Executive functions and theory of mind associations in middle childhood: Does social interaction act as a mediator?

This study explored the interplay of executive functions (EFs), social interactions, and theory of mind (ToM) in middle childhood. The first aim was to examine how specific EFs-shifting, inhibition, and working memory (WM)-predict social-perceptual and social-cognitive ToM. The second aim was to explore the potential mediating role of social interactions in the EF-ToM relationship. A total of 98 children aged 8 to 11 years completed three computerized EF tasks (task switching, flanker, and running span) and two ToM tasks (Strange Stories and Reading the Mind in the Eyes). The quality and quantity of social interactions were self-reported by using questionnaires. First, multiple regression analyses with age-adjusted scores examined how specific EFs predict ToM scores. The regression model was significant for social-cognitive ToM, but not for social-perceptual ToM. WM accuracy was the only significant, positive predictor for performance on the Strange Stories task. Second, mediation analyses assessed whether social interactions mediate this EF-ToM relationship. There were no significant mediation effects of the quality and quantity of social interactions on the relationship between WM and social-cognitive ToM. In conclusion, EFs play a significant role in explaining social-cognitive ToM variability in middle childhood. WM is relevant for understanding others' mental states, in contrast to shifting and inhibition that lacked predictive value. The results also suggest different cognitive processes associated with social-perceptual versus social-cognitive ToM in this developmental stage.

Difficulty sensitivity replaces reward sensitivity during adolescence: Task-related fMRI and functional connectivity during self-regulative learning choices.

AIM: We examined age-related differences in valuation and cognitive control circuits during value-based decision-making. METHODS: 13-year-olds (N = 25) and 17-year-olds (N = 22) made a metacognitive choice to be tested or not on an upcoming learning task, based on reward and difficulty associated with word-pairs. To investigate whether these determinants of subjective value are differently processed at different ages, we performed region-of-interest(ROI)-based analyses of task-related and functional connectivity data. RESULTS: We observed age-related differences in responsiveness of valuation structures (amygdala, ventral striatum, ventromedial prefrontal cortex) and caudate nucleus, with activity modulated by reward in 13-year-olds, while in 17-year-olds activity being responsive to difficulty. These accompanied age-related differences in functional connectivity between medial prefrontal and striatal/amygdala seeds. DISCUSSION: These results are in line with current views that sensitivity changes for reward and difficulty during adolescence are the result of a maturational switch in effort-related signalling in the cognitive control circuit, which increasingly regulates value-signalling structures.

Further validation of a new ADHD screening questionnaire measuring parents' explanations (time processing, cognition, and motivation) of inattention symptoms in their school-aged children.

The triple pathway model suggests that different neuropsychological factors underlie symptoms of inattention (i.e., time, cognition and/or motivation problems). However, screening instruments asking individuals to judge the link between these neuropsychological factors and inattention are lacking. The recently developed screening questionnaire, PASSC, aims to examine these factors possibly causing inattention by asking parents to indicate to what extent their child experiences inattention symptoms and to what extent different neuropsychological factors explain this inattention. The present study extends prior validation research of the PASSC by examining associations between PASSC inattention explained by time, cognition, and/or motivation and children's performance on tests measuring these same three constructs. Results indicated positive correlations between PASSC inattention explained by time and less accurate performance on a time discrimination test, and between PASSC inattention explained by cognition and more working memory errors as well as higher attention switching costs. Furthermore, children whose parents indicated that their inattention was best explained by cognition showed higher switching costs than children whose inattention was best explained by motivation. This support for construct validity of the PASSC is limited to two PASSC explanations (i.e., time, cognition) and a subset of tests (i.e., time discrimination, attention switching, memory span). Future research should focus on integrating PASSC and performance test results to differentiate between children with attention problems but different underlying neuropsychological problems. Concluding, the PASSC can be a promising screening tool to identify inattention in children and the underlying explanation indicated by parents.

Psychometric properties of a new ADHD screening questionnaire: Parent report on the (potential) underlying explanation of inattention in their school-aged children.

