The Time Knowledge Questionnaire for children.

Based on a definition of time knowledge as the correct representation and use of the various time units, a validated questionnaire, the Time Knowledge Questionnaire (TKQ) has been developed with norms for typically developing children aged 6-11 years. The TKQ is a relatively short (10-45 min) and innovative tool, comprising 25 questions broken down into 7 categories. The TKQ has good internal consistency. A total score and two summary scores are provided, assessing conventional time and estimative time respectively. A clinical application of the tool was shown to be of interest for children with disorders or disabilities.

The Discrepancy between Performance-Based Measures and Questionnaires when Assessing Clinical Outcomes and Quality of Life in Pediatric Patients with Neurological Disorders.

In clinical outcome assessment, the relation between performance-based measures and questionnaire ratings of the same domain is weak, but correlations between questionnaires proposed for the evaluation of different domains are strong. The present study aims to illustrate these phenomena in a group of patients with neurofibromatosis type 1 (NF1) and to propose an explanatory hypothesis. A single neuropsychologist interviewed the parents about the child's situation and current difficulties and then assessed this parental view as overall positive or overall negative. The same assessor then administered the Wechsler Intelligence Scales and neuropsychological tests to 78 children and adolescents with NF1 (5-18 years). Parents then completed the Child Behavioral Checklist (CBCL), the Conners' Parent Rating Scale, the Behavior Rating Inventory of Executive Function (BRIEF), as well as questionnaires assessing quality of life, impact of the medical disorder, and their own difficulties. All questionnaires were inter-correlated (r = 0.29 - 0.84) and associated with the overall positive or negative parental view of the child's progress (effect size = 0.41-1.46). Conversely, questionnaires were weakly or not significantly related to intelligence, cognitive measures, or clinical severity. In conclusion, the parental view of the child's progress was related to the answers to questionnaires assessing quality of life or strengths and difficulties of patients with a neurological disorder. This factor should be assessed independently and taken into account when assessing clinical outcome.

[Preschool familial environment and academic difficulties: A 10-year follow-up from kindergarten to middle school]. / Facteurs associés aux difficultés scolaires : une étude de suivi de la maternelle à la fin du collège.

The persistence of academic difficulties from childhood through adulthood has led researchers to focus on the identification of the early factors influencing children's subsequent achievement in order to improve the efficient screening of children who might be at risk of school failure. The foundations of academic achievement can be accurately traced back to the preschool years prior to children's entry in formal schooling and are largely influenced by environmental determinants. Importantly, some environmental conditions act as early risk factors undermining children's later academic achievement due to the well-established relation between underachievement and exposure to moderate to high levels of environmental risk. In the present study, we aimed to investigate the longitudinal effects of environment-level factors (sociodemographic and family characteristics) and early risk exposure at kindergarten on children's subsequent academic achievement at the end of middle school (grade 9). The sample of analysis comprised 654 kindergarteners aged 5-6 years (2001-2002 school year) followed through the end of middle school when they were aged 14-15 years (2010-2011 school year). At kindergarten, assessment included questionnaire-based measures of sociodemographic and family background characteristics. These included an original set of information pertaining to family background including parental nationality, education level, history of reading difficulties, type of early childcare, family situation, family size, and language-based bedtime routines, as well as individual-level factors such as children's first language, medical history, language delay, birth weight, age of walking onset, and gestation period. At grade 9, outcome measures were composed of children's results in the national evaluations performed at the end of middle school ("Diplôme National du Brevet"), or history of repetition for a second year of the same class. The results indicated that all family background characteristics at kindergarten were related to later academic outcomes at grade 9. From the original set of family characteristics, parental educational level, family situation, language-based bedtime routines, and type of early childcare significantly predicted later academic achievement at grade 9. Moreover, a multiple risk index score aggregating these specific family characteristics, together with three individual-level factors (gender, medical history, and language delay) was robustly and positively associated with an increased likelihood of school failure at the end of middle school. Unique to our study was the finding relative to the longitudinal association over a 10-year span of language-based bedtime routines with children's academic performance at the end of middle school. These findings underline the importance of including family background information in early surveillance procedures in order to improve the efficient screening of children who might be at risk of academic underachievement. Importantly, some of these contextual factors represent environmental characteristics that can be reversed early in life through appropriate and informed support to families. Moreover, the present work has important implications regarding the early detection of children who are at familial risk of underachievement, allowing the activation and promotion of adequate intervention strategies early in children's educational trajectories.

