Inhibition explains the relationship between the efficiency of brain networks and adaptive outcomes in pediatric brain tumor survivors.

OBJECTIVE: Research has found altered brain network connectivity in pediatric brain tumor survivors. Efficient brain networks are critical for performing complex behaviors involved in adaptive functioning (AF). The present study explored relationships between structural brain network characteristics and AF in survivors. We examined whether this relationship is mediated by inhibition and cognitive flexibility, important cognitive abilities for AF. METHOD: Thirty-seven young adult survivors and 37 matched healthy controls (HC; overall Mage = 23.1, SD = 4.9) underwent neuropsychological assessment. Informants completed the Scales of Independent Behavior-Revised (SIB-R) interview. Color-Word Interference Inhibition and Inhibition-Switching from the Delis-Kaplan Executive Functioning System measured inhibition and cognitive flexibility performance. Deterministic tractography was performed on diffusion-weighted imaging, the Automated Anatomical Labeling (AAL) atlas defined nodes, and edges were the average fractional anisotropy between nodes. Global efficiency (GE), average clustering coefficient (CC), and density were computed. Partial correlations and analysis of indirect effects were conducted. RESULTS: There were significant relationships between GE and all SIB-R scales, but findings with CC were limited to two subscales. Inhibition was moderately related to GE, but this was no longer significant after Holm's correction. Cognitive flexibility was not found to be related to graph metrics. Finally, significant indirect effects were found such that inhibition explained the relationship between GE and SIB-R Motor and Social/Communication. CONCLUSIONS: Based on these findings, higher levels of brain network integration, as measured by GE, is related to inhibition in survivors, which facilitates proficient adaptive motor and social/communication skills. Future work should investigate tumor location and treatment factors as potential moderators of the relationships found in this study to better understand specific risk factors in this group. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Caregiver- and Clinician-Reported Adaptive Functioning in Rett Syndrome: a Systematic Review and Evaluation of Measurement Strategies.

Rett syndrome is the second most common cause of intellectual disability in females worldwide. The severity of many individuals' impairment limits the effectiveness of traditional assessment. However, clinician and parent reports of adaptive functioning may provide insight into these patients' abilities. This review aims to synthesize the current literature assessing adaptive functioning in Rett syndrome and evaluate existing measurement tools in this population. A search was conducted on PubMed using the search term "Rett syndrome." Studies that quantitatively assessed adaptive functioning outcomes in Rett syndrome with published and normed questionnaire measures were included. Twenty-three studies met inclusion criteria. Overall results indicate that the population of people with Rett syndrome is highly impaired, both in overall adaptive functioning as well as in specific subdomains (e.g., mobility, activities of daily living). Atypical Rett syndrome groups performed better on measures of adaptive functioning relative to patients with classic Rett syndrome. Our findings identified measurement weaknesses, as many of the studies found floor effects and therefore were unable to capture meaningful variability in outcomes. Individuals with Rett syndrome are highly reliant on caregivers due to disrupted adaptive functioning abilities. Optimizing measurement of adaptive skills in Rett syndrome will facilitate the quantification of meaningful change in skills and the identification of efficacious interventions aimed at improving outcomes and quality of life.

Neurological predictor scale is associated with academic achievement outcomes in long-term survivors of childhood brain tumors.

INTRODUCTION: Survivors of childhood brain tumors exhibit impairments in academic performance and have lower rates of educational attainment compared to healthy same-aged peers. Prior research has demonstrated the concurrent validity of the Neurological Predictor Scale (NPS), a measure that incorporates tumor-related treatments and complications into one cumulative score, in predicting IQ, adaptive functioning, and core neurocognitive skills. The purpose of this study is to determine whether the NPS predicts academic achievement outcomes over and above the effects of individual treatment factors alone. METHODS: Sixty-two adult survivors completed four untimed measures of academic achievement from the Woodcock-Johnson III. RESULTS: NPS scores significantly predicted performance on all four academic measures: Letter Word ID (R2 = - 0.454, p < .01), Calculation (R2 = - 0.494, p < .01), Spelling (R2 = - 0.428, p < .01) and Passage Comprehension (R2 = - 0.447, p < .01). 16% of survivors were impaired on the Letter Word ID, 23% on Calculation, 19% on Spelling, and 11% on Passage Comprehension subtests with impairment defined as z ≤ - 1.5. The NPS predicted academic outcomes over and above chemotherapy, surgery, seizure medication, endocrine dysfunction, hydrocephalus, and radiation on all measures. CONCLUSION: This study extends prior research by demonstrating that the NPS is significantly associated with academic achievement in survivors on average 15.9 years after diagnosis. The NPS may be especially helpful in clinical research when studies lack the statistical power to investigate how treatments and neurological conditions individually contribute to outcomes.

Wechsler Intelligence Scale for Children-V: Test Review.

Changes from the fourth edition of the Wechsler Intelligence Scale for Children (WISC) to the fifth edition are discussed, with particular emphasis on how the electronic administration facilitated assessment. The hierarchical organization and conceptualization of primary indices have been adjusted, based on recent theory and research on the construct of intelligence. Changes also include updates to psychometric properties and consideration of cultural bias. The scoring program allows intelligence scores to be linked statistically to achievement measures to aid in diagnoses of learning disabilities. Electronic assessment was clunky at times but overall delivered on its promise of quicker and more accurate administration and scoring.