Submit to Children Review for Children Propose a Special Issue

Journal Menu

Journal Browser

Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neurology & Neurodevelopmental Disorders".

Deadline for manuscript submissions: closed (10 August 2025) | Viewed by 11984

Share This Special Issue

Special Issue Editors

Dr. Yael Fogel

E-Mail Website
Guest Editor

Department of Occupational Therapy, School of Health Sciences, University of Ariel, Ariel, Israel
Interests: relationships between individuals’ daily functioning and higher-level cognitive processes (executive function and awareness); individuals with neurodevelopmental difficulties (attention, learning, and motor difficulties, autistic disorders, etc.); ecological and performed-based assessment tool; generation and implementation of cognitive strategies with cognitive graduated prompts training; mental effort during daily activities; developing and implementing therapy programs (FITTED)

Prof. Dr. Naomi Josman

E-Mail Website
Guest Editor

Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3498838, Israel
Interests: cognitive rehabilitation; executive function; occupation; children with neurodevelopmental deficits; schizophrenia

Special Issue Information

Dear Colleagues,

I am pleased to invite you to submit articles to this Special Issue of Children on "Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis".

Ecological assessments evaluate how well a tool reflects a child or adolescent's functioning in their real-world daily life. In the literature, performance-based ecological diagnoses are widely recognized as effective for cognitive assessment, particularly for evaluating executive functions.

We seek papers on innovative ecological assessment tools, including their effectiveness, practical applications, interdisciplinary approaches, and evidence-based recommendations. This Special Issue aims to enhance our understanding and support for children and adolescents with neurodevelopmental disabilities by showcasing cutting-edge research and fostering a comprehensive discourse on novel strategies and interventions. We are particularly interested in original research articles, systematic reviews, meta-analyses, and case studies that contribute to this critical field.

We look forward to your valuable contributions.

Dr. Yael Fogel
Prof. Dr. Naomi Josman
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

children and adolescents
functional cognition
ecological assessment
performances-based assessment
neurodevelopmental disorders

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (9 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

12 pages, 775 KB

Open AccessArticle

Assessment of Fine Motor Abilities Among Children with Spinal Muscular Atrophy Treated with Nusinersen Using a New Touchscreen Application: A Pilot Study

by Inbal Klemm, Alexandra Danial-Saad, Alexis R. Karlin, Rya Nassar-Yassien, Iuliana Eshel, Hagit Levine, Tamar Steinberg and Sharon Aharoni

Children 2025, 12(10), 1378; https://doi.org/10.3390/children12101378 - 12 Oct 2025

Viewed by 337

Abstract

Background/Objectives: Spinal Muscular Atrophy (SMA) is a genetic neurodegenerative disease characterized by severe muscle weakness and atrophy. Advances in disease-modifying therapies have dramatically changed the natural history of SMA and the outcome measures that are used to assess the clinical response to therapy. Standard assessment methods for SMA are limited in their ability to detect minor changes in fine motor abilities and in patients’ daily functions. The aim of this pilot study was to evaluate the feasibility and preliminary use of the Touchscreen-Assessment Tool (TATOO) alongside standardized tools to detect changes in upper extremity motor function among individuals with SMA receiving nusinersen therapy. Methods: Thirteen individuals with genetically-confirmed SMA, aged 6–23 years, eight with SMA type 2, and five with SMA type 3, participated. The patients continued the maintenance dosing of nusinersen during the study period. They were evaluated at the onset of the study, then twice more at intervals at least six months apart. Upper extremity functional assessments were performed via the TATOO and standardized tools: the Hand Grip Dynamometer (HGD), Pinch Dynamometer (PD), Revised Upper Limb Module (RULM), and Nine-Hole Peg Test (NHPT). Results: Significant changes in fine motor function were detected using the TATOO together with other standardized tools. Participants demonstrated notable improvements in hand grip strength and fine motor performance, as measured by the NHPT. The RULM results were not statistically significant for the total study group, particularly in ambulatory patients with SMA type 3. TATOO provided detailed metrics, and revealed enhancements in accuracy and speed across various tasks. However, given the small sample size, the lack of a control group, and the lack of baseline assessment before receiving therapy, these findings should be considered preliminary and exploratory. Conclusions: The findings suggest that the TATOO, alongside traditional assessment tools, offers a sensitive measure of fine motor function changes in patients with SMA. This study highlights the potential of touchscreen-based assessments to address gaps in current outcome measures and emphasizes the need for larger, multicenter studies that will include pre-treatment, baseline, and control data. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

15 pages, 510 KB

Open AccessArticle

Effects of Medical Cannabis Treatment for Autistic Children on Family Accommodation: An Open-Label Mixed-Methods Study

by Ayelet David, Eynat Gal, Ayelet Ben-Sasson, Elkana Kohn, Matitiahu Berkovitch and Orit Stolar

