Search Results (53)

Background: Children with heart failure (HF) are at risk of cognitive and psychiatric problems, and reduced health-related quality of life (QoL), yet data remain limited. This study compared neurocognition, social cognition, health-related quality of life, and psychiatric symptoms among children awaiting transplantation with or without ventricular assist devices (VADs), those who had undergone heart transplantation, and matched controls. Methods: Twenty-three patients at Ege University and 17 age- and sex-matched controls were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version (K-SADS-PL), Screen for Child Anxiety-Related Emotional Disorders (SCARED), Children’s Depression Inventory (CDI), Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV), Eyes Test, and Pediatric Quality of Life Inventory (PedsQL), evaluating psychiatric diagnoses, anxiety and depressive symptoms, cognition, social cognition, and health-related quality of life. Results: Diagnosis rates and CDI and SCARED child scores were comparable, but SCARED parent scores were significantly higher in the HF group. Patients scored significantly lower on most WISC-IV subtests (8 of 10) and all composite scores and the Eyes Test, indicating impaired social cognition. Child- and parent-reported PedsQL scores were significantly lower across all domains. Cognitive outcomes did not differ significantly across treatment subgroups, though these comparisons were underpowered. Conclusions: Children with HF show marked impairments in neurocognition, social cognition, and health-related quality of life versus healthy peers. Cognitive outcomes did not differ significantly across treatment subgroups, although these subgroup analyses (5–7 children per group) were underpowered and cannot establish the absence of a treatment effect. These findings underscore the need for integrated multidisciplinary care. Full article

Background: Childhood malnutrition, manifesting as both underweight and obesity, is a global health concern with potential repercussions on neurodevelopment and metabolic health. Objective: To analyze the relationship between nutritional status, metabolic biomarkers, and cognitive performance in school-aged children. Methods: A cross-sectional study was conducted with 100 children between 6 and 12 years of age from a public elementary school in the municipality of Chiconcuac de Juárez, Mexico. Participants were categorized according to BMI: underweight (UW), normal weight (NW), overweight (OW), and obesity (OB). Anthropometric evaluation, serum biochemical markers, and three surrogate metabolic indices, namely the Triglyceride–Glucose (TyG), Triglyceride/high-density lipoprotein cholesterol (TG/HDL), and TyG-Body Mass Index (TyG-BMI), were calculated. Cognitive performance was assessed using the Wechsler Intelligence Scale for Children (WISC-IV). Results: The OB group children showed significantly higher levels of TG, TC and LDL-C, as well as elevated levels of TyG, TG/HDL and TyG-BMI indices (p < 0.05) and lower HDL-C concentration. While no significant differences were found in Full-Scale IQ (FSIQ), the NW group showed significantly higher performance in the PSI compared to all other groups outside the healthy weight range after FDR correction. Spearman’s correlation showed that surrogate metabolic indices exhibited exclusive negative correlations with the PSI in unadjusted bivariate models. Conclusions: The extremes of the nutritional status spectrum (UW and OB) are concurrently associated with early metabolic alterations and latent cardiovascular risk, while concurrently tracking with lower performance in selective fluid cognitive domains within unadjusted models. Furthermore, surrogate metabolic indices were shown to be valuable tools that co-vary with neurocognitive profiles. Full article

This study investigates the “competence–performance gap” between cognitive ability (measured by the WISC-IV) and actual adaptive performance (measured by the ABAS-II) in children with autism spectrum disorder (ASD), and examines the moderating role of family environment, specifically parental education levels. We applied Latent Profile Analysis (LPA) to cross-sectional data from 3246 children with ASD (aged 6–16 years). The analysis identified three distinct cognitive–adaptive subgroups: the Balanced High-Functioning group (33%), the Classic Mismatch group (44%), and the Cognitively Vulnerable group (23%). Notably, the Classic Mismatch group was characterized by adaptive performance that significantly trailed cognitive potential. Multinomial logistic regression revealed that maternal education—but not paternal education—significantly predicted a child’s likelihood of being in the “Balanced High-Functioning” group. This moderating effect was especially pronounced during the school-age years. These findings highlight the critical role of environmental factors in the translation of intellectual potential into practical social adaptive functioning, providing theoretical support for targeted family-based interventions. Full article

