Neuropsychological Symptoms Associated with Multiple Shunts

Hydrocephalus is the excessive accumulation of cerebrospinal fluid within the cranium which may result in increased intracranial pressure, dilation of cerebral ventricles and displacement of adjacent brain structures. Ventriculoperitoneal shunting is often needed to treat hydrocephalus. Patients with Ventriculoperitoneal shunts have been found to have IQ scores below the mean of the general population. In addition, many of these patients experience shunt infections or other complications that require shunt replacement. Shunt replacements and shunt infections have been associated with additional deficits in intellectual functioning. However, previous research has failed to address the neuropsychological ramifications of shunt infections and shunt replacements. Given the high prevalence of hydrocephalus in patients with spina bifida, this patient population was chosen for this study. Results from this study indicate a significant correlation between shunt replacements and deficits in general intelligence, visuospatial skills, and memory functioning in children with spina bifida. Shunt infections were not significantly related to any aspect of neuropsychological functioning. However, patients with a history of shunt infection generally receive a greater number of shunt replacements than patients without a history of shunt infection, and thus display lower intellect and more visuospatial and memory deficits

Relations between measures of attention and memory in the assessment of children with attentional difficulties

Attentional difficulties are associated with a number of different pediatric clinical disorders, including attention deficit hyperactivity disorder (ADHD), learning disabilities (LD), and traumatic brain injury (TBI). Further, two cognitive functions dependent upon attention, learning and memory, are characteristic deficits in LD children, and have been documented as correlated weaknesses in ADHD and TBI populations. However, few investigations have examined the relation between these cognitive functions, in terms of understanding the respective contributions of attention, learning, and memory deficits in the clinical groups indicated above. In the present study, a measure of attention, the Gordon Diagnostic System (GDS) was compared to a measure of learning and memory in children, the Wide Range Assessment of Memory and Learning (WRAML), in ADHD, LD/ADHD, TBI, and typically-functioning Control groups (aged 9--14 inclusive, N = 25 per group). The purposes of this comparison were a) to determine the correlation between the GDS and learning and memory subtests thought to have a strong attentional component, and b) to examine how performance profiles on the various measures would discriminate among clinical groups, and predict group classification. Results of the correlational analysis indicated relations among the measures along the lines of visual and verbal working memory, versus the expected attention/memory dichotomy. The discriminant analysis revealed that the LD/ADHD group demonstrated significantly more difficulties on both verbal and visual working memory tasks, compared to the other groups, and that visual working memory tasks primarily separated the ADHD and TBI groups from the Control group. These findings were discussed in terms of the importance of considering working memory as a significant factor in attentional functions of children with ADHD, LD, and TBI

The effects of video game playing on academic task performance and brain wave activity

The purpose of this investigation was to examine whether playing video games affected children’s ability to perform certain cognitive functions. Thirty middle school students 10 to 14 years old who played video games in their leisure time participated in this controlled study. Restricted measures of math performance, memory, attention and planning, reading rate and comprehension, as well as beta and theta activity in the brain were collected as pre- and post-test measures. Participants were randomly assigned to either the experimental or control group. Participants in the experimental group played video games for one hour, while participants in the control group played card or board games for one hour. Multivariate analysis of variance (MANOVA) procedures were used to analyze pre- and post-test mean differences between groups for all variables. No significant differences were noted. When this sample of middle school aged children engaged in video game play with mildly rated (E for Everyone) recreational video games without blood, gore, and carnage for a limited time (60 minutes), brain wave activity and ability to perform certain academic tasks did not appear to be disrupted. Practical applications of the study are discussed

The appropriateness of the raven's coloured progressive matrices and its existing normative data for Zulu speakers.

Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.Increasing focus is being placed on fair assessment practices in South Africa. Most psychological tests used in this country were designed and developed in other countries. Research has shown that when using these tests on a different target population, it is important to determine the suitability of the test for that population. This involves investigating reliability, validity and possible sources of bias. It is equally important to have local normative data with which scores can be compared and interpreted. Research in this area has been limited. The purpose of this study was to undertake such research by evaluating a widely used test, the Raven's Coloured Progressive Matrices (RCPM), and its existing norms, for Zulu children in South Africa. The study also aimed to provide raw data, which could be used to assist with the compilation of local norms. The test was administered to a convenience sample of 522 primary school children between the ages of 5 and 12 years old. The sample was divided into two groups to represent two different geographical locations: rural and urban. The sample consisted of 284 rural children and 237 urban children. There were 263 males and 259 females in the sample. Findings indicated good test reliability for this sample. Test validity however could not be confirmed as possible sources of bias at the content and item levels were shown. Age had a significant effect on performance, but level of education appeared to be the strongest predictor of performance on the RCPM for this sample. Significant gender differences were found. There was a tendency for males to outperform females on the test. Location had a significant effect on scores, where urban children performed better than rural children. Comparison of Zulu sample scores with those produced by the British standardisation sample, revealed a large discrepancy in performance between the two different cultural groups. The Zulu sample mean scores were significantly lower than the British mean scores. These findings highlight the need for locally developed normative data. The validity of the test for the sample requires further investigation. Results indicate that test adaptation may be required for Zulu children

