Anxiety and verbal learning in typically developing primary school children: Less efficient but equally effective

BACKGROUND

Despite evidence that high levels of anxiety can impair Working Memory (WM) functioning, little is known about how anxiety is associated with classroom learning activities, which make high demands on verbal WM.

AIMS

To investigate the association between anxiety and learning on a task which makes high demands on verbal WM.

SAMPLE

Participants were 119 typically developing, Australian elementary school children (M age = 9.25 years; SD = 7.6 months).

METHOD

In individual testing sessions, measures of trait anxiety (Spence Childhood Anxiety Scales) and state anxiety (Visual Analogue scale) were made. The Rey Auditory Verbal Learning Test, which makes similar demands on WM to many classroom activities, was administered.

RESULTS

Neither trait nor state anxiety alone was associated with mean recall across trials, however their interaction showed a significant effect. In children high on both measures of anxiety, learning followed a different trajectory. They learned more slowly on the first three trials than less anxious peers, then caught up on the remaining trials. While their mean recall scores across trials were significantly lower than those of less anxious peers, they retained as many words on the delayed learning trial.

CONCLUSION

In a group of typically developing children, learning on the early, more demanding learning trials of a verbal learning task was vulnerable to heightened anxiety. However, the extra opportunities to learn on later trials enabled more anxious children to learn as much as their less anxious peers. While they learnt less efficiently, they learnt equally effectively.

Loving and angry? Happy and sad? Understanding and reporting of mixed emotions in mother-child relationships by 6- to 12-year-olds

The Evaluative Space Model of emotions allows for the coactivation of positive-appetitive and negative-avoidant systems, but few studies have examined mixed emotions in child development. Existing research suggests children's understanding of opposite valence emotion combinations emerges by approximately 11 years of age. However, it is not yet clear whether various opposite valence combinations are understood at different ages, nor whether children can understand them in others before they have experienced such mixed emotions themselves. Semi-structured interviews with 97 children investigated whether they regarded six combinations of opposite valence mixed emotions as possible, could provide reasons for them, and report their own experience of each in the context of mother-child relationships. Both understanding that such combinations are possible and ability to provide reasons for them increased after age 6 and up to age 11, but were still incomplete in 12-year-olds. Understanding of different opposite valence combinations developed at different rates. At each age, fewer children who showed understanding of these combinations in others reported having had a similar experience themselves. The findings suggest a need to systematically examine a range of mixed emotions in order to develop a comprehensive theory of the development of mixed emotion understanding. They also suggest extending research into adolescence.

Functioning of 7-year-old children born at 32 to 35 weeks' gestational age

OBJECTIVE

To compare neuropsychological functions in moderately preterm (32-35 weeks' gestation) and full-term children at the age of 7 years and identify gender differences.

METHODS

Community-based prospective cohort study of 248 moderately preterm children (138 boys) and 130 full-term children (58 boys). Neuropsychological tests included IQ, memory, attention, visual perception, motor skills, visuomotor skills, and parental report of executive functioning.

RESULTS

The moderately preterm group performed significantly worse on total and performance IQ, visuospatial reasoning, attention control, inhibition, and executive functioning. No differences were found in verbal IQ, verbal memory, and visuomotor and motor skills. Preterm children were at higher risk for scores <10th percentile on intelligence, visuospatial reasoning (relative risk ratio both: 1.69 [95% confidence interval: 1.29-2.28]), and executive functioning problems (relative risk: 1.94 [95% confidence interval: 1.51-2.57]). Using gender-specific norms, preterm boys performed significantly worse than full-term boys on visuospatial reasoning (P < .01); preterm girls performed significantly worse than full-term girls on visuospatial reasoning, intelligence, attention, and executive functioning (P < .05).

CONCLUSIONS

Moderately preterm birth is associated with lower intelligence and poorer neuropsychological functioning at early school age. No differences in motor skills and verbal memory were found. Using gender-specific norms, our data suggest that moderately preterm boys catch up, whereas moderately preterm girls lag behind their peers on various neuropsychological functions by the age of 7 years.

Patterns of functioning and predictive factors in children born moderately preterm or at term

AIM

The aim of this study was to identify subgroups of children born moderately preterm (MPT) and term with distinctive levels and patterns of functioning, and the perinatal and demographic factors that predict subgroup membership.

