Published papers

Background: Action monitoring, the process for evaluating the appropriateness of one's own actions, is reported to be atypical in individuals with autism spectrum disorder (ASD). Method: We examined the characteristics of action monitoring in 11 children with ASD and 12 children with typical development (TD), analyzing stimulus-locked and response-locked event-related potential components (i.e., N2; error-related negativity, ERN; and error positivity, Pe) related to execution of a flanker task. Results: We found a smaller N2 amplitude in children with ASD than in those with TD. Children with ASD also had a larger amplitude of ERN for partial error responses (electromyographic activity corresponding to the inappropriate hand side before response execution) than did children with TD. Additionally, the ERN amplitude for the partial error response was correlated with the Autistic Mannerisms of the Social Responsiveness Scale. There were no significant differences in Pe amplitudes between children with ASD and those with TD. Conclusion: The results suggest that action monitoring in children with ASD is significantly different both before and after response execution. We hypothesized that the detail-focused processing style of ASD reduces the demands of action monitoring before response execution; however, autistic mannerisms evoke excessive concern regarding trivial mistakes after response execution.

We examined the usefulness of the self-assessment of school life for children who have difficulty verbalizing their concerns. Eighty-six students were asked to answer their "concerns about their school life by using open questions and self-assessment of school life. Compared to open questions, there were significantly more children who were able to verbalize their concerns by the self-assessment of school life, and it was considered that the verbalization of concerns was promoted by the quantification process of their own school life.

【目的】多言語環境にある小児の読み書き困難は、学習機会の少なさといった環境要因が原因とされやすいが、発達性読み書き障害や知的能力障害などに基づく場合もある。本研究では、日本語-英語のバイリンガル症例に両言語による基礎的な読み書き評価を適用し、多言語環境児における発達性読み書き障害の評価・診断のあり方を検討した。【方法】読み書きの困難を主訴として医療機関を受診した、日本語-英語バイリンガル児4名に標準化知能検査、英語の口頭言語能力評価、および両言語の基礎的な読み書き検査を実施し、DSM-5による限局性学習症の読字・書字表出困難の診断を行った。【結果】全般的な知的発達水準と口頭言語能力は、全例で正常範囲内にあった。日本語の読み書き検査では、症例1、3、4がひらがな読字から、症例2が漢字で困難を示した。学校言語が英語の2名では、アルファベットの呼称(症例3)と英語の文章音読(症例3、4)にも重篤な困難が認められた。これらより、症例1、3、4は読字および書字表出、症例2は書字表出に特異的な困難がある発達性読み書き障害と診断された。【結論】文字や単語の基礎的な読み書き検査は、多言語環境児の診断的評価に有用であった。複数言語での評価は実施面の課題が多いが、中核症状である正確性・流暢性低下、および言語歴や学習時間等との乖離の把握により、環境要因では説明しがたい生得的な限局性学習症を特定できる。(著者抄録)

ABSTRACT Math anxiety negatively affects math performance and future career choices in math‐related fields. Various tools assess math anxiety, but the Abbreviated Math Anxiety Scale (AMAS) is noteworthy for its ease of administration and good psychometric properties. This study evaluates the AMAS's applicability and utility in a sample of approximately 170 Japanese elementary‐school children. Findings indicate that the Japanese version of the AMAS has very good internal consistency, good test–retest reliability and validity, both convergent and concurrent. Results from a multigroup analysis showed that the scale shows no gender bias, although girls scored higher on the AMAS despite similar performance to boys on a standardised math test. These findings highlight the AMAS's potential as a screening tool for math anxiety in young children.

