Sudden anisocoria in a healing pediatric multitrauma patient.

ABSTRACT: This article describes a teenager who developed anisocoria with no obvious neurologic deficits or decline after a motor vehicle accident. The condition resolved over several hours before reappearing in the opposite eye 2 days later. Again no clinical neurologic deficits were noted and the condition resolved after several hours. The patient's asymptomatic anisocoria was finally determined to be secondary to aerosolized ipratropium treatments and an ill-fitting mask.

Teachers' Perceptions of Supporting Young Carers in Schools: Identifying Support Needs and the Importance of Home-School Relationships.

Recognition and support for young carers has improved steadily in the past two decades; with stronger legislation and more visibility and awareness of the challenges that many of the YC face, especially with respect to their education. Recent UK-based initiatives providing toolkits and guidance for school staff have provided much needed direction for schools, to support the loosely defined statutory requirements. The aim of the current research was to hear from school staff about their experiences in identifying and supporting young carers, to better understand any enablers and barriers. The thematic analysis of the interview data from 18 school staff was organized into two main themes: perceptions regarding the characteristics of young carers; and perceptions regarding the importance of home-school communication. Each superordinate theme contained several sub-themes. Overall, the teachers perceived many difficulties identifying young carers who did not volunteer this information and felt that the main enabler of identification was the trust relationships between the school and the pupil and parents. Once identified, the schools perceived the main areas of need that they could provide support for were the emotional wellbeing of the pupils and additional academic opportunities. They spoke too of the difficulties balancing the provision of this extra support within the constraints of the school context, both in terms of the school day, and the competing priorities relating to academic and social-emotional needs. School staff recognized that extra time outside of school was difficult for young carers to attend. Other subthemes are discussed with consideration to enablers and barriers. The implications for the dissemination of good practice, and addressing policy are considered.

Effects of alcohol and task difficulty on visual tracking and inattentional blindness.

RATIONALE: Inattentional blindness (IB) describes the failure to notice salient but unexpected stimuli in one's focal visual field. It typically occurs while performing a demanding task (e.g. tracking and counting basketball passes), which consumes attentional resources. Alcohol intoxication is also known to reduce attentional resources, thereby potentially increasing IB and disrupting task performance. OBJECTIVES: To test the extent to which acute alcohol and task difficulty disrupt counting performance and increase the rate of IB across two experimental tasks. METHODS: To test the effects of alcohol consumption and task difficulty on IB, we used the Simons and Chabris (Percept 28:1059-1074, 1999) and Simons (2010) "gorilla in our midst" basketball clip in experiment 1 and abstract but analogous stimuli presented in a computerised alternative to that task in experiment 2. RESULTS: IB was associated with increased (counting) task difficulty but not alcohol consumption. However, counting accuracy was impaired by both alcohol and increased task difficulty, with the largest detriment being for alcohol participants who noticed the salient but unexpected stimulus. CONCLUSION: The absence of alcohol effects on IB in both experiments was unexpected and warrants further investigation in a field vs lab study comparison and in combination with baseline cognitive measures to test for alcohol expectancy and task compensation effects.

Alcohol increases inattentional blindness when cognitive resources are not consumed by ongoing task demands.

RATIONALE: Inattentional blindness (IB) is the inability to detect a salient yet unexpected task irrelevant stimulus in one's visual field when attention is engaged in an ongoing primary task. The present study is the first to examine the impact of both task difficulty and alcohol consumption on IB and primary task performance. OBJECTIVES: On the basis of alcohol myopia theory, the combined effects of increased task difficulty and alcohol intoxication were predicted to impair task performance and restrict the focus of attention on to task-relevant stimuli. We therefore expected increases in breath alcohol concentration to be associated with poorer primary task performance and higher rates of IB, with these relationships being stronger under hard than easy task conditions. METHODS: This hypothesis was tested in a field study where alcohol drinkers in a local bar were randomly assigned to perform a dynamic IB task with an easy or hard visual tracking and counting task at its core (Simons and Chabris in Perception 28:1059-1074, 1999). RESULTS: Increasing the difficulty of the primary task reduced task accuracy but, surprisingly, had no impact on the rate of IB. Higher levels of alcohol intoxication were, however, associated with poorer task performance and an increased rate of IB, but only under easy primary task conditions. CONCLUSIONS: Results are consistent with alcohol myopia theory. Alcohol intoxication depletes attentional resources, thus reducing the drinker's awareness of salient stimuli that are irrelevant to some ongoing primary task. We conclude that this effect was not observed for our hard task because it is more resource intensive, so leaves no spare attentional capacity for alcohol to deplete.

