Revised Dual Task Screen is a Valid Measure of Dual Task Performance: Developing a Motor and Cognitive Dual Task Measure with Healthy Female Athletes.

Multitasking measures, such as dual task assessments, are particularly useful in detecting subtle deficits that can influence occupational performance after injuries, like sports-related concussion (SRC). In past work, our research team developed and revised a dual task assessment, the Dual Task Screen (DTS). Here, we evaluated nineteen healthy athletes using the revised DTS to address two specific research objectives. First, to replicate pilot study findings and demonstrate that the revised DTS is sensitive to dual task motor costs (i.e. poorer motor performance under dual task conditions, compared to single task conditions). Second, to evaluate if the revised DTS is sensitive to dual task cognitive costs (i.e. poorer cognitive performance under dual task conditions, compared to single task conditions). We confirmed that the revised DTS was sensitive to both dual task motor and cognitive costs; thus it is a valid measure of dual task performance. These positive findings support its prospective, future use by occupational therapists to evaluate multitasking performance after injuries, like SRC, or other injuries and illnesses that elicit deficits affecting optimal occupational performance.

Revised Dual Task Screen is a Valid Measure of Dual Task Performance: Developing a Motor and Cognitive Dual Task Measure with Healthy Female Athletes.

Multitasking measures, such as dual task assessments, are particularly useful in detecting subtle deficits that can influence occupational performance after injuries, like sports-related concussion (SRC). In past work, our research team developed and revised a dual task assessment, the Dual Task Screen (DTS). Here, we evaluated nineteen healthy athletes using the revised DTS to address two specific research objectives. First, to replicate pilot study findings and demonstrate that the revised DTS is sensitive to dual task motor costs (i.e. poorer motor performance under dual task conditions, compared to single task conditions). Second, to evaluate if the revised DTS is sensitive to dual task cognitive costs (i.e. poorer cognitive performance under dual task conditions, compared to single task conditions). We confirmed that the revised DTS was sensitive to both dual task motor and cognitive costs; thus it is a valid measure of dual task performance. These positive findings support its prospective, future use by occupational therapists to evaluate multitasking performance after injuries, like SRC, or other injuries and illnesses that elicit deficits affecting optimal occupational performance.

Home food availability and child intake among rural families identified to be at-risk for health disparities.

BACKGROUND: Home food environments (HFE) of children impact dietary intake, though relatively few studies have focused on young children from backgrounds with socioeconomic and racial-ethnic diversity. The objective of the present study was to examine the relationship between the HFE and child dietary intake of preschool-aged children from rural and low-income, culturally diverse families. METHODS: Children (aged 2-5 years) and their primary caregivers (n = 164 parent-child dyads) participated in this study using a cross-sectional design. HFE, including home food availability, accessibility and purchasing, was measured by the Home-IDEA, a checklist instrument completed by parents. Parents also reported child dietary intake using the Block Kids Food Screener (BKFS). RESULTS: Home food availability of both healthful and unhealthful foods, including fruits, vegetables, meats, and sugar-sweetened beverages significantly predicted reported child intake of these foods after controlling for demographic, location and weight status. Overall dietary intake recommendations were not met for vegetables, whole grains, protein, and dairy. The accessibility and purchasing frequency of foods was not associated with reported child dietary intake. CONCLUSIONS: The available HFE showed positive associations with dietary intake for a broad range of foods ranging from healthy and less healthy foods among preschool-aged children from a health disparate population. Recommendations to improve the quality of dietary intake for young children may be facilitated by modifying the HFE by focusing on increasing the availability of healthy foods and diminishing the presence of less healthful options.

Participation in Early Childhood Educational Environments for Young Children with and Without Developmental Disabilities and Delays: A Mixed Methods Study.