METHOD

A total of 378 children aged 7 years, 248 MPT (138 males, 110 females; gestational age 32-36 wks) and a comparison group of 130 children born at term (58 males, 72 females; gestational age 38-41 wks), were selected from a community-based cohort study. Latent class analyses were performed on measures of intelligence, verbal memory, attention, executive functioning, and visuomotor and motor skills. χ(2) automatic interaction detection analyses were performed to detect associations between the subgroups and predictors.

RESULTS

Four subgroups differing in levels of performance were identified, with parental education being the only statistically significant determinant of subgroup assignment (p < 0.01). The subgroup that performed the most poorly showed an irregular pattern of performance, with specific weakness in attentional skill and relative strength in intelligence and verbal memory. Parental education predicted classification probability in the preterm group (p = 0.04) but not in the term group (p = 0.15).

INTERPRETATION

Our results show that the poorer performance of children born MPT reflects a higher proportion of children with below average performance rather than a subgroup with extremely poor performance. They indicate that MPT birth affects neurodevelopmental functioning at early school age only slightly, with effects being largest in such children with low parental education.

The quality of preterm infants' spontaneous movements: an early indicator of intelligence and behaviour at school age

BACKGROUND

The quality of very preterm infants' spontaneous movements at 11 to 16 weeks post-term age is a powerful predictor of their later neurological status. This study investigated whether early spontaneous movements also have predictive value for the intellectual and behavioural problems that children born very preterm often experience.

METHODS

Spontaneous movement quality was assessed, using Prechtl's method, at 11 to 16 weeks post-term in 65 infants born at <or= 33 weeks of gestation in a single centre. Intelligence and behaviour were assessed with standardised tests at 7 to 11 years of age. Neurological status was assessed with Touwen's test. Multiple regression was used to determine the predictive value of movement quality for intelligence and behavioural problems. The Sobel test was used to determine if neurological status mediated associations found between early movement quality and outcome.

RESULTS

Spontaneous movement quality at 11 to 16 weeks post-term was significantly, positively associated with later intelligence. The number of normal postural patterns displayed contributed most strongly to the association, which was not mediated by neurological status. Fidgety movements, strong predictors of later neurological dysfunction, were not associated with intelligence. Spontaneous movement quality was not associated with internalising or externalising problems but showed a trend to an association with attention problems.

CONCLUSION

These findings suggest that, in children born preterm, early spontaneous movement quality has clear prognostic value for neurological and intellectual outcome, and to a lesser extent, for attentional outcome. However, cognitive outcome was associated with the presence of specific, age-appropriate postural patterns, while neurological outcome has been associated with the presence of global movement abnormalities. The presence of specific, age-appropriate postural patterns may reflect the integrity of areas of the brain involved in cognitive processing and the regulation of attention later in childhood. Alternately, it may facilitate cognitive and attentional development.

Quantitative aspects of the early motor repertoire in preterm infants: do they predict minor neurological dysfunction at school age?

BACKGROUND

Qualitative aspects of the motor repertoire, at 11-16 weeks post-term are predictive for minor neurological dysfunction (MND) at 7 to 11 years of age. Predictive value of quantitative aspects is unknown so far.

AIM

To investigate whether quantitative aspects of the motor repertoire between 6 and 24 weeks post-term also have predictive value for neurological outcome at 7 to 11 years of age.

STUDY DESIGN

Prospective cohort study.

SUBJECTS

Preterm infants from whom several quantitative aspects of the motor repertoire were assessed between 6 and 24 weeks post-term.

OUTCOME MEASURES

Neurological outcome at 7-11 years of age was assessed according to Touwens' neurological examination. Children were classified as neurologically normal, or as having complex MND or cerebral palsy (CP).

RESULTS

Eighty-two children were included. At 7 to 11 years of age 15 children (18%) had developed CP, 49 (60%) were neurologically normal, and 18 (22%) had MND. Multiple logistic regression analysis showed that, when the qualitative aspects of the motor repertoire known to predict neurological outcome were taken into account, only the asymmetric tonic neck (ATN) posture provided additional predictive value. In case of normal fidgety movements (FMs) accompanied by an abnormal concurrent motor repertoire, the presence of an obligatory ATN increased the risk for developing complex MND to 75%; absence of an obligatory ATN reduced the risk to 15% (p<0.05).

CONCLUSIONS

Quantitative aspects of the motor repertoire at 11-16 weeks post-term, in particular the presence of an obligatory ATN posture, contribute to the prediction of neurological outcome at 7 to 11 years of age.