Neuropsychological evaluation and parental assessment of behavioral and motor difficulties in children with neurofibromatosis type 1.

Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem disorder, with large inter and intrafamilial clinical variability and uncertain prognosis. In children with NF1 cognitive disorders, learning difficulties and behavioral problems are common. The present study aims to establish the neuropsychological and behavioral profiles of 78 patients with NF1, aged between 5 and 18 years, and to examine the relationship between these profiles and the transmission of NF1 (sporadic vs. familial), clinical manifestations, and environmental factors. We used several questionnaires completed by parents and neuropsychological tests. The results confirmed specific neuropsychological disabilities in children with NF1, especially involving visuospatial and fine motor skills, learning difficulties and behavioral problems. Cognitive difficulties were significantly more frequent in patients with familial than in those with sporadic NF1. All parental questionnaires were correlated with each other, but parental reports were not associated with FSIQ, SES, school status, and clinical manifestations of the disease. Neuropsychological tests were poorly related to parental reports of cognitive and behavioral difficulties.

Assessment of executive functioning in children and young adults treated for frontal lobe tumours using ecologically valid tests.

There is a lack of studies assessing executive functions (EF) using ecologically valid tests in children with frontal lobe lesions. This study aimed to (1) evaluate EF in children, adolescents and young adults treated for childhood frontal lobe tumours, (2) identify factors influencing performance, such as age at diagnosis or type of treatment, and (3) examine correlations between intellectual ability and classical and ecological tests of EF. Twenty-one patients, aged 8-27 years, treated for a childhood benign or malignant frontal lobe tumour, and 42 healthy controls (matched for gender, age and socio-economic status) were assessed using classical tests of EF, and the BADS-C ecological battery. Patients also underwent assessment of intellectual ability and parent and teacher ratings of the BRIEF questionnaire. IQ scores ranged from 45 to 125 (mean FSIQ = 84) and were lower in case of epilepsy, hydrocephalus and lower parental education. Patients displayed deficits in most, but not all measures of EF. Most classical and ecological measures of EF were strongly correlated to IQ. This study confirms the frequency of EF deficits in this population; it also highlights the utility of ecological measures of EF and some limitations of classical tests of EF in children.

Long-term functional outcome of patients with cerebellar pilocytic astrocytoma surgically treated in childhood.

UNLABELLED: Abstract Purpose: A number of studies report neurological and cognitive deficits and behavioural disorders in children after surgical treatment for a benign cerebellar tumour. The present study explores functional outcome in adolescents and adults treated for a low-grade cerebellar astrocytoma in childhood. MATERIALS AND METHODS: Participants were 18 adolescents and 46 adults treated for low-grade astrocytoma in childhood. Academic achievement, professional status and neurological, cognitive and behavioural disturbances were collected using self-completed and parental questionnaires for adolescents and phone interview for adults. For the adolescent group, a control group filled in the same questionnaires. RESULTS: Mean time lapse from surgery was 7.8 years for adolescents and 12.9 years for adults. Five adults (11%) had major sequelae related to post-operative complications, post-operative mutism and/or brain stem involvement. All the other participants presented close-to-normal academic achievement and normal autonomy, despite a high rate of reported cognitive difficulties and difficulties related to mild neurological sequelae (fine motor skills, balance). CONCLUSION: The long-term functional outcome of low-grade cerebellar astrocytoma is generally favourable, in the absence of post-operative complications and brain stem involvement. No major impact of neurological deficits, cognitive problems and emotional disorders on academic achievement and independent functioning was observed.

Clinical evidence of the role of the cerebellum in the suppression of overt articulatory movements during reading. A study of reading in children and adolescents treated for cerebellar pilocytic astrocytoma.

It has been suggested that the cerebellum is involved in reading acquisition and in particular in the progression from automatic grapheme-phoneme conversion to the internalization of speech required for silent reading. This idea is in line with clinical and neuroimaging data showing a cerebellar role in subvocal rehearsal for printed verbalizable material and with computational "internal models" of the cerebellum suggesting its role in inner speech (i.e. covert speech without mouthing the words). However, studies examining a possible cerebellar role in the suppression of articulatory movements during silent reading acquisition in children are lacking. Here, we report clinical evidence that the cerebellum plays a part in this transition. Reading performances were compared between a group of 17 paediatric patients treated for benign cerebellar tumours and a group of controls matched for age, gender, and parental socio-educational level. The patients scored significantly lower on all reading, but the most striking difference concerned silent reading, perfectly acquired by almost all controls, contrasting with 41 % of the patients who were unable to read any item silently. Silent reading was correlated with the Working Memory Index. The present findings converge with previous reports on an implication of the cerebellum in inner speech and in the automatization of reading. This cerebellar implication is probably not specific to reading, as it also seems to affect non-reading tasks such as counting.