Background/Objectives: Executive function (EF) impairments are common in neurodevelopmental disorders but are often examined using group-level approaches that may overlook clinically meaningful cognitive heterogeneity. This study explored EF heterogeneity in children with attention deficit hyperactivity disorder (ADHD), developmental dyslexia, and comorbid presentations using a clinically grounded mixed-method approach. Methods: Standardized neuropsychological data from the NEPSY-II, WISC-IV, and Woodcock–Johnson IV batteries were integrated with a case-based thematic synthesis of 11 clinical evaluations. Semi-inductive analysis was informed by preliminary patterns observed in a larger clinical sample. Results: Three executive function profiles were identified: (1) globally reduced executive functioning, characterized by widespread deficits in inhibition, attention, and working memory; (2) verbal–mnestic executive vulnerability, marked by weaknesses in verbal memory and attention regulation despite relative cognitive strengths; and (3) selective executive control deficit, reflecting impairments in inhibitory control and self-regulation. These profiles revealed clinically meaningful patterns that were not fully captured by categorical diagnostic classifications. Conclusions: The findings support the value of integrated, profile-based approaches for understanding executive function heterogeneity in neurodevelopmental conditions. Such approaches may enhance ecological validity in assessment and contribute to individualized intervention planning. Given the exploratory and case-based nature of the study, the findings should be considered preliminary and hypothesis-generating. Full article

Speech sound disorder (SSD) is common in childhood and can persist, adversely affecting language, literacy, and social functioning. Yet consonant error patterns in school-age children, particularly in non-English-speaking populations, remain insufficiently characterized. Short-term memory (STM) supports phonological processing and speech learning, but its relationship with SSD severity in school-age children is not well established. This study profiles consonant errors and short-term memory in school-age Chinese children with SSD and examines short-term memory correlates and predictors of disorder severity to inform targeted interventions. A total of 142 Mandarin-speaking school-age children with SSD were recruited. For the short-term memory analyses, we randomly selected 70 children with SSD and recruited 70 typically developing controls. Speech was assessed using a word-level picture-naming task to derive consonant accuracy and characterize error types/patterns, and short-term memory was measured with the WISC-IV Digit Span (forward and backward). Substitutions predominated for most consonants, and individual phonemes often exhibited co-occurring error patterns. In addition, school-age children with SSD showed significantly poorer short-term memory than typically developing peers across multiple indices. Notably, backward digit span was positively associated with consonant accuracy and remained an independent predictor of consonant accuracy. These results advance our understanding of the mechanisms underlying SSD and provide an evidence-based rationale for future interventions that combine speech-focused therapy with cognitive training to enhance clinical outcomes. Full article

Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) shows substantial cognitive heterogeneity, complicating individualized clinical formulation. This study examined whether Cognitive Disengagement Syndrome (CDS), anxiety, and ADHD symptom severity are associated with memory functions and visuospatial skills in children with ADHD. Methods: The sample included 120 children aged 6–12 years with ADHD (ADHD + CDS: n = 40; ADHD-only: n = 80). Memory was assessed with the Oktem Verbal Memory Processes Test (OVMPT) and Wechsler Memory Scale–Visual Reproduction (WMS–VR), and visuospatial skills with WISC-IV Block Design and Judgment of Line Orientation (JLO). ADHD symptoms were rated using combined parent–teacher Turgay-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Disruptive Behavior Disorders Scale (T-DSM-IV-S) scores; CDS symptoms with the Barkley Child Attention Scale; and anxiety with the SCARED-Child Form. Group comparisons, correlation analyses, and multivariable linear regression models were conducted. Results: The ADHD + CDS group performed worse on WISC-IV Block Design than the ADHD-only group (p = 0.005). In the ADHD + CDS group, inattention severity showed a strong negative association with WMS–VR short-term memory (r = −0.560, p < 0.001). In the ADHD-only group, inattention severity was negatively associated with OVMPT Spontaneous Recall (ρ = −0.319, p = 0.004) and JLO total score (ρ = −0.348, p = 0.002). Anxiety severity in the ADHD-only group was positively associated with OVMPT Total Learning (ρ = 0.350, p = 0.001), Highest Learning (ρ = 0.370, p = 0.001), and WMS–VR short-term memory (ρ = 0.304, p = 0.006). In regression analyses, the presence of CDS independently and negatively predicted WMS–VR short-term memory (β = −0.187, p = 0.018) and Block Design performances (β = −0.226, p = 0.016). Inattention symptom severity was also independently and negatively associated with Block Design performance (β = −0.243, p = 0.013). Conclusions: CDS status and symptom dimensions contribute to cognitive variability in pediatric ADHD, with CDS showing independent associations with timed visuospatial construction and short-term visual memory. Inattention severity emerged as a robust dimensional predictor of cognitive inefficiency across domains, supporting the clinical utility of symptom-based cognitive profiling in ADHD diagnostic evaluations. In addition, mild anxiety symptoms demonstrated meaningful associations with some learning and memory performances within the ADHD-only group, indicating that affective factors may modulate cognitive outcomes in ADHD. Taken together, these findings support considering CDS status and symptom dimensions jointly when characterizing cognitive variability in ADHD. Full article

Background/Objectives: Increasing fruit and vegetable (F&V) intake may benefit children’s neurobehavioral development, but randomized evidence remains limited. We evaluated whether F&V-enriched breakfast improves cognition, attention and mood in primary school children. Methods: We conducted a 12-week class-randomized controlled trial in Shanghai, China. A total of 251 children aged 7–11 years received either a daily F&V-enriched breakfast or a standardized control breakfast with comparable energy provision, both centrally prepared and home-delivered. The primary outcome was change in Full-Scale IQ (FSIQ) measured by the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV). Secondary outcomes included WISC-IV composite indices, attention-related behavioral symptoms assessed by the Parent Symptom Questionnaire, and mood by the Profile of Mood States—Brief. Analyses followed the intention-to-treat principle with multiple imputation. Results: Among 282 children screened, 251 were randomized, with 243 completing post-intervention assessments and 230 completing follow-up. The adjusted mean change in FSIQ did not differ between groups (mean difference = −0.63; 95% CI −5.15~3.89; p = 0.807). No statistically significant between-group differences in change were observed for other cognitive indices, behavioral symptoms, or overall mood disturbance. Exploratory analyses suggested a greater reduction in fatigue scores among children aged ≤8 years in the intervention group compared with controls. Dietary assessment confirmed higher dietary fiber and carotene intakes in the intervention group at week 12. No intervention-related adverse events were reported. Conclusions: An F&V-enriched breakfast improved dietary quality but did not produce measurable between-group improvements in cognitive or neurobehavioral outcomes over 12 weeks. Exploratory age-specific findings warrant further investigation. Full article

Autism spectrum disorder (ASD) and intellectual disability (ID) frequently coexist and share heterogeneous cognitive manifestations, yet their specific performance patterns on Wechsler scales remain poorly systematized. This meta-analysis synthesized data from 31 studies using the WISC-IV, WISC-V, WAIS-III, and WAIS-IV to compare cognitive index profiles in individuals with ASD, ID and ASD+ID. Standardized mean differences (Hedges’ g) were calculated using random-effects models, adopting a normative reference of mean 100 and SD 15. Results showed a distinct profile for ASD, with greater impairments in the Processing Speed Index (PSI) and Working Memory Index (WMI), while the Vocabulary Comprehension Index (VCI), Perceptual/Fluid Reasoning Index (PRI/FRI), and Visual Processing Index (VPI) remained close to normative scores. In contrast, ID and ASD+ID exhibited generalized deficits across all indices, with the lowest scores in Full-Scale IQ (FSIQ) and broad effects above g = −2.5. No significant differences emerged between Wechsler versions or age-based test types. Heterogeneity was high in ASD and ID across outcomes, but negligible in ASD+ID due to reduced k. These findings reinforce that ASD presents a specific cognitive pattern, whereas ID and ASD+ID display diffuse impairment, and that Wechsler scales are consistent across versions for identifying these profiles. Full article