Testing Alcohol Myopia Theory: Examining the Effects of Alcohol Intoxication on Simultaneous Central and Peripheral Attention.

The effect of alcohol intoxication on central and peripheral attention was examined as a test of Alcohol Myopia Theory (AMT). Previous research has supported AMT in the context of visual attention, but few studies have examined the effects of alcohol intoxication on central and peripheral attention. The study followed a 2 (alcohol treatment) × 2 (array size) × 2 (task type) mixed design. Forty-one participants (placebo or intoxicated) viewed an array of four or six colored circles, while simultaneously counting the flashes of a centrally presented fixation cross. Participants were instructed to prioritize flash counting accuracy. The subsequently presented colored probe matched the cued peripheral stimulus on 50% of trials. Flash counting and probe identification accuracy were recorded. There was a significant main effect of alcohol treatment on accuracy scores, as well as an alcohol treatment by task type interaction. Accuracy scores for the central flash counting task did not differ between treatment groups, but scores for peripheral probe identification were lower in the alcohol group. As predicted by AMT, alcohol impairment was greater for peripheral probe detection than for the central and prioritized flash counting task. The findings support the notion that alcohol intoxication narrows attentional focus to the central aspects of a task.

How caring for a parent affects the psychosocial development of the young.

AIM: To investigate the impact of caring for a parent on the psychosocial development of the young person. METHODS: A total of 20 young carers and 20 non-caregiving peers, aged 11-18 years, were compared on self-report measures of life satisfaction, self-esteem, and behavioural strengths and difficulties. Parental reports on their child's behaviour were obtained and measured. RESULTS: Young carers reported lower life satisfaction and self-esteem compared with non-caregiving peers, and their parents rated them as having more difficulties with peer relationships and more emotional symptoms. There was no evidence of more pro-social behaviour on the part of young carers. CONCLUSIONS: Caregiving has a negative effect on young people overall; improved support of and more research around young carers are required.

MEG measures of covert orienting and gaze processing in children.

We investigated developmental differences in the cortical attention processing network using magnetoencephalography (MEG) and a spatial cueing task in 7-8 and 12-13 year old children. The cueing paradigm consisted of a centrally presented face with left or right averted eye-gaze in the gaze cue condition, and a central face with straight gaze presented with a cue stimulus to the left or right of the face in the peripheral cue condition. Cue congruency was 50 %. MEG was recorded during the two conditions and event-related beamforming was used to determine the timing and location of the brain activity related to target detection with the two types of cueing. The MEG data showed no age differences in the eye-gaze condition, but a developmental difference characterised by slower and more diffuse activations for peripheral cues in the younger versus the older age group. In the 7-8 year olds activation peaked around 300 ms, and was localised to left inferior frontal gyrus as well as posterior areas related to visuo-spatial processing. The 12-13 year olds showed a temporoparietal pattern of activation characteristic of spatial reorientation which resembled that seen for adult participants using the same paradigm (Nagata et al. 2012). The activation peaked around 200 ms and was localised to the left superior frontal gyrus, middle frontal gyrus but bilaterally near the temporoparietal junction. The data indicate maturational changes in brain activity for peripheral cueing.

