Abstract: Down syndrome (DS) is the most commonly identifiable genetic form of intellectual disability. Individuals with DS have considerable deficits in intellectual functioning (i.e., low intellectual quotient, delayed learning and/or impaired language development) and adaptive behavior. Previous pharmacological studies in this population have been limited by a lack of appropriate endpoints that accurately measured change in cognitive and functional abilities. Therefore, the current longitudinal observational study assessed the suitability and reliability of existing cognitive scales to determine which tools would be the most effective in future interventional clinical studies. Subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Cambridge Neuropsychological Test Automated Battery (CANTAB), and Clinical Evaluation of Language Fundamentals-Preschool-2 (CELF-P-2), and the Observer Memory Questionnaire-Parent Form (OMQ-PF), Behavior Rating Inventory of Executive Function®–Preschool Version (BRIEF-P) and Leiter International Performance Scale-Revised were assessed. The results reported here have contributed to the optimization of trial design and endpoint selection for the Phase 2 study of a new selective negative allosteric modulator of the GABAA receptor α5-subtype (Basmisanil), and can be applied to other studies in the DS population.

Abstract: Adults with intellectual disability are increasingly being encouraged to take control of their lives through a range of goal-setting, choice- and decision-making opportunities. The current objectiv...

Abstract: The cognitive profile and measured intellectual level vary according to assessment tools in children on the autism spectrum, much more so than in typically developing children. The recent inclusion of intellectual functioning in the diagnostic process for autism spectrum disorders leads to the crucial question on how to assess intelligence in autism, especially as some tests and subtests seem more sensitive to certain neurodevelopmental conditions. Our first aim was to examine the cognitive profile on the current version of the most widely used test, the Wechsler Intelligence Scales for Children (WISC-IV), for a homogenous subgroup of children on the autism spectrum, i.e. corresponding to DSM-IV diagnosis of "autism". The second aim was to compare cognitive profiles obtained on the third edition versus 4th edition of WISC, in order to verify whether the WISC-IV yields a more distinctive cognitive profile in autistic children. The third aim was to examine the impact of the WISC-IV on the cognitive profile of another subgroup, children with Asperger's Syndrome. 51 autistic, 15 Asperger and 42 typically developing children completed the WISC-IV and were individually matched to children who completed the WISC-III. Divergent WISC-IV profiles were observed despite no significant intelligence quotient difference between groups. Autistic children scored significantly higher on the Perceptual Reasoning Index than on the Verbal Comprehension Index, a discrepancy that nearly tripled in comparison to WISC-III results. Asperger children scored higher on the VCI than on other indexes, with the lowest score found on the Processing Speed Index. WISC-IV cognitive profiles were consistent with, but more pronounced than WISC-III profiles. Cognitive profiles are a valuable diagnostic tool for differential diagnosis, keeping in mind that children on the autism spectrum might be more sensitive to the choice of subtests used to assess intelligence.

Abstract: Objective: Traumatic brain injury (TBI) is the most common cause of brain damage, resulting in long-term disability. The ever increasing life expectancies among TBI patients necessitate a critical examination of the factors that influence long-term outcome. Our objective was to evaluate the contribution of premorbid factors (which were identified in our previous work) and acute injury indices to long-term functioning following TBI. Method: Eighty-nine participants with moderate-to-severe TBI were evaluated at an average of 14.2 years postinjury (range: 1–53 years) with neuropsychological battery, medical examination, clinical interviews, and questionnaires. Results: TBI severity predicted cognitive, social, and daily functioning outcomes. After controlling for injury severity, preinjury intellectual functioning predicted cognitive status, as well as occupational, social, emotional, and daily functioning. Preinjury leisure activity also predicted cognitive, emotional, and daily functioning, whereas socioec...

