Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities.

Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity.

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Irrelevant speech impairs serial recall of verbal but not spatial items in children and adults.

Immediate serial recall of visually presented items is reliably impaired by task-irrelevant speech that the participants are instructed to ignore ("irrelevant speech effect," ISE). The ISE is stronger with changing speech tokens (words or syllables) when compared to repetitions of single tokens ("changing-state effect," CSE). These phenomena have been attributed to sound-induced diversions of attention away from the focal task (attention capture account), or to specific interference of obligatory, involuntary sound processing with either the integrity of phonological traces in a phonological short-term store (phonological loop account), or the efficiency of a domain-general rehearsal process employed for serial order retention (changing-state account). Aiming to further explore the role of attention, phonological coding, and serial order retention in the ISE, we analyzed the effects of steady-state and changing-state speech on serial order reconstruction of visually presented verbal and spatial items in children (n = 81) and adults (n = 80). In the verbal task, both age groups performed worse with changing-state speech (sequences of different syllables) when compared with steady-state speech (one syllable repeated) and silence. Children were more impaired than adults by both speech sounds. In the spatial task, no disruptive effect of irrelevant speech was found in either group. These results indicate that irrelevant speech evokes similarity-based interference, and thus pose difficulties for the attention-capture and the changing-state account of the ISE.

Differential Effects of Task-Irrelevant Monaural and Binaural Classroom Scenarios on Children's and Adults' Speech Perception, Listening Comprehension, and Visual-Verbal Short-Term Memory.

Most studies investigating the effects of environmental noise on children's cognitive performance examine the impact of monaural noise (i.e., same signal to both ears), oversimplifying multiple aspects of binaural hearing (i.e., adequately reproducing interaural differences and spatial information). In the current study, the effects of a realistic classroom-noise scenario presented either monaurally or binaurally on tasks requiring processing of auditory and visually presented information were analyzed in children and adults. In Experiment 1, across age groups, word identification was more impaired by monaural than by binaural classroom noise, whereas listening comprehension (acting out oral instructions) was equally impaired in both noise conditions. In both tasks, children were more affected than adults. Disturbance ratings were unrelated to the actual performance decrements. Experiment 2 revealed detrimental effects of classroom noise on short-term memory (serial recall of words presented pictorially), which did not differ with age or presentation mode (monaural vs. binaural). The present results add to the evidence for detrimental effects of noise on speech perception and cognitive performance, and their interactions with age, using a realistic classroom-noise scenario. Binaural simulations of real-world auditory environments can improve the external validity of studies on the impact of noise on children's and adults' learning.

Examining the Auditory Selective Attention Switch in a Child-Suited Virtual Reality Classroom Environment.

The ability to focus ones attention in different acoustical environments has been thoroughly investigated in the past. However, recent technological advancements have made it possible to perform laboratory experiments in a more realistic manner. In order to investigate close-to-real-life scenarios, a classroom was modeled in virtual reality (VR) and an established paradigm to investigate the auditory selective attention (ASA) switch was translated from an audio-only version into an audiovisual VR setting. The new paradigm was validated with adult participants in a listening experiment, and the results were compared to the previous version. Apart from expected effects such as switching costs and auditory congruency effects, which reflect the robustness of the overall paradigm, a difference in error rates between the audio-only and the VR group was found, suggesting enhanced attention in the new VR setting, which is consistent with recent studies. Overall, the results suggest that the presented VR paradigm can be used and further developed to investigate the voluntary auditory selective attention switch in a close-to-real-life classroom scenario.

Early environmental quality and life-course mental health effects: The Equal-Life project.

BACKGROUND: There is increasing evidence that a complex interplay of factors within environments in which children grows up, contributes to children's suboptimal mental health and cognitive development. The concept of the life-course exposome helps to study the impact of the physical and social environment, including social inequities, on cognitive development and mental health over time. METHODS: Equal-Life develops and tests combined exposures and their effects on children's mental health and cognitive development. Data from eight birth-cohorts and three school studies (N = 240.000) linked to exposure data, will provide insights and policy guidance into aspects of physical and social exposures hitherto untapped, at different scale levels and timeframes, while accounting for social inequities. Reasoning from the outcome point of view, relevant stakeholders participate in the formulation and validation of research questions, and in the formulation of environmental hazards. Exposure assessment combines GIS-based environmental indicators with omics approaches and new data sources, forming the early-life exposome. Statistical tools integrate data at different spatial and temporal granularity and combine exploratory machine learning models with hypothesis-driven causal modeling. CONCLUSIONS: Equal-Life contributes to the development and utilization of the exposome concept by (1) integrating the internal, physical and social exposomes, (2) studying a distinct set of life-course effects on a child's development and mental health (3) characterizing the child's environment at different developmental stages and in different activity spaces, (4) looking at supportive environments for child development, rather than merely pollutants, and (5) combining physical, social indicators with novel effect markers and using new data sources describing child activity patterns and environments.

[Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia]. / Wirksamkeit des computergestützten grapho-phonologischen Trainingsprogramms Lautarium bei Kindern mit Lese-Rechtschreib-Störung.

Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia The effects of the computer-based training program Lautarium on phonological awareness and literacy skills were investigated in 41 third-grade children with developmental dyslexia who attended special dyslexia classes in a primary school in Saxony, Germany. Based on the proven efficacy of phonics-based instruction, Lautarium combines training of phoneme perception and phonological awareness with training of grapheme-phoneme-relationships and reading and spelling of transparent words. In addition, rapid access from written words to meaning is included. The children of the training group (N = 27) worked through the program during school lessons, 5 times per week for 30 minutes, for a period of 7 weeks. During the training period, the controls (N = 14) received traditional remedial reading instruction, 2-3 times per week, in small groups. Children's performance in phonological awareness, reading, and spelling was assessed at three time points (pretest, immediate posttest, and follow-up after 9 weeks). Pretest scores did not differ between groups. For spelling and subtests of phonological awareness, group comparisons of raw scores at posttest and follow-up including the respective pretest score as covariate confirmed stronger improvements in the training group when compared to the controls. Effect sizes were medium to strong. For reading, improvements did not differ between groups. In both groups, standard scores (T-scores) for reading and spelling increased significantly and substantially across the study period (from pretest to follow-up). The results confirm the efficacy of computer-based training with Lautarium in children with dyslexia, and the efficacy of school-based remedial instruction provided in the dyslexia classes.

Phonological, temporal and spectral processing in vowel length discrimination is impaired in German primary school children with developmental dyslexia.

It is still unclear whether phonological processing deficits are the underlying cause of developmental dyslexia, or rather a consequence of basic auditory processing impairments. To avoid methodological confounds, in the current study the same task and stimuli of comparable complexity were used to investigate both phonological and basic auditory (temporal and spectral) processing in dyslexia. German dyslexic children (Grades 3 and 4) were compared to age- and grade-matched controls in a vowel length discrimination task with three experimental conditions: In a phonological condition, natural vowels were used, differing both with respect to temporal and spectral information (in German, vowel length is phonemic, and vowel length differences are characterized by both temporal and spectral information). In a temporal condition, spectral information differentiating between the two vowels of a pair was eliminated, whereas in a spectral condition, temporal differences were removed. As performance measure, the sensitivity index d' was computed. At the group level, dyslexic children's performance was inferior to that of controls for phonological as well as temporal and spectral vowel length discrimination. At an individual level, nearly half of the dyslexic sample was characterized by deficits in all three conditions, but there were also some children showing no deficits at all. These results reveal on the one hand that phonological processing deficits in dyslexia may stem from impairments in processing temporal and spectral information in the speech signal. On the other hand they indicate, however, that not all dyslexic children might be characterized by phonological or auditory processing deficits.

Does noise affect learning? A short review on noise effects on cognitive performance in children.

The present paper provides an overview of research concerning both acute and chronic effects of exposure to noise on children's cognitive performance. Experimental studies addressing the impact of acute exposure showed negative effects on speech perception and listening comprehension. These effects are more pronounced in children as compared to adults. Children with language or attention disorders and second-language learners are still more impaired than age-matched controls. Noise-induced disruption was also found for non-auditory tasks, i.e., serial recall of visually presented lists and reading. The impact of chronic exposure to noise was examined in quasi-experimental studies. Indoor noise and reverberation in classroom settings were found to be associated with poorer performance of the children in verbal tasks. Regarding chronic exposure to aircraft noise, studies consistently found that high exposure is associated with lower reading performance. Even though the reported effects are usually small in magnitude, and confounding variables were not always sufficiently controlled, policy makers responsible for noise abatement should be aware of the potential impact of environmental noise on children's development.

