Many studies supported that children with autism spectrum disorder (ASD) have worse executive functions (EFs) when compared to typically developmental (TD) children in many domains, such as planning, flexibility, inhibition, and self-monitoring. The current study aims to use an adapted version of the computerized tower test to investigate the EFs of children with ASD. Furthermore, the researcher also assessed children's EFs-related behaviors in their schools using a teacher-filled behavior rating inventory of executive function, 2nd edition (BRIEF-2).

61 Children aged 7 to 12 years old (M = 9.23) were included in the current study. 29 of them were in the ASD group, and 31 of them were in the TD group. All participants conducted an adapted computerized tower test. All participants' teachers completed BRIEF-2 to investigate their EFs-related behaviors in their schools.

The results indicated that there were no significant differences in the tower test between the ASD group and TD group in all indexes. Therefore, it implied that the current indexes might not be sensitive enough to distinguish whether a child has ASD or not. In addition, we further investigate the correlations between the tower test and the teacher-filled BRIEF-2. We found the different patterns in the two groups. In the ASD group, we found that the task-monitor index was positively correlated with total-number-of-rule-violations, total-complete-time, and total-rule-violations-per-item-ratio. The task-monitor index was negatively correlated with total-achievement-score, implying that poorer ability to monitor tasks leads to a longer completion time, more rule violations, and a lower total achievement score. Moreover, we also found a high correlation between the organization-of-materials in BRIEF-2 and total-complete-time in the tower test, suggesting the long problem-solving time in ASD groups is highly related to the disability of keeping working space ordered. In addition, we found that the shift index is positively correlated with total-complete-time and total-rule-violations-per-item-ratio. Hence, it indicates that those with poor flexibility in solving problems tend to need more time to complete tasks and violate more rules in ASD groups. In the TD group, we only found the correlation effects were significant between inhibition and self-monitor in the BRIEF-2 and the total-rule-violations-per-item-ratio in the tower test. It suggested that individuals with behavioral regulation problems, such as impulse control and monitoring problems are more likely to make rule violations. The result indicated that behavioral regulations play a more significant role in the TD group. In contrast, cognitive and emotional regulations are more critical in ASD children.

Our findings found no significant difference in the computerized tower test between children with and without ASD, suggesting that the current indexed might not be sensitive enough to differentiate children with or without ASD. However, the results of the correlation between the tower test and teacher-filled BRIEF-2 showed that different patterns might be the cause of the EF performances between the two groups, indicating that there might be a different domain of EFs the children used in the tower test between two groups.

Therefore, further research could focus on developing new indexes in the Tower test and finding the EF mechanism of ASD children with different approaches.

Persons with behavioral variant frontotemporal dementia (bvFTD) have been shown to exhibit altered morality, manifested as atypical utilitarian tendencies towards sacrificial moral dilemmas. This takes the form of endorsing harmful actions towards single individuals, including vulnerable or relationally close individuals (e.g. children, loved ones), in order to promote the greater good for the community or society as a whole. The dual process model of moral cognition interprets such tendencies as deriving from a lack of emotional engagement, whereas moral emotion theory views them as selective impairment in prosocial sentiments. We hypothesized that both the widespread neuropsychological practice of using sacrificial moral dilemmas to evaluate moral reasoning, and these tests' overreliance on quantitative results, inadequately represent how persons with bvFTD reason and feel while responding to moral dilemmas. To evaluate this hypothesis, we applied a mixed-methods approach to identify the reasoning, motivations, and emotional experiences of bvFTD persons during their deliberation about moral scenarios.

We conducted semi-structured interviews with 14 participants: 7 persons with bvFTD & 7 older healthy controls. Transcripts were coded in Atlas 5.0 to characterize the underlying reasoning, emotions, response processes, and values that emerged when responding to a structured set of moral dilemmas. Our dilemmas measured utilitarian reasoning holistically by incorporating both sacrificial and impartial/altruistic components, as suggested by the 2-dimensional model of utilitarianism.

Unexpectedly, bvFTD persons articulated a prosocial compass when asked about their values, stating they were organizing their choices predominantly around kindness and altruism, even when they were making choices to harm loved ones or vulnerable individuals to promote the greater good. During moral deliberation, persons with bvFTD showed significantly less metacognition (bvFTD = 10%, HC = 90%) but reported more positive emotions (joy; bvFTD = 83%, HC = 17%) than negative (frustration; bvFTD = 30 %, HC = 70 %) compared to controls. Qualitatively, this observed emotional outlook was typically coupled with a more rigid, simplistic viewpoint (e.g., "I felt great, it was a no brainer"), suggesting a moral understanding lacking emotional nuance and complexity.

Our data showed that bvFTD persons' utilitarian responses to moral dilemmas did not arise from an emotionally flat or antisocial cognitive perspective, but instead were guided by positive emotionality, simplistic reasoning, and prosocial values. These findings challenge the current understanding of the reasoning processes and experiences of persons with bvFTD and highlight the importance of incorporating mixed method approaches in dementia research that take into consideration the viewpoint of the cognitively compromised individual.

Previous research suggests that individuals with isolated Agenesis of the Corpus Callosum (AgCC) have cognitive and psychosocial deficiencies that include impaired recognition of the emotions of others (Symington et al., 2010) and a diminished ability to infer and describe the emotions of others (Paul et al., 2021; Turk et al., 2010). In addition, galvanic skin responses effectively discriminated between emotional images despite atypical emotion ratings (Paul et al, 2006), supporting a dissociation between cognitive and affective empathy in AgCC. Likewise, atypical patterns of visual attention to faces corresponded with impaired emotion recognition in AgCC (Bridgman et al, 2014), suggesting that atypical visual attention in AgCC negatively impacts the ability to identify others’ emotions. This study used the Multifaceted Empathy Test [MET] (Foell et al., 2018) to examine the impact of visual aesthetics (photo composition) on empathetic feelings (affective empathy) and situational emotion recognition (cognitive empathy) in persons with AgCC. Both cognitive and affective empathy scores are typically higher on MET stimuli composed according to the “Golden Spiral” (Callaway, 2022).

