This study examined early intervention programs for autism spectrum disorder using bibliometric methods. A total of 1,065 research and review articles published in English between 1992 and 2025 and indexed in the Web of Science database were analyzed. The findings showed a marked increase in publications after 2013, with most studies originating from the United States, Australia, Canada, and the United Kingdom. In recent years, telehealth and JASPER have emerged as prominent research topics. Overall, this study provides a comprehensive bibliometric overview of the intellectual landscape of early intervention research on autism spectrum disorder by mapping publication trends, geographical distribution, and thematic developments. In addition, it establishes a bibliometric foundation for future studies investigating the neuropsychological mechanisms underlying early intervention programs, including research on brain function, neuroimaging, and developmental outcomes in children with autism spectrum disorder.
Objective: This study aims to investigate the relationship between parent-reported daily life auditory behaviors and teacher-evaluated executive functions in preschool children using cochlear implants (CIs). Material and Methods: Forty-seven children (23 girls, 24 boys) aged 4-6 years with bilateral CIs participated. The clinical profile showed successful auditory access (aided thresholds: 24.8 dB HL; word recognition: 82.5%). Auditory Behavior in Everyday Life (ABEL) and the Childhood Executive Functioning Inventory (CHEXI) scales were used. Data were analyzed using correlation, hierarchical regression, and mediation analyses. Results: Duration of CI use correlated significantly with auditory behaviors (r = .50, p < .01) and working memory (WM) (r = .48, p < .01). Regression analysis showed WM explained an additional 22% of variance in auditory performance (β = .45, p < .001). Mediation analysis confirmed auditory behaviors partially mediate the relationship between device experience and WM development (β = .22, p = .014). Girls demonstrated significantly higher WM scores than boys (p = .032). Conclusion: WM is a vital neurocognitive resource operating in synergy with auditory experience. Clinical protocols should include integrated strategies supporting WM capacity to maximize developmental potential.
Sport concussions can have serious cognitive, academic, psychological, and neurological consequences. Although most parents permit their children to play sports with high concussion risk, little research has examined why parents make these decisions. This study examined factors associated with parents' willingness to permit their children to play high-risk sports and whether their children played high-risk sports. Hierarchical multiple regression analyses indicated that greater concussion risk acceptance, stronger trust in coaches, athletic trainers, and medical personnel, stronger character and toughness beliefs, being a male parent, and prior parent participation in contact sports predicted willingness. Objective concussion knowledge, overconfidence in concussion knowledge, education, household income, and concussion history did not predict willingness. Concussion risk acceptance partially mediated the relationship between trust and willingness. Logistic regression analyses showed that stronger character and toughness beliefs, greater concussion risk acceptance, and being a male parent predicted whether the parent's child played a high-risk sport, but concussion knowledge and the other variables were not significant predictors. Parents' decisions were influenced more strongly by beliefs, attitudes, and risk acceptance than by concussion knowledge. Efforts to promote informed decisions may benefit from addressing beliefs about character development, trust in sport professionals, and acceptance of concussion-related risks.
This is the first study comparing children with and without seizures in a large clinical sample and examining differences in diagnoses, IQ, neuropsychological and achievement test scores, and psychological problems. Mothers rated 2,212 children (4-17 years) with autism and/or ADHD on the Pediatric Behavior Scale. A subgroup 6-16 years had neuropsychological and academic achievement test data (n = 820). In the autism/ADHD sample, 2.8% had mother-reported seizures with falling and loss of consciousness, whereas only 0.8% of the population-based contrast sample did. Differences between children with autism, ADHD-Combined, and ADHD-Inattentive were nonsignificant. Seizures were strongly associated with lower IQ, cognitive disengagement syndrome/CDS, and incoordination. Controlling for IQ, the remaining variables were nonsignificant, including working memory, processing speed, verbal comprehension, perceptual reasoning, graphomotor, attention, reading and math scores and maternal ratings of attention deficit, hyperactivity/impulsivity, autism, irritability/tantrums, oppositional behavior, conduct problems, anxiety, depression, insomnia, and social impairment. Findings have implications for understanding associations between seizures and psychological functioning, future studies (e.g., the importance of controlling for IQ), and clinical practice (e.g., assessing for CDS, motor incoordination, and low IQ in children with seizures and providing targeted intervention if these problems are present).