Background/Objectives: Children born small for gestational age (SGA) are at increased risk for impaired growth, metabolic disturbances, and neurodevelopmental difficulties. Although previous research has examined cognitive and behavioral outcomes in this population, findings remain inconsistent. Moreover, limited evidence is available regarding the potential effects of recombinant human growth hormone (rhGH) therapy on cognitive development. We aimed to assess cognitive performance, emotional–behavioral functioning, and neonatal predictors of neurocognitive outcomes in term SGA children compared with age- and sex-matched peers born appropriate for gestational age (AGA). We also explored potential differences in cognitive outcomes between rhGH-treated and untreated SGA children. Methods: A total of 18 term SGA children and 23 AGA controls underwent anthropometric measurements, biochemical evaluation, cognitive testing using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV), and behavioral assessment through the Child Behavior Checklist (CBCL). Birth weight, length, and head circumference were analyzed as potential predictors of cognitive performance. Results: SGA children demonstrated significantly lower Intelligence Quotient (IQ) scores than AGA peers, with marked weaknesses in Perceptual Reasoning index (PRI) and Processing Speed index (PSI), while Verbal Comprehension and Working Memory were preserved. They also exhibited higher internalizing behavioral symptoms, whereas externalizing behaviors did not differ between groups. Birth head circumference emerged as a strong predictor of PRI and a modest predictor of PSI. No associations were found between rhGH treatment parameters and cognitive outcomes. Larger longitudinal studies are needed to clarify how early growth restriction affects brain development and cognition and whether GH therapy influences these processes. Full article

Background/Objective: Neuroimmune and metabolic dysregulation have been increasingly implicated in the cognitive heterogeneity of autism spectrum disorder (ASD). However, it remains unclear whether anti-inflammatory diets engage distinct biological and cognitive pathways in autistic and neurotypical children. This study examined whether a 12-week anti-inflammatory dietary protocol produces group-specific neuroimmune–metabolic signatures and cognitive responses in autistic children, neurotypical children receiving the same diet, and untreated neurotypical controls. Methods: Twenty-two children (11 with ASD, six a on neurotypical diet [NT-diet], and five neurotypical controls [NT-control]) completed pre–post assessments of plasma IFN-γ, CXCL1, RANTES (CCL5), trimethylamine-N-oxide (TMAO), and an extensive ENI-2/WISC-IV neuropsychological battery. Linear mixed-effects models were used to test the Time × Group effects on biomarkers and cognitive domains, adjusting for age, sex, and baseline TMAO. Bayesian estimation quantified individual changes (posterior means, 95% credible intervals, and posterior probabilities). Immune–cognitive coupling was explored using Δ–Δ correlation matrices, network metrics (node strength, degree centrality), exploratory mediation models, and responder (≥0.5 SD domain improvement) versus non-responder analyses. Results: In ASD, the diet induced robust reductions in IFN-γ, RANTES, CXCL1, and TMAO, with decisive Bayesian evidence for IFN-γ and RANTES suppression (posterior P(δ < 0) > 0.99). These shifts were selectively associated with gains in verbal learning, semantic fluency, verbal reasoning, attention, and visuoconstructive abilities, whereas working memory and executive flexibility changes were heterogeneous, revealing executive vulnerability in individuals with smaller TMAO reductions. NT-diet children showed modest but consistent improvements in visuospatial processing, attention, and processing speed, with minimal biomarker changes; NT controls remained biologically and cognitively stable. Network analyses in ASD revealed a dense chemokine-anchored architecture with CXCL1 and RANTES as central hubs linking biomarker reductions to improvements in fluency, memory, attention, and executive flexibility. ΔTMAO predicted changes in executive flexibility only in ASD (explaining >50% of the variance), functioning as a metabolic node of executive susceptibility. Responders displayed larger coordinated decreases in all biomarkers and broader cognitive gains compared to non-responders. Conclusions: A structured anti-inflammatory diet elicits an ASD-specific, coordinated neuroimmune–metabolic response in which suppression of CXCL1 and RANTES and modulation of TMAO are tightly coupled with selective improvements in verbal, attentional, and executive domains. Neurotypical children exhibit modest metabolism-linked cognitive benefits and minimal immune modulation. These findings support a precision-nutrition framework in ASD, emphasizing baseline immunometabolic profiling and network-level biomarkers (CXCL1, RANTES, TMAO) to stratify responders and design combinatorial interventions targeting neuroimmune–metabolic pathways. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by cognitive and behavioural impairments. This study aimed to identify cognitive patterns associated with ADHD in a sample of 719 children and adolescents (363 with ADHD and 356 controls) assessed using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV). Compared to controls, the clinical group exhibited significantly lower scores in the Working Memory Index (WMI), Processing Speed Index (PSI), and Cognitive Proficiency Index (CPI). No significant group differences were found in Verbal Comprehension (VCI) or Perceptual Reasoning (PRI) after controlling for age and sex. Factorial MANOVA results revealed that WMI, PSI, and CPI deficits remained stable across age groups and were more pronounced in males. Females with ADHD outperformed males in PSI. A binary logistic regression model including WISC-IV core indices classified VCI, PRI, WMI, and PSI with a Nagelkerke R² of 0.44 as significant predictors of group membership, indicating that lower scores in WMI and PSI, and higher scores in VCI and PRI, increased the likelihood of ADHD classification. These findings reinforce the use of the WISC-IV as a complementary tool in the cognitive characterisation and clinical assessment of ADHD in youth. Full article

