Coactivation of Autonomic and Central Nervous Systems During Processing of Socially Relevant Information in Autism Spectrum Disorder: A Systematic Review.

Body-brain interaction provides a novel approach to understand neurodevelopmental conditions such as autism spectrum disorder (ASD). In this systematic review, we analyse the empirical evidence regarding coexisting differences in autonomic (ANS) and central nervous system (CNS) responses to social stimuli between individuals with ASD and typically developing individuals. Moreover, we review evidence of deviations in body-brain interaction during processing of socially relevant information in ASD. We conducted systematic literature searches in PubMed, Medline, PsychInfo, PsychArticles, and Cinahl databases (until 12.1.2022). Studies were included if individuals with ASD were compared with typically developing individuals, study design included processing of social information, and ANS and CNS activity were measured simultaneously. Out of 1892 studies identified based on the titles and abstracts, only six fulfilled the eligibility criteria to be included in synthesis. The quality of these studies was assessed using a quality assessment checklist. The results indicated that individuals with ASD demonstrate atypicalities in ANS and CNS signalling which, however, are context dependent. There were also indications for altered contribution of ANS-CNS interaction in processing of social information in ASD. However, the findings must be considered in the context of several limitations, such as small sample sizes and high variability in (neuro)physiological measures. Indeed, the methodological choices varied considerably, calling for a need for unified guidelines to improve the interpretability of results. We summarize the current experimentally supported understanding of the role of socially relevant body-brain interaction in ASD. Furthermore, we propose developments for future studies to improve incremental knowledge building across studies of ANS-CNS interaction involving individuals with ASD.

Cognitive and non-cognitive factors in educational and occupational outcomes-Specific to reading disability?

Low education and unemployment are common adult-age outcomes associated with childhood RD (c-RD). However, adult-age cognitive and non-cognitive factors associated with different outcomes remain unknown. We studied whether these outcomes are equally common among individuals with c-RD and controls and whether these outcomes are related to adult-age literacy skills or cognitive and non-cognitive factors or their interaction with c-RD. We examined adult participants with c-RD (n = 48) and their matched controls (n = 37). Low education was more common among c-RD than the controls, whereas long-term unemployment was equally common in both groups. Moreover, adult-age literacy skills, cognitive skills and non-cognitive factors were related to both low education and long-term unemployment. Only a few c-RD-specific associations emerged: c-RD, especially in interaction with low verbal or reading comprehension, was associated with low education, and c-RD in interaction with slow adult-age reading was associated with long-term unemployment. Avoidant coping style, emotional wellbeing and social functioning were related to education, and life-satisfaction to unemployment irrespective of c-RD. Thus, the non-cognitive factors associated with education and employment are similar in individuals with and without c-RD. Special attention should be paid to training c-RD individuals in basic academic, social and emotional skills.

Resolving reading disability-Childhood predictors and adult-age outcomes.

We examined frequency of adult-age reading disability (RD) and its childhood predictors among 48 adults (20 to 39 years) with documented childhood RD, and contrasted their cognitive skills, education, and employment with 37 matched controls. Among individuals with childhood RD, more than half had improved in their reading fluency to the level where the set criterion for adult-age RD was not met anymore. More fluent rapid naming, less severe childhood RD, and multiple support providers in childhood together predicted improvement of reading fluency. More fluent naming differentiated the childhood RD participants whose reading fluency had improved by adult-age from those participants whose RD persisted to adult-age. All the individuals with childhood RD performed weaker than the controls in adult-age working memory, processing speed, and verbal skills. Educational level among both RD groups was lower than that among the controls. Unemployment of individuals with persistent adult-age RD (31.6%) was higher than that of individuals with improved adult-age RD (13.8%) or that of the controls (8.1%). According to our findings, rapid naming is one evident factor differentiating individuals with persisted RD from those with ameliorated reading fluency. Also, better adult-age reading fluency has significance for adult-age employment among individuals with childhood RD.

Adolescents' school-related self-concept mediates motor skills and psychosocial well-being.

