https://doi.org/10.23641/asha.5313454.

Objective To compare Executive Functioning (EF) profiles across several pediatric medical conditions and explored the influence of age of diagnosis and evaluation. Methods This was a retrospective, cross sectional study of 734 children ages 5-18 across five medical groups [brain tumor, leukemia (ALL), epilepsy (EPI), Neurofibromatosis Type 1 (NF1), and Ornithine Transcarbamylase Deficiency (OTC-D)], ADHD controls, and matched healthy controls. We compared groups across the subscales of a parent completed Behavior Rating Inventory of Executive Functioning (BRIEF) using MANOVA. Separate MANOVAs were conducted to look at age factors. Results The ADHD group differed from all other groups and had the highest level of reported EF problems. The NF1 and OTC-D groups differed significantly from the healthy comparison group for overall EF problems, while the EPI and cancer groups did not. Working Memory was the most elevated subscale across medical groups, followed by Plan/Organize. Children with medical disorders were two to four times as likely as healthy controls to have clinically significant problems in several EF domains. There was a main effect for age at diagnosis and age at evaluation.. Conclusions A subset of children with medical disorders were found to have parent reported EF difficulties, with particular vulnerability noted in working memory and organizational/planning skills. This has relevance for the development of interventions that may be helpful across disorders. Children with particular diagnoses and earlier age of diagnosis and evaluation had greater reported EF problems.

Purpose Children with dyslexia often struggle with nonphonological aspects of language and executive functioning. The purpose of this study was to investigate the impact of executive functioning on language abilities at both structural (e.g., grammar in sentences) and functional (e.g., narrative) levels in 92 third- and 4th-grade students with dyslexia. Additionally, we asked if working memory updating contributed a significant amount of variance in narrative language ability beyond what would be expected by students' structural language skills alone. Method Students' language and executive functioning skills were evaluated using a range of language and cognitive measures including the Clinical Evaluation of Language Fundamentals–Fourth Edition ( Semel, Wiig, & Secord, 2003 ), the Peabody Picture Vocabulary Test–Fourth Edition ( Dunn & Dunn, 2007 ), the Test of Narrative Language ( Gillam & Pearson, 2004 ), the Delis–Kaplan Executive Function Scale ( Kaplan, Kramer, & Delis, 2001 ), and the Corsi Block-Tapping Test (WISC-IV Integrated; Kaplan, Fein, Kramer, Delis, & Morris, 2004 ). Results Low correlations between the language measures suggested that each of these assessments captures a unique element of language ability for children with dyslexia. Hierarchical regression analysis indicated that working memory updating accounted for a significant amount of unique variance in oral narrative production beyond what would be expected by structural language ability. Conclusions The range of performance found across language measures suggests that it may be important to include a variety of language measures assessing both structural and functional language skills when evaluating children with dyslexia. Including cognitive measures of executive functioning may also be key to determine if deficits in working memory updating are contributing to functional expressive language difficulties.

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