How do children acquire early grammar and build multiword utterances? A corpus study of French children aged 2 to 4.

In the last 50 years, researchers have debated over the lexical or grammatical nature of children's early multiword utterances. Due to methodological limitations, the issue remains controversial. This corpus study explores the effect of grammatical, lexical, and pragmatic categories on mean length of utterances (MLU). A total of 312 speech samples from high-low socioeconomic status (SES) French-speaking children aged 2-4 years were annotated with a part-of-speech-tagger. Multiple regression analyses show that grammatical categories, particularly the most frequent subcategories, were the best predictors of MLU both across age and SES groups. These findings support the view that early language learning is guided by grammatical rather than by lexical words. This corpus research design can be used for future cross-linguistic and cross-pathology studies.

Early manifestations of manual specialisation in infants: a longitudinal study from 20 to 30 weeks.

This longitudinal study examined lateral differences between latency time of the two hands during the development of prehension in 12 infants from 20 to 30 weeks. Latency time (LT) is defined as the delay between the visual localisation of a reachable target and the beginning of the movement and could be considered as a phase in the preparation of action. If LT varies with the hand used and the type of movement, this would suggest differences in information processing (nature and/or quantity). Results show that the latency time is shorter for the left hand approach movements and shorter for the right hand grasping movements. These findings are in favour of a manual specialisation--clearly present from 20 weeks--and are discussed in a possible hemispheric specialisation perspective.

Quality-of-life, mood and executive functioning after childhood craniopharyngioma treated with surgery and proton beam therapy.

PRIMARY OBJECTIVE: Childhood craniopharyngioma, a benign tumour with a good survival rate, is associated with important neurocognitive and psychological morbidity, reducing quality-of-life (QoL). METHOD: This retrospective study analysed QoL, mood disorders, everyday executive functioning and disease's impact on family life in 29 patients (mean age at diagnosis 7 years 10 months (SD = 4.1); mean follow-up period 6 years 2 months (SD = 4.5)) treated for childhood craniopharyngioma by surgery combined with radiotherapy using proton beam. Assessment included a semi-structured interview and standardized scales evaluating self-report of QoL (Kidscreen 52) and depression (MDI-C) and proxy-reports of QoL (Kidscreen 52), executive functioning (BRIEF) and disease's impact (Hoare and Russel Questionnaire). RESULTS: Twenty-three families answered the questionnaires completely. Overall QoL self-report was within the normal range. QoL proxy-report was lower than self-report. Eleven patients reported depression; 24-38% had dysexecutive symptoms. A majority of families felt 'very concerned' by the disease. Depression and low parental educational level were associated with lower QoL and higher levels of executive dysfunction. CONCLUSION: Given the high morbidity of childhood craniopharyngioma, screening for psychosocial outcome, cognitive functioning, including executive functions, mood and QoL should be systematic and specific interventions should be developed and implemented.

Behaviour assessment and reading ability in second grade greek school children.

Studies on ADHD show high comorbidity with behavioural and learning disorders. However, the specific association of behavioural and attention factors with learning disorders is not clear. The aim of this study is to examine the relationships between hyperactivity, inattentionand reading ability in a non-referred sample in Greece. Data were collected from 201 pupils attending second grade in public school in an Athens district. The CBCL was administrated to parents in order to evaluate behavioural disorders, inattention and hyperactivity. Teachers completedthe CBCL and the Conner's scale. Reading ability was assessed by a reading test appropriate for second grade. Attention difficulties reported by the teacher were associated with lower readingskills, but hyperactivity and behaviour disorders were not. Correlations of reading skills with CBCL scores were very low, especially through parental ratings. Girls showed better reading skills and less"hyperactivity" than boys. There was consistency in teachers' ratings between the Conner's and the CBCL. Teacher-parent concordance on CBCL was very low or absent. Report of hyperactivity without report of attention problems was not associated with reading difficulties in a non-referred Greek sample of second grade schoolchildren. This observation must be considered when therapeutic and/or educational planning is undertaken.

[Quality of life in children with epilepsy: a review]. / La qualité de vie chez l'enfant avec épilepsie: revue de la littérature.

