Assessing adherence and clinical utility of modified goal management training for adolescents with ADHD: A pilot study.

Many adolescents with attention-deficit hyperactivity disorder (ADHD) have executive functioning (EF) difficulties that contribute to academic and social-emotional challenges. This pilot explored adherence to and effectiveness of modified Goal Management Training (GMT), an EF intervention, with ADHD youth. Six adolescents with ADHD (14-17 years, 2 female) participated in a 6-session online group. Adherence was tracked via attendance and homework. Reliable change scores gaged pre-post differences on measures before and after training (primary: everyday EF and goal attainment; secondary: EF task performance, functional impairment, emotional adjustment, and self-concept). All youth attended at least 4 sessions, though homework completion was mixed. Four youth achieved their goal, some demonstrated reliable change on outcome measures, and all evidenced a reduction in impairment. Results support the feasibility of modified GMT in adolescents with ADHD and suggest that youth may benefit from this more personalized and holistic approach to EF intervention.

The Post-Concussion Symptom Scale: Normative Data for Adolescent Student-Athletes Stratified by Gender and Preexisting Conditions.

BACKGROUND: The Post-Concussion Symptom Scale (PCSS) is a self-report questionnaire measuring symptoms that commonly occur after a concussion; however, these symptoms are nonspecific and can be related to co-occurring orthopaedic injuries (eg, cervical strain) or patient characteristics and preexisting conditions, even in the absence of a recent injury. As such, clinicians may have difficulty determining whether symptom elevations are attributable to a recent concussion as opposed to a confounding injury or a preexisting condition, which may be especially difficult when preinjury baseline symptom data are unavailable. PURPOSE: This study aimed to further validate the 4-factor model of the PCSS (ie, cognitive, sleep-arousal, physical, and affective symptoms) with adolescent student-athletes and provide normative reference data for each factor and the total score, stratified by gender and preexisting health conditions. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Participants were 9358 adolescent student-athletes who completed the PCSS during a preseason baseline evaluation (mean age, 14.9 years; SD, 1.3 years [range, 13-18 years]; 49.3% boys). The 4-factor model of the PCSS was tested for the full sample and separately for boys and girls using confirmatory factor analysis. Symptom severity percentiles were created for the PCSS total score and each factor, stratified by gender and preexisting conditions (ie, attention-deficit/hyperactivity disorder, mental health history, headache/migraine history, learning disability/dyslexia, academic problems, and concussion history). RESULTS: The 4-factor model of the PCSS replicated in the full sample (comparative fit index [CFI] = 0.959) and in both gender groups (boys: CFI = 0.961; girls: CFI = 0.960). The total PCSS score at the 84th percentile varied by preexisting conditions as follows: healthy participants = 8, attention-deficit/hyperactivity disorder = 18, mental health history = 26, headache/migraine history = 18, learning disability = 19, and academic problems = 17. On all PCSS subscales, participants with a mental health history had the highest scores, and high scores were associated with having >1 preexisting condition. Girls had higher scores than boys for each stratification. CONCLUSION: The 4-factor model of the PCSS replicates for adolescent student-athletes. Gender, number of preexisting conditions, and mental health history are important factors to account for when interpreting PCSS symptom severity. The normative data provided herein could assist clinicians in determining whether an adolescent student-athlete is presenting with persistent postconcussion symptoms or a typical symptom experience based on their gender and personal health history.

Why might negative mood help or hinder inhibitory performance? An exploration of thinking styles using a Navon induction.

