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Mental health conditions such as anxiety, depression, aggression, and inattention are common in autistic youth and are challenging to treat by community providers. We aim to parse the heterogeneity of autism based on dimensions of executive function and determine whether specific executive function profiles are differentially related to psychiatric symptoms. Parents of 397 well-characterized 8–14-year-old autistic children without an intellectual disability reported on their child's executive function skills and psychiatric symptoms. We applied a data-driven, graph theory-based, community-detection approach to a common executive function measure, revealing three distinct executive function profile subgroups. Despite having similar social challenges, the executive function subgroups differed on anxiety, aggression, affect, and inattention symptoms. Results support the need for more intensive subtyping with autistic youth to develop appropriate, individualized mental health treatments and supports. Characterizing youth through neurocognitive strengths and challenges can guide the development of precision medicine, allowing for more meaningful, specialized treatment. Many autistic people struggle with mental health problems like anxiety, depression, inattention, and aggression, which can be challenging to treat. Executive function challenges, which impact many autistic individuals, may serve as a risk factor for mental health problems or make treating mental health conditions more difficult. While some people respond well to medication or therapy, others do not. This study tried to understand if there are different subgroups of autistic young people who may have similar patterns of executive function strengths and challenges—like flexibility, planning, self-monitoring, and emotion regulation. Then, we investigated whether executive function subgroups were related to mental health problems in autistic youth. We found three different types of executive function subgroups in autistic youth, each with different patterns of mental health problems. This helps us identify specific profiles of executive function strengths and challenges that may be helpful with identifying personalized supports, services, and treatment strategies for mental health conditions. [ABSTRACT FROM AUTHOR]

Executive function influences children's learning abilities and organizes their cognitive processes, behaviors, and emotions. This cross-sectional study examined whether an Indonesian Computer-Based Game (ICbG) prototype could be used as a Computer-Based Game Inventory for Executive Function (CGIEF) in children and adolescents. The study was conducted with 200 children, adolescents, and their parents. The parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF) questionnaire, and the children and adolescents completed the CGIEF. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were performed using LISREL Version 8.80. The construct of CGIEF was valid/fit with normal theory-weighted least squares = 15.75 (p >.05). SEM analysis showed that the theoretical construct of the CGIEF was a valid predictor of executive function. The critical t value of the pathway was 2.45, and normal theory-weighted least squares was 5.74 (p >.05). The construct reliability (CR) for CGIEF was 0.91. Concurrent validity was assessed using the Bland–Altman plot, and the coefficient of repeatability (bias/mean) was nearly zero between the t scores of total executive functions of the CGIEF and BRIEF. This preliminary study showed that the CGIEF can be useful as a screening tool for executive dysfunction, metacognitive deficits, and behavioral regulation problems among children and adolescents in clinical samples. [ABSTRACT FROM AUTHOR]

Evidence suggests that child maltreatment is a risk factor for adolescent suicidal behavior. However, the differential influence of distinct forms of child maltreatment on adolescent suicide attempts is understudied and the factors that might exacerbate or ameliorate these associations warrant attention. We examined the associations between two distinct forms of child maltreatment (threat and deprivation) and suicide attempt history, and investigated whether executive function domains moderated these associations. Participants were 119 adolescents (M = 15.24, SD = 1.46, 72.3% female) recruited from an inpatient psychiatric hospital during hospitalization for suicidal thoughts and behaviors. Results indicated that the executive function domains of initiation, shifting, and planning/organization moderated the associations between threat and suicide attempt history. Associations between threat and suicide attempt history were significant only when initiation and shifting T-scores were lower (OR = 1.22, p =.03 and OR = 1.32, p =.01, respectively). The association between threat and suicide attempt history trended toward significance when planning/organization T-scores were lower (OR = 1.15, p =.10). None of the executive function domains moderated the link between deprivation and suicide attempt history. Findings highlight the need for research investigating whether initiation, shifting, and planning/organization might be amendable to intervention in the context of threat-related child maltreatment. [ABSTRACT FROM AUTHOR]

This study involved a psychometric evaluation of the Short Executive Function Scale (SEFS), a new 15-item self-report questionnaire measuring five constructs: Planning, Inhibition, Working Memory, Shifting, and Emotional Control. Participants included 717 U.S. undergraduate students (M = 18.9 years old, SD = 1.9; 78.8% cisgender female, 81.7% White) who completed the SEFS. A subset of 156 participants (M = 18.8 years old, SD = 0.9; 79.5% cisgender female, 83.3% White) completed the SEFS again at 2- to 3-month retest along with the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) and the Patient Health Questionnaire (PHQ-8). The five-factor model fit well (CFI = 0.941, RMSEA = 0.079) and each scale had acceptable internal consistency (ω range:.68–.81) and test–retest reliability (ICC range:.75–.89). Apart from Shifting, all SEFS scales had significantly larger convergent validity coefficients with their respective BRIEF-A scales (r range: −.25 to −.70) than discriminant validity coefficients with the PHQ-8 (r range: −.06 to −.28). These findings provide preliminary psychometric support for the SEFS. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of Baduanjin exercise on executive function in community-dwelling older adults with cognitive frailty. Design: Randomized controlled trial. Setting: Community residential centers. Subjects: 120 eligible older adults. Interventions: Baduanjin training group received supervised Baduanjin training, 60 min sessions three times per week for 24 weeks. The control group did not receive any exercise intervention. Main measures: Primary outcome was executive function, assessed using Clock Drawing Test. Secondary outcomes included the subcomponents of executive function (working memory, inhibitory control and cognitive flexibility), attention and cognitive frailty (global cognitive function, physical frailty) assessed using Verbal Fluency Test, Trail Making Test-A/B, Stroop Test, Montreal Cognitive Assessment and Edmonton Frailty Scale, respectively, at baseline and 24 weeks after intervention. Results: After the 24-week intervention, the scores of Clock Drawing Test and Verbal Fluency Test, the Trail Making Test-B time and the Card correct numbers of Stroop Test in Baduanjin training group showed significant improvement compared with control group (all P < 0.05) with small to moderate effect sizes and the significant interaction effect of group by time in the Clock Drawing Test and Trail Making Test-B test (P = 0.003 and P = 0.043); cognitive frailty variables, including Montreal Cognitive Assessment and Edmonton Frail Scale scores, also showed significant improvement (P = 0.002 and P = 0.004) with a moderate effect sizes and a significant interaction effect (P < 0.001, P = 0.013). No adverse events were reported. Conclusion: Regular Baduanjin training may be an effective and safe intervention to improve cognitive frailty and executive function in community-dwelling older adults with cognitive frailty. Trial registration: Chinese Clinical Trial Registry, ChiCTR2100050857. Data of registration: 8/5/2020, https://www.chictr.org.cn/showproj.html?proj = 133037. [ABSTRACT FROM AUTHOR]

