Browsing by Subject "Executive Function"
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Item ADHD Subtypes and the Convergent Validity of the Brief Three-Factor Approach and D-KEFS Color-Word Interference Test(2014-05-02) Oasay, Larry M. K.; Silver, Cheryl H.; Glasier, Paul; Stavinoha, Peter L.Deficits in executive functioning (EF) often translate to significant impairment in real-life situations. EF can be assessed by performance-based tests or through the use of behavior ratings; however, most research has found little to no associations between performance-based EF tests and parent ratings. ADHD is a neurodevelopmental disorder characterized by EF deficits, but some studies have found differences on EF measures between subtypes of ADHD. The first aim of this study is to examine the convergent validity between the D-KEFS CWIT, a performance-based EF task, and the recently revised three-factor BRIEF. The second aim of this study is to examine whether there are differences between ADHD-I and ADHD-HI/C subtypes on either of these EF measures. A sample of 49 children with ADHD, aged 6 to 12 years, were administered the D-KEFS CWIT and their parents were given the BRIEF to complete. No significant correlations between Condition 3 of the CWIT and the new Self-Monitor and Inhibit subdomains of the BRIEF were obtained, but the Shift subdomain of the BRIEF significantly correlated with Condition 3. Participants with ADHD-HI/C were rated by parents as having greater executive dysfunction compared to participants with ADHD-I. No significant differences between subtypes were observed on the CWIT after controlling for symptoms of inattention. It would be beneficial to continue developing EF measures with the goal of greater convergent validity between performance-based and informant-report measures. Also, more research should be conducted in identifying differences between ADHD subtypes in their EF profiles as it can potentially aid in improving evaluation and treatment of this disorder.Item Attention-Deficit/Hyperactivity Disorder and Executive Functions : Potential Vulnerabilities for Bully/Victimization Behaviors(2006-08-11) Kulesza, Krista; Silver, Cheryl H.Children diagnosed with Attention-Deficit/Hyperactivity Disorder can present with numerous difficulties in several areas of life, and particularly within the social realm. These interpersonal problems are linked to deficits in executive functions, which are the most prominent neuropsychological defects found in children with Attention-Deficit/Hyperactivity Disorder. Previous literature highlights the specific components of executive functions often problematic in children with Attention-Deficit/Hyperactivity Disorder including inhibition, set-shifting, working memory, planning, verbal fluency, and emotional regulation. Further, problems in executive functions appear to exacerbate the unsatisfactory interpersonal relationships these children experience. Additionally, Attention-Deficit/Hyperactivity Disorder is more prevalent among children identified as bullies and victims, and literature indicates that certain interpersonal problems children with Attention-Deficit/Hyperactivity Disorder experience, also increase the risk for involvement in bully/victimization behaviors. This involvement in bully/victimization behaviors among children with Attention- Deficit/Hyperactivity Disorder also appears to be related to deficits in executive functions. A group of children diagnosed with Attention-Deficit/Hyperactivity Disorder were assessed with performance-based executive functioning measures and self-reported questionnaires on bully/victimization behaviors. Parents completed a measure of emotional regulation, and the child's teacher completed an informant-rating scale on executive functions and equivalent measures on bully/victimization behaviors. Analyses of the data demonstrated that several of the teacher-reported executive function measures were related to, and predictive of, the teacher-reported bully/victimization behaviors. The performancebased executive function measures routinely demonstrated non-significant correlational and predictive findings with the bully/victimization measures. Additionally, the self-reported bullying measures had no significant relationships with any of the executive functioning measures. These results were consistent with literature questioning the validity of these types of measures. The results did show that executive functions, particularly those related to social skills, and emotional regulation, and the symptoms of Attention-Deficit/Hyperactivity Disorder, predict involvement with bully/victimization behaviors. Additional research is needed on the complex relationship among Attention- Deficit/Hyperactivity Disorder, executive functions, and bully/victimization behaviors. Specifically, potential studies should focus on utilizing a broader sample of participants, informants, and measures of executive functions and bully/victimization. Future research investigating the relationship among Attention-Deficit/Hyperactivity Disorder, executive dysfunction, and bully/victimization should focus on advancing beneficial interventions to comprehensively address these conditions in order to improve the child.s overall quality of life.Item Executive Functioning In Child Survivors of Pediatric Cerebellar Astrocytomas(2008-05-13) Perez, Rogelio; Stavinoha, Peter L.Twenty children who underwent surgery for CPA and were between the ages of eight and 16 years participated in the study. Each child was administered a multidimensional neuropsychological battery of EF, which consisted of the Delis-Kaplan Executive Function System, Wisconsin Card Sorting Test, and the subtests comprising the Working Memory Index from the Wechsler Intelligence Scale for Children - Fourth Edition. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Behavior Assessment System for Children - Second Edition (BASC-2). No significant differences were found between the CPA group's performance on the clinical measures and the normative test means. Teacher ratings on the BRIEF showed that the CPA group exhibited significantly more difficulties with working memory, whereas parent ratings showed significantly more difficulties with inhibition, mental flexibility, emotional control, initiation of activities, working memory, planning/organization, and monitoring behavior. In terms of emotional and behavioral functioning on the BASC-2, parents rated the CPA group as exhibiting significantly more difficulties with depression, withdrawal, and overall behavioral problems. Parent ratings on the BASC-2 also showed significantly more problems in several areas of adaptive functioning. This study did not replicate the findings of previous studies on EF in pediatric CPA samples. Although EF impairments were not evident, the CPA sample exhibited subtle and mild EF and behavioral/emotional difficulties.Item Executive Functioning in Children with ADHD : Relationships Between Rating Scales and Standardized Tests(2005-05-11) Gehrmann, Helena Ruth; Silver, Cheryl H.Impairment of executive functioning is exhibited in children with Attention-Deficit/Hyperactivity Disorder. Executive functioning has traditionally been measured with standardized tests such as the Wisconsin Card Sorting Test. However, two rating scales to measure executive dysfunction have been developed and may be a useful adjunct to traditional measures. This study proposes to examine two such scales, the Brief Rating Inventory of Executive Function and the Children's Executive Functions Scale, as well as measure their relationship with two standardized measures. Implications of possible outcomes of the study are then discussed.Item Identification of Attention-Deficit/Hyperactivity Disorder in Children with an Identified Oral Language Disorder: The Diagnostic Utility of the Quotient/ADHD System and the impact of Executive Function and Working Memory on Diagnosis(2009-09-04) Baker, Kristine Genovese; Hughes, Carroll W.Common symptomatology in oral language disorders and attention-deficit/hyperactivity disorder, including inattention, hyperactivity, and behavior associated with impaired executive function, impacts the validity of diagnostic evaluations. Research demonstrates that the identification of these disorders can be dependent on evaluation setting and clinicians' field of training. Inaccurate diagnosis predicts inappropriate and/or inadequate intervention, and hence, impaired functioning across multiple domains. Assessment instruments to improve the evaluation of attention-deficit/hyperactivity disorder in the context of impaired oral language are needed. The present study explored the impact of comorbid attention-deficit/hyperactivity disorder on attention, movement, executive function, and working memory in children with an identified oral language disorder. Utility of the Quotient/ADHD SystemTM, a continuous performance test with motion actigraphy, and the Children's Executive Functions Scale, a parent-report of executive function, for the accurate identification of an attention disorder in the context of impaired language was evaluated. The sample consisted of 51 children, between 6 and 13 years, with an orallanguage disorder; 30 child participants met diagnostic criteria for attention-deficit/hyperactivity disorder. Children with and without comorbid attention-deficit/hyperactivity disorder were compared on four domains: attention,movement, executive function, and working memory. Attention and movement were objectively measured with the Quotient/ADHD SystemTM. Executive functioning was assessed using the subscale and Total scores on the Children's Executive Functions Scale. Verbal and visual-spatial working memory were evaluated separately with Digit Span and Spatial Span subtests of the Wechsler Intelligence Scale for Children, Fourth Edition, Integrated. Ingestion of prescribed stimulant medication was delayed until after testing. Results of analyses of variance revealed significant group differences in movement, overall executive functioning, and behavioral inhibition; differences in attention and working memory were not found. Logistic regression and discriminant function analyses supported the use of the Quotient/ADHD SystemTM and the Children's Executive Functions Scale for the identification of an attention disorder in this