Nonverbal learning disability (NVLD) is a widely recognized, though still debated, neurodevelopmental profile characterized by relative weaknesses in nonverbal domains alongside preserved verbal abilities. Its nosological status remains uncertain, with recent proposals to redefine it as a developmental visuospatial disorder (DVSD) or to position it as overlapping with developmental coordination disorder (DCD). Using operational criteria derived from recent studies, we retrospectively analyzed 366 children referred for learning and neurodevelopmental difficulties. NVLD was defined by a significant discrepancy between the WISC-V verbal index and the visuospatial and fluid reasoning indices, along with at least two associated domains of nonverbal impairment; 135 children met these criteria. Consistent with the operational definition, the NVLD group showed a broad distribution of nonverbal and performance-related vulnerabilities, including visuospatial, motor coordination, graphomotor, attentional, and social-communication impairments. Moreover, WISC-V analyses showed that the verbal advantage was not limited to the defining verbal-visuospatial or verbal-fluid reasoning contrasts but often extended to processing-speed and working-memory indices. Comparisons with DCD-only and DVSD-only groups suggested only partial overlap. These findings support a dimensional, configuration-based account of NVLD as a clinically recognizable pattern of uneven neurodevelopment within referred clinical populations, rather than a single-domain nosographic disorder.
The present research integrated source-localized power envelope connectivity (PEC) with sensor-level individualized alpha frequency (IAF) analysis to identify group-level neurophysiological features that differ between the combined presentation attention deficit hyperactivity disorder (ADHD-C) and the predominantly inattentive presentation (ADHD-I) of ADHD. A total of 99 children with ADHD (46 ADHD-I, 53 ADHD-C) and 19 typically developing children were recruited for the study, with resting-state electroencephalogram (EEG) data collected from all participants. Source-level analyses showed that differences between ADHD presentations were mainly localized within alpha-band networks, particularly in fronto-occipital, frontoparietal, and attention-related circuits. These effects were frequency-specific and state-dependent, rather than reflecting global connectivity alterations. Sensor-level analyses further revealed differences in alpha-band characteristics between ADHD-I and ADHD-C. Compared with ADHD-I, ADHD-C showed higher parietal individualized alpha peak frequency. Correlation analyses indicated that lower alpha frequency was associated with higher hyperactivity-impulsivity scores in the ADHD-I group. In addition, both presentations exhibited reduced alpha power relative to typically developing controls. These findings highlight regionally distributed differences in alpha oscillatory dynamics between clinically defined ADHD presentations. Overall, the findings indicate that ADHD-I and ADHD-C differ in the organization and modulation of alpha-band networks across resting states, supporting frequency- and network-specific neurophysiological differences between ADHD presentations.
OBJECTIVE:Cognitive Disengagement Syndrome (CDS) is an attentional construct characterized by excessive daydreaming, mental fogginess, and slowed behavior. This study examined CDS/SCT symptoms and their association with learning difficulties in children with epilepsy. METHODS:In this cross-sectional case-control study, 400 children aged 6-16 years (200 with epilepsy, 200 healthy controls) were assessed using the WISC-R, Turgay DSM-IV Scale, Barkley Child Attention Survey, and Specific Learning Difficulty Symptom Scale. RESULTS:Children with epilepsy demonstrated significantly higher CDS scores than controls (18.28 ± 5.47 vs. 16.36 ± 5.34; p < 0.001; g = 0.36) and lower IQ scores (95.0 ± 7.9 vs. 97.0 ± 6.1; p = 0.004; g = 0.29). CDS symptoms correlated significantly with learning difficulties (r = 0.65), inattention (r = 0.52), and hyperactivity/impulsivity (r = -0.37). In multiple regression analysis (epilepsy group, n = 200), CDS (β = 0.52), inattention (β = 0.42), hyperactivity/impulsivity (β = 0.11), and polytherapy (β = 0.09) independently predicted learning difficulties (R2 = 0.89); epilepsy duration was not significant (p = 0.055). CONCLUSION:CDS symptoms independently associated with learning difficulties in pediatric epilepsy beyond ADHD-related symptoms. Routine CDS screening should be considered in children with epilepsy presenting with academic concerns.
