Caron A. C. Clark

The Structure of Executive Function in 3-Year-Olds.

Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that differed in format and response requirements and in putative working memory and inhibitory control demands. Tasks appeared to be age appropriate, with adequate sensitivity across the range of performance and without floor or ceiling effects. Tests of the relative fit of several alternative models supported a single latent EF construct. Measurement invariance testing revealed less proficient EF in children at higher sociodemographic risk relative to those at lower risk and no differences between boys and girls. At 3years of age, when EF skills are emerging, EF appears to be a unitary, more domain-general process.

Executive control and dimensions of problem behaviors in preschool children

BACKGROUND Despite the widespread recognition of the importance of executive control (EC) in externalizing psychopathology, the relation between EC and problem behavior has not been well characterized, particularly in typically developing preschoolers. METHOD Using the sample, battery of laboratory tasks, and latent variable modeling methods described in Wiebe, Espy, and Charak (2008), systematic latent dimensions of parent-rated problem behavior, measured by integrating scales from developmental and clinical traditions, were determined empirically, and then were related to EC. RESULTS Substantial relations between EC and problem behaviors were revealed by extracting the common variance of interest and eliminating extraneous variance, which were robust to estimated child intelligence and differed somewhat in preschool boys and girls. CONCLUSION Preschool EC measured by laboratory tasks appears to tap abilities that strongly and robustly support broad control processes enabling behavioral regulation across cognitive and emotional domains.

Neonatal Cerebral Abnormalities and Later Verbal and Visuospatial Working Memory Abilities of Children Born Very Preterm

As part of a prospective, longitudinal study, 103 very preterm children underwent structural magnetic resonance (MR) imaging at term equivalent age and an assessment of verbal (Digit Span) and visuospatial (Corsi Blocks) working memory at 6 years corrected age. Compared to children born full term (N = 108), very preterm children were characterized by poorer verbal and visuospatial working memory performance. Very preterm children without cerebral abnormalities performed similarly to full-term children. Verbal impairments were largely confined to children with earlier moderate-severe cerebral abnormalities, while children with mild and moderate-severe abnormalities showed greater difficulties in visuospatial working memory. Findings suggest that very preterm children may be particularly vulnerable to visuospatial impairment. They also highlight the role of early neurological disturbance in the evolution of these difficulties.

Very preterm birth: maternal experiences of the neonatal intensive care environment

Objective:Examine sources, predictors and child outcomes associated with neonatal intensive care unit (NICU)-related stress for mothers of infants born very preterm (VPT).Study Design:Participants were 133 mothers of VPT infants admitted to a regional level-III NICU. At term equivalent, mothers completed the Parental Stressor Scale: NICU and were interviewed about their psychological well-being and family circumstances. Infant clinical data were also collected. At corrected age 4 years, 49 children were assessed for cognition, language and socio-emotional development.Result:Mothers reported moderate to low stress, with parental role alteration considered most stressful and parent–staff communications least stressful. Predictors of overall stress included maternal educational underachievement, stressful life events, postnatal depression and infant unsettled-irregular behavior. NICU-related stress was associated with child anxiety and poorer language development.Conclusion:Parental well-being is an important focus of care in the neonatal setting. Strategies are needed to optimize early engagement and reduce stress levels to assist improved child outcomes.

Underpinnings of the Costs of Flexibility in Preschool Children: The Roles of Inhibition and Working Memory

This study addressed the respective contributions of inhibition and working memory to two underlying components of flexibility, goal representation (as assessed by mixing costs) and switch implementation (as assessed by local costs), across the preschool period. By later preschool age (4 years, 6 months and 5 years, 3 months), both inhibition and working-memory performance were associated with mixing costs, but not with local costs, whereas no relation was observed earlier (3 years, 9 months). The relations of inhibition and working memory to flexibility appear to emerge late in the preschool period and are mainly driven by goal representation.

Prenatal tobacco exposure and self-regulation in early childhood: Implications for developmental psychopathology.

Prenatal tobacco exposure (PTE) has a well-documented association with disruptive behavior in childhood, but the neurocognitive effects of exposure that underlie this link are not sufficiently understood. The present study was designed to address this gap, through longitudinal follow-up in early childhood of a prospectively enrolled cohort with well-characterized prenatal exposure. Three-year-old children (n = 151) were assessed using a developmentally sensitive battery capturing both cognitive and motivational aspects of self-regulation. PTE was related to motivational self-regulation, where children had to delay approach to attractive rewards, but not cognitive self-regulation, where children had to hold information in mind and inhibit prepotent motor responses. Furthermore, PTE predicted motivational self-regulation more strongly in boys than in girls, and when propensity scores were covaried to control for confounding risk factors, the effect of PTE on motivational self-regulation was significant only in boys. These findings suggest that PTEs impact on neurodevelopment may be greater in boys than in girls, perhaps reflecting vulnerability in neural circuits that subserve reward sensitivity and emotion regulation, and may also help to explain why PTE is more consistently related to disruptive behavior disorders than attention problems.

