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The focus-execute component of attention: A comparison of children with turner syndrome with healthy children
Abstracts from the 18th Annual Meeting
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output and very poor phonology. Additional features associated with defective programming of verbal motor output include drooling, and difficulty chewing and swallowing. We present a case study of an 8-year, 9-month-old female with a history of severe developmental delay and the absence of language until age 5. Referral was made to confirm diagnosis and to make recommendations for educational and treatment planning. General medical findings were noncontributory with the exception of inconsistent tongue deviation and right-sided facial droop. In evaluation, eye-contact, prosody, and social engagement were good allowing autistic spectrum disorders to be ruled out. Language continued to be characterized by extremely limited expressive and receptive skills. Assessment was functional in nature evaluating adaptive behavior, motor skill, and verbal and nonverbal cognition. Focus will be on criteria for differential diagnoses for DVD, functional assessment techniques, and treatment recommendations.
Kibby, M. Y., & Long, C. J. Instigation of Verbal Memory in Children with Dyslexia Utilizing the CVL T-C. Children with developmental dyslexia often present with deficits in reading, spelling, naming, and articulation. Several studies have revealed that these children also demonstrate impaired short-term verbal memory, although limited research has been conducted using the California Verbal Learning Test-Children's Version (CVLT-C) with this population. Our investigation utilized the CVLT-C as it assesses both quantitative and qualitative aspects of memory for familiar words. Participants included 18 children between the ages of 9 to 14 with a diagnosed learning disability in reading and 18 controls matched for age, Full Scale IQ, gender, and socio-economic status. The complete CVLT-C was administered, and the two groups were compared on the following indices using ANOVA: total immediate recall List A, immediate recall List B, proactive interference from List A to List B, retroactive interference from List B to List A, short-term delayed recall, long-term delayed recall, savings from short-delay to long-delay recall, recognition memory, intrusions, perseverations, learning curve, semantic clustering and serial clustering. Groups differed only on total immediate recall for List A, and this difference lost its significance when VIQ was entered into the equation as a covariate. Hence, children with dyslexia performed comparably to controls on most areas of verbal memory assessed by the CVLT-C. It is not likely that these results were merely due to low power, as group performance differed substantially on a separate non-word immediate memory task given during the same study. Furthermore, children with dyslexia continued to perform considerably worse than controls on this task after VIQ differences were statistically controlled. The children with dyslexia presented with reduced verbal intellect when compared to the normal readers. It appears this weakness contributed to a mild immediate memory impairment for familiar words which often were encoded semantically. However, the greatest memory impairment in these children was for non-words encoded phonetically. Our study's findings are consistent with prior research demonstrating impaired phonological processing is one of the key deficits in children with dyslexia. Lesniak-Karpiak, K., Barakat, L. B., & Ross, J. L. The Focus-Execute Component of Attention: A Comparison of Children with Turner Syndrome with Healthy Children. Performance on the focus-execute attention measures of children with Turner Syndrome (TS) (n = 61) and healthy children (n = 60), whose ages ranged from 6 to 17, was compared. The focus-execute component of attention is the ability to identify salient features, and perform rapid responses under conditions of distractions. Findings sug-
12
Abstracts from the 18th Annual Meeting
gested that children with TS performed significantly less well on the following measures of the focus-execute component of attention: Stroop Color and Word Test and the Trail Making Test B. No differences between the groups were found on the Symbol Digit Modalities Test and Concentration Endurance Test. The pattern of performance on the focus-execute attention measures of young and old children with TS did not differ from that of young and old healthy comparison children. Karyotype of children with TS was not related to the level of performance on the focus-execute attention measures. In examining unique contributions of several potentially confounding variables (e.g., visualspatial, motor, impulse control, and working memory) to the focus-execute attention measures, visual-spatial skills and working memory were found to account for variance in the performance on the Stroop Color condition only, indicating that the focus-execute measures used in the study are relatively not confounded. Results are discussed in the context of an integrated neuropsychological and cognitive model of attention proposed by the present author to explain the nature of the focus-execute attention tests. The need for establishing ecological validity of the focus-execute attention tests to assist in planning psychoeducational interventions for children with TS is suggested.
