Many patients that experience a concussion have impairing symptoms that persist beyond typical recovery timeframes. Concussion symptoms often remit within a month, but persisting impairments are difficult to characterize and attribute to concussion given the poorly defined diagnostic criteria of post-concussion syndrome and inadequate understanding of the cognitive symptoms associated with this condition. The current study aims to clarify the cognitive profiles of school-aged concussion patients (n = 21; N = 36; 64% male) that have persisting symptoms to improve the clinical identification methods for this condition. Logistic regression was used to explore the importance of cognitive processing speed and working memory for identifying patients with persisting concussion symptoms (PCS). Additional exploratory analyses were conducted to clarify cognitive domains that may be impacted by having PCS. Findings indicate processing speed and working memory abilities alone are not adequate to identify patients with PCS. Further, measures of processing speed, fluid reasoning, working memory, and long-term retrieval together were found to be necessary to identify those who had a prior concussion with PCS. These findings indicate clinical neuropsychological batteries must include measures of these four cognitive domains when assessing school-aged patients with chronic symptoms that extend beyond three months following injury.

Unilateral cerebral palsy (UCP) usually results in damage to the unilateral pyramidal system. However, the clinical presentation of neuromotor deficits also suggests lesions to the extrapyramidal and cerebellar systems bilaterally. In this study, we developed and tested a behavioral neuromotor examination protocol assessing impairments at three levels of motor integration for children with UCP, also considering impairments of the non-paretic upper limb as well as the influences of the laterality of the lesion. We included 30 children with UCP (10.79 ± 2.61 years) and 60 healthy children (8.27 ± 1.57 years) in the study. All children were assessed on general cognitive ability and classified according to the manual ability classification system (MACS). Our neuromotor examination protocol incorporated specific tasks for each level of motor integration: pyramidal, extrapyramidal and cerebellar. Children with UCP and controls did not differ with respect to general cognitive abilities and sex but children with UCP were significantly older. Controls performed significantly better than children with UCP on neuromotor tasks at all levels of motor integration. Additionally, performance of the non-plegine hand in children with UCP was significantly inferior to controls. With the exception of fine motor skills (pyramidal level), children with right and left UCP did not differ. Our behavioral neuromotor examination was sensitive to reveal impairments at all three levels of motor integration bilaterally in children with UCP—although more subtle for the non-paretic limb.

Objective To develop clinical cutoffs using change scores for the VOMS individual items and an overall VOMS change score that identified concussion in adolescent athletes. Methods Change score clinical cutoffs were calculated from a sample of adolescents (13–18 years) with SRC (n = 147) and a sample of uninjured adolescents CONTROL (n = 147). Receiver operating characteristic (ROC) curves, with area under the curve (AUC), based on Youden’s J statistic were used to identify optimal cutoffs for identifying SRC from CONTROLS using VOMS individual item change scores, an overall VOMS change scores, and NPC distance (cm). Results AUC values for VOMS item change scores ranged from .55 to .71. Optimal change score cutoffs were ≥1 for VOMS items and ≥3 for overall VOMS change score. The optimal cutoff for NPC distance was ≥3 cm. A ROC analysis revealed a three-factor model (AUC = .76) for identifying SRC that included vertical vesibular ocular reflex (VVOR), visual motion sensitivity (VMS), and NPC distance items. The AUC (.73) for the overall VOMS change score was higher than any individual VOMS AUC values. Conclusions This study supports an alternate scoring approach and clinical interpretation of VOMS items involving change scores that account for pretest symptoms.