Abstract: Background Social difficulties are often noted among people with intellectual disabilities. Children and adults with 22q.11.2 deletion syndrome (22q11DS) often have poorer social competence as well as poorer performance on measures of executive and social-cognitive skills compared with typically developing young people. However, the relationship between social functioning and more basic processes of social cognition and executive functioning are not well understood in 22q11DS. The present study examined the relationship between social-cognitive measures of emotion attribution and theory of mind with executive functioning and their contribution to social competence in 22q11DS. Method The present cross-sectional study measured social cognition and executive performance of 24 adolescents with 22q11DS compared with 27 age-matched typically developing controls. Social cognition was tested using the emotion attribution task (EAT) and a picture sequencing task (PST), which tested mentalising (false-belief), sequencing, cause and effect, and inhibition. Executive functioning was assessed using computerised versions of the Tower of London task and working memory measures of spatial and non-spatial ability. Social competence was also assessed using the parent-reported Strengths and Difficulties Questionnaire. Results Adolescents with 22q11DS showed impaired false-belief, emotion attribution and executive functioning compared with typically developing control participants. Poorer performance was reported on all story types in the PST, although, patterns of errors and response times across story types were similar in both groups. General sequencing ability was the strongest predictor of false-belief, and performance on the false-belief task predicted emotion attribution accuracy. Intellectual functioning, rather than theory of mind or executive functioning, predicted social competence in 22q11DS. Conclusions Performance on social-cognitive tasks of theory of mind indicate evidence of a general underlying dysfunction in 22q11DS that includes executive ability to understand cause and effect, to logically reason about social scenarios and also to inhibit responses to salient, but misleading cues. However, general intellectual ability is closely related to actual social competence suggesting that a generalised intellectual deficit coupled with more specific executive impairments may best explain poor social cognition in 22q11DS.

Abstract: Aim Emerging research indicates that gene mutations within the RAS-MAPK signaling cascade, which cause Noonan syndrome and related disorders, affect neurophysiologic activity in brain regions underlying attention and executive functions. The present study examined whether children with Noonan syndrome are at heightened risk for symptoms of attention-deficit–hyperactivity disorder (ADHD) and executive dysfunction relative to an unaffected sibling comparison group, and investigated three key aspects of behavioral attention: auditory attention, sustained attention, and response inhibition. Method Children and adolescents with Noonan syndrome (n=32, 17 males, 15 females, mean age 11y 3mo, SD 3y) and their unaffected siblings (n=16, eight males, eight females, mean age 11y, SD 3y 6mo) were administered standardized tests of intellectual functioning and clinic-based measures of behavioral attention. Parent ratings of ADHD symptoms, executive functioning, and behavior were also obtained. Results Children with Noonan syndrome demonstrated higher rates of past ADHD diagnosis, as well as reduced performance compared with unaffected siblings on behavioral attention measures. Parent-rated functional impairments in attention, social skills, working memory, and self-monitoring were more prevalent in the Noonan syndrome group. The relationship between attention regulation skills (sustained attention and inhibitory control) and intellectual test performance was significantly stronger in the Noonan syndrome group than the comparison group. Interpretation Clinical screening/evaluation for ADHD and executive dysfunction in Noonan syndrome is recommended to facilitate appropriate intervention and to address functional impact on daily life activities.

Abstract: The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.

Abstract: Background: The Behaviour Problems Inventory-Short Form (BPI-S) is a spin-off of the BPI-01 that was empirically developed from a large BPI-01 data set. In this study, the reliability and factorial validity of the BPI-S was investigated for the first time on newly collected data from adults with intellectual disabilities. Methods: The sample consisted of 232 adults with intellectual disabilities who represented all levels of intellectual functioning. They were recruited at several day programs in the USA (n = 148) and the UK (n = 84). Results: We found acceptable reliability in terms of internal consistency, inter-rater agreement and test–retest reliability. Confirmatory factor analysis validated the three BPI-S subscale structure. Conclusions: We corroborated the factor structure underly-ing the three subscales and found the BPI-S to have adequate to good psychometric properties in a newly collected sample of adults with intellectual disabilities.

