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. 2021 Jan 14;11:596075. doi: 10.3389/fpsyg.2020.596075

TABLE 2.

Brief description of the tests and variables used in the study.

EF Test Variables Brief description of the tests Proposals for measurement errors and methodological biases control
Inhibitory Control Stroop Interference Time This version is divided in three subtasks: ‘Naming’, ‘Reading’ and ‘Interference’. Three colors are used (blue, red and green) and before the administration of each part, a training phase is performed composed by 10 items in order to verify the children’s understanding of the task. The test proposes 100 items per subtask, divided into 10 lines of 10 stimuli on a white paper in landscape format; the child is instructed to complete each subtask as quickly as possible (timed event) and by committing the least possible mistakes. The interference time score corresponds to the subtraction of the time in seconds of part C (interference) minus part A (naming). Similarly, the interference errors score corresponds to the subtraction of the errors (corrected and uncorrected) of part C minus part A. -Preliminary control conditions (naming and reading) -Unlimited time, no correction to every mistake made, consideration of time and errors
Interference Errors
Tapping Go/No-Go Time It was designed to preferentially evaluate the inhibitory abilities of a predominant or automatic motor response, including a Go/No-Go component and a conflictual conditioning component. After a first phase of “simple conditioning” where the child must repeat the motor action produced by the examiner (tapping once or twice with the index on the table), the child must inhibit this pattern of automated response by no longer reacting when the examiner taps twice (“Go/No-Go” component). In a third and final phase (called “Conflict”), the conditioning becomes antagonistic in the sense that the child must be able to do the opposite of the initial phase (typing twice when the examiner taps once and vice versa), while incorporating a new no-go condition (do nothing when the examiner is tapping with two fingers). The last and most difficult condition therefore imposes both the inhibition of the previously learned response pattern and the automatic “echo” response, and the adaptation to a new no-go component. Each of these three conditions includes a series of 30 items, with sequences varying randomly from one condition to another, to avoid any form of learning. The event is timed and the child’s mistakes are recorded at each phase of the event. To calculate the Go/no go time variable, a subtraction of the time (in seconds) of part B (Go/no go) minus time (in seconds) of part A (simple conditioning) must be made. For the calculation of the Time Conflict, the time (in seconds) of part C is subtracted from the time (in seconds) of part A. The same logic is applied for Go/No-Go and Conflict errors, where both corrected and uncorrected errors are considered. -Preliminary phase of simple conditioning (repeat a motor action in echo)
Go/No-Go Errors
Conflict Time
Conflict Errors
Cross-out Joe Time It is a test of identification and crossing-out of a visual target among a set of morphologically close distractors, in order to approach the inhibitory control capabilities (inhibition of distractors, selective attention) and sustained attention. The child must cross-out the Joe character from a set of other characters. To verify the understanding of the task, the child performs a training phase with the examiner. The material of the test is composed by two white sheets in A3 format and portrait orientation, on which two series (A and B) of 240 items (16 lines of 15 characters) are randomly distributed. The target (Joe) appears unpredictably for the child, once every five characters, adding up to a total of 48 identifiable targets among 192 distractors (per sheet). This is a timed task in which the child is instructed to work as quickly as possible but also as accurately as possible. The time variable is calculated by the sum of the execution time (in seconds) for series A and B. The error variable is obtained by the sum of the number of omissions (“Joe” forgotten) in series A and B, and the number of false alarms (character other than “Joe” wrongly crossed out) in series A and B. -Evaluate inhibition in a long-term task
Speed