Health-related quality of life (HRQOL) is a multidimensional construct, without general agreement on the number of domains and the content of each domain. In children with epilepsy, the HRQOL evaluation includes both nonspecific aspects, such as behavioral, psychological and cognitive difficulties and the impact of a chronic pediatric illness on the child and its family and specific aspects, such as the perception of the severity of the seizures and of the undesirable effects of the antiepileptic treatments, as well as the social impact of a negative attitude toward epilepsy. The present article presents a review of the methods proposed for the assessment of HRQOL in children with epilepsy. Most methods rely on parental reports; however, there is an increasing effort to develop tools taking the child's point of view into account. HRQOL tools have often been used in clinical trials and, especially, to evaluate the surgical treatments of epilepsy. For the clinician, HRQOL tools may be a preliminary approach to the patient's problems to be interpreted in relation to the patient's medical, psychological, cognitive, social and familial context. In France, few large-scale studies on HRQOL in children with epilepsy have been conducted. We present the preliminary results of a French study based on parental reports.

Influence of anxiety and reported stressful life events on relapses in multiple sclerosis: a prospective study.

OBJECTIVE: Self-reported stressful life events and infections have been associated with relapses in multiple sclerosis. Also, anxiety has been reported to influence other diseases of unpredictable course. To study relation of self-reported stressful life events, levels of anxiety, and episodes of infection, with relapses of the disease in women with multiple sclerosis. METHODS: This is a one-year prospective study. Thirty seven women with multiple sclerosis were regularly seen every four weeks, for one year. They were keeping diaries of events they considered stressful. These events were ranked according to the Holmes and Rahe Social Readjustment Rating Scale. Their anxiety levels were assessed with the Hamilton rating scale for anxiety. Relapses and episodes of infection were verified at additional visits. Results were studied using a survival analysis model adapted for several recurrent events. RESULTS: A total of 291 stressful events, 37 episodes of infection, and 48 relapses, were registered. High level of anxiety were stongly related to the number and the severity of reported stressful events during the preceding period and with the advent of a relapse in the following period (Hamilton score greater than 18 is associated with 4.2 times the rate of relapsing and three or more reported stressful events with 5.7 times the rate of relapsing). CONCLUSIONS: Anxiety and self-reported stressful events may in fact be two measures of the same underlying emotional factor, which plays an important role on the course of the disease, in addition to episodes of infection.

Teachers' reporting of behavioural problems and cognitive-academic performances in children aged 5-7 years.

BACKGROUND: The behavioural and academic performance of young children with teachers' reported hyperactivity, conduct problems or inattention is under debate. AIM: This study investigates the associations between teachers' reported behavioural difficulties and academic and cognitive performances in two large samples of preschool and school children in France. SAMPLES AND METHOD: Behavioural data relating to two large samples of preschool (N=475) and first grade (N=465) children were collected from their teachers by means of a questionnaire. A factorial analysis of the questionnaire revealed a four-factor structure ('hyperactivity', 'inattention', 'conduct problems' and 'unsociability') that was similar in both age groups. Cognitive tests were used for each age group. RESULTS: Teachers' reporting of 'inattention' was associated with significantly lower performances in all tests in both the preschool and first grade samples. 'Hyperactivity' or 'conduct problems' were not consistently associated with the test results, when the effect of 'inattention' was taken into account. Preschool 'inattention', but not 'hyperactivity' or 'conduct/sociability problems', was related to poor performances at reading tasks in first grade. CONCLUSION: These findings question the pathological significance of teachers' report of 'hyperactivity' in young children without associated attention problems.

Cognitive associations of bimanual haptico-visual recognition in preschoolers.

We have investigated the relation between haptico-visual recognition of objects and cognitive tasks in two large samples of preschoolers (n = 534; n = 750). Children aged 6 years completed a cross-modal task in which they have first to haptically explore an object and second to visually recognize it; they also performed phonological, verbal semantic, and visual tasks. For two consecutive years, bimanual haptico-visual recognition was significantly correlated to performance at all the cognitive tasks. The meaning of this relationship is discussed. The study supports the view that haptico-visual recognition tasks should be used as screening tools for early identification of children at risk of learning difficulties.

[Behavior difficulties, attention difficulties and learning problems in children aged from 3.5 to 8 years: a longitudinal school study]. / Comportement perturbateur, difficultés d'attention et apprentissages entre 3,5 ans et 8 ans: une étude longitudinale en milieu scolaire.

