Executive function treatment and intervention in schools.

This selective review article examines treatment and intervention strategies for executive function (EF) deficits within the school environment. We begin by providing a broad definition of EF. We then examine the scope of EF deficits within the school setting and identify profiles of special populations of students who present with such deficits. A focus is placed on the developmental trajectory that both EF and the frontal lobes follow and how this drives the selection and effectiveness of treatments and interventions at particular "critical periods" throughout a child's academic career. Direct and indirect school-based diagnostic assessment methods to identify EF deficits in students will be briefly reviewed. Against that background, various treatment methods and intervention strategies to remediate both cognitive and affective EF deficits within the confines of the school setting will be presented. Individual and group intervention strategies will be presented as will their current acceptance within the scientific community and applicability to the educational arena. The importance of incorporating school-based neuropsychological assessment methods that aid in the differential diagnosis of academic and behavioral difficulties directly related to EF will also be discussed, as the accurate identification of these impairments is necessary to facilitate data-based decision making when selecting the most appropriate interventions following a developmental model in educational settings. Topics addressing EF treatment modalities and research-based interventions for clinical and school-based practitioners to consider within educational settings will also be presented as suggestions for future research with pediatric populations.

Using IQ discrepancy scores to examine the neural correlates of specific cognitive abilities.

The underlying neural determinants of general intelligence have been studied intensively, and seem to derive from the anatomical and functional characteristics of a frontoparietal network. Little is known, however, about the underlying neural correlates of domain-specific cognitive abilities, the other factors hypothesized to explain individual performance on intelligence tests. Previous preliminary studies have suggested that spatially distinct neural structures do not support domain-specific cognitive abilities. To test whether differences between abilities that affect performance on verbal and performance tasks derive instead from the morphological features of a single anatomical network, we assessed in two independent samples of healthy human participants (N=83 and N=58; age range, 5-57 years) the correlation of cortical thickness with the magnitude of the verbal intelligence quotient (VIQ)-performance intelligence quotient (PIQ) discrepancy. We operationalized the VIQ-PIQ discrepancy by regressing VIQ onto PIQ (VIQ-regressed-on-PIQ score), and by regressing PIQ onto VIQ (PIQ-regressed-on-VIQ score). In both samples, a progressively thinner cortical mantle in anterior and posterior regions bilaterally was associated with progressively greater (more positive) VIQ-regressed-on-PIQ scores. A progressively thicker cortical mantle in anterior and posterior regions bilaterally was associated with progressively greater (more positive) PIQ-regressed-on-VIQ scores. Variation in cortical thickness in these regions accounted for a large portion of the overall variance in magnitude of the VIQ-PIQ discrepancy. The degree of hemispheric asymmetry in cortical thickness accounted for a much smaller but statistically significant portion of variance in VIQ-PIQ discrepancy.

The neurocognitive assessment of Hispanic English-language learners with reading failure.

This study examined the performance of referred Hispanic English-language learners (N = 40) on the English and Spanish versions of the Cognitive Assessment System (CAS; Naglieri & Das, 1997 ). The CAS measures basic neuropsychological processes based on the Planning, Attention, Simultaneous, and Successive (PASS) theory (Naglieri & Das, 1997 ; Naglieri & Otero, 2011c). Full Scale (FS) scores as well as PASS processing scale scores were compared, and no significant differences were found in FS scores or in any of the PASS processes. The CAS FS scores on the English (M = 86.4, SD = 8.73) and Spanish (M = 87.1, SD = 7.94) versions correlated .94 (uncorrected) and .99 (corrected for range restriction). Students earned their lowest scores in Successive processing regardless of the language in which the test was administered. PASS cognitive profiles were similar on English and Spanish versions of the PASS scales. These findings suggest that students scored similarly on both versions of the CAS and that the CAS may be a useful measure of these four abilities for Hispanic children with underdeveloped English-language proficiency.

Multigroup confirmatory factor analysis of U.S. and Italian children's performance on the PASS theory of intelligence as measured by the Cognitive Assessment System.