Autistic individuals are at significantly higher risk of suicide than non-autistic individuals, with transition-aged youth at potentially the highest risk. While lower executive function (EF) skills have been significantly associated with suicide risk in other clinical samples, the link between EF and suicidality has not yet been examined for autistic individuals. In this study, 183 transition-aged autistic youths completed routine suicide risk assessments and self- and informant-reports of autistic traits, depression, and EF skills. On the P4 Suicide Screener, approximately one-third of the sample (33.3%) endorsed having thoughts of hurting themselves with the intent to end their lives (i.e., suicidal ideation) in their lifetime. In addition to depressive symptoms, EF impairment independently predicted endorsement of suicidal ideation, indicating that both are crucial intervention goals to target suicidal risk for transition-aged youth on the spectrum. Findings suggest that executive functioning, a prevalent area of difficulty and common intervention target for the autistic community, is an important indicator of suicide risk in this population. Autistic people are more likely to consider suicide than non-autistic people, with transition-aged youth (ages 16–21 years) at potentially the highest risk. Research has also shown that difficulties with executive functioning (e.g., difficulties with organization, sequencing, and decision-making) may heighten suicide risk among non-autistic people, but it is not clear whether this is also true for autistic people. This study explored this question by asking 183 transition-aged autistic youth about their experience with suicidal behavior and examining the relationship between their responses and additional measures of depression, autistic traits, and executive function skills. About one-third of autistic transition-aged youth (33.3%) said that they had experienced thoughts of hurting themselves with the intent to end their lives (i.e., suicidal ideation). Both depression and executive function challenges predicted suicide risk (i.e., participants who experienced depression were more likely to have had suicidal thoughts than those who had not, and participants who had more difficulty with executive function skills were more likely to have had suicidal thoughts than those who had less difficulty). These findings suggest that executive functioning, a common area of difficulty among autistic people, is an important indicator of suicide risk in this population. [ABSTRACT FROM AUTHOR]

There is a long tradition of research into autistic people's executive function skills. Yet, despite decades of research on EF in autism, the existing literature remains contradictory and 'confusing', with a large – and unresolved – discrepancy between small-to-moderate effect sizes demonstrated on laboratory-based EF tasks and large effect sizes on questionnaire-based everyday EF measures. We sought to understand this mismatch between 'lab and life' by inviting 12 autistic adolescents (12–19 years) and their mothers (n = 7) to convey their views and perspectives about their own, or their child's, EF skills as they transition to adulthood. We followed Braun and Clarke's method for reflexive thematic analysis using an inductive approach. Participants told us that their EF skills were highly variable, acutely dependent on the context in which they were deployed and potentially related to differences in the way that they process information more broadly. Participants' reports provided rare insights into their and their children's executive control – insights that do not straightforwardly map onto traditional theoretical models of EF. Future work on EF needs to take seriously the perspectives and subjectivity of autistic people themselves, including by triangulating quantitative, objective assessments with qualitative, subjective reports in complementary (controlled, uncontrolled) settings. Autism researchers have a long-time interest in a set of skills called executive function. These skills include planning, inhibition, and switching between one activity and another. There was a theory that these skills explained the social and thinking difficulties autistic people might have. After years of study into this, the evidence is confusing and contradictory. Autistic people tend to report struggling quite a lot with these skills. Yet, when researchers test these skills, they do not tend to find such big difficulties. In this study, we spoke to 12 autistic teenagers and seven of their mothers about this. We asked them what they thought about their own, or their child's, executive function skills. We wanted to know about things they were good at and things they struggled with. They told us that their skills were very changeable from one context to the next and from one time to the next. According to their reports, their skills depended on how motivated they were by doing the task. Another thing that influenced their skills were how anxious they felt at the time they needed to use the skill. Finally, they told us that sometimes they think differently about how best to perform a task. We discuss what these insights mean for autism researchers who study these skills. In future, research should ask people about their experiences alongside testing their abilities in different contexts. Combining these information sources will give us a better understanding of autistic people's everyday skills as well as how best to support them. [ABSTRACT FROM AUTHOR]

In multimedia learning, there is a lot of new information that learners are exposed to, making it a cognitively intensive process. Poorly-designed multimedia lessons can introduce distractions that must be dealt with by the learner. However, learners do not all share the same skill at managing incoming information or holding capacity, which could create individual differences in the impact of multimedia lessons on learning and lead to inequity in learning. In three experiments, learners saw a multimedia lesson varying in the amount of distracting material included: high (Experiment 1), moderate (Experiment 2), or low (Experiment 3). Learners took a posttest and completed tasks to assess individual differences in managing incoming information (executive function) and holding capacity (working memory capacity). When distractions were present (Experiment 1 and Experiment 2), executive function was related to posttest performance such that as executive functioning increased, performance on the posttest increased. However, when distractions were not present (Experiment 3), executive function was not related to posttest performance. Individual differences in working memory capacity were not related to posttest performance at any level of distraction. This indicates the importance of considering individual differences in learners' executive functioning in the design of multimedia lessons. [ABSTRACT FROM AUTHOR]

This longitudinal study investigated the roles of elementary schoolers' executive function (EF) and theory of mind (ToM) as predictors in their academic achievements in Japanese language skills (e.g., speaking and listening ability, writing ability, reading ability, and linguistic knowledge) from first through fifth grade. We assessed the EF, ToM, and academic achievements of 85 Japanese elementary schoolers, when they were grade 1 (M = 90.19 months) and grade 3 (M = 114.34 months). Moreover, academic achievements of same children tested in grade 5 (M = 137.92 months). A path analysis revealed that EF abilities in Grades 1 and 3 predicted Japanese language achievement via ToM ability, and EF and ToM in Grade 1 had an indirect effect on achievements in Grades 3 and 5. Further, Japanese language skills achievement in Grade 1 predicted EF ability in Grade 3 and EF predicted achievement in Grade 5. These findings indicate the vital role of elementary schoolers' EF on academic achievement in Japan. [ABSTRACT FROM AUTHOR]

Enrollment rates of students with disabilities (SWD) in postsecondary education continue to rise, yet SWD continue to face challenges with persistence toward degree completion. Executive function deficits (e.g., difficulty concentrating, managing time, problem solving, or planning) often impact academic, social, and occupational function. Academic and social adjustment to the complexity of life beyond students' homes can be stressful, further exacerbating difficulties with executive function skills necessary for postsecondary success. Coaching can assist young adults during postsecondary education to enhance executive function skills and has the potential to reduce stress and anxiety. Coaching is a collaborative, client-centered process designed to elicit client identification of goal areas, increase self-awareness, and problem-solving solutions. This practitioner article explores executive function skills, coaching, and how technology can be used within the coaching process to support executive function deficits for students in the postsecondary environment. [ABSTRACT FROM AUTHOR]

This study examined whether the assessment of executive function (EF) added a unique contribution to second language (L2) reading comprehension in children in French immersion. Participants were 8- to 9-year old children who completed a collection of measures assessing French reading (i.e., word reading, decoding, and reading comprehension) and EF (working memory, inhibition, and shifting). After controlling for word-level reading, measures of shifting explained the most variance in reading comprehension compared to the variance accounted for by working memory and inhibition. The results add to the growing evidence of EF's contribution—especially shifting—to reading comprehension within the context of early literacy learning in the L2. [ABSTRACT FROM AUTHOR]

