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Investigating executive functions in children with severe speech and movement disorders using structured tasks

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      Abstract

      Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters, and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. Twenty-nine children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children (a) directed the partner to perform actions like building a Lego tower from a model the partner could not see and (b) gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring, and impulse control were coded from the children's on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language tax executive functions more than speech. The results may also indicate that aided communicators have less experience with these kinds of play activities. The findings broaden the perspective on executive functions and have implications for interventions for motor-impaired children developing aided communication.

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      To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the classification system until consensus among 48 experts (physical therapists, occupational therapists, and developmental pediatricians with expertise in cerebral palsy) was achieved. Interrater reliability (kappa) was 0.55 for children less than 2 years of age and 0.75 for children 2 to 12 years of age. The classification system has application for clinical practice, research, teaching, and administration.
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        The Nature and Organization of Individual Differences in Executive Functions: Four General Conclusions.

        Executive functions (EFs)-a set of general-purpose control processes that regulate one's thoughts and behaviors-have become a popular research topic lately and have been studied in many subdisciplines of psychological science. This article summarizes the EF research that our group has conducted to understand the nature of individual differences in EFs and their cognitive and biological underpinnings. In the context of a new theoretical framework that we have been developing (the unity/diversity framework), we describe four general conclusions that have emerged from our research. Specifically, we argue that individual differences in EFs, as measured with simple laboratory tasks, (1) show both unity and diversity (different EFs are correlated yet separable); (2) reflect substantial genetic contributions; (3) are related to various clinically and societally important phenomena; and (4) show some developmental stability.
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          Insensitivity to future consequences following damage to human prefrontal cortex.

          Following damage to the ventromedial prefrontal cortex, humans develop a defect in real-life decision-making, which contrasts with otherwise normal intellectual functions. Currently, there is no neuropsychological probe to detect in the laboratory, and the cognitive and neural mechanisms responsible for this defect have resisted explanation. Here, using a novel task which simulates real-life decision-making in the way it factors uncertainty of premises and outcomes, as well as reward and punishment, we find that prefrontal patients, unlike controls, are oblivious to the future consequences of their actions, and seem to be guided by immediate prospects only. This finding offers, for the first time, the possibility of detecting these patients' elusive impairment in the laboratory, measuring it, and investigating its possible causes.
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            Author and article information

            Affiliations
            1Department of Psychology, University of Oslo Oslo, Norway
            2Section of Paediatric Neuro-habilitation, Department of Clinical Neurosciences for Children, Oslo University Hospital Oslo, Norway
            3CanChild Centre for Childhood Disability Research, McMaster University Hamilton, Canada
            4Behavioural Science Institute, Radboud University Nijmegen Nijmegen, Netherlands
            5Department of Psychology, Gothenburg University Gothenburg, Sweden
            6Catholic University of Applied Sciences Freiburg, Germany
            Author notes

            Edited by: Yusuke Moriguchi, Joetsu University of Education, Japan

            Reviewed by: Ayelet Lahat, McMaster University, Canada; Oriane Landry, McMaster University, Canada

            *Correspondence: Kristine Stadskleiv, Department of Psychology, PO Box 1094 Blindern, 0317 Oslo, Norway; Section of Peadiatric Neuro-habilitiation, Department of Clinical Neurosciences for Children, Women and Children's Division, Oslo University Hospital, PO Box 4956 Nydalen, 0424 Oslo, Norway e-mail: kristine.stadskleiv@ 123456psykologi.uio.no ; kristine.stadskleiv@ 123456oslo-universitetssykehus.no

            This article was submitted to Developmental Psychology, a section of the journal Frontiers in Psychology.

            Contributors
            Journal
            Front Psychol
            Front Psychol
            Front. Psychol.
            Frontiers in Psychology
            Frontiers Media S.A.
            1664-1078
            08 September 2014
            2014
            : 5
            4157461 10.3389/fpsyg.2014.00992
            Copyright © 2014 Stadskleiv, von Tetzchner, Batorowicz, van Balkom, Dahlgren-Sandberg and Renner.

            This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

            Counts
            Figures: 0, Tables: 8, Equations: 0, References: 84, Pages: 14, Words: 11882
            Categories
            Psychology
            Original Research Article

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