AIM: To evaluate the long term impact of teacher's report of behavior difficulties in children aged 3.5 years. METHOD: Teachers assessed behavior and attention difficulties in 2054 children by questionnaire; reading performance, and behavior and attention difficulties were re-assessed in 695 of these children at second grade (7-8 years). RESULTS: Reading delay was not significantly associated with behavior and attention assessment at 3.5 years. Children with behavior problems according to the teacher were most often different at 3.5 years and at 7-8 years. CONCLUSION: Reading delay at second grade was not related to teacher's report of behavior problems at 3.5 years of age in this french longitudinal school study. These observations are discussed in relation to DSM-IV criteria of disruptive behavior and attention deficit in children.

[Language and behavioral difficulties at age 3 and half and reading delay in grade 2]. / Difficultés de langage et de comportement à 3 ans et demi et retard en lecture au cours élémentaire.

BACKGROUND: Early detection of specific language impairment and dyslexia in children is an important public health problem. Longitudinal studies are needed for the distinction of real impairments from simple transitory delays. METHODS: Teachers filled a 29-item questionnaire on language and behavior for 695 children aged 3.5 years. Four years later (at second grade of primary school) the same children were evaluated for reading and writing. Statistical analysis focused on the relationships between teacher's early observations and reading delay 4 years later. Associated factors were age, sex, educational level and bilinguism of the parents, and area of the school. RESULTS: The delay in written language acquisition (8.5% of the children) was significantly associated with low educational level (but not bilinguism) of the parents and to the area of the school. In univariate analysis, most of the teacher's early negative assessments were significantly related to reading/writing delay, with the exception of some behavioral problems. However, when the effect of associated factors was taken into account only a few items, mainly concerning language expression, remained significantly associated with later reading/writing delay. CONCLUSION: These data show a major role of associated factors (educational level of the parents, area of the school) in reading delay, and help to select specific teacher's observations for an early prediction of this delay.

Cross-cultural differences for three visual memory tasks in Brazilian children.

Norms for three visual memory tasks, including Corsi's block tapping test and the BEM 144 complex figures and visual recognition, were developed for neuropsychological assessment in Brazilian children. The tasks were measured in 127 children ages 7 to 10 years from rural and urban areas of the States of São Paulo and Minas Gerais. Analysis indicated age-related but not sex-related differences. A cross-cultural effect was observed in relation to copying and recall of Complex pictures. Different performances between rural and urban children were noted.

Smooth pursuit eye movements are associated with phonological awareness in preschool children.

Phonological awareness is strongly related to reading ability, but reports are more conflicting concerning the association of high level oculomotor skills with reading. Here, we show that phonological awareness is specifically associated with the ability to perform smooth pursuit eye movements in preschool children. Two large independent samples of preschool children (n=838 and n=732) aged 5-6.4 years, without history of neurological disorder, were examined by school medical doctors for visual and oculomotor problems. Nineteen percent of the children in the first sample and 14% in the second failed at the clinical evaluation of smooth pursuit eye movements, and 17 and 15%, respectively, presented another visual or oculomotor problem. Ten short cognitive tests were performed by the same children. Visual and oculomotor problems other than a failure on smooth pursuit were not consistently related to the cognitive tasks, with one exception, the visual recognition of letters. Children who failed at smooth pursuit obtained lower scores at a number of cognitive tasks, and especially phonological awareness tasks and copy of visually presented trajectories. Poor working memory and/or failure of anticipation during the tracking of a visual or auditory stimulus related to frontal cortex immaturity may explain these associations in preschool children.

[Screening by teachers for language and behavior difficulties in 2059 children aged 3,5 years]. / Repérage par les enseignants des difficultés de langage et de comportement chez 2,059 enfants de 3 ans et demi.

BACKGROUND: Several tools have been proposed for screening for specific language impairment and behavioral problems in pre-school children. These disorders are risk factors for later poor school achievement and social life. However, presence of real disorders must be differentiated from environmental factors, such as low educational level of the parents or bilingual family. METHODS: A 29-item teachers'questionnaire was used for screening for language and behavioral disorders in 2059 nursery-school children aged 3.5 years from 200 nursery-schools of different areas in France. RESULTS: According to the teachers, difficulties were clearly more frequent in boys than girls, in children from low educational level families, and in children with not-french-speaking parents. CONCLUSION: The gender of the child and the characteristics of the family play a very important role in the teachers'assessment of a young pre-school child's language and behavior. Longitudinal studies would be required to differentiate the presence of specific disorders, requiring individual intervention, from simple delays due to environmental factors.