AIMS: This mixed methods study examined: 1) how young children with and without developmental disabilities and delays participate in daycare or preschool activities; 2) similarities and differences in environmental factors impacting daycare or preschool participation; and 3) strategies used by parents who desired a change in their child's participation. METHODS: Data were drawn from 129 parents of young children with and without developmental disabilities and delays (mean age = 49.3 months) residing in North America. Summary and item-level group differences based on disability status were assessed for participation and environmental supports to participation. Narrative data on parental strategies were content coded, transformed into numerical counts, and summarized to identify strategies commonly employed by parents to promote their child's participation. RESULTS: Moderate to large disability related group differences in participation and environmental support to participation were found even after controlling for confounding effects of child age, child gender, and family income. Parents commonly described strategies focused on "child care tasks" and "child peer groups," irrespective of the type(s) of change they desired. CONCLUSIONS: Study findings suggest that discrepancies in school participation between young children with and without disabilities and delays can be detected and intervened on during the early childhood period.

Young Children's Food Neophobia Characteristics and Sensory Behaviors Are Related to Their Food Intake.

BACKGROUND: Food neophobia in children has been associated with poor dietary variety and nutrient intakes. Underlying characteristics that may predispose a child to neophobia have not been widely studied. OBJECTIVE: We investigated the associations between children's food neophobia, sensory sensitivity, and dietary intake in a diverse sample of typically developing preschoolers. METHODS: Caregiver reports of children's food neophobia and sensory behaviors (SBs) as measured by the Food Neophobia Scale and the Sensory Profile, children's observed weight outcome [body mass index z score (BMIz)], and children's food intake as estimated from the Block Kids Food Screener were collected at baseline in the Colorado LEAP (Longitudinal Eating and Physical Activity Study) study of childhood obesity. Preschool-aged children (n = 249; 136 girls, 113 boys; aged 55.6 ± 4.7 mo; BMIz = 0.54 ± 1.14) and caregivers [n = 180; 57 Hispanic, 119 non-Hispanic white (NHW), 4 unknown] participated. Data were analyzed by Pearson correlations and multivariate hierarchical linear regression analyses. RESULTS: Lower scores for children's oral sensory characteristics (i.e., more atypical) were related to higher neophobia ratings (r = -0.53, P < 0.001), and neophobia was negatively associated with reported vegetable intake (r = -0.31, P = 0.001) and dietary variety (r = -0.22, P < 0.001). Hispanic caregivers reported more atypical child SB scores (46.2 ± 8.8) than did NHW caregivers (50.5 ± 7.6; P = 0.006); however, no differences were noted for neophobia and SB scores by parent income and education or child sex. Neophobia was negatively associated with vegetable intake and dietary variety (P < 0.001 for both). SBs were associated with children's energy intake from sugar-sweetened beverages in bivariate analyses (r = -0.18, P < 0.05); however, in regression models, only ethnicity was significantly associated with energy from sugar-sweetened beverages (P < 0.001). Hispanic ethnicity was positively associated with sugar-sweetened beverage consumption (P < 0.001). CONCLUSIONS: Children's neophobia and sensory sensitivity may be important in understanding underlying issues related to limited food acceptance in typically developing young children and for helping caregivers facilitate healthy dietary intake patterns for their children. This trial was registered at clinicaltrials.gov as NCT01937481.

Psychometric properties of the Young Children's Participation and Environment Measure.

OBJECTIVE: To evaluate the psychometric properties of the newly developed Young Children's Participation and Environment Measure (YC-PEM). DESIGN: Cross-sectional study. SETTING: Data were collected online and by telephone. PARTICIPANTS: Convenience and snowball sampling methods were used to survey caregivers of children (N=395, comprising children with [n=93] and without [n=302] developmental disabilities and delays) between the ages of 0 and 5 years (mean age±SD, 35.33±20.29 mo) and residing in North America. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The YC-PEM includes 3 participation scales and 1 environment scale. Each scale is assessed across 3 settings: home, daycare/preschool, and community. Data were analyzed to derive estimates of internal consistency, test-retest reliability, and construct validity. RESULTS: Internal consistency ranged from .68 to .96 and .92 to .96 for the participation and environment scales, respectively. Test-retest reliability (2-4 wk) ranged from .31 to .93 for participation scales and from .91 to .94 for the environment scale. One of 3 participation scales and the environment scale demonstrated significant group differences by disability status across all 3 settings, and all 4 scales discriminated between disability groups for the daycare/preschool setting. The participation scales exhibited small to moderate positive associations with functional performance scores. CONCLUSIONS: Results lend initial support for the use of the YC-PEM in research to assess the participation of young children with disabilities and delays in terms of (1) home, daycare/preschool, and community participation patterns; (2) perceived environmental supports and barriers to participation; and (3) activity-specific parent strategies to promote participation.