Abstract: Background Executive function (EF) deficits are a recognised component of the cognitive phenotype of youth with Down Syndrome (DS). Recent research in this area emphasises the use of behaviour ratings, such as the Behavior Rating Inventory of Executive Functions—Preschool Version (BRIEF-P), to capture the real-world applications of executive functions. To account for the intellectual functioning of youth with DS, this measure is used out of age range; however, its psychometric properties when used in this fashion are unknown. The goals of this study are to evaluate psychometric characteristics of the BRIEF-P among youth with DS and to examine the pattern of EF strengths/weaknesses in children with DS and co-occurring psychiatric conditions. Method A total of 188 clinically referred youth with DS, ages 3–13 were rated by their caregivers using the BRIEF-P. These youth were evaluated by a clinician with expertise in DS and were characterised as having no co-occurring behavioural disorder (Typical DS group), co-occurring Autism Spectrum Disorder (DS + ASD) or co-occurring Disruptive Behaviour Disorder (DS + DBD). Results An exploratory factor analysis of item-level BRIEF-P data from clinically referred youth with DS supported the theoretically derived three-factor structure originally proposed for the BRIEF-P (Emergent Metacognition, Flexibility and Inhibitory Self-Control); however, the item composition of each factor varied somewhat in comparison to the original structure of the measure. Group comparisons indicate that, while youth with typical DS evidence fewer executive function difficulties across all domains, youth with DS + ASD show the greatest weaknesses in Emergent Metacognition, and youth with DS + DBD show significant difficulties in both Emergent Metacognition and Inhibition. Conclusions These findings offer preliminary support for use of the BRIEF-P with clinically referred youth with Down Syndrome. Some scoring modifications may be necessary if the theoretically derived index scores are to be used with this population. BRIEF-P scores may offer an empirical basis for differentiating DS youth with varying behavioural profiles. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd

Abstract: Objective Identifying bipolar patients at high-suicide risk is a major health issue. To improve their identification, we compared dimensional and neuropsychological profile of bipolar patients with or without history of suicide attempt, taking into account suicidal severity (i.e. admission to intensive ward). Method A total of 343 adult euthymic bipolar out-patients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into three subgroups: 214 patients without history of suicide attempt, 88 patients with past history of non-severe suicide attempt and 41 patients with past history of severe suicide attempt. General intellectual functioning, speed of information processing, verbal learning and memory, verbal fluency and executive functioning were assessed. Results Severe suicide attempters had lower affective intensity and lability than non-severe attempters. Severe suicide attempters outperformed non-severe attempters for verbal learning and non-attempters for Stroop word reading part after adjustment for study centre, age, gender, educational level, antipsychotics use, depression score, anxious and addictive comorbidities. Conclusion Neuropsychological tasks commonly used to assess bipolar patients do not seem accurate to identify suicide attempters in euthymic patients. In the future, decision-making and emotional recognition tasks should be assessed. Moreover, clinical and neuropsychological profiles should be considered together to better define suicidal risk.

Abstract: Stress is implicated in the development and course of psychotic illness, but the factors that influence stress levels are not well understood. The aim of this study was to examine the impact of neuropsychological functioning and coping styles on perceived stress in people with first-episode psychosis (FEP) and healthy controls (HC). Thirty-four minimally treated FEP patients from the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, and 26 HC participants from a similar demographic area participated in the study. Participants completed a comprehensive neuropsychological test battery as well as the Coping Inventory for Stressful Situations (task-, emotion- and avoidance-focussed coping styles) and Perceived Stress Scale (PSS). Linear regressions were used to determine the contribution of neuropsychological functioning and coping style to perceived stress in the two groups. In the FEP group, higher levels of emotion-focussed and lower levels of task-focussed coping were associated with elevated stress. Higher premorbid IQ and working memory were also associated with higher subjective stress. In the HC group, higher levels of emotion-focussed coping, and contrary to the FEP group, lower premorbid IQ, working memory and executive functioning, were associated with increased stress. Lower intellectual functioning may provide some protection against perceived stress in FEP.

Abstract: Background: The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who “recovered from autism”. They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. Methods: At about 10 years of age they were targeted for a new follow-up. Parents were given a semistructured interview regarding the child’s daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism – Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. Results: The vast majority of the children had moderate-to-severe problems with attention/ activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Conclusion: Children diagnosed at 2–4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3–4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD.