Objective: To examine the theoretical and empirical contribution of Joe Biederman and his colleagues to the understanding of executive function (EF) and ADHD. Method: We searched PubMed for references to EF in Biederman's publications and conducted a narrative review of this literature. Results: In 50 or more papers using neuropsychological tests, rating scales and measures of mind wandering, Biederman demonstrated that EF are evident in ADHD and closely linked to its underlying neurobiological and genetic risk. He argued that EF need to be monitoring to ensure comprehensive assessment and treatment, but could not be used as a diagnostic proxy. Conclusion: Biederman built an innovative and impressive collaboration to address the issue of EF in ADHD. His work shows a commitment to understanding of EF in order to improve patient care. Biederman laid down a roadmap for research in ADHD and EF for the rest of the field to follow. [ABSTRACT FROM AUTHOR]

Digital technology in primary education can both be distracting and increase attentiveness. Many students with Special Educational Needs (SEN) have difficulties with skills that address attention, and teachers are expected to provide support. Such skills are referred to as Executive Function (EF) in neuroscience, relating to self-regulation, attention shifting, and inhibition of behavior. This systematic literature review outlines research on primary education during 2000–2022 that relates students' EF and digital technology through empirical data and suggested SEN-inclusive educational interventions. 288 full-text journal articles were assessed, and 26 were included for analysis. Findings include common game-based solutions for EF and SEN support, enabling explicit goals, short teaching activities, and recorded outcomes. Other examples include EF skills training and classroom management with digital monitoring devices. A substantially increased research interest during 2021–2022 was observed. Aspects needing further research are discussed, such as more special education views with cost-effective behavioral approaches. [ABSTRACT FROM AUTHOR]

Integrated writing (i.e., writing from sources) being a complex process, requires various linguistic and cognitive skills interacting with each other in a dynamic way. While recent studies have increasingly documented that writing processes are driven by a suite of cognitive abilities named executive function (EF), their roles in a literacy activity as complex as integrated writing remain underexplored. To address this core issue, the present study aimed to examine the direct and indirect effects of EF skills on students' performance of a Chinese listening-reading-writing task. A total of 135 Chinese undergraduates were involved, completing a battery of tests, including a computerized Chinese integrated writing task measuring their writing performance and five EF tasks measuring inhibition, cognitive flexibility, working memory (auditory-verbal and visual-spatial), and planning skills respectively. Students' integration activities were also recorded using a writing webpage. The path model indicated that inhibition, visual-spatial working memory, and planning skills could significantly and directly predict students' writing performance and the visual-spatial working memory could indirectly predict writing performance via the mediation of source-text switches while listening. This study offers new preliminary insights into the association between EF and integrated writing among Chinese undergraduates; pedagogical implications for the teaching of integrated writing are also discussed. [ABSTRACT FROM AUTHOR]

Introduction: This study explored treatment of executive functioning impairment in adults after acquired brain injury (ABI), clinician's confidence and support received, in a sample of occupational therapists in the United Kingdom. Methods: A 24-item online questionnaire was sent to 750 members of the Royal College of Occupational Therapists Specialist-Section in Neurological Practice. Data was collected at a nominal and ordinal level and included yes/no Likert-type scale and free field comments. Descriptive statistical analysis was completed. Results: Seventy-six occupational therapists working in a range of neurological settings completed the survey. Frequently used interventions included education (n = 57, 75%), task modification (n = 56, 73%), instrumental activities of daily living (ADL) (n = 54, 71%), personal ADL (n = 53, 70%) and goal setting (n = 53, 70%). Seventy-one percent used metacognitive strategies. Occupation-based metacognitive approaches were rarely used. Thirty-one (41%) participants reported being fairly confident and 28 (37%) were very confident. Support for clinical practice was accessed most frequently through joint clinical sessions (n = 30, 39%). Findings: Participants used various clinical interventions to treat service users with executive dysfunction after ABI. Meta-cognitive strategies were employed; however, occupation-based metacognitive approaches were infrequently utilised, suggesting uncertainty in adopting these in practice. The need for further training on evidence-based interventions and knowledge translation support was highlighted. [ABSTRACT FROM AUTHOR]

Although it has been found that autistic children exhibit delays in executive function abilities and atypical patterns of attention, less is known about the relationship between executive function and attention abilities and social and language skills in early childhood. In this study, 180 autistic children, age 2–8 years, participated in a study examining the relationship between executive function abilities, measured by the Behavior Rating Inventory of Executive Function, and assessments of sustained attention measured via eye-tracking and several language and social communication measures. Results revealed that children with higher caregiver-reported executive function skills, specifically, working memory and planning/organization abilities, demonstrated higher levels of caregiver-reported receptive-expressive social communication abilities measured via the Pervasive Developmental Disorder Behavior Inventory. Higher executive function abilities across all domains were associated with lower levels of social pragmatic problems. Children who were able to sustain their attention for a longer duration demonstrated higher expressive language abilities. These results suggest that executive function and attention skills may play an important role in multiple domains of functioning in autistic children. It will be useful to determine whether therapies that seek to improve executive function skills in autistic individuals also positively influence their social/communication and language abilities. Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication. [ABSTRACT FROM AUTHOR]

Executive functions, which begin developing in early childhood, are necessary for the tasks of daily life, such as decision making and planning. Despite their early development, often without teaching, many teens with disabilities need explicit instruction to acquire and apply executive functions each day. Gaps in executive functions directly impact a teens ability to achieve post-secondary success, as executive functions support planning, goal setting, and organization. This article provides instruction on how to support teens with disabilities on three executive functions: (a) building habits that form routines, (b) utilizing sensory reminders to manage time, and (c) applying a planning tool. This article also instructs teachers on embedding executive function instruction within transition planning for individualized education programs. [ABSTRACT FROM AUTHOR]

Introduction: Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear. Methods: We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD. Results: Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions. Conclusion: A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary. [ABSTRACT FROM AUTHOR]

Objective: To replicate a seven-factor model previously reported for the Delis–Kaplan Executive Function System (D-KEFS). Method: This study used the D-KEFS standardization sample including 1,750 non-clinical participants. Several seven-factor models previously reported for the D-KEFS were re-evaluated using confirmatory factor analysis (CFA). Previously published bi-factor models were also tested. These models were compared with a three-factor a priori model based on Cattell–Horn–Carroll (CHC) theory. Measurement invariance was examined across three age cohorts. Results: All previously reported models failed to converge when tested with CFA. None of the bi-factor models converged after large numbers of iterations, suggesting that bi-factor models are ill-suited to represent the D-KEFS scores as reported in the test manual. Although poor fit was initially observed for the three-factor CHC model, inspection of modification indices showed potential for improvement by including method effects via correlated residuals for scores derived from similar tests. The final CHC model showed good to excellent fit and strong metric measurement invariance across the three age cohorts with minor exceptions for a subset of Fluency parameters. Conclusions: CHC theory extends to the D-KEFS, supporting findings from previous studies that executive functions can be integrated into CHC theory. [ABSTRACT FROM AUTHOR]

