Cognitive development in children with chronic protein energy malnutrition

<p>Abstract</p> <p>Background</p> <p>Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age). The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures.</p> <p>Methods</p> <p>Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory</p> <p>Results</p> <p>Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children.</p> <p>Conclusion</p> <p>Chronic protein energy malnutrition (stunting) affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in long lasting cognitive impairments.</p

Growth Patterns of Neuropsychological Functions in Indian Children

We investigated age-related differences in neuropsychological performance in 400 Indian school children (5–15 years of age). Functions of motor speed, attention, executive functions, visuospatial functions, comprehension, learning, and memory were examined. Growth curve analysis was performed. Different growth models fitted different cognitive functions. Neuropsychological task performance improved slowly between 5 and 7 years, moderately between 8 and 12 years and slowly between 13 and 15 years of age. The overall growth patterns of neuropsychological functions in Indian children have been discussed with the findings reported on American children. The present work describes non-linear, heterogeneous, and protracted age trends of neuropsychological functions in Indian children and adolescents

Specific Cognitive Deficits in ADHD: A Diagnostic Concern in Differential Diagnosis

We present a critical account of existing tools used to diagnose children with Attention Deficit Hyperactivity Disorder and to make a case for the assessment of cognitive impairments as a part of diagnostic system. Surveys have shown that clinicians rely almost entirely upon subjective reports or their own clinical judgment when arriving at diagnostic decisions relating to this prevalent disorder. While information from parents and teachers should always be carefully considered, they are often influenced by a host of emotional and perceptual factors. It increases the possibility for misdiagnosis of a condition like ADHD. Recent experimental literature on ADHD has identified unique underlying cognitive dysfunction, specific to ADHD. Therefore, we propose that there is a need to incorporate information on cognitive mechanisms underlying ADHD and inculcate such information in the diagnostic system, which will provide a more sensitive as well as specific tool in differential diagnosis of ADHD

Bilingual Language Control and General Purpose Cognitive Control among Individuals with Bilingual Aphasia: Evidence Based on Negative Priming and Flanker Tasks

Background. Bilingualism results in an added advantage with respect to cognitive control. The interaction between bilingual language control and general purpose cognitive control systems can also be understood by studying executive control among individuals with bilingual aphasia. Objectives. The current study examined the subcomponents of cognitive control in bilingual aphasia. A case study approach was used to investigate whether cognitive control and language control are two separate systems and how factors related to bilingualism interact with control processes. Methods. Four individuals with bilingual aphasia performed a language background questionnaire, picture description task, and two experimental tasks (nonlinguistic negative priming task and linguistic and nonlinguistic versions of flanker task). Results. A descriptive approach was used to analyse the data using reaction time and accuracy measures. The cumulative distribution function plots were used to visualize the variations in performance across conditions. The results highlight the distinction between general purpose cognitive control and bilingual language control mechanisms. Conclusion. All participants showed predominant use of the reactive control mechanism to compensate for the limited resources system. Independent yet interactive systems for bilingual language control and general purpose cognitive control were postulated based on the experimental data derived from individuals with bilingual aphasia

Effect of language proficiency on proactive occulo-motor control among bilinguals.

We examined the effect of language proficiency on the status and dynamics of proactive inhibitory control in an occulo-motor cued go-no-go task. The first experiment was designed to demonstrate the effect of second language proficiency on proactive inhibitory cost and adjustments in control by evaluating previous trial effects. This was achieved by introducing uncertainty about the upcoming event (go or no-go stimulus). High- and low- proficiency Hindi-English bilingual adults participated in the study. Saccadic latencies and errors were taken as the measures of performance. The results demonstrate a significantly lower proactive inhibitory cost and better up-regulation of proactive control under uncertainty among high- proficiency bilinguals. An analysis based on previous trial effects suggests that high- proficiency bilinguals were found to be better at releasing inhibition and adjustments in control, in an ongoing response activity in the case of uncertainty. To further understand the dynamics of proactive inhibitory control as a function of proficiency, the second experiment was designed to test the default versus temporary state hypothesis of proactive inhibitory control. Certain manipulations were introduced in the cued go-no-go task in order to make the upcoming go or no-go trial difficult to predict, which increased the demands on the implementation and maintenance of proactive control. High- proficiency bilinguals were found to rely on a default state of proactive inhibitory control whereas low- proficiency bilinguals were found to rely on temporary/transient proactive inhibition. Language proficiency, as one of the measures of bilingualism, was found to influence proactive inhibitory control and appears to modulate the dynamics of proactive inhibitory control

Specific Cognitive Deficits in ADHD: A Diagnostic Concern in Differential Diagnosis

Abstract We present a critical account of existing tools used to diagnose children with Attention Deficit Hyperactivity Disorder and to make a case for the assessment of cognitive impairments as a part of diagnostic system. Surveys have shown that clinicians rely almost entirely upon subjective reports or their own clinical judgment when arriving at diagnostic decisions relating to this prevalent disorder. While information from parents and teachers should always be carefully considered, they are often influenced by a host of emotional and perceptual factors. It increases the possibility for misdiagnosis of a condition like ADHD. Recent experimental literature on ADHD has identified unique underlying cognitive dysfunction, specific to ADHD. Therefore, we propose that there is a need to incorporate information on cognitive mechanisms underlying ADHD and inculcate such information in the diagnostic system, which will provide a more sensitive as well as specific tool in differential diagnosis of ADHD