Beyond the Bayley: Neurocognitive Assessments of Development During Infancy and Toddlerhood

The use of global, standardized instruments is conventional among clinicians and researchers interested in assessing neurocognitive development. Exclusively relying on these tests for evaluating effects may underestimate or miss specific effects on early cognition. The goal of this review is to identify alternative measures for possible inclusion in future clinical trials and interventions evaluating early neurocognitive development. The domains included for consideration are attention, memory, executive function, language and socio-emotional development. Although domain-based tests are limited, as psychometric properties have not yet been well-established, this review includes tasks and paradigms that have been reliably used across various developmental psychology laboratories

Social re-orientation and brain development: An expanded and updated view.

Social development has been the focus of a great deal of neuroscience based research over the past decade. In this review, we focus on providing a framework for understanding how changes in facets of social development may correspond with changes in brain function. We argue that (1) distinct phases of social behavior emerge based on whether the organizing social force is the mother, peer play, peer integration, or romantic intimacy; (2) each phase is marked by a high degree of affect-driven motivation that elicits a distinct response in subcortical structures; (3) activity generated by these structures interacts with circuits in prefrontal cortex that guide executive functions, and occipital and temporal lobe circuits, which generate specific sensory and perceptual social representations. We propose that the direction, magnitude and duration of interaction among these affective, executive, and perceptual systems may relate to distinct sensitive periods across development that contribute to establishing long-term patterns of brain function and behavior

Cognitive dysfunction after analgesia and sedation: Out of the operating room and into the pediatric intensive care unit

In the midst of concerns for potential neurodevelopmental effects after surgical anesthesia, there is a growing awareness that children who require sedation during critical illness are susceptible to neurologic dysfunctions collectively termed pediatric post-intensive care syndrome, or PICS-p. In contrast to healthy children undergoing elective surgery, critically ill children are subject to inordinate neurologic stress or injury and need to be considered separately. Despite recognition of PICS-p, inconsistency in techniques and timing of post-discharge assessments continues to be a significant barrier to understanding the specific role of sedation in later cognitive dysfunction. Nonetheless, available pediatric studies that account for analgesia and sedation consistently identify sedative and opioid analgesic exposures as risk factors for both in-hospital delirium and post-discharge neurologic sequelae. Clinical observations are supported by animal models showing neuroinflammation, increased neuronal death, dysmyelination, and altered synaptic plasticity and neurotransmission. Additionally, intensive care sedation also contributes to sleep disruption, an important and overlooked variable during acute illness and post-discharge recovery. Because analgesia and sedation are potentially modifiable, understanding the underlying mechanisms could transform sedation strategies to improve outcomes. To move the needle on this, prospective clinical studies would benefit from cohesion with regard to datasets and core outcome assessments, including sleep quality. Analyses should also account for the wide range of diagnoses, heterogeneity of this population, and the dynamic nature of neurodevelopment in age cohorts. Much of the related preclinical evidence has been studied in comparatively brief anesthetic exposures in healthy animals during infancy and is not generalizable to critically ill children. Thus, complementary animal models that more accurately reverse translate critical illness paradigms and the effect of analgesia and sedation on neuropathology and functional outcomes are needed. This review explores the interactive role of sedatives and the neurologic vulnerability of critically ill children as it pertains to survivorship and functional outcomes, which is the next frontier in pediatric intensive care

Layers Of Maturation In Cortical Hierarchies

Hierarchies form critical scaffolds for top-down processing but are often multiplex. In the brain, multiple layers of complex hierarchies intersect, dissociate, and re-converge over the lifespan. Although aspects of local hierarchical organizations are well-mapped for sensory systems, the fashion by which hierarchical organization extends globally is unknown. Human neuroimaging provides a means by which to observe both the developmental emergence and functions of global neurohierarchical organization. Here, we leveraged these advances to distill multiple layers of hierarchical formation across diverse brain-tissue quantifications. We demonstrate that these layers form common and dissociable biomarkers of the developmental emergence of complex cognition. Our results indicate that multiplex neurocognitive development both processes across a normative hierarchical pattern and contributes to engraining the pattern into cortical function. Further, our results suggest that neurocognitive development is largely contemporaneous with neurocognitive aging in an integrated, flexible lifespan sequence

Beyond Stereotypes of Adolescent Risk Taking: Placing the Adolescent Brain in Developmental Context

Recent neuroscience models of adolescent brain development attribute the morbidity and mortality of this period to structural and functional imbalances between more fully developed limbic regions that subserve reward and emotion as opposed to those that enable cognitive control. We challenge this interpretation of adolescent development by distinguishing risk-taking that peaks during adolescence (sensation seeking and impulsive action) from risk taking that declines monotonically from childhood to adulthood (impulsive choice and other decisions under known risk). Sensation seeking is primarily motivated by exploration of the environment under ambiguous risk contexts, while impulsive action, which is likely to be maladaptive, is more characteristic of a subset of youth with weak control over limbic motivation. Risk taking that declines monotonically from childhood to adulthood occurs primarily under conditions of known risks and reflects increases in executive function as well as aversion to risk based on increases in gist-based reasoning. We propose an alternative Lifespan Wisdom Model that highlights the importance of experience gained through exploration during adolescence. We propose, therefore, that brain models that recognize the adaptive roles that cognition and experience play during adolescence provide a more complete and helpful picture of this period of development

Institutional paraconsciousness and its pathologies

This analysis extends a recent mathematical treatment of the Baars consciousness model to analogous, but far more complicated, phenomena of institutional cognition. Individual consciousness is limited to a single, tunable, giant component of interacting cognitive modules, instantiating a Global Workspace. Human institutions, by contrast, support several, sometimes many, such giant components simultaneously, although their behavior remains constrained to a topology generated by cultural context and by the path-dependence inherent to organizational history. Such highly parallel multitasking - institutional paraconsciousness - while clearly limiting inattentional blindness and the consequences of failures within individual workspaces, does not eliminate them, and introduces new characteristic dysfunctions involving the distortion of information sent between global workspaces. Consequently, organizations (or machines designed along these principles), while highly efficient at certain kinds of tasks, remain subject to canonical and idiosyncratic failure patterns similar to, but more complicated than, those afflicting individuals. Remediation is complicated by the manner in which pathogenic externalities can write images of themselves on both institutional function and therapeutic intervention, in the context of relentless market selection pressures. The approach is broadly consonant with recent work on collective efficacy, collective consciousness, and distributed cognition

Reassessing emotion regulation.

Developmental research on emotion regulation is increasingly advancing toward a systems view that integrates behavioral and biological constituents of emotional self-control. However, this view poses fundamental challenges to prevailing conceptualizations of emotion regulation. In portraying emotion regulation as a network of multilevel processes characterized by feedback and interaction between higher and lower systems, it becomes increasingly apparent that emotion regulation is a component of (rather than a response to) emotional activation, that it derives from the mutual influence of multiple emotion-related systems (rather than the maturation of higher control processes alone), and that it sometimes contributes to maladaptive behavioral outcomes, especially in conditions of environmental adversity. The implications of this perspective for the developmental study of emotion regulation are discussed