Predicting treatment resistance in schizophrenia patients: Machine learning highlights the role of early pathophysiologic features.

Detecting patients with a high-risk profile for treatment-resistant schizophrenia (TRS) can be beneficial for implementing individually adapted therapeutic strategies and better understanding the TRS etiology. The aim of this study was to explore, with machine learning methods, the impact of demographic and clinical patient characteristics on TRS prediction, for already established risk factors and unexplored ones. This was a retrospective study of 500 patients admitted during 2020 to the University Hospital Group for Paris Psychiatry. We hypothesized potential TRS risk factors. The selected features were coded into structured variables in a new dataset, by processing patients discharge summaries and medical narratives with natural-language processing methods. We compared three machine learning models (XGBoost, logistic elastic net regression, logistic regression without regularization) for predicting TRS outcome. We analysed feature impact on the models, suggesting the following factors as markers of a high-risk TRS profile: early age at first contact with psychiatry, antipsychotic treatment interruptions due to non-adherence, absence of positive symptoms at baseline, educational problems and adolescence mental disorders in the personal psychiatric history. Specifically, we found a significant association with TRS outcome for age at first contact with psychiatry and medication non-adherence. Our findings on TRS risk factors are consistent with the review of the literature and suggest potential in using early pathophysiologic features for TRS prediction. Results were encouraging with the use of natural-langage processing techniques to leverage raw data provided by discharge summaries, combined with machine leaning models. These findings are a promising step for helping clinicians adapt their guidelines to early detection of TRS.

Inclusive classroom norms and children's expectations of inclusion of peers with learning difficulties in their social world.

We examined whether inclusive classroom norms predicted children's reasoning and expectations about the inclusion of peers with learning difficulties from different perspectives (i.e., self, friends, and unfamiliar story protagonist). Swiss elementary school children (N = 1019; 51% girls; Mage = 10.20 years; Grades 3-6) shared their perceptions of inclusive classroom norms and answered questions regarding the inclusion of a character with learning difficulties in an academic scenario. Multilevel analyses revealed that children expected less inclusion from their friends (estimated OR = 0.14, p < .001) or the unfamiliar story protagonist (estimated OR = 0.15, p < .001) than from themselves. Inclusive classroom norms positively predicted children's own (estimated OR = 3.17, p = .041) and their friends' inclusion expectations (estimated OR = 4.59, p = .007). Moreover, individuals who perceived higher inclusive norms than the classroom average were less concerned that the inclusion of the child with learning difficulties would threaten successful group functioning (γ = - 0.19, p = .011). To target the inclusion of children with learning difficulties, school psychologists can heighten classmates' perceptions of inclusive norms and pay attention to individual differences in norm perception.

Exploring the impact of a fraction sense intervention in authentic school environments: An initial investigation.

A solid understanding of fractions is the cornerstone for acquiring proficiency with rational numbers and paves the way for learning advanced mathematical concepts such as algebra. Fraction difficulties limit not only students' educational and vocational opportunities but also their ability to solve everyday problems. Students who exit sixth grade with inadequate understanding of fractions may experience far-reaching repercussions that lead to lifelong avoidance of mathematics. This article presents the results of a randomized controlled trial focusing on the first two cohorts of a larger efficacy investigation aimed at building fraction sense in students with mathematics difficulties. Teachers implemented an evidence-informed fraction sense intervention (FSI) within their sixth-grade intervention classrooms. The lessons draw from research in cognitive science as well as mathematics education research. Employing random assignment at the classroom level, multilevel modeling revealed a significant effect of the intervention on posttest fractions scores after controlling for pretest fractions scores, working memory, vocabulary, proportional reasoning, and classroom attentive behavior. Students in the FSI group outperformed their counterparts in the control group, with noteworthy effect sizes on most fraction measures. Challenges associated with carrying out school-based intervention research are addressed.

Agreement and disagreement in pediatric functional neurological symptom disorders: Comparing patient reported outcome measures (PROMs) and clinician assessments.