Results from 50 control participants recruited from Cloud Research were compared to responses from 19 participants with AgCC and normal-range FSIQ (>80). Data was gathered through an online version of the MET, which uses a series of photographs of individuals displaying an emotion, half of which adhere to the compositional technique known as “The Golden Spiral.” To measure cognitive empathy, the participants are asked to pick the correct emotion being displayed with three distractors for each item. To measure affective empathy, they are then asked on a sliding scale, “how much do you empathize with the person shown” (1 = Not at all, 7 = Very much).

Repeated measures mixed ANOVAs revealed no difference between AgCC and control groups on affective empathy, and as expected on the MET, both groups had significantly higher ratings for photos composed according to the Golden Spiral (AgCC, np2 = .071; control, np2 = .136). In contrast, the AgCC group scored significantly lower than controls overall on cognitive empathy, np2 =.065. Exploratory post-hoc found a significant group difference in cognitive empathy only on photos composed according to the Golden Spiral, np2 = .090, with the scores in the AgCC group unimpacted by composition type while the control group exhibiting significantly higher scores Golden Spiral images, np2 = .254.

Empathic deficits in AgCC were restricted to the cognitive component, while affective empathy was not impaired. Visual aesthetics of photo composition influenced affective empathy ratings in both AgCC and control groups. However, adults with AgCC had diminished ability to give cognitive labels to the emotional states of others, which was not enhanced by the formal aesthetics of stimuli. Thus the corpus callosum seems to facilitate the ability to cognitively label emotions by facilitating visual attention. It also suggests that the corpus callosum does not facilitate affective empathy, in part because it does not appear to determine whether formal aesthetics influences the processing of visual stimuli in AgCC or neurotypical controls.

The COVID-19 pandemic created barriers to healthcare that necessitated changes in services to meet needs of individuals. With these changes, technological advances in computerized cognitive testing became critical. As researchers and clinicians accelerated adaptation of computerized testing formats, considerations for development and interpretation of such tools have proved imperative. One such computerized tool, RC21X, utilizes performance measurement software comprising 15 modules to evaluate an individual’s processing speed, memory, executive functions, and neuromotor coordination. Although initial data has revealed strong psychometric properties (Saganis et al., 2020), a need to explore various attributes of this web-based tool has emerged. The current study examined impact of dominant handedness on an RC21X neuromotor task.

The sample consisted of 602 participants: 553 (91.86%) were right-hand dominant and 49 (8.14%) were left-hand dominant. Of participants who identified their sex, 81.2% were male, 18.3% were female; 0.5% chose not to identify. Age ranged from 7-95 years (M = 41.21, SD = 18.81). This study focused on the RC21X Eye-Hand Coordination subtest. Using a Fitts’ Law paradigm, the module provided instruction for participants to alternately press the “A” and “L” keys on a keyboard as quickly and accurately as possible using only one upper extremity (UE) at a time (tested separately for right then left UE). We computed a one-way between groups multivariate analysis of variance (MANOVA) to investigate handedness differences on task performance. Dependent variables were individuals’ performances on right- and left-UE tasks; the independent variable was dominant handedness. We conducted preliminary assumption testing with no serious violations noted. We also separated the sample by dominant handedness to compare right versus left-hand performance using paired samples t-tests within each group. There were no significant differences between the two groups on either age or sex.

There was a statistically significant difference between right-hand dominant and left-hand dominant participants on the dependent variables, F (2, 599) = 8.84, p < .001, Wilks’ Lambda = .971. Mean scores indicated that right-hand dominant participants (M = 52.87, SD = 20.42) outperformed their left-hand dominant counterparts (M = 46.30, SD = 12.79) when using their right UE, though both groups performed similarly when using their left UE (right-hand dominant M = 48.55, SD = 17.81; left-hand dominant M = 49.70, SD = 14.13). These findings were present despite expected results from paired samples t-tests that revealed individuals performed best with their dominant hand.

Results revealed that handedness is necessary to consider in design and utilization of computerized neuropsychological tests. The large proportion of right-hand dominant individuals may have affected our results; however, our sample is representative of handedness distribution in the general population. Although our paired samples t-tests support validity of RC21X, continued investigation of computerized performance measurement tools is necessary. Future research must explore the possibility of an ordering effect (i.e., right-handed participants starting with their dominant UE, but left-handed participants starting with their nondominant UE) or due to construction of everyday items (e.g., computer keyboards) primarily for right-hand dominant people.

It is well known that there are differences between men and women in anxiety and aggression. Moreover, prior research has shown an association between anxiety and aggression but the strength of these associations in males and females has not been well characterized, and it remains unclear whether such associations are driven by comorbid disorders such as posttraumatic stress disorder (PTSD) or substance abuse. Therefore, we examined these associations in a large sample of males and females, and statistically controlled for the aforementioned potential confounding variables.