Less efficient elementary visuomotor processes in 7- to 10-year-old preterm-born children without cerebral palsy: an indication of impaired dorsal stream processes

Follow-up studies of preterm children without serious neurological complications have consistently found deficits in visuomotor skills. To determine whether these deficits may be related to impaired elementary visuomotor processes, we investigated movement programming and execution of simple pointing movements in 7- to 10-year-old preterm (<34 weeks g.a. and/or b.w. <1800 g) and full-term children. Such detailed analysis of simple pointing movements provides information on the extent to which processes associated with dorsal and/or cerebellar functions are impaired. Multi-level analysis showed that movement programming and execution were slowed in the 7-, 9-, and 10-year-old preterm groups. This indicates impaired dorsal visual stream functioning in preterm children, but do not rule out impaired cerebellar functioning. At 8 years of age, there were no differences between the two groups in movement execution time. This could have reflected a transition in the development of movement control in the control group, which has been associated in typically developing children with a decrease in motor speed. Interestingly, a similar decrease was not found in the preterm group at 8 years of age.

The quality of the early motor repertoire in preterm infants predicts minor neurologic dysfunction at school age

OBJECTIVE

The quality of a child's motor repertoire at age 3 to 4 months postterm is predictive of later cerebral palsy (CP). Its predictive power for minor neurologic dysfunction (MND) is unclear. This study aimed to investigate the predictive value of the quality of the early motor repertoire for the development of MND at school age.

STUDY DESIGN

We assessed the motor repertoire from video recordings made at 6 to 24 weeks postterm in 82 preterm infants (mean gestational age, 29.7 +/- 1.9 weeks; mean birth weight, 1183 +/- 302 g). At age 7 to 11 years, Touwen's neurologic examination was performed, and the children were classified as normal (n = 49; 60%), MND (n = 18; 22%), or CP (n = 15; 18%).

RESULTS

Multiple logistic regression analysis showed that the quality of fidgety movements (FMs) and the quality of the concurrent motor repertoire had independent prognostic value for MND at school age. Abnormal FMs evolved into MND in 64% of the children. Nine of the 28 children with normal FMs and an abnormal concurrent motor repertoire developed abnormally (32%). Only 1 child of the 21 children with normal FMs and a normal concurrent motor repertoire developed MND (5%).

CONCLUSIONS

Assessment of the quality of the early motor repertoire can accurately identify individual infants at high and low risk for MND at school age.

Parenting stress in mothers and fathers of a child with a hemiparesis: sources of stress, intervening factors and long-term expressions of stress

BACKGROUND

In a substantial minority of children with a hemiparesis, motor impairments are accompanied by behavioural problems. This combination confronts parents with several persistent, frequently intense, sources of stress. At the same time, it is likely to reduce the effectiveness of psychosocial resources, such as feelings of competence, which would normally buffer the impact of the stressors. Aim To investigate the association between motor and behavioural problems in children with a hemiparesis and symptoms of stress in their parents, with particular attention to psychosocial factors which may mediate between the child's problems and parents' symptoms of stress.

METHOD

Questionnaires assessing the medical, functional and behaviour problems of the child, and the parents' experience of stress were completed by the mothers and fathers of 108 children with a hemiparesis who were members of the Association for the Motor Handicapped in the Netherlands.

RESULTS

Both parents reported (extremely) high levels of long-term stress significantly more frequently than parents in a normative sample. Indices of long-term stress were associated with the child's behavioural problems and, less strongly, with dysfunctionality in daily life. However, behavioural problems and dysfunctionality also reduced parents' feelings of competence and social support. A mediation analysis showed that feelings of incompetence and social isolation mediated between the child's problems and the parents' symptoms of stress. Fathers and mothers did not differ in level of reported stress, or in the associations between the child's problems and degree of experienced stress.

CONCLUSION

Both parents of a child with a hemiparesis experience high levels of stress, which are strongly associated with feelings of incompetence and social isolation. This suggests that one focus of intervention should be the alleviation of parenting stress with particular attention to increasing perceived competence in the parenting role and reducing feelings of social isolation.