Theories of affective influences on cognition posit that negative mood may increase cognitive load, causing a decrement in task performance (Seibert & Ellis, [1991]. Irrelevant thoughts, emotional mood states, and cognitive task performance. Memory & Cognition, 19(5), 507-513), or cause a shift to more analytic thinking, which benefits tasks requiring attention to detail (Schwarz & Clore, [1983]. Mood, misattribution, and judgments of well-being: Informative and directive functions of affective states. Journal of Personality and Social Psychology, 45(3), 513-523). We previously reported that individuals who are higher in the trait of emotional reactivity performed better on an inhibitory task with increasing negative mood whereas low-reactive individuals showed the converse pattern (Gabel & McAuley, [2018]. Does mood help or hinder executive functions? Reactivity may be the key. Personality and Individual Differences, 128, 94-99; [2020]. React to act: Negative mood, response inhibition, and the moderating role of emotional reactivity. Motivation and Emotion, 44(6), 862-869). Because high-reactive individuals are more accustomed to negative affect (Nock et al., [2008]. The emotion reactivity scale: Development, evaluation, and relation to self-injurious thoughts and behaviors. Behavior Therapy, 39(2), 107-116), we speculated that negative mood engendered analytic thinking but without a task-incongruent increase in cognitive load - thereby facilitating performance. Here, we induced a heuristic or analytic approach to information processing prior to performance of an inhibitory task and expected different results pending the thinking style induced. In the heuristic condition, increasing negative mood was associated with better performance for high-reactive participants but not their low-reactive counterparts. In the analytic condition, increasing negative mood was associated with better performance irrespective of emotional reactivity. Our results are consistent with the notion that negative mood engenders analytic thinking which may benefit response inhibition provided it does not increase task-incongruent cognitive load.

Global executive dysfunction, not core executive skills, mediate the relationship between adversity exposure and later health in undergraduate students.

Executive function (EF) represents a set of higher-order cognitive skills that permit engagement in goal-oriented behavior. EF deficits are associated with wide-ranging negative health-related consequences, including psychopathology and engagement in risky health-related behaviors. Because neural substrates supporting EF develop over a protracted period of time, an extended window of vulnerability exists whereby environmental stressors can interrupt development, culminating in lifelong EF deficits. We capitalized on this understanding of the vulnerability of EF-relevant neural structures to elucidate the link between adverse childhood experiences (ACEs) and early mortality. ACEs are highly prevalent in the general population and exert negative downstream implications for many health-related behaviors, ultimately hastening mortality. However, underlying mechanisms linking ACEs with poor health remain less understood. To address this gap in the literature, we assessed ACE history and health factors, including psychopathology and risky alcohol use behaviors in undergraduates. We further assessed EF using performance-based and rating scale measures. Results revealed that some measures of EF mediated the relationship between ACEs and current mental health, but EF did not mediate the association between ACEs and engagement in risky health-related behaviors. These results partially support a neurodevelopmental model of ACE exposure vis-à-vis future health, focusing on the role of EF.

Trauma exposure and mental health in a community sample of children and youth.

OBJECTIVE: Childhood trauma is common and has implications for mental health. Research conducted retrospectively with clinical samples of adults and prospectively with high-risk samples of children has identified factors that moderate negative mental health sequelae (e.g., age, gender, nature and amount of trauma). Presently, however, there is a paucity of research examining mental health outcomes, and potential moderators of these outcomes, that may be associated with the experience of trauma among children in the general community. METHOD: To address this knowledge gap, the present study analyzed data from youth aged 8-17 years in the Nathan Kline Institute-Rockland Sample, a publicly available repository of information collected from a nationally representative sample of participants across the life span. We report the frequency and nature of trauma in our sample; bivariate correlations between trauma, demographic variables, and mental health outcomes; and hierarchical regressions in which these outcomes were modeled as a function of multivariate predictors. RESULTS: Anxiety was elevated in older youth and in females who experienced more cumulative trauma, particularly when trauma was accidental in nature. Conversely, increased depressed mood was associated with more cumulative trauma for females regardless of age and for younger boys-findings that were driven by the experience of interpersonal trauma for both genders. CONCLUSIONS: Our investigation demonstrates that although the prevalence of trauma is lower among children in the general community, the negative impact of trauma experiences on children's anxiety and mood remains significant. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Hospital-Based Modified Cogmed Working Memory Training for Youth With ADHD.

OBJECTIVE: This study evaluated a modified working memory training program, Cogmed, for ADHD youth. METHOD: Forty youth were randomized to modified Cogmed training (MCT) or treatment as usual (CON). MCT was delivered in an outpatient mental health clinic in 3 weekly 35-minute sessions with a dedicated coach for 10 weeks. Participants completed assessments at baseline, after the intervention, and again 3 months later. RESULTS: After controlling for baseline, groups were comparable on working memory, academics, and ADHD symptoms. The MCT group was rated by parents and teachers as having fewer executive function challenges and youth endorsed better self-concept compared with the CON group. CONCLUSIONS: MCT was associated with some improvement, which could not be attributed to increased working memory capacity and may reflect other facets of the program. Results question the usefulness of Cogmed but highlight considerations for optimizing adherence, engagement, and the therapeutic alliance in interventions for ADHD youth.