A total of 13,313 adults completed the survey on Amazon Mechanical Turk between April 2020 and April 2021, including 5,598 females (Mage=36.4, SD=11.9) and 7,654 males (Mage=37.81, SD=12.7). Aggression was measured using the Buss Perry Aggression Questionnaire (BPAQ), while the Generalized Anxiety Disorders (GAD-7) scale was used to gauge anxiety levels. PTSD was assessed with the PC-PTSD scale, and alcohol misuse was assessed with the Alcohol Use Disorders Inventory (AUDIT). Data were analyzed with zero-order correlations and linear regression to control for the effects of PTSD and alcohol misuse. Lastly, we used a Fisher r-to-z transformation to compare the correlations between males and females for both physical and verbal aggression with anxiety.

Higher aggression (i.e., BPAQ) was correlated with greater anxiety (i.e., GAD; r(13213)=0.482, p<0.0001)). This association between anxiety and aggression held even when other potential confounders were controlled, such as PTSD (p<0.0001), and alcohol misuse, p<0.0001. Additionally, the correlation between anxiety and physical aggression was significantly stronger in males than females (z=5.02, p<0.0001), a pattern that was also true for the association between anxiety and verbal aggression (z=4.13, p<0.0001).

Our findings suggest that there is a linear relationship between the severity of anxiety and the severity of both verbal and physical aggression, that these associations tend to be stronger among males, and are not accounted for by associated conditions such as PTSD or alcohol misuse. This data augments existing research on the factors that contribute to aggression and further suggest that anxious feelings are more directly associated with aggression in males. These findings raise the possibility that interventions that target anxiety may prove helpful in reducing aggressive behavior among males. It may be fruitful for future work to identify neural systems that are associated with both anxiety and aggression and which are also modulated by sex. While measures of neurochemistry were not collected here, prior research has suggested that there are sex differences in brain systems that rely on serotonergic neurotransmission and arginine vasopressin, which could provide a target for future work.

Motor impairments are one of the most common adverse outcomes after pediatric arterial ischemic stroke (AIS), affecting approximately half of survivors. The development of motor and cognitive skills is closely interrelated, and they share common neural substrates. The objective of this study was to examine whether motor functioning after the acute phase of stroke is associated with school-age intellectual abilities. We also examined associations between concurrent motor functioning and intellectual abilities. Finally, we explored clinical features associated with motor impairments.

Participants were 64 children, 34 childhood AIS (Meanage= 11.90[2.38]); 30 perinatal AIS (Meanage= 8.75[2.22]), from the Children’s Stroke Program at SickKids Hospital. Motor functioning was assessed with the Pediatric Stroke Outcome Measure sensorimotor subscale at two timepoints, Time 1 or early recovery (childhood group between 30 days post-stroke to 1 year; perinatal group between 2-5 years of age) and Time 2, closest to neuropsychological testing. Intellectual abilities were measured using the Wechsler Intelligence Scale for Children 4th or 5th edition. Associations between motor and intellectual functioning were examined separately in childhood and perinatal AIS groups. Clinical features associated with motor impairment were examined across the full sample.

Motor functioning during early recovery was significantly associated with processing speed (r= -.391, p= .036) in the perinatal group and with overall intellectual functioning (r= -.414, p= .018) verbal intellectual abilities (r= -.444, p= .011), working memory (r= .393, p= .026), and processing speed (r= -.351, p= .042) in the childhood group. There were no associations between concurrent motor and intellectual functioning in the perinatal group, and only with processing speed (r= -.525, p= .002) in the childhood group. When motor functioning was dichotomized as no/mild motor deficit and moderate/severe motor deficit at Time 1, children in the perinatal group with moderate/severe motor deficit had significantly lower perceptual reasoning scores (f[28]= 2.15, p= .040) and participants in the childhood group with moderate/severe motor deficit had significantly lower perceptual reasoning (f[32]= 2.35, p= .025) and processing speed (f[32]= 2.14, p= 0.41) scores. There were no differences between no/mild and moderate/severe motor deficit groups for either perinatal or childhood AIS at Time 2. Clinical features associated with moderate/severe motor deficit at Time 1 were cortical+subcortical infarcts, large lesions, presenting with hemiparesis and seizures at time of neuropsychological assessment, and accessing occupational therapy and physical therapy.

Results suggest that motor functioning during early stroke recovery is associated with intellectual outcome, whereas motor functioning at time closest to neuropsychological assessment is not. This may be related neuroplastic changes post-injury, likely in frontal-subcortical connections, that result in observable motor deficits after stroke and affect subsequent hierarchal brain maturational processes thereby impacting later cognitive outcome. Different patterns of associations between motor functioning and specific intellectual abilities in perinatal and childhood groups suggest possible age-mediated effects on this relationship.

Self-concept is a mental representation of the self—an internal sense of personal identity. This complex representation is unique to the human mind. Behavioral studies on self-concept have demonstrated that self-relevant information is remembered better than other types of information, a phenomenon commonly known as the “self-reference effect” (SRE). However, the underlying neural mechanisms of SRE remain largely unknown.

Here, we recorded neural activity from ∼600 neurons from 15 neurosurgical epilepsy patients, who were implanted with depth electrodes for seizure monitoring. The SRE paradigm consisted of an incidental learning (encoding) task and subsequent memory recognition test. During the incidental learning task, participants were asked to rate various personality traits in three distinct encoding conditions: the self, a friend, and a celebrity. In the recognition part of the task, participants were asked to distinguish between traits that were presented during the encoding phase (old) and traits that were not presented (new).

Our behavioral findings showed the highest memory accuracy on the recognition test for traits that were associated with the “self” condition, which is consistent with previous studies on SRE. Additionally, we found that traits associated with the “friend” category were more accurately recognized than those associated with a celebrity, indicating that personally familiar information—even if not self-related— improves memory recognition. Through single-unit analyses from target brain regions, including the medial temporal lobe (MTL) and medial prefrontal cortex (mPFC), we identified unique patterns of neural activity during the memory encoding phase, specifically increased responses during self-referential encoding in a subset of the neuronal population.

