Assessing Executive Functions in Preschoolers Using Shape School Task

Development of working memory and inhibitory control in early childhood: Cross-sectional analysis by age intervals and gender in Ecuadorian preschoolers

Working memory (WM) and inhibitory control (IC) play a crucial role in learning during early childhood. The literature suggests a non-linear developmental trajectory of executive functions (EFs) with varied results according to gender, usually attributed to environmental factors. However, there is insufficient and inconclusive data on whether this pattern is reproduced in the Latin American preschool population since most studies have been conducted in English-speaking, European, and Asian environments. Thus, objectively comparing children's executive performance across diverse international geographical contexts becomes challenging. This study aimed to conduct a cross-sectional analysis of the performance in WM and IC of 982 Ecuadorian preschoolers aged between 42 and 65 months (M = 53.71; SD = 5.714) and belonging to medium-high, medium, and low-medium socioeconomic strata. The participants consisted of 496 boys (M = 53.77; SD = 5.598) and 486 girls (M = 53.65; SD = 5.834), representing nine cities in Ecuador. To assess the effect of age and gender on performance in these two domains, the sample was divided into four 6-month age intervals. Two tests were administered to the participants, and a survey was conducted with 799 of their usual caregivers. Viewing the cross-sectional mean scores of the WM and IC tests as a temporal continuum reveals an upward trend in each age interval studied. Girls outperformed boys on the IC test, showing statistically significant differences in the earliest age interval. The gender differences in executive performance reported in the literature emphasize the need to explore the modulating effect of environmental variables on early childhood development. This information could offer valuable insights for adapting and optimizing cognitive and didactic strategies in early childhood tailored to the characteristics and needs of the preschool population.

The trajectory of maternal perinatal depressive symptoms predicts executive function in early childhood

BACKGROUND

Perinatal maternal depression may affect fetal neurodevelopment directly or indirectly via exposures such as smoking, alcohol, or antidepressant use. The relative contribution of these risk factors on child executive function (EF) has not been explored systematically.

METHODS

A prospective pregnancy cohort of 197 women and their children was studied to determine whether maternal depression diagnosis and the trajectory of maternal depressive symptoms (MDSs) from early pregnancy to 12 months postpartum predicts child EF at age 4 (measured using the preschool age psychiatric assessment, NEPSY-II, and Shape School task) using latent growth curve modeling. Indirect effects of smoking, alcohol, and antidepressant use were also formally tested.

RESULTS

Increasing maternal perinatal depressive symptoms over time predicted more inattentive symptoms, poorer switching, and motor inhibition, but not cognitive inhibition. When adjusted for multiple comparison, and after accounting for maternal cognition and education, the association with child inattentive symptoms remained significant. However, diagnosed depression did not predict child EF outcomes. Prenatal exposure to smoking, alcohol, and antidepressants also did not mediate pathways from depressive symptoms to EF outcomes. Our findings were limited by sample size and statistical power to detect outcome effects of smaller effect size.

CONCLUSIONS

This study suggests that increasing MDSs over the perinatal period is associated with poorer EF outcomes in children at age 4 - independent of prenatal smoking, drinking, or antidepressant use. Depressive chronicity, severity, and postpartum influences may play crucial roles in determining childhood outcomes of EF.

Five-year outcomes of premature infants randomized to high or standard loading dose caffeine

OBJECTIVE

To examine 5-year outcomes in children enrolled in a pilot randomized controlled trial of a high loading dose of caffeine after preterm birth.

STUDY DESIGN

Seventy-four very low birth weight neonates were randomized within the first 24 h of life to receive a high (80 mg/kg) or standard (20 mg/kg) loading dose of caffeine citrate. At 5 years of age, we conducted standardized neurodevelopmental tests and collected parent reports of child socioemotional problems.

RESULT

Seventy-four percent of survivors returned for follow up. Children obtained similar scores on neurodevelopmental and socioemotional evaluations. There was no difference in the incidence of any neurodevelopmental delay after controlling for confounding factors.

CONCLUSION

Five-year follow up of a pilot trial of high loading dose caffeine citrate documented no profound impacts on childhood neurodevelopment or socioemotional outcome.