How do adverse childhood experiences impact health? Exploring the mediating role of executive functions.

Objective: Adverse childhood experiences (ACEs) are stressful life events that occur during development. It is well-established that ACE exposure has negative downstream implications for a broad range of health-related behaviors, ultimately hastening mortality. Underlying mechanisms linking the experience of early life adversity with poor health remain less understood, however, and thus potential targets for intervention remain elusive. This work seeks to fill an important theoretical gap in the ACE literature by evaluating whether executive functions (EFs) constitute a biologically plausible mediating mechanism in this causal pathway. Methods: Two separate studies were conducted. In Study 1, undergraduate students completed measures of ACE exposure, EF, health-risk behaviors (e.g., drug and alcohol use, unsafe sexual practices), and psychopathology (e.g., anxiety, depression). Study 2 sought to replicate this work in a community sample. Results: Multivariate modeling determined that executive dysfunction in daily life mediated the relationship between childhood adversity exposure and mental health concerns but not the effect between ACEs and health-risk behaviors in an undergraduate sample. In a community sample, EF difficulties in daily life mediated the relationship between ACEs and both psychopathology symptoms and health-risk behavior, but not physical health status. Conclusions: These results partially support a neurodevelopmental model of ACE exposure vis-à-vis future health, focusing on the role of EF. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD.

OBJECTIVE: Working memory (WM) is often a deficit in children with attention deficit hyperactivity disorder (ADHD) and is related to other impairments within this clinical population. Cogmed, a computerized WM training program, is sometimes prescribed as a treatment for ADHD youth - although the efficacy of this intervention remains controversial. Our main objective was to explore whether ADHD youths' motivational style predicted training engagement or performance on outcome measures. A second objective was to obtain a more nuanced understanding of potential benefits of the program via interviews. METHOD: The current study focuses on 10 ADHD youth (age 8 - 14 years) randomized to a modified 30-session Cogmed protocol, as part of a larger clinical trial. Youth completed an adapted Self-Regulation Questionnaire (SRQ) and participated in a semi-structured interview at three-month follow-up. RESULTS: All youth showed adherence to the modified Cogmed protocol. More externally motivated youth started training at a higher level of performance and also reached higher peak performance. At follow-up, higher levels of external forms of motivation correlated with better spatial working memory but worse academic performance. In addition, greater endorsement of external motivation was associated with lower self-concept. Qualitative analyses suggested that youth displayed multiple motivational styles with regard to participation and noted subjective improvements in their everyday lives. CONCLUSIONS: Youth endorsed both extrinsic and intrinsic motivation and reported that training was useful. Larger studies should consider assessing individual differences in motivational style and incorporating qualitative methodology to identify additional intervention outcome variables to consider amongst ADHD youth.

OBJECTIF: La mémoire de travail (MT) est souvent en déficit chez les enfants souffrant du trouble de déficit de l'attention avec hyperactivité (TDAH) et est liée à d'autres déficiences dans cette population clinique. Cogmed, un programme informatique d'entraînement de la MT, est parfois prescrit comme traitement aux adolescents souffrant du TDAH ­ bien que l'efficacité de cette intervention demeure controversée. Notre principal objectif était d'explorer si le style motivationnel des adolescents souffrant du TDAH prédisait l'engagement ou le rendement à l'entraînement dans les mesures de résultat. Un deuxième objectif était d'obtenir une compréhension plus nuancée des bénéfices potentiels du programme par les entrevues. MÉTHODE: La présente étude porte sur 10 adolescents souffrant du TDAH (de 8 à 14 ans) randomisés à 30 séances modifiées du protocole Cogmed dans le cadre d'un essai clinique plus vaste. Les adolescents ont rempli un questionnaire d'autorégulation (QAR) adapté et ont participé à une entrevue semi-structurée au suivi de 3 mois. RÉSULTATS: Tous les adolescents ont démontré une observance du protocole Cogmed modifié. Les adolescents plus extérieurement motivés ont commencé l'entraînement à un degré de rendement plus élevé et ont aussi atteint un rendement plus optimal. Au suivi, des niveaux plus élevés de formes extérieures de la motivation corrélaient avec une meilleure mémoire de travail spatiale, mais avec un rendement scolaire moins bon. En outre, un degré d'appui plus élevé à la motivation extérieure était associé à un concept de soi plus faible. Les analyses qualitatives suggéraient que les adolescents présentaient de multiples styles motivationnels à l'égard de la participation et remarquaient des améliorations subjectives dans leur vie quotidienne. CONCLUSIONS: Les adolescents appuyaient la motivation tant extrinsèque qu'intrinsèque et estimaient que l'entraînement était utile. Des études plus vastes devraient envisager d'évaluer les différences individuelles de style motivationnel et d'incorporer la méthodologie qualitative afin d'identifier les variables additionnelles du résultat de l'intervention à prendre en compte chez les adolescents souffrant du TDAH.