The present study examined psychometric properties of a recently developed parent report screening questionnaire, i.e., Parent ADHD Screening questionnaire: Signaling the Core explanation underlying behavioral symptoms (PASSC). The PASSC aims to measure (1) ADHD symptoms and (2) what parents view to be the main underlying explanation(s) of these symptoms. The PASSC questions 3 (potential) underlying explanations based on the triple pathway model (TPM): i.e., time, cognition and/or motivation problems. Parents of 1166 Dutch children aged 4-12 filled in the PASSC, as well as 2 questionnaires measuring time, cognition and motivation (i.e., the FTF and the SPSRQ-C). Reliability of the PASSC is good, indicated by high internal consistency of the sumscores. Principal component analyses supported the distinction between inattention and hyperactivity-impulsivity symptoms as defined in the DSM-5, and the distinction between the 3 TPM explanations given by parents for inattention, but not for hyperactivity-impulsivity symptoms. The majority of parents selected one and the same explanation for inattention problems of their child, most often being cognition (31.2%) and motivation (28.2%). PASSC validity was further supported by positive associations between the explanation sumscores for inattention symptoms and other parent questionnaires measuring the same constructs (i.e., time, cognition and motivation; convergent validity), although we found no evidence for discriminant validity. Groups (based on age group, sex and ADHD diagnosis) differed on the PASSC sumscores in the expected directions. Concluding, the PASSC is a promising tool to assess a child's ADHD symptoms as well as the parent view on (potential) explanation(s) of inattention.

Mind wandering in children: Examining task-unrelated thoughts in computerized tasks and a classroom lesson, and the association with different executive functions.

Mind wandering is associated with worse performance on cognitively demanding tasks, but this concept is largely unexplored in typically developing children and little is known about the relation between mind wandering and specific executive functions (EFs). This study aimed, first, to measure and compare children's mind wandering in controlled computerized tasks as well as in an educational setting and, second, to examine the association between mind wandering and the three core EFs, namely inhibition, working memory, and set shifting/switching. A total of 52 children aged 9-11 years performed a classroom listening task and a computerized EF battery consisting of flanker, running span, and attention switching tasks. Mind wandering was measured using online probed and/or retrospective self-reports of task-unrelated thoughts (TUTs) during task performance. Children reported TUTs on 20-25% of the thought probes, which did not differ between classroom and EF tasks. Regression models, hierarchically adding the three core EFs, accounted for a small but significant portion of variance in TUT frequency when measured in class and retrospectively after EF tasks, but not when measured online in EF tasks. Children with worse inhibition were more prone to mind wander during classroom and EF tasks. Lower attention switching accuracy also explained variation in retrospectively reported TUTs during EF tasks. Working memory was not a significant predictor. These results suggest that mind wandering is common and reliably measurable in children in controlled computerized and educational tasks. Lower executive control abilities predict more frequent mind wandering, although different EFs are related to mind wandering in diverse tasks/measures.

Age-related differences in task-induced brain activation is not task specific: Multivariate pattern generalization between metacognition, cognition and perception.

Adolescence is associated with widespread maturation of brain structures and functional connectivity profiles that shift from local to more distributed and better integrated networks, which are active during a variety of cognitive tasks. Nevertheless, the approach to examine task-induced developmental brain changes is function-specific, leaving the question open whether functional maturation is specific to the particular cognitive demands of the task used, or generalizes across different tasks. In the present study we examine the hypothesis that functional brain maturation is driven by global changes in how the brain handles cognitive demands. Multivariate pattern classification analysis (MVPA) was used to examine whether age discriminative task-induced activation patterns generalize across a wide range of information processing levels. 25 young (13-years old) and 22 old (17-years old) adolescents performed three conceptually different tasks of metacognition, cognition and visual processing. MVPA applied within each task indicated that task-induced brain activation is consistent and reliably different between ages 13 and 17. These age-discriminative activation patterns proved to be common across the different tasks used, despite the differences in cognitive demands and brain structures engaged by each of the three tasks. MVP classifiers trained to detect age-discriminative patterns in brain activation during one task were significantly able to decode age from brain activation maps during execution of other tasks with accuracies between 63 and 75%. The results emphasize that age-specific characteristics of task-induced brain activation have to be understood at the level of brain-wide networks that show maturational changes in their organization and processing efficacy during adolescence.