BACKGROUND: The health benefits of exercise participation and physical activity for mental health and psychosocial well-being (PSWB) have been shown in several studies. However, one important background factor, that is, motor skills (MSs), has largely been ignored. In addition, most of the existing research focuses on poor MSs, that is, poor MSs are often connected to poorer PSWB. The mechanism linking MSs and PSWB is unclear. However, a preliminary suggestion has been made that self-worth or self-perceptions might mediate the association between MSs and PSWB. AIM: We investigated whether the self-concepts (SCs) of school-related physical education (SCPE), reading (SCR), and mathematics (SCM) mediate the relationship between MSs and PSWB in adolescence. METHODS: The study sample consisted of a second-grade female cohort (N = 327), ranging in age between 12 and 16 (years) in a municipality in Central Finland. PSWB was measured by the Strengths and Difficulties Questionnaire and the school-related SCs by the SC of ability scale adapted for use in Finland. MSs was assessed by a self-reported adolescent version of the Developmental Coordination Disorder Questionnaire. Structural mediator modelling was used to test the associations between MSs and PSWB with SC as a mediator. RESULTS: First, MSs was strongly associated with school-related SCPE and SCM. However, a mediator role was observed only for SCPE, which weakly mediated peer problems. Second, MSs and PSWB, especially conduct problems, showed a very strong direct association. CONCLUSIONS: The study suggests that MSs is connected to PSWB in adolescent girls. Enhancement of MSs could be a preventive strategy for supporting PSWB in adolescent girls.

Predicting adult-age mental health with childhood reading and math disability: do resilience and coping styles matter?

We studied the associations between childhood-identified learning disabilities and adult-age mental health and whether adult-age reading and math skills, coping styles, or resilience influenced the associations. The participants were 159 Finnish adults (60.4% males). Of them, 48 (30%) had a reading disability (RD), 22 (14%) had a math disability (MD), 21 (13%) had RD + MD identified in childhood, and 68 (43%) were population-based controls, matched based on gender, age, and place of residence. At ages 20-40 (Mage = 29), they reported their mental health, coping styles, and resilience, and their reading and math skills were assessed. The hierarchical regression analyses, predicting mental health with RD, MD, and their interaction while controlling for gender and age, indicated that childhood MD predicted the occurrence of more mental health problems in adulthood, but this was not observed in the case of RD. The RDxMD positive interaction effect reflected better mental health in both the RD and the RD + MD groups than in the MD group. Controlling for adult-age reading and math skills had no effect on the association between MD and mental health outcomes while controlling for resilience and coping styles diminished the impact of MD. Strong resilience without the use of an emotion-oriented coping may thus alleviate the association between MD and mental health. As childhood MD can have long-term associations with mental health problems, these issues need to be addressed in school, at work, and in healthcare. Based on our findings, strengthening effective coping and resilience may be one avenue of support.

A Register Study Suggesting Homotypic and Heterotypic Comorbidity Among Individuals With Learning Disabilities.

The present study examined whether learning disabilities (LD) in reading and/or math (i.e., reading disability [RD], math disability [MD], and RD+MD) co-occur with other diagnoses. The data comprised a clinical sample (n = 430) with LD identified in childhood and a sample of matched controls (n = 2,140). Their medical diagnoses (according to the International Classification of Diseases nosology) until adulthood (20-39 years) were analyzed. The co-occurrence of LD with neurodevelopmental disorders was considered a homotypic comorbidity, and co-occurrence with disorders or diseases from the other diagnostic categories (i.e., mental and behavioral disorders, diseases of the nervous system, injuries, other medical or physical diagnoses) was considered a heterotypic comorbidity. Both homotypic and heterotypic comorbidity were more common in the LD group. Co-occurring neurodevelopmental disorders were the most prominent comorbid disorders, but mental and behavioral disorders, diseases of the nervous system, and injuries were also pronounced in the LD group. Accumulation of diagnoses across the diagnostic categories was more common in the LD group. No differences were found among the RD, MD, and RD+MD subgroups. The findings are relevant from the theoretical perspective, as well as for clinical and educational practice, as they provide understanding regarding individual distress and guiding for the planning of support.

Returning to Work after Stroke: Associations with Cognitive Performance, Motivation, Perceived Working Ability and Barriers.