Ratings of Everyday Executive Functioning (REEF): A parent-report measure of preschoolers' executive functioning skills.

Executive functioning (EF) facilitates the development of academic, cognitive, and social-emotional skills and deficits in EF are implicated in a broad range of child psychopathologies. Although EF has clear implications for early development, the few questionnaires that assess EF in preschoolers tend to ask parents for global judgments of executive dysfunction and thus do not cover the full range of EF within the preschool age group. Here we present a new measure of preschoolers' EF-the Ratings of Everyday Executive Functioning (REEF)-that capitalizes on parents' observations of their preschoolers' (i.e., 3- to 5-year-olds) behavior in specific, everyday contexts. Over 4 studies, items comprising the REEF were refined and the measure's reliability and validity were evaluated. Factor analysis of the REEF yielded 1 factor, with items showing strong internal reliability. More important, children's scores on the REEF related to both laboratory measures of EF and another parent-report EF questionnaire. Moreover, reflecting divergent validity, the REEF was more strongly related to measures of EF as opposed to measures of affective styles. The REEF also captured differences in children's executive skills across the preschool years, and norms at 6-month intervals are reported. In summary, the REEF is a new parent-report measure that provides researchers with an efficient, valid, and reliable means of assessing preschoolers' executive functioning. (PsycINFO Database Record

Clinical, Sociobiological, and Cognitive Predictors of ADHD Persistence in Children Followed Prospectively Over Time.

With increasing awareness that ADHD is chronically disabling, a burgeoning literature has examined childhood clinical indicators of ADHD persistence. This study investigates whether childhood factors reflecting biological risk and cognitive reserve have additive predictive value for the persistence of ADHD that is unique beyond childhood indicators of disorder severity. One-hundred thirty children with ADHD (mean age = 8.9 years, 75 % male) were followed into adolescence (mean age = 14.0 years). Childhood ADHD and co-morbidities were assessed via interviews with parents and teachers; parental psychopathology was assessed via parent interview; exposure to neurobiological and psychosocial adversity were indexed by parent questionnaire; and cognitive reserve was evaluated through children's performance on measures of IQ and executive functioning. Univariate analyses identified childhood inattention and hyperactivity-impulsivity, co-morbid oppositional defiant disorder, overall impairment, and paternal anxiety and depression as more prevalent amongst adolescents with persistent compared with remitted ADHD. Only child-level predictors remained significant in a final multivariate model. These results suggest that children who are most likely to experience persistent ADHD have a more severe clinical presentation in childhood, reflected by increased levels of inattention, oppositional behavior, and impairment. They also are more likely to have fathers with internalizing concerns, but these concerns do not uniquely predict ADHD persistence beyond child-level factors. Contrary to expectations, childhood adversity and cognitive functioning did not predict the course of ADHD.

The Emotion Word Fluency Test (EWFT): Initial psychometric, validation, and physiological evidence in young adults.

INTRODUCTION: The clinical assessment of affective functioning has been slow to incorporate findings from affective neuroscience. Of particular interest in the current study is the assessment of affective word production. METHOD: In a series of four studies, we examined test-retest and interrater reliability for the Emotion Word Fluency Test (EWFT), basic construct validity with existing verbal fluency measures, physiological responses across verbal fluency tasks, and a novel scoring method to examine qualitative aspects of participant response sets. RESULTS: Results demonstrated interrater and test-retest reliability values that were comparable to those of other commonly used verbal fluency tests. Construct validity was demonstrated by relations between the EWFT and other verbal fluency tests as well as through physiological evidence that performance on the EWFT is related to greater sympathetic activity than traditional verbal fluency tasks. Lastly, some of the novel scoring metrics related to two self-report measures of emotional functioning. CONCLUSIONS: Taken together, our findings provide initial support for the use of the EWFT as a measure of emotion word generation ability in young adults. This measure may prove to be useful in the assessment of affective language production in patient populations.