The association between cortisol and the BOLD response in male adolescents undergoing fMRI.

MRI participation has been shown to induce subjective and neuroendocrine stress reactions. A recent aging study showed that cortisol levels during fMRI have an age-dependent effect on cognitive performance and brain functioning. The present study examined whether this age-specific influence of cortisol on behavioral and brain activation levels also applies to adolescence. Salivary cortisol as well as subjective experienced anxiety were assessed during the practice session, at home, and before, during and after the fMRI session in young versus old male adolescents. Cortisol levels were enhanced pre-imaging relative to during and post-imaging in both age groups, suggesting anticipatory stress and anxiety. Overall, a negative correlation was found between cortisol output during the fMRI experiment and brain activation magnitude during performance of a gambling task. In young but not in old adolescents, higher cortisol output was related to stronger deactivation of clusters in the anterior and posterior cingulate cortex. In old but not in young adolescents, a negative correlation was found between cortisol and activation in the inferior parietal and in the superior frontal cortex. In sum, cortisol increased the deactivation of several brain areas, although the location of the affected areas in the brain was age-dependent. The present findings suggest that cortisol output during fMRI should be considered as confounder and integrated in analyzing developmental changes in brain activation during adolescence.

Maturation of task-induced brain activation and long range functional connectivity in adolescence revealed by multivariate pattern classification.

The present study uses multivariate pattern classification analysis to examine maturation in task-induced brain activation and in functional connectivity during adolescence. The multivariate approach allowed accurate discrimination of adolescent boys of respectively 13, 17 and 21years old based on brain activation during a gonogo task, whereas the univariate statistical analyses showed no or only very few, small age-related clusters. Developmental differences in task activation were spatially distributed throughout the brain, indicating differences in the responsiveness of a wide range of task-related and default mode regions. Moreover, these distributed age-distinctive patterns generalized from a simple gonogo task to a cognitively and motivationally very different gambling task, and vice versa. This suggests that functional brain maturation in adolescence is driven by common processes across cognitive tasks as opposed to task-specific processes. Although we confirmed previous reports of age-related differences in functional connectivity, particularly for long range connections (>60mm), these differences were not specific to brain regions that showed maturation of task-induced responsiveness. Together with the task-independency of brain activation maturation, this result suggests that brain connectivity changes in the course of adolescence affect brain functionality at a basic level. This basic change is manifest in a range of tasks, from the simplest gonogo task to a complex gambling task.

The effect of perspective and content on brain activation during mentalizing in young females.

In the present functional magnetic resonance imaging (fMRI) study, we investigated the role of different brain regions in separate aspects of mentalizing. Young females aged 18-19 years were asked to imagine a social situation and answer a question. Perspective, self and other, as well as content, emotion, and behavior, were varied. Activation was observed in the left precuneus, left temporoparietal junction, left medial prefrontal cortex and left middle temporal gyrus. Left precuneus and left temporoparietal junction were recruited more when taking the perspective of other than when taking the perspective of self. Medial prefrontal areas might be more involved during mentalizing about emotion versus baseline than about behavior versus baseline.

Developmental changes between ages 13 and 21 years in the extent and magnitude of the BOLD response during decision making.

Developmental neuroimaging results have suggested a progression in focalization in functional activations from childhood to adulthood. The mechanisms underlying this process are thought to be an age-related decrease in activation extent as well as an increased magnitude in task-related areas. The present study aimed to evaluate these notions while controlling for confounders that may bias towards focalization. We used adolescent subjects in small age ranges. In addition, head motion corrections were incorporated in statistical analyses and regions of interest were identified for each participant separately to overcome inter-individual variability in anatomy and functional organization. Activation patterns of 13-, 17- and 21-year-old males were compared during the decision phase of a challenging and complex gambling paradigm. The BOLD amplitude enhanced with increasing age, modulated by task conditions. First, response amplitude during difficult, endogenous relative to exogenous decisions increased with age. This decision difficulty effect was most pronounced in 21-year-olds, both in areas associated with task execution and default mode areas. Second, deciding to pass as opposed to gamble exerted more effort in inferior frontal and parietal areas only by 13- and 17-year-olds. There was neither an age-related decrease in activation extent, nor any qualitative shifts in activated areas as suggested by the focalization hypothesis. These results suggest that although different age groups throughout adolescence engage similar brain areas during decision making, the response magnitude in these areas increases with age particularly during difficult task conditions, providing that confounding factors are controlled.

