 year-old children from Montevideo, we assessed the relationship between urinary arsenic (U-As) and academic achievement, and tested for effect modification by B-vitamin intake, status, and arsenic methylation capacity.

METHODS

Broad math and reading scores were calculated based on six subtests (calculation, math facts fluency, applied problems, sentence reading fluency, letter word identification, passage comprehension) from the Woodcock-Muñoz Achievement Battery. B-vitamin intake was assessed from two non-consecutive 24-h dietary recalls, serum folate and vitamin B-12 levels were measured in a subset of participants. Arsenic methylation capacity was measured as the proportion of urinary monomethylarsonic acid (%MMA). Multiple imputation using chained equations was conducted to account for missing covariate and exposure data. Ordinal regressions assessed associations between U-As and achievement score tertiles in the complete case and imputed samples. A "B-vitamin index" was calculated using principal component analysis. Interactions by urinary %MMA and the B-vitamin index were assessed.

RESULTS

Median specific gravity adjusted U-As was 11.7 μg/L (range: 2.6, 50.1). We found no association between U-As and broad math and reading scores, nor effect modification by %MMA or B-vitamins.

CONCLUSION

At low-levels of exposure, U-As does not appear to affect children's academic achievement.

Concentration Endurance Test (d2): Normative data for Spanish-speaking pediatric population

OBJECTIVE

To generate normative data for the Concentration Endurance Test (d2) in Spanish-speaking pediatric populations.

METHOD

The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the d2 test as part of a larger neuropsychological battery. The Total number of items processed (TN), Total number of correct responses (CR), Total performance (TP), and Concentration performance (CP) scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses.

RESULTS

The final multiple linear regression models showed main effects for age on all scores, such that scores increased linearly as a function of age. TN scores were affected by age2 for Guatemala and Puerto Rico; CR scores were affected by age2 for Mexico; TP scores were affected by age2 for Chile, Mexico, Puerto Rico, and Spain; and CP scores for Mexico and Spain. Models indicated that children whose parents had a MLPE >12 years obtained higher scores compared to children whose parents had a MLPE≤12 years for Mexico and Spain in all scores, and Puerto Rico for TN, CR, and TP, and Guatemala and Paraguay for CP scores. Sex affect the scores for Ecuador and Honduras (CP scores).

CONCLUSIONS

This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate approach to interpret the d2 test in pediatric populations.

Neurocognitive Functions in 3- to 15-Year-Old Children: An International Comparison

OBJECTIVES

Performance on neurocognitive tasks develops with age, but it is still unknown whether this performance differs between children from different cultures. We compared cross-sectionally the development of neurocognitive functions in 3- to 15-year-old children from three countries: Finland, Italy, and the United States (N=2745).

METHODS

Language, face memory, emotion recognition, theory of mind, and visuospatial processing subtests from the NEPSY-II standardizations in Finland, Italy, and the United States were used to evaluate if children and adolescents from different linguistic and cultural backgrounds differ in performance on these measures.

RESULTS

We found significant differences in performance on the tasks between the countries. Generally, the differences were more pronounced in the younger age groups. Some subtests showed greater country effects than others, performance on these subtests being higher, in general, in one country over the others, or showed different patterns of age associated changes in test performance.

CONCLUSIONS

Significant differences in neurocognitive performance between children from Finland, Italy, and the United States were found. These findings may be due to cultural or educational differences that impact test performance, or due to factors associated with the adaptation of measures from one culture to another. The finding of performance differences across countries on similar tasks indicate that cross-cultural and background variables impact performance on neuropsychological measures. Therefore, clinicians need to consider a child's cultural background when evaluating performance on neuropsychological assessments. The results also indicate that future cross-cultural studies are needed to further examine the underlying cultural factors that influence neurocognitive performance. (JINS, 2017, 23, 367-380).

Figural fluency and immediate visual memory in patients with at-risk mental state for psychosis: empirical study

AIM

Although a number of cognitive functions have been assessed in the ultra-high risk (UHR) population, only one study has reported on figural fluency. Visual memory was measured by different tests providing inconsistent results. The aim of the present study was to compare figural fluency and visual immediate memory performance in UHR patients and normal subjects.