Background: Electronic waste (e-waste) recycling in informal settings like Agbogbloshie in Accra, Ghana, releases toxic metals into the environment, posing serious health risks to nearby residents, particularly children. This study assessed the body burdens of lead (Pb), manganese (Mn), cadmium (Cd), chromium (Cr), nickel (Ni), and arsenic (As) and their association with cognitive function in schoolchildren living within 1 km of the Agbogbloshie site. Method: A cross-sectional study involving 56 pupils collected demographic data and blood and urine samples and administered the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV). Blood was tested for Pb and Mn and urine for Cd, Cr, Ni, and As. Associations between metal levels and cognitive outcomes were examined using regression analyses, adjusting for confounders. Result: Children showed elevated metal levels, with mean blood Pb of 60.43 µg/L and urinary s of 21.50 µg/L. Symptoms of cognitive dysfunction were common: 75% reported confusion, 67.9% poor memory, and 66% poor concentration. Urinary Cr levels were significantly associated with lower Full-Scale IQ (β = −18.42, p < 0.05) and increased difficulty in decision-making (OR = 0.1, p < 0.05). Conclusion: These findings underscore the neurodevelopmental risks of heavy metal exposure from e-waste in low- and middle-income countries and call for urgent public health interventions and policy actions. Full article

Background/Objectives: Children with above-average cognitive functioning often present complex developmental profiles, combining high cognitive potential with heterogeneous socio-emotional and learning trajectories. Although the cognitive and behavioral characteristics of giftedness have been widely studied in Anglophone countries, evidence remains limited in Southern Europe. This study aimed to investigate the cognitive, academic, and emotional–behavioral profiles of Italian children and adolescents with above-average cognitive functioning, using an inclusive, dimensional approach (IQ > 114). Methods: We analyzed a cross-sectional sample of 331 children and adolescents (ages 2.11–16.5 years), referred for clinical cognitive or behavioral evaluations. Participants were assessed using the WPPSI-III or WISC-IV for cognitive functioning, the MT battery for academic achievement, and the Child Behavior Checklist (CBCL) for emotional and behavioral symptoms. Comparative and correlational analyses were performed across age, gender, and functional domains. A correction for multiple testing was applied using the Benjamini–Hochberg procedure. Results: Gifted participants showed strong verbal comprehension (mean VCI: preschoolers = 118; school-aged = 121) and relative weaknesses in working memory (WM = 106) and processing speed (PS = 109). Males outperformed females in perceptual reasoning (PR = 121 vs. 118; p = 0.032), while females scored higher in processing speed (112 vs. 106; p = 0.021). Difficulties in writing and arithmetic were observed in 47.3% and 41.8% of school-aged participants, respectively. Subclinical internalizing problems were common in preschool and school-aged groups (mean CBCL T = 56.2–56.7). Working memory negatively correlated with total behavioral problems (r = −0.13, p = 0.046). Conclusions: These findings confirm the heterogeneity of gifted profiles and underscore the need for personalized educational and psychological interventions to support both strengths and vulnerabilities in gifted children. Caution is warranted when interpreting these associations, given their modest effect sizes and the exploratory nature of the study. Full article