Abstract: Extant data suggest that the cognitive profiles of individuals with ASD may be characterized by variability, particularly in terms of verbal intellectual functioning (VIQ) and non-verbal intellectual functioning (NVIQ) discrepancies. The Differential Ability Scales, Second Edition (DAS-II) has limited data available on its use with youth with ASD. The current study examined data from 2,110 youth with ASD in order to characterize performance on the DAS-II and to investigate potential discrepancies between VIQ and NVIQ. A larger proportion of individuals in the ASD sample had significant discrepancies between VIQ and NVIQ when compared to the normative sample [early years sample χ2 (2) = 38.36; p < .001; school age sample χ2 (2) = 13.48; p < .01]. Clinical and research implications are discussed.

Abstract: Sir, Intellectual disability (ID) is characterized by significant limitations in both intellectual functioning and adaptive behavior that begin before the age of 18 years.[1] Prevalence of ID has been reported around 1-3% population in the world and of these mild, moderate, severe, and profound ID affects about 85%, 10%, 4%, and 2% of the population, respectively.[1,2,3,4] According to Harris[5] and Maulik et al.[2] studies, the highest prevalence is in low income countries (16.41/1000 population), whereas for middle- and high-income countries is around 15.94 and 9.21/1000 population, respectively. Furthermore, the prevalence of ID is more among child/adolescent population (18.30/1000) in comparison with an adult population (4.94/1000). In this study, data were extracted from the Statistical Center of Iran.[6] According to census results in 2011, the prevalence of ID is around 13/1000 population in Iran. In Figure 1, the prevalence of ID is showed according to age and gender. In general, the prevalence of ID among men (5.3/1000) is more than women (3.5/1000), and it has the highest rate for adolescents and young people. Figure 1 Prevalence of intellectual disability according to age and gender in Iran (per 1000 population), x-axis: (%), y-axis: age group The results in comparison to other studies showed that the prevalence of ID in Iran is lower than global estimates significantly. Because of the different definitions of ID and data collection methods, rates are different in Iran as compared with other countries.[7] The study reveals that there is an extensive conceptual and methodological gap in the census method and we should pay more attention to reduce the gap. The International Classification of Functioning disability and health (ICF) is a comprehensive population health measurement framework applied for the scientific standardization of data on health and disability worldwide. ICF makes it possible to collect those vital data in a consistent and internationally comparable manner.[8,9] In 1998, in order to reach a universally accepted conceptual framework to define and classify disability, World Health Organization (WHO) has developed an instrument entitled the WHO Disability Assessment Schedule (WHODAS 2.0) that provides a standardized method for measuring health and disability across cultures. WHODAS 2.0 has been developed specifically to reflect key features of the ICF.[10] The instrument has been used in many countries and it should be valid in Iran for increasing data quality in surveys and censuses.[11] In conclusion, using the conceptual framework of ICF in censuses and national health surveys is important and essential in Iran. ICF - based prevalence can provide comparable data at the national and global level for health and social policy development and monitoring, health and disability-related legislation, and service provision and development of disability research. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Abstract: Problem behavior of 52 children with Williams syndrome ages 6 to 17 years old was examined based on both parent and teacher report. Generally good inter-rater agreement was found. Common areas of problem behavior based both on parent and teacher report included attention problems, anxiety difficulties, repetitive behaviors (e.g., obsessions, compulsions, picking nose or skin), and social problems, reflecting a robust behavioral phenotype in Williams syndrome present across contexts. Some rater differences were observed; most notably, parents reported more attention and mood difficulties than did teachers, while teachers reported more oppositionality and aggression than did parents. Relations to intellectual functioning, age, and gender were examined. The implications of the findings for understanding the behavioral phenotype associated with Williams syndrome are discussed.

Abstract: Insufficient literature has been produced addressing children with borderline intellectual functioning (BIF) and gifted intellectual functioning (GIF). The goal of this work is to compare levels of...

Abstract: Introduction: Many studies have shown altered neuropsychological functioning of children with epilepsy even in the absence of intellectual disability, with notable concerns for both patients and their families. Although studies have described the cognitive profiles associated with specific epilepsy syndromes, there is incomplete agreement on the relation between spared and impaired abilities in different cognitive domains and on how deficits in one neuropsychological ability can secondarily affect performance in other cognitive domains. The aim of this study was to investigate the neuropsychological profile and vulnerabilities of children with epilepsy without intellectual disability or borderline intellectual functioning. Method: 23 children aged 7–15 years, with a diagnosis of epilepsy of genetic or unknown cause and average intellectual functioning (IQ >85), were administered all age-appropriate tests of the Italian-language version (Urgesi, Campanella, & Fabbro, 2011) of a comprehensive neuropsycholog...