Fentanyl Exposure in Preterm Infants: Five-Year Neurodevelopmental and Socioemotional Assessment

Objective

To evaluate the association between cumulative fentanyl dose during neonatal intensive care and 5-year neurodevelopmental and socioemotional outcomes in very preterm infants.

Materials and Methods

Patient demographics and clinical factors during the perinatal and neonatal course were collected in 84 patients born between 23- and 30-weeks gestational age (GA). Cumulative fentanyl dose during neonatal intensive care was calculated. Developmental testing at age 5 years included the Wechsler Preschool and Primary Scale of Intelligence Full-Scale Intelligence Quotient, Third Edition, Clinical Evaluation of Language Fundamentals-Preschool, Second Edition, Movement Assessment Battery for Children, Second Edition (MABC-2), and Shape School Assessment. Socioemotional outcomes were assessed via caregiver's responses on the Child Behavior Checklist/1.5-5 (CBCL/1.5-5.5) and Social Responsiveness Scale, Second Edition (SRS-2). Covariates were identified on bivariate analysis (p < 0.1). Linear regression models related outcome measures to the log of cumulative fentanyl dose adjusted for covariates.

Results

Higher cumulative fentanyl dose was associated with lower composite motor scores on bivariate analysis (p < 0.01). Cumulative fentanyl dose did not correlate with composite intelligence quotient, language, or executive function. The Clinical Risk Index for Babies score, log of mechanical ventilation, inotrope, and anesthesia duration, and log of cumulative midazolam and hydrocortisone dose were also associated with MABC-2 scores (p < 0.1). Cumulative fentanyl dose was not associated with composite MABC-2 scores on multiple linear regression. Higher cumulative fentanyl dose was associated with decreased socioemotional problems based on caregiver's response on CBCL/1.5-5.5 t-scores driven by fewer symptoms of depression. The McMaster Family Assessment Device general functioning scale score, maternal age, GA, log of total parenteral nutrition days, patent ductus arteriosus requiring treatment, and log of inotrope hours were also associated with CBCL/1.5-5.5 t-scores (p < 0.1). Cumulative fentanyl dose (p = 0.039) and family dysfunction score (p = 0.002) remained significant after controlling for covariates on multiple linear regression.

Conclusion

Cumulative fentanyl dose during neonatal intensive care did not correlate with 5-year motor, cognitive, or language outcomes after controlling for other variables. Fentanyl dose was associated with caregiver reported total socioemotional problems on the CBCL/1.5-5.5 on multivariate modeling. Additional long-term studies are needed to fully elucidate the safety of fentanyl in very preterm neonates.

Assessment of Preschool-age Executive Functions: A Systematic Review

Executive functions (EF) are higher-order cognitive processes present in the prefrontal cortex, and are fundamental in planning, executing, and monitoring goal-oriented behaviors. Evaluating EF in early stages of child development is essential for identifying any cognitive alterations in young children, given that it allows for early intervention and minimizes future complications. Additionally, it contributes to a better understanding of this construct in this age bracket, as well as its operational model. Study of EF has recently been the focus of multiple researcher; however, there is still a serious lack of instruments and measurements validated towards children's age bracket. This systematic review's main goal is to evaluate instruments and/or tasks that serve to evaluate and analyze EF and/or their components between the ages of 36 and 72 months. Forty-nine studies were analyzed, containing multiple tasks and tools oriented towards EF and their constituent components. Results indicate the existence of various tasks that grade the different components independently from one another; nevertheless, they also confirm the lack of any global measurement instrument or method. Therefore, this systematic review presents itself as an important contribution in the study of EF, not only stressing the importance of further investing into constructing and validating new and better tools for evaluating the construct, but also the study of operating models of executive functioning, especially in an age bracket where comprehending it is notoriously difficult.

