Parent ratings of executive functioning in children adopted from psychosocially depriving institutions

This is a summary and analysis of a recently-published study about executive function in post-institutional children.

• working memory –ability to store and manipulate information over brief periods of time. This is key to language processing, reading comprehension and learning.
• inhibitory control-ability to suppress responses not relevant to the task at hand.
• planning
• set-shifting/shifting-ability to move back and forth between tasks, operations, or mental sets in response to changing goals or environmental experiences

• There were no differences in gender on EF preliminary analyses so this was not analyzed in the main analysis.
• There was no association between EF impairment and low birth weight or prematurity.
• The onset of adolescence corresponded to higher EF difficulties for children who were adopted at 18 months or older. Particularly in the aspects of inhibit scale (controling impulses and stopping behavior at appropriate time), working memory, planning, organizing materials, monitor scale (ability to check work, assess own performance and keep track of one’s own actions) and initiate scale (ability to begin a task or activity and to generate ideas independently.)
• Preschool-aged children had significantly lower scores than never-institutionalized peers on the Flexibility Index. The Flexibility Index is comprised of a scale of Emotional Control and Shifting ability (ability to move back and forth between tasks, operations, or mental sets in response to changing goals or environmental experiences).
• Overall, preschool-aged children did not have greater parent-reported EF difficulties than never-institutionalized peers. This is consistent with other studies.
• Older-adopted school-age children had greater parent-reported EF deficits than younger-adopted children.
• Prolonged exposure to institutional deprivation during early childhood was associated with later EF problems.
• There may be a step-like relation between age at adoption from institutions and EF difficulties. Deficits were higher than expected in children adopted at 18 months or older compared to children adopted younger than 18 months. There was no difference between children placed at 18 to 26 months and those placed at 27 months and older. This is consistent with other studies.

• All of the children were from the same agency and region of the world.
• The scales used were not standardized with post-institutional (PI) children so this is not ideal.
• PI group likely differed from the standard sample due to genetic risk factors, prenatal care, birth and adoption circumstances, though birth circumstances were NOT found to be associated with EF difficulties.
• IQ was not measured so in this study it could not be accounted for. Prior studies have found hat PI children show EF deficits on lab tasks after correcting for IQ differences.

• Previous Studies show that PI children are particularly susceptible to attention problems and perform poorly on EF tasks
• School-age children adopted after 18 months from psychosocially depriving Russian institutions were found to have increased parent-reported EF difficulties relative to younger-adopted children and the never-institutionalized normative sample
• Older-adopted school-age PI children had greater increases in EF problems during adolescence than those adopted at younger ages.
• Support services for PI children might target EF skills to improve academic performance and older-adopted PI adolescents might have increased treatment needs.

• The risks are low at the preschool age of having a child with overall EF difficulties, if the child is not severely disabled.
• The risks are high at the preschool age of having issues with Emotional control and ability to move back and forth between tasks, operations, or mental sets in response to changing goals or environmental experiences even if the child is not severely disabled.
• The risk of overall EF difficulties increasing as the child ages, particularly at adolescence is high even if not severely disabled. Particularly in the aspects of inhibit scale (controling impulses and stopping behavior at appropriate time), working memory, planning, organizing materials, monitor scale (ability to check work, assess own performance and keep track of one’s own actions) and initiate scale (ability to begin a task or activity and to generate ideas independently.)

• The risk of overall EF difficulties  particularly at adolescence is high even if not severely disabled. Particularly in the aspects of inhibit scale (controling impulses and stopping behavior at appropriate time), working memory, planning, organizing materials, monitor scale (ability to check work, assess own performance and keep track of one’s own actions) and initiate scale(ability to begin a task or activity and to generate ideas independently.)