Youth with functional neurological symptom disorder (FNSD) often perceive themselves as having limited capabilities, which may not align with clinical evaluations. This study assessed the disparities between clinician evaluations and patient-reported outcome measures (PROMs) regarding pain, motor function, and learning difficulties in youth with FNSD. Sixty-two youths with FNSD participated in this study, all of whom reported experiencing pain, motor problems, and/or learning difficulties. Clinicians also assessed these domains, resulting in a two-by-two categorization matrix: (1) agreement: child and clinician report "problems"; (2) agreement: child and clinician report "no problems"; (3) disagreement: child reports "problems" while the clinician does not; and (4) disagreement: clinician reports "problems" while the child does not. Agreement/disagreement differences were analyzed. No significant differences in prevalence were observed between the evaluators regarding pain (clinician-85%, child-88%), motor (clinician-98%, child-95%), or learning problems (clinician-69%, child-61%). More than 80% of the children and clinicians report pain and motor disorders. Instances in which children and clinicians reported learning problems (40.3%) exceeded cases in which both reported no problems (9.6%) or only the child reported problems (20.9%). Overall, the agreement between pain and motor function assessments was high (>90%), whereas that concerning learning difficulties was moderate (49.9%). Disagreement in pain/motor assessments was minimal (<5%), whereas for learning difficulties, disagreement rates were high (>20%). In conclusion, a significant concordance exists between PROMs and clinician assessments of pain and motor problems. However, the higher frequency of disagreements regarding learning difficulties emphasizes the importance of incorporating patient and clinician evaluations in pediatric FNSD treatment.

Psychophysiological evaluation of the Smartick method in children with reading and mathematical difficulties.

Introduction: Assistive technologies for learning are aimed at promoting academic skills, such as reading and mathematics. These technologies mainly embrace mobile and web apps addressed to children with learning difficulties. Nevertheless, most applications lack pedagogical foundation. Additionally, the task of selecting suitable technology for educational purposes becomes challenging. Hence, this protocol posits the psychophysiological assessment of an online method for learning (OML) named Smartick. This platform comprises reading and math activities for learning training. In this protocol, individual monitoring of each child is proposed to determine the progress in learning caused by Smartick. Methods and analysis: One hundred and twelve children aged between 8 and 12 who present reading or math difficulty after a rigorous psychometric evaluation will be recruited. The study comprises four sessions. In sessions 1 and 2, collective and individual psychometric evaluations will be performed, respectively. Reading and mathematical proficiency will be assessed, as well as attentional levels and intellectual quotient. Subsequently, each child will be semi-randomly assigned to either the experimental or control groups. Afterward, a first EEG will be collected for all children in session 3. Then, experimental groups will use Smartick for 3 months, in addition to their traditional learning method. In contrast, control groups will only continue with their traditional learning method. Finally, session 4 will consist of performing a second psychometric evaluation and another EEG, so that psychophysiological parameters can be encountered that indicate learning improvements due to the OML, regardless of the traditional learning method at hand. Discussion: Currently, few studies have validated learning improvement due to assistive technologies for learning. However, this proposal presents a psychophysiological evaluation addressed to children with reading or math difficulties who will be trained with an OML.

The development of number line estimation in children at risk of mathematics learning difficulties: A longitudinal study.

Children with mathematics learning difficulties (MLD) show poorer performance on the number line task, but how performance on this task relates to other mathematical skills is unclear. This study examined the association between performance on the number line task and mathematical skills during the first 2 years of school for children at risk of MLD. Children (N = 100; Mage = 83.63 months) were assessed on four occasions on the number line task and other mathematical skills (math fluency, numerical operations, and mathematical reasoning). Estimation patterns were analyzed based on the representational shift and proportional judgment accounts separately. More consistent longitudinal trends and stronger evidence for differences in mathematical skills based on estimation patterns were found within the representational shift account. Latent growth curve models showed accuracy on the number line task as a predictor of growth in some mathematical skills assessed. We discuss impacts of methodological limitations on the study of estimation patterns.

The Assessment of Vision in Children with Severe Learning Difficulties: A Systematic Review.

