Cognitive Predictors of the Overlap of Reading and Math in Middle School.

Math and reading skills are known to be related, and predictors of each are well researched. What is less understood is the extent to which these predictors, uniquely and collectively, overlap with one another, are differentially important for different academic skills, and account for the overlap of math and reading. We examined 20 potential predictors from four domains (working memory, processing speed, attention, and language) using latent variables and both timed and untimed achievement skill, in a sample (N=212) of at-risk middle schoolers, half of whom were English learners. The predictors accounted for about half of the overlap among achievement skills, suggesting that other factors (e.g., domain specific skills) might also be relevant for the overlap. We also found some differential prediction (language for reading, working memory for math). The present results extend and refine our understanding of the contribution of these cognitive predictors for reading and math.

A survey of the perceptions and practices of faculty in clinical neuropsychology doctoral training programs: is heterogeneity the norm?

Objective: Doctoral education is a cornerstone in the training of clinical neuropsychologists. However, we know little about perceptions, practices, and needs of the faculty who oversee doctoral training in clinical neuropsychology (CN). Method: Seventy-one faculty from 45 doctoral programs providing CN training completed at least part of a survey assessing characteristics of their programs, current training practices and views, and challenges to CN doctoral training. Results: Over half of CN faculty reported having zero or only one CN colleague. CN faculty reported that the goals of CN doctoral training are research training, clinical training, and acquisition of knowledge and skills reflected in the Houston Conference Guidelines (HCG). CN faculty reported that doctoral trainees obtain more clinical hours than faculty would like and endorsed alternative clinical metrics, including competency-based ratings. CN faculty are divided about the benefits of a required two-year postdoctoral CN fellowship. Conclusions: The HCG states that specialization in CN begins at the doctoral level. CN faculty in doctoral programs are fully immersed in the early development and education of future CN researchers and practitioners. Tensions between clinical and research training in CN at the doctoral level-and student overemphasis on accruing clinical hours-might place CN at risk for failing to make research innovations necessary for our field to evolve and thrive. More CN doctoral faculty are needed to serve as mentors to students, especially for students from backgrounds that have been historically excluded and marginalized. A greater voice from CN doctoral faculty in CN governance is needed.

Framing Executive Function as a Construct and its Relation to Academic Achievement.

The goal of this work is to provide a framework for understanding the relationship of executive function (EF) to reading and other academic achievement to promote future work in this area. After briefly reviewing extant theoretical and empirical support about what is known in this area, we then more deeply evaluate the construct of EF itself. This is necessary because EF means any number of things to any number of individuals, scientists included. Review of several pertinent conceptualizations of EF, including our own, reveals agreement that EF is domain general (although the meaning of domain generality is varied); additional commonalities include a focus on control/management and goal direction. However, there is less agreement on whether EF is singular or plural, or whether EF is one or more "thing(s)" versus process(es). These alternatives are discussed with a focus on the implications for understanding the role of EF for important functional outcomes.

PROPERTIES OF A COMBINED MEASURE OF READING AND WRITING: THE ASSESSMENT OF WRITING, SELF-MONITORING, AND READING (AWSM READER).

There is significant overlap between reading and writing, but no known standardized measure assesses these jointly. The goal of the present study is to evaluate the properties of a novel measure, the Assessment of Writing, Self-Monitoring, and Reading (AWSM Reader), that simultaneously evaluates both reading comprehension and writing. In doing so, we evaluate reliability (Cronbach's alpha) and various aspects of construct-related validity, including separate criterion measures of reading and writing, and the AWSM Reader's relations with other variables, including language and executive function (EF), both of which are implicated for both reading and writing. Participants were 377 3rd, 4th, and 5th graders with or at-risk for reading and writing difficulties. Reliability was low for the AWSM Reader reading comprehension (α = .58), but good for writing (α = .75-.80). Criterion-related validity indices revealed moderate correlations with other standardized and commonly used reading and writing measures, r = .47 to .50 (all ps < .001). Additionally, validity data supported the relations of both language and EF to AWSM Reader reading and writing, with EF showing unique prediction in both reading and writing domains. Results provide initial support for the measure per se but stress the difficulty in constructing combined reading and writing measures; directions are given for future work. Results also add to data on the contributions of language and EF to both reading and writing.

An Evaluation of the Structure of Attention in Adolescence.