Future analyses will explore the relationship between increased MTL activity during self-referential encoding and improved memory recognition of traits rated in relation to the self, and network interactions between MTL and mPFC in self-oriented memory processes.

There is rising concern over the potential cumulative and long-lasting effects of prior concussions in active and retired athletes. Previous studies suggest that there is an inverse relationship between concussion (or mild traumatic brain injury) and sleep, with increasing evidence of individuals reporting chronically disrupted sleep following remote concussion. The extent to which these effects are cumulative across repeat concussions is unknown. This project aimed to investigate the association between the number of prior concussions and subjective sleep quality in otherwise healthy collegiate-aged athletes. Furthermore, we investigated which aspects of sleep are most associated with prior concussion.

A total of 176 collegiate-aged athletes (Mage = 21.19, SD = 1.63; 65.9% men) completed off-season clinical visits, at least 6 months since their most recent concussion. Semi-structured interviews captured detailed sport and head injury history across the lifespan. The number of prior concussions for each participant was retrospectively assessed based on American Congress of Rehabilitation Medicine criteria. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A general linear model tested the relationship between number of prior concussions and global PSQI score (i.e., overall sleep quality). Logistic regression models were fit to investigate the association of the number of prior concussions with individual subcomponents of the PSQI (i.e., quality, latency, duration, efficiency, disturbances, use of sleep medications, and daily dysfunction), which were binarized based on their distribution. Sex and total number of years of exposure to contact sports were included as covariates for all models.

The number of prior concussions was significantly associated with worse overall sleep quality as assessed by the global PSQI score, F(3,172)=6.92, p= <0.001, unstandardized beta[B](standard error[SE])=0.54(0.14). Investigation of sub-components showed that the number of prior concussions was significantly associated with multiple PSQI subcomponents, including: poorer sleep quality, odds ratio [OR]=1.35, 95% CI [1.05, 1.74], p=0.02; longer sleep latency, OR=1.35, 95% CI [1.08, 1.68], p=0.008; more sleep disturbances, OR=1.56, 95% CI [1.15, 2.12], p=0.004; and more sleep-related daily dysfunction, OR=1.46, 95% CI [1.16, 1.83], p=0.001. The number of prior concussions was not significantly associated with sleep duration, sleep efficiency, or the use of sleep medication (ps>0.05). There were no years of exposure effects (ps>0.05). Select sex-related effects on sleep quality were observed. Specifically, women reported significantly worse global sleep scores, F(3,172)=6.92, p=0.048, B(SE)=-0.99(0.50), and women reported significantly more sleep disturbances, B(SE)=1.47(0.70), p=0.04, OR=4.34 (95% CI [1.11, 16.98].

These results suggest a potential dose-effect of concussion history on poorer sleep quality ratings in otherwise healthy athletes. Specific facets of sleep that were adversely associated with prior concussion included sleep quality, latency, disturbances, and daily dysfunction, highlighting potential areas for sleep-related clinical interventions. Given the adverse effects of chronic sleep disturbance on mental health, future studies are needed to determine the role of concussion-related sleep problems in the adverse psychological outcomes observed in some athletes with multiple prior concussions.

Previous studies have demonstrated a high prevalence of social and emotional problems in young adults with a history of childhood epilepsy, with social skill impairment hypothesized to play a significant role in these outcomes. Few studies have examined social skills within children with epilepsy and very few have examined this within the context of other neuropsychological and neurological variables. This study aims to examine the association between social problems and other relevant neuropsychological variables (IQ, adaptive functioning, social skills) within the pediatric epilepsy population.

Participants were 86 epilepsy patients between the ages 5 and 18 years of age who were referred for neuropsychological assessment as a part of their surgical candidacy work-up. Pearson correlation analysis was conducted to examine the correlations between performance on objective measures of full-scale IQ, and parent ratings on questionnaires assessing parent perception of the patients’ overall adaptive functioning, social skills, and social problems.

As expected, earlier age of onset was associated with lower IQ, which itself was associated with weaker overall daily living skills and social skills. Later age of seizure onset was associated greater social problems. Social skills were not correlated with social problems.

The results of this study suggest that children with later age of onset of seizures, are at increased risk of social problems and that these problems may not related to social skill impairment. Implications for clinical practice and future directions are discussed.

Chronic alcohol consumption has been associated with widespread cognitive deficits, including psychomotor speed. Researchers have found impairments in reaction speed, information processing, and fine-finger movement in alcoholics (Oscar-Berman et al., 2015). There have also been mixed findings on the impact of duration of alcohol use on neurocognitive functioning (Beatty et al., 2000; Oscar-Berman et al., 2004). This meta-analytical study examines: (a) the performance of abstinent alcohol-dependent individuals on psychomotor speed using the Trail Making TestA (TMT-A), and (b) the effect of duration of alcohol use on TMT-A.

As part of a larger study, two researchers independently searched eight databases, extracted required data, and calculated effect sizes on neuropsychological data in alcohol dependent (AD) individuals. Inclusion criteria for articles were: (a) comparison of abstinent alcohol-dependent patients to healthy controls, (b) matched control group on age, education, or IQ, and (c) standardized neuropsychological testing. Exclusion criteria included: (a) diagnosis of Axis I disorders (other than alcohol dependence), (b) comorbidity with other disorders that impact neuropsychological functioning, or (c) not published or translated into English. Twenty-seven articles (AD n= 840 and HC n = 881) were analyzed in this study.