Background: Children with learning difficulties that require a vision assessment may not be able to perform standard clinical vision tests, for example, Forced Choice Preferential Looking (FCPL). There is a lack of standardisation on the procedure of vision assessment in this group of children. The aim of this literature review was to identify and evaluate methods of vision assessment when standard clinical vision tests are not possible in children with severe learning difficulties. Method: Three databases (CINAHL, PubMed, Web of Science) were searched from inception to Nov 2022 for methods of vision assessment in children with learning difficulties. Reference lists and grey literature were also searched. The McMaster University Critical review form for quantitative studies was used to assess the methodological quality of the primary studies identified. Results: Five-hundred and seventy one papers were identified from databases and 16 were identified from searching reference lists and grey literature. Of the 587, five studies were relevant and fulfilled all the inclusion and exclusion criteria. Three methods of vision assessment were identified: Visually Evoked Potentials (VEP), questionnaires, and the Bradford visual function box (BVFB). Discussion: The VEP method was validated and reliable, although it had a similar success rate to the standardised FCPL tests in children with learning difficulties. The BVFB was a standardised method for measurement of vision threshold in children that cannot successfully complete FCPL tests, however it has not been validated. Questionnaires are an efficient way to gather descriptive information on the child's functional vision, however no guidance on the interpretation of the information is available. The BVFB and questionnaires require further development and validation. All three methods (VEP, questionnaires, and BVFB) can be useful as part of the assessment of vision in a child with severe learning difficulties where standard clinical tests are not possible, when used in a standardised manner.

The Relationship between Auditory Analysis and Dictation Skills among Jordanian Fourth-Grade Students with Learning Difficulties.

This study aims to explore the skills of Jordanian Arabic-speaking fourth graders with learning difficulties in terms of auditory analysis and dictation tests. It mainly aims to investigate the relationship between students' abilities to perform auditory analyses and dictation tests. The sample in the study consists of 110 Jordanian fourth graders, who are then divided into 54 students with learning difficulties who are diagnosed as having a satisfactory level of reading and writing and 56 typically developing students. The students are asked to respond to two tests, the auditory analysis and the phonological awareness test, which are prepared by the researcher himself. The results demonstrate a statistically significant positive correlation between the auditory analysis and dictation skills of fourth-grade students with learning difficulties. This means that improving the auditory analysis skills corresponds to an increase in the dictation skills of these students. The results also reveal a statistically significant correlation between auditory analysis and dictation skills in typically developing students.

A quantitative study examining infographic assessment guidelines for undergraduate nursing students with specific learning difficulties (SpLDs).

This research investigates the perceived clarity and usefulness of infographic versus traditional text-based assessment guidelines among undergraduate nursing students with and without specific learning difficulties (SpLDs). Through quantitative analysis, the study reveals that undergraduate nursing students with SpLDs significantly prefer infographics over text-based guidelines, both in terms of clarity and usefulness (p < .001). Interestingly, there were no statistically significant differences in the perceptions of students without SpLDs. These findings suggest that the use of infographics as a tool for presenting assessment guidelines could contribute to more inclusive educational practices. The research further highlights the potential of infographics to not only make complex information more accessible but also to cater to diverse learning needs. As higher education institutions strive to be more inclusive, adapting assessment guidelines to suit the varied learning styles and cognitive needs of all students, particularly those with SpLDs, becomes increasingly important. This paper provides initial evidence to support the adoption of infographic-based assessment guidelines as a step towards achieving this goal.

Curriculum effectiveness for secondary-aged students with severe intellectual disabilities or profound and multiple learning difficulties in Australia: Teacher perspectives.

The active inclusion of students within education systems relies on a curriculum that caters to all. This article presents partial findings from Australian mixed methods research examining 46 teacher perspectives on the curriculum and its ability to support their practice in supporting students aged 12-19 years with severe intellectual disability or profound and multiple learning difficulties who attend specialist school settings. Results reveal that Australian teachers see the current curriculum as insufficient in its design and content and unable to cater to their students educational and social capacities or needs. Strengths essential to the reform process are highlighted, emergent challenges discussed and recommendations for future action are presented.