OBJECTIVE: To investigate post-stroke return-to-work and its associations with cognitive performance, motivation, perceived working ability, and self-perceived barriers to returning to work. DESIGN: Prospective cohort study of a clinical sample. SUBJECTS AND METHODS: Participants were 77 stroke patients younger than age 69 years. Assessment included a cognitive screening method for stroke patients (CoMet), a questionnaire regarding work-related matters, and a question regarding motivation to return to work. A predictive model of return-to-work was built, and how participants managed in their working life was examined. RESULTS: Cognitive performance was significantly connected with returning to work. Three of the 5 individuals who dropped out of working life had cognitive dysfunction. Cognitive performance predicted 80% of those who had not returned and 37% of those who had returned by 6 months after the initial assessment. Self-perceived working ability and barriers predicted 64% of those who had not returned and 78% of those who had returned at the 12-month follow-up. CONCLUSION: Cognitive performance seems to be a crucial predictor of return-to-work post-stroke, but individuals' own evaluations of their working capabilities are also important.

School-based group intervention in attention and executive functions: Intervention response and moderators.

Objective: This study investigated the effects of a school-based skill-training intervention in attention control and executive functions for pupils with hyperactivity-impulsivity (H-I) and cognitive control (CC) deficits. The main aim was to examine whether the intervention differently influenced H-I and CC, and whether cognitive abilities or conduct problems moderated response to the intervention. Method: Elementary school pupils from 41 schools participated the study and were divided into an intervention group (n = 71) and a waitlist control group (n = 77). Intervention outcomes were assessed with an inventory assessing executive function difficulties (including H-I and CC) completed by classroom teachers. Results: Significant intervention effects and positive changes were detected in CC but not in H-I. Significant intervention effects were found mainly among pupils with low levels of conduct problems. Conclusions: The results suggest that a skill-training intervention has specific positive effects on CC, but conduct problems may diminish response to intervention.

Learning Disabilities Elevate Children's Risk for Behavioral-Emotional Problems: Differences Between LD Types, Genders, and Contexts.

Our purpose was to study the frequency of behavioral-emotional problems among children identified with a learning disability (LD). The data were obtained for 579 Finnish children (8-15 years) with reading disability (RD-only), math disability (MD-only), or both (RDMD) assessed at a specialized clinic between 1985 and 2017. We analyzed percentages of children with behavioral-emotional symptoms reaching clinical range (i.e., z score ≥1.5 SDs) and the effects of the LD type, gender, and context (home vs. school) on them. Furthermore, we analyzed the effect of the severity of LD and gender on the amount of behavioral-emotional symptoms reported by teachers and parents. Alarmingly high percentages of children, irrespective of LD type, demonstrated behavioral-emotional problems: more than 37% in Affective, Anxiety, and Attention-Deficit/Hyperactivity Disorder (ADHD) problems. Contextual variation was large, as more problems were reported by teachers than by mothers. The unique effects of gender and LD type were rare, but the results raised concern for those with MD-only, especially boys. The results underscore the need to draw attention to the importance of assessing children with LD for behavioral-emotional problems and emphasize the importance of teachers' awareness of behavioral-emotional problems among students with LD and cooperation among child, teacher, and parents in assessment and support planning.

Longitudinal and situational associations between math anxiety and performance among early adolescents.

Studies have found math anxiety and achievement to be related from the beginning of formal schooling, but the knowledge regarding the direction of the relationship is vague. The purpose of the present study was to study this relationship. We investigated math anxiety from two points of view: trait and state anxiety. In the first substudy, we investigated the longitudinal relationship between math anxiety and performance from sixth to seventh grade (n = 848) with cross-lagged modeling. In the second substudy, we investigated the situational relationship of anxiety and performance by giving the participants (n = 149) challenging and nonchallenging math tasks adapted to their skill level, and then examining the association between anxiety and the performance. The results suggest that math anxiety has a small longitudinal effect on performance: High anxiety in sixth grade predicted low performance in seventh grade. Anxiety also had a situational association with performance: when anxiety was aroused, the participants performed more poorly compared to their skill level. The results adduce the two-fold effect of anxiety on achievement: math anxiety seems to have both a real-time association with performance and a long-term effect on the development of basic arithmetic skills.