Background/Objectives: Attention deficit hyperactivity disorder (ADHD) and anxiety disorders (AD) are prevalent in childhood and adolescence, often presenting with overlapping symptoms. This study aimed to assess cognitive and executive functions—specifically attention, inhibition, and working memory—in children with ADHD, AD, and comorbid ADHD + AD. It also sought to identify potential neuropsychological markers that differentiate ADHD from AD and ADHD + AD comorbidity. Methods: Cognitive and executive functions were assessed in a sample of 48 school-age children and adolescents (aged 8–15 years) using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) and the NEPSY-II battery. The MASC 2 self-report questionnaire was also used to assess anxiety symptoms. The participants were divided into three groups based on clinical diagnoses: ADHD, AD, and ADHD + AD. Results: No significant group differences emerged in cognitive performance, attention, or working memory. Significant differences emerged in inhibition performance, with children in the AD group demonstrating more efficient inhibition compared to both the ADHD and ADHD + AD groups. Children with ADHD showed longer response times. Better performance on inhibition tasks was associated with more severe anxiety symptoms. Conclusions: These findings suggest that anxiety may modulate specific aspects of executive functioning during tasks requiring attentional and inhibitory control. However, the complex interaction between ADHD and anxiety requires further investigation. This study underscores the importance of distinguishing ADHD from AD based on cognitive and executive profiles, particularly inhibition. In this context, it supports the routine use of the NEPSY-II in combination with the MASC 2 questionnaire to facilitate differential diagnosis in clinical practice. Full article

Several studies have indicated that parental education predicts children’s intelligence. In contrast, fewer studies have simultaneously analyzed the role of parental intelligence, education, and personality in shaping their children’s giftedness. This study investigated the effects of parental education, cognitive abilities (based on CHC theory), and personality traits (based on the Five-Factor Model) on the expression of gifted children’s cognitive abilities. Sixty-five gifted children (IQ ≥ 120) aged 6 to 14 years (M = 9.91 years; SD = 2.24 years) were assessed using the WISC-IV, while parents (65 mothers, M = 44.00 years; SD = 4.20 years, and 61 fathers, M = 45.70 years; SD = 5.40 years) completed the WAIS-IV and the Big-Five Inventory. The results indicated that maternal education was a key predictor of children’s Verbal Comprehension Index (VCI) in bivariate analyses, though its effect was not robust in multivariate models. Children’s Perceptual Reasoning Index (PRI) was associated with maternal conscientiousness, and fathers’ short-term memory (Gsm) emerged as the primary predictor of children’s Working Memory Index (WMI). Maternal processing speed (Gs) was the strongest predictor of children’s Processing Speed Index (PSI) across both bivariate and multivariate analyses. While personality traits, such as maternal conscientiousness, played a role in facilitating visual-spatial reasoning, their effects were weaker compared to cognitive and educational factors. The findings obtained, which are only partly consistent with data in the literature, highlight the domain-specific influence of parental characteristics on children’s giftedness and underscore the need for further research into the interplay of genetic, cognitive, and environmental factors. Full article