Objective: To evaluate if children and adolescents with a diagnosis of ASD or ADHD have distinct executive function (EF) profiles. Methods: Peer-reviewed articles comparing ASD, ADHD, and typically developing individuals under 19 years of age were identified. The domains evaluated were: working memory, response inhibition, planning, cognitive flexibility, attention, processing speed, and visuospatial abilities. Results: Fifty-eight articles met inclusion criteria. Analyses were performed on 45 performance metrics from 24 individual tasks. No differences in EF were found between individuals diagnosed with ASD and ADHD. Individuals diagnosed with ASD and ADHD exhibited worse performance in attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition than typically developing individuals. Groups did not differ in planning abilities. Conclusion: Children and adolescents with ASD and ADHD have similar EF profiles. Further research is needed to determine if comorbidity accounts for the commonality in executive dysfunction between each disorder. [ABSTRACT FROM AUTHOR]

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity; however, other executive function dysregulation is common, including inhibition and working memory. This study aims to identify CT differences based on executive function performance in individuals with and without ADHD. Methods: Data for this study was acquired from the Adolescent Brain and Cognitive Development (ABCD) database (61 ADHD, and 61 age and sex matched controls). General linear models were used to assess relationships between measures, CT, and diagnosis. Results: We found a significant relation between CT and working memory scores in the right precentral area. Additionally, we found significant interactions between CT, diagnosis, and measure outcome in the Flanker assessment (in the left fusiform area) and the attention score of the CBCL (in the right precentral region). Conclusion: This suggests that there may be different relationships that exist between CT and executive function in children with ADHD. [ABSTRACT FROM AUTHOR]

Objectives: The current study examined whether informal caregivers performed worse, better, or similar to non-caregivers on cognitive tests of executive functioning and episodic memory over 10 years. Methods: Data were from waves 2 (2003–04) and 3 (2013–14) of the Midlife in the United States (MIDUS) study (N = 2086). Multiple linear regression models examined whether caregiving at both waves 2 and 3 predicted better cognitive functioning at wave 3, than caregiving at only one time point or no caregiving (reference) while controlling for baseline covariates (i.e., sociodemographic, health, and functional status). Results: After controlling for covariates, caregiving at both waves was independently associated with better performance in episodic memory (b =.24, SE =.10, p =.013) but not executive function (b = −.06, SE =.05, p =.246). Discussion: The findings partially supported both healthy caregiver and stress process models, indicating caregiving may be associated with better episodic memory but not executive functioning over time among the middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Infant neglect is a common type of child maltreatment. According to the Social Information Processing theory, maternal executive function (EF) and reflective function (RF) are assumed to be important contributing factors to infant neglect. However, empirical evidence about this assumption is sparse. This was a cross-sectional study. A total of 1010 eligible women participated. The Behavior Rating Inventory of Executive Function—Adult Version, Parental Reflective Function Questionnaire, and Signs of Neglect in Infants Assessment Scale (SIGN) were used to assess maternal EF, RF, and infant neglect, respectively. Random forest was used to assess the relevant importance of maternal EF and RF. K-means clustering was used to identify the profiles of maternal EF and RF. Multivariable linear regression and generalized additive models were used to examine the independent and combined effects of maternal EF and RF on infant neglect. Each dimension of EF was linearly related to infant neglect. The associations between each dimension of RF and infant neglect were nonlinear. The inflection point for each dimension of RF was indicated. Random forest showed EF was more closely related to infant neglect. EF and RF had accumulative effects on infant neglect. Three profiles were identified. Among them, those with globally impaired EF had the highest level of infant neglect compared with those who had normal cognition or only impaired RF. Maternal EF and RF had independent and combined effects on infant neglect. Interventions with maternal EF and RF as targets are promising for reducing infant neglect. [ABSTRACT FROM AUTHOR]

Increasing evidence documents turnover of the resting-state blood-oxygen-level dependent signal (TBOLD) as a key measure of local cortical brain status. Here we evaluated contemporaneous and lagged associations between TBOLD and cognitive function in 711 participants in the Human Connectome Project on Aging (HCP-A; 316 males and 395 females, age range 36-90 years). We found that TBOLD was negatively associated with Montreal Cognitive Assessment (MoCA) Total scores and with performance on 2 subscales, Delayed Recall and Visuospatial/Executive Function, controlling for sex, age, and handedness. This negative association was largely documented across brain areas and was significantly stronger in the left hemisphere compared to the right. In addition, analyses evaluating forward lagged crosscorrelations between TBOLD and cognitive performance demonstrated that TBOLD predicted decrements in future performance on MoCA Total score, Delayed Recall, and Visuospatial/Executive Function subscales, controlling for sex and handedness. Taken together, we found that increased TBOLD is associated with decreased cognitive performance contemporaneously and in the future. On the hypothesis that increased TBOLD is the outcome of neuroinflammatory processes, these findings provide a mechanism linking neuroinflammation with decreased cognitive performance. [ABSTRACT FROM AUTHOR]

Strategies to improve executive function that rely on external structures to help students successfully plan and complete tasks at school will not achieve the same outcome as would develop if these structures were combined with authentic experiences that require careful planning by individuals for themselves and their community. If the goal of external strategies to improve executive function is to help students internalize them, experience is the bridge to internalization. Without experience, connection is hard to develop and one is less likely to be motivated to pursue and master the concepts embedded in the experience. [ABSTRACT FROM AUTHOR]

This randomized trial compared the first online parent training program for an evidence-supported executive function intervention for autism to in-person parent training with the same dose and content. Parents of autistic children (8–12 years-old; Full Scale IQ above 70) were randomized to in-person (n = 51) or online (n = 46) training. Training acceptability and feasibility were rated highly by parents, without significant differences between groups. The completion rate was lower for parents in the online versus the in-person training condition, but neither the total time spent with training materials, nor parent and child outcomes differed by condition. Parents reported that training resulted in a reduction in caregiver strain (Cohen's d = 0.66) and modest improvements in child flexibility, emotional control and global EF, but not planning and organization. Dose of parent training had a significant positive effect on child planning and organization problems. These findings did not support the hypothesized superiority of online to in-person training, but they did indicate online is as effective as in-person training at helping parents learn to improve their autistic children's EF abilities and reduce their own experience of parenting strain. Implications included increased access to training for parents who experience barriers to receiving in-person care. Trial Registration: clinicaltrials.gov Identifier: NCT02708069 This study compared the first online parent training program for executive function intervention for autism to in-person parent training on the same content. Participants were parents of autistic children, who were between 8 and 12 years of age and did not have intellectual disability. Parents were randomized to the in-person (n = 51) or online (n = 46) training conditions. Both trainings were developed with stakeholder (parents and autistic people) guidance. In this trial, most parents reported that they liked both trainings and that they were able to implement what they learned with their children. Parents in both groups spent equivalent amounts of time (about 8 hours) with the training materials, but while 94% of parents in the in-person training attended both parent trainings, only 59% of parents in the online group completed all 10 online modules. Parents reported that it was difficult to stay motivated to complete the online trainings over the 10-week trial. Parent and child outcomes did not differ significantly between the groups. Overall, parents reported that the trainings resulted in a reduction in their own parenting strain and improvements in their child's flexibility, emotional control, and global executive function, but not planning and organization. These findings indicated brief in-person and online training can help parents learn to support and improve their autistic children's executive function abilities, reducing their own experience of parenting strain. The finding that the online training was equivalent to the in-person trainings is important because it is accessible to parents who encounter barriers to in-person care. [ABSTRACT FROM AUTHOR]