Validity of the Play Assessment for Group Settings: an evaluation of differential item functioning between children with specific language impairment and typically developing peers.

AIM: The purpose of this study was to evaluate the validity evidence based on internal structure of the Play Assessment for Group Settings (PAGS). METHODS: The study was conducted in day care centres by comparing observations of the free play performance of two groups of children: those with specific language impairments (SLIs) (n=55) and those with typical language development (n=55). The participating children were 3 to 6.5 years of age. Data were subjected to many-faceted Rasch analyses and differential item functioning analysis was conducted to identify possible group-specific items in the PAGS. The effect of differentially functioning items on mean play performance measurements between two subgroups of children was controlled with two different independent samples t-tests. RESULTS: According to the results, 80% of the test items were stable across the groups of children. Four items were harder for children with SLI, and clearly required language skills. Two items were relatively speaking easier for children with SLI, and reflected explorative functioning. The differential functioning items did not affect the ability of the PAGS to separate the children with SLI in mean play performance from their typically developing peers. CONCLUSION: We concluded that the PAGS is a valid tool for identifying children who have challenges in their play performance and can be used for clinical purposes. However, the slight variability supports the fact that differential item functioning should be controlled in research when using the PAGS for comparison of different subgroups in play performance.

Benefits of Integrating an Explicit Self-Efficacy Intervention With Calculation Strategy Training for Low-Performing Elementary Students.

This study examined the malleability of math self-efficacy (SE) among children with poor calculation fluency via an intervention that targeted four sources of SE (mastery experiences, vicarious experiences, social persuasions, and emotional and physiological states). The effect of pure strategy training was contrasted with an intervention that integrated strategy training and explicit SE support. Moreover, the changes in SE source experiences and their relation with math SE, as well as the relation between math-SE profiles and calculation fluency development, were examined. In a quasi-experimental design, 60 Finnish children with calculation fluency problems in Grades 2 to 4 participated in strategy training (N = 38) or in an intervention that integrated SE support with strategy training (N = 32) for 12 weeks. The results showed that the explicit SE intervention integrated with strategy training enhanced math SE among children with poor calculation fluency and low SE (effect size, r = 0.61). Changes in mastery experiences and social persuasions were positively associated with changes in math SE among children who received the explicit SE intervention. An initially high math-SE profile and a profile indicating an increase from low to high math SE were related to growth in calculation fluency that approached the children's average age level during the interventions. In conclusion, an integrated approach that combined skill training and SE intervention was especially beneficial for children with poor calculation fluency and low math SE.

Effects of multidomain risk accumulation on cognitive, academic, and behavioural outcomes.

This longitudinal study examined the predictive associations between cumulative multidomain risk factors and cognitive (IQ), academic (reading fluency), and social adaptive outcomes at 8 to 9 years among 190 children with or without familial risk for dyslexia. Other risk factors included parental and neurocognitive risks assessed when the children were 1 to 6 years of age. Risks accumulated more among children with familial risk for dyslexia than among children without familial risk. A higher number of risks was associated with poorer performance in all outcome measures as postulated by the cumulative risk model. However, when the effects of individual risk variables were controlled for at the outset, the cumulative risk indices did not have incremental effects beyond those of individual risks. This suggests that the detrimental effect of several risks was due to the content-specific effect of individual risks. Children with familial risk were not differentially affected by the number of risks.

Associations Between Childhood Learning Disabilities and Adult-Age Mental Health Problems, Lack of Education, and Unemployment.

We studied the impact of diverse subtypes of learning disabilities (LD) on adult-age mental health, education, and employment by comparing the LD group ( n = 430) with a matched control group without a known history of LD ( n = 2,149). The clinical archived data were merged with lifelong register data on sickness allowances/disability pensions granted on the basis of psychiatric illnesses, reimbursements for psychoactive medication, having a degree after compulsory education, and having received unemployment allowances. Differences emerged between the LD and control groups in all outcomes, suggesting that a higher proportion of individuals with LD had mental health problems compared to the control group, and a notable share of them had not attained a degree after compulsory education and had been unemployed for an extended period. Subgroup comparisons indicated that math disability (MD) was associated with antidepressant use and unemployment, whereas the reading disability (RD) group showed the least problems with employment. Interactions between subgroup and gender suggested that MD (with/without RD) may pose a higher risk than RD for females, whereas RD seemed to pose a risk for males. The findings suggest the need for researchers, clinicians, and those involved with adult education to consider mental health and educational problems among individuals with LD.