METHODS

The UHR sample consisted of 55 help-seeking individuals meeting CAARMS criteria. The control group consisted of 65 subjects. They were matched as a group by age, gender and education level. Figural fluency (RFFT) and immediate visual memory (BVRT) were assessed within 2 weeks after inclusion in the study in the UHR patient group.

RESULTS

Significant differences were obtained in RFFT and BVRT results. In BVRT, UHR patients scored lower in number of correct designs (P < 0.001) and higher in number of errors (P < 0.0001), especially omissions (P < 0.001) and distortions (P < 0.0001). UHR subjects accurately recalled fewer designs, omitted and distorted more test figures. In RFFT, they scored lower in production of novel designs (P < 0.0001) and higher in the error ratio index (P < 0.008). They produced fewer novel designs and made more preservative errors.

CONCLUSIONS

The current study concerns non-verbal cognitive functions in UHR samples. Our results suggest that figural fluency and visual immediate memory are impaired in help-seeking UHR individuals as compared with matched controls.

Collective screening tools for early identification of dyslexia

Current response to intervention models (RTIs) favor a three-tier system. In general, Tier 1 consists of evidence-based, effective reading instruction in the classroom and universal screening of all students at the beginning of the grade level to identify children for early intervention. Non-responders to Tier 1 receive small-group tutoring in Tier 2. Non-responders to Tier 2 are given still more intensive, individual intervention in Tier 3. Limited time, personnel and financial resources derail RTI’s implementation in Brazilian schools because this approach involves procedures that require extra time and extra personnel in all three tiers, including screening tools which normally consist of tasks administered individually. We explored the accuracy of collectively and easily administered screening tools for the early identification of second graders at risk for dyslexia in a two-stage screening model. A first-stage universal screening based on collectively administered curriculum-based measurements was used in 45 7 years old early Portuguese readers from 4 second-grade classrooms at the beginning of the school year and identified an at-risk group of 13 academic low-achievers. Collectively administered tasks based on phonological judgments by matching figures and figures to spoken words [alternative tools for educators (ATE)] and a comprehensive cognitive-linguistic battery of collective and individual assessments were both administered to all children and constituted the second-stage screening. Low-achievement on ATE tasks and on collectively administered writing tasks (scores at the 25th percentile) showed good sensitivity (true positives) and specificity (true negatives) to poor literacy status defined as scores ≤1 SD below the mean on literacy abilities at the end of fifth grade. These results provide implications for the use of a collectively administered screening tool for the early identification of children at risk for dyslexia in a classroom setting.

Executive functioning in children with developmental dyslexia

The term "executive function" has been used to describe several higher-order cognitive processes. This study examined the processing speed, shifting, planning, and verbal fluency of a sample of 50 Portuguese children with developmental dyslexia (DD) and 50 typically developing children (TDC; chronological-age-matched controls) between 8 and 12 years of age to evaluate the children's executive functioning. Compared to TDC, children with DD revealed significant processing speed, shifting, and verbal fluency deficits. After controlling for differences in the general intellectual ability, significant group differences remained for shifting, verbal fluency and marginally for processing speed. No significant differences in planning ability were observed between the groups. No significant interaction of group, gender, and age was found for any of the executive functions measures studied. Word productivity in both semantic and phonemic verbal fluency tasks decreased significantly over the 60 seconds for both groups. Shifting was the only significant predictor of DD in the binary logistic regression analysis and yielded the highest area under the curve value (receiver operating characteristics curve analysis). Therefore, although these findings highlight the presence of specific executive functions deficits in children with DD, they should not be interpreted as indicative of the presence or absence of this learning disorder.

The cross-cultural utility of foreign- and locally-derived normative data for three WHO-endorsed neuropsychological tests for South African adolescents

Interpretation of neuropsychological tests may be hampered by confounding sociodemographic factors and by using inappropriate normative data. We investigated these factors in three tests endorsed by the World Health Organization: the Grooved Pegboard Test (GPT), the Children's Color Trails Test (CCTT), and the WHO/UCLA version of the Auditory Verbal Learning Test (AVLT). In a sample of 12-15-year-old, Afrikaans- and English-speaking adolescents from the Cape Town region of South Africa, analyses of covariance (ANCOVAs) demonstrated that quality of education was the sociodemographic factor with the biggest influence on test performance, and that age also significantly influenced GPT and CCTT performance. Based on those findings, we provide appropriately stratified normative data for the age group in question. Comparisons between diagnostic interpretations made using foreign normative data versus those using the current local data demonstrate that it is imperative to use appropriately stratified normative data to guard against misinterpreting performance.

