Cinzia R. De Luca

Normative Data From the Cantab. I: Development of Executive Function Over the Lifespan

The study of executive function within a developmental framework has proven integral to the advancement of knowledge concerning the acquisition and decline of higher skill processes. Still in its early stages, there exists a discontinuity in the literature between the exploration of executive capacity in young children and the elderly. Research of age-related differences utilising a lifespan approach has been restricted by the lack of assessment tools for the measurement of executive skills that are applicable across all age levels. This paper addresses these issues using the computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB) to identify periods of development in executive capacities using a normative sample of 194 participants ranging in age from 8 to 64 years. Findings of executive function in children as young as 8 years of age were extended, with functional gains found in the efficiency of working memory capacity, planning and problem-solving abilities, between the ages of 15 and 19 years and again at 20–29 years of age. Cognitive flexibility was assessed at adult-levels in even the youngest children. Declines in performance on all tasks were revealed for the 50–64 year old sample, providing support for the vulnerability of executive skills to normal aging.

Developmental coordination disorder in geographic cohorts of 8‐year‐old children born extremely preterm or extremely low birthweight in the 1990s

Aim  The aim of the study was to examine the prevalence of developmental coordination disorder (DCD) at the age of 8 years in a geographic cohort of extremely preterm or extremely‐low‐birthweight (EP/ELBW) children and a term‐born comparison group, as well as associated academic outcomes, parents’ perceptions of motor performance, and changes in prevalence during the 1990s.

Executive Function in Adolescents Born <1000 g or <28 Weeks: A Prospective Cohort Study

BACKGROUND AND OBJECTIVES: Extremely preterm (EP; <28 weeks) birth and extremely low birth weight (ELBW; <1000 g) are risk factors for poor cognitive outcomes, including in executive function (EF; higher-order cognitive skills necessary for goal-directed, adaptive functioning and important for academic and behavioral-emotional outcomes). We aimed to (1) extend the limited data on EF in EP/ELBW survivors in adolescence compared with normal birth weight controls, and (2) determine changes in EF between ages 8 and 17 years in both groups. METHODS: Two hundred twenty-eight EP/ELBW and 166 control adolescents (mean age, 17 years) from a prospective geographical cohort were assessed with multiple EF tasks, and parent- and self-ratings of behavioral EF. The Rey Complex Figure and Behavior Rating Inventory of Executive Function parent report were also administered at age 8 years, enabling examination of change in scores between childhood and adolescence. RESULTS: EP/ELBW adolescents performed more poorly than controls in verbal processing speed, attentional control, cognitive flexibility, and goal-setting (effect sizes, −0.7 to −0.2 SD), but not psychomotor reaction time. Group differences were of similar magnitude across tasks. From childhood to late adolescence, EP/ELBW children improved their accuracy of the Rey Complex Figure copy more than controls. According to parents, executive behaviors were largely stable over time in both groups. CONCLUSIONS: Adolescents born EP/ELBW have poorer EF skills across multiple domains than controls. From childhood to late adolescence, different aspects of EF improved, but others did not, underscoring the need for multidomain, longitudinal assessments in this high-risk population.

Motor functioning during and following treatment with chemotherapy for pediatric acute lymphoblastic leukemia

This systematic review evaluated empirical studies examining motor skills in children during and following treatment for acute lymphoblastic leukemia. Most studies indicated that children on‐treatment display poorer gross and fine motor abilities than healthy peers, but generally have intact visual‐motor integration skills. Studies have reported gross motor difficulties in 5–54% of survivors. There is some limited evidence for long‐term fine motor deficits. The evidence for visual‐motor integration difficulties in the survivor population is less consistent. Larger studies with a longitudinal design are needed to further specify the onset and timing of motor difficulties and ascertain risk factors. Pediatr Blood Cancer 2013;60:1261–1266.