How your executive functioning impacts me: Findings from a normative sample of older couples.

Although executive functioning (EF) has implications for one's emotional functioning and interpersonal behavior, and EF skills become more variable as we age, little research has investigated whether normative age-related changes in EF impact social-emotional outcomes in close others. The current study used a dyadic approach to examine the impact of individual differences in core aspects of EF on indices of well-being in 91 married or cohabiting couples aged 55 years and older. Participants in each dyad completed EF tasks of inhibition, working memory, and task switching, control tasks of language and short-term memory (STM) in which EF demands were comparatively minimal, and self-report measures of depression and quality of life. Dyadic analyses showed that individuals with lower levels of EF self-reported more depressive symptoms, though there was no significant association between an individual's EF and their partner's self-reported mood. Conversely, individuals with lower levels of EF had partners who endorsed a lower quality of life, though there was no significant association between an individual's EF and their own quality of life ratings. Control tasks did not predict either aspect of well-being in either member of the dyad. Taken together, these findings highlight EF-and not simply cognition in general-as a potential determinant of well-being in oneself and one's partner among aging couples.

Social Communication is Predicted by Inhibitory Ability and ADHD Traits in Preschool-Aged Children: A Mediation Model.

OBJECTIVE: Given the role inhibitory control plays in both ADHD and communication, this study examined whether inattentive and hyperactive-impulsive traits mediate the impact of weak inhibitory ability upon the knowledge and application of pragmatic rules early in development. METHOD: Participants were 36 typically developing preschoolers and their caregivers. ADHD traits were assessed per caregiver report. Inhibition was assessed in children using a distraction task. Pragmatic language was assessed by asking children about hypothetical social situations (knowledge) and by asking caregivers to report on children's actual communicative behaviors (application). RESULTS: Individual differences in inhibition predicted both facets of pragmatic language development. Hyperactive-impulsive behaviors were a significant mediator of this relationship-but only with regard to children's ability to effectively apply pragmatic rules in everyday life. CONCLUSION: Our findings suggest that social communication difficulties in some young children are a downstream consequence of hyperactive-impulsive behaviors that arise from poorly developed inhibitory control.

Childhood ADHD and addictive behaviours in adolescence: a canadian sample.

OBJECTIVE: To compare rates of early addictive behaviours in a clinic sample of youth with childhood attention-deficit/hyperactivity disorder (ADHD) with those in community populations. METHOD: We surveyed 142 adolescents (14.1 ± 1.14 years), diagnosed with ADHD before age 12, about early substance use and problem gambling using questions from two cross-sectional population studies: the Canadian National Longitudinal Survey of Children and Youth, Ontario subsample, (N=1,317; 10-15 years) and the Ontario Student Drug Use and Health Survey (N=9,288; 12-18 years). RESULTS: The ADHD sample reported using cigarettes, 17.8% (95% CI 12.1-25.5), alcohol, 27.1% (20.1-35.5), cannabis, 14.2% (8.9-21.7), at a similar or lower rate than the NLSCY (cigarettes, 28.3% (25.8-30.9), alcohol, 28.6% (26.0-31.3), cannabis, 16.5% (14.0-19.4), and OSDUHS samples (cigarettes, 21.9% (20.2-23.7), alcohol, 58.6% (56.0-61.2), cannabis, 26.0% (23.9-28.2). With regards to gambling, there is a non-significant trend for ADHD youth to report gambling more frequently than the provincial average, 7.9% (3.3-17.9) vs. 4.3% (2.9-6.3). CONCLUSIONS: Our findings support the emerging literature that youth diagnosed with ADHD in childhood may not be at greater risk for onset of substance use in early adolescence. The study identified two areas that warrant further investigation in this population; the possible increased risk for substance use among females and a trend toward early onset of gambling behaviours.