The TMT-A evidenced a statistically significant and medium effect size estimate (g = 0.624, p < 0.001). The heterogeneity of TMT-A was statistically significant (Q=61.935, df=26, p=0.000) and moderate (I2=58.021%). The meta-regression analysis between duration of alcohol use in days and TMT-A was not statistically significant (Q=0.012, df=1, p=0.913).

TMT-A detects psychomotor speed deficits associated with alcohol dependence. Duration of alcohol use did not affect TMT-A performance, suggesting that other factors may have moderated this relationship. Further research should analyze other factors that affect psychomotor performance in alcohol dependent individuals.

Children with unilateral hearing loss (UHL) have difficulty hearing in noisy environments and localizing sounds, impacting learning and social opportunities across contexts. Using a visible device like a cochlear implant (CI) may improve functioning but can also create psychological risk. Audiological measures alone are insufficient for predicting social, emotional, educational, adaptive, and quality-of-life post-operative outcomes, which are highly variable in this population and can also be impacted by a secondary diagnosis. Extending beyond audition to consider the “whole child” through neuropsychological evaluation may produce a sharper picture of potential outcomes, with or without surgical/audiological intervention. Given recent FDA approval for CI in children with UHL, more are receiving this elective surgery despite difficulties predicting who will experience significant benefit. Here we describe neuropsychological profiles of children with UHL who underwent CI candidacy evaluation at a tertiary pediatric hospital.

During pre-operative clinical care, CI candidates completed targeted neuropsychological evaluation to identify patient- and family-level factors that could impact CI use and outcomes from surgery. Cognitive, language, attention/executive, visuoperceptual/visuomotor, academic, adaptive, and emotional/behavioral functioning were assessed. Evaluations integrated history, observations, caregiver report forms, and performance-based test data.

18 individuals were evaluated (age 7-months to 16-years). Most had left-sided UHL (67%) and were male (61%). Known hearing loss etiologies were congenital cytomegalovirus (n=5), enlarged vestibular aqueduct (n=1), traumatic brain injury (n=1), meningitis (n=1), cholesteatoma (n=1), neurofibromatosis type 1 (n=1), and Waardenburg syndrome (n=1). Indices of general cognitive ability were generally low average to average. Patterns of cognitive impairment were not restricted to language-based tasks (e.g., Beery VMI-6 range 56-109, M=89.42, SD=16.27). Standardized parent ratings of everyday executive functioning, social/emotional/behavioral functioning, and adaptive skills were collected. Eight (44%) had a behavioral health diagnosis: Attention Deficit Hyperactivity Disorder (n=2), Global Developmental Delay (n=2), Unspecified Neurodevelopmental Disorder (n=2), Autism Spectrum Disorder (n=1), and Depression (n=1). Thirteen (72%) received or will receive a CI, of whom 38% had a behavioral health diagnosis. Average Area Deprivation Index (a marker of socio-economic status) was lower for individuals who ultimately received CIs (M=18%tile) compared to those who did not (M=25%tile).

There may be increased rates of neurodevelopmental/psychological conditions among children with UHL, especially when the etiology involves the central nervous system. Albeit preliminary, results align with findings from bilateral hearing loss samples. Findings highlight the importance of routine neuropsychological screening in children with UHL and close interdisciplinary collaboration for optimal outcomes. Socio-economic disparities among those who do and do not receive CI need further exploration as those who did not receive CIs tended to be from less resourced neighborhoods. Additional research is warranted to understand the full range of risk and protective factors for children with UHL and how these relate to outcomes for those who opt for cochlear implantation.

Socioeconomic factors, spanning from childhood to mid-adulthood, were examined in an older adult Black cohort to better understand their influence on the ability to complete instrumental activities of daily living. Previous research with socioeconomic factors has primarily focused on cognitive changes rather than everyday functioning. Additionally, research that has been conducted examining functioning has been with predominantly White samples.

Data on Black participants were obtained from Rush University’s Memory and Aging Project (MAP), Minority Aging Research Study (MARS), and the Latino CORE study (CORE). Participants (n = 1,273) were predominately female (79.9%) and ranged in age from 54 - 97 years (M = 73 years old). Participants were stratified into two groups based on their consensus diagnosis: no cognitive impairment (NCI; 76.1%) and mild cognitive impairment (MCI). Linear regression analyses were utilized on each group to examine predictors of decreased functioning in instrumental activities of daily living. Predictors included income levels during childhood, at age 40, and current income level. Additionally, sex, education level, and parental education levels were included in the models.

Impairment of functioning in instrumental activities of daily living was predicted by the age of the participants at the time of their visit in both NCI and MCI groups (p < 0.001). Current income levels for the NCI participants significantly predicted functioning in IADLs (p < 0.001). This relationship was not present for the MCI group, rather, total family income at age 40 better predicted functioning (p = 0.043).

Previous research has found that early and mid-life socioeconomic circumstances have cascading and complex effects on late life cognition. These same associations may be applicable to functioning with instrumental activities of daily living as they are with cognition. In the present study, current income levels were influential on the functioning of participants without cognitive impairment. Although, when examining those with mild cognitive impairment, mid-life economic circumstances were more impactful on everyday functioning. While the economic status of both groups were predictors of functioning, these findings highlight the importance of better understanding socioeconomic factors across the lifespan and all levels of cognition.

To investigate differences in performance on a widely used cognitive screener between community-dwelling older adults from two disparate socioeconomic groups.