Spatio-temporal localisation of attentional orienting to gaze and peripheral cues.

Another person's eye gaze often triggers our attention such that we follow their direction of gaze. We investigated how the neural mechanisms for processing eye-gaze and spatial attention interact using magnetoencephalography (MEG) in young adults. In a cueing paradigm, a face was presented centrally with left or right averted eye-gaze serving as the directional cue in the eye-gaze condition. In the peripheral cue condition, the face with a straight gaze was presented with a cue stimulus appearing on the left or right of the face. Cue validity was 50%. MEG was recorded during the two conditions and event-related beamforming was used to determine the timing and location of the brain activity related to the two types of cueing. The MEG data indicated that generally the network of activation in response to our two cue types was similar. In contrast, MEG responses to the targets demonstrated one main peak at 286-306 ms for the eye-gaze cue condition while two peaks were found at 238-258 ms and 286-306 ms for the peripheral cue condition. Activation was also consistently larger for the invalid than valid trials. Source images for the invalid minus valid contrasts for the 238-258 ms window showed significant activation only in the peripheral cueing condition, in the left temporoparietal junction and left inferior frontal gyrus. In the 286-306 ms window, both conditions showed left medial frontal activations. Thus, peripheral cues showed more rapid neural processing than the eye-gaze cues, with the second component being common to both, reflecting in part common processing. We suggest that attentional processing was maximal in the left hemisphere, as the right hemisphere was likely engaged in processing the face information.

Is it in the eyes? Dissociating the role of emotion and perceptual features of emotionally expressive faces in modulating orienting to eye gaze.

This study investigated the role of the eye region of emotional facial expressions in modulating gaze orienting effects. Eye widening is characteristic of fearful and surprised expressions and may significantly increase the salience of perceived gaze direction. This perceptual bias rather than the emotional valence of certain expressions may drive enhanced gaze orienting effects. In a series of three experiments involving low anxiety participants, different emotional expressions were tested using a gaze-cueing paradigm. Fearful and surprised expressions enhanced the gaze orienting effect compared with happy or angry expressions. Presenting only the eye regions as cueing stimuli eliminated this effect whereas inversion globally reduced it. Both inversion and the use of eyes only attenuated the emotional valence of stimuli without affecting the perceptual salience of the eyes. The findings thus suggest that low-level stimulus features alone are not sufficient to drive gaze orienting modulations by emotion. Rather, they interact with the emotional valence of the expression that appears critical. The study supports the view that rapid processing of fearful and surprised emotional expressions can potentiate orienting to another person's averted gaze in non-anxious people.

Brain responses differ to faces of mothers and fathers.

We encounter many faces each day but relatively few are personally familiar. Once faces are familiar, they evoke semantic and social information known about the person. Neuroimaging studies demonstrate differential brain activity to familiar and non-familiar faces; however, brain responses related to personally familiar faces have been more rarely studied. We examined brain activity with fMRI in adults in response to faces of their mothers and fathers compared to faces of celebrities and strangers. Overall, faces of mothers elicited more activity in core and extended brain regions associated with face processing, compared to fathers, celebrity or stranger faces. Fathers' faces elicited activity in the caudate, a deep brain structure associated with feelings of love. These new findings of differential brain responses elicited by faces of mothers and fathers are consistent with psychological research on attachment, evident even during adulthood.

Skill-related uncertainty and expected value in 5- to 7-year-olds

Studies using an Information Integration approach have shown that children from four years have a good intuitive understanding of probability and expected value. Experience of skill-related uncertainty may provide one naturalistic opportunity to develop this intuitive understanding. To test the viability of this view, 16 5- and 16 7-year-olds played a marble rolling game in which size of the target and distance from it varied factorially. Task difficulty judgements (prior to practical experience with the game) reflected both objective task structure and subsequent performance for both age groups. Children then judged how happy they would be playing games of variable difficulty for different prizes. These judgements had the multiplicative structure predicted by the normative expected value model, again for both age groups. Thus children can use task difficulties as estimates of personal success probability in skill-related tasks. Our findings therefore extend previous work on early probability understanding from games of chance to games of skill(AU)

Neural correlates of personally familiar faces: parents, partner and own faces.

