The impact of interactive book sharing on child cognitive and socio-cognitive development (the REaL trial): study protocol for a randomized controlled trial.

BACKGROUND: The quality of children's early home learning environment has an influence on their cognitive development, preliteracy skills, and subsequent educational outcomes. Early intervention programs that promote positive parenting behaviors and child cognition have great potential to positively influence children's school readiness and thereby support social equality. One often advocated parental practice for promoting child language and cognition is interactive book sharing. METHODS: We have conducted a randomized controlled trial to evaluate the effects of a parent-child interactive book sharing intervention on early child language, cognition, and parental behaviors. Participating caregivers and their 10-month-old child were randomized to an interactive book sharing intervention group (n = 59) or to an active control group (n = 56). The intervention was delivered by a facilitator to small groups of parent-child dyads on a weekly basis over 5 weeks. The primary outcomes were child language and socio-cognition; secondary outcomes were child executive function and parental scaffolding, sensitivity and reciprocity during book sharing, and problem-solving tasks. Data were collected at baseline, post-intervention, and at 6 and 12 months post-intervention. DISCUSSION: The Roadmap to Executive function and Language (REaL) trial aims to evaluate the impact of a brief early parenting intervention on key factors for child development, including child cognition and parental behaviors. If this intervention is beneficial for child outcomes, that would be of significance for the development of early interventions to promote child development. TRIAL REGISTRATION: The REaL trial is registered on the International Standard Randomized Controlled Trial Number database, registration number ISRCTN22319305. Retrospectively registered on 7 February 2020.

Predicting children's emerging understanding of numbers.

How do children construct a concept of natural numbers? Past research addressing this question has mainly focused on understanding how children come to acquire the cardinality principle. However, at that point children already understand the first number words and have a rudimentary natural number concept in place. The question therefore remains; what gets children's number learning off the ground? We therefore, based on previous empirical and theoretical work, tested which factors predict the first stages of children's natural number understanding. We assessed if children's expressive vocabulary, visuospatial working memory, and ANS (Approximate number system) acuity at 18 months of age could predict their natural number knowledge at 2.5 years of age. We found that early expressive vocabulary and visuospatial working memory were important for later number knowledge. The results of the current study add to a growing body of literature showing the importance of language in children's learning about numbers.

Social and emotional contexts predict the development of gaze following in early infancy.

The development of gaze following begins in early infancy and its developmental foundation has been under heavy debate. Using a longitudinal design (N = 118), we demonstrate that attachment quality predicts individual differences in the onset of gaze following, at six months of age, and that maternal postpartum depression predicts later gaze following, at 10 months. In addition, we report longitudinal stability in gaze following from 6 to 10 months. A full path model (using attachment, maternal depression and gaze following at six months) accounted for 21% of variance in gaze following at 10 months. These results suggest an experience-dependent development of gaze following, driven by the infant's own motivation to interact and engage with others (the social-first perspective).

The social foundation of executive function.

In this study, we propose that infant social cognition may 'bootstrap' the successive development of domain-general cognition in line with the cultural intelligence hypothesis. Using a longitudinal design, 6-month-old infants (N = 118) were assessed on two basic social cognitive tasks targeting the abilities to share attention with others and understanding other peoples' actions. At 10 months, we measured the quality of the child's social learning environment, indexed by parent's abilities to provide scaffolding behaviors during a problem-solving task. Eight months later, the children were followed up with a cognitive test-battery, including tasks of inhibitory control and working memory. Our results showed that better infant social action understanding interacted with better parental scaffolding skills in predicting simple inhibitory control in toddlerhood. This suggests that infants' who are better at understanding other's actions are also better equipped to make the most of existing social learning opportunities, which in turn may benefit future non-social cognitive outcomes.

Early development of visual attention in infants in rural Malawi.

Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high-resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312-376, depending on analysis). Infants were assessed with eye-tracking-based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd-even split-half and test-retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well-being, socioeconomic status, and care practices). The results replicate infants' early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low-resource settings. The results provided no evidence that the initial manifestation of infants' attentional capacities is associated with risk factors that are common in low-resource environments.

Training Basic Visual Attention Leads to Changes in Responsiveness to Social-Communicative Cues in 9-Month-Olds.