WM Visuospatial updating Baseline It evaluates the updating dimension of the visuospatial capacity of updating. It involves mimicking a researcher as they tap a sequence of up to 10 identical spatially separated blocks. The task consists of two steps: 1- Baseline ‘visuospatial span’: aims to globally evaluate the ability to remember the locations touched by the examiner. 1 point is awarded per recalled location belonging to the series presented. The minimum score is therefore 0 and the maximum score is 30 (5 items of 6 locations). This score will determine the number of locations (n) to be recalled in the updating step. - Score lower than 15: the updating step will not be performed. In this situation, the ability to maintain the information in the short term is considered insufficient for a reliable result. - Score between 15 and 20: the number of locations to be recalled is set at 3 (n = 3). When presenting a series of locations of variable length, the child will always only have to return the last 3. - Score higher than 20: the number of locations to be recalled is set to 4 (n = 4). When presenting a series of locations of variable length, the child will always have to recall the last 4. 2- Updating: the last three or four items of a given sequence must be recalled. The sequence comprises sets of variable length, from which they must then sequentially recall a specific number of recent elements. There are three types of items: items requiring 3 updates (R3, the number of locations presented is equal to n + 3), items requiring 2 updates (R2, the number of locations presented is equal to n + 2) and items requiring 0 updates (R0) where all presented locations must be recalled. The recall must be in order and one point is counted for each correct location. The performance score is calculated by sum of points for items without updating and items implying 2 and 3 updates. The task starts with 3 tests to make sure that the setpoint is understood. -Task adjusted to span capacities. -Variation in the amount of information to be updated to control the executive load (contrasted with items where no update is required)
Performance score
Visuospatial Updating Baseline It evaluates the updating dimension of the verbal capacity of updating. Participants are presented with sets of letters of variable length, from which they must then sequentially recall a specific number of recent elements. The task consists of two steps: 1- Baseline ‘verbal span’: aims to globally evaluate the ability to remember the letters recited by the examiner. 1 point is awarded per recalled letter belonging to the series presented. The minimum score is therefore 0 and the maximum score is 30 (5 items of 6 letters). This score will determine the number of letters (n) to be recalled in the updating step. - Score lower than 18: the updating step will not be performed. In this situation, the ability to maintain the information in the short term is considered insufficient for a reliable result. - Score between 18 and 25: the number of letters to be recalled is set at 3 (n = 3). When presenting a series of letters of variable length, the child will always only have to return the last 3. - Score higher than 25: the number of letters to be recalled is set to 4 (n = 4). When presenting a series of letters of variable length, the child will always have to recall the last 4. 2- Updating: the last three or four items of a given sequence must be recalled. There are three types of items: items requiring 3 updates (R3, the number of letters presented is equal to n + 3), items requiring 2 updates (R2, the number of letters presented is equal to n + 2) and items requiring 0 updates (R0) where all presented letters must be recalled. The recall must be in order and one point is counted for each correct location. The performance score is calculated by sum of points for items without updating and items implying 2 and 3 updates. The task starts with 3 tests to make sure that the setpoint is understood.
Performance score
Dual task Span score Dual task paradigms involve first performing two tasks separately and then simultaneously. The difference in performance between each separate task and the dual-task condition provides an indicator of the dual-task capability. For this purpose, four subtasks are performed with a duration of one minute and 30 seconds: 1 - digits span (baseline): establishment of ‘span’ (baseline), which corresponds to the number of digits in the last series where there have been at least two successes, that is, for the extension before the interruption; 2 - span task (simple condition): after the establishment of the baseline ‘span’, sequences of the same length are presented for one minute and 30 s; 3- cancelation task: the child is presented with a sheet containing disorderly arranged clown heads connected by a line. For one minute and 30 s the child should draw an X on the clown heads they find on the sheet, following the line; 4- double condition: at this stage, the child is asked to perform the two previous activities simultaneously: make an X on all the clowns’ heads and, at the same time, repeat the series of digits presented by the psychologist according to the baseline established for the “Span” task, for one minute and 30 s. To calculate the variable span score are considered: 1- Number of series correctly recalled in order (EnS) and total number of series proposed (EpS) during the single condition and 2- Number of series correctly recalled in order (EnD) and total number of series proposed (EpD) during the double condition. These indicators