Investigations of the neural correlates of face recognition have typically used old/new paradigms where subjects learn to recognize new faces or identify famous faces. Familiar faces, however, include one's own face, partner's and parents' faces. Using event-related fMRI, we examined the neural correlates of these personally familiar faces. Ten participants were presented with photographs of own, partner, parents, famous and unfamiliar faces and responded to a distinct target. Whole brain, two regions of interest (fusiform gyrus and cingulate gyrus), and multiple linear regression analyses were conducted. Compared with baseline, all familiar faces activated the fusiform gyrus; own faces also activated occipital regions and the precuneus; partner faces activated similar areas, but in addition, the parahippocampal gyrus, middle superior temporal gyri and middle frontal gyrus. Compared with unfamiliar faces, only personally familiar faces activated the cingulate gyrus and the extent of activation varied with face category. Partner faces also activated the insula, amygdala and thalamus. Regions of interest analyses and laterality indices showed anatomical distinctions of processing the personally familiar faces within the fusiform and cingulate gyri. Famous faces were right lateralized whereas personally familiar faces, particularly partner and own faces, elicited bilateral activations. Regression analyses show experiential predictors modulated with neural activity related to own and partner faces. Thus, personally familiar faces activated the core visual areas and extended frontal regions, related to semantic and person knowledge and the extent and areas of activation varied with face type.

Executive functions in school-age children born very prematurely.

BACKGROUND: School-age preterm children are at risk for cognitive difficulties including Executive Dysfunction and low average IQ. AIM: The aim of this study was to determine the performance of very preterm, school-age children on three components of Executive Function (EF), two components of Executive Attention and a measure of IQ. STUDY DESIGN: Cross-sectional, independent samples comparison. METHODS: A UK sample of 40 very preterm (<32 weeks gestational age, Mean 28.43, SD 2.41) children and 41 term born control children aged between 6 and 12 years (mean ages 8 years 5 months in both groups) was assessed on IQ, EF (inhibition, working memory and set shifting) and attention (sustained and selective). Between group comparisons were made using multivariate analysis of variance and covariance. RESULTS: Multivariate analyses indicated that preterm children scored significantly lower than their term born peers across Executive Function and executive attention tasks. As expected, the preterm group achieved IQ scores at the low end of the average range. Univariate analyses indicated some difficulties with shifting and inhibition components of EF, although covariate analysis revealed that only shifting was independent of IQ. CONCLUSIONS: Preterm children showed mild executive function and executive attention difficulties in the context of average IQ scores. The findings highlight the benefit of using multivariate assessments of executive skills rather than general intellectual outcome alone, to obtain a better distinction of the specific cognitive weaknesses associated with preterm birth.

Spatiotemporal analysis of feedback processing during a card sorting task using spatially filtered MEG.

A card sorting paradigm was used to observe the neural correlates of feedback processing in adult participants. Visually presented feedback was used to indicate response accuracy and the requirement to shift response set in a 2-category card sorting task. Magnetoencephalography (MEG) responses to feedback cues were analysed using a beamformer-based spatial filtering algorithm (event-related Synthetic Aperture Magnetometry, erSAM). Analysis of source power revealed activity in rostral anterior cingulate cortex (ACC) only to negative feedback processing, which peaked at 260 ms after stimulus onset. The results are in agreement with both evidence from fMRI on spatial characteristics of negative feedback processing, and evidence from event-related potentials (ERPs) on the temporal profile of this ACC response. The superior temporal gyrus was activated only with positive feedback, reflecting integration of actions with successful outcomes. The present MEG erSAM findings are the first to provide both accurate spatial localization as well as temporal specificity for the neural correlates of feedback processing.