Home food and activity assessment. Development and validation of an instrument for diverse families of young children.

The purpose of this study was to refine and psychometrically test an instrument measuring the home food and activity environment of geographically and economically diverse families of preschool aged children. Caregivers of preschool aged children (n = 83) completed a modified self-report questionnaire. Reliably trained researchers conducted independent observations on 25 randomly selected homes. Agreement statistics were conducted at the item level (154 total items) to determine reliability. Frequency counts were calculated to identify item availability. Results showed Kappa statistics were high (.67-1.00) between independent researchers but varied between researchers and parents resulting in 85 items achieving criterion validity (Kappa >.60). Analyses of reliable items revealed the presence in the home of a high frequency of unhealthy snack foods, high fat milk and low frequency of availability of fruits/vegetables and low fat milk. Fifty-two percent of the homes were arranged with a television in the preschool child's bedroom. Physical Activity devices also were found to have high frequency availability. Families reporting lower education reported higher levels of sugar sweetened beverages and less low-fat dairy (p < .05) compared with higher education families. Low-income families (<$27K per year) reported significantly fewer Physical Activity devices (p < .001) compared with higher income families. Hispanic families reported significantly higher numbers of Sedentary Devices (p < .05) compared with non-Hispanic families. There were no significant differences between demographic comparisons on available fruits/vegetables, meats, whole grains, and regular fat dairy. A modified home food and activity instrument was found to reliably identify foods and activity devices with geographically and economically diverse families.

The Colorado LEAP study: rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program.

BACKGROUND: The preschool years are a critical window for obesity prevention efforts; representing a time when children establish healthy eating habits and physical activity patterns. Understanding the context in which these behaviors develop is critical to formulating a model to address childhood obesity. The Colorado LEAP Study, an intervention study designed to prevent early childhood obesity, utilizes a social ecological approach to explore individual, family and environmental factors and their relationship to child weight status over a 3 year timeframe. METHODS: The study is located in 5 rural Colorado preschool centers and elementary schools (2 treatment and 3 control). Treatment sites receive The Food Friends nutrition (12 weeks) and physical activity (18 weeks) interventions during preschool. Observational measures assess 3 layers of the social ecological model including individual, family and organizational inputs. Children's food preferences, food intake, gross motor skills, physical activity (pedometers/accelerometers), cognitive, physical and social self-competence and height/weight are collected. Parents provide information on feeding and activity practices, child's diet, oral sensory characteristics, food neophobia, home food and activity environment, height/weight and physical activity (pedometers). School personnel complete a school environment and policy assessment. Measurements are conducted with 3 cohorts at 4 time points - baseline, post-intervention, 1- and 2-year follow-up. DISCUSSION: The design of this study allows for longitudinal exploration of relationships among eating habits, physical activity patterns, and weight status within and across spheres of the social ecological model. These methods advance traditional study designs by allowing not only for interaction among spheres but predictively across time. Further, the recruitment strategy includes both boys and girls from ethnic minority populations in rural areas and will provide insights into obesity prevention effects on these at risk populations. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01937481.

Developmental trends of auditory novelty oddball P3 while accounting for N2 in 7- to 25-year-olds.