Use of objective psychomotor tests in health professionals

Evaluation of psychomotor skills is undertaken in a number of broad contexts. This includes testing of health professional populations as a measure of innate ability, to evaluate skill acquisition, or to compare professions. However, the use of psychomotor tests is frequently confounded by a lack of understanding of a particular tool's psychometric properties, strengths, and weaknesses. To identify and appraise the most commonly used tests on health professional populations, 86 articles were reviewed and the top nine tests identified. Few tests have had sufficient validity or reliability testing on health professionals. Based on the evidence available, use of the Grooved Pegboard Test, the Purdue Pegboard Test, or the Finger Tapping Test is recommended for the evaluation of dexterity in a health professional population; however, this choice may be dependent on the task(s) to which findings are generalised. More rigorous evaluation of validity and other psychometric properties is required.

Validation of the Spanish Version of the Woodcock-Johnson Mathematics Achievement Tests for Children Aged 6 to 13

This study validated the four mathematics tests of the Spanish version of the Woodcock-Johnson III (WJ-III) Achievement (ACH) battery for use in the first six grades of school in Spain. Developmental effects and gender differences were also examined. Participants were a normal population sample of 424 (216 boys) children aged 6 to 13 years. Results showed that the tests have good test-retest and internal reliability and good construct and criterion-related validity. Significant main effects of schooling were obtained with scores increasing across the six school grades, but scores between fourth and fifth graders did not differ significantly. Overall, boys scored higher than girls on all tests but the effect sizes of these gender differences were small ( d ≤ .12).

Recommendations for the use of common outcome measures in pediatric traumatic brain injury research

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges.

Potential cognitive endophenotypes in multigenerational families: segregating ADHD from a genetic isolate

Endophenotypes are neurobiological markers cosegregating and associated with illness. These biomarkers represent a promising strategy to dissect ADHD biological causes. This study was aimed at contrasting the genetics of neuropsychological tasks for intelligence, attention, memory, visual-motor skills, and executive function in children from multigenerational and extended pedigrees that cluster ADHD in a genetic isolate. In a sample of 288 children and adolescents, 194 (67.4%) ADHD affected and 94 (32.6%) unaffected, a battery of neuropsychological tests was utilized to assess the association between genetic transmission and the ADHD phenotype. We found significant differences between affected and unaffected children in the WISC block design, PIQ and FSIQ, continuous vigilance, and visual-motor skills, and these variables exhibited a significant heritability. Given the association between these neuropsychological variables and ADHD, and also the high genetic component underlying their transmission in the studied pedigrees, we suggest that these variables be considered as potential cognitive endophenotypes suitable as quantitative trait loci (QTLs) in future studies of linkage and association.

New trends in gender and mathematics performance: a meta-analysis

In this article, we use meta-analysis to analyze gender differences in recent studies of mathematics performance. First, we meta-analyzed data from 242 studies published between 1990 and 2007, representing the testing of 1,286,350 people. Overall, d = 0.05, indicating no gender difference, and variance ratio = 1.08, indicating nearly equal male and female variances. Second, we analyzed data from large data sets based on probability sampling of U.S. adolescents over the past 20 years: the National Longitudinal Surveys of Youth, the National Education Longitudinal Study of 1988, the Longitudinal Study of American Youth, and the National Assessment of Educational Progress. Effect sizes for the gender difference ranged between -0.15 and +0.22. Variance ratios ranged from 0.88 to 1.34. Taken together, these findings support the view that males and females perform similarly in mathematics.

State of multicultural neuropsychological assessment in children: current research issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.

Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico's Oportunidades

BACKGROUND

Many governments have implemented conditional cash transfer (CCT) programmes with the goal of improving options for poor families through interventions in health, nutrition, and education. Families enrolled in CCT programmes receive cash in exchange for complying with certain conditions: preventive health requirements and nutrition supplementation, education, and monitoring designed to improve health outcomes and promote positive behaviour change. Our aim was to disaggregate the effects of cash transfer from those of other programme components.