【目的】ひらがな読み検査は,発達性読み書き障害の診断と治療に不可欠である.その一方で,現行の検査では低学年において読字困難の過剰判定をもたらす危険性がある.本研究では,小学校1,2年生における同検査の大規模データを収集し,実態解明,過剰判定の検証,ならびに新たな基準値の探索と現行基準との比較検討を目的とした.【方法】公立小学校の1年生511名,2年生422名にひらがな読み検査を実施し,音読時間を現行基準と比較した.次に,現行基準に基づく,各学年の異常判定率を検証した.さらに,3年生までの縦断追跡データから新基準値を作成し,1,2年生の異常判定率を検証するとともに,縦断追跡経過を現行基準と比較した.【結果】1,2年の音読時間は現行基準よりも大幅に長く,現行基準に基づく異常判定率は1年生で47.0%,2年生で30.3%に達した.新基準は,現行基準よりも大幅に寛容な値となり,異常判定率は両学年で7%前後となった.縦断追跡経過の比較では,現行基準下で対象児の半数近くが読字困難に分類されたのに対し,新基準下では約15%に低下し,過剰判定の改善が示された.【結論】ひらがな読み検査の現行基準は,1,2年生の実態よりも厳格であり,読字困難を過剰判定する危険性が極めて高いことが示された.新基準は,医学診断および教育的介入の両面でより適切と考えられ,今後は学年基準値の修正を進めていく必要がある.(著者抄録)

Near-infrared spectroscopy studies in children with attention deficit hyperactivity disorder (ADHD) have shown excessive prefrontal activity responsible for coping with interference. However, it is possible that the previous results were influenced by verbal, reading, and memory developments. The flanker task is an interference task that does not require a verbal response, reading, or memorization. We examined activity in the superior frontal cortex (SFC) during the flanker task in 12 children with ADHD and 14 children with typical development using near-infrared spectroscopy. SFC activity was significantly greater in children with ADHD than in those with typical development. The results showed excessive interference coping activity in children with ADHD irrespective of verbal, reading, and memory development. Moreover, SFC activity was positively correlated with the inattention subscale score of the ADHD rating scale. We suggest that children with ADHD need greater SFC activation to cope with interference, and the inefficient mechanism is demanding and hard to sustain, which causes inattention symptoms of children with ADHD.

The present study aimed to review previous research conducted on face recognition in patients with autism spectrum disorders (ASD). Face recognition is a key question in the ASD research field because it can provide clues for elucidating the neural substrates responsible for the social impairment of these patients. Historically, behavioral studies have reported low performance and/or unique strategies of face recognition among ASD patients. However, the performance and strategy of ASD patients is comparable to those of the control group, depending on the experimental situation or developmental stage, suggesting that face recognition of ASD patients is not entirely impaired. Recent brain function studies, including event-related potential and functional magnetic resonance imaging studies, have investigated the cognitive process of face recognition in ASD patients, and revealed impaired function in the brain's neural network comprising the fusiform gyrus and amygdala. This impaired function is potentially involved in the diminished preference for faces, and in the atypical development of face recognition, eliciting symptoms of unstable behavioral characteristics in these patients. Additionally, face recognition in ASD patients is examined from a different perspective, namely self-face recognition, and facial emotion recognition. While the former topic is intimately linked to basic social abilities such as self-other discrimination, the latter is closely associated with mentalizing. Further research on face recognition in ASD patients should investigate the connection between behavioral and neurological specifics in these patients, by considering developmental changes and the spectrum clinical condition of ASD.

Background: To reveal the neural substrate of communication difficulties in children with autism spectrum disorders (ASDs), we investigated the P300 component of event-related potentials (ERPs) as represented by the average of electroencephalography findings time-locked to events and behavior. Because the P300 amplitude influences attentional resource allocation during discrimination, the component elicited during perception of known and unknown faces should indicate familiarity processing. Methods and results: Nine typically developing children (TD) and nine children with ASDs participated in this study (Experiment 1). The P300 amplitude in TD children was significantly larger during familiar face perception than during unfamiliar face perception (p < 0.01). However, there was no evidence of familiarity effect in children with ASDs. In three children with ASDs, we also assessed the P300 amplitude during perception of a therapist's face one month before (baseline), a few days before and after social skills training (SST) sessions (Experiment 2). To evaluate the effect of familiarity on facial identity processing, we analyzed the therapist/unknown ratio of P300 amplitudes related to the face discrimination task as an index. The ratio was larger after SST sessions than before, but there was no difference in the ratio between baseline and before SST assessments. Conclusion: The P300 might be influenced by attentional resource allocation depending on the stage of learning face identification in children with ASDs. We speculate that this approach to evaluating brain responses during facial identity recognition could be used as a tool to clarify children's communication difficulties. (C) 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Phonological awareness is essential for reading, and is common to all language systems, including alphabetic languages and Japanese. This cognitive factor develops during childhood, and is thought to be associated with shifts in brain activity. However, the nature of this neurobiological developmental shift is unclear for speakers of Japanese, which is not an alphabetical language. The present study aimed to reveal a shift in brain functions for processing phonological information in native-born Japanese children. We conducted a phonological awareness task and examined hemodynamic activity in 103 children aged 7-12 years. While younger children made mistakes and needed more time to sort phonological information in reverse order, older children completed the task quickly and accurately. Additionally, younger children exhibited increased activity in the bilateral dorsolateral prefrontal cortex (DLPFC), which may be evidence of immature phonological processing skills. Older children exhibited dominant activity in the left compared with the right DLPFC, suggesting that they had already acquired phonological processing skills. We also found significant effects of age and lateralized activity on behavioral performance. During earlier stages of development, the degree of left lateralization appears to have a smaller effect on behavioral performance. Conversely, in later stages of development, the degree of left lateralization appears to have a stronger influence on behavioral performance. These initial findings regarding a neurobiological developmental shift in Japanese speakers suggest that common brain regions play a critical role in the development of phonological processing skills among different languages systems, such as Japanese and alphabetical languages.

