The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games.

Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.

Electrifying discourse: Anodal tDCS of the primary motor cortex selectively reduces action appraisal in naturalistic narratives.

Non-invasive stimulation of the primary motor cortex (M1) modulates processing of decontextualized action words and sentences (i.e., verbal units denoting bodily motion). This suggests that language comprehension hinges on brain circuits mediating the bodily experiences evoked by verbal material. Yet, despite its relevance to constrain mechanistic language models, such a finding fails to reveal whether and how relevant circuits operate in the face of full-blown, everyday texts. Using a novel naturalistic discourse paradigm, we examined whether direct modulation of M1 excitability influences the grasping of narrated actions. Following random group assignment, participants received anodal transcranial direct current stimulation over the left M1, or sham stimulation of the same area, or anodal stimulation of the left ventrolateral prefrontal cortex. Immediately afterwards, they listened to action-laden and neutral stories and answered questions on information realized by verbs (denoting action and non-action processes) and circumstances (conveying locative or temporal details). Anodal stimulation of the left M1 selectively decreased outcomes on action-relative to non-action information -a pattern that discriminated between stimulated and sham participants with 74% accuracy. This result was particular to M1 and held irrespective of the subjects' working memory and vocabulary skills, further attesting to its specificity. Our findings suggest that offline modulation of motor-network excitability might lead to transient unavailability of putative resources needed to evoke actions in naturalistic texts, opening promising avenues for the language embodiment framework.

Adapting an internet-delivered intervention for depression for a Colombian college student population: An illustration of an integrative empirical approach.

BACKGROUND: Culturally adapted psychotherapy (CAP) studies are limited and until now there are few published examples that illustrate the process of cultural adaptation with internet-delivered treatments. AIM: This paper aims to illustrate an integrative approach to the cultural adaptation of an evidence-based internet-delivered cognitive-behavioural therapy intervention for depression (Space from Depression programme). METHOD: Mixed method approach utilising quantitative and qualitative methods to assist in the cultural adaptation of the Space from Depression programme was used. The adaptation involved a framework for cultural sensitivity (CSF), alongside an ecological validity framework (EVF) and principles from cross-cultural assessment research. The method included the development of a theory-informed measure, the Cultural Relevance Questionnaire (CRQ), designed specifically for this research. RESULTS: The adaptation included an establishment of CSF, which included the incorporation of Colombian cultural expressions. College students' (n = 5) and experts' (n = 7) evaluated the EVF based on cross-cultural assessment principles of a preliminary adapted version through the CRQ, showing reliability in the sample (Cronbach's Alpha 0.744). Qualitative analysis supported the culturally sensitive changes or incorporations made to the programme, such as: personal stories and textual translations from English and these were considered ecologically valid and representative. CONCLUSIONS: The research provided support for the idea that CAP can be conducted systematically for internet-delivered interventions.

Out of the office and into the field: Exploring neuropsychological correlates between search behavior and a traditional desktop task in children and adolescents with ADHD / Del consultorio a la vida cotidiana: Una exploración de los correlatos neuropsicológicos entre una prueba tradicional de escritorio y de la conducta de búsqueda en niños y adolescentes con TDAH

Abstract Introduction Cognitive assessment of patients with attention deficit hyperactivity disorder (ADHD) can help clinicians provide individually tailored treatment and advice, and researchers to identify potential associations between psychopathology and specific cognitive deficits. Assessment instruments, however, have received some criticism regarding their ecological validity, that is, the capacity to extrapolate from the performance on such tasks to aspects of everyday functioning. In order to meet this challenge we developed the Ball Search Field Task (BSFT) that takes place outdoors and uses large, open areas. In the BSFT, the goal is to search for target objects hidden under opaque containers, with experimenters assessing the efficiency of participants' strategies to collect a maximum of these. Objective Here we explore how the measures produced by one of the latest versions of this task (the patchy BSFT) match up with a traditional desktop task often used in clinical environments, the Tower of London (ToLo). Method We applied the BSFT and ToLo to children and adolescents with ADHD and compared the metrics using Spearman correlations. Results We found significant, moderate correlations between instruments, as exemplified by that of balls collected per cones lifted (BSFT) and number of moves (ToLo) (r = -.44). Discussion and conclusion Matching correlates between the BSFT and ToLo suggest these tasks may be tapping into similar cognitive processes. The addition of assessment tools with ecological validity may help provide a more comprehensive evaluation and a better understanding of the day-to-day impact of cognitive afflictions underlying psychiatric disorders such as ADHD.