Structural Extension of the Cattell-Horn-Carroll Cross-Battery Approach to Include Measures of Visual-Motor Integration

In spite of the long-standing tradition of including measures of visual-motor integration in psychological evaluations, visual-motor abilities have not been included in the Cattell-Horn-Carroll (CHC) theory of cognitive abilities or its complementary cross-battery approach to assessment. The purpose of this research was to identify the shared constructs of a popular test of visual-motor integration and a test of intellectual functioning, and to investigate how a test of visual-motor integration would be classified within the CHC model. A large normative sample of 3,015 participants that ranged in age from 5 to 97 years completed the Bender Visual-Motor Gestalt Test, Second Edition (Bender-Gestalt II; Brannigan & Decker, 2003) and the Stanford-Binet Intelligence Scale, Fifth Edition (SB5; Roid, 2003). Correlational analyses indicated positive moderate correlations across all age ranges between the Bender-Gestalt II Copy measure and the SB5 Nonverbal Visual-Spatial Processing subscale and between the Bender-Gestalt II Recall measure and the SB5 Nonverbal Visual-Spatial Processing and Nonverbal Working Memory subscales. Exploratory factor analyses revealed a three-factor model for four age groupings and four-factor model for one age grouping, suggesting factors which represent crystallized ability, fluid reasoning, and visual-motor ability. The results of this study suggest that the Bender-Gestalt II measures abilities that are not included in the SB5. Therefore, the Bender-Gestalt II would complement an intelligence test such as the SB5 in order to form a CHC Visual Processing (Gv) broad ability factor. These findings also address the need for further research to validate the constructs measured by newer versions of widely-used tests of cognitive ability

Study of the Cognitive Functioning of Medicated and Non-Medicated Elementary School-Aged Children Diagnosed with Attention Deficit HyperactivIty Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a serious disability that has been shown to adversely affect cognition, affect, and behavior. Research using traditional measures of cognitive functioning, such as intelligence tests has shown that children diagnosed with ADHD perform poorly on cognitive measures of processing speed, and on working memory in particular (Kerns, Mclnerney & Wilde, 2001; Weiler, Bernstein, Bellinger & Waber, 2000). Mahone, et al. (2003), note that reviews involving the Wechsler Scales for children suggest that Full Scale IQ scores (FSIQ) on the WISC-III average 5 to 6 points lower than scores in the WISC-R. It was hypothesized that changes on revised subtests of the WISC-III Performance Scale may place ADHD children at a disadvantage if their performance on these subtests is compared to their performance on analogous WISC-R subtests. Mahone, et al. (2003) theorize that increased executive demands resulted in lower FSIQ scores and call for further analysis upon future Wechsler revisions. Although results are equivocal, research suggests that psychostimulant medication may ameliorate ADHD cognitive deficiencies that adversely impact working memory and processing speed. Brown and Borden (1989) suggest that stimulant drug improvement occurs primarily on rote or simple tasks, but measures emphasizing the processing of higher-order information may be less influenced. Barkley (1998) indicates that the impact of drugs upon behavior and concentration was most salient, with performance on intelligence tests unaffected by medication. However, most of these studies extrapolated IQ scores either from short forms or from several subtests of the Wechsler scales. Research using more traditional measures of cognitive functioning (e.g., standardized intelligence tests), and focusing on long-term effects of cognitive performance (Gillberg, et aI., 1997; Livingston, Mears, Marshall, Gray & Haak, 1996; Mahone, et aI., 2003), suggests that results depend on the measures and methods used. As part of the initial validation of the revised WISC-IV, an ADHD group was compared to a matched control group. Additional research called for investigations comparing the performance of medicated ADHD children with nonmedicated ADHD children. This research used the Wechsler Intelligence Test for Children-fourth edition (WISC-IV) to assess the cognitive performance of medicated ADHD children and nonmedicated ADHD children. Results were used to answer the questions: Are there differences in IQ scores between ADHD children and normal controls, and between medicated ADHD children and nonmedicated ADHD children

Individual and developmental differences in susceptibility to the irrelevant speech effect.