Abstract: Youth with spina bifida (SB) have been identified as being at risk for psychosocial difficulties, including poor social competence and increased internalizing symptoms (Ammerman et al., 1998; Holmbeck & Devine, 2010; Holmbeck et al., 2003, 2010). SB is a congenital birth defect caused by incomplete closure of the neural tube during the early weeks of gestation. In addition to serious health complications, such as paralyzed lower extremities, bladder and bowel incontinence, and seizures, many individuals with SB develop hydrocephalus, which is commonly treated with a shunt at birth (Holmbeck et al., 2003). The purpose of the current study is to test the utility of a longitudinal meditational model (see Figure 1) that posits associations between neuropsychological functioning and internalizing symptoms as mediated by social competence. Figure 1. The effect of neuropsychological functioning on internalizing symptoms, as mediated by social competence. Previous work has revealed that youth with SB are at higher risk for psychological maladjustment compared with typically developing youth (Holmbeck et al., 2003), and research on predictors of internalizing symptoms in this population has emerged as an important area of inquiry (e.g., Bellin et al., 2010). In particular, neuropsychological functioning (i.e., executive dysfunction, performance attention skills, reported attention problems, and IQ) may be a salient domain that impacts internalizing symptoms in youth with SB. Due to brain malformations characteristic of SB and the consequences of shunt placement at birth (i.e., shunt infections and replacement), the majority of youth with SB display mild to moderate cognitive impairments, such as executive dysfunction, inattention, and impaired intellectual functioning (Rose & Holmbeck, 2007). Researchers investigating the link between neuropsychological functioning and internalizing symptoms have proposed a biopsychosocial model of chronic illness, which suggests that youth who have executive function deficits may exhibit difficulties shifting attention from stressful stimuli and, thus, may be at an increased risk for internalizing symptoms (Compas & Boyer, 2001). In support of this model, executive function deficits that are common in SB (i.e., difficulties in the areas of metacognition, encoding, focusing, and shifting attention; Loss, Yeates, & Enrile, 1998; Zabel et al., 2013) have been linked to internalizing symptoms (Kelly et al., 2012). Further, while research to date has not examined the impact of inattention on internalizing symptoms in this population, inattention has been linked to greater internalizing symptoms in other pediatric populations (e.g., children with chronic fatigue syndrome; Tucker, Haig-Ferguson, Eaton, & Crawley, 2011). Similarly, low verbal IQ has been linked to greater internalizing symptoms (i.e., anxiety) in youth with epilepsy (Caplan et al., 2005). However, there have been variable results with regard to the link between IQ and internalizing symptoms in youth with SB. One study found that verbal IQ is not a significant predictor of depressive symptoms (Schellinger, Holmbeck, Essner, & Alvarez, 2012), whereas another study found that lower verbal IQ is predictive of poorer psychosocial adaptation (Coakley, Holmbeck, & Bryant, 2006). Although studies examining associations between neuropsychological functioning and internalizing symptoms in pediatric populations have steadily increased in the past decade, less attention has been paid to underlying mechanisms, or mediators, of this association. In particular, the link between neuropsychological functioning and internalizing symptoms may be mediated by social competence, such that neuropsychological functioning may impact social competence, which, in turn, may impact internalizing symptoms. Previous research on youth with SB has identified significant social deficits that map onto Cavell’s (1990) tri-component model of social competence: (1) social adjustment (e.g., fewer close friendships; Devine, Holmbeck, Gayes, & Purnell, 2012), (2) social performance (e.g., social immaturity, withdrawal, and passivity; Ammerman et al., 1988; Holmbeck et al., 2003; Rose & Holmbeck, 2007), and (3) social skills (e.g., inappropriate sociability and verbosity; Burmeister et al., 2005). Highlighting the impact of neuropsychological functioning on social competence, Rose and Holmbeck (2007) found that both performance- and questionnaire-based measures of executive dysfunction contributed to social competence impairment in youth with SB. Further, youth with SB exhibiting deficits in problem solving and planning may have difficulty performing appropriate social behavior, such as communicating necessary information to peers (i.e., social language) and understanding the rules of social engagement (Landry, Robinson, Copeland, & Garner, 1993). Symptoms of inattention may also impact social competence and internalizing symptoms in youth with SB. Individuals with SB tend to exhibit attention problems that are similar to children with attention-deficit/hyperactivity disorder (ADHD), including high distractibility, poor organization of materials, and difficulty staying on task (Burmeister et al., 2005). Children with ADHD often have peer conflicts, are less popular with peers, experience higher levels of peer rejection, and lack close friendships. These social difficulties evident in children with ADHD appear to increase their risk of later psychopathology (Nijmeijer et al., 2008). Similarly, preliminary findings have revealed that adolescents with SB have enduring attention problems that are associated with difficulties with social competence (Rose & Holmbeck, 2007), such as fewer friendships and a lower level of closeness with same-age peers (Holmbeck et al., 2010). Further, with regard to the link between IQ and social competence, children with intellectual disabilities may show decreased social competence, including poor peer relationships, social withdrawal, and delayed development of social skills (e.g., difficulties with communication and using appropriate social interaction strategies; Bellanti & Bierman, 2000; Guralnick, 1999; Zion & Jenvey, 2011). Finally, the connection between social competence and internalizing symptoms has shown strong and consistent support in the literature. Social competence difficulties, such as peer rejection, have been linked to increases in internalizing symptoms in several pediatric populations, including children with inflammatory bowel disease (Greenley et al., 2010), glycogen storage disease type 1 (Storch et al., 2008), pediatric pain (i.e., disease- and non-disease-related pain; Claar & Walker, 2006; Gauntlett-Gilbert & Eccelston, 2007; Peterson & Palermo, 2004; Sandstrom & Schanberg, 2004), and youth with SB (Essner, Murray, & Holmbeck, 2014). Youth may experience increased internalizing symptoms as a result of poor social competency for a variety of reasons, including limited social interactions, feelings of low self-worth related to peer status, or increased anxiety in social situations. While studies have begun to investigate associations among neuropsychological functioning, social competence, and internalizing symptoms in youth with SB, these domains have yet to be tested within one unified model. Thus, the purpose of this study was to examine the utility of a model of neuropsychological functioning (i.e., executive dysfunction, performance attention skills, reported attention problems, and IQ), social competence, and internalizing symptoms in youth with SB (see Figure 1). It was expected that social competence would mediate the relationship between neuropsychological functioning and internalizing symptoms in youth with SB. Specifically, executive dysfunction, inattention, and lower IQ were expected to predict lower levels of social competence that, in turn, would predict increased internalizing symptoms in this population.