allow us to calculate the Span score, which corresponds to the measure of efficiency in double condition compared to the single condition (retention rate): (Pd/Ps)*100 with Ps = EnS/EpS; Pd = EnD/EpD. On the other hand to calculate the Clowns score, the total number of clowns correctly crossed out by the child during the 1 min 30 in both simple (CnS) and double (CnD) condition is needed. Following the same logic of the maintenance rate and efficiency of the double condition in relation to the simple, the computation of the clown score is: (CnD/CnS)*100. In addition to these scores, it is also possible to calculate a Score Mu that expresses the child’s effectiveness in relation to a simple task. The calculation is done by: (Span score + Clowns score)/2 - Preliminary execution of both tasks individually -Task adjusted to span capacities
Clowns score
Score Mu
Flexibility Trail Making Test Flexibility Index This version is an adaptation of the TMT, which aims to evaluate the ability to alternate the attention focus between sets of stimuli. Unlike the original version, this task consists of three subtasks: subtask ‘A Numbers’, subtask ‘A Letters’ and subtask ‘B Numbers and Letters’. In the first subtask (’A Numbers’) the child is asked to connect numbers (1-20) in ascending order. In subtask 2 (’A Letters’) the child must connect the letters in alphabetical order (A-T) and finally, in subtask 3 (’B Numbers and Letters’) the child must connect letters and numbers alternately while following the alphabetical order and ascending numerical order. A flexibility index is calculated and consists of: (time part B - (time part A numbers + time part A letters)/2) Alternation errors in part B (failure to respect the alternation between a number and a letter), if the subject for example links C to D by omitting the number 4 or links 5 to 6 by omitting E) is also considered. - Control of numerical and alphabetical chain mastery, visual exploration and perceptual-motor skills in two preliminary parts (numbers then letters, respectively)
Alternance Errors
Kids Card Sorting Test Time In this test, the child is required to combine a series of 48 response cards with one of four target cards. Each response card can be combined according to its color, shape and number, and the child must guess what is the combination rule based solely on the evaluators feedback (‘yes’ or ‘no’). After six correct answers, the combination rule is changed. In this version, the child is informed of the three possible classifications beforehand. The time variable is obtained through the time of realization in seconds. The number of perseverations consists of the repetition of an error or continuation of a classification mode when a “no” was formulated for the item just before. -Only cards that are unambiguous regarding the pairing with the target cards are used - The rules are presented to the child, which reduces the possibility of not understanding the categories
Perseverations
Frog test Time This task evaluates the abstraction and deduction capacities of operating rules, which require cognitive flexibility. The child needs to deduce the rules of movement of a frog that moves on several water lilies around a pond according to several logical displacement rules, and to adapt to the actions of the frog, which changes the rule of movement without warning. It is composed by 70 successive cards and in each card there are 10 water lilies (in the middle of a pond, drawn on an A4 sheet in landscape format), numbered from 1 to 10. From one card to another, the frog changes position according to a logical movement rule: the child must therefore anticipate the position of the frog on the next map. Ten rules of displacement are to be discovered by the end of the test, which are not based on mathematical reasoning. The changing of the rule is unpredictable and occurs in a pseudo-random manner every 4 to 9 attempts. The rules of displacement are: -1 (n = 6); + 1 (n = 5); -2 (n = 7); -1 (n = 8); High low (n = 7); + 1 (n = 4); + 2/-2 (n = 9); Status quo (n = 8); + 1 (n = 6) and Left-right (n = 9). The time variable is obtained through the time of realization in seconds and the score variable consists of the number of correct answers made by the child. - Random and variable rule change to make the test less predictable
Score