Gross and fine motor skills in children treated for acute lymphoblastic leukaemia

Objective: Chemotherapy treatment for acute lymphoblastic leukaemia (ALL) may disrupt motor development, with suggestions that gross and fine motor deficits are different depending on time since treatment. Methods: Thirty-seven participants aged between 2.5 to 5 years at the time of diagnosis were assessed using the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Bruininks–Oseretsky Test of Motor Proficiency, 2nd Edition, Short Form (BOT-2 SF), and divided into groups (i.e. months-off-treatment): (1) 0–12, (2) 13–24, and (3) 25–60 for comparison. Results: MABC-2 and BOT-2 SF mean total scores fell within the average range. Twenty-six percent of the sample performed in the impaired range on the MABC-2. Group 2 had significantly lower Manual Dexterity scores than the normative population and lower BOT-2 SF scores than Group 1. Conclusion: Most children treated for ALL display appropriate motor skills, yet around a quarter experience general motor difficulties. Time-off-treatment did not affect the prevalence of motor impairments on any measure.

The relationship between cognitive and neuroimaging outcomes in children treated for acute lymphoblastic leukemia with chemotherapy only: A systematic review.

Cognitive late‐effects have been identified in patients treated with chemotherapy‐only protocols for childhood acute lymphoblastic leukemia (ALL), yet the underlying neuropathology is not well understood. This review synthesized recent findings from eight articles investigating the relationship between neurocognitive and neuroimaging outcomes for patients treated for ALL with chemotherapy‐only protocols. Reported cognitive domains, imaging methods, and neuroanatomy examined were variable. Despite this, 62.5% (n = 5) of the reviewed studies found a significant relationship between cognitive and imaging outcomes. Greater understanding of the effects of treatment on neuroanatomy and cognitive outcomes is critical for proactively managing ALL cognitive late‐effects. Research directions are suggested.

Feasibility of neurobehavioral screening following diagnosis of pediatric cancer

Neurobehavioral deficits will affect up to 50% of pediatric cancer survivors treated with central nervous system (CNS)‐directed therapies. Guidelines suggest assessment of neurobehavioral skills at diagnosis be extended from patients with brain tumors to include all patients requiring CNS‐directed therapies. However, comprehensive neuropsychological assessment at diagnosis is difficult to implement and resource intensive. A screening assessment targeted at the neurobehavioral domains known to be impacted by cancer treatments may be more feasible. This study aimed to assess the feasibility of implementing baseline neurobehavioral screening following childhood cancer diagnosis.

Neuropsychological profile of children with subcortical band heterotopia

Aim  Subcortical band heterotopia (SBH) or ‘double cortex’ is a malformation of cortical development resulting from impaired neuronal migration. So far, research has focused on the neurological, neuroimaging, and genetic correlates of SBH. More recently, clinical reports and small sample studies have documented neuropsychological dysfunction in patients with this malformation. This study aimed to characterize further the phenotype of patients with SBH by describing the neuropsychological profiles of children.

Visuomotor Function in Children Treated for Acute Lymphoblastic Leukaemia With Chemotherapy Only

This study aimed to evaluate visuomotor function in children treated for acute lymphoblastic leukaemia (ALL). The performance of 64 children, 1–7 years post-chemotherapy for ALL, was compared to that of their healthy peers (n = 56) on visuomotor integration (VMI) and motor coordination (MC) tasks. Children posttreatment for ALL displayed significantly reduced VMI, but not MC, performances as compared to controls. Children treated on chemotherapy-only ALL regimes are at heightened risk for visuomotor integration deficits. Monitoring of visuomotor skills and implementation of appropriate interventions targeting higher level visuomotor integration skills should form an important component of any ALL long-term effects program.

White Matter Microstructure and Information Processing at the Completion of Chemotherapy-Only Treatment for Pediatric Acute Lymphoblastic Leukemia

ABSTRACT Little is known about white matter microstructure and its role in information processing abilities of children treated for acute lymphoblastic leukemia (ALL) early posttreatment. Twenty-one survivors of ALL and 18 controls (7–16 years) underwent neurocognitive assessment. A subsample underwent diffusion-weighted magnetic resonance imaging. The ALL group performed poorer on measures of processing capacity, and had widespread areas of decreased fractional anisotropy and increased radial diffusivity. Significant group by white matter microstructure interactions was found when predicting processing speed. Findings provide evidence for an atypical brain–behavior relationship early posttreatment for childhood ALL. Replication in a larger sample is required.