Internalizing problems in individuals with reading, mathematics and unspecified learning difficulties: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to examine if individuals with reading difficulties (RD), mathematics difficulties (MD), or unspecified learning difficulties (ULD) experience internalizing problems (i.e., anxiety, depression, somatic complaints, and social withdrawal) to the same extent, and if the effect sizes are influenced by moderators (age, internalizing problems type, anxiety type, rater type, selection criteria, and attention control). We reviewed 2,806 studies published in English between January 2000 and April 2023. Our final sample consisted of 96 studies that reported effect sizes or data to calculate them (a total of 120 unique samples, 83,260 participants, age range = 7.3 - 34.8 years). Risk of bias and sensitivity were assessed. A random-effects model analysis revealed a significant and moderate overall effect size (Hedge's g = -.54), indicating that individuals with RD, MD or ULD experience more internalizing problems than their chronological-age (CA) controls. Follow-up analyses showed that neither learning difficulties type nor age of participants were significant moderators, but selection criteria (diagnosis versus screening) and internalizing problems type were. These findings suggest that individuals with RD do not differ from those with MD or ULD in internalizing problems, and all fare poorly compared to CA controls.

Developmental dyscalculia is not associated with atypical brain activation: A univariate fMRI study of arithmetic, magnitude processing, and visuospatial working memory.

Functional neuroimaging serves as a tool to better understand the cerebral correlates of atypical behaviors, such as learning difficulties. While significant advances have been made in characterizing the neural correlates of reading difficulties (developmental dyslexia), comparatively little is known about the neurobiological correlates of mathematical learning difficulties, such as developmental dyscalculia (DD). Furthermore, the available neuroimaging studies of DD are characterized by small sample sizes and variable inclusion criteria, which make it problematic to compare across studies. In addition, studies to date have focused on identifying single deficits in neuronal processing among children with DD (e.g., mental arithmetic), rather than probing differences in brain function across different processing domains that are known to be affected in children with DD. Here, we seek to address the limitations of prior investigations. Specifically, we used functional magnetic resonance imaging (fMRI) to probe brain differences between children with and without persistent DD; 68 children (8-10 years old, 30 with DD) participated in an fMRI study designed to investigate group differences in the functional neuroanatomy associated with commonly reported behavioral deficits in children with DD: basic number processing, mental arithmetic and visuo-spatial working memory (VSWM). Behavioral data revealed that children with DD were less accurate than their typically achieving (TA) peers for the basic number processing and arithmetic tasks. No behavioral differences were found for the tasks measuring VSWM. A pre-registered, whole-brain, voxelwise univariate analysis of the fMRI data from the entire sample of children (DD and TA) revealed areas commonly associated with the three tasks (basic number processing, mental arithmetic, and VSWM). However, the examination of differences in brain activation between children with and without DD revealed no consistent group differences in brain activation. In view of these null results, we ran exploratory, Bayesian analyses on the data to quantify the amount of evidence for no group differences. This analysis provides supporting evidence for no group differences across all three tasks. We present the largest fMRI study comparing children with and without persistent DD to date. We found no group differences in brain activation using univariate, frequentist analyses. Moreover, Bayesian analyses revealed evidence for the null hypothesis of no group differences. These findings contradict previous literature and reveal the need to investigate the neural basis of DD using multivariate and network-based approaches to brain imaging.

The Effects of Visual Cueing on Students with and without Math Learning Difficulties in Online Problem Solving: Evidence from Eye Movement.

This study investigated the impact of visual cueing on attention guidance, deep-thinking promotion, and performance optimization in arithmetic word problem solving for students with mathematical learning difficulties (MLD). The participants included eight students with MLD and twenty students without MLD who attempted to solve mathematical word problems with and without visual cueing. Eye movements were recorded during the tasks. A repeated-measure design and nonparametric tests were applied to enhance the statistical power of the study. The data analysis results indicated that visual cueing effectively guided and sustained the attention of students with MLD, reducing their off-task duration. However, it showed limited influence in facilitating deep thinking and performance improvement for these students. There were no significant attention-guidance or performance-improvement effects observed in the problem-solving processes of students without MLD, who initially demonstrated better concentration levels and performance. The potential explanations for these findings are further discussed in this paper.

