Poster #56 - Executive Dysfunction and Behavioral Dysregulation in Clinically Referred Preschoolers

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Developmental Psychopathology

Integrative Statement

Background: Deficits in executive functioning (EF), a collection of cognitive control processes, comprise a core, transdiagnostic feature of psychopathology. EF is one of the strongest predictors of poor clinical and functional outcomes, yet there remains a dearth of research on EF in preschool-aged children. The early childhood battery (ages 3-6 years) within the NIH Toolbox Cognition Battery (NTCB; Gershon et al., 2013; Weintraub et al., 2013) provides a novel opportunity to measure EF in preschoolers, although research on its use in young children with psychopathology remains limited. As such, the goals of this study were to 1) identify EF deficits in young children participating in a psychiatric day treatment program and 2) examine the association between EF deficits and parent-reported behavioral dysregulation.

Method: Participants were 26 young children (7 girls), ages 3 to 6 years (M = 5.6 years), recruited from a psychiatric day treatment program for young children with severe behavior problems. Participating children completed the NTCB Early Childhood Battery, including Picture Vocabulary (PV), Flanker Inhibitory Control (FIC), Dimensional Change Card Sorting (DCCS), and Picture Sequence Memory (PSM) tasks, with age-corrected standardized scores calculated for each subtest. Parents completed the Child Behavior Checklist for Ages 1 ½ - 5 or 6 – 18 years (CBCL; Achenbach & Rescorla, 2000, 2001). For the purposes of this study, we focused on scales comprising the Dysregulation Profile (CBCL-DP; Althoff et al., 2010; Kim et al., 2012), i.e., Anxiety/Depression, Aggression, and Attention Problems. The CBCL-DP was computed as the sum of t-scores in these domains, with scores > 210 indicating clinically significant behavioral dysregulation.

Results and Discussion: Descriptive findings are presented in Table 1. As shown, participating children demonstrated widely ranging EF skills. However overall sample performance was similar to that of the standardization sample (M = 100, SD = 15) for the PV (one-sample t = 0.85, p = ns), DCCS (t = 0.69, p = ns), and PSM subtests (t = 0.15, p = ns). Sample performance was significantly weaker for FIC subtest (t = 3.25, p = .003).

Children who performed poorly on the DCCS (defined as age-corrected standard score < 85 or unable to complete practice/teaching items) were rated by their parents as more behaviorally dysregulated, χ2 (1, N = 24) = 5.04, p = .025. Specifically, of the seven children who performed poorly on the DCCS, six (86%) met criteria for the CBCL-DP, as compared to only 6 of the 17 children (35%) of children with average to above average DCCS performance. There were no differences in behavioral dysregulation with respect to children’s performance on PV, FIC, or PSM tasks.

Findings indicate that 1) valid neurocognitive results can be obtained in this early childhood treatment setting, 2) these children are at risk for EF deficits, particularly in inhibitory control, and 3) EF deficits, particularly cognitive inflexibility, may be directly related to their overall behavioral regulation. Findings are discussed with regard to implications for developmental models of early psychopathology, as well as prevention and intervention efforts.

Authors

• Sarah E. Martin, Simmons College
  Presenting Author

• Mia DeMarco, E. P. Bradley Hospital
  Non-Presenting Author

• Lauren R. Mernick, E. P. Bradley Hospital
  Non-Presenting Author

• Brian C. Kavanaugh, Brown University
  Non-Presenting Author

• John R. Boekamp, Brown University
  Non-Presenting Author