This study investigated transfer effects of gaze-interactive attention training to more complex social and cognitive skills in infancy. Seventy 9-month-olds were assigned to a training group (n = 35) or an active control group (n = 35). Before, after, and at 6-week follow-up both groups completed an assessment battery assessing transfer to nontrained aspects of attention control, including table top tasks assessing social attention in seminaturalistic contexts. Transfer effects were found on nontrained screen-based tasks but importantly also on a structured observation task assessing the infants' likelihood to respond to an adult's social-communication cues. The results causally link basic attention skills and more complex social-communicative skills and provide a principle for studying causal mechanisms of early development.

Saccadic reaction times in infants and adults: Spatiotemporal factors, gender, and interlaboratory variation.

Saccade latency is widely used across infant psychology to investigate infants' understanding of events. Interpreting particular latency values requires knowledge of standard saccadic RTs, but there is no consensus as to typical values. This study provides standard estimates of infants' (n = 194, ages 9 to 15 months) saccadic RTs under a range of different spatiotemporal conditions. To investigate the reliability of such standard estimates, data is collected at 4 laboratories in 3 countries. Results indicate that reactions to the appearance of a new object are much faster than reactions to the deflection of a currently fixated moving object; upward saccades are slower than downward or horizontal saccades; reactions to more peripheral stimuli are much slower; and this slowdown is greater for boys than girls. There was little decrease in saccadic RTs between 9 and 15 months, indicating that the period of slow development which is protracted into adolescence begins in late infancy. Except for appearance and deflection differences, infant effects were weak or absent in adults (n = 40). Latency estimates and spatiotemporal effects on latency were generally consistent across laboratories, but a number of lab differences in factors such as individual variation were found. Some but not all differences were attributed to minor procedural differences, highlighting the importance of replication. Confidence intervals (95%) for infants' median reaction latencies for appearance stimuli were 242 to 250 ms and for deflection stimuli 350 to 367 ms. (PsycINFO Database Record

Eye-tracking-based assessment of cognitive function in low-resource settings.

BACKGROUND: Early development of neurocognitive functions in infants can be compromised by poverty, malnutrition and lack of adequate stimulation. Optimal management of neurodevelopmental problems in infants requires assessment tools that can be used early in life, and are objective and applicable across economic, cultural and educational settings. OBJECTIVE AND DESIGN: The present study examined the feasibility of infrared eye tracking as a novel and highly automated technique for assessing visual-orienting and sequence-learning abilities as well as attention to facial expressions in young (9-month-old) infants. Techniques piloted in a high-resource laboratory setting in Finland (N=39) were subsequently field-tested in a community health centre in rural Malawi (N=40). RESULTS: Parents' perception of the acceptability of the method (Finland 95%, Malawi 92%) and percentages of infants completing the whole eye-tracking test (Finland 95%, Malawi 90%) were high, and percentages of valid test trials (Finland 69-85%, Malawi 68-73%) satisfactory at both sites. Test completion rates were slightly higher for eye tracking (90%) than traditional observational tests (87%) in Malawi. The predicted response pattern indicative of specific cognitive function was replicated in Malawi, but Malawian infants exhibited lower response rates and slower processing speed across tasks. CONCLUSIONS: High test completion rates and the replication of the predicted test patterns in a novel environment in Malawi support the feasibility of eye tracking as a technique for assessing infant development in low-resource setting. Further research is needed to the test-retest stability and predictive validity of the eye-tracking scores in low-income settings.

Attention to Faces Expressing Negative Emotion at 7 Months Predicts Attachment Security at 14 Months.

To investigate potential infant-related antecedents characterizing later attachment security, this study tested whether attention to facial expressions, assessed with an eye-tracking paradigm at 7 months of age (N = 73), predicted infant-mother attachment in the Strange Situation Procedure at 14 months. Attention to fearful faces at 7 months predicted attachment security, with a smaller attentional bias to fearful expressions associated with insecure attachment. Attachment disorganization in particular was linked to an absence of the age-typical attentional bias to fear. These data provide the first evidence linking infants' attentional bias to negative facial expressions with attachment formation and suggest reduced sensitivity to facial expressions of negative emotion as a testable trait that could link attachment disorganization with later behavioral outcomes.

Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

Developmental precursors of social brain networks: the emergence of attentional and cortical sensitivity to facial expressions in 5 to 7 months old infants.

Biases in attention towards facial cues during infancy may have an important role in the development of social brain networks. The current study used a longitudinal design to examine the stability of infants' attentional biases towards facial expressions and to elucidate how these biases relate to emerging cortical sensitivity to facial expressions. Event-related potential (ERP) and attention disengagement data were acquired in response to the presentation of fearful, happy, neutral, and phase-scrambled face stimuli from the same infants at 5 and 7 months of age. The tendency to disengage from faces was highly consistent across both ages. However, the modulation of this behavior by fearful facial expressions was uncorrelated between 5 and 7 months. In the ERP data, fear-sensitive activity was observed over posterior scalp regions, starting at the latency of the N290 wave. The scalp distribution of this sensitivity to fear in ERPs was dissociable from the topography of face-sensitive modulation within the same latency range. While attentional bias scores were independent of co-registered ERPs, attention bias towards fearful faces at 5 months of age predicted the fear-sensitivity in ERPs at 7 months of age. The current results suggest that the attention bias towards fear could be involved in the developmental tuning of cortical networks for social signals of emotion.

Eighteen-month-olds' ability to make gaze predictions following distraction or a long delay.

The abilities to flexibly allocate attention, select between conflicting stimuli, and make anticipatory gaze movements are important for young children's exploration and learning about their environment. These abilities constitute voluntary control of attention and show marked improvements in the second year of a child's life. Here we investigate the effects of visual distraction and delay on 18-month-olds' ability to predict the location of an occluded target in an experiment that requires switching of attention, and compare their performance to that of adults. Our results demonstrate that by 18 months of age children can readily overcome a previously learned response, even under a condition that involves visual distraction, but have difficulties with correctly updating their prediction when presented with a longer time delay. Further, the experiment shows that, overall, the 18-month-olds' allocation of visual attention is similar to that of adults, the primary difference being that adults demonstrate a superior ability to maintain attention on task and update their predictions over a longer time period.

Individual differences in 10-month-olds' performance on the A-not-B task.

This study used the classical A-not-B task (Piaget, ) to explore individual differences in cognitive flexibility in 10-month-old infants by: (1) examining how differences in search performance during A trials relate to search performance during B trials; (2) studying the relation between temperamental dimensions and A-not-B performance; and (3) investigating differences in search performance between looking and reaching responses within the same task. Forty infants were tested on a fixed-design-version of the A-not-B task, not allowing for training or individual adjustment, but instead eliciting additional search behaviors than the common correct responses in A trials and perseverative errors in B trials. Infants were also rated by their parents on the temperamental scales Activity level and Attention span. The main findings were: (1) performance on A trials affected B trial performance, with infants being more correct on A trials having more incorrect and less 'no search' responses on B trials; (2) activity level, but not attention span, was related to performance on the A-not-B task, with infants performing better on A trials having a lower activity level; and (3) there were a few differences in performance with regard to modality, indicating that responding correctly by looking may be less cognitively demanding than doing so by reaching. This study demonstrated that 10-month-olds show a wide variation of search behaviors on this A-not-B task, resulting in individual differences in performance. These differences are suggested to reflect variation in temperamental activity level as well as maturity of short term/working memory, inhibition and cognitive flexibility.

A graphical user interface for infant ERP analysis.

Recording of event-related potentials (ERPs) is one of the best-suited technologies for examining brain function in human infants. Yet the existing software packages are not optimized for the unique requirements of analyzing artifact-prone ERP data from infants. We developed a new graphical user interface that enables an efficient implementation of a two-stage approach to the analysis of infant ERPs. In the first stage, video records of infant behavior are synchronized with ERPs at the level of individual trials to reject epochs with noncompliant behavior and other artifacts. In the second stage, the interface calls MATLAB and EEGLAB (Delorme & Makeig, Journal of Neuroscience Methods 134(1):9-21, 2004) functions for further preprocessing of the ERP signal itself (i.e., filtering, artifact removal, interpolation, and rereferencing). Finally, methods are included for data visualization and analysis by using bootstrapped group averages. Analyses of simulated and real EEG data demonstrated that the proposed approach can be effectively used to establish task compliance, remove various types of artifacts, and perform representative visualizations and statistical comparisons of ERPs. The interface is available for download from http://www.uta.fi/med/icl/methods/eeg.html in a format that is widely applicable to ERP studies with special populations and open for further editing by users.