Planning 8 Mazes Completed This test consists of 8 mazes of increasing difficulty presented on A4 sheets (mazes 1 to 7) or on A3 sheets (maze 8). For each maze, a small dinosaur indicates the starting point, a dinosaur that will have to be lead out of the maze. The exit is marked with a “Exit” flag. The test requires the subjects to draw, with a pencil, the path leading out from the starting point to the exit point, trying not to get into dead-end paths. A maze is considered complete (Completed variable) when the child reaches the end flag in a time less than 240 s. The total time of completion indicates the child’s ability to anticipate and execute the “plan” for solving the maze. The total time variable consists of the average time (in seconds) taken to perform the completed labyrinths. However, if the number of labyrinths presented is less than 6, this average time cannot be calculated. Concerning the impasses, an impasse is counted each time the child goes down a dead-end street and tries to turn back (when he or she realizes it). Specifically, dead ends refer to the drawing of a line that clearly crosses an “imaginary” line that connects each of the two sides of a dead-end street. The impasses variable is calculated among completed mazes and weighted by the number of possible impasses. It is therefore a proportion: the closer it is to 1, the more the child has engaged in all the possible dead ends. -Consider time and error for the score
Total time
Impasses
Rey Osterrieth Complex Figure Planning Index In this version, in addition to the traditional copy of the figure – formulation condition –we added the realization of execution condition. In this second part the child progressively reproduced the figure on the basis of successive and progressive cues in which each new group of elements was represented in a distinct color. Children were not informed that they were creating a larger figure from its components. Each cue was presented on a new, separate sheet and children were systematically asked to continue their drawings by including the new colored group of elements. The order of these cues was (1) central rectangle; (2) central diagonals; (3) two major horizontal and vertical lines and upper and major right triangles; (4) diamond at the end of the major triangle, vertical line in major right triangle, lower left square and lower cross attached to vertical midline below rectangle, and upper left cross outside of rectangle; and (5) minor rectangle with diagonals, horizontal lines in upper left corner of central rectangle, vertical line in upper right corner of central rectangle, upper right circle, and lower right oblique lines. The Copy Score (C) of the formulation condition is rated as conventionally assessed on 36 points (accuracy and location considered) and a Program Score (P) of the execution condition is also rated based on the same scoring principles (each of the 18 items rated on 2 points, maximum total on 36 points). From these scores a Planning Index (PI) is calculated. It consists of a proportion where PI: (P/C) *100. The higher the PI, the more the child benefits from the help provided by the program, and the more the difficulties identified in spontaneous copying can be attributed to a problem in planning and organizational strategies. -Measurement of the facilitating effect of copying with the program in contrast to spontaneous copying -Rigorous and objective instructions for the evaluation of the precision and location of the figure elements
Scripts Time The Scripts task is composed of a series of sequential everyday life actions. These schemes form conceptual units that allow the individual to be prepared to think and act in specific contexts. The scripts proposed in this task are: 1 - Take a shower; 2 - Prepare the backpack to go to school; 3 - Do the shopping at the supermarket. For each script there are actions that the child must put in order to build a coherent script according to the given title. Among the cards provided, two of the envelopes (Envelope 1 - Take a Shower and Envelope 2 - Prepare School Bag) contain actions considered as intrusive, i.e., actions that are not related to the script. The child must justify the order of the arrangements, including the intrusions, explaining his or her behavior in relation to them. It is important to note that at no circumstances is the child informed that there are intrusions in the scripts, and whenever the child questions these actions, the examiner answers without giving the child the impression that he or she has the right to reject or accept the intrusion. The time variable is obtained through the sum of time of realization in seconds of the 3 scripts. The total of 3 scripts is composed by 22 actions. The sequence errors are considered as poorly placed items in the expected order of the actions. Thus, the variable sequence errors can vary from 0 to 22. The Intruders variable is calculated by the number of semantically implausible intruders placed within the target action sequence for the two scripts with intruders (by the candies, break the eggs for the “Shower” script and prepare the salad, search for the shells for the “Schoolbag” scripts). Semantically plausible intruders (swimming for the “shower” script; sitting for the “schoolbag” script) placed in the target-action sequence are not considered for the Intruder variable. They are considered in a qualitative way as a weakness of internal coherence in the representation of the script. -New task created to evaluate the child’s ability to anticipate the order necessary for the execution of a daily action
Sequence errors
Intruders