Age, sex, and pubertal phase influence mentalizing about emotions and actions in adolescents.

This study examined (1) emotional versus cognitive developmental trajectories and (2) the influence of age-extrinsic factors (i.e., sex and puberty). Using a cross-sectional design, adolescents (N = 252) divided into four age-groups (ages 13, 15, 17, 19) performed two versions of a mentalizing task, about emotions and actions, as well as the Tower task. First, performance on all tasks improved linearly into late adolescence (age 19). Thus no differential trajectories were found for emotional versus cognitive development. Second, girls outperformed boys in mentalizing speed regarding both emotions and actions. In boys, a later pubertal phase was associated with increased mentalizing speed after controlling for age-group.

Development of inattention, impulsivity, and processing speed as measured by the d2 Test: results of a large cross-sectional study in children aged 7-13.

The development of three aspects of selective attention was studied in 451 Dutch schoolchildren attending second to sixth grade. Selective attention was measured with the d2 Test of attention. The largest age differences were found for processing speed that continued to improve until the sixth grade. Impulsivity, as measured by the percentage of errors of commission, decreased until the fourth grade. Inattention, measured by the percentage of errors of omission, was stable in all grades. Processing speed and impulsivity were correlated with the score on the Attention Problems subscale of the Child Behavior Checklist. These results imply that selective attention continues to develop, at least, until the end of elementary school. The findings are support for a step-wise model of cognitive development (P. Anderson, 2002).

Subtypes of learning disabilities: neuropsychological and behavioural functioning of 495 children referred for multidisciplinary assessment.

Aim of the present study was two fold: (1) to evaluate the course of referring and diagnosing Learning Disabilities (LD) and the contribution of multidisciplinary assessment and (2) to describe characteristics of three LD subtypes: Attention with or without Motor function Disabilities (AMD), Verbal Learning Disabilities (VLD) and Non-Verbal Learning Disabilities (NVLD). Diagnostics, behavioural and neuropsychological data from 495 children aged 6-17 years were described. First, AMD and VLD was the most frequent LD. Multidisciplinary assessment could contribute to the diagnostic process of LD, especially in diagnosing uncommon LD and comorbidities. Secondly, behavioural ratings, information processing, attention regularity and visual-motor integration proved to be most sensitive in discriminating between the three LD subtypes. However, diagnosing NVLD requires additional developmental information. Multiple discriminant function analysis correctly classified 61.7% of a selection of the present sample into LD subtypes as diagnosed by the multidisciplinary team. It is believed that the three subtypes are clinically relevant and suggestions are made to test the present classification functions in an independent sample, preferably diagnosed using a structured diagnostic interview.

Methylphenidate improves reading performance in children with attention deficit hyperactivity disorder and comorbid dyslexia: an unblinded clinical trial.

Attention Deficit Hyperactivity Disorder (ADHD) and dyslexia are frequently co-occurring disorders. Although methylphenidate (MPH) is the primary treatment for ADHD, the effect on reading in children with these comorbid problems is not yet known. This study was an unblinded clinical trial to evaluate the reading performance before and after treatment with MPH. Reading performance was compared with General Linear Model repeated measures between three groups: (1) an experimental group of children with both ADHD and dyslexia (N = 24), (2) a control group of children with ADHD (N = 9) and (3) a control group of children with dyslexia (N = 10). MPH improved reading performance significantly stronger in the experimental group than in the control groups; the number of correctly read words increased to a larger extent. In conclusion, MPH proved to be an aid in the reading process of children with ADHD and comorbid dyslexia by improving the learning conditions, but MPH cannot cure the reading disorder. Future research should study the effect of MPH on reading in a double-blind clinical trial.