OBJECTIF: Comparer les taux des comportements de dépendance précoces dans un échantillon clinique d'adolescents souffrant du trouble de déficit de l'attention/hyperactivité (TDAH) avec ceux de populations communautaires. MÉTHODE: Nous avons interrogé 142 adolescents (14,1 ans ± 1,14 an), ayant reçu un diagnostic de TDAH avant l'âge de 12 ans, au sujet de l'utilisation de substances précoce et du jeu problématique à l'aide des questions de deux études transversales dans la population: l'Enquête longitudinale nationale sur les enfants et les jeunes (ELNEJ), sous-échantillon de l'Ontario (N=1 317; 10­15 ans), et le Sondage sur la consommation de drogues et la santé des élèves de l'Ontario (SCDSEO) (N=9 288; 12­18 ans). RÉSULTATS: L'échantillon du TDAH déclarait utiliser des cigarettes; 17,8% (IC à 95% 12,1­25,5), de l'alcool; 27,1% (20,1­35,5), du cannabis; 14,2% (8,9­21,7), à un taux semblable ou inférieur à celui de l'ELNEJ [cigarettes, 28,3% (25,8­30,9), alcool, 28,6% (26,0­31,3), cannabis, 16,5% (14,0­19,4)], et des échantillons du SCDSEO [cigarettes, 21,9% (20,2­23,7), alcool, 58,6% (56,0­61,2), cannabis, 26,0% (23,9­28,2)]. En ce qui concerne le jeu, il y a une tendance non significative pour les adolescents du TDAH à déclarer le jeu plus fréquemment que la moyenne provinciale, 7,9% (3,3­17,9) contre 4,3% (2,9­6,3). CONCLUSIONS: Nos résultats soutiennent ce qu'affirme la nouvelle littérature, soit que les adolescents ayant reçu un diagnostic de TDAH dans l'enfance ne sont pas à risque accru de commencer l'utilisation de substances au début de l'adolescence. L'étude a identifié deux domaines qui nécessitent plus de recherche dans cette population; le risque accru possible d'utilisation de substances chez les filles et une tendance au début précoce de comportements de jeu problématique.

The persistence of cognitive deficits in remitted and unremitted ADHD: a case for the state-independence of response inhibition.

BACKGROUND: Response inhibition, working memory, and response variability are possible endophenotypes of ADHD based on their association with the disorder and evidence of heritability. One of the critical although rarely studied criteria for a valid endophenotype is that it persists despite waxing and waning of the overt manifestations of the disorder, a criterion known as state-independence. This study examined whether these aspects of cognition exhibit state-independence in ADHD. METHODS: One hundred and seventy-nine children diagnosed with ADHD in a rigorous baseline assessment were contacted for follow-up assessment in adolescence. Of this sample, 130 (73%) were reascertained. At follow-up, children previously diagnosed with ADHD were identified as remittent (n = 24), persistent (n = 64), or in partial remission (n = 42) based on symptoms and impairment of the disorder. Response inhibition, working memory, and response variability were assessed both in childhood (baseline) and adolescence (follow-up) and were compared with age-matched controls (40 children and 28 adolescents) seen at either time point. RESULTS: Relative to controls, ADHD children showed baseline deficits in response inhibition, working memory, and response variability. Only the group difference in response inhibition remained significant in adolescence. In general, cognitive performance among ADHD participants improved with age and did so regardless of changes in ADHD symptoms and impairment. Within the ADHD group, however, cognitive performance in childhood and in adolescence did not differ amongst those with persistent, remittent, and partially remittent forms of the disorder. CONCLUSIONS: Results demonstrate that response inhibition not only distinguishes ADHD children from their unaffected peers but is also state-independent, such that deficits remain present irrespective of changes in the disease phenotype. In other words, inhibitory deficits measured in childhood persist into adolescence even when the ADHD phenotype remits. These findings provide further evidence that the ability to stop prepotent actions is an endophenotype of ADHD.

Mapping the development of response inhibition in young children using a modified day-night task.

Response inhibition was examined in 40 children 3½ to 8 years of age using a modified day-night task. Performance in a neutral condition explained variance in congruent and incongruent conditions, indicating that age-related improvements in these latter conditions were partly mediated by working memory and processing speed. After controlling for neutral performance, age did not explain variance in congruent performance but explained variance in incongruent performance. These findings indicate that the associative strength between pictures and labels used in the task is age invariant and that older children are better than younger children at inhibiting responses to these associations.