Abstract: Although prior research has shown lower intellectual functioning across pediatric solid organ transplant recipients relative to matched siblings or norm comparisons, few studies have assessed intellectual and academic performance prior to transplant across organ groups. The current data examine intellectual and academic functioning in children being evaluated for kidney, liver, or heart transplant. This investigation included intellectual and academic testing data from 195 children and adolescents between the ages of six and 19 yr evaluated for solid organ transplantation. Across organ groups, patients' intellectual functioning as estimated by the WASI/WASI-II at the time of pretransplant evaluation was within the average range, but lower compared to test norms. Patients demonstrated lower estimates of word reading, math computation, and spelling skills compared to the normal population, with the exception of heart patients' word reading and spelling skills and liver patients' spelling scores. Cognitive and academic impairments exist in children prior to transplantation. Findings emphasize the support that patients may require to manage the complicated medical regimen and succeed academically. Routine cognitive and academic assessment can inform healthcare providers regarding transplant patients' capacity to take on increasing medical responsibility and successfully reintegrate into the school environment.

Abstract: Stress is implicated in the development and course of psychotic illness, but the factors that influence stress levels are not well understood. The aim of this study was to examine the impact of neuropsychological functioning and coping styles on perceived stress in people with first-episode psychosis (FEP) and healthy controls (HC). Thirty-four minimally treated FEP patients from the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, and 26 HC participants from a similar demographic area participated in the study. Participants completed a comprehensive neuropsychological test battery as well as the Coping Inventory for Stressful Situations (task-, emotion- and avoidance-focussed coping styles) and Perceived Stress Scale (PSS). Linear regressions were used to determine the contribution of neuropsychological functioning and coping style to perceived stress in the two groups. In the FEP group, higher levels of emotion-focussed and lower levels of task-focussed coping were associated with elevated stress. Higher premorbid IQ and working memory were also associated with higher subjective stress. In the HC group, higher levels of emotion-focussed coping, and contrary to the FEP group, lower premorbid IQ, working memory and executive functioning, were associated with increased stress. Lower intellectual functioning may provide some protection against perceived stress in FEP.

Abstract: Recent efforts have contributed to significant advances in the detection of malingered performances in adults during cognitive assessment. However, children's ability to purposefully underperform has received relatively little attention. The purpose of the present investigation was to examine children's performances on common intellectual measures, as well as two symptom validity measures: the Test of Memory Malingering and the Dot-Counting Test. This was accomplished through the administration of measures to children ages 6 to 12 years old in randomly assigned full-effort (control) and poor-effort (treatment) conditions. Prior to randomization, children's general intellectual functioning (i.e., IQ) was estimated via administration of the Kaufman Brief Intellectual Battery-Second Edition (KBIT-2). Multivariate analyses revealed that the conditions significantly differed on some but not all administered measures. Specifically, children's estimated IQ in the treatment condition significantly differed from t...

Abstract: The current experiment investigated the extent to which three variables (autism severity, nonverbal intellectual functioning, and verbal intellectual functioning) are associated with over-selective responding in a group of children with Autism Spectrum Disorder. This paper also analyzed the association of these three variables with the recovery of responding to a previously under-selected stimulus following extinction of the previously over-selected stimulus. The results demonstrated that participants showed over-selectivity, and demonstrated that extinction of the over-selected stimulus led to recovery of responding to the previously under-selected stimulus. For both over-selectivity, and recovery from over-selectivity, verbal functioning appeared to predict the effects most strongly, with greater over-selectivity in the lower functioning individuals, and greater recovery in the higher functioning individuals.

Abstract: Over the past few decades, care for people with intellectual disability in the UK has moved from long-stay hospitals to the community. As in the general population, a number of these people have mental health and behavioural difficulties for which they may require in-patient services. Consequently, psychiatrists need to be aware of the in-patient mental healthcare provision for these individuals. This article describes the different categories of in-patient bed for patients with intellectual disability and ways to monitor the quality and outcomes of in-patient care.