Validation of a New Cognitive Screening Method for Stroke Patients.

OBJECTIVE: Two million adults under fifty years of age have a cerebral stroke every year worldwide. Neuropsychological assessment is the best way to identify poststroke cognitive dysfunction, but it is often time-consuming and can be tiring for the patient, and hospitals vary in their availability of neuropsychological expertise. A valid and reliable cognitive screening method could be advantageous in identifying patients who need comprehensive neuropsychological examination. Our purpose in this study was to validate a newly developed cognitive screening method as an identifier of cognitive dysfunction after stroke in working-aged patients. METHODS: We analyzed new cognitive screening method concurrent validity by comparing it in two groups formed on the basis of a comprehensive neuropsychological examination for 77 stroke patients. We identified the best balance of sensitivity and specificity by using receiver operating characteristic curve analysis and investigated the impact of the sociodemographic variables to the screening method total score variation. RESULTS: We found a significant correlation between the method's total score and performance in neuropsychological examination. The cognitive method's internal consistency was strong; Cronbach's alpha for all items was .818. The best balance of sensitivity (88%) and specificity (50%) was found at a total score cut point of 138. Subjects' age and length of education were each responsible for 10% of total score variation. CONCLUSIONS: This study shows promising results for this new cognitive screening tool's ability to identify poststroke cognitive decline and patients' need for further detailed neuropsychological examination.

Does Multi-Component Strategy Training Improve Calculation Fluency Among Poor Performing Elementary School Children?

The aim of the present study was to extend the previous intervention research in math by examining whether elementary school children with poor calculation fluency benefit from strategy training focusing on derived fact strategies and following an integrative framework, i.e., integrating factual, conceptual, and procedural arithmetic knowledge. It was also examined what kind of changes can be found in frequency of using different strategies. A quasi-experimental design was applied, and the study was carried out within the context of the school and its schedules and resources. Twenty schools in Finland volunteered to participate, and 1376 children were screened in for calculation fluency problems. Children from second to fourth grades were recruited for the math intervention study. Children with low performance (below the 20th percentile) were selected for individual assessment, and indications of using counting-based strategies were the inclusion criteria. Altogether, 69 children participated in calculation training for 12 weeks. Children participated in a group based strategy training twice a week for 45 min. In addition, they had two short weekly sessions for practicing basic addition skills. Along with pre- and post-intervention assessments, a 5-month follow-up assessment was conducted to exam the long-term effects of the intervention. The results showed that children with dysfluent calculation skills participating in the intervention improved significantly in their addition fluency during the intervention period, showing greater positive change than business-as-usual or reading intervention controls. They also maintained the reached fluency level during the 5-month follow-up but did not continue to develop in addition fluency after the end of the intensive training program. There was an increase in fact retrieval and derived fact/decomposition as the preferred strategies in math intervention children and a decrease of the use of counting-based strategies, which were the most common strategies for them before the intervention. No transfer effect was found for subtraction fluency.

Math anxiety and its relationship with basic arithmetic skills among primary school children.

BACKGROUND: Children have been found to report and demonstrate math anxiety as early as the first grade. However, previous results concerning the relationship between math anxiety and performance are contradictory, with some studies establishing a correlation between them while others do not. These contradictory results might be related to varying operationalizations of math anxiety. AIMS: In this study, we aimed to examine the prevalence of math anxiety and its relationship with basic arithmetic skills in primary school children, with explicit focus on two aspects of math anxiety: anxiety about failure in mathematics and anxiety in math-related situations. SAMPLE: The participants comprised 1,327 children at grades 2-5. METHODS: Math anxiety was assessed using six items, and basic arithmetic skills were assessed using three assessment tasks. RESULTS: Around one-third of the participants reported anxiety about being unable to do math, one-fifth about having to answer teachers' questions, and one tenth about having to do math. Confirmatory factor analysis indicated that anxiety about math-related situations and anxiety about failure in mathematics are separable aspects of math anxiety. Structural equation modelling suggested that anxiety about math-related situations was more strongly associated with arithmetic fluency than anxiety about failure. Anxiety about math-related situations was most common among second graders and least common among fifth graders. CONCLUSIONS: As math anxiety, particularly about math-related situations, was related to arithmetic fluency even as early as the second grade, children's negative feelings and math anxiety should be identified and addressed from the early primary school years.