population. Exploratory analyses raise questions regarding attention-deficit/hyperactivity disorder subtypes and the not otherwise specified category. Findings have important implications for the evaluation of attention-deficit/hyperactivity disorder. Questions regarding the role of attentional mechanisms in oral language disorders and potential new adjunct interventions for improving language are highlighted.Item The Impact of Parenting Stress on the Ecological Validity of Executive Function Testing in Children with ADHD(2008-05-13) Ball, Krystle Paige; Silver, Cheryl H.Measurement of executive functioning is difficult and findings from standardized tests may not have ecological validity. Parent report is one way to achieve ecological validity, but correlations between standardized tests and parent report frequently are low. Greater parental stress may lead to parents reporting more problem behaviors, so higher scores on a measure of parenting stress were expected to impact the relationship between parent report of child executive functioning and child performance on a standardized test of executive functioning. No significant correlations were found between Color-Word Interference scores and the BRIEF and CEFS, controlling for IQ. Many BRIEF and CEFS subscales were correlated with parenting stress. Relationships between the BRIEF or CEFS and the Color-Word Interference Test were not significantly smaller for parents expressing greater stress.Item An Investigation of Executive Function Impairment in Adolescents and Adults with Depression(2011-01-26) Warren, Kimberly Anne; Rao, UmaDepressive illness has been associated with impairment in executive functioning (EF); however the relationship between neurocognitive dysfunction and depressive illness is not well understood. Similar deficits in EF in depressive illness have been demonstrated in the research among adults and adolescents, although the research among youth is limited. Additionally, no published reports were found that have examined developmental differences in EF among youth and adults with depression. The current pilot study sought to provide information on the influences of age and depressive illness status on EF, as well as the extent to which deficits in EF are evidenced in youngsters with depression. An additional purpose of this study was to provide information on the utility of age-appropriate measures in assessing EF in youth. Data were analyzed on 105 participants (depressed adolescents and depressed adults, and their healthy counterparts) on ten outcome measures of EF. The performance of all groups fell within the average range across all ten outcome measures; however, significant group differences emerged on several outcomes on the Woodcock-Johnson III Tests of Cognitive Abilities (WJ-III COG). Additionally, adolescents with depression demonstrated a decreased performance across the majority of EF measures compared to their healthy counterparts, although these differences were not significant. Results from the current study revealed a significantly lower performance among depressed adolescents compared to both depressed and healthy adults on tasks involving processing speed, interference control and sustained attention ability. This finding suggests that depressive illness during early life may have mild effects on select executive functions (EFs), such as those that remain underdeveloped in youth. Results also revealed a decreased performance among both depressed and healthy adolescents compared to healthy adults on tasks involving planning ability, interference control or inhibition, and mental flexibility. This finding suggests that EF may be less reliable in youth, due to the ongoing maturation of this system in youngsters, and may improve with age. Finally, differences in performance in EF emerged only on the WJ-III COG, but not on other measures, which suggests that the WJ-III COG offers sensitivity in detecting developmental differences in EF among youth and adults.Item Mild Traumatic Brain Injury Rehabilitation: A Model for ADHD Treatment(2016-11-18) Yates, Ashley Nicole; Silver, Cheryl H.; Brewer-Mixon, Karen; Fulbright, Richard L.Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects approximately 4.4% of adults in the U.S. (Kessler et al., 2006) and is most commonly treated with psychopharmacological interventions. More recently, non-pharmacological interventions have been developed for ADHD. Cognitive Behavioral Therapy (CBT) has emerged as an efficacious treatment for ADHD and typically consists of training compensatory strategies and the use of external aids. The aims of this thesis were to examine the similarities between ADHD and mild Traumatic Brain Injury (mTBI) as well as review treatment options for mTBI and discuss their possible usefulness in treating ADHD. Based on the literature reviewed, there were striking similarities of deficits between ADHD and mTBI, specifically in the executive functioning of both. It is hypothesized that treatment for mTBI could also be beneficial for ADHD. Currently, some of the techniques used to treat ADHD and mTBI overlap. However in, cognitive rehabilitation (CR) for TBI, there is