Participants were part of a larger study of cognitive screening in healthy older adults. The total sample (N=79, 69.6% female, 19% White/Caucasian, 12.7% Asian, 43% Latino/a, 25.3% Black/African-American) consisted of community-dwelling adults (Mage=73.1 years [SD=7.2] and Meducation=14.3 years [SD=2.6]) who were initially recruited via social media, flyers, and general community announcements. A lack of ethnic minority participants resulted in a two-year commitment to reach communities of color via visits and provision of health literacy to local religious and community programs. Continuous contact with leaders/gatekeepers helped establish research study credibility and forge a stronger sense of trust among ethnically diverse participants in the greater Houston, TX, area. Testing was initially conducted at the clinical study site. Due to low participation rates among people of color, greater effort was placed on tailored strategies to overcome economic and time constraints (i.e., schedule/time conflicts, lack of transportation, inability to pay for parking). To fit the priorities and needs of the participants, testing was also conducted at their homes (25.3%) and nearby religious and community centers (22.8%). Participants identifying as Latino/a or Black were predominantly recruited and tested at their local community center (as requested by gatekeepers/participants) to increase access to the study, in contrast to Caucasian participants. Median income estimates were used to stratify participants by socioeconomic status (SES) based on zip codes into low SES (L-SES) or high SES (H-SES) groups.

Participants from the L-SES group had significantly lower total scores on the MoCA than their H-SES counterparts, t(77J=2.837, p=0.003, g=0.696. The average MoCA total score for participants from the L-SES group was 2.64 points lower. The observed differences in MoCA total score when stratifying by ethnicity may be attributable to differences in education level and SES, which are known risk factors for cognitive impairment and will be further examined upon recruitment completion.

Studies have found that ethnically diverse older adults not only encounter more barriers to accessing quality health care but also experience disparities in brain health research. Communities of color comprise a sizeable portion of our older adults but have been traditionally underrepresented in clinical research, limiting the generalizability of research findings to clinical treatment. Socioeconomic deprivation has been identified as one of several barriers to research engagement for people of color, placing ethnic communities at increased risk for under- or misdiagnosis and limited access to medical intervention. Preliminary findings have implications for the recruitment of ethnically diverse groups in clinical research. Given the growing racial and ethnic diversity among the United States population, we must do our due diligence to increase understanding of participation and recruitment barriers for racial/ethnic individuals. Tailored community outreach and engagement strategies may be effective in improving the inclusion of ethnically diverse populations and facilitating recruitment and retention in clinical research studies.

A critical need in the neuropsychology field is development and validation of efficient, scalable assessments of cognition. The Mobile Toolbox (MTB), a novel suite of mobile device-compatible, app-based cognitive assessments, was developed to address this need. The goals of this study were (1) To collect longitudinal normative data for the MTB assessments in a large, ethnoculturally and educationally diverse cohort; (2) To assess the feasibility and usability of remote assessment using MTB.

Participants were recruited from the UCSF Brain Health Registry (BHR), an online cohort (N>100,000) that collects longitudinal cognitive, functional, behavioral, and health data using online neuropsychological tests and self- and study-partner report surveys. BHR participants who opted to learning about additional research opportunities were sent automated email invitations to enroll in the MTB study. Those who indicated study interest were provided instructions within the BHR online portal for downloading the MTB app. All participants had the opportunity to complete a single baseline administration of MTB (Word Meaning, Sequences, Spelling, Arranging Pictures, Arrow Matching, Faces and Names, Shape-Color Sorting, Number Match). Those who completed the baseline assessment within three days were invited to continue into the longitudinal study, where they complete MTB assessments at a single, short-term timepoint (day 7, 14, or 21; study arms sequentially assigned), and then at 6-month intervals. Enrollment across demographic groups was monitored, and study invitations were sent to specific demographic groups, with the goal of enrolling a sample of 800 participants in the longitudinal study: equal distribution across eight, 10-year age bands (ages 18-80+); 60% with <16 years of education; 10% non-Latinx Black, 15% Latinx, and 5% non-White other ethnocultural identity.

Between January-June 2022, 48,110 BHR participants were invited to the MTB study. Of those, 8294 (17%) expressed interest, 3401 (7%) completed the baseline assessment, 850 (1.8%) were assigned to the longitudinal study, and 782 (1.6%) completed a short-term longitudinal assessment. Study staff received 797 help tickets submitted by participants asking for email support to complete MTB. The baseline cohort had and average age of 64 years and an average of 16.6 years of education, 76.2% female, 2.1% non-Latinx Black, 7.1% Latinx, 86.8% non-Latinx White, and 4% from other ethnocultural groups. The longitudinal cohort had an average age of 62.3 years and an average of 16.1 years of education, 80% female, 2.8% non-Latinx Black, 8.5% Latinx, 83.5% non-Latinx White; and 5% other ethnocultural group. Compared to those invited to the study, those who enrolled in the longitudinal study were older, had higher educational attainment, and were more likely to be female and self-identify as non-Latinx White (p<0.05 for all).

Efficient enrollment and task completion of a large cohort in a novel, app-based mobile cognitive assessment is feasible in a completely remote setting. Most participants were able to complete MTB without individual support, indicating good usability. This approach can be scaled up to efficiently assess cognition in many research and healthcare settings. A remaining challenge is achieving robust ethnocultural and educational diversity.

The Texas Functional Living Scale (TFLS) is a measure of adaptive functioning commonly utilized across the geriatric population. Current research suggests that those with Alzheimer’s disease and other dementias perform poorly on the TFLS, compared to those with mild cognitive impairment (MCI) and normal cognition (Cullum et al., 2001). Additional research is needed to examine the influence anxiety and depressive symptoms have on activities of daily living (ADLS) in individuals being evaluated for memory disorders. This study will examine the effects of anxiety and depression on adaptive functioning across all patients, and within samples of those with dementia and MCI. It is hypothesized that higher reported anxiety and depressive symptoms will predict lower scores of ADLS.