Resumen Introducción La evaluación cognitiva de pacientes con déficit de atención e hiperactividad (TDAH) puede ayudar al personal clínico a personalizar el tratamiento y a los investigadores a identificar asociaciones entre psicopatología y deficitarios cognitivos específicos. Los instrumentos de evaluación han recibido críticas en cuanto a su validez ecológica, esto es, la capacidad de extrapolar el desempeño en dichos instrumentos a situaciones de la vida diaria. Con este desafío en mente, desarrollamos la Prueba de Búsqueda de Pelotas (BSFT, por sus siglas en inglés) que se lleva a cabo en áreas abiertas y amplias. La BSFT consiste en buscar objetos escondidos bajo contenedores opacos para evaluar la eficiencia de la búsqueda que intenta encontrar el mayor número posible de objetos. Objetivo Exploramos la manera en que una versión de esta tarea (la BSFT en parches) se compara con una tarea de uso común en ambientes clínicos, la Torre de Londres (ToLo, por sus siglas en inglés). Método Aplicamos la BSFT y la ToLo a niños y adolescentes con TDAH y comparamos las métricas resultantes mediante una correlación de Spearman. Resultados Encontramos correlaciones significativas entre estas pruebas, como lo ejemplifica aquella entre el número de conos levantados (BSFT) y el número de secuencias correctas (ToLo) (r = -.48). Discusión y conclusión Correlatos de equivalencia entre la BSFT y la ToLo sugieren que estas tareas demandan procesos cognitivos similares. Investigar tareas con validez ecológica puede ayudarnos a ofrecer una evaluación más completa y a entender mejor el impacto diario de las afectaciones cognitivas subyacentes a trastornos psiquiátricos como el TDAH.

Effect of official judo matches on handgrip strength and perceptual responses.

This study aimed to verify the effect of judo matches on handgrip strength and perceptual responses during an official tournament in medalists and nonmedalists. Thirty-four male judo athletes participated in an official judo tournament. Before the first match and immediately after each match, maximum isometric handgrip strength and rate of perceived exertion overall and in specific areas were assessed. Analysis of variance for repeated measures was used to compare variables before the first match and after each match, and t-test was used to compare medalists and nonmedalists with the level of significance set at 5%. Also, effect size (ES) analysis was used. The results showed decrease in handgrip strength in both hands from the third match (P<0.05). The rate of perceived exertion (RPE) increased from the first match and remained high over the subsequent matches (P<0.001). A very large effect for nonmedalist group (ES=3.44) and large effect for medalist group (ES=1.94) was found in the third match compared to prematch. Forearm and fingers were the body regions most cited by athletes in both groups. We concluded that an official judo competition induced significant drop in handgrip strength from the third match and increased the RPE from first match. Medalists seem to have better recovery after the third match compared to nonmedalists.

A novel experimental paradigm to evaluate children and adolescents diagnosed with attention-deficit/hyperactivity disorder: Comparison with two standard neuropsychological methods.

INTRODUCTION: In this study we evaluated a recently developed test, the Ball Search Field Task (BSFT) as a neuropsychological tool for measuring cognitive and behavioral performance of individuals with disorders such as attention-deficit/hyperactivity disorder (ADHD), which are frequently accompanied by cognitive deficits and a lack of behavioral inhibition. The task provides a complementary method of assessment that attempts ecological validity by drawing on challenges faced in real-world situations. In this task, energetic costs and gross sensorimotor feedback are involved, as participants are required to search for targets in a large open area. METHOD: We compared performance on the BSFT in a clinical sample of children and adolescents with a diagnosis of ADHD with their scores on two widely used neuropsychological tools, the Tower of London (ToLo) and the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: We found no correlations between scores on the BRIEF and those on either the BSFT or ToLo. However, we found moderate correlations between rule violations on ToLo and several BSFT variables, suggesting the capacity of these tests to detect common aspects of executive dysfunction. CONCLUSIONS: These findings, although modest, encourage further study of tasks like the BSFT, which may help assess cognitive dysfunction found in neurodevelopmental disorders such as ADHD in ecologically valid situations.