This study examined Italian and U.S. children's performance on the English and Italian versions, respectively, of the Cognitive Assessment System (CAS; Naglieri & Conway, 2009; Naglieri & Das, 1997), a test based on a neurocognitive theory of intelligence entitled PASS (Planning, Attention, Simultaneous, and Successive; Naglieri & Das, 1997; Naglieri & Otero, 2011). CAS subtest, PASS scales, and Full Scale scores for Italian (N=809) and U.S. (N=1,174) samples, matched by age and gender, were examined. Multigroup confirmatory factor analysis results supported the configural invariance of the CAS factor structure between Italians and Americans for the 5- to 7-year-old (root-mean-square error of approximation [RMSEA]=.038; 90% confidence interval [CI]=.033, .043; comparative fit index [CFI]=.96) and 8- to 18-year-old (RMSEA=.036; 90% CI=.028, .043; CFI=.97) age groups. The Full Scale standard scores (using the U.S. norms) for the Italian (100.9) and U.S. (100.5) samples were nearly identical. The scores between the samples for the PASS scales were very similar, except for the Attention Scale (d=0.26), where the Italian sample's mean score was slightly higher. Negligible mean differences were found for 9 of the 13 subtest scores, 3 showed small d-ratios (2 in favor of the Italian sample), and 1 was large (in favor of the U.S. sample), but some differences in subtest variances were found. These findings suggest that the PASS theory, as measured by CAS, yields similar mean scores and showed factorial invariance for these samples of Italian and American children, who differ on cultural and linguistic characteristics.

Relations between Executive Function and Academic Achievement from Ages 5 to 17 in a Large, Representative National Sample.

This study examined age-related changes in complex executive function (EF) in a large, representative sample (N = 2,036) aged 5 to 17 using the Cognitive Assessment System (CAS; Naglieri & Das, 1997a). Relations between complex EF and academic achievement were examined on a sub-sample (N = 1,395) given the Woodcock-Johnson Tests of Achievement-Revised (Woodcock & Johnson, 1989). Performance on the three complex EF tasks improved until at least age 15, although improvement slowed with increasing age and varied some across tasks. Moreover, the different developmental patterns in the correlations between completion time and accuracy provide clues to developmental processes. Examination of individual achievement subtests clarified the specific aspects of academic performance most related to complex EF. Finally, the correlation between complex EF and academic achievement varied across ages, but the developmental pattern of the strength of these correlations was remarkably similar for overall math and reading achievement, suggesting a domain-general relation between complex EF and academic achievement.

A cognitive strategy instruction to improve math calculation for children with ADHD and LD: a randomized controlled study.

The authors examined the effectiveness of cognitive strategy instruction based on PASS (Planning, Attention, Simultaneous, Successive) given by special education teachers to students with ADHD randomly assigned by classroom. Students in the experimental group were exposed to a brief cognitive strategy instruction for 10 days, which was designed to encourage development and application of effective planning for mathematical computation, whereas the comparison group received-standard math instruction. Standardized tests of cognitive processes and math achievement were given at pretest. All students completed math worksheets throughout the experimental phase. Standardized achievement tests (Woodcock-Johnson Tests of Achievement, Third Edition, Math Fluency and Wechsler Individualized Achievement Test, Second Edition, Numerical Operations) were administered pre- and postintervention, and Math Fluency was also administered at 1 year follow-up. Large pre-post effect sizes were found for students in the experimental group but not the comparison group on math worksheets (0.85 and 0.26), Math Fluency (1.17 and 0.09), and Numerical Operations (0.40 and -0.14, respectively). At 1 year follow-up, the experimental group continued to outperform the comparison group. These findings suggest that students with ADHD evidenced greater improvement in math worksheets, far transfer to standardized tests of math (which measured the skill of generalizing learned strategies to other similar tasks), and continued advantage 1 year later when provided the PASS-based cognitive strategy instruction.

Exercise improves executive function and achievement and alters brain activation in overweight children: a randomized, controlled trial.

OBJECTIVE: This experiment tested the hypothesis that exercise would improve executive function. DESIGN: Sedentary, overweight 7- to 11-year-old children (N = 171, 56% girls, 61% Black, M ± SD age = 9.3 ± 1.0 years, body mass index [BMI] = 26 ± 4.6 kg/m², BMI z-score = 2.1 ± 0.4) were randomized to 13 ± 1.6 weeks of an exercise program (20 or 40 min/day), or a control condition. MAIN OUTCOME MEASURES: Blinded, standardized psychological evaluations (Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III) assessed cognition and academic achievement. Functional MRI measured brain activity during executive function tasks. RESULTS: Intent to treat analysis revealed dose-response benefits of exercise on executive function and mathematics achievement. Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity attributable to exercise was also observed. CONCLUSION: Consistent with results obtained in older adults, a specific improvement on executive function and brain activation changes attributable to exercise were observed. The cognitive and achievement results add evidence of dose-response and extend experimental evidence into childhood. This study provides information on an educational outcome. Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic, physical activity may prove to be a simple, important method of enhancing aspects of children's mental functioning that are central to cognitive development. This information may persuade educators to implement vigorous physical activity.

A national study on the development of visual attention using the cognitive assessment system.