Children 2025, 12(10), 1373; https://doi.org/10.3390/children12101373 - 11 Oct 2025

Viewed by 678

Abstract

Background/Objectives: Parents of autistic children often face behavioral and participation challenges of their children, leading them to make accommodations to maintain a stable daily family routine. These family accommodations (FA) involve adapting family routines, actively engaging with the child’s support needs and symptoms, and avoiding specific situations. Methods: This open-label, mixed-methods study investigated the impact of CBD-rich cannabis treatment on FA. In the quantitative phase, analyses included 44 parents (from 87 initially recruited) who had complete FAS-RRB data at baseline, 3 months, and 6 months. In the following qualitative phase, 15 parents from the full sample participated in semi-structured interviews. Results: Quantitative results showed reductions in FA frequency and parental distress at 3 and 6 months. Qualitative findings revealed positive changes in family routines, enhanced well-being, and improved parental engagement in meaningful activities and social interactions. Conclusions: This study provides preliminary evidence that CBD-rich cannabis treatment may reduce family accommodation (FA) and parental distress, while improving family routines and well-being. However, given the open-label design and observed adverse events and withdrawals, the findings should be interpreted with caution. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

14 pages, 883 KB

Open AccessArticle

Independence in Activities of Daily Living Among Autistic Toddlers: A Pilot Study Using Ecological Momentary Assessment

by Shani Hillel, Ben Aaronson and Yafit Gilboa

Children 2025, 12(10), 1316; https://doi.org/10.3390/children12101316 - 1 Oct 2025

Viewed by 635

Abstract

Background: The acquisition of adaptive skills is critical for independence and participation in activities of daily living (ADL). While caregiver perceptions provide valuable insights, most studies on autistic participation have focused on older children and relied on one-time clinic-based assessments. As a result, little is known about how autistic toddlers function in their natural environments across time. Ecological momentary assessment (EMA) is a real-time, context-sensitive method in which parents can report behaviors at multiple time points in the child’s natural environment. This pilot study aimed to examine ADL independence in autistic toddlers compared to their typically developing (TD) peers, to assess the feasibility of using EMA in early childhood, and to compare EMA-based assessments with a one-time standardized report. Methods: 23 autistic toddlers and 28 TD toddlers (aged 18–40 months) participated in the study. Parents completed a one-time report on the self-care scales of the Pediatric Evaluation of Disability Inventory (PEDI) and the Functional Independence Measure for Children (WeeFIM) and then rated their child’s independence on the WeeFIM twice a day for two weeks via their smartphones. Results: EMA was feasible with high response rates (ASD: 91.1%, TD: 88.55%). Autistic toddlers showed different participation profiles, with less independent performance in ADL compared to TD peers. In the autism group, the average EMA scores (M = 16.53, SD = 6.58) were significantly higher than the one-time WeeFIM scores (M = 13.74, SD = 5.23), t (22) = 3.23, p < 0.01, suggesting underreporting in single-time assessments. In contrast, no such difference was found in the TD group. Significant positive correlations were found between the EMA mean and the one-time WeeFIM scores in both groups (r > 0.80), indicating convergent validity. In the autism group only, greater variability in EMA was moderately associated with higher functional independence (r = 0.46, p < 0.01). Conclusions: These findings indicate that autistic toddlers demonstrated higher levels of participation in their natural environment than reflected by the one-time assessment, emphasizing the limitations of single-time-point evaluations. This underscores the importance of collecting data across multiple time points to accurately assess adaptive functioning and ADL participation. The EMA technique demonstrated in this study provides exploratory evidence of feasibility as an ecologically valid approach to assessing functional independence in autistic toddlers, offering a richer and more context-sensitive alternative to traditional one-time clinical assessments. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

10 pages, 198 KB

Open AccessArticle

ADHD Reporting in Developmental Age: The Role of the Informants

by Dario Esposito, Federica Gigliotti, Beatrice Colotti, Carlo Di Brina, Francesco Pisani and Maria Romani

Children 2025, 12(7), 914; https://doi.org/10.3390/children12070914 - 11 Jul 2025