Development of a version of the self-ordered pointing task: a working memory task for Brazilian preschoolers.

OBJECTIVE: Working memory is a fundamental cognitive function and is predictive of outcomes and achievement in a wide range of domains from an early age. The focus of this study was to develop a computerized Brazilian version of the Self-Ordered Pointing Task (SOPT) for preschoolers and to provide initial normative and validation data for this task. METHODS: The sample of the present study was composed of 248 children aged 3 (n = 41), 4 (n = 88) and 5 (n = 119) years from 13 private and public schools in Belo Horizonte. Children were evaluated with the SOPT and the Columbia Mental Maturity Scale (CMMS), a measure of intelligence, and their parents completed the Brazilian Criterion of Economic Classification (CCEB) to assess their SES. A subsample of parents of 184 children also filled the Child Behavior Checklist for Ages 11/2-5 years (CBCL 11/2-5), a measure of psychopathology. RESULTS: A multiple regression analysis found chronological age, intelligence, and SES to be predictive of performance on the SOPT. Furthermore, five-year olds performed better than three- and four-year olds in the task. A difference between children in private and public kindergartens also emerged. Additionally, SOPT performance was negatively correlated with Internalizing, Externalizing, and Total psychopathological problems, as well as to several other psychopathological measures as accessed by the CBCL, although the correlations were small. CONCLUSION: Taken together, this study provides initial normative and validation data for the SOPT, but further validation studies are needed.

Processos Cognitivos Visuoespaciais e Ambiente Visual Circundante: Implicações Educacionais / Visuospatial Cognitive Processes and Visual Surrounding Environment: Educational Implications

RESUMO Nesta revisão de literatura, abordamos a importância da atenção seletiva, da inibição e da memória de trabalho na aprendizagem das crianças. Começamos por apresentar as suas definições e principais mecanismos funcionais. Apresentamos igualmente conclusões de vários estudos que abordam a importância desses processos, sobretudo em tarefas visuoespaciais. Finalmente, abordamos o papel que o ambiente visual circundante desempenha na aprendizagem, chamando a atenção para uma lacuna que se verifica em grande parte dos estudos: a sua pouca validade ecológica. É também defendido que o ambiente visual externo deve ser considerado nos modelos explicativos dos processos cognitivos básicos. Conclui-se o trabalho alertando para a necessidade de se estudar de forma mais sistemática a relação entre estes dois elementos (cognição e ambiente).

ABSTRACT This literature review focuses on the importance of selective attention, inhibition and working memory in children's learning. We start by presenting the definition and functional mechanisms of these cognitive processes. We then present the main results of several studies that report the importance of these processes, particularly in visuospatial tasks. We also discuss the role of the visual surrounding environment in learning, particularly with respect to an existing gap in most studies: Their low ecological validity. We argue for the importance of considering the visual external environment when trying to explain performance in basic cognitive processes. Finally, we stress the need for more empirical studies exploring in a systematic way the relation between these two elements (cognition and environment).

Guia de Avaliação das Capacidades Parentais: Estudo de Validade Ecológica / Evaluation Guide of Parental capacities: An Ecological Validity Study

RESUMOEste estudo teve como objetivo avaliar e maximizar a adequação do Guia de Avaliação das Capacidades Parentais (De Rancourt, Paquette, Paquette, & Rainville, 2006) ao sistema de proteção à infância português. Utilizou-se uma metodologia de grupos focais com técnicos psicossociais, magistrados e académicos que trabalham diretamente com a avaliação da parentalidade. As discussões focaram a exequibilidade da aplicação, a utilidade da informação recolhida e dos juízos clínicos efetuados para a elaboração de pareceres técnicos, e as alterações consideradas necessárias. Da análise efetuada com o software QSRNVivo8, concluiu-se que o Guia assenta em conhecimento científico atualizado e possibilita a obtenção de informação suficiente. Foram identificadas e detalhadas alterações metodológicas, estruturais e de conteúdo a introduzir no instrumento.