Movement adaptations in 7- to 10-year-old typically developing children: Evidence for a transition in feedback-based motor control

We used a modified double-step pointing task to study movement adaptations in 7- to 10-year-old typically developing children. We found that the majority (63%) were able to optimally adapt fast, goal-directed visually-guided movements to a late change in target location meeting the requirements of speed and accuracy. A minority (35%) failed to meet the requirement of accuracy resulting in a less optimal adaptation. The results showed that the ability to adapt movements optimally develops before the age of 7 years in typically developing children. Literature proposes a transition in development of motor control around the age of 8 years. The present results replicate and extend this by suggesting that this transition affects the later phases of fast, goal-directed visually-guided movements rather than the early phases, such as movement programming and acceleration. Finally, the results indicate that the optimally adapted movements were the result of a specific strategy in which a specific component of movement execution was slowed on all trials. This suggests that 7- to 10-year-old typically developing children have developed implicit knowledge about which movement components are the most efficient to adapt.

Quality of general movements and the development of minor neurological dysfunction at toddler and school age

OBJECTIVE

To evaluate the reliability of assessing infants' general movements (GMs) using a new classification and its validity in predicting complex minor neurological dysfunction (MND) at toddler and at school age.

DESIGN

Prospective study of two groups of infants, each consisting of a mix of low-risk and high-risk infants.

SETTING

University Hospital Groningen, the Netherlands.

SUBJECTS

Group A consisted of 16 low-risk and 21 high-risk infants; group B of 28 low-risk and 24 high-risk infants.

MAIN OUTCOME MEASURES

Between term age and four months post term: multiple assessments of neurological condition by means of (a) assessment of GMs, and (b) a traditional neurological examination. GMs were classified into four classes using a standardized qualitative description: two classes of normal movements (normal-optimal and normal-suboptimal) and two classes of abnormal movements (mildly and definitely abnormal movements). Follow-up neurological examination with special attention to presence of MND was carried out in group A at 1 1/2 years, in group B at 4-9 years.

RESULTS

GMs could be assessed reliably. They were stable over age in about 60% of the infants. Both the condition of the GMs and the infant neurological condition were significantly related to neurological condition at follow-up. Best prediction of complex MND was achieved when both types of infant assessment at the age of 2-4 months post term were combined.

CONCLUSIONS

The assessment of GMs is a valuable tool, in particular when combined with the traditional neurological examination, to predict at early age the development of complex MND.

Maternal rigidity in infancy and level of intelligence at school age in children born preterm

Forty-four children who had been born preterm and their mothers participated in the follow-up study. At 3 and 14 months (corrected age) cognitive development was assessed using the BOS 2-30, the Dutch version of the Bayley Scales of Infant Development. The BOS yields measures of mental and motor development. At 7.5 years, intelligence was measured using the WISC-RN, the Dutch version of the WISC-R. A composite measure of maternal rigidity, tapping rigidity as a personality trait and rigid attitudes to child-rearing was used. The results of a multiple regression analysis indicated that maternal rigidity, measured in the first year of the child's life, was not associated with mental performance at 3 or 14 months. At 7.5. years, however, it was strongly associated with cognitive development, contributing uniquely to performance IQ.

A longitudinal study of the development of shifts of gaze to a peripheral stimulus in preterm infants with transient periventricular echogenicity

Shifts of gaze to peripheral targets were studied longitudinally, between 6 and 26 weeks corrected age, in full-term and very preterm infants with transient periventricular echogenicity (PVE). Before 10 weeks, simple shifts of gaze were faster and more frequent in preterms with PVE<14 days than in full-terms, suggesting these preterms profited from additional early visual experience. After 16 weeks, there were subtle differences between full- and preterm infants in the development of shifts of gaze requiring disengagement. The differences suggest that, after disengagement had become established, its fine-tuning occurred more slowly in the preterms. Slower fine-tuning of disengagement was not associated with duration of PVE, since it was more marked in preterms with PVE<14 days than in preterms with PVE> or =14 days. The differences in performance between full- and preterm infants were small. However, even small differences may affect the efficiency of visually guided behaviors.

Rigidity, sensitivity and quality of attachment: the role of maternal rigidity in the early socio-emotional development of premature infants

The associations between a mother's rigidity, her sensitivity in early (3 month) interaction and the quality of her premature infant's attachment at 13 months were investigated. Rigidity as a personality characteristic was not found to be significantly associated with sensitivity or quality of attachment. Rigid attitudes to child rearing were related to sensitivity and to the responsivity of the infant. Rigid attitudes were not related to security of attachment. Infants who were rated less responsive at 3 months, however, tended to be less securely attached, and high Attitude Rigidity in the mother increased their chances of an insecure attachment.