Viewed by 988

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex neurodevelopmental condition typically requiring information from multiple informants for accurate diagnosis. However, the consistency and diagnostic value of reports from teachers, parents, primary care providers (PCPs), and other professionals remain debated. This study aimed to examine the role and diagnostic accuracy of different informants in the referral and diagnostic process for ADHD in children aged 3–11. Methods: This retrospective study analyzed data from 120 children referred for suspected ADHD. Initial reports were obtained from teachers, parents, PCPs, and other professionals, and final diagnoses were determined through comprehensive neuropsychiatric evaluations. Diagnostic concordance and informant-specific contributions were assessed. Results: Of the 120 children, 64 (53.3%) received an ADHD diagnosis. Teachers were the most frequent informants, followed by parents, with fewer referrals from PCPs and other professionals. No significant differences in diagnostic accuracy were found among informants, aligning with previous studies suggesting that no single informant is superior in identifying ADHD. Notably, over 93% of referred children were diagnosed with a neuropsychiatric disorder, though not necessarily ADHD. Conclusions: The findings underscore the importance of combining reports from parents and teachers to capture symptom expression across different environments, which is essential for accurate ADHD diagnosis. Enhanced training for informants and a multidisciplinary approach is recommended to improve diagnostic accuracy and support early identification and intervention efforts. These results support nuanced evaluation strategies that account for informant variability and help mitigate potential misinterpretations of ADHD symptoms. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Graphical abstract

16 pages, 241 KB

Open AccessEditor’s ChoiceArticle

Developmental Patterns in Autism and Other Neurodevelopmental Disorders in Preschool Children

by Maria Eugenia Martelli, Federica Gigliotti, Federica Giovannone, Giuliana Lentini, Filippo Manti and Carla Sogos

Children 2025, 12(2), 125; https://doi.org/10.3390/children12020125 - 24 Jan 2025

Cited by 5 | Viewed by 4273

Abstract

Background: Neurodevelopmental disorders (NDDs) encompass an inclusive group of conditions that appear during the developmental period but continue to persist in adulthood, ranging from particular difficulties to a global impairment of social, cognitive, and emotional functioning. The developmental trajectories associated with these conditions are highly heterogeneous. This study aimed to analyze and compare developmental and adaptive profiles of preschool-aged children with different NDDs to better characterize their developmental trajectories. Methods: We analyzed data from the initial global evaluation of 196 children with NDDs (aged 20 to 71 months), enrolled in three subgroups: 108 with autism spectrum disorder (ASD), 52 with language disorder (LD), and 36 with mixed specific developmental disorder (MSDD). A comprehensive neuropsychiatric evaluation was performed using standardized tools (Griffiths-III, ADOS-2, VABS-II, and ADI-R), and the parents completed the DP-3 and the CBCL 1½-5. Results: Our results showed that all NDDs exhibited poor psychomotor skills, with children with ASD being the most impaired, although their profiles were comparable to those of MSDD in communication and motor areas. CBCL’s pervasive developmental problem scale has been shown to provide relevant information for distinguishing children with ASD. Furthermore, DP-3 and VABS-II measure highly differentiated developmental profiles of each diagnostic group. Conclusions: Our results highlighted the importance of including parents’/caregivers’ perspectives in defining children’s functioning and the possibility of using DP-3 as a screening tool for different neurodevelopmental disorders. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

21 pages, 1688 KB

Open AccessArticle

A Virtual Reality Platform for Evaluating Deficits in Executive Functions in Deaf and Hard of Hearing Children—Relation to Daily Function and to Quality of Life

by Shaima Hamed-Daher, Naomi Josman, Evelyne Klinger and Batya Engel-Yeger

Children 2024, 11(9), 1123; https://doi.org/10.3390/children11091123 - 13 Sep 2024

Viewed by 2301

Abstract

Background: Childhood hearing loss is a common chronic condition that may have a broad impact on children’s communication and motor and cognitive development, resulting in functional challenges and decreased quality of life (QoL). Objectives: This pilot study aimed to compare executive functions (EFs) as expressed in daily life and QoL between deaf and hard-of-hearing (D/HH) children and children with typical hearing. Furthermore, we examined the relationship between EFs and QoL in D/HH children. Methods: The participants were 76 children aged 7–11 yr: 38 D/HH and 38 with typical hearing. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and Pediatric Quality of Life Inventory (PedsQL), while the child performed a shopping task in the virtual action planning supermarket (VAP-S) to reflect the use of EFs in daily activity. Results: D/HH children showed significantly poorer EFs (as measured by BRIEF and VAP-S) and reduced QoL. Difficulties in EFs were correlated with lower QoL. BRIEF scores were significant predictors of QoL domains. Conclusions: Difficulties in EFs may characterize children with D/HH and reduce their QoL. Therefore, EFs should be screened and treated. VAP-S and BRIEF are feasible tools for evaluating EFs that reflect children’s challenges due to EF difficulties in real-life contexts. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

Review

Jump to: Research, Other

20 pages, 1180 KB

Open AccessReview

Can Functional Cognitive Assessments for Children/Adolescents Be Transformed into Digital Platforms? A Conceptual Review

by Yael Fogel, Naomi Josman, Ortal Cohen Elimelech and Sharon Zlotnik

Children 2025, 12(10), 1384; https://doi.org/10.3390/children12101384 - 14 Oct 2025