ABSTRACTThis aim of this study was to promote and improve the adaptation of the Parental Capacities Evaluation Guide (De Rancourt, Paquette, Paquette, & Rainville, 2006) to the Portuguese child protection system. A focus group methodology was used with professionals who work directly on parenting assessment: Social workers, judges and researchers. The discussions of the focus group concentrated on the Guide ‘feasibility, the usefulness of the information obtained, the clinical judgements made and on the major changes needed. From content analysis with the QSRNVivo8 software, it was concluded that the Guide is based on updated scientific knowledge and that it provides sufficient information for the assessment of parenting capacities. Three major kinds of changes to be made were identified: methodological, structural and content changes.

Executive functioning and adaptive coping in healthy adults.

Middle-aged individuals encounter multiple environmental demands to which they must develop efficient solutions, thus making the study of executive functions and coping strategies within this age group important. This study evaluated the relationship between the planning and flexible organization of executive function with adaptive coping strategies (ACS) in adults aged 43 to 52 years old. The study included 104 participants, including 52 men and 52 women, with no history of neurological or psychiatric illnesses, diabetes, or hypertension. The participants engaged in the Tower of London(DX) (TOL(DX)) test, the Wisconsin Card-Sorting Test (WCST), and the Coping Strategies Inventory. A relationship was observed between the percentage of errors and conceptual-level responses (WCST) and the Problem Solving ACS. In a separate analysis performed on the men, a negative relationship was discovered between the WCST and the Emotional Expression ACS. In the female group, the dimensions of the WCST and the TOL(DX) were associated with the ACS Emotional Expression and Problem-Solving subscales and the maladaptive coping strategy Social Withdrawal subscale. The relationship between executive functioning and the ACS is multidimensional, complex, and different between men and women. This study adds a neuropsychological characterization of the relationship between executive functions and ACS with ecological validity. The study confirms a relationship between the flexible organization of executive function and the Problem-Solving ACS.

Estrutura de prática e validade ecológica no processo adaptativo de aprendizagem motora / Practice schedule and ecological validity in the adaptive process of motor learning

O objetivo desse estudo foi investigar o efeito da estrutura de prática no processo adaptativo de aprendizagem motora em função da validade ecológica da situação experimental. Participaram do estudo 104 crianças distribuídas em oito grupos experimentais (dois níveis de validade ecológica x quatro estruturas de prática). A tarefa consistiu em rebater uma bola de tênis de mesa lançada por um equipamento ou pelo experimentador, com o objetivo de acertar um alvo localizado no lado oposto da mesa. O estudo envolveu duas fases: estabilização e adaptação. O desempenho foi analisado por meio da soma dos pontos obtidos em blocos de 10 tentativas. Os resultados mostraram que os efeitos das práticas constante, aleatória, constante-aleatória e aleatória-constante no processo adaptativo de aprendizagem motora foram similares em ambos os níveis de validade ecológica; a prática constante foi a estrutura menos efetiva no processo adaptativo de aprendizagem motora em ambas as situações experimentais.

The aim of this study was to investigate the effect of different practice schedules in the adaptive process of motor learning in function of the ecological validity of the experimental situation. Participants were 104 children distributed in eight experimental groups (2 levels of ecological validity x 4 practice schedules). The task was to hit a table tennis ball thrown by equipment or experimenter, aiming to hit a target located on the opposite side of the table. The study was carried out in two phases: stabilization and adaptation. Performance was analyzed through the sum of the points achieved in ten trial blocks. Results showed that the effects of constant, random, constant-random and random-constant practice on the adaptive process of motor learning were similar in both levels of ecological validity; constant practice was the less effective schedule on the adaptive process of motor learning in both experimental situations.