Processing speed, executive function, and academic achievement in children with dextro-transposition of the great arteries: Testing a longitudinal developmental cascade model.

Abstract

Objective To establish executive function (EF) structure/organization and test a longitudinal developmental cascade model linking processing speed (PS) and EF skills at 8-years of age to academic achievement outcomes, both at 8- and 16-years, in a large sample of children/adolescents with surgically-repaired dextro-transposition of the great arteries (d-TGA). Method Data for this study come from the 8-(n = 155) and 16-year (n = 139) time points of the Boston Circulatory Arrest Study and included WISC-III, Trail Making Test, Test of Variables of Attention, and WIAT/WIAT-II tasks. Results A 2-factor model (Working Memory/Inhibition and Shifting) provided the best fit for the EF data, χ2(3) = 1.581, p = .66, RMSEA = 0, CFI = 1, NNFI = 1.044). Working Memory/Inhibition and Shifting factors were not correlated. In the structural equation model, PS was directly related to both EF factors and Reading at 8 years, and was indirectly related to Math and Reading achievement, both concurrently and longitudinally, via its effects on Working Memory/Inhibition. Shifting at 8 years was significantly associated with Math (but not Reading) at 16 years. Conclusions The academic difficulties experienced by children and adolescents with d-TGA may be driven, at least in part, by underlying deficits in processing speed and aspects of executive function. Intervention efforts aimed at bolstering these abilities, particularly if implemented early in development, may prove beneficial in improving academic outcomes and, perhaps by extension, in reducing the stress and diminished self-confidence often associated with academic underachievement.

Modelo de funciones ejecutivas basado en análisis factoriales en población infantil y escolar: metaanálisis

“…La asociación entre las diferentes dimensiones ejecutivas y la edad arroja una asociación estadísticamente significativa entre la edad y la dimensión de flexibilidad [24,28,30,33,[36][37][38][55][56][57][58]. Junto con la flexibilidad, existen otras dos dimensiones predominantes en los estudios analizados (inhibición y memoria de trabajo) [26,32,[59][60][61].…”

Neuropsychological and Psychiatric Outcomes in Dextro-Transposition of the Great Arteries across the Lifespan: A State-of-the-Art Review

“…There is growing awareness that executive functioning is particularly vulnerable in d -TGA (20–22). In the BCAS, 8-year children had substantial difficulties in metacognitive aspects of behavior, such as planning, organizational skills, and cognitive flexibility (13).…”

“…In sum, the cognitive and behavioral challenges faced by children with d -TGA place them at high risk of long-term learning disabilities and academic under-achievement (22). Indeed, nearly 50% requires early remedial services (e.g., psychotherapy, speech therapy, or educational support) (30).…”

“…In children with d -TGA, Calderon et al (25) showed that deficits on some aspects of executive functioning (i.e., cognitive flexibility) became worse between the ages of 5 and 7, whereas more basic processes (e.g., motor control) tended to catch-up. Interestingly, Cassidy et al (22) reported that reading and math difficulties of adolescents with d -TGA at age 16 were predicted by deficits in processing speed and executive function at age 8. Indeed, executive function deficits and difficulties in other key areas of neurodevelopment are often comorbid.…”

Cognitive flexibility in critical CHD: a target for intervention

“…47 for an ongoing preliminary trial of acceptance and commitment therapy with adults with CHD). This is unfortunate for several reasons, including the fact that problems related to cognitive flexibility are among the most frequent clinical concerns expressed by the parents of school-age children with CHD 46 ; rates of autism spectrum disorder and anxiety disorder diagnosestwo conditions in which cognitive inflexibility is often a hallmark feature 48,49 are notably elevated among children and adolescents with CHD [42][43][44]50,51 ; and, deficits in cognitive flexibility have the potential to undermine academic achievement, [52][53][54] trait resilience, 55 health, 56 and quality of life across the lifespan. 57 The remainder of this paper will describe cognitive flexibility and its relevance for individuals with CHD.…”