Parents' Views on Play and the Goal of Early Childhood Education in Relation to Children's Home Activity and Executive Functions: A Cross-Cultural Investigation

The present study investigated the cross-cultural variations in parents' views on the role of play in child development and the primary purpose of preschool education from Ethiopia and Hungary. It also examined the cross-cultural variations in preschoolers' executive functions (EF), the frequency of their engagement in home activities, and the role of these activities in the development of EF skills. Participants included 266 preschoolers (Ethiopia: 139 of which 44.6% boys; M _age = 63.83 months; SD = 7.68 months; Hungary: 127 of which 48% boys; M _age = 62.06 months; SD = 9.37 months) with their parents (Ethiopia: 45.32% male; M_age = 36.66 years; SD = 7.14 years; Hungary: 13.18% male; M _age = 37.71 years; SD = 5.97 years). The independent samples t-test showed that Ethiopian parents view fostering academic skills for preschooler significantly more important than their Hungarian counterparts do. We also found that while Ethiopian parents hold the belief that academic and cognitive development is the major purpose of preschool education, Hungarian prioritize social-emotional development and entertainment. Additionally, preschoolers in Ethiopia were reported to engage in academic and arts and crafts activities after preschool significantly more frequently than their Hungarian counterparts. On the contrary, preschoolers in Hungary were found to engage in fine-motor activities, solitary play, sports and other physical activities significantly more frequently than their Ethiopian counterparts. No significant differences were found in EF skills between preschoolers from Ethiopia and Hungary. Results from hierarchical regression analyses showed that, after accounting for age and SES, preschoolers' frequency of pretend play and their parents' play support beliefs were found to be small to medium-sized predictors of inhibitory control skills in both samples. However, children's frequency of having breakfast at home was another significant predictor in the Ethiopian sample only. The frequency of participation in arts and crafts and other fine-motor activities were found to be important predictors of preschoolers' visual-spatial working memory skills in the Ethiopian and the Hungarian samples, respectively. We also found that, after controlling for SES, parental play support was an important factor associated with preschoolers' shifting skills only in the Hungarian sample. Based on the findings, we made important conclusions.

Differences in Coping Strategies Between Young and Older Adults: The Role of Executive Functions

Executive functions (EFs) have been identified as processes in the ability to select and apply adaptive strategies for coping with stress. This study compares executive functioning, short-term memory, and coping in a sample of young and older adults with no prior diagnosis of depression and with normal cognitive function ( N = 216). The study collected measures of depression, EFs, short-term memory, and coping. Young participants scored higher than older adults on EFs and short-term memory. Moreover, in young adults, there was a prevalence of avoidance coping strategies. Scores on depressive symptomatology were found to be related to avoidant coping strategies. Older adults with higher score on inhibition used less avoidant coping. Thus, it seems that executive deficits might contribute to depression, as they affect processes for coping with stress. This finding may have implications for the role of EFs and coping in psychological well-being and successful adaptation of individuals to stressful situations.

Systematic Observation: Relevance of This Approach in Preschool Executive Function Assessment and Association with Later Academic Skills

Executive functions (EFs) are high-level cognitive processes that allow us to coordinate our actions, thoughts, and emotions, enabling us to perform complex tasks. An increasing number of studies have highlighted the role of EFs in building a solid foundation for subsequent development and learning and shown that EFs are associated with good adjustment and academic skills. The main objective of this study was to analyze whether EF levels in 44 Spanish children in the last year of preschool were associated with levels of literacy and math skills the following year, that is, in the first year of compulsory education. We used a multi-method design, which consisted of systematic observation to observe preschool children during play and selective methodology to assess their reading, writing, and math skills in the first year of compulsory primary education. General linear modeling was used to estimate the percentage of variability in academic skills in the first year of primary school that was explained by preschool EF abilities. The results showed that preschool EF level, together with participants and the instrument used to assess academic skills, explained 99% of the variance of subsequent academic performance. Another objective was to determine whether our findings were generalizable to the reference population. To make this determination, we estimated the optimal sample size for assessing preschool EFs. To do this, we performed a generalizability analysis. The resulting generalizability coefficient showed that our sample of 44 students was sufficient for assessing preschool EFs. Therefore, our results are generalizable to the reference population. Our results are consistent with previous reports that preschool EF abilities may be associated with subsequent literacy and math skills. Early assessment of EFs may therefore contribute to identifying children who are likely to experience later learning difficulties and guide the design of suitable interventions for the optimization of EFs.