Abstract: It is well known that survivors of acute lymphoblastic leukemia (ALL) and brain tumors are at increased risk for the development of neurocognitive late effects due to their disease and treatment.1,2 There is a wide range of difficulties experienced by survivors of CNS-impacting cancers as a group (particularly survivors of brain tumors), including visual and verbal episodic memory, visual-motor integration, executive functioning, and some mental health symptoms.1,2 The most frequently described neurocognitive late effects, however, pertain to IQ, working memory, and processing speed.3–5 The severity of these late effects has been found to be greatest for pediatric patients who were treated at a young age and with therapies that impact the central nervous system (eg, intrathecal methotrexate, cranial radiation, and neurosurgery).6,7 Not only do deficits in neurocognitive ability impact intellectual and academic functioning, they can also lead to reduced quality of life that includes higher rates of failure to achieve milestones such as marriage, independent living, and employment.8,9 Given these implications, it remains critical to work towards improving neurocognitive evaluation and interventions for survivors. The nature of neurocognitive impairment observed in survivors of childhood cancer presents a unique conceptual challenge to researchers, clinicians, and educators. As researchers have refined the cognitive phenotype in survivors, many have also sought to compare the late effects profile to the frameworks of other known cognitive or developmental disorders. Such efforts serve to facilitate understanding of survivors' deficits and to better direct the search for effective interventions. One frequently referenced model is attention deficit/hyperactivity disorder, predominantly inattentive type (ADHD-In). ADHD-In is a developmental disorder characterized by pervasive and impairing difficulties with inattention, concentration, and distractibility that have been observed consistently over time and across settings beginning in early childhood.10 Working memory deficits, delays in processing speed, and executive dysfunction are also associated with ADHD-In.10–12 A significant body of literature has documented attention problems in survivors of both ALL and brain tumors,13–18 which supports this conceptual model. Broadly speaking, survivors of brain tumors demonstrate high rates of attention problems and associated impairments, particularly when they have been treated with cranial radiation19 or have been treated for hydrocephalus.20–22 Attentional difficulties have been documented for survivors of numerous tumor types, including medulloblastoma,5 ependymoma,23 low-grade astrocytoma,24 pilocytic astrocytoma,22 and craniopharyngioma.25 Notably, increased rates of attentional difficulties have been documented even in survivors of ALL who have no global intellectual, memory, or academic deficits.13,26 Further, research has also suggested that 70% of survivors' functional impairment at school and other settings can be accounted for by their attention problems.27 Because of the prevalence of attention problems, performance-based measures and rating scales of attention are often included in neuropsychological evaluations of survivors of childhood cancer. Best practice guidelines from the Children's Oncology Group28 recommend, at minimum, a comprehensive neuropsychological evaluation at entry into long-term follow-up for all survivors who have the potential to be at risk for neurocognitive late effects (most predominantly survivors of ALL and brain tumors). Reevaluation is then recommended based on clinical need and the anticipated trajectory for the emergence of late effects. However, it is often difficult to comply with these recommendations due to limitations of practice (eg, insurance, long waiting lists, and family reluctance). As such, it is important to evaluate efficient and economical methods for identifying those patients who are at heightened risk for neurocognitive late effects and would thus benefit from a comprehensive evaluation. Prior studies have suggested that the use of parent-reported questionnaires may be a quick and feasible means for screening a large group of patients for neurocognitive concerns.29 Specifically, Patel et al29 evaluated the utility of a broad-based measure of emotional and behavioral functioning to identify attention problems in survivors of brain tumors. They found that elevated ratings of inattention on this measure were predictive of greater attention problems on more objective, laboratory-based measures.29 However, they did not evaluate the predictive validity of their attention measure to other measures of neurocognitive functioning that are typically impaired in survivors, including working memory and processing speed tasks. Furthermore, their sample was limited to survivors of brain tumors and did not include patients with ALL, who are also at risk for attention deficits.26 Therefore, as a logical extension of previous work in this area, we aimed to clarify the association between survivors' clinically significant attention problems and other neuropsychological difficulties (ie, working memory, processing speed, behavioral outcomes). Broadband, parent-completed rating scales, which include items designed to measure ADHD symptoms, have been shown to reliably distinguish between children with and without ADHD as well as children with and without working memory deficits.30,31 Such rating scales have also been used previously in the research literature to characterize the attention profile of survivors of ALL and brain tumors.32–34 If parent-rated attention problems can reliably predict broader neuropsychological late effects in survivors, parental ratings may help clinicians triage survivors so that resources are allocated to those who are in need of comprehensive evaluations. This may be particularly relevant for survivors of ALL, who may not evidence global declines in cognitive functioning but do demonstrate attention problems.1,13,26 Our first hypothesis was that survivors' difficulties with attention would be predictive of lower scores on performance-based tasks of global intellectual functioning, processing speed, and working memory. Our second hypothesis was that the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)35 ADHD-In symptoms, as rated by parents, would identify survivors experiencing specific neurocognitive and psychosocial dysfunction.

Abstract: Objective: The accurate estimation of premorbid intellectual functioning in patients with known or suspected cognitive impairment is crucial for clinicians. However, there is no reliable method for estimating premorbid intelligence in South Korea. The purpose of this study was to develop the Korea Premorbid Intelligence Estimate (KPIE) as an estimate of the premorbid intellectual functioning. Method: Data from the Korean WAIS-IV standardization sample were used to generate several Full Scale Intelligence Quotient (FSIQ) estimation formulas using demographic variables and current WAIS-IV subtest performance. The standardization sample (N = 1216) was randomly divided into two groups: the first group was used to develop the formulas and the second group was used to validate the prediction equations. Age, education, gender, region of the country, and select subtest raw scores (Vocabulary, Information, Matrix Reasoning, and Visual Puzzle) were used as predictor variables. Results: Five KPIE-4 equations were ge...