This study evaluated the factor structure of attention, considering internal and external attention, and juxtaposed alongside processing speed (PS) and working memory (WM). We expected the hypothesized model to fit better than unitary or method factors. We included 27 measures with 212 Hispanic middle schoolers from Spanish-speaking backgrounds, where a substantial proportion were at risk for learning difficulties. Confirmatory factor analytic models separated factors of PS and WM, but the final model did not align with theoretical predictions; rather only measurement factors emerged. Findings extend and refine our understanding of the structure of attention in adolescents.

Brain Engagement During a Cognitive Flexibility Task Relates to Academic Performance in English Learners.

English Learners (ELs), students from non-English-speaking backgrounds, are a fast-growing, understudied, group of students in the U.S. with unique learning challenges. Cognitive flexibility-the ability to switch between task demands with ease-may be an important factor in learning for ELs as they have to manage learning in their non-dominant language and access knowledge in multiple languages. We used functional MRI to measure cognitive flexibility brain activity in a group of Hispanic middle school ELs (N = 63) and related it to their academic skills. We found that brain engagement during the cognitive flexibility task was related to both out-of-scanner reading and math measures. These relationships were observed across the brain, including in cognitive control, attention, and default mode networks. This work suggests the real-world importance of cognitive flexibility for adolescent ELs, where individual differences in brain engagement were associated with educational outcomes.

The Not-So-Simple View of Writing in Struggling Readers/Writers.

Research suggests that executive function, motivation, transcription, and composition processes are implicated in the writing quality and productivity of children with and without learning difficulties. However, numerous components embedded within these constructs create both conceptual and empirical challenges to the study of written expression. These challenges are reflected in the writing research by way of poor delineation of constructs and insufficient distinction among domain general resources (e.g. working memory) versus processes related to the academic domain of writing (e.g. pre-planning), as well as among lower- (e.g. handwriting) and higher-order (e.g. editing) writing-specific processes. The current study utilizes the Not-so-Simple View of Writing (NSVW) as an organizing framework for examining the relations among multiple components, correlates, and attributes of writing in a sample of struggling readers/writers (n = 402) in grades 3-5. Data were collected on measures of (a) handwriting, spelling, planning, revision, and editing, derived from the Test of Oral Written Language (TOWL-4), (b) executive function derived from the NIH Examiner, and (c) motivation/self-efficacy derived from the Student Contextual Learning Scale. Structural equation modeling was utilized to test direct and indirect relations in the NSVW model. Results showed generally moderate correlations among observed/latent variables and found support for relations among writing-specific processes. Domain-general resources (executive function and motivation/self-efficacy) were related to spelling directly and indirectly to writing. Domain-specific processes (handwriting, spelling, planning, editing, and revision) were related to writing. The results have implications for explicit instruction of writing processes and for future research on empirical models.

Cognitive predictors of social adjustment in pediatric brain tumor survivors treated with photon versus proton radiation therapy.

BACKGROUND: Pediatric brain tumor survivors are at risk for poor social outcomes. It remains unknown whether cognitive sparing with proton radiotherapy (PRT) supports better social outcomes relative to photon radiotherapy (XRT). We hypothesized that survivors treated with PRT would outperform those treated with XRT on measures of cognitive and social outcomes. Further, we hypothesized that cognitive performance would predict survivor social outcomes. PROCEDURE: Survivors who underwent PRT (n = 38) or XRT (n = 20) participated in a neurocognitive evaluation >1 year post radiotherapy. Group differences in cognitive and social functioning were assessed using analysis of covariance (ANCOVA). Regression analyses examined predictors of peer relations and social skills. RESULTS: Age at evaluation, radiation dose, tumor diameter, and sex did not differ between groups (all p > .05). XRT participants were younger at diagnosis (XRT M = 5.0 years, PRT M = 7.6 years) and further out from radiotherapy (XRT M = 8.7 years, PRT M = 4.6 years). The XRT group performed worse than the PRT group on measures of processing speed (p = .01) and verbal memory (p < .01); however, social outcomes did not differ by radiation type. The proportion of survivors with impairment in peer relations and social skills exceeded expectation; χ2 (1) = 38.67, p < .001; χ2 (1) = 5.63, p < .05. Household poverty predicted peer relation difficulties (t = 2.18, p < .05), and verbal memory approached significance (t = -1.99, p = .05). Tumor diameter predicted social skills (t = -2.07, p < .05). CONCLUSIONS: Regardless of radiation modality, survivors are at risk for social challenges. Deficits in verbal memory may place survivors at particular risk. Results support monitoring of cognitive and social functioning throughout survivorship, as well as consideration of sociodemographic risk factors.