A latent variables examination of processing speed, response inhibition, and working memory during typical development.

This study addressed three related aims: (a) to replicate and extend previous work regarding the nonunitary nature of processing speed, response inhibition, and working memory during development; (b) to quantify the rate at which processing speed, response inhibition, and working memory develop and the extent to which the development of these latter abilities reflect general changes in processing speed; and (c) to evaluate whether commonly used tasks of processing speed, response inhibition, and working memory are valid and reliable when used with a developmentally diverse group. To address these aims, a latent variables approach was used to analyze data from 147 participants 6-24years of age. Results showed that processing speed, response inhibition, and working memory were separable abilities and that the extent of this separability was stable across the age range of participants. All three constructs improved as a function of age; however, only the effect of age on working memory remained significant after processing speed was controlled. The psychometric properties of tasks used to assess the constructs were age invariant, thereby validating their use in studies of executive development.

Is the behavior rating inventory of executive function more strongly associated with measures of impairment or executive function?

The Behavior Rating Inventory of Executive Function (BRIEF) is commonly used in the assessment of children and adolescents presenting with a wide range of concerns. It is unclear, however, whether the questionnaire is more closely related to general measures of behavioral disruption and impairment or to specific measures of executive function. In the present study, associations between the Behavioral Regulation Index and Metacognition Index of the BRIEF and cognitive, behavioral, and academic measures were examined in a sample of clinic-referred youth (n = 60) and healthy youth (n = 37) 6-15 years of age. Measures included ratings of inattentive and hyperactive-impulsive symptoms in youth, ratings of how well youth functioned in their everyday environments, youth's scores on measures of reading and math, and youth's scores on measures of inhibition, performance monitoring, and working memory. Although both BRIEF indices were strongly related to parent and teacher ratings of behavioral disruption and impairment, neither was associated with youth's scores on the performance-based tasks of executive function. These findings support the use of the BRIEF as a clinical tool for assessing a broad range of concerns, but raise questions about the relation of the BRIEF to performance-based tasks that are commonly used to assess executive function.

Functional developmental similarities and differences in the neural correlates of verbal and nonverbal working memory tasks.

Relatively little is known about the functional development of verbal and nonverbal working memory during adolescence. Behavioral studies have demonstrated that WM capacity increases with age, yet relatively few studies have assessed the relationship between brain-activity and age-related changes in WM capacity, especially as it differs across multiple domains. The present study used an n-back task and functional magnetic resonance imaging to assess age-related differences in the neural correlates of word and face working memory tasks. Seventy-eight individuals between the ages of 14 and 27 underwent scans while performing word and face "n-back" working memory tasks. We found very little evidence for age-related differences in accuracy and reaction time. We did find similarities and differences between adolescents and adults in the neural correlates of word and face working memory tasks, even in the absence of performance differences. More specifically, we found similar age-related differences in left superior parietal cortex for both word and face stimuli. We also found that age-related differences in a number of other regions (including left inferior frontal lobe, left supramarginal gyrus, left rolandic sulcus, right cerebellum and left fusiform gyrus) differed according to stimulus type. Our results provide further evidence for continued functional development through adolescence and into adulthood.

Performance on an episodic encoding task yields further insight into functional brain development.

To further characterize changes in functional brain development that are associated with the emergence of cognitive control, participants 14 to 28 years of age were scanned while performing an episodic encoding task with a levels-of-processing manipulation. Using data from the 12 youngest and oldest participants (endpoint groups), 18 regions were identified that showed group differences in task-related activity as a function of processing depth. One region, located in left inferior frontal gyrus, showed enhanced activity in deep relative to shallow encoding that was larger in magnitude for the older group. Seventeen regions showed enhanced activity in shallow relative to deep encoding that was larger in magnitude for the youngest group. These regions were distributed across a broad network that included both cortical and subcortical areas. Regression analyses using the entire sample showed that age made a significant contribution to the difference in beta weights between deep and shallow encoding for 17 of the 18 identified regions in the direction predicted by the endpoint analysis. We conclude that the patterns of brain activation associated with deep and shallow encoding differ between adolescents and young adults in a manner that is consistent with the interactive specialization account of functional brain development.