Early detection and treatment promote positive outcomes in mental health problems among infants. This study developed a simple and reliable screening inventory for infants' mental health. Participants were 579 primary caregivers who had Japanese infants aged 2-6 years. Participants evaluated their children using the Mental Health Inventory for Infants (MHII; developed in this study), which contains 24 items. Exploratory factorial analysis identified the MHII factor structure; confirmatory factorial analysis examined its factorial validity. Internal consistency and criterion-related validity were also examined. Irritability (8 items), somatic symptoms (6 items), and signs of insecurity (4 items) were identified as factors in the MHII; each of these factors measures a critical aspect of infants' mental health. The MHII's internal consistency and scale homogeneity were acceptable; its criterion-related validity was supported. In this study, male infants exhibited greater irritability and less insecurity than females. The present results support the MHII's reliability and validity; additionally, they indicate that caregivers may use the MHII to quickly screen for three critical aspects of infants' mental health. We expect that the MHII will be used for early detection of mental health difficulties in infants to facilitate treatment.

This study used a longitudinal method to investigate relations between motor abilities and mental health in young children. We analyzed longitudinal data of 38 Japanese children who were 3–6 years old. We administered the Movement Assessment Battery for Children–Second edition (MABC2) and Strength and Difficulties Questionnaire (SDQ) at 3–4 years and 5–6 years of age: MABC2 was used to evaluate each child’s motor ability; SDQ was used to assess the degree of their mental health difficulties and prosocial behavior. Logistic regression results indicated that the MABC2 score at 3–4 years can predict the risk of motor skill impairments at 5–6 years (adjusted odds ratio was 0.354). Motor ability assessed at 3–4 years, however, did not predict the risk of mental health problems at 5–6 years. Analyses of longitudinal quantitative changes in motor ability and mental health confirmed these results. Mental health problems that occurred at 5–6 years were related only to individual SDQ score differences at 3–4 years. The MABC2 total score at 3–4 years was not related to later prosocial behavior. Boys tended to obtain a lower MABC2 score at 5–6 years. Girls tended to obtain a higher SDQ prosocial score at 5–6 years. Results of this study suggest that motor skill impairment and SDQ-measured mental health are independent characteristics in young Japanese children aged 3–6 years.

Though recent studies have elucidated the earliest mechanisms of processing in multisensory integration, our understanding of how multisensory integration of more sustained and complicated stimuli is implemented in higher-level association cortices is lacking. In this study, we used magnetoencephalography (MEG) to determine how neural oscillations alter local and global connectivity during multisensory integration processing. We acquired MEG data from 15 healthy volunteers performing an audio-visual speech matching task. We selected regions of interest (ROIs) using whole brain time-frequency analyses (power spectrum density and wavelet transform), then applied phase amplitude coupling (PAC) and imaginary coherence measurements to them. We identified prominent delta band power in the temporal pole (TP), and a remarkable PAC between delta band phase and beta band amplitude. Furthermore, imaginary coherence analysis demonstrated that the temporal pole and well-known multisensory areas (e.g., posterior parietal cortex and post-central areas) are coordinated through delta-phase coherence. Thus, our results suggest that modulation of connectivity within the local network, and of that between the local and global network, is important for audio-visual speech integration. In short, these neural oscillatory mechanisms within and between higher-level association cortices provide new insights into the brain mechanism underlying audio-visual integration.