Visual attention and reading: A test of their relation across paradigms.

Relations of visual attention to reading have long been hypothesized; however, findings in this literature are quite mixed. These relations have been investigated using several different visual attention paradigms and with variable controls for other competing reading-related processes. We extended current knowledge by evaluating four of the key visual attention paradigms used in this research-visual attention span, attention blink, visual search, and visuospatial attention-in a single study. We tested the relations of these to reading in 90 middle schoolers at high risk for reading difficulties while considering their effect in the context of known language predictors. Performance on visual-spatial, visual search, and attentional blink paradigms showed weak nonsignificant relations to reading. Visual attention span tasks showed robust relations to reading even when controlling for language, but only when stimuli were alphanumeric. Although further exploration of visual attention in relation to reading may be warranted, the robustness of this relationship appears to be questionable, particularly beyond methodological factors associated with the measurement of visual attention. Findings extend and refine our understanding of the contribution of attention to reading skill and raise questions about the mechanism by which visual attention is purported to affect reading.

Characterization of English and Spanish language proficiency among middle school English learners with reading difficulties.

Among bilinguals, language-related variables such as first and second language proficiency and balance may be related to important cognitive and academic outcomes, but approaches to characterizing these variables are inconsistent, particularly among at-risk samples of children. The current study employed comprehensive language assessment of English and Spanish language skills and contrasted various approaches to the characterization of language among at-risk ELs in middle school (N = 161). Specifically, we contrasted variable-centered and person-centered approaches, and convergence between objective and self-report measures. Findings support a two-factor structure of English and Spanish language skills in this population, three profiles of students (balanced, moderately unbalanced-higher Spanish, and very unbalanced-higher English), convergence between variable-centered and person-centered approaches, and mixed support for subjective indices of usage. Results provide a foundation from which to examine the roles of L1 and L2 proficiency as well as balance in important cognitive and academic outcomes in this at-risk and understudied population.

Sustained attention and behavioral ratings of attention in struggling readers.

Attention is correlated with reading, but the extent to which behavioral ratings and sustained attention relate to reading skills is unclear. We assessed 245 4th and 5th grade struggling readers (mean age = 10.3 years) on behavioral ratings of attention, sustained attention, and reading over a school year. Contributions of behavioral ratings and sustained attention were considered cross-sectionally and longitudinally in the context of other important predictors of reading. Results suggest that sustained measures and behavioral ratings assess distinct, yet overlapping, aspects of attention. Both types of attention accounted for unique variance in comprehension, but not word reading accuracy or fluency, when evaluated cross-sectionally. Results also support the role of behavioral ratings of attention in fluency and in comprehension growth. Findings suggest that multidimensional assessment of attention is useful when considering its relation to reading, and highlights the need to integrate conceptualizations of attention that arise from different theoretical approaches.

Long-term cognitive and academic outcomes among pediatric brain tumor survivors treated with proton versus photon radiotherapy.

BACKGROUND: Proton radiotherapy (PRT) may be associated with less neurocognitive risk than photon RT (XRT) for pediatric brain tumor survivors. We compared neurocognitive and academic outcomes in long-term survivors treated with XRT versus PRT. METHODS: Survivors underwent neurocognitive evaluation >1 year after craniospinal (CSI) or focal PRT or XRT. Groups were compared using separate one-way analyses of covariance for the CSI and focal groups. RESULTS: PRT (n = 58) and XRT (n = 30) subgroups were similar on gender (66% male), age at RT (median = 6.5 years), age at follow-up (median = 14.6 years), and government assistance status (32%). PRT and XRT focal groups differed on follow-up interval, shunt history, and total RT dose (all p < .05), whereas PRT and XRT CSI groups differed on follow-up interval, baseline neurocognitive performance score, boost volume, and CSI dose (all p < .05). The PRT focal group outperformed the XRT focal group on inhibition/switching (p = .04). The PRT CSI group outperformed the XRT CSI group on inattention/impulsivity (both p < .05). Several clinical variables (i.e., RT dose, boost field, baseline performance) predicted neurocognitive outcomes (all p < .05). The PRT focal group performed comparably to population means on most neurocognitive measures, while both CSI groups performed below expectation on multiple measures. The XRT CSI group was most impaired. All groups fell below expectation on processing speed, fine motor, and academic fluency (most p < .01). CONCLUSIONS: Findings suggest generally favorable neurocognitive and academic long-term outcomes following focal PRT. Impairment was greatest following CSI regardless of modality. Dosimetry and baseline characteristics are important determinants of outcome alone or in combination with modality.