BACKGROUND:Evidence on written language assessment remains limited in Persian-speaking children, particularly in clinical populations such as children with cleft lip and/or palate (CL/P), who may present with higher-order language difficulties. This study aimed to develop and validate the Persian Written Language Assessment Profile (PWLAP). METHODS:A sequential mixed-methods design was used. In Phase I, the PWLAP was developed through literature review, expert interviews, and a two-round Delphi process involving 14 specialists. In Phase II, the profile was administered to 184 Persian-speaking students in grades 3-6 (128 typically developing (TD) and 56 with CL/P). Written language was evaluated using lexical measures (total number of words, number of different words, and type-token ratio) and morphosyntactic indices (T-unit measures, clause production, clausal complexity, and morphosyntactic errors). RESULTS:Strong expert consensus supported the content validity of the PWLAP. The PWALP successfully differentiated students with CL/P from TD peers across lexical and morphosyntactic measures (p < 0.05), supporting construct validity. Reliability analyses demonstrated excellent inter- and intra-rater reliability (ICC ≥ 0.95). CONCLUSION:The PWLAP is a valid and reliable tool for assessing written language in Persian-speaking students and may be useful in assessment of written language in children with CL/P.
BACKGROUND:Adolescents with Attention-Deficit/Hyperactivity Disorder-Predominantly Inattentive Presentation (ADHD-I) often show deficits in executive functions, sustained attention, and auditory processing. This study evaluated auditory selective attention, reaction time, and auditory processing in adolescents with ADHD-I. METHODS:This cross-sectional study included adolescents aged 12-18 years with ADHD-I and age- and sex-matched controls. Auditory processing was assessed using a computerized experimental Auditory Selective Attention Test (ASAT), adapted into Turkish, with monaural and dichotic conditions measuring accuracy and reaction time (RT). Executive functions and symptom severity were evaluated using CPRS-R:L, BDEFS-CA, and SNAP-IV. RESULTS:Adolescents with ADHD-I showed lower accuracy and longer reaction times in both ASAT conditions compared to controls. Accuracy was negatively correlated with CPRS-R:L hyperactivity, inattention, global index, and restlessness/impulsivity scores, while reaction times were positively correlated. Higher BDEFS-CA scores-particularly in organization, impulse control, self-motivation, and ADHD index-were associated with poorer ASAT performance. Regression analysis indicated that SNAP-IV inattention was the only significant predictor of auditory selective attention. CONCLUSION:Adolescents with ADHD-I demonstrate impairments in auditory selective attention and processing. Greater inattention severity is associated with reduced accuracy and prolonged reaction times, suggesting increased vulnerability to auditory distraction and reduced discrimination efficiency, with findings that may be considered preliminary.
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) exhibit significant motor instability, yet the specific mechanisms remain unclear. This study introduces the "Start-Stop Paradigm" to investigate motor vulnerabilities at critical transition points: task initiation, continuation, and resumption after a break. Participants were 96 children aged 9 to 10 years (48 with ADHD, 48 typically developing; 48 boys, 48 girls). Re-analyzing data from a dart-throwing task, we found that children with ADHD demonstrated greater performance instability, with 12 out of 17 throw-to-throw transitions showing significant sequential dependencies (φ = 0.3-0.5), compared to only 8 in typically developing children. A pronounced "reverse hot hand" effect was observed at the block transition (resumption after a pause) in both groups, but it was more marked in the ADHD group. This indicates that resuming a task after a stop is a particular vulnerability. The Start-Stop Paradigm posits that children with ADHD struggle disproportionately with motor planning and execution at these transitions due to deficits in attention shifting, working memory updating, and motor parameter recalibration. These findings suggest that motor interventions for ADHD should be specifically tailored to stabilize performance at transitions, rather than focusing solely on overall practice volume.