Many difficult behaviors are rooted in a lack of executive function (EF) skills. EF includes a variety of skills including attention, persistence, and regulating emotions, among others. It is important for all students to learn the skills that contribute to developing appropriate EF skills, but it is especially important for students with disabilities to learn these skills to be successful in school. This article includes a summary of the variety of specific EF skills, existing music research in these skill areas, and strategies teachers can use to improve EF skills in inclusive music classrooms. [ABSTRACT FROM AUTHOR]

The mediators of real-world executive functions in autism during the transition into adulthood are mainly unknown. This study aimed to identify the mediators for the behavioral and cognitive domains of real-world executive functions in late adolescent and young adult autistic populations. We followed up 289 autistic children (aged 11.6 ± 3.8, male 82.2%) and 203 non-autistic controls (10.7 ± 2.9, 66.5%) to their ages of 16.9 ± 4.7 and 15.8 ± 3.9, respectively. The Behavior Rating Inventory of Executive Function, comprising two global scales (Behavioral Regulation Index and the Metacognitive Index), was used to assess real-world executive functions at Time 2. Mediators of behavior regulation and metacognition were explored among a wide range of clinical correlates and parental bonding. We found that the autistic group had lower executive functions than the non-autistic group with lower behavior regulation and metacognition subscores. Several childhood factors were significant mediators. Multiple mediation analyses revealed that childhood inattention remained a significant mediator for both behavior regulation and metacognition in late adolescence, and peer problems were the specific mediators of metacognition. Our findings suggest several childhood factors may mediate real-world executive functions during late adolescence. Treating common mediators such as inattention may improve real-world executive functions in autistic individuals during adulthood. Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood. [ABSTRACT FROM AUTHOR]

Executive function (EF), a set of neurocognitive processes, is central to students' emotional and behavioral well-being. Despite students with emotional and behavioral disorders (EBD) being at risk for negative long-term outcomes, there is a paucity of EF research with students at risk for EBD in early elementary school, an important identification and intervention period. Thus, we conducted a cross-sectional latent profile analysis with a sample of 1,154 kindergarteners and first graders identified as at risk for EBD to determine whether unique EF profiles existed and the extent to which profile membership was related to distinct patterns of functioning. Results indicated a theoretically supported, three-profile solution of mildly, moderately, and clinically at-risk EF profiles. Differences between EF profiles were noted such that students with moderately and clinically at-risk EF profiles demonstrated more problematic behaviors, less social competence, and greater language difficulties. We discuss implications for early identification, intervention efforts, and future research. [ABSTRACT FROM AUTHOR]

Aims and objectives/purpose/research questions: The bilingual advantage in executive function (EF) has recently been explored with functional near-infrared spectroscopy (fNIRS) technology, but the results are still controversial because of the limited statistical analysis. This study aims to fill the gap by replicating the existing studies and advancing the statistical analysis. Design/methodology/approach: Altogether, 35 preschoolers (aged between 4.1 and 6.3 years, Mage = 5.0 years, SD = 0.59) completed the Peabody Picture Vocabulary Test—Fourth Edition (PPVT-4) and the Dimensional Change Card Sort (DCCS) task. Their behavioral performance and the associated brain activities during the three sessions of the DCCS task were measured using fNIRS. In addition, they were classified into either Bilingual or Monolingual groups based on the PPVT scores. Data and analysis: t -tests and quadratic regression analyses were conducted to examine whether children's performance in the DCCS was related to their bilingualism and whether the changes in oxygenated hemoglobin (HbO) in the prefrontal regions were related to their bilingualism and performance in the DCCS. Findings/conclusions: The behavioral data analysis indicated no significant differences between the monolinguals and bilinguals. However, the fNIRS evidence indicated that (1) the monolinguals had to recruit 15 channels to complete the cognitive shifting of DCCS tasks, whereas the bilinguals only employed 11; (2) the bilinguals had significantly more brain activation with fewer channels in BA 44 than the monolinguals, demonstrating more effective executive function. Originality: This study has advanced the statistical analysis of the HbO changes for the cognitive shifting in the DCCS by confirming the nonlinear U-shape by quadratic regression a better fit than the linear V-shape by GLM. Significance/implications: This finding implies that early bilingual experience has equipped young children with more effective executive function. [ABSTRACT FROM AUTHOR]

This study aimed to examine associations between gross motor skills and executive functions (EF) in a large sample of Australian preschool-aged children. Of 566 children (mean age = 3.2 ± 0.4 years, 51.2% girls), locomotor, object control, and total skill competence were significantly associated with visual spatial working memory and inhibition (p < 0.05). Total skill competence was associated with shifting and locomotor skills were significantly associated with self-regulation (p < 0.05). Static balance was significantly associated with inhibition and shifting (p < 0.05). In boys, an association between object control skills and visual spatial working memory was observed. In girls, an association between static balance and visual spatial working memory, phonological working memory, and shifting was observed. The identification of significant associations between gross motor skills and different EFs is an important contribution to the growing evidence on the relationship between motor skills and EFs in early childhood. [ABSTRACT FROM AUTHOR]

Objective: This study aims to perform a systematic review and meta-analysis of the effect of MBIs (Mindfulness, Tai Chi, Yoga, and Qigong) on symptoms and executive function (EF) in ADHD. Method: PubMed, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Embase, and CNKI databases were searched to collect randomized controlled trials (RCTs) on the effects of MBIs on symptoms and EF in ADHD. Data extraction and methodological quality evaluation were conducted by two researchers, and a meta-analysis was conducted by Stata SE. Results: The pooled meta-analyses of MBIs revealed a positive and small effect on inattention (g = −0.26), hyperactivity/impulsivity (g = −0.19), and EF (g = −0.35). Conclusion: Results suggest that MBIs have a significant improvement relative to the control condition. Although some results show that symptoms are affected by age, interventions, and total time of moderators, while EF is not affected by age and measurement, it needs to be supported by more research evidence. (J. of Att. Dis. XXXX; XX(X) XX-XX) [ABSTRACT FROM AUTHOR]

Dementia, or major neurocognitive disorder, is one of the most common causes of disability and dependency in older adults with far-reaching social, physical, and economic impacts. In the absence of adequate treatment, much research has been directed towards prevention. Physical exercise has been shown to increase cerebral blood flow, amplify production of neurotrophic factors, and enhance brain volume. Whether these changes on a structural and cellular level result in cognitive preservation is less clear. This systematic review synthesizes findings from seventeen randomized controlled trials that examine the effects of physical activity on global cognition, memory, and executive function in older adults. Cognitive benefits of exercise are strongest for those who are cognitively intact or with mild cognitive impairment. In studies with long-term follow up, cognitive gains tended to decay after cessation of physical intervention suggesting that sustained physical exercise may be required to preserve cognitive function in older adults prior to onset of dementia. [ABSTRACT FROM AUTHOR]