Patients at a memory disorder clinic (N = 756; 58.2% female) were screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA). A brief neuropsychological evaluation (BNE) was then conducted in which the TFLS, Geriatric Depression Scale (GDS), and Geriatric Anxiety Inventory (GAI) were administered, among other measures.

A stepwise hierarchical regression was conducted on the entire sample to examine the effects of anxiety and depressive symptoms on TFLS performance, controlling for cognitive impairment using the MoCA. Lower MoCA scores explained a significant amount of variance in TFLS performance (R2 = 0.456, F(1, 754) = 632.78, p < .001). MoCA scores (b = 1.27, p < .001), the GAI (b = 0.14, p = .019), and the GDS (b = 0.10, p = 0.039) were significant predictors of poor TFLS performance across the entire sample. Although the MoCA, GDS, and GAI were each significant predictors of the TFLS, the increased variance explained by the GDS and GAI individually was incremental (AR2 = 0.003, F(1, 752) = 3.90, p = .049). Stepwise hierarchical regressions were also conducted on subsamples diagnosed with MCI (N = 171) and dementia (N = 394). For those with MCI, MoCA scores explained a significant amount of variance in TFLS performance (R2 = 0.044, F(1, 169) = 7.80, p = .006). Neither the GAI nor GDS explained significant additional variance. Only MoCA scores (b = .30, p =.006) predicted TFLS performance. For those with dementia, MoCA scores explained significant variance in TFLS scores (R2 = 0.338, F(1, 392) = 200.47, p < .001). The GAI explained additional significant variance when added (AR2 = 0.009, F(1, 391) = 5.26, p = .022). The GDS did not explain any additional variance. Both the MoCA (b = 1.29, p < .001) and the GAI (b = -0.15, p = .002) significantly predicted TFLS performance.

While results suggest that anxiety and depressive symptoms alone do not explain a significant degree of variance within scores of adaptive functioning across the entire sample, elevated ratings of anxiety and depressive symptoms were significant predictors of lower scores of ADLS, suggesting some support for our hypothesis. Additionally, anxiety symptoms significantly explained increased variance in TFLS scores for those diagnosed with dementia, suggesting a potential relationship between anxiety levels and poor adaptive functioning for dementia patients.

An effective support system for families with children with an Autism Spectrum Disorder (ASD) consists of multiple methods of educational and therapeutic delivery. Such methods are adapted to meet a family’s needs and needs of the time, like the COVID-19 pandemic. Individualized Educational Plan (IEP) are established by schools to support success in academics for children with ASD. IEPs can vary depending on the district and accessibility, thus, the effective implementation and communication between this support system is important for its success. The current case study examines academic and therapeutic outcomes of an IEP implementation during hybrid learning of a child with ASD and their family.

Purposeful sampling identified a participant from a previous IRB approved study through the UNLV Educational Psychology program that interviewed parents on their remote learning experience. A qualitative case study was applied to further investigate student outcomes. Parent interview and the child’s progress report were coded and analyzed systematically. The identified family included correspondence from the mother (Lisa, 37) and her son (Noah, 9). Noah attended third grade at a Charter School and was diagnosed with ASD in 2019. His IEP included 80% in General Education (online) with Special Education assistance (in person; reading, writing, and mathematics) and Occupational (OT), Speech/Language (SLP), and Physical Therapy (PT) (hybrid).

Noah began hybrid learning in October 2020, with in-person learning two days a week and remote learning everyday for two to three hours each day. Progress report and interview were collected in April 2021 at the halfway point of his IEP implementation which described Noah’s current special education and therapy services goals/outcomes in March 2021. This included 11 goals that were observed and assessed in OT (2), PT(2), Reading (2), Writing (1), Math (2), and SLP (2). Noah progressed in 9 of 11 goals, with 1 being met and 8 classified as satisfactory by displaying some improvement in respective skills mid year. The remaining OT (2) goals showed no definitive conclusion. Lisa mentioned that lack of direct observation of particular skills and too many online classes to attend led to inconclusive outcomes. Lisa and Noah came across difficulties while engaging in OT online sessions encountering emotional stress when adjusting to the mode of delivery. Lisa expressed positive emotions when referring to the support system and described it as collaborative with adequate attention to multiple aspects of his development. She voiced understanding of her’s and other professionals’ role and the extent of their abilities in the context of the pandemic.

Of the 11 IEP goals, there was adequate progress for the child amid hybrid learning. The parent preferred that OT be delivered in person as certain procedures require direct contact and affected outcomes. Hybrid learning has allowed for parents to directly access their children’s endeavors and heighten communication with professionals. This suggests that maintenance of IEP standards can be satisfactory in a hybrid learning model with adequate monitoring from parents and treatment teams for children with ASD.

To assess the impact of injury severity on disease specific quality of life after Traumatic Brain Injury

The study was carried out in Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India after obtaining ethical clearance from Institute Ethics Committee. Sixty consecutive patients aged 18 and above with moderate to severe TBI (GCS score of 3-12 at admission) attending the Outpatient Department of Neurosurgery Specialty were screened. Out of 60 participants, 40 had moderate TBI (GCS 9-12) and 20 patients had severe TBI (GCS 3-8). The participants having any pre-existing major psychiatric disorders, intellectual disability, current or past history of substance abuse, degenerative and/or progressive condition, terminal illness and past history of TBI were excluded. Written informed consent was obtained from each participant. Socio-demographic details and information about clinical status at the time of admission and discharge were obtained from participant and hospital records. Disease specific quality of life was measured by QOLIBRI (Quality of life after brain injury). It is a self-reported measure comprising of 37 items. The first part assesses the subjects’ satisfaction with his HRQL in 4 domains (cognition, self, daily life and autonomy, and social relationships). The second part measures how much the subject is bothered after TBI in 2 domains (emotions and physical problems). The other tools administered were Glasgow Outcome Scale and Barthel’s Index of Activities of Daily Living (functional status); Mini Mental State Examination (cognitive status): Hospital Anxiety and Depression Scale (anxiety and depression).