Many previous studies examining developmental trends in P3 amplitude or latency have used a two-stimulus (standard and target) oddball paradigm. Fewer studies exist using the novelty oddball paradigm, a three-tone (standard, target, and novel) paradigm. In this study with 204 typically developing participants aged 7-25 years, the influence of participant traits-age and sex-on the developmental trends of P3 peak-to-peak amplitude and latency were examined. Additionally, interactions between the three tones of the novelty oddball paradigm and scalp sites on P3 amplitude and latency were evaluated. While previous studies using baseline-to-peak measures have shown smaller P3 amplitude in children compared with adults, this study, using peak-to-peak measures (P3 minus N2 amplitude), found the opposite effect with children having larger P3 amplitudes than adults. This finding is explained by further analyses of N2, representing discrimination. N2 baseline-to-peak amplitude significantly predicted P3 baseline-to-peak amplitude; a mediation effect such that as N2 becomes less negative, P3 becomes larger. Regression analyses revealed that developmental trends of the P3 amplitude were primarily linear, but trends in P3 latency were mostly non-linear. Sex differences were observed, although limited to latency measures. Results from ancovas found significant interactions between the three tones and between frontal (Fz) and parietal (Pz) sites, with larger P3 amplitude during target and novel tones at Pz than Fz, and larger amplitudes during frequent tones at Fz than Pz. These findings highlight the importance of considering more than P3 amplitude in understanding developmental trends in cognitive processing during oddball paradigms.

The Relationship Between Attention, Sensory Processing, and Social Responsiveness Among Adults on the Autism Spectrum.

This study evaluated attention, sensory processing, and social responsiveness and the relationship between these constructs among autistic and neurotypical adults. Participants included 24 autistic adults (17-30 years) and 24 neurotypical peers who completed the Test of Everyday Attention, Adolescent/Adult Sensory Profile (AASP), and the Social Responsiveness Scale-2. Autistic individuals showed greater attention, sensory processing, and social responsiveness challenges compared to neurotypical peers. Using mediation models, we showed that the relationship between attention and social responsiveness was mediated by sensory processing, specifically the low registration and sensation-seeking AASP quadrants. The relationship between attention, sensory processing, and social responsiveness suggests that adults with greater attention issues may have greater sensory and social challenges. Specifically, having poor attention may lead to poor sensory processing skills which compound poor social responsiveness. Understanding the relationships between these domains is critical for developing effective interventions and support for autistic adults.

Modeling electrophysiological measures of decision-making and performance monitoring in neurotypical children engaging in a speeded flanker task.

This study aims to use structural equation modeling (SEM) to investigate the role of error processing in behavioral adaptation in children by testing relationships between error-related and stimulus-related event-related potentials (ERPs) obtained from two sessions of a speeded Eriksen flanker task. First, path models of averaged ERP components and mean response times (N1 â†’ P2 â†’ N2 â†’ P3 â†’ RTs) while controlling for trait effects, age, and sex, on each was examined separately for correct and incorrect trials from each session. While the model demonstrated acceptable fit statistics, the four models yielded diverse results. Next, path models for correct and incorrect trials were tested using latent variables defined by factoring together respective measures of ERP component amplitudes from each session. Comparison of correct and incorrect models revealed significant differences in the relationships between the successive measures of neural processing after controlling for trait effects. Moreover, latent variable models controlling for both trait and session-specific state variables yielded excellent model fit while models without session-specific state variables did not. In the final model, the error-related neural activity (i.e., the ERN and Pe) from incorrect trials was found to significantly relate to the stream of neural processes contributing to trials with the correct behavior. Importantly, the relationship between RT and error detection in the final model signifies a brain-and-behavior feedback loop. These findings provided empirical evidence that supports the adaptive orienting theory of error processing by demonstrating how the neural signals of error processing influence behavioral adaptations that facilitate correct behavioral performance.

Electroencephalography in children with and without sensory processing disorders during auditory perception.

OBJECTIVE: We sought to determine whether children with sensory processing disorder (SPD) differ from typically developing children on a neurophysiological measure, the P300 component of event-related potentials produced in response to brief auditory stimulation. METHOD: We used electroencephalographic measures (i.e., N200 and P300 components) to examine auditory processing in 20 children with SPD and 71 typically developing children, ages 5-10 yr. RESULTS: Children with SPD demonstrated significantly smaller P300 amplitudes and shorter N200 latencies than typically developing children. Brain activity correctly distinguished children with SPD from typically developing children with 77% accuracy. We also found a significant relationship between the neurophysiological measures and functional performance on sensory and motor tasks. CONCLUSION: This study presents empirical evidence that children with SPD display unique brain processing mechanisms compared with typical children and, therefore, provide further evidence for the neural deviations associated with SPD.