OBJECTIVE: Developmental changes in the performance of children and adolescents are studied using the Cognitive Assessment System (CAS) which is an individually administered test of 4 basic cognitive processes. METHOD: The test measures the Planning, Attention, Simultaneous, and Successive (PASS) processes as a theory of intelligence that can provide the framework for an alternative to traditional IQ tests. The CAS, which includes a scale of attention comprising 3 subtests, each of which is presented visually, provides an opportunity to study the development of visual attention for 2,200 children and adolescents aged 5- to 17-years-old who participated in the national standardization sample. A subsample ( n = 1,395) is also administered the Woodcock-Johnson Tests of Achievement - Revised (WJ-R). RESULTS: On all 3 CAS attention subtests, the mean scores improve with age, and the rate of change between adjacent age groups is moderate-to-large up to 15-years-old. At all ages the CAS Attention standard score is moderately related to WJ-R Achievement Cluster scores. CONCLUSION: The results are discussed in light of conclusions about the development of attention based on the standardization sample of the NEPSY-A Developmental Neuropsychological Assessment.

Exercise and Children's Intelligence, Cognition, and Academic Achievement.

Studies that examine the effects of exercise on children's intelligence, cognition, or academic achievement were reviewed and results were discussed in light of (a) contemporary cognitive theory development directed toward exercise, (b) recent research demonstrating the salutary effects of exercise on adults' cognitive functioning, and (c) studies conducted with animals that have linked physical activity to changes in neurological development and behavior. Similar to adults, exercise facilitates children's executive function (i.e., processes required to select, organize, and properly initiate goal-directed actions). Exercise may prove to be a simple, yet important, method of enhancing those aspects of children's mental functioning central to cognitive development.

Effects of aerobic exercise on overweight children's cognitive functioning: a randomized controlled trial.

The study tested the effect of aerobic exercise training on executive function in overweight children. Ninety-four sedentary, overweight but otherwise healthy children (mean age = 9.2 years, body mass index 85th percentile) were randomized to a low-dose (20 min/day exercise), high-dose (40 min/day exercise), or control condition. Exercise sessions met 5 days/week for 15 weeks. The Cognitive Assessment System (CAS), a standardized test of cognitive processes, was administered individually before and following intervention. Analysis of covariance on posttest scores revealed effects on executive function. Group differences emerged for the CAS Planning scale (p = .03). Planning scores for the high-dose group were significantly greater than those of the control group. Exercise may prove to be a simple, yet important, method of enhancing aspects of children's mental functioning that are central to cognitive and social development.

Utility of the PASS theory and cognitive assessment system for Dutch children with and without ADHD.

This study examined the utility of the Planning, Attention, Simultaneous, Successive (PASS) theory of intelligence as measured by the Cognitive Assessment System (CAS) for evaluation of children with attention-deficit/hyperactivity disorder (ADHD). The CAS scores of 51 Dutch children without ADHD were compared to the scores of a group of 20 Dutch children with ADHD. The scores of the Dutch children were also compared to American standardization samples of children with and without ADHD. The findings showed that children with ADHD in both countries demonstrated relatively low scores on the Planning and Attention scales of the CAS, but average scores on the Simultaneous and Successive scales. These findings are similar to previously published research suggesting that the PASS theory, as operationalized by the CAS, has sensitivity to the cognitive processing difficulties found in some children with ADHD.

Race and ethnic differences and human figure drawings: clinical utility of the DAP:SPED.

This study examined race and ethnic differences on the Draw A Person: Screening Procedure for Emotional Disturbance (DAP:SPED; Naglieri, McNeish, & Bardos, 1991) for youths 6 though 17 years of age for 2 matched samples. Samples were drawn from the DAP:SPED nationally representative standardization sample and matched on gender, grade, and school classroom. No statistically significant differences were found for big figure, small figure, or shading item composites. A statistically significant difference was found between Black-White pairs on figure omissions but showed a small effect size (d value = .25). Further, no statistically significant differences were found between the DAP:SPED Total T scores for Black and White youth (M = 47.67, SD = 10.09; N =138) or Hispanic and White youth (M = 48.20, SD = 9.56; N = 59), showing very small effect sizes. In addition, equivalence testing showed similarities across race and ethnic pairs for all composites and DAP:SPED total score, lending preliminary support to the DAP:SPED's clinical utility as a measure that yields similar scores across these groups.

Relationships between the WISC-III and the Cognitive Assessment System with Conners' rating scales and continuous performance tests.