The Irrelevant Speech Effect (ISE) is a phenomenon in which the presentation of auditory materials (typically speech) impairs the serial recall of visually presented materials, either digits or letters. Although this effect has been replicated in a large number of studies, a wide range of individual differences in susceptibility to the auditory distracters has been found. The current study investigates four possible determinants of individual differences of the ISE: (1) The sequence length of the short-term memory (STM) task, (2) the content of the STM task and auditory distracter, (3) the STM capacity of the individual, and (4) developmental differences. Results from a series of experiments suggest that (1) increasing sequence length can have substantial negative effects on STM task performance, but it does not increase the ISE. This indicates that individual differences in the ISE do not depend on individual differences related to task difficulty. (2) When sequence length is adjusted to equate STM task performance, the ISE is only observed for speech distracters. This result is important because it implies a primary role of phonological rehearsal in the ISE. Additional testing with a vi suo-spatial STM task that did not require rehearsal showed a release from the ISE. (3) Individuals with high memory capacity appear to be less susceptible to the ISE. This result is among the first to demonstrate the roll of STM capacity in the ISE, and is consistent with past work that shows relationships between working memory capacity (WMC) and susceptibility to distraction. (4) When tested at span (the longest sequence length an individual can recall 50% of the time), children and adults show similar magnitudes of the ISE. This too is consistent with the view that the ISE is related to memory capacity, rather than age. Taken together, these outcomes indicate that the ISE is caused by a disruption of memory encoding at the phonological rehearsal stage, which in tum is related to memory capacity. These results inform theory development of STM and the processes involved in auditory attention. In addition, results may be applied to the improvement of acoustical conditions in learning environments

Novel word learning in children with hearing impairment

This study examined novel word-learning abilities in young school-age children with mild-to-moderate hearing losses. We questioned whether degree of hearing loss or measures of language and phonological processing abilities were more likely to be related to novel wordlearning ability. Subjects were 20 children with hearing impairment (M = 9:0) and 20 children with normal hearing (M = 6:5) matched for receptive vocabulary knowledge. Children were administered measures of language and phonological processing. The novel word-learning task consisted of an acquisition and retention phase in which children received a series of trials to learn to produce four novel words. Half of the children with hearing impairment performed comparably to the children with normal hearing on all of the measures obtained, whereas the other 10 children with hearing impairment performed more poorly than the higher functioning children with hearing impairment and all of the children with normal hearing on most of the measures of language, phonological processing, and novel word learning. Degree of hearing loss was not related to language or word-learning abilities. These findings suggest that the population of children with mild-to-moderate hearing loss may contain two distinct groups: a group of normally developing children who have a hearing loss and a group of children with language impairment who have a hearing loss. The implications of this categorization will be discussed. KEY WORDS: hearing impairment, phonological processing, language impairment, novel word learning, mild-to-moderate hearing los

The Functional Impact of Neurocognitive Deficits in Pediatric Cancer Survivors and Associated Risk Factors

Childhood cancer survivors are at risk for long-term neurocognitive morbidities. Current research has only recently begun to examine how these neurocognitive late effects translate into impairments across important aspects of daily living. Additionally, research remains in its early stages of identifying risk factors associated with neurocognitive and broad functional impairments. The current study explores a proposed model of neurocognitive late effects by examining the relationship between neurocognitive deficits and broad functional impairment in cancer survivors relative to healthy controls. The current study also explores the contribution of associated risk factors including treatment severity and time since treatment among cancer survivors and long-term stress reactivity among both cancer survivors and healthy controls. Cancer survivors and healthy controls were between the ages of five and eighteen years. Hair samples were collected from the children to assess cortisol, a measure of long-term stress reactivity. Parents completed a functional impairment questionnaire while a brief neurocognitive exam was administered to the children. Results found no differences in neurocognitive performance or levels of functional impairment in cancer survivors relative to healthy controls; however, verbal reasoning was found to be a more robust predictor of functional impairment (FI) in cancer survivors in comparison to healthy controls. Importantly, and calling into question the validity of FI measurement in children, approximately half of both cancer survivors and health controls reported clinically significant levels of FI. This was in excess of that reported by parents. Additionally, cortisol levels were found to differentially predict neurocognitive performance in cancer survivors relative to healthy controls. Taken together, these findings suggest that verbal reasoning predicts functional impairment, but only in cancer survivors. Additional risk factors require more exploration in future research