Continuity From Prelinguistic Communication to Later Language Ability: A Follow-Up Study From Infancy to Early School Age.

Purpose: This longitudinal study examined the development of prelinguistic skills and the continuity of communication and language from the prelinguistic stage to school age. Method: Prelinguistic communication of 427 Finnish children was followed repeatedly from 6 to 18 months of age (n = 203-322 at ages 6, 9, 12, 15, and 18 months), and its associations with language ability at ages 2;0 (n = 104), 3;0 (n = 112), 4;7 (n = 253), 5;3 (n = 102), and 7;9 (n = 236) were examined using latent growth curve modeling. Results: Prelinguistic development across several skills emerged as a rather stable intraindividual characteristic during the first 2 years of life. Continuity from prelinguistic development to later language ability was indicated. The common level and growth of prelinguistic skills were significant predictors of language ability between ages 2;0 (years;months) and 7;9; the percentage explained varied between 10.5% and 53.3%. A slow pace of development across multiple skills, in particular, led to weaker language skills. Conclusions: The results support (a) the idea of a developmental continuum from prelinguistic to linguistic ability and (b) the dimensional view of language ability by indicating that individual variations in early communication skills show consistency that extends beyond the toddler years. Our results also advocate developmental surveillance of early communication by emphasizing the significance of growth in predicting language development.

Children with differing developmental trajectories of prelinguistic communication skills: language and working memory at age 5.

PURPOSE: In this article, the authors examine the developmental continuity from prelinguistic communication to kindergarten age in language and working memory capacity. METHOD: Following work outlining 6 groups of children with different trajectories of early communication development (ECD; Määttä, Laakso, Tolvanen, Ahonen, & Aro, 2012), the authors examined their later development by psychometric assessment. Ninety-one children first assessed at ages 12-21 months completed a battery of language and working memory tests at age 5;3 (years;months). RESULTS: Two of the ECD groups previously identified as being at risk for language difficulties continued to show weaker performance at follow-up. Seventy-nine percent of the children with compromised language skills at follow-up were identified on the basis of the ECD groups, but the number of false positives was high. The 2 at-risk groups also differed significantly from the typically developing groups in the measures tapping working memory capacity. CONCLUSIONS: In line with the dimensional view of language impairment, the accumulation of early delays predicted the amount of later difficulties; however, at the individual level, the prediction had rather low specificity. The results imply a strong link between language and working memory and call for further studies examining the early developmental interaction between language and memory.

Associations between toddler-age communication and kindergarten-age self-regulatory skills.

PURPOSE: In this study, the authors aimed at gaining understanding on the associations of different types of early language and communication profiles with later self-regulation skills by using longitudinal data from toddler age to kindergarten age. METHOD: Children with early language profiles representing expressive delay, broad delay (i.e., expressive, social, and/or symbolic), and typical language development were compared in domains of kindergarten-age executive and regulative skills (attentional/executive functions, regulation of emotions and behavioral activity, and social skills) assessed with parental questionnaires. RESULTS: Children with delay in toddler-age language development demonstrated poorer kindergarten-age self-regulation skills than children with typical early language development. Broad early language delays were associated with compromised social skills and attentional/executive functions, and early expressive delays were associated with a generally lower level of kindergarten-age executive and regulative skills. Regression analyses showed that both earlier and concurrent language had an effect especially on the attentional/executive functions. CONCLUSIONS: The findings suggest that different aspects of toddler-age language have differential associations with later self-regulation. Possible mechanisms linking early language development to later self-regulative development are discussed.