METHODS

In an intervention that began in 1998 in Mexico, low-income communities (n=506) were randomly assigned to be enrolled in a CCT programme (Oportunidades, formerly Progresa) immediately or 18 months later. In 2003, children (n=2449) aged 24-68 months who had been enrolled in the programme their entire lives were assessed for a wide variety of outcomes. We used linear and logistic regression to determine the effect size for each outcome that is associated with a doubling of cash transfers while controlling for a wide range of covariates, including measures of household socioeconomic status.

FINDINGS

A doubling of cash transfers was associated with higher height-for-age Z score (beta 0.20, 95% CI 0.09-0.30; p<0.0001), lower prevalence of stunting (-0.10, -0.16 to -0.05; p<0.0001), lower body-mass index for age percentile (-2.85, -5.54 to -0.15; p=0.04), and lower prevalence of being overweight (-0.08, -0.13 to -0.03; p=0.001). A doubling of cash transfers was also associated with children doing better on a scale of motor development, three scales of cognitive development, and with receptive language.

INTERPRETATION

Our results suggest that the cash transfer component of Oportunidades is associated with better outcomes in child health, growth, and development.

Evidence-based assessment of cognitive functioning in pediatric psychology

OBJECTIVE

To review the evidence base for measures of cognitive functioning frequently used within the field of pediatric psychology.

METHODS

From a list of 47 measures identified by the Society of Pediatric Psychology (Division 54) Evidence-Based Assessment Task Force Workgroup, 27 measures were included in the review. Measures were organized, reviewed, and evaluated according to general domains of functioning (e.g., attention/executive functioning, memory).

RESULTS

Twenty-two of 27 measures reviewed demonstrated psychometric properties that met "Well-established" criteria as set forth by the Assessment Task Force. Psychometric properties were strongest for measures of general cognitive ability and weakest for measures of visual-motor functioning and attention.

CONCLUSIONS

We report use of "Well-established" measures of overall cognitive functioning, nonverbal intelligence, academic achievement, language, and memory and learning. For several specific tests in the domains of visual-motor functioning and attention, additional psychometric data are needed for measures to meet criteria as "Well established."

Demographically corrected norms for the Brief Visuospatial Memory Test-revised and Hopkins Verbal Learning Test-revised in monolingual Spanish speakers from the U.S.-Mexico border region

The large number of primary Spanish speakers both in the United States and the world makes it imperative that appropriate neuropsychological assessment instruments be available to serve the needs of these populations. In this article we describe the norming process for Spanish speakers from the U.S.-Mexico border region on the Brief Visuospatial Memory Test-revised and the Hopkins Verbal Learning Test-revised. We computed the rates of impairment that would be obtained by applying the original published norms for these tests to raw scores from the normative sample, and found substantial overestimates compared to expected rates. As expected, these overestimates were most salient at the lowest levels of education, given the under-representation of poorly educated subjects in the original normative samples. Results suggest that demographically corrected norms derived from healthy Spanish-speaking adults with a broad range of education, are less likely to result in diagnostic errors. At minimum, demographic corrections for the tests in question should include the influence of literacy or education, in addition to the traditional adjustments for age. Because the age range of our sample was limited, the norms presented should not be applied to elderly populations.

Hand skill and hand–eye preference in relation to verbal ability in healthy adult male and female right-handers

Verbal as well as non-verbal performances were investigated in relation to both hand skill assessed by finger-tapping performances and hand-eye preference in 83 healthy adult right-handers, most of them students. The primary objective of this study was to show better finger-tapping performances in right-handed participants with best verbal IQ values. We found that it was not the non-verbal but the verbal abilities that were related to finger-tapping performances. This was proven, especially as to the left-hand taps. Faster left-hand taps in participants with higher verbal IQ values may be due to a closer cooperation of right-hemispheric regions in information processing and an intimate relationship between language and finger-motor functions. Secondary objectives assessed by explorative data analyses included gender differences and hand-eye preference. While in the females left-hand taps correlated somewhat more with verbal IQ values, in the males this effect was seen in selected variables of the right-hand taps. Moreover, laterality assessed in finger-tapping performances may not be in accordance with laterality found in the handedness questionnaire. In addition to this, congruent hand-eye dominance was found to be slightly more prevalent in participants with best verbal IQ values. However, these findings will have to be confirmed in further experiments.