more emphasis on remediation of deficits compared to treatment of ADHD. Also, cognitive tasks for mTBI are more often completed in a real-life setting or as close to a real-life setting as possible. At this time, the literature regarding cognitive rehabilitation specific to mTBI is somewhat limited because it continues to be a growing field of literature. However, CR in general may be a beneficial treatment for the executive functioning deficits that also commonly affect ADHD.Item Relationship of Internalizing Behavior Problems to Intelligence and Executive Functioning in Children(2005-12-20) McClintock, Shawn Michael; Silver, Cheryl H.The current theme of research regarding children has focused greatly on emotional intelligence, Attention Deficit Hyperactivity Disorder (ADHD), and other problems involving emotional disorders. While there is a great amount of research devoted to these topics, there is a lack of consensus on the effects these emotional disorders have on the areas of intelligence and executive functioning in children. This study examined the relationship between internalizing behavior problems (depression, anxiety, and social withdrawal) and intelligence and executive functioning in children. Archival data, from 75 children between the ages of 6 and 14, were used. The sample consisted of children with internalizing behavior problems and children without internalizing or externalizing behavior problems, which was classified using the Child Behavior Checklist (CBCL). Each child was evaluated using the Wechsler Intelligence scale for Children-Third Edition (WISC-III), Children's Executive Function Scale (CEFS), and the Category Test. Results indicated that children with internalizing behavior problems performed significantly worse in domains of global executive function, problem solving, and initiative. No significant differences were found between the control and internalizing groups in the domain of intellectual functioning. This study supports the premise that executive function and intelligence are separate domains and should both be assessed in children with internalizing behavior disorders.Item Symptom Presentation in ADHD and Its Association with Inhibitory Control(2014-01-21) Loris, Colin Patrick; Silver, Cheryl H.; Stavinoha, Peter L.; Glasier, PaulAttention-Deficit/Hyperactivity Disorder (ADHD) has been associated with problems in executive functioning (EF). However, subtype difference in EF may exist between the inattentive type of ADHD and the hyperactive/impulsive and combined types of ADHD. As small number of studies, in fact, have found that inhibitory control is more strongly related to symptoms of inattention than symptoms of hyperactivity/impulsivity, suggesting that children with the inattentive type of ADHD may have more deficits in inhibition. The D-KEFS Color Word Interference Test (CWIT) was administered to 35 children, ages 8-17 years, diagnosed previously with ADHD, to examine possible differences in inhibition between a Predominantly Inattentive group and a Combined group (Predominantly Hyperactive-Impulsive and Combined types). Both ADHD group means on the CWIT were within normal limits. Results from a MANOVA showed no differences between groups on the CWIT, except for the word reading condition (Condition 2). Analysis of the CWIT and symptoms of inattention from the Conners Parent Rating Scale-Revised showed no significant relationship between performance on the CWIT and parent report of inattentive behaviors. Contrary to the hypotheses, this study did not provide evidence that children in the Predominantly Inattentive group display more deficits in inhibition than children in the Combined group, or that deficits in inhibition are related to inattentive behaviors.Item Tower of California Performance Early in Parkinson's Disease(2008-09-19) Vega, Martin C.; Silver, Cheryl H.Cognitive impairment associated with Parkinson's disease (PD) is widely described in the literature. Executive dysfunction has been reported even when the patients are not experiencing dementia. A significant (24% - 50+%) number of PD patients display cognitive impairment from the onset of the disease and progressively worsen. However, executive dysfunction in newly diagnosed patients often escapes clinical detection. This paper describes a study designed to test both early and late PD patients (0-5 years disease duration and 5-10 years disease duration, respectively) vs. controls on a novel tower task, the Tower of California (TOC, Delis, Kaplan,&Kramer, 2001). Use of the TOC with PD patients has not been published. The TOC is designed to be more difficult and may be more sensitive to subtle executive impairment, specifically in the areas of planning and spatial working memory. It is predicted that the early PD group will perform worse than the control group but better than the late PD group in the number of successful towers (ST) built. The early PD group is also expected to have a longer time to first move on ST built even when corrected for bradykinesia, but not as long as the late PD group, which is anticipated to be the slowest. Implications of the possible outcomes of this study are then discussed.