Viewed by 772

Abstract

Background/Objectives: Functional cognition, integrating cognitive abilities during real-life task performance, is essential for understanding daily functioning in children and adolescents. Traditional paper-based cognitive assessments in controlled environments often lack ecological validity. Although performance-based assessments more accurately represent functioning in natural contexts, most have not been transformed into digital formats. With technology increasingly embedded in education and healthcare, examining the extent/nature of adaptations, benefits, and challenges of digitizing these tools is important. This conceptual review aimed to (1) examine the extent/nature of traditional performance-based cognitive assessments adapted into digital platforms, (2) compare ecological validity/scoring metrics of traditional and digital tools, and (3) identify opportunities and propose recommendations for future development. Methods: We used an AI-based tool (Elicit Pro, Elicit Plus 2024) to conduct a literature search for publications from the past decade, focusing on transformations of traditional assessments into digital platforms for children and adolescents. This initial search yielded 240 items. After screening, 45 were retained for manual review. Studies were extracted based on their discussion of the assessments (traditional or digital) and assessment tools used. Ultimately, 13 papers that met the inclusion criteria were evaluated based on units of analysis. Results: The analysis yielded three units. The first unit focused on digital transformation trends: four assessments (31%) were converted to digital platforms, two (15%) were developed as native digital tools, and the majority (seven, 54%) remained traditional. In the second unit, assessments were evaluated according to ecological validity and digital availability, demonstrating that assessments with high ecological validity tended not to be digitally accessible. The third unit synthesized scoring metrics, identifying eight distinct cognitive domains. Conclusions: Digitizing functional cognitive assessments offers greater accessibility, precision, and scalability, but replicating real-world contexts remains challenging. Emerging technologies may enhance ecological validity and support development of effective, technology-enhanced assessment practices. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

18 pages, 503 KB

Open AccessReview

Sleep Disorders in Children with Rett Syndrome

by Christopher Harner, Thomas A. Gaffey, Shannon S. Sullivan, Manisha Witmans, Lourdes M. DelRosso and Mary Anne Tablizo

Children 2025, 12(7), 869; https://doi.org/10.3390/children12070869 - 30 Jun 2025

Viewed by 1031

Abstract

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder marked by neurological regression, autonomic dysfunction, seizures, and significant sleep and breathing abnormalities. About 80% of affected individuals, especially young children, experience sleep disturbances such as insomnia, sleep-disordered breathing, nocturnal vocalizations, bruxism, and seizures. Breathing irregularities during sleep—like apnea, alternating hyperventilation, and hypoventilation—are common, with both obstructive and central sleep apnea identified through polysomnography. This review focuses on the prevalent sleep disorders in children with Rett syndrome and highlights current recommendations for the management of sleep disorders. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Figure 1

Other

Jump to: Research, Review

14 pages, 318 KB

Open AccessSystematic Review

XR Technologies in Inclusive Education for Neurodivergent Children: A Systematic Review 2020–2024

by Bárbara Valverde Olivares, Loretto Muñoz Araya, José Luis Valín, Marcela Jarpa Azagra, Rocío Hidalgo Escobar, Isabel Cuevas Quezada and Cristóbal Galleguillos Ketterer

Children 2025, 12(11), 1474; https://doi.org/10.3390/children12111474 - 1 Nov 2025

Viewed by 43

Abstract

Background/Objectives: Extended reality (XR) technologies have been increasingly applied in inclusive education settings to assist neurodivergent children. However, the existing evidence remains fragmented across diverse contexts and disciplines. This systematic review synthesizes current research to identify the educational purposes, implementation characteristics, and reported outcomes associated with the use of XR in inclusive educational environments. Methods: A comprehensive literature search was conducted in major academic databases using predefined keyword combinations related to XR, inclusive education, and neurodivergence. Peer-reviewed articles that applied XR tools in educational settings for neurodivergent children were screened against predefined inclusion and exclusion criteria. Data were extracted regarding study design, participant characteristics, XR modality, educational objectives, and outcome indicators. Results: The reviewed studies report heterogeneous applications of XR technologies, including virtual and augmented reality, to support cognitive, social, and behavioral skill development in neurodivergent learners. Most studies employed small sample sizes and quasi-experimental or exploratory designs. Although several studies reported improvements in engagement, communication skills, and task performance, outcome measures varied substantially and methodological rigor was limited in many cases. Conclusions: Current evidence suggests that XR technologies hold potential as complementary tools in inclusive education for neurodivergent children. Nonetheless, the heterogeneity of study designs and the lack of standardized assessment metrics limit the generalizability of the results. More robust empirical investigations are required to establish evidence-based guidelines for the implementation of XR in inclusive educational contexts. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

► Show Figures

Journal Menu

Journal Browser

Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (9 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI