Touchscreen cognitive tools for mild cognitive impairment and dementia used in primary care across diverse cultural and literacy populations: a systematic review

Background: Touchscreen cognitive tools opened new promising opportunities for the early detection of cognitive impairment; however, most research studies are conducted in English-speaking populations and high-income countries, with a gap in knowledge about their use in populations with cultural, linguistic, and educational diversity.Objective: To review the touchscreen tools used in primary care settings for the cognitive assessment of mild cognitive impairment (MCI) and dementia, with a focus on populations of different cultures, languages, and literacy.Methods: This systematic review was conducted following the PRISMA guidelines. Studies were identified by searching across MEDLINE, EMBASE, EBSCO, OVID, SCOPUS, SCIELO, LILACS, and by cross-referencing. All studies that provide a first-level cognitive assessment for MCI and dementia with any touchscreen tools suitable to be used in the context of primary care were included.Results: Forty-two studies reporting on 30 tools and batteries were identified. Substantial differences among the tools emerged, in terms of theoretical framework, clinical validity, and features related to the application in clinical practice. A small proportion of the tools are available in multiple languages. Only 7 out of the 30 tools have a multiple languages validation. Only two tools are validated in low-educated samples, e.g., IDEA and mSTS-MCI.Conclusion: General practitioners can benefit from touchscreen cognitive tools. However, easy requirements of the device, low dependence on the examiner, fast administration, and adaptation to different cultures and languages are some of the main features that we need to take into consideration when implementing touchscreen cognitive tools in the culture and language of underrepresented populations

The effect of morphology on spelling and reading accuracy: A study on Italian children

In opaque orthographies knowledge of morphological information helps in achieving reading and spelling accuracy. In transparent orthographies with regular print-to-sound correspondences, such as Italian, the mappings of orthography onto phonology and phonology onto orthography are in principle sufficient to read and spell most words. The present study aimed to investigate the role of morphology in the reading and spelling accuracy of Italian children as a function of school experience to determine whether morphological facilitation was present in children learning a transparent orthography. The reading and spelling performances of 15 third-grade and 15 fifth-grade typically developing children were analyzed. Children read aloud and spelled both low-frequency words and pseudowords. Low-frequency words were manipulated for the presence of morphological structure (morphemic words vs non-derived words). Morphemic words could also vary for the frequency (high vs low) of roots and suffixes. Pseudo-words were made up of either a real root and a real derivational suffix in a combination that does not exist in the Italian language or had no morphological constituents. Results showed that, in Italian, morphological information is a useful resource for both reading and spelling. Typically developing children benefitted from the presence of morphological structure when they read and spelled pseudowords; however, in processing low-frequency words, morphology facilitated reading but not spelling. These findings are discussed in terms of morpho-lexical access and successful cooperation between lexical and sublexical processes in reading and spelling

Spelling acquisition in a consistent orthography: The facilitatory effect of syllable frequency in novice spellers

This study investigates the effects of two sublexical variables, syllable frequency, and word length, in the spelling acquisition of novice spellers dealing with a transparent orthography, such as Italian. Two groups of 1 st-grade Italian children were tested respectively after 4 and 8 months of schooling, with a spelling-to-dictation task of single words created ad hoc by manipulating syllable frequency orthogonally (high vs low frequency of the first syllable) and length (short vs long words). The results show that after only four months of schooling, children could offset their difficulty in writing long words by taking advantage of the high frequency of the initial syllable. However, the regularity of Italian spelling makes it easy to capture fine-sized phoneme-to-grapheme units, rendering the syllable effect no longer detectable in more schooled children

Sleepiness, Neuropsychological Skills, and Scholastic Learning in Children

Abstract: Excessive daytime sleepiness is a frequent condition among children and adolescents that may lead to several and significant daytime consequences, including impaired neurocognitive skills and scholastic performance. Here, we evaluated in one hundred and ninety-one unselected primary school children, the relationship between sleepiness and a wide range of cognitive and academic skills through a standardized neuropsychological test battery. In order to assess the statistical relationship, we performed a partial least squares path modelling, a non-parametrical approach which combined a model of paths between latent variables and the coefficients between indicators and dimensions. Results were validated through the bootstrap approach and suggest that sleepiness is not associated with all cognitive and scholastic abilities, but only with those relying on verbal abilities and complex cognitive functions (i.e., reading comprehension, oral/syntactic comprehension, spelling, and mathematic skills). Our data suggest the idea that sleepiness in children is associated mostly with “higher” (mainly verbal) cognitive function(s), while the visuospatial domain was not affected

The Simple View of Reading in Children Acquiring a Regular Orthography (Italian): A Network Analysis Approach

In the present study, we explored the unique contribution of reading accuracy, reading fluency and linguistic comprehension within the frame of Simple View of Reading (SVR). The experimental sample included 118 3rd to 5th grade children learning Italian, a language with a highly regular orthography. We adopted a flexible method of analysis, i.e., the Network Analysis (NA), particularly suited for exploring relations among different domains and where the direct relations between a set of intercorrelated variables is the main interest. Results indicated an independent and unique contribution of syntactic comprehension skills as well as reading fluency and reading accuracy in the comprehension of a written text. The decoding measures were not directly associated with non-verbal reasoning and the latter was not directly associated with reading comprehension but was strongly related to oral syntactic comprehension. Overall, the pattern of findings is broadly consistent with the predictions of SVR and underscores how, in an orthographically regular language, reading fluency and reading accuracy as well as oral comprehension skills directly influence reading comprehension. Data are discussed in a cross-linguistic perspective. Implications for education and rehabilitation are also presented

Ability to Consolidate Instances as a Proxy for the Association Among Reading, Spelling, and Math Learning Skill

Learning skills (as well as disorders) tend to be associated; however, cognitive models typically focus either on reading, spelling or maths providing no clear basis for interpreting this phenomenon. A recent new model of learning cognitive skills proposes that the association among learning skills (and potentially the comorbidity of learning disorders) depends in part from the individual ability to consolidate instances (taken as a measure of rate of learning). We examined the performance of typically developing fifth graders over the acquisition of a novel paper-and-pencil task that could be solved based on an algorithm or, with practice, with reference to specific instances. Our aim was to establish a measure of individual rate of learning using parameters envisaged by the instance theory of automatization by Logan and correlate it to tasks requiring knowledge of individual items (e.g., spelling words with an ambiguous transcription) or tasks requiring the application of a rule or an algorithm (e.g., spelling non-words). The paper-and-pencil procedure yielded acquisition curves consistent with the predictions of the instance theory of automatization (i.e., they followed a power function fit) both at a group and an individual level. Performance in tasks requiring knowledge of individual items (such as doing tables or the retrieval of lexical representations) but not in tasks requiring the application of rules or algorithms (such as judging numerosity or spelling through sublexical mapping) was significantly predicted by the learning parameters of the individual power fits. The results support the hypothesis that an individual dimension of “ability to consolidate instances” contributes to learning skills such as reading, spelling, and maths, providing an interesting heuristic for understanding the comorbidity across learning disorders

Independent adaptation mechanisms for numerosity and size perception provide evidence against a common sense of magnitude

Abstract How numerical quantity is processed is a central issue for cognition. On the one hand the “number sense theory” claims that numerosity is perceived directly, and may represent an early precursor for acquisition of mathematical skills. On the other, the “theory of magnitude” notes that numerosity correlates with many continuous properties such as size and density, and may therefore not exist as an independent feature, but be part of a more general system of magnitude. In this study we examined interactions in sensitivity between numerosity and size perception. In a group of children, we measured psychophysically two sensory parameters: perceptual adaptation and discrimination thresholds for both size and numerosity. Neither discrimination thresholds nor adaptation strength for numerosity and size correlated across participants. This clear lack of correlation (confirmed by Bayesian analyses) suggests that numerosity and size interference effects are unlikely to reflect a shared sensory representation. We suggest these small interference effects may rather result from top-down phenomena occurring at late decisional levels rather than a primary “sense of magnitude”

Visuo-spatial working memory and mathematical skills in children: a network analysis study

Visuo-spatial working memory is one of the main domain-general cognitive mechanisms underlying mathematical abilities and their development in children. However, if visuo-spatial working memory involves different processes and components, then the term ‘mathematics’ refers to a broad concept that includes multiple domains and skills. The aim of this present study was to investigate the relationship between different visuo-spatial working memory components and several mathematical abilities in a sample of third- to fifth-grade Italian children. To assess the relationships between different visuo-spatial working memory components and different mathematical abilities, we relied on Network Analysis (NA). Results indicate that some but not all visuo-spatial working memory components are associated with some mathematical abilities

Genuine Memory Deficits as Assessed by the Free and Cued Selective Reminding Test (FCSRT) in the Behavioural Variant of Frontotemporal Dementia. A Systematic Review and Meta-analysis Study

The current diagnostic criteria for the behavioural variant of frontotemporal dementia (bvFTD) foresee a relative sparing of long-term memory. Although bvFTD patients were thought to report secondary memory deficits associated with prefrontal dysfunctions, some studies indicated the presence of a "genuine memory deficit" related to mesial temporal lobe dysfunctions. Among various neuropsychological tests, the Free and Cue Selective Reminding Test (FCSRT) has been recommended to distinguish genuine from apparent amnesia. We conducted a systematic review and a random effect Bayesian meta-analysis to evaluate the nature and severity of memory deficit in bvFTD. Our objective was to determine whether the existing literature offers evidence of genuine or apparent amnesia in patients with bvFTD, as assessed via the FCSRT. On 06/19/2021, we conducted a search across four databases (PMC, Scopus, Web of Science, and PubMed). We included all studies that evaluated memory performance using the FCSRT in patients with bvFTD, as long as they also included either cognitively unimpaired participants or AD groups. We tested publication bias through the Funnel plot and Egger's test. To assess the quality of studies, we used the Newcastle-Ottawa quality assessment scale adapted for cross-sectional studies. We included 16 studies in the meta-analysis. The results showed that bvFTD patients perform better than AD patients (pooled effects between 0.95 and 1.14), as their memory performance stands between AD and control groups (pooled effects between - 2.19 and - 1.25). Moreover, patients with bvFTD present both genuine and secondary memory disorders. As a major limitation of this study, due to our adoption of a rigorous methodology and stringent inclusion criteria, we ended up with just 16 studies. Nonetheless, our robust findings can contribute to the ongoing discussion on international consensus criteria for bvFTD and the selection of appropriate neuropsychological tools to facilitate the differential diagnosis between AD and bvFTD