The aim of this study was to examine the relationships between intelligence, ratings of behavior, and continuous performance test scores for a sample of 117 children aged 6-16 years who were referred to a specialty clinic. The sample was comprised of children who had a primary (45%) or secondary (36%) diagnosis of ADHD. All children were given the Wechsler Intelligence Scale for Children Third Edition (WISC-III), Cognitive Assessment System (CAS), Conners' Continuous Performance Test (CPT), and Conners' Parent and Teacher Rating Scales--Revised, Long Form. Correlations between Conners' Behavior Rating Scale and Conners' Continuous Performance Test were uniformly low and non-significant (the highest correlation was .17). Correlations between the WISC-III and Conners' Parent Rating Scale were all non-significant, but Teacher Ratings showed significant correlations between most of the WISC-III factors and the Cognitive Problems/Inattention scores. Few significant correlations were found between CPT with the WISC-III and CAS. These results suggest that practitioners should expect to find a lack of consistency between the scores provided by these measures and should be conservative of their use in clinical settings.

Ipsative comparisons of WISC-IV index scores.

The Wechsler Intelligence Scale for Children-4th Edition (Wechsler, 2003a) yields standard scores for four indexes that can be compared when practitioners examine within-child variability. The test manual provides pairwise comparison tables that clinicians can use to examine the scale variability, but it does not adequately caution them about the statistical pitfalls of multiple pairwise comparisons (e.g., inflated error rate). An alternative to the pairwise comparison approach called an ipsative method can be used to compare the 4 WISC-IV standard scores to an individual child's mean of the 4 index scores with more control over the error rate. These values were computed at the .05 and .01 levels following the method used by Naglieri (1993) for the Wechsler Intelligence Scale for Children-3rd Edition (WISC-III; Wechsler, 1991) as originally suggested by Davis (1959) and modified by Silverstein (1982) for previous versions of Wechsler's scales and other multiscore intelligence tests. An example of the use of the technique is provided, as are interpretive cautions.

Psychological testing on the Internet: new problems, old issues.

The Internet has significantly changed the way people conduct business, communicate, and live. In this article, the authors' focus is on how the Internet influences the practice of psychology as it relates to testing and assessment. The report includes 5 broad sections: background and context, new problems yet old issues, issues for special populations, ethical and professional issues, and recommendations for the future. Special attention is paid to implications for people with disabling conditions and culturally and linguistically diverse persons. The authors conclude that ethical responsibilities of psychologists and current psychometric standards, particularly those regarding test reliability and validity, apply even though the way in which the tests are developed and used may be quite different.

Comparison of Hispanic children with and without limited English proficiency on the Naglieri Nonverbal Ability Test.

Hispanic children with (n=148) and without (n=148) limited English proficiency were given the Naglieri Nonverbal Ability Test (NNAT; J. A. Naglieri. 1997a) and the Stanford Achievement Test-9th edition (SAT-9: 1995). The groups were selected from the NNAT standardization sample (N=22.620) and matched on geographic region, gender, socioeconomic status, urbanicity. and ethnicity. There was a very small difference (d ratio=0.1) between the NNAT standard scores for the children with limited English proficiency (M - 98.0) and those without limited English proficiency (M=96.7). The NNAT correlated moderately and similarly with achievement for the 2 groups. The sample of children with limited English proficiency earned considerably lower scores on SAT-9 Reading and Verbal subtests. Results suggest that the NNAT may be useful for the assessment of Hispanic children with and without limited English proficiency.

Relationships between psychiatric conditions and behavior problems among adults with mental retardation.

Adults with predominantly severe and profound mental retardation (N = 180) who lived in a developmental center were assessed with the Behavior Problems Inventory and the Diagnostic Assessment for the Severely Handicapped-II. Individuals with self-injurious, stereotyped, or aggressive/destructive behavior had generally higher psychopathology scores than individuals without, and the presence of behavior problems increased the likelihood of almost all psychiatric conditions up to three-fold. Factor analysis revealed that behavior problems tended to be associated with psychiatric conditions conventionally linked with behavior problems. A Self-Injury and Aggression/Destruction factor was related to impulse control and conduct problems, and a Stereotyped Behavior factor was linked to pervasive developmental disabilities and somewhat less so to schizophrenia. Stereotyped Behavior factor was independent of the Self-Injury/Aggression/Destruction factor.

Mathematical learning difficulties and PASS cognitive processes.

This study examined the relationships between mathematical learning difficulties (MLD) and the planning, attention, simultaneous, successive (PASS) theory of cognitive processing. The Cognitive Assessment System (CAS) was used to measure the PASS processes for a group of 267 Dutch students with MLD who attended either general or special education. The results showed that students with MLD performed lower than their peers on all CAS scales and that the MLD group contained many students with cognitive weaknesses in planning or successive processing. Moreover, students who had specific difficulties with the acquisition of basic math facts, the automatization of such facts, or word-problem solving were found to have distinct PASS cognitive profiles. In order to investigate the relationships between cognitive abilities and improvement in the mastery of basic math facts and problem solving, 165 of the students with MLD were given a special multiplication intervention. It appeared that the effectiveness of this particular intervention did not differ across the groups of students with specific cognitive weaknesses.