Enhancing Time Reading and Recording Skills in First-Grade Children with Learning Difficulties Using the "Clock Motor Game".

This study aimed to explore the effect of the motor game, "Clock Motor Games", on the improvement of "Reading and Recording of Time" (RRT) in children with Grade 1 mathematical learning difficulties (MLDs). A within-school cluster-randomized intervention study was conducted with 232 children (aged 6-7 years) with limited physical education experience (0.7 ± 0.3 years). The participants were divided into two groups: a control group, which received conventional teaching on time without any additional motor activities, and an experimental group, which incorporated the concept of time with the "Clock Motor Game", for 3 weeks. The Clock-Reading Test was administered before the intervention (T0), immediately after each session (T1), and five weeks after the intervention (T2) in both groups. The results demonstrated that the experimental group exhibited significantly greater improvements in RRT performance compared to the control group (U = 4416.5; p < 0.001; r = 0.3; medium effect). Additionally, the experimental group was more likely to show progress and less likely to experience regression or stagnation compared to the control group (25% vs. 38.4%). The findings suggest that practicing "Clock Motor Games" can positively contribute to the RRT ability in children with Grade 1 MLD.

Especificidades dos erros cometidos e do tempo despendido na actividade discriminação perceptiva de símbolos gráficos em alunos com dificuldades de aprendizagem / Specifics of errors and time spent in perceptual discrimination of graphic symbols in students with learning difficulties / Particularidades de los errores cometidos y el tiempo empleado en la actividad de la discriminación perceptiva de símbolos gráficos en estudiantes con dificultades de aprendizaje

A discriminação perceptiva de símbolos depende da organização perceptiva do sujeito da ação como sistema bio-psico-social complexo. Objectivo: estudo de especificidades da discriminação perceptiva de símbolos em alunos com dificuldades de aprendizagem. Amostra: 550 participantes ­ 275 com e 275 sem dificuldades de aprendizagem; idades 7 ­ 15 anos; escolaridade ­ 1º, 2º e 3º ciclo do ensino básico. Instrumentos metodológicos ­ entrevista clínico--psicológica, observação psicológica, Teste de Símbolos e Dígitos (SDMT). Resultados: Alunos com dificuldades de aprendizagem tendem a evidenciar mais emparelhamentos dígito-símbolo incorretos e menos corretos e a despenderem bastante mais tempo na execução da tarefa; portanto, executam menos emparelhamentos corretos por minuto, comparativamente a alunos sem dificuldades de aprendizagem. Conclusão: Nas dificuldades de aprendizagem, cometem-se mais erros e assinalam-se menos emparelhamentos correctos na tarefa de emparelhamento, quando há limites no tempo de execução; caso contrário, a disponibilidade de tempo compensa, reduzindo a quantidade de incorreções. Nas dificuldades de aprendizagem, é necessário mais tempo para executar a tarefa de emparelhamento, devido ao processamento de informação mais lento; tempo consumido na decodificação e identificação das correspondências dígito-símbolo e a discriminação perceptiva não se infirma com a rapidez necessária à simultaneidade e automatização do ato. (AU)

The perceptual discrimination of symbols depends on the perceptual organization of the individual as a complex bio-psychosocial system in action. Objective: To study the specifics of perceptual discrimination of symbols in students with learning difficulties. Sample: 550 participants - 275 with learning difficulties and 275 without; aged 7 to 15; educational levels ranging from the 1st to 3rd cycles of basic education. Methodological instruments included clinical-psychological interviews, psychological observations, and the Symbols Digit Modalities Test (SDMT). Results: Students with learning difficulties tend to display more incorrect and fewer correct digit-symbol pairings, and they invest considerably more time in task execution. Consequently, they achieve fewer correct pairings per minute compared to students without learning difficulties. Conclusion: Learning difficulties are associated with increased errors and fewer correct pairings in the task of pairing symbols when time constraints exist. Conversely, when ample time is available, it mitigates the quantity of inaccuracies. Learning difficulties necessitate more time for task completion due to slower information processing. The time spent on decoding, identifying digit-symbol correspondences, and perceptual discrimination does not align with the speed required for simultaneity and automation of the task. (AU)

