Article Summary - School Neuropsychology: Mind, Brain & Education (PSB3E-CN04)

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Artikelen School Neuropsychology

Article 1 Otero (2014) Executive Function Treatment & Intervention in Schools

Children with EF deficits in the school environment
- Cognitive  often manifest in academic difficulties
- Affective  are often viewed as behavioral problems
- problems:
o Shifting between activities
o Difficulty prioritizing
o Time management and meeting deadlines
o Planning for the future is difficult

Identification of EF deficits in the school setting
- Qualitatively  behavioral observations how students approach and complete a task
- Quantitative  CAS-2, NEPSY-11, Wisconsin Card Sorting test, frequency measures

6 general principles regarding EF training
1. Those who most need improvement benefit the most
2. Transfer effects from EF trainings are narrow
3. EFs should be challenged throughout training
4. Repeated practice is key
5. Whether EF gains are produced depends on how an activity is done
6. Outcome measures must test the limits of the children’s EF abilities to see a benefit

Before intervention it is important to consider
- The age of the children
- The current level of developmental functioning of the child
- Certain neurodevelopmental disorders, such as ADHD and ASD
- A careful review of the diagnostic information available
- Demographics, cultural and environmental factors
- School personnel must answer the question of what is feasible to implement

Treatment methods and intervention strategies
- Treatments outside of the scope of the school setting
o Psychopharmacology
o Neurofeedback treatment
- Computerized training
o Targets working memory and attention
o Implemented within a group setting is appealing (no need for additional
recourses)
o Continuously adapt the difficulty based on the child’s performance
o Research  mixed results
- Strategy instruction
o Student-centered approach that supplies struggling learners with tools and
techniques to understand and learn new material

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o Global by nature and targets constellation of cognitive processing abilities
- Curricula
o Educational Service Department of the Rush Neurobehavioral Centre (RNBC)
developed an EF curriculum
o Important constructs for classroom instruction:
 Self-regulation
 Self-awareness
 Goal-directed behavior
 Self-monitoring
 Flexibility to solve problems and revise plans
o Need for future research
- Mindfulness and Physical Activities
o Meditation, martial arts, yoga, aerobics
o Require repetition and continued practice to gain maximum benefits
- Games
o Traditional childhood games can help improve EFs in children
o Easy to implement in school setting
o May help in development of working memory and response inhibition
o Shared activities with peers are enjoyable and low-cost

Future directions for school setting
- Neurofeedback is an intervention that could be implemented in school setting
- Schools must consider financial constraints when selecting interventions
- Strategy instruction and mind/body approaches can be implemented at low-cost
- Future research  include factors that look at generalization and optimal
developmental periods to achieve maximum effectiveness

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Article 2 Hoza (2016) Using Physical Activity to Manage ADHD Symptoms

Point 1: Neuroscience and developmental perspective  optimistic view on potential of
physical activity for improving ADHD symptoms
- Brain science perspective: research shows PA may promote adaptive functioning in
ADHD individuals (change in neurotransmitter levels, enhanced cerebral capillary
growth & blood flow to the brain, promotion of neurogenesis & brain tissue growth)
- PA may have a corrective effect on neurodevelopment for those at risk for ADHD,
potentially preventing or altering the course of the disorder

Point 2: Despite optimism, good research is limited
- Distinction between acute and chronic application of PA
- Goal of the review: consider the evidence for use of PA to manage ADHD symptoms
over long term  the discussion is restricted to studies of chronic effects of PA

Point 3: The limited amount of research conducted to date reflects the difficulties to
conduct the type of research that is needed
- Studies of chronic PA are more likely to succeed in settings where child lives daily life
- Three key challenges are discouraging in research conducted in natural settings:
o Random assignment to condition
o Blinded raters
o Adequate control groups

Point 4: Despite limitations, current literature shows promise
- Aerobic PA shows beneficial effects on ADHD symptoms (parent/teacher rated)
- Pa shows benefit on variety of cognitive capacities (measured primarily using
neurodevelopmental or EF tasks)
- Systematic PA benefits additional functional domains in ADHD (social functioning,
motor skills, behavior and affective/emotional domain)
- At least one study  beneficial effects of PA are associated with measurable
changes in brain activity

Point 5: What we do not kno0w is just as important as what we know
- What is optimal dose? (Individual session length and frequency, program length)
- Is there an age where the PA effects are optimized?
- How does PA perform when compared directly to established treatments for ADHD?
- Do the effects of PA persist beyond the period when PA is actively administered?

Conclusion
- Much more is unknown than is known about PA as a management strategy for ADHD
- Preliminary work suggests beneficial impact in multiple areas of dysfunction, with
none of the available studies reporting adverse effects
- There is currently insufficient research to warrant recommending PA as a sole
intervention  adequate body of well-designed research studies is needed