Effects of noise and reverberation on speech perception and listening comprehension of children and adults in a classroom-like setting.

The effects of classroom noise and background speech on speech perception, measured by word-to-picture matching, and listening comprehension, measured by execution of oral instructions, were assessed in first- and third-grade children and adults in a classroom-like setting. For speech perception, in addition to noise, reverberation time (RT) was varied by conducting the experiment in two virtual classrooms with mean RT = 0.47 versus RT = 1.1 s. Children were more impaired than adults by background sounds in both speech perception and listening comprehension. Classroom noise evoked a reliable disruption in children's speech perception even under conditions of short reverberation. RT had no effect on speech perception in silence, but evoked a severe increase in the impairments due to background sounds in all age groups. For listening comprehension, impairments due to background sounds were found in the children, stronger for first- than for third-graders, whereas adults were unaffected. Compared to classroom noise, background speech had a smaller effect on speech perception, but a stronger effect on listening comprehension, remaining significant when speech perception was controlled. This indicates that background speech affects higher-order cognitive processes involved in children's comprehension. Children's ratings of the sound-induced disturbance were low overall and uncorrelated to the actual disruption, indicating that the children did not consciously realize the detrimental effects. The present results confirm earlier findings on the substantial impact of noise and reverberation on children's speech perception, and extend these to classroom-like environmental settings and listening demands closely resembling those faced by children at school.

Can the irrelevant speech effect turn into a stimulus suffix effect?

The irrelevant sound effect (ISE) and the stimulus suffix effect (SSE) are two qualitatively different phenomena, although in both paradigms irrelevant auditory material is played while a verbal serial recall task is being performed. Jones, Macken, and Nicholls (2004) have proposed the effect of irrelevant speech on auditory serial recall to switch from an ISE to an SSE mechanism, if the auditory-perceptive similarity of relevant and irrelevant material is maximized. The experiment reported here (n = 36) tested this hypothesis by exploring auditory serial recall performance both under irrelevant speech and under speech suffix conditions. These speech materials were spoken either by the same voice as the auditory items to be recalled or by a different voice. The experimental conditions were such that the likelihood of obtaining an SSE was maximized. The results, however, show that irrelevant speech - in contrast to speech suffixes - affects auditory serial recall independently of its perceptive similarity to the items to be recalled and thus in terms of an ISE mechanism that crucially extends to recency. The ISE thus cannot turn into an SSE.

Phonological working memory in German children with poor reading and spelling abilities.

Deficits in verbal short-term memory have been identified as one factor underlying reading and spelling disorders. However, the nature of this deficit is still unclear. It has been proposed that poor readers make less use of phonological coding, especially if the task can be solved through visual strategies. In the framework of Baddeley's phonological loop model, this study examined serial recall performance in German second-grade children with poor vs good reading and spelling abilities. Children were presented with four-item lists of common nouns for immediate serial recall. Word length and phonological similarity as well as presentation modality (visual vs auditory) and type of recall (visual vs verbal) were varied as within-subject factors in a mixed design. Word length and phonological similarity effects did not differ between groups, thus indicating equal use of phonological coding and rehearsal in poor and good readers. However, in all conditions, except the one that combined visual presentation and visual recall, overall performance was significantly lower in poor readers. The results suggest that the poor readers' difficulties do not arise from an avoidance of the phonological loop, but from its inefficient use. An alternative account referring to unstable phonological representations in long-term memory is discussed.

Effects of irrelevant speech and traffic noise on speech perception and cognitive performance in elementary school children.

The effects of background noise of moderate intensity on short-term storage and processing of verbal information were analyzed in 6 to 8 year old children. In line with adult studies on "irrelevant sound effect" (ISE), serial recall of visually presented digits was severely disrupted by background speech that the children did not understand. Train noises of equal Intensity however, had no effect. Similar results were demonstrated with tasks requiring storage and processing of heard information. Memory for nonwords, execution of oral instructions and categorizing speech sounds were significantly disrupted by irrelevant speech. The affected functions play a fundamental role in the acquisition of spoken and written language. Implications concerning current models of the ISE and the acoustic conditions in schools and kindergardens are discussed.