Executive Functioning with the NIH EXAMINER and Inference Making in Struggling Readers.

Executive functioning (EF) is a domain-general process implicated in reading, but there remains lack of clarity within the domain due to varied assessment methods. We investigated the relation of EF (indexed with the NIH EXAMINER) to word reading, reading fluency, and reading comprehension in struggling readers and evaluated the mediational role of inference making for the EF-comprehension link. Analyses revealed an overall effect of EF on reading, with significant differences between fluency and comprehension, and between single word reading and comprehension, but not between fluency and single-word reading. The EF-reading comprehension relation was fully mediated by inference making.

The Structure of Processing Speed in Children and its Impact on Reading.

The present study had two aims. First, we set out to evaluate the structure of processing speed in children by comparing five alternative models: two conceptual models (a unitary model, a complexity model) and three methodological models (a stimulus material model, an output response model, and a timing modality model). Second, we then used the resulting models to predict multiple types of reading, a highly important developmental outcome, using other well-known predictors as covariates. Participants were 844 children enrolled in third through fifth grade in urban public elementary schools who received 16 measures of processing speed that varied in the above dimensions. A two-factor complexity model that differentiated between simple and complex processing speed was the preferred model and fit the data well. Both types of PS predicted reading fluency, and complex (but not simple) PS predicted single word reading and comprehension. Results offer insight to the structure of processing speed, its relation to closely related concepts (such as executive function), and provide nuance to the understanding of the way processing speed influences reading.

The Role of Reading Anxiety among Struggling Readers in Fourth and Fifth Grade.

Cognitive predictors of reading are well known, but less is understood about the roles of "noncognitive" factors, including emotional variables such as anxiety. While math anxiety has been a focus of study, its analogue in the reading literature is understudied. We assessed struggling fourth and fifth graders (n = 272) on reading anxiety in the context of general anxiety, cognitive predictors (working memory, verbal knowledge), and demographics. Regressions tested for unique contributions to three reading outcomes: word reading accuracy, oral reading fluency, and reading comprehension. Reading anxiety and general anxiety correlated moderately (r = .63) but were differentially related to reading. Reading anxiety predicted comprehension when all other predictors were considered, and predicted oral reading fluency until word reading accuracy was added to the model. Results offer a more nuanced understanding of the nature of reading anxiety, and its implications for struggling readers.

Frontostriatal White Matter Integrity Relations with "Cool" and "Hot" Self-Regulation after Pediatric Traumatic Brain Injury.

Traumatic brain injury (TBI) produces microstructural damage to white matter pathways connecting neural structures in pre-frontal and striatal regions involved in self-regulation (SR). Dorsal and ventral frontostriatal pathways have been linked to cognitive ("cool") and emotional ("hot") SR, respectively. We evaluated the relation of frontostriatal pathway fractional anisotropy (FA) 2 months post-TBI on cool and hot SR assessed 7 months post-TBI. Participants were 8-15 years of age, including children with uncomplicated mild TBI (mTBI; n = 24), more severe TBI (complicated-mild, moderate, severe [cms]TBI; n = 60), and typically developing (TD) children (n = 55). Diffusion tensor tractography was used to map frontostriatal pathways. Cool SR included focused and sustained attention performance, and parent-reported attention, whereas hot SR included risk-taking performance and parent-reported emotional control. Multivariate general linear models showed that children with cmsTBI had greater parent-reported cool and hot SR difficulties and lower dorsal and ventral FA than TD children. Focused attention, risk taking, and emotional control correlated with FA of specific dorsal and ventral pathways; however, only the effect of TBI on focused attention was mediated by integrity of dorsal pathways. Results suggest that frontostriatal FA may serve as a biomarker of risk for SR difficulties or to assess response to interventions targeting SR in pediatric TBI and in broader neurodevelopmental populations.

Reporting of Demographic Variables in Neuropsychological Research: An Update of O'Bryant et al.'s Trends in the Current Literature.