Aim Assessment of intelligence and executive function in 9–10-year-old preterm children as compared to a full-term comparison group and to reveal the background of the individual differences in the outcomes by analyzing the effects of perinatal and social-economic factors. Method Seventy-two preterm children (divided into two groups: 32 extremely low birth weight, 40 very low birth weight) and a matched group of 33 healthy full-term children, aged 9–10 years, were tested using the Wechsler Intelligence Scales for Children (WISC-IV) and digital versions of tasks measuring executive function. As background information perinatal variables and maternal education were entered in the analysis. Results In the WISC-IV all three groups performed in the normal range. The preterm children, particularly the ELBW subgroup, scored significantly lower than the full-term comparison group in several outcome measures. Behind the group means there were massive scatters of the individual scores. Lower maternal education, male gender, and bronchopulmonary dysplasia (BPD) increased the risk for performance deficits. Conclusion Low-to-moderate risk preterm children as groups are disadvantaged in the development of intelligence and executive function as compared to healthy full-term children even until school-age. However, with appropriate protective factors they may have chances to develop comparably with their full-term, non-risk counterparts.

The purpose of the current study was to examine predictors (e.g., pre-injury anxiety and sub-types, concussion symptom severity, neurocognitive performance, and vestibular/ocular-motor impairment) of post-injury anxiety scores following concussion among youth aged 10–18 years. This observational cohort study enrolled patients (n = 129) within 30 days of a diagnosed concussion. Patients completed Screening for Child Anxiety Related Disorders-Child Reports (SCARED-C), Generalized Anxiety Disorder-7 (GAD-7), Post-concussion Symptom Scale, neurocognitive testing, and Vestibular-Ocular Motor Screening. Logistic regression analyses were conducted to evaluate the role of risk factors and clinical outcomes as predictors of mild (GAD-7 > 5) and moderate levels (GAD-7 > 10) of post-injury anxiety. Twenty-two percent (n = 28) of patients reported clinical levels of pre-injury anxiety, and 13% (n = 17) reported clinical levels of post-injury anxiety. The logistic regression model predicting mild or greater anxiety was significant (R2 = 31.7%; p < 0.001) and supported pre-injury panic symptoms (OR = 1.38) and total symptom severity (OR = 1.04) as the most robust predictors. The logistic regression model predicting clinical anxiety was significant (R 2 = 47.2%; p < 0.001) and supported non-SRC injury type (OR = 9.48), vestibular dysfunction (OR = 1.74) and pre-injury panic symptoms (OR = 1.57) as the most robust predictors. Results suggest that clinicians should employ measures of pre-injury and post-injury emotional functioning when evaluating and treating concussion among adolescents. Moreover, these results highlight the importance of assessing different types of pre-injury and post-injury anxiety in the context of concussion management.

Evaluating general cognitive ability (i.e., intelligence) is common in neuropsychological practice, and identifying abbreviated assessments of intelligence is often advantageous. Despite the Wechsler Intelligence Scale for Children, Fifth Edition’s (WISC-V) widespread contemporary use, limited research has identified clinically useful short form (SF) full scale IQ (FSIQ) estimations in clinical samples. This study sought to address this gap in the literature. Two hundred sixty-eight pediatric participants (M age = 9.79; 69% male; 88% Caucasian/White) who underwent psychological/neuropsychological evaluation were included. Mean scores for WISC-V scores fell in the low average-to-average ranges, consistent with the clinical nature of this sample (e.g., M FSIQ = 85.3). Ten unique SF combinations with five (pentad) and four (tetrad) subtests, each intentionally selected to represent a breadth of domains subsumed by WISC-V FSIQ, were described by summing subtest age-corrected scaled scores. Regression-based and prorated FSIQ estimates were calculated, and mean differences suggested some prorated estimates should be arithmetically adjusted. Both regression-based and prorated/adjusted methods provided FSIQ estimates that were accurate within five Standard Score points of true FSIQ for approximately 81–92% (pentad) and 65–76% (tetrads) of participants. Prorated/adjusted estimates appeared to provide somewhat better accuracy than regression-based estimates. Relationships between SFs and true FSIQ did not appear to be moderated by participant age, gender, nor how many WISC-V subtests were administered to participants within this archival sample (i.e., 7 vs. 10). Implications of these findings, including benefits, detriments, and other considerations of each SF combination, in addition to limitations of this study, are discussed in detail.