The aim of this study was to determine performances in executive functions in preschool children and the relationship with children's age and their receptive and expressive language skills. The study was conducted in four public kindergartens in Baltim that approved the research. The study was conducted on three age groups: 3 (3 years, 0 months - 3 years, 11 months), 4 (4 years, 0 months - 4 years, 11 months), and 5 (5 years, 0 months - 5 years, 11 months). A total of 160 children were included, 83 girls and 77 boys. The Mann-Whitney U test was also applied to analyze gender differences. The relationships between executive function tasks and the Arabic receptive and expressive language skills test were analyzed using the Spearman rank correlation test. A significance level of .05 was used in all analyses. Findings from the Night/Day Task indicate no significant age-related performance increase related to this task. When the relationship between Language Test scores and executive function tasks was examined, it was found that NDT had no relationship with receptive and expressive language scores.
OBJECTIVE:This randomized, placebo-controlled trial investigated the cognitive effects of three phosphatidylserine (PS) formulations, with or without docosahexaenoic acid (DHA), in children aged 10-14 years diagnosed with attention-deficit/hyperactivity disorder (ADHD) or presenting with clinically significant subthreshold ADHD symptoms. MATERIAL AND METHODS:Forty-five medication-naïve children meeting DSM-5 criteria for ADHD or exhibiting subthreshold symptoms confirmed by standardized parent-teacher rating scales (Turgay/Conners) and clinical evaluation were randomized in a 1:1:1:1 ratio to receive placebo, PS Capsule (100 mg PS + 17.78 mg DHA), PS Sachet (117.78 mg PS without DHA), or PS Plus Capsule (150 mg PS + 26.67 mg DHA) for eight weeks. Cognitive performance was assessed at baseline and post-intervention using the MOXO continuous performance test and the Stroop test. RESULTS:Significant between-group differences were observed across MOXO and Stroop outcomes. The PS Plus group showed the greatest improvements in attention, impulsivity, and hyperactivity, along with the largest reductions in reaction time. The placebo, Capsule, and Sachet groups demonstrated smaller and generally comparable changes. Stroop error rates and correction counts decreased significantly only in the PS Plus group, suggesting enhanced inhibitory control and cognitive flexibility. CONCLUSION:Higher-dose phosphatidylserine combined with DHA (PS Plus) yielded superior cognitive benefits compared with placebo and lower-dose formulations.
OBJECTIVE:This study aims to evaluate the effects of psychoeducational psychotherapy (PEP) on neurocognitive functions, symptomatology, quality of life, and emotion regulation in euthymic adolescents diagnosed with BD. MATERIALS AND METHODS:Thirty-two adolescents diagnosed with BD were randomized, with 16 receiving psychoeducational psychotherapy. They were assessed using the Wisconsin Card Sorting Test and the Stroop Test; Pediatric Quality-of-Life Inventory, the Difficulties in Emotion Regulation Scale (DERS), the Affective Reactivity Index, the Young Mania Rating Scale and the Children's Depression Rating Scale. RESULTS:When comparing the group that received PEP with the non-PEP group after 12 weeks, DERS scores, quality of life scores, irritability scores and disease severity showed improvements. No changes were observed in neurocognitive function assessments. CONCLUSION:Our study demonstrates that PEP has a positive impact on difficulties in emotion regulation and quality of life in adolescents diagnosed with BD. It also suggests that PEP contributes to reducing irritability and improving overall functioning. Therefore, PEP appears to be a beneficial therapeutic approach that can be incorporated into routine treatment for adolescents with BD.