OBJECTIVE: Demographic trends and the globalization of neuropsychology have led to a push toward inclusivity and diversity in neuropsychological research in order to maintain relevance in the healthcare marketplace. However, in a review of neuropsychological journals, O'Bryant et al. found systematic under-reporting of sample characteristics vital for understanding the generalizability of research findings. We sought to update and expand the findings reported by O'Bryant et al. METHOD: We evaluated 1648 journal articles published between 2016 and 2019 from 7 neuropsychological journals. Of these, 1277 were original research or secondary analyses and were examined further. Articles were coded for reporting of age, sex/gender, years of education, ethnicity/race, socioeconomic status (SES), language, and acculturation. Additionally, we recorded information related to sample size, country, and whether the article focused on a pediatric or adult sample. RESULTS: Key variables such as age and sex/gender (both over 95%) as well as education (71%) were frequently reported. Language (20%) and race/ethnicity (36%) were modestly reported, and SES (13%), and acculturation (<1%) were more rarely reported. SES was more commonly reported in pediatric than adult samples, and the opposite was true for education. There were differences between the present results and those of O'Bryant et al., though the same general trends remained. CONCLUSIONS: Reporting of demographic data in neuropsychological research appears to be slowly changing toward greater comprehensiveness, though clearly more work is needed. Greater systematic reporting of such data is likely to be beneficial for the generalizability and contextualization of neurocognitive function.

Executive Function: Association with Multiple Reading Skills.

Executive function (EF) is related to reading. However, there is a lack of clarity around (a) the relative contribution of different components of EF to different reading components (word reading, fluency, comprehension), and (b) how EF operates in the context of known strong language predictors (e.g., components of the Simple View of Reading or SVR), and other skills theoretically related to reading (e.g., vocabulary, processing speed) and/or to EF (e.g., short-term memory, motor function). In a large sample of 3rd to 5th graders oversampled for struggling readers, this paper evaluates the impact of EF derived from a bifactor model (Cirino, Ahmed, Miciak, Taylor, Gerst, & Barnes, 2018) in the context of well-known covariates and demographics. Beyond common EF, five specific factors (two related to working memory, and factors of fluency, self-regulated learning, and behavioral inattention/metacognition) were addressed. EF consistently showed a unique contribution to already-strong predictive models for all reading outcomes; for reading comprehension, EF interacted with SVR indices (word reading and listening comprehension). The findings extend and refine our understanding of the contribution of EF to reading skill.

Cognitive, Intervention, and Neuroimaging Perspectives on Executive Function in Children With Reading Disabilities.

The role of executive function (EF) in the reading process, and in those with reading difficulties, remains unclear. As members of the Texas Center for Learning Disabilities, we review multiple perspectives regarding EF in reading and then summarize some of our recent studies of struggling and typical readers in grades 3-5. Study 1a found that a bi-factor structure best represented a comprehensive assessment of EF. Study 1b found that cognitive and behavioral measures of EF related independently to math and reading. Study 1c found that EF related to reading, above and beyond other variables, but Study 1d found no evidence that adding an EF training component improved intervention response. Study 1e found that pretest EF abilities did not relate to intervention response. Neuroimaging studies examined EF-related brain activity during both reading and nonlexical EF tasks. In Study 2a, the EF task evoked control activity, but generated no differences between struggling and typical readers. The reading task, however, had group differences in both EF and reading regions. In Study 2b, EF activity during reading at pretest was related to intervention response. Across studies, EF appears involved in the reading process. There is less evidence for general EF predicting or improving intervention outcomes.

Executive Functions and Response to Intervention: Identification of Students Struggling with Reading Comprehension.

Inadequate responders demonstrate significant risk for learning disabilities. Previous investigations of the cognitive profiles of inadequate and adequate responders have not included measures of executive functions (EF), which have well-documented associations to reading comprehension. We evaluated EF performance on a common factor comprised of shared variance across tasks as well as five separable EF factors in the context of an intensive reading intervention for struggling fourth graders. To determine if EF performance at pretest is associated with subsequent responder status, we compared EF performance of three subgroups of students: inadequate and adequate responders and typical students not at-risk for reading disabilities. Results of discriminant function analyses and linear regression models comparing groups were largely null; EF performance at pretest demonstrated only small associations with responder status. These results suggest that the assessment of EF may have limited value in predicting which individual students will respond to intensive reading interventions.