The influence of the parents' educational level on the development of executive functions

Information about the influence of educational variables on the development of executive functions is limited. The aim of this study was to analyze the relation of the parents' educational level and the type of school the child attended (private or public school) to children's executive functioning test performance. Six hundred twenty-two participants, ages 5 to 14 years (276 boys, 346 girls) were selected from Colombia and Mexico and grouped according to three variables: age (5-6, 7-8, 9-10, 11-12, and 13-14 years), gender (boys and girls), and school type (private and public). Eight executive functioning tests taken from the Evaluacion Neuropsicologica Infantil; Matute, Rosselli, Ardila, & Ostrosky, (in press) were individually administered: Semantic Verbal Fluency, Phonemic Verbal Fluency, Semantic Graphic Fluency, Nonsemantic Graphic Fluency, Matrices, Similarities, Card Sorting, and the Mexican Pyramid. There was a significant effect of age on all the test scores and a significant effect of type of school attended on all but Semantic Verbal Fluency and Nonsemantic Graphic Fluency tests. Most children's test scores, particularly verbal test scores, significantly correlated with parents' educational level. Our results suggest that the differences in test scores between the public and private school children depended on some conditions existing outside the school, such as the parents' level of education. Implications of these findings for the understanding of the influence of environmental factors on the development of executive functions are presented.

Normative data for the Boston Naming Test in native Dutch-speaking Belgian children and the relation with intelligence

This paper reports the results of a normative study of the 60-item version of the Boston Naming Test (BNT) in a group of 371 native Dutch-speaking Flemish children between the ages of 6 and 12 years. Analysis of test results revealed that BNT performance was significantly affected by age and gender. The gathered norms were shown to be significantly lower than published norms for comparable North-American children. Error analysis disclosed remarkable similarities with data from elderly subjects, with verbal semantic paraphasias and 'don't know' responses occurring most frequently. Finally, BNT scores were shown to correlate strongly with general intelligence as measured with the Raven Progressive Matrices. The relation between both measures can be of help in the diagnosis of identification naming deficits and impaired word-retrieval capacities.

Verbal and nonverbal fluency in Spanish-speaking children

Fluency measures are commonly used in clinical developmental neuropsychology to assess executive functions. Little is known about the effect of age on performance in these tests. This article analyzes the effect of age on measures of verbal (semantic and phonologic) and nonverbal (semantic and nonsemantic) fluency in 171 children (81 boys, 90 girls) between ages 6 and 15. Participants were selected from public and private schools in Guadalajara and Tijuana, Mexico. A significant age effect was found on all tests but no interaction between age and type of test was found. Significant correlations among the 4 fluency tasks ranged from.36 to.46. Results are consistent with the findings of normative studies carried out in other countries and support the cross-language validity of verbal fluency tests.

The impact of culture and education on non-verbal neuropsychological measurements: a critical review

Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influenced by the individual's culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.

Intermanual transfer in a simple motor task

The present study examines the effects of a four-week training session in a pegboard task on uni- and bimanual performance. Of particular interest was whether practice transfer from the trained to the untrained hand takes place. Twenty-five consistently right-handed subjects were trained to perform the task with the dominant hand, or the subdominant hand, or with both hands. After this training, the learning effects for the trained and untrained hands were analysed. To summarise, we obtained the following findings: (1) After training, movement times were considerably reduced for all hands and for all training conditions (practice effects); (2) practice effects were found for the hand trained and also for the untrained hand; (3) there was not a great difference in the size of the practice effects for the right hand after left hand training or for the left hand after right hand training; (4) task difficulty had no clear influence on the practice effect; (5) and finally, we discovered that bimanual movements not only profit from bimanual training but also from unimanual training and conversely unimanual movements benefit from bimanual training. These findings are discussed in the context of different motor control models and in the light of recent brain imaging findings.

Introduction to the Special Issue on Normal Neuropsychological Development in the School-Age Years

In neuropsychological research on normal development relatively little interest has been devoted to age-related changes in school age. This is surprising in light of the significance of the changes that take place in this period of life, the availability of normative data, and the ongoing research on neural development. The studies included in this issue take a closer look at normative data from school-age children of various ages in performances of attention, language, sensorimotor functions, perceptual functions, memory and learning, and functional asymmetries. A finding evident in many of the studies is that age effects seem to be more accentuated below 9 to 10 years than after that age. It is hoped that this special issue will draw attention to the scarcity of data in this realm and to the possibilities of utilizing existing databases for study on normal development in school age.