Separating Family-Level and Direct Exposure Effects of Smoking During Pregnancy on Offspring Externalizing Symptoms: Bridging the Behavior Genetic and Behavior Teratologic Divide

AbstractMaternal smoking during pregnancy (MSDP) has been robustly associated with externalizing problems and their developmental precursors in offspring in studies using behavioral teratologic designs (Wakschlag et al., Am J Public Health 92(6):966–974, 2002; Espy et al., Dev Psychol 47(1):153–169, 2011). In contrast, the use of behavior genetic approaches has shown that the effects commonly attributed to MSDP can be explained by family-level variables (D’Onofrio et al., Dev Psychopathol 20(01):139–164, 2008). Reconciling these conflicting findings requires integration of these study designs. We utilize longitudinal data on a preschool proband and his/her sibling from the Midwest Infant Development Study-Preschool (MIDS-P) to test for teratologic and family level effects of MSDP. We find considerable variation in prenatal smoking patterns both within and across pregnancies within families, indicating that binary smoking measures are not sufficiently capturing exposure. Structural equation models indicate that both conduct disorder and oppositional defiant disorder symptoms showed unique effects of MSDP over and above family level effects. Blending high quality exposure measurement with a within-family design suggests that it is premature to foreclose the possibility of a teratologic effect of MSDP on externalizing problems. Implications and recommendations for future studies are discussed.

Executive function in children born preterm: Risk factors and implications for outcome.

Executive function (EF) refers to the set of cognitive processes involved in the self-regulation of emotion and goal-directed behavior. These skills and the brain systems that support them develop throughout childhood and are frequently compromised in preterm children, even in those with broadly average global cognitive ability. Risks for deficits in EF in preterm children and attendant problems in learning and psychosocial functioning are higher in those with more extreme prematurity, neonatal complications, and related brain abnormalities. Associations of higher levels of EF with more supportive home and school environments suggest a potential for attenuating these risks, especially with early identification. Further research is needed to understand how deficits in EF evolve in preterm children, refine assessment methods, and develop interventions that either promote the development of EF in this population or help children to compensate for these weaknesses.

Building an adaptive brain across development: targets for neurorehabilitation must begin in infancy.

Much progress has been made toward behavioral and pharmacological intervention in intellectual disability, which was once thought too difficult to treat. Down syndrome (DS) research has shown rapid advances, and clinical trials are currently underway, with more on the horizon. Here, we review the literature on the emergent profile of cognitive development in DS, emphasizing that treatment approaches must consider how some “end state” impairments, such as language deficits, may develop from early alterations in neural systems beginning in infancy. Specifically, we highlight evidence suggesting that there are pre- and early postnatal alterations in brain structure and function in DS, resulting in disturbed network function across development. We stress that these early alterations are likely amplified by Alzheimer’s disease (AD) progression and poor sleep. Focusing on three network hubs (prefrontal cortex, hippocampus, and cerebellum), we discuss how these regions may relate to evolving deficits in cognitive function in individuals with DS, and to their language profile in particular.

Developmental pathways from prenatal tobacco and stress exposure to behavioral disinhibition.

Prenatal tobacco exposure (PTE) and prenatal stress exposure (PSE) both have been linked to externalizing behavior, although their effects generally have been considered in isolation. Here, we aimed to characterize the joint or interactive roles of PTE and PSE in early developmental pathways to behavioral disinhibition, a profile of cognitive and behavioral under-control that presages severe externalizing behavior. As part of a prospective, longitudinal study, 296 children were assessed at a mean age of 5 years. Exposures were assessed via repeated interviews across the prenatal period and bioassays of cotinine were obtained. Behavioral disinhibition was assessed using temperament measures in infancy, performance-based executive control tasks and measures of disruptive and inattentive behavior. PSE was associated with a higher probability of difficult temperament in infancy. Each exposure independently predicted poorer executive control at age 5 years. Difficult temperament and executive control difficulties in turn predicted elevated levels of disruptive behavior, although links from PTE and PSE to parent-reported attention problems were less robust. Children who experienced these prenatal exposures in conjunction with higher postnatal stress exposure showed the lowest executive control and highest levels of disruptive behavior. Findings highlight the compounding adverse impact of PTE and PSE on childrens behavioral trajectories. Given their high concordance, prenatal health campaigns should target these exposures in tandem.