Mahone, E. M., Hagelthorn, K. M., Cutting, L., Schuerholz, L. J., Pelletier, S. F., Rawlins, C., & Denckla, M. B. Developmental Course of Executive Function in High Functioning Children with ADHD. In recent years, neuropsychological investigations of ADHD have focused on executive function (EXF) and the role of the frontal brain systems (Pennington, 1991; Reader et al., 1994). EXF has also been considered central in successful acquisition and efficient use of academic skills--particularly in efforts to overcome information processing deficits (Denckla, 1996). Unfortunately, neuropsychological measures of EXF have been inconsistent in their prediction and diagnosis of ADHD (Barkley, 1994). Recently, Barkley (1997) proposed a hybrid model of A DHD as a neurologically-based disorder involving executive (self regulatory) dysfunction, primarily manifest in behavioral regulation difficulties. According to Barkley's model, EXF develops at different periods throughout the lifespan and includes working memory, self-regulation of arousal, internalization of speech, and reconstitution, all of which act to bring motor behavior, fluency and syntax under the control of internally represented information. The present study compares performance between high functioning children with ADHD and controls on measures of EXF (as defined by Barkley's model) across age groups and across levels of intellectual functioning. Participants were 105 children (68 ADHD, 37 control), ages 6-16, who completed measures of nonverbal working memory (Rey Osterrieth Complex Figure--immediate recall), self-regulation of arousal (TOVA), internalization of speech (Wisconsin Card Sort) and reconstitution (Letter-Word Fluency). When controlling for IQ, results showed multivariate main effects for age (p < .0001) and for group (p < .05), with measures of self-regulation (i.e., TOVA commissions and variability) emerging as the only consistent predictors of group differences. In all measures except TOVA, a linear developmental trajectory, was found for both ADHD and control subjects, with ADHD children reaching adult level of performance at the expected time. However, on the TOVA, the ADHD group reached plateau at a 7-year level or below--even among those children with high IQ levels (i.e., >120). These results suggest that available measures of self-regulation (i.e., continuous performance tests) may be most useful in highlighting the deficits in ADHD across age spans and in high IQ groups. Although trends were consistently found among the other EXF measures, ADHD children with high IQ may be able to effectively use compensatory strategies to perform at or near normal age level expectations.
11
output and very poor phonology. Additional features associated with defective programming of verbal motor output include drooling, and difficulty chewing and swallowing. We present a case study of an 8-year, 9-month-old female with a history of severe developmental delay and the absence of language until age 5. Referral was made to confirm diagnosis and to make recommendations for educational and treatment planning. General medical findings were noncontributory with the exception of inconsistent tongue deviation and right-sided facial droop. In evaluation, eye-contact, prosody, and social engagement were good allowing autistic spectrum disorders to be ruled out. Language continued to be characterized by extremely limited expressive and receptive skills. Assessment was functional in nature evaluating adaptive behavior, motor skill, and verbal and nonverbal cognition. Focus will be on criteria for differential diagnoses for DVD, functional assessment techniques, and treatment recommendations.
Kibby, M. Y., & Long, C. J. Instigation of Verbal Memory in Children with Dyslexia Utilizing the CVL T-C. Children with developmental dyslexia often present with deficits in reading, spelling, naming, and articulation. Several studies have revealed that these children also demonstrate impaired short-term verbal memory, although limited research has been conducted using the California Verbal Learning Test-Children's Version (CVLT-C) with this population. Our investigation utilized the CVLT-C as it assesses both quantitative and qualitative aspects of memory for familiar words. Participants included 18 children between the ages of 9 to 14 with a diagnosed learning disability in reading and 18 controls matched for age, Full Scale IQ, gender, and socio-economic status. The complete CVLT-C was administered, and the two groups were compared on the following indices using ANOVA: total immediate recall List A, immediate recall List B, proactive interference from List A to List B, retroactive interference from List B to List A, short-term delayed recall, long-term delayed recall, savings from short-delay to long-delay recall, recognition memory, intrusions, perseverations, learning curve, semantic clustering and serial clustering. Groups differed only on total immediate recall for List A, and this difference lost its significance when VIQ was entered into the equation as a covariate. Hence, children with dyslexia performed comparably to controls on most areas of verbal memory assessed by the CVLT-C. It is not likely that these results were merely due to low power, as group performance differed substantially on a separate non-word immediate memory task given during the same study. Furthermore, children with dyslexia continued to perform considerably worse than controls on this task after VIQ differences were statistically controlled. The children with dyslexia presented with reduced verbal intellect when compared to the normal readers. It appears this weakness contributed to a mild immediate memory impairment for familiar words which often were encoded semantically. However, the greatest memory impairment in these children was for non-words encoded phonetically. Our study's findings are consistent with prior research demonstrating impaired phonological processing is one of the key deficits in children with dyslexia. Lesniak-Karpiak, K., Barakat, L. B., & Ross, J. L. The Focus-Execute Component of Attention: A Comparison of Children with Turner Syndrome with Healthy Children. Performance on the focus-execute attention measures of children with Turner Syndrome (TS) (n = 61) and healthy children (n = 60), whose ages ranged from 6 to 17, was compared. The focus-execute component of attention is the ability to identify salient features, and perform rapid responses under conditions of distractions. Findings sug-
12
Abstracts from the 18th Annual Meeting
gested that children with TS performed significantly less well on the following measures of the focus-execute component of attention: Stroop Color and Word Test and the Trail Making Test B. No differences between the groups were found on the Symbol Digit Modalities Test and Concentration Endurance Test. The pattern of performance on the focus-execute attention measures of young and old children with TS did not differ from that of young and old healthy comparison children. Karyotype of children with TS was not related to the level of performance on the focus-execute attention measures. In examining unique contributions of several potentially confounding variables (e.g., visualspatial, motor, impulse control, and working memory) to the focus-execute attention measures, visual-spatial skills and working memory were found to account for variance in the performance on the Stroop Color condition only, indicating that the focus-execute measures used in the study are relatively not confounded. Results are discussed in the context of an integrated neuropsychological and cognitive model of attention proposed by the present author to explain the nature of the focus-execute attention tests. The need for establishing ecological validity of the focus-execute attention tests to assist in planning psychoeducational interventions for children with TS is suggested.
Mahone, E. M., Hagelthorn, K. M., Cutting, L., Schuerholz, L. J., Pelletier, S. F., Rawlins, C., & Denckla, M. B. Developmental Course of Executive Function in High Functioning Children with ADHD. In recent years, neuropsychological investigations of ADHD have focused on executive function (EXF) and the role of the frontal brain systems (Pennington, 1991; Reader et al., 1994). EXF has also been considered central in successful acquisition and efficient use of academic skills--particularly in efforts to overcome information processing deficits (Denckla, 1996). Unfortunately, neuropsychological measures of EXF have been inconsistent in their prediction and diagnosis of ADHD (Barkley, 1994). Recently, Barkley (1997) proposed a hybrid model of A DHD as a neurologically-based disorder involving executive (self regulatory) dysfunction, primarily manifest in behavioral regulation difficulties. According to Barkley's model, EXF develops at different periods throughout the lifespan and includes working memory, self-regulation of arousal, internalization of speech, and reconstitution, all of which act to bring motor behavior, fluency and syntax under the control of internally represented information. The present study compares performance between high functioning children with ADHD and controls on measures of EXF (as defined by Barkley's model) across age groups and across levels of intellectual functioning. Participants were 105 children (68 ADHD, 37 control), ages 6-16, who completed measures of nonverbal working memory (Rey Osterrieth Complex Figure--immediate recall), self-regulation of arousal (TOVA), internalization of speech (Wisconsin Card Sort) and reconstitution (Letter-Word Fluency). When controlling for IQ, results showed multivariate main effects for age (p < .0001) and for group (p < .05), with measures of self-regulation (i.e., TOVA commissions and variability) emerging as the only consistent predictors of group differences. In all measures except TOVA, a linear developmental trajectory, was found for both ADHD and control subjects, with ADHD children reaching adult level of performance at the expected time. However, on the TOVA, the ADHD group reached plateau at a 7-year level or below--even among those children with high IQ levels (i.e., >120). These results suggest that available measures of self-regulation (i.e., continuous performance tests) may be most useful in highlighting the deficits in ADHD across age spans and in high IQ groups. Although trends were consistently found among the other EXF measures, ADHD children with high IQ may be able to effectively use compensatory strategies to perform at or near normal age level expectations.