Developmental dyslexia (DD) is primarily attributed to phonological processing deficits, but visual-spatial processing may also shape individual variability. Relatively few studies have examined whether discrete CHC-based visual-spatial indicators provide incremental and conditional information for dyslexia classification beyond phonological and RAN-based predictors, particularly in transparent orthographies. This study tested whether visual-spatial indicators have independent and moderating effects on dyslexia classification in a transparent orthography, within a moderation (risk × protection) framework. Participants were 658 Polish-speaking, age- and sex-matched, school-aged students (329 with DD, 329 without DD). Hierarchical logistic regression models contrasted the contributions of phonological composites, RAN, and Cattell-Horn-Carroll visual-spatial (Gv) indicators-perceptual organization (PO), visual memory (VM), and visual-motor coordination (VMC)-to dyslexia status. Phonological and literacy measures were the strongest predictors. However, visual-spatial indicators showed selective effects, with perceptual organization emerging as the most robust Gv predictor, whereas VMC showed a significant but cautionary adjusted association consistent with shared-variance/suppression effects. Interaction analyses showed that higher PO and VM moderated the associations between phonological/RAN-based predictors and dyslexia classification, such that these predictors showed reduced classification strength at higher levels of PO or VM. Findings provide evidence that visual-spatial indicators are independently and conditionally associated with dyslexia classification, supporting an interaction-aware, multifactorial account of DD.
Children born preterm present a high incidence of language development delay and motor difficulties. However, the association between these two developmental dimensions has been scarcely studied. Thus, the aim of this study was to determine the association between motor abilities (gross and fine) and language development (vocabulary size), in a sample of children born very preterm and extremely preterm in Chile. We conducted a comparative cross-sectional study in a sample of 38 very preterm and extremely preterm children from a pediatric hospital in Chile, compared with 42 term-born children from a kindergarten. Children were evaluated at 2 years of corrected age (preterm) or 2 years of chronological age (term-born), using standardized instruments. The association between language development and motor development was evaluated using generalized additive models. Our results show that there is a significant positive association between vocabulary size and gross motor development in preterm children up to a vocabulary size 200 words, but no association in term-born children. These results provide preliminary evidence for a relationship between motor skill scores and language development at small vocabulary sizes in very preterm and extremely preterm children, which future studies should expand into a multi-center design.
Psychometrically robust Persian reading assessments are limited, particularly tools that simultaneously measure oral reading rate, accuracy, and comprehension. This study introduces and evaluates the psychometric properties of the assessment tool KHANA-2, consisting of two parallel booklets (A and B) with grade-appropriate passages. Content and face validity were confirmed by 20 experts. The sample included 260 typically developing readers and 15 students suspected of reading disorder in elementary students Grades 2-6. Reading rate, accuracy, and comprehension were assessed. A Multivariatelinear mixed model (MLMM) examined differences across grade levels, reading-status groups, and gender. Pearson correlations evaluated associations among components, and reliability was estimated using intraclass correlation coefficients (ICC), Cronbach's alpha, and paired-sample t-tests comparing booklet performance. KHANA-2 showed strong construct validity, significantly differentiating performance across grade levels and between typically developing readers and those suspected of reading disorder (p < 0.001), with no gender effects (p > 0.05). Reading time and errors were positively correlated across booklets (r = .66-.68; p < .001), while both were negatively correlated with comprehension (r = -0.24 to -0.30; p < 0.001). Internal consistency ranged from α = 0.81-0.93 for rate, α = 0.58-0.82 for accuracy, and α = 0.32-0.65 for comprehension. Inter- and intra-rater reliability were excellent (ICC > 0.95). Although accuracy differed slightly between booklets (p = 0.002, d = 0.19), ICCs (0.77-0.85) supported parallel-form equivalence. Overall, KHANA-2 is a valid and reliable tool for assessing oral reading skills in Persian-speaking students in Grades 2-6.