Expanding our understanding of sensory gating in children with autism spectrum disorders.

OBJECTIVE: This study examined sensory gating in children with autism spectrum disorders (ASD). Gating is usually examined at the P50 component and rarely at mid- and late-latency components. METHODS: Electroencephalography data were recorded during a paired-click paradigm, from 18 children with ASD (5-12 years), and 18 typically-developing (TD) children. Gating was assessed at the P50, N1, P2, and N2 event-related potential components. Parents of all participants completed the Short Sensory Profile (SSP). RESULTS: TD children showed gating at all components while children with ASD showed gating only at P2 and N2. Compared to TD children, the ASD group showed significantly reduced gating at P50, N1, and P2. No group differences were found at N2, suggesting typical N2 gating in the ASD group. Time-frequency analyses showed reduced orientation and neural synchronization of auditory stimuli. P50 and N1 gating significantly correlated with the SSP. CONCLUSION: Although children with ASD have impaired early orientation and filtering of auditory stimuli, they exhibited gating at P2 and N2 components suggesting use of different gating mechanisms compared to TD children. Sensory deficits in ASD may relate to gating. SIGNIFICANCE: The data provide novel evidence for impaired neural orientation, filtering, and synchronization in children with ASD.

Individual differences in error monitoring in healthy adults: psychological symptoms and antisocial personality characteristics.

Recent studies have investigated the relationship between psychological symptoms and personality traits and error monitoring measured by error-related negativity (ERN) and error positivity (Pe) event-related potential (ERP) components, yet there remains a paucity of studies examining the collective simultaneous effects of psychological symptoms and personality traits on error monitoring. This present study, therefore, examined whether measures of hyperactivity-impulsivity, depression, anxiety and antisocial personality characteristics could collectively account for significant interindividual variability of both ERN and Pe amplitudes, in 29 healthy adults with no known disorders, ages 18-30 years. The bivariate zero-order correlation analyses found that only the anxiety measure was significantly related to both ERN and Pe amplitudes. However, multiple regression analyses that included all four characteristic measures while controlling for number of segments in the ERP average revealed that both depression and antisocial personality characteristics were significant predictors for the ERN amplitudes whereas antisocial personality was the only significant predictor for the Pe amplitude. These findings suggest that psychological symptoms and personality traits are associated with individual variations in error monitoring in healthy adults, and future studies should consider these variables when comparing group difference in error monitoring between adults with and without disabilities.

Evidence review to investigate the support for subtypes of children with difficulty processing and integrating sensory information.

We investigated the evidence for subtypes in children with difficulty processing and integrating sensory information. Fifty-seven articles were incorporated into a systematic literature review; only 4 articles provided direct evidence for subtypes. These studies did not provide a comprehensive assessment of all sensory functions and sensory-based motor functions (i.e., praxis) and included different diagnostic groups. Therefore, generalized conclusions about subtypes could not be drawn. The other 53 studies reviewed provided meaningful information about strengths and challenges that children with difficulty processing and integrating sensory information demonstrate, but these studies were limited in scope. A principal theme was the importance of conducting comprehensive assessments of sensory-based functions, including multiple measures of sensory integrative functions such as praxis, sensory modulation, and sensory discrimination in children and adolescents with various clinical disorders. In addition, more consistency in the use of specific assessment tools will allow for synthesis of data across studies.

Sensory Processing and Attention Profiles Among Children With Sensory Processing Disorders and Autism Spectrum Disorders.