La discriminación perceptiva de los símbolos depende de la organización perceptiva del sujeto de la acción como un complejo sistema bio-psico-social. Objetivo: estudiar las especificidades de la discriminación perceptiva de símbolos en estudiantes con dificultades de aprendizaje. Muestra: 550 parti-cipantes - 275 con y 275 sin dificultades de aprendizaje; edades de 7 a 15 años; escolaridad - 1º, 2º y 3º ciclo de educación básica. Instrumentos metodológicos: entrevista clínico-psicológica, observación psicológica, Test de Símbolos y Dígitos (SDMT). Resultados: Los estudiantes con dificultades de aprendizaje tienden a mostrar una mayor cantidad de emparejamientos dígito-símbolo incorrectos y menos correctos y dedican mucho más tiempo a la ejecución de la tarea; por lo tanto, realizan menos emparejamientos correctos por minuto, en comparación con los estudiantes sin dificultades de aprendizaje. Conclu-sión: En las dificultades de aprendizaje se cometen más errores y se notan menos emparejamientos correctos en la tarea de emparejamiento, cuando hay límites en el tiempo de ejecución; de lo contrario, la disponibilidad de tiempo es compensatoria, reduciendo el número de inexactitudes. En las dificultades de aprendizaje, se necesita más tiempo para realizar la tarea de empareja-miento, debido al procesamiento más lento de la información; el tiempo que se consume en decodificar e identificar las correspondencias dígito-símbolo y la discriminación perceptiva no ocurre tan rápidamente como es necesario para la simultaneidad y automatización del acto. (AU)

Development of reading fluency and metacognitive knowledge of reading strategies during reciprocal teaching: do these changes actually contribute to reading comprehension?

The study examined the effect of reciprocal teaching on students' reading comprehension, reading fluency, and metacognitive knowledge of reading strategies, especially among students with learning difficulties. The special focus was to assess how the increase in reading fluency and metacognitive knowledge during the intervention contributes to the reading comprehension outcome. The sample consisted of 301 Grade 3 students, of whom 77 had learning difficulties. Analyzes of (co)variances were used for estimating the effects of reciprocal teaching on the development of reading comprehension, reading fluency, and metacognitive knowledge. Multigroup path analysis was used for testing the effect of increase in reading fluency and metacognitive knowledge on reading comprehension. We found reciprocal teaching had a positive effect on reading comprehension, especially for students with learning difficulties. Reading fluency and metacognitive knowledge improved significantly, but similarly in both the intervention and control groups. However, the increase in metacognitive knowledge only contributed to reading comprehension in the intervention group, not in the control group. The study sheds light on the cognitive and metacognitive mechanisms underlying students' reading comprehension process, emphasizing metacognitive knowledge and especially the systematic practice of reading strategies as key factors in improving reading comprehension.

Hypothyroidism Among College Students and Its Association With Academic Performance: A Cross-Sectional Study.