Regulatory variant of the TPH2 gene and early life stress are associated with heightened attention to social signals of fear in infants.

BACKGROUND: Cross-species evidence suggests that genetic and experiential factors act early in development to establish individual emotional traits, but little is known about the mechanisms that emerge during this period to mediate long-term outcomes. Here, we tested the hypothesis that known genetic and environmental risk conditions may heighten infants' natural tendency to attend to threat-alerting stimuli, resulting in a cognitive bias that may contribute to emotional vulnerability. METHODS: Data from two samples of 5-7-month-old infants (N = 139) were used to examine whether established candidate variations in the serotonin-system genes, i.e., TPH2 SNP rs4570625 (-703 G/T) and HTR1A SNP rs6295 (-1019 G/C), and early rearing condition (maternal stress and depressive symptoms) are associated with alterations in infants' attention to facial expressions. Infants were tested with a paradigm that assesses the ability to disengage attention from a centrally presented stimulus (a nonface control stimulus or a neutral, happy, or fearful facial expression) toward the location of a new stimulus in the visual periphery (a geometric shape). RESULTS: TPH2 -703 T-carrier genotype (i.e., TT homozygotes and heterozygotes), presence of maternal stress and depressive symptoms, and a combination of the T-carrier genotype and maternal depressive symptoms were associated with a relatively greater difficulty disengaging attention from fearful facial expressions. No associations were found with infants' temperamental traits. CONCLUSIONS: Alterations in infants' natural attentional bias toward fearful facial expressions may emerge prior to the manifestation of emotional and social behaviors and provide a sensitive marker of early emotional development.

Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents.

OBJECTIVE: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. METHOD: A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. RESULTS: The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. CONCLUSION: These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

Attention demands influence 10- and 12-month-old infants' perseverative behavior.

The present study examined the role of attentional demand on infants' perseverative behavior in a noncommunicative looking version of an A-not-B task. The research aimed at clarifying age-related improvements in the attention process that presumably underlies the development of cognitive control. In a between-subjects design, forty 10-month-olds and forty 12-month-olds were assigned to either a distractor or a no-distractor condition as a means of testing the role of attentional load. The authors used an eye tracker to record infants' looking behavior while they anticipated the reappearance of the target of interest as well as continuously throughout the task. The data demonstrated that 10-month-olds show more perseverative looking than do 12-month-olds and that increased attentional demand leads to more perseverative looking. Correct anticipation, however, was not affected by age or distraction. The results also failed to show that 12-month-olds are better than 10-month-olds at handling the increased attentional demand introduced in the distractor condition, in that the effect of the distractor was not larger for the younger infants. Our results are in line with the theoretical view of cognitive control as dependent on a limited attentional resource, which can explain perseverative behaviors in different tasks and at different ages.

The relation between working memory components and ADHD symptoms from a developmental perspective.

The objective was to examine the relations between attention deficit hyperactivity disorder (ADHD) symptoms and four working memory (WM) components (short-term memory and central executive in verbal and visuospatial domains) in 284 6-16-year-old children from the general population. The results showed that verbal and visuospatial short-term memory and verbal central executive uniquely contributed to inattention symptoms. Age interacted with verbal short-term memory in predicting inattention, with the relation being stronger in older children. These findings support the notion of ADHD as a developmental disorder, with changes in associated neuropsychological deficits across time. The results further indicate ADHD-related deficits in several specific WM components.

Independent contributions of cognitive functioning and social risk factors to symptoms of ADHD in two nordic populations-based cohorts.

This study examined independent contributions of executive functioning (EF), state regulation (SR), and social risk factors to symptom dimensions of attention deficit hyperactivity disorder (ADHD) in two cohorts, which included 221 Norwegian children and 294 Finnish adolescents. Independent contributions of EF and SR were shown in the Norwegian cohort and EF contributed independently in the Finnish cohort. When controlling for each symptom dimension, cognitive functioning and social risk factors were differentially associated with inattention and hyperactivity/impulsivity symptoms. The results show the need to include both social risk factors and cognitive functioning to obtain a better understanding of ADHD symptoms.