This study explores the differences in the profile of relationships between sensory processing and attention abilities among children with sensory processing disorder (SPD), autism spectrum disorder (ASD), and typically developing (TD) children. The Test of Everyday Attention for Children (TEA-Ch), a performance-based measure of attention, was administered to 69 children (TD: n = 24; SPD: n = 21; ASD: n = 24), ages 6-10 years. All participants' parents completed the Short Sensory Profile (SSP), a standardized parent-report measure of sensory-related behaviors. Discriminant analyses using the TEA-Ch and the SSP domains revealed two classification functions; the first revealed that both clinical groups significantly differed from the TD group with greater sensory processing challenges in the categories of auditory filtering, under-responsive/seeks sensation, low energy/weak, and taste/smell sensitivity subscales of the SSP. The second function discriminated between the two clinical groups, indicating that children with ASD had significantly greater control and sustained attention deficits and less sensory issues than did children with SPD. Together, the two functions correctly classified 76.8% of the participants as to their group membership. The different profiles of sensory processing and attention abilities in children with SPD and ASD may provide guidance in identifying appropriate individualized therapeutic strategies for these children.

Test-Retest Reliability of Electroencephalographic Measures of Performance Monitoring in Children and Adults.

This study examined the test-retest reliability of the error-related negativity (ERN) and error positivity (Pe) amplitudes using a Flanker task in 118 neurotypical children and 53 adults before and after latency jitter adjustments. The reliability of the ERN and Pe amplitudes was moderate for children and moderate to strong for adults. The latency variability adjustment did not improve the reliability of the ERN and Pe amplitudes for either group, suggesting that latency variability may be a trait-like measure. For comparison purposes, the reliability of the stimulus-locked ERPs was strong for correct trials, yet the reliability was weak for incorrect trials.

Evaluating Motor Control Improves Discrimination of Adolescents with and without Sports Related Concussion.

Disrupted motor performance is increasingly recognized as a critical sequela of concussion which may have relevance for diagnosis and treatment. In 17 adolescents with recent concussion and 20 never-concussed controls, we evaluated the discriminant ability of a commonly used neurocognitive measure compared to a motor subtle sign exam, which evaluates gait, balance, and fine and gross motor control. We found that the motor subtle sign exam had better discriminant ability than the neurocognitive measure, but combining both measures was superior to analyses with individual measures (Wilks' ƛ = .297, p < .001). This supports that there is an added benefit of evaluating motor control along with neurocognitive capacities after suspected concussion to enhance diagnosis and treatment of injury.

Rasch analysis of the School Function Assessment provides additional evidence for the internal validity of the activity performance scales.

OBJECTIVE: The internal construct validity of the School Function Assessment (SFA) was determined by examining its unidimensionality and hierarchical structure. METHOD: The SFA was completed for 64 elementary school children (35 with disabilities, 29 without disabilities). Data were examined through Rasch analysis. RESULTS: The majority of test items (252 of 266) within the Activity Performance Scales met the criterion set for Rasch goodness-of-fit statistics. All but three scales were found to be unidimensional, measuring a single construct. Item difficulty analysis yielded a hierarchical structure of the scales similar to the existing item layout of the SFA. CONCLUSION: Internal validity was supported for 15 of the 18 Activity Performance scales. Each scale is psychometrically sound in measuring a specific functional task. The reliable hierarchical pattern of the assessment helps anticipate and document the student's progress in functional performance from easier to more difficult school tasks.

Developmental trends of performance monitoring measures in 7- to 25-year-olds: Unraveling the complex nature of brain measures.

This study explores how trial-to-trial latency variability contributes to the developmental trends observed in ERN amplitude found in the incorrect trials of a performance monitoring task, the visual flanker task. An Adaptive Woody filter was used to measure and correct for the trial-to-trial latency variability of the ERN in 240 participants aged 7-25 years. Using three measures of latency variability, the degree of trial-to-trial latency variability was shown to decrease as the age of the participants increased from 7 to 25 years. The success of the Adaptive Woody filter technique to remove the trial-to-trial latency variability was demonstrated in a straightforward manner by the significant changes in the measures of fit and intraindividual variability obtained before and after applying the filter. After the latency variability effects were removed and adjusted averaged ERPs were obtained, a more subtle but significant nonlinear developmental trend was still found in the amplitude of the ERN component.