BACKGROUND: Little is known about the impact of hypothyroidism and its contribution to learning difficulties and academic performance in college-age students. OBJECTIVE: The objective is toassess the frequency of hypothyroidism and its associations with academic performance in college-age students. METHODS: A cross-sectional study included 395 students studying across various Jeddah universities and selected by non-probability convenient sampling. Students self-answered the survey using Google Forms. The survey included demographic data, thyroid data, academic achievement as measured by overall grade point average (GPA), and student persistence as measured by academic failure and delay. RESULTS: Three hundred ninety-five students were included, their median age was 23 years (17-33), 96 were males (24.3%) and 299 were females (75.7%). Their median GPA was 4 (2.76-4). Thirty-two students (8.1%) had been treated for hypothyroidism and eight students (25.8%) were non-compliant with therapy. Odds of hypothyroidism increased among females (OR 3.33, 95% CI: 0.99-10.78, p=0.048), older age (OR 2.60, 95% CI: 1.33-5.77, p=0.009), those with a positive family history of thyroid illnesses (OR 5.49, 95% CI: 2.30-13.07, p<0.001), and those with academic failure (OR 3.31, 95% CI: 1.43-7.30, p=0.003) and academic delay (OR 2.83, 95% CI: 1.14-7.05, p=0.020). There was no significant association between hypothyroidism and GPA (OR 2.42, 95% CI: 0.83-7.77, P=0.092). CONCLUSION: Hypothyroidism was prevalent among college students (8%), especially among older females. Hypothyroidism was associated with difficult student persistence, but this association did not reflect on their overall academic achievement. Incompliance with thyroid replacement therapy may be a common issue among hypothyroid patients. Further studies should focus on specific tests of the cognitive function of different learning domains and the role of treatment.

Executive functioning skills and (low) math achievement in primary and secondary school.

Schoolchildren with better executive functioning skills achieve better mathematics results. It is less clear how inhibition, cognitive flexibility, and working memory combine to predict mathematics achievement and difficulty throughout primary and secondary school. This study aimed to find the best combination of executive function measures for predicting mathematical achievement in Grades 2, 6, and 10 and to test whether this combination predicts the probability of having mathematical difficulties across school grades even when fluid intelligence and processing speed were included in the models. A total of 426 students-141 2nd graders (72 girls), 143 6th graders (72 girls), and 142 10th graders (79 girls)-were cross-sectionally assessed with 12 executive tasks, one standardized mathematical task, and a standardized test of intelligence. Bayesian regression analyses found various combinations of executive predictors of mathematical achievement for each school grade spanning Grade 2 to measures of cognitive inhibition (negative priming) and cognitive flexibility (verbal fluency); Grade 6 to measures of inhibition: resistance to distractor interference (receptive attention), cognitive flexibility (local-global), and working memory (counting span); and Grade 10 to measures of inhibition: resistance to distractor interference (receptive attention) and prepotent response inhibition (stop signal) and working memory (reading span). Logistic regression showed that the executive models derived from the Bayesian analyses had a similar ability to classify students with mathematical difficulty and their peers with typical achievement to broader cognitive models that included fluid intelligence and processing speed. Measures of processing speed, cognitive flexibility (local-global), and prepotent response inhibition (stop signal) were the main risk factors in Grades 2, 6, and 10, respectively. Cognitive flexibility (verbal fluency) in Grade 2 and fluid intelligence, which was more stable in all three grades, acted as protective factors against mathematical difficulty. These findings inform practical considerations for establishing preventive and intervention proposals.

Severe Pandemic Learning Loss and the Promise of Remotely Delivered Intervention in Students With Comorbid Reading and Mathematics Learning Difficulty.

Analyses were conducted with second graders, drawn from an ongoing multi-cohort randomized controlled trial (RCT), who had been identified for RCT entry based on comorbid reading comprehension and word-problem solving difficulty. To estimate pandemic learning loss, we contrasted fall performance for 3 cohorts: fall of 2019 (pre-pandemic; n = 47), 2020 (early pandemic, when performance was affected by the truncated preceding school year; n = 35), and 2021 (later pandemic, when performance was affected by the truncated 2019 to 2020 school year plus the subsequent year's ongoing interruptions; n = 75). Across the 2 years, declines (standard deviations below expected growth) were approximately 3 times larger than those reported for the general population and for students in high-poverty schools. To estimate the promise of structured remote intervention for addressing such learning loss during extended school closures, we contrasted effects in the RCT's 2018 to 2019 cohort (entirely in-person intervention delivery; n = 66) against the same intervention's effects in the 2020 to 2021 cohort (alternating periods of remote and in-person delivery; n = 29). Large intervention effects were not moderated by pandemic status, suggesting potential for structured remote intervention to address student needs during extended school closures.