The data was analyzed using statistical package for social sciences software version 21 (SPSS). There were no significant differences between both groups with regard to age, gender, education status, marital status, family type and place of residence. Both groups were similar with regard to mode of injury and duration of injury. With regard to treatment during admission both group had significant differences. Among severe TBI group 90% underwent surgical intervention whereas among moderate TBI group only 45% underwent surgical intervention. Significant difference was present in GCS score at discharge between both the groups. After 6 months of injury both group had no significant difference with regard to functional status, global cognitive functioning, anxiety and depression. With regard to quality of life significant difference emerged between the groups on QOLIBRI total score. On various subscales of QOLIBRI - significant differences were noted only in the domains of social relationship and emotions. There were no differences between them on domains of cognition, self, daily life and physical problems.

After 6 months of TBI, the participants in both groups (Moderate TBI and severe TBI) had similar functioning with regard to daily activities and psychological functioning. With regard to quality of life both groups emerged to be significantly different on overall quality of life and domains of social relationship and emotions.

The Tower of London is commonly used to assess planning ability. Deficient outcomes may however have different causes: A participant may not have the ability to think a sufficient number of steps into the future, or may become, for example, impatient to evaluate different possible paths. Outcomes are thus not pure measures of the "planning" construct of primary interest, which may have contributed to findings of low reliability and low validity of these outcomes in the literature. The advent of computerized testing combined with computational modeling potentially allows to go beyond traditional outcomes such as "total number of moves" and "total time taken" and disentangle different processes that are of primary interest. The goal of the current study is to establish whether a model that consists of "planning ability" and "response inhibition" parameters can be used to describe Tower of London data.

We constructed an algorithm that produces Tower of London data, and a computational model that uses every single decision of a participant as input (e.g., whether a participant moves the red or the blue ball to the right peg in setting 15 when trying to get to setting 28). There are 210 unique decision situations that participants can encounter. Our algorithm and Bayesian hierarchical model uses two parameters for each participant as well as a guessing rule, that together determine the participant's decision at every step. The appropriateness of the model was evaluated in a simulation study, where the simulated distribution of data implied by this model is compared to the empirical distribution of total number of moves observed in real datasets. Data were simulated for 10 items with a sample size of 200 participants.

Our simulation study shows that with our model the empirical distribution of total number of moves is successfully replicated in the distribution of the simulated data.

Computational modeling provides a new window into Tower of London performance by identifying different processes. Modeling thus allows us to go beyond aspecific descriptions of planning ability. Furthermore, using the high-resolution data of computerized testing allows us to estimate these parameters reliably without requiring "big data", keeping participant burden low. This study will be followed up in three ways. First, predictions will be preregistered and tested for these new cognitive outcomes in several large oncological patient samples. Second, the model will be extended to include reaction times, to include an additional metric of cognitive computation. Third, the new cognitive process outcomes will be analyzed in conjunction with cognitive process outcomes on other tests to establish process communalities.

Given the aging population, there are significant public health benefits to delaying the onset of Alzheimer’s disease (AD) in individuals at risk. However, adherence to health behaviors (e.g., diet, exercise, sleep hygiene) is low in the general population. The Health Belief Model proposes that beliefs such as perceived threat of disease, perceived benefits and barriers to behavior change, and cues to action are mediators of behavior change. The aim of this study was to gain additional information on current health behaviors and beliefs for individuals at risk for developing AD. This information can then be used to inform behavioral interventions and individualized strategies to improve health behaviors that may reduce AD risk or delay symptom onset.

Surveys were sent to the Rhode Island AD Prevention Registry, which is enriched for at-risk, cognitively normal adults (i.e., majority with a family history and/or an APOE e4 allele). A total of 177 individuals participated in this study. Participants were 68% female; 93% Caucasian and non-Hispanic; mean age of 69.2; 74% with family history of dementia; 40% with subjective memory decline. The survey included measures from the Science of Behavior Change (SoBC) Research Network to measure specific health belief factors, including individual AD risk, perceived future time remaining in one’s life, generalized self-efficacy, deferment of gratification, consideration of future consequences as well as dementia risk awareness and a total risk score for dementia calculated from a combination demographic, health and lifestyle behaviors.

Participants who were older had higher scores for dementia risk (r=0.78), lower future time perspective (r=-0.33), and lower generalized self-efficacy (r=-0.31) (all at p<0.001). Higher education correlated with higher consideration of future consequences (r=-.31, p<0.001) and lower overall dementia risk score (r=-0.23, p=0.006). Of all scales examined, only generalized self-efficacy had a significant linear relationship to both frequency (r2=0.06) and duration (r2=0.08) of weekly physical activity (p<0.001). Total dementia risk score also had significant linear relationships (r2=0.19) with future time perspective (p<0.001) and generalized self-efficacy (p=0.48).

Overall, individuals who rated themselves higher in self-efficacy were more likely to exercise more frequently and for a longer duration. Individuals who had lower overall risk for dementia due to both demographic and behavioral factors were more likely to endorse higher self-efficacy and more perceived time remaining in their lives. Increasing self-efficacy and targeting perceived future time limitations may be key areas to increase motivation and participation in behavioral strategies to reduce AD risk. Developing individual profiles based on these scales may further allow for individually tailored intervention opportunities.