Considerable research has documented the impact of teacher perceptions on students' academic-related outcomes (e.g., classroom performance). This body of literature clearly shows that teacher perceptions (resulting from direct interactions with students) can have both positive and negative effects with respect to student behaviors and experiences in the classroom. What remains unclear is whether teachers perceive changes that result from interventions administered outside of their classrooms. The purpose of this study was to examine changes in teacher perceptions of working memory and executive function concerns (two important predictors of academic success) among students who participated in a computerized cognitive training program designed to enhance working memory skills. The current results indicate that teachers perceived fewer concerns following students' participation in the training; this outcome was supplemented with significant improvements in the students' working memory capabilities following the training program. These findings have important implications given the literature highlighting the relation between teacher perceptions and student outcomes as a function of a school-based computerized cognitive training intervention. [ABSTRACT FROM AUTHOR]

It is important to both protect the healthy development and maintain the oral health of the child population. The study examined the effect of early childhood exposures to water fluoridation on measures of school-age executive functioning and emotional and behavioral development in a population-based sample. This longitudinal follow-up study used information from Australia's National Child Oral Health Study 2012–14. Children aged 5 to 10 y at baseline were contacted again after 7 to 8 y, before they had turned 18 y of age. Percent lifetime exposed to fluoridated water (%LEFW) from birth to the age 5 y was estimated from residential history and postcode-level fluoride levels in public tap water. Measures of children's emotional and behavioral development were assessed by the Strength and Difficulties Questionnaire (SDQ), and executive functioning was measured by the Behavior Rating Inventory of Executive Function (BRIEF). Multivariable regression models were generated to compare the associations between the exposure and the primary outcomes and controlled for covariates. An equivalence test was also conducted to compare the primary outcomes of those who had 100% LEFW against those with 0% LEFW. Sensitivity analysis was also conducted. A total of 2,682 children completed the SDQ and BRIEF, with mean scores of 7.0 (95% confidence interval, 6.6–7.4) and 45.3 (44.7–45.8), respectively. Those with lower %LEFW tended to have poorer scores of the SDQ and BRIEF. Multivariable regression models reported no association between exposure to fluoridated water and the SDQ and BRIEF scores. Low household income, identifying as Indigenous, and having a neurodevelopmental diagnosis were associated with poorer SDQ/BRIEF scores. An equivalence test confirmed that the SDQ/BRIEF scores among those with 100% LEFW were equivalent to that of those who had 0% LEFW. Exposure to fluoridated water during the first 5 y of life was not associated with altered measures of child emotional and behavioral development and executive functioning. [ABSTRACT FROM AUTHOR]

Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations. [ABSTRACT FROM AUTHOR]

Sleep problems are common in children with autism spectrum disorder. Although previous research has shown the positive effects of parent-based sleep intervention, it was mainly focused on face-to-face modality, which might limit accessibility. This study aimed to examine the efficacy of a telehealth-delivered parent-based sleep-focused intervention in treating insomnia in preschool children with autism spectrum disorder. A total of 62 parents/caregivers with a child with autism spectrum disorder and comorbid insomnia (aged 3–6 years) were randomized to receive either three weekly group sessions of sleep-focused intervention via Zoom with telephone support (n = 30) or treatment as usual (n = 32). The intervention group had significantly greater improvements in overall sleep problems (Children's Sleep Habit Questionnaire total score; p < 0.05), bedtime resistance (p < 0.05), and sleep-onset delay (p < 0.05) at post-treatment as compared to the treatment as usual group. The intervention group also showed significant improvements in overall behavioral and emotional problems (p < 0.05), especially externalizing problems (p < 0.05) as measured by Strengths and Difficulties Questionnaire, and parental stress level (p < 0.05) as measured by Depression, Anxiety and Stress Scale-21 as compared to the treatment as usual group (partial η2 = 0.081–0.101). The findings supported the feasibility and promising effects of a brief parent-based sleep intervention delivered via telehealth. Sleep problems are common in children with autism spectrum disorder. Although the effects of parent-based sleep intervention were shown to be promising, previous research was limited to the face-to-face service model, which might limit accessibility. This study examined a sleep-focused parent training group delivered via telehealth for treating insomnia in preschool children with autism spectrum disorder, which allowed parents to join the intervention remotely. Results showed that children in the intervention group had greater improvements in sleep and insomnia symptoms after treatment, as compared to those who only received care as usual. This sleep-focused treatment also led to improved daytime behaviors, especially externalizing problems such as hyperactivity and conduct problems, in children with autism spectrum disorder. Parents who had attended the training also reported reduced parental stress level after treatment. The findings supported the feasibility and promising effects of a brief parent-based sleep intervention delivered via telehealth for preschooler with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Background: Aging is a process inherent to the human condition that is characterized by various biological, psychological, and social changes that can lead to certain mental health problems. Objective: This study aimed to understand and characterize how biological, psychological, and social factors influence mental health symptoms and neuropsychological function in the aging process. Methods: A sample consisting of 616 participants (73.8% female) aged between 50 and 90 years, (mean [SD]: 69.6 [17.2] years). Data collection involved a neuropsychological assessment carried out by a psychologist in a clinical interview session and the self-completion of a questionnaire. Results: Regression models revealed that depressive symptoms are explained by anxiety, psychological and environmental quality of life, and sleep habits. Anxiety symptoms are explained by depression, physical quality of life, and sleep habits. Statistically significant differences were identified between participants with and without anxiety in neuropsychological terms at the level of agnosia and praxis. Statistically significant differences were identified between participants with and without depression in neuropsychological terms at the level of memory, language, agnosia and praxis, and executive function (eg, prefrontal tests). Conclusions: Depression and anxiety symptoms are associated and could negatively influence the aging process. Aging should be understood in an ecological way taking into account the action of biological, psychological, social, and environmental factors, as well as the relationship and influence between the different levels and factors. This knowledge is important for diagnosis, for clinical practice, and for the development and definition of public policies to promote healthy aging. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the influence of aerobic exercise training on inhibitory control of executive functions in children with hemiplegic cerebral palsy. Design: Single-blind randomized controlled trial. Setting: Outpatient Physical Therapy Clinic. Participants: Children aged 7–11 with left-sided hemiplegic cerebral palsy with emotional and behavioral dysregulation evidenced by scores >28 on Paediatric Symptom Checklist and GMFCS I or II (n = 60). Intervention: Participants were randomly allocated into two equal groups. The control group received standard-of-care physical therapy for 1 h, and the aerobic exercise group received standard-of-care physical therapy for 30 min and moderate-intensity continuous exercise on a bicycle ergometer for 30 min. All groups received treatment three times a week for 12 weeks. Main Measures: The Eriksen Flanker test and Stroop Color–Word test were used to assess inhibitory control of executive function at the baseline and after 12 weeks. Results: Differences between pre- and post-treatment values in the exercise group showed significant improvement in Flanker response accuracy and Stroop response accuracy (p = 0.001) and significant decreases in Flanker congruent reaction time and Stroop congruent reaction time (p < 0.05). However, there were no significant differences between both groups in Flanker incongruent reaction time and Stroop incongruent reaction time (p > 0.05). Conclusions: Aerobic exercise has a promising effect on inhibitory control of executive function in children with left-sided hemiplegic cerebral palsy. [ABSTRACT FROM AUTHOR]