Both quantitative electroencephalography (qEEG) and cognitive measures have been used to understand the underlying brain changes that occur in individuals after experiencing a traumatic brain injury, however, research exploring the relationship between qEEG patterns and cognitive test performance is scarcely studied in school-aged populations. The purpose of the present study was to explore first, the neuropsychological and academic deficits in young individuals with TBI; and second, the underlying relationship between qEEG patterns and cognitive test performance. Analyses included 21 school-aged participants whom have experienced a recent TBI and 15 school-aged participants whom have never experienced a TBI. Mean subtest and composite scores were compared and regression analyses were used to determine whether alpha band and beta band qEEG coherence values predicted processing speed measures. Results suggest that young individuals who experienced a recent TBI exhibit general deficits in cognition and academic skills beyond what would be expected in the general population. Further, beta band coherence with the frontal brain regions significantly predicted processing speed scores, providing evidence of a relationship between qEEG patterns and processing speed. This outlines a relatively inexpensive method for utilizing neural connectivity to verify cognitive deficits for school-aged individuals with a recent TBI.

The term dyslexia originated in 1887 when an ophthalmologist described the difficulty of learning to read. After more than a century of research, we still do not know the etiology of such pathology. Several hypotheses have been suggested to explain dyslexia and in the present article we will describe in detail the visual attentional deficits reported in dyslexia. Reading is a complex cognitive process during which several mechanisms are involved (visual perception, eye movements -saccades and fixations-, semantic and linguistic abilities); consequently, a deficit in one of these different components could cause impairment in reading acquisition. In children with dyslexia, we observed abnormal oculomotor patterns during reading: frequent saccades of small amplitude, long-term fixation, high number of saccades to the left (retro-saccades), and poor binocular coordination during and after the saccades. These results suggest a deficit of visual information processing as well as an immaturity of the interaction between the saccade and vergence systems. In the present review, we will discuss different methods that use short periods of visual rehabilitation or text manipulation, and by using an eye tracker in order to obtain objective information on eye movement’s performance during reading, assist in improved reading performance of dyslexic children.

Word-level reading is strongly associated with phonological processing. The aim of this study was to investigate the effects of cognitive and environmental variables on word reading performance. Our sample consisted of 185 fourth-grade students. Linear regression analyses were used to investigate the role of the following variables as potential predictors of word reading accuracy and fluency: phonological processing (phonological awareness, rapid automatized naming, and phonological memory); verbal fluency; working memory; socioeconomic status and an indicator of school quality (IDEB) in Brazil. Phonological awareness and rapid automatic naming were the best predictors of reading, supporting the role of phonological processing as a key contributor to the lexical aspects of reading, beyond the early years of literacy acquisition. Environmental variables were significant predictors of irregular word reading (socioeconomic status) and fluency (IDEB), corroborating multicomponent models of reading performance. The present findings demonstrate the complex interplay of factors underlying reading performance and highlight the importance of a multidimensional approach to the study of reading.

Adolescents having moderate to severe traumatic brain injury (TBI) often experience long-lasting cognitive, emotional, and behavioral problems. In current clinical practice, rehabilitation techniques to treat cognitive abnormalities may be classified in two main categories, i.e. conventional or advanced. Aim of this case study was to evaluate the safety and efficacy of an immersive virtual environment (Computer Assisted Rehabilitation Environment [CAREN]), in a young boy affected by severe TBI. A 15-year-old boy with TBI involving the right parietal-temporal region underwent two different rehabilitation trainings, including standard cognitive rehabilitation alone in a usual clinical setting (face-to-face intervention with a paper and pencil approach) or the same cognitive program using virtual scenarios by means of CAREN. We evaluated the patient’s cognitive status, before and after the two different trainings, by using a specific psychometric battery to evaluate the cognitive and behavioral functioning, such as attention abilities, visuo-spatial and executive functions. Only at the end of the CAREN training, we observed a significant improvement in specific cognitive and motor domains, such as attention abilities, visuo-executive processes, emotional awareness, and balance. Cognitive training, using immersive Virtual Reality, may be a useful tool to facilitate cognitive recovery in TBI patients.