This study aimed to evaluate the psychometric properties of the Taiwanese Traditional Chinese Version of the Teenage Executive Functioning Inventory (TC-TEXI) in a sample of 784 Taiwanese high school students, their parents, and their teachers. Notably, this research is the first to establish the psychometric properties of teacher ratings across all language versions of the TEXI. The results of confirmatory factor analyses partially supported a two-factor model of executive functioning, namely working memory and inhibition, particularly for teacher ratings. The findings also supported adequate internal and test-retest reliability. Multiple regressions were implemented to explore how the scores from the three types of the TC-TEXI predicted positive mental health among high school students in Taiwan. The results revealed that while the data supported that the self-report TC-TEXI best correlated with the self-acceptance, human relationships, emotional balance, and optimism/enterprising aspects of their positive mental health, teacher-rating and parent-rating were also statistically significantly correlated with the family harmony aspect of positive mental health. Implications regarding the correlation pattern were suggested. The linear age effect commonly found with performance-based EF tasks was not supported in the current study. Future research involving randomly drawn samples from each grade or a longitudinal design should help reconfirm the non-linear effect.
OBJECTIVE:This study aimed to investigate the associations of maternal epilepsy and prenatal antiepileptic drug (AED) exposure with neurodevelopmental outcomes in preschool-aged children, with a particular focus on adaptive functioning, emotional and behavioral problems, and autism spectrum disorder (ASD). METHODS:This retrospective, case-control study included 53 children aged 2-6 years born to mothers with epilepsy and 53 age- and sex-matched controls whose mothers had no history of epilepsy or other chronic illness. Developmental outcomes and emotional problems were assessed using the Vineland Adaptive Behavior Scales-II (VABS-II), the Strengths and Difficulties Questionnaire (SDQ), and the Autism Behavior Checklist. RESULTS:Linear regression analysis showed that prenatal AED exposure was significantly associated with lower total VABS-II scores (R2 = 0.201, p = .040). Within the AED-exposed subgroup, higher standardized AED doses were negatively correlated with total VABS-II scores (r = -.425, p = .021). Hyperactivity/inattention and peer relationship problems were significantly higher in both AED-exposed and non-exposed epilepsy groups compared with controls (p < .05). Three cases of ASD were identified, all in the AED-exposed group. CONCLUSIONS:Maternal epilepsy and prenatal AED exposure may be associated with differences in adaptive functioning and behavioral outcomes in preschool-aged children. These findings should be interpreted cautiously given the observational design and potential residual confounding.
OBJECTIVE:This study aims to examine psychopathological factors associated with Cognitive Disengagement Syndrome (CDS) in preterm school-aged children, while controlling for the potential confounding effects of inattention, emotional problems, and peer difficulties. METHODS:A comparative cross-sectional design was utilized with 181 children (89 preterm, 92 full-term). Assessment tools included the Turgay DSM-IV-Based Screening Scale, the Barkley Child Attention Scale, and the Strengths and Difficulties Questionnaire (SDQ). Group differences were analyzed using t-tests. A univariate ANCOVA was conducted to assess the effect of prematurity on CDS symptom scores after adjusting for birth weight, age, gender, and psychopathological covariates. RESULTS:The preterm group had significantly lower birth weight and gestational age (p < .001). While no significant difference was found in raw CDS symptom scores between groups (p = .603), preterm children scored significantly higher on the SDQ Peer Problems subscale (p = .002). The ANCOVA model revealed that prematurity status was not independently associated with CDS severity after adjusting for covariates (p = .432). Instead, ADHD-inattention (p < .001), emotional problems (p = .001), and peer problems (p = .004) emerged as significant predictors of CDS severity. CONCLUSION:Prematurity status is not an independent risk factor for CDS in school-aged children. The variance in CDS severity is primarily accounted for by co-occurring psychopathological vulnerabilities, particularly inattention and internalizing social challenges. Clinical evaluations of preterm children should prioritize screening for these associated factors to better manage the risk of cognitive disengagement.