Objectives: A systematic review and meta-analysis of studies of single exercise on core symptoms and executive function in adolescents with ADHD. Methods: Four databases were searched for studies of the effects of single exercise on core symptoms and executive functioning in adolescents with ADHD. Results: Thirteen studies were included, and a single session of exercise had small effect-size improvements in core symptoms and executive function in adolescents with ADHD: 10 to 13 year olds in the early adolescent–elementary school years and 18 to 24 year olds in the late adolescent–college years. Moderate-intensity continuous training, high-intensity interval training, single sessions of less than 30 minutes, and single sessions of 30 minutes and more significantly improved cycling training, attention, inhibition, substance use, and pre-study abstinence. Conclusions: A single session of exercise had an overall ameliorative effect on core symptoms and executive function in adolescents with ADHD. [ABSTRACT FROM AUTHOR]

Objective: Parenting behavior is a well-established correlate of offspring ADHD. However, little is known about how parenting exerts its effects on offspring ADHD symptomatology. We examined whether prospective associations between positive and negative parenting behaviors and child ADHD symptoms are mediated by deficits in child executive function (EF) and reward responsivity (RR). Method : One hundred and thirty-five children with and without ADHD were assessed across two Waves, when children were mean ages 6 and 8 respectively. Children completed tasks on EF, and parents completed questionnaires about their parenting behaviors and their children's RR and ADHD symptoms. Results : Negative parenting behavior at Wave 1 was indirectly associated with offspring ADHD symptoms at Wave 2 via offspring EF. Conclusion : Individual differences in EF, but not RR, during early childhood may constitute a potential pathway by which negative parenting behaviors exerts its effects on subsequent offspring ADHD symptomatology. Treatment implications are discussed. [ABSTRACT FROM AUTHOR]

Background: A better understanding of the mechanisms underlying cognitive impairment in schizophrenia is imperative, as it causes poor functional outcomes and a lack of effective treatments. Aims: This study aimed to investigate the relationships of two proposed main pathophysiology of schizophrenia, altered prefrontal–striatal connectivity and the dopamine system, with cognitive impairment and their interactions. Methods: Thirty-three patients with schizophrenia and 27 healthy controls (HCs) who are right-handed and matched for age and sex were recruited. We evaluated their cognition, functional connectivity (FC) between the dorsolateral prefrontal cortex (DLPFC)/middle frontal gyrus (MiFG) and striatum, and the availability of striatal dopamine transporter (DAT) using a cognitive battery investigating attention, memory, and executive function, resting-state functional magnetic resonance imaging with group independent component analysis and single-photon emission computed tomography with 99mTc-TRODAT. Results: Patients with schizophrenia exhibited poorer cognitive performance, reduced FC between DLPFC/MiFG and the caudate nucleus (CN) or putamen, decreased DAT availability in the left CN, and decreased right–left DAT asymmetry in the CN compared to HCs. In patients with schizophrenia, altered imaging markers are associated with cognitive impairments, especially the relationship between DLPFC/MiFG–putamen FC and attention and between DAT asymmetry in the CN and executive function. Conclusions: This study is the first to demonstrate how prefrontal–striatal hypoconnectivity and altered striatal DAT markers are associated with different domains of cognitive impairment in schizophrenia. More research is needed to evaluate their complex relationships and potential therapeutic implications. [ABSTRACT FROM AUTHOR]

Background/Objective: Pediatric intensive care unit (PICU) survivors risk significant cognitive morbidity, particularly those with acquired brain injury (ABI) diagnoses. Studies show sedative and analgesic medication may potentiate neurologic injury, but few studies evaluate impact on survivor outcomes. This study aimed to evaluate whether exposures to analgesic and sedative medications are associated with worse neurocognitive outcome. Methods: A retrospective cohort study was conducted of 91 patients aged 8 to 18 years, undergoing clinical neurocognitive evaluation approximately 1 to 3 months after PICU discharge. Electronic health data was queried for sedative and analgesic medication exposures, including opioids, benzodiazepines, propofol, ketamine, and dexmedetomidine. Doses were converted to class equivalents, evaluated by any exposure and cumulative dose exposure per patient weight. Cognitive outcome was derived from 8 objective cognitive assessments with an emphasis on executive function skills using Principal Components Analysis. Then, linear regression was used to control for baseline cognitive function estimates to calculate a standardized residualized neurocognitive index (rNCI) z -score. Multivariable linear regression evaluated the association between rNCI and medication exposure controlling for covariates. Significance was defined as P <.05. Results: Most (n = 80; 88%) patients received 1 or more study medications. Any exposure and higher cumulative doses of benzodiazepine and ketamine were significantly associated with worse rNCI in bivariate analyses. When controlling for Medicaid, preadmission comorbid conditions, length of stay, delirium, and receipt of other medication classes, receipt of benzodiazepine was associated with significantly worse rNCI (β -coefficient = −0.48, 95% confidence interval = −0.88, −0.08). Conclusions: Exposure to benzodiazepines was independently associated with worse acute phase cognitive outcome using objective assessments focused on executive function skills when controlling for demographic and illness characteristics. Clinician decisions regarding medication regimens in the PICU may serve as a modifiable factor to improve outcomes. Additional inquiry into associations with long-term cognitive outcome and optimal medication regimens is needed. [ABSTRACT FROM AUTHOR]

More older adults are using cannabis for recreational and/or medical purposes, but most studies examining cognitive function and cannabis use do not include older adults. The current small pilot study sought to compare cognitive function and emotional functioning among adults age 60 and older who were regular, primarily recreational cannabis users (n = 28) and nonusers (n = 10). A bimodal distribution was observed among cannabis users such that they had either initiated regular use more recently ("short-term" users; ≤7 years, n = 13) or earlier in life ("long-term" users; ≥19 years, n = 15). Nonusers, short-term, and long-term users were not different in depression, anxiety, or emotion regulation, or alcohol use. Nonusers scored significantly higher than long-term users in executive function. Short-term users scored significantly higher than long-term users in executive function, processing speed, and general cognition. Additionally, greater recent cannabis use frequency was negatively associated with working memory. The current findings suggest that short-term recreational cannabis use does not result in differences in cognitive performance compared to nonusers, which may indicate that short-term use is relatively benign in older adults. However, longer duration of use is associated with poorer processing speed and executive functioning, and more recent cannabis use is associated with poorer working memory, which may impact older adults' overall cognitive functioning. [ABSTRACT FROM AUTHOR]

This short article is a commentary on this special section of Perceptual and Motor Skills entitled Relationships between Executive Function and Sports/Exercise. Given the vast executive function research in sports already published, this moment is opportune for highlighting (a) progress to date, (b) research limitations yet to address, and (c) inspirational new findings. The articles that follow illustrate these themes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the sensitivity of a digital platform to assess attentional and executive function in systemic lupus erythematosus (SLE) patients, and to evaluate the impact of an at-home interactive digital treatment to improve cognitive dysfunction in this clinical population. Background: Deficits in attention and executive function are common in patients with SLE. Despite these cognitive difficulties, there are limited brief assessment techniques and few treatment options to improve cognitive abilities in patients with SLE. Interactive digital treatment approaches (use of video game-based software) have been successful in identifying and improving cognition in other clinical populations. Methods: Sixty SLE patients completed baseline neuropsychological tests (of attention, psychomotor speed, and executive function), a tablet-based digital platform (EVOTM Monitor), and biobehavioral measures. The patients were randomized into treatment SLE (n = 30) or no contact control SLE (n = 30) groups, and returned 4 weeks later for follow-up cognitive, EVO Monitor, and biobehavioral testing. The SLE treatment group was trained on a tablet-based digital treatment (AKL-T01) and was instructed to complete 5 sessions at least 5 days per week for 4-weeks for a total of approximately 25 min of gameplay per day. Results: Systemic lupus erythematosus patients demonstrated impairment in visuomotor and processing speed, visual attention, and cognitive flexibility/sequencing skills at baseline. The video game-like treatment group (AKL-T01) had significant improvement in visuomotor speed (Trail Making A) and cognitive flexibility/sequencing (Trail Making B) compared to the control group at 4-week follow-up. The treatment group also demonstrated significant improvement in EVO Monitor multitasking at follow-up (with no change in controls). At baseline, a multitasking metric from EVO Monitor was associated with performance on tasks of cognitive flexibility (Trail Making B) and psychomotor speed (WAIS-IV Coding). Conclusions: These findings provide evidence that SLE patients who participated in a 4-week interactive digital video game-like activity had significant improvement in motor speed and executive functions, and would benefit from participation in digital interventions designed to target frontoparietal networks of the brain. Preliminary findings also suggest specific metrics from EVO Monitor may also be useful to detect cognitive impairment and cognitive changes in patients with SLE. [ABSTRACT FROM AUTHOR]

Individuals diagnosed with autism spectrum disorder (ASD) are more likely to have suicidal thoughts and behaviors. However, little research delineates the temporal and mechanistic associations between potential risk factors and suicidality in autistic individuals. We assessed 129 autistic and 121 age-matched and sex-assigned-at-birth-matched typically developing (TD) children and youth at baseline and follow-up. We evaluated internalizing/externalizing problems, bullying experiences, and three executive function tasks at a mean baseline age of 13.4 years (standard deviation: 4.2 years). After an average of 5.8 years (standard deviation: 1.7 years), we evaluated their suicidal thoughts and behaviors. The experiences of being bullied partially mediated the temporal relationship between pre-existing ASD and later-reported suicidal thoughts. Several cognitive flexibility and sustained attention indices mediated the temporal relationship between pre-existing ASD and later-reported suicidal thoughts. A multiple mediation model confirmed that bullying victimization and cognitive flexibility jointly mediated the temporal relationship between ASD and suicidal thoughts. Better cognitive flexibility and experiences of bullying victimization in autistic children/youth were both associated with higher risks of later-reported suicidal thoughts in adolescence/adulthood. School bullying-prevention programs and tailored clinical support for autistic youth with better cognitive flexibility are warranted for personalized suicide prevention for the autistic population. Autistic people are more likely to experience suicidal thoughts and behaviors. The underlying relationships between potential risk factors and suicidal thoughts and behaviors in autistic individuals remain unclear. To understand this, we investigated whether specific factors in childhood/youth explain the effects of pre-existing autism spectrum disorder (ASD) diagnoses on later suicidal thoughts and behaviors in adolescence/adulthood. We assessed internalizing and externalizing problems, bullying experiences, and executive functions (including cognitive flexibility, sustained attention, and spatial working memory) at an average baseline age of 13.4 years and suicidal thoughts and behaviors at an average follow-up age of 19.2 years among 129 autistic and 121 typically developing (TD) individuals. During the follow-up period in adolescence/adulthood, autistic individuals were more likely to report suicidal thoughts than TD individuals. Being bullied partially accounted for the relationship between a pre-existing ASD diagnosis and later-reported higher suicidal thoughts. Contrary to our hypothesis, higher (instead of lower) cognitive flexibility in some autistic young people appeared to partially explain their higher rates of suicidal thoughts compared with typically developing young people. The findings imply that school bullying prevention and tailored intervention programs for autistic people, especially those with higher cognitive flexibility, are warranted to reduce their risks of experiencing suicidal thoughts. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the relations among children's symbolic functioning at 15 months, joint attention at 24 months, expressive communication at 24 and 36 months, and executive functioning at 36 months. With the sample from rural areas in the United States collected by the Family Life Project (N = 1,008), a longitudinal data analysis was conducted. The results of structural equation modeling suggested that children's symbolic functioning at 15 months and children's executive functioning at 36 months was directly related to each other. These two variables were also indirectly related to each other through joint attention at 24 months and expressive communication at 24 and 36 months. Psychological distancing and verbal and nonverbal communication were used to explain the role symbolic functioning plays in the development of executive functioning during the second and the third years of children's lives. [ABSTRACT FROM AUTHOR]

Background: Cognitive phenotyping may be useful for predicting rehabilitation response in multiple sclerosis. Objective: To evaluate the association between cognitive phenotype(s) and response to restorative cognitive rehabilitation (RRCR). Methods: In a post hoc retrospective analysis of the RRCR study including 51 multiple sclerosis patients, we evaluated both impairment within specific cognitive domains as well as overall global impairment severity to investigate their relationship to improvement following rehabilitation. Results: Greater improvement in executive function was predicted by impairment within this domain as well as by having fewer impaired cognitive domains overall. Similar results were observed for visuospatial memory. Conclusions: Patients most likely to benefit from restorative cognitive rehabilitation may exhibit impairment within the domain of interest yet lower cognitive burden overall. [ABSTRACT FROM AUTHOR]

Science knowledge refers to the depth and breadth of facts acquired within the life, social, and earth sciences, and it has implications for both public and personal health. Drawing from cognitive aging theory, we examine whether levels of science knowledge are associated with age, neuropsychological functioning, and personal health literacy. Fifty-two younger and fifty older healthy adults completed our telephone-based study that included a commonly used test of science knowledge, as well as measures of neuropsychological functioning, health literacy, and relevant descriptives (e.g., mood). Adjusting for other demographics and neuropsychological functioning, older adults had significantly lower science knowledge test scores than younger adults. In the full sample, lower science knowledge showed medium-to-large associations with episodic memory, executive functions, and health literacy, independent of years of education. These results suggest that older adults' science knowledge falls slightly below that of their younger counterparts and is independently associated with higher order neuropsychological functions and aspects of personal health, which may have implications for accessing, understanding, and using relevant public health information across the lifespan. [ABSTRACT FROM AUTHOR]