© 2020 The Japanese Society of Child Neurology Introduction: An alteration in postoperative cognitive function varies according to the patients’ background characteristics, such as etiology, focus, and seizure duration. Accurate prediction and assessment of postoperative cognitive function is difficult in each patient. Adaptive behavior could describe the typical performance of daily activities and represents the ability to translate cognitive potential into real-world skills. We examined the relationship between alterations of executive function (EF) and adaptive behavior in school children undergoing surgery for intractable epilepsy. Methodology: We enrolled 31 children with focal resection or corpus callosotomy for intractable epilepsy [mean age at surgery, 12.5 years; 16 boys; mean intellectual quotient, 73.3]. We surveyed answered questionnaires on attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and adaptive behavior using the Vineland Adaptive Behavior Scale, 2nd edition (VABS-II), and performed continuous performance tests (CPTs) on children pre- and postoperatively. Result: ADHD and ASD symptoms improved after epilepsy surgery. The omission error (OE) in the CPT variable improved after epilepsy surgery, especially in children with a shorter preoperative period. Improved ASD symptoms led to an increased score of the coping skills subdomain. The reduced OE observed after surgery also increased the score of the community skills subdomain. Conclusion: Improvement in EF and ASD symptoms resulted in better adaptive behavior postoperatively. These results were important for the pre- and postoperative evaluation and re-evaluation of children with epilepsy requiring special education and related services.

Introduction: Neurofeedback (NF) training aims the enhancement of self-regulation over brain activities. While it is largely recognized as an effective treatment for attention deficit hyperactivity disorder (ADHD), the existence of non-learners has also been reported. The present study explored pre-training assessment indices that could predict learners prior to NF training. Methods: Twenty-two children with ADHD participated in slow cortical potential (SCP) NF training and completed pre- and post-training assessments. Participants were classified into learners or non-learners based on their progress in the SCP regulation, and pre-training indices that differentiate the two groups were examined by decision tree analysis. Results and Discussion: The learner rate in NF training was 45.5%. Learners were predicted by pre-training cognitive and neurophysiological measures regarding Stroop tasks, which suggested relatively intact executive function as their characteristics. Given that NF training is not universally effective for children with ADHD, further studies are necessary to establish application criteria.

Background: This study seeks to ascertain how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders (NDDs) who had experienced sleep schedules alteration and clarify what psychological status predicted low QOL in children with and without altered sleep patterns. Materials and Methods: Study participants were 86 children between 8 and 17 years of age (mean age, 11.7 years; 70 boys, 16 girls; mean intellectual quotient, 83.6). QOL was evaluated using the self-assessment KINDLR. Participants answered questions regarding depression and anxiety on a visual analog scale (VAS) for temporary mood. Their parents answered questionnaires regarding their maladaptive behaviors and differences in sleep patterns before and during the COVID-19 pandemic. The student's t-test was performed to examine the presence or absence of sleep changes in the children, which affected QOL, temporary mood, and maladaptive behaviors. Multiple or simple linear regression analyses were also performed to identify the psychogenic factors that significantly affected decreased QOL for each group with and without changes in sleep schedule. Results: During the COVID-19 stay-at-home period, 46.5% of participants experienced changes in sleep patterns. These changes were associated with decreased QOL as well as internalized symptoms. The decreased QOL of children with sleep patterns changed was predicted by a high level of depression. In addition, low QOL in children with unchanged sleep patterns was predicted by a high level of depression and low current mood status. Conclusions: Almost half of the participants experienced a poor sleep schedule during the stay-at-home period. These alterations in sleep patterns were associated with a low QOL. The QOL of children with a stable life schedule was affected not only by depressive tendencies but also temporary moods. Therefore, they need to live a fulfilling life to maintain their QOL. However, the QOL of children with poor sleep patterns was affected only by depressive tendencies. Hence, clinicians need to ensure that children with NDDs are well-diagnosed with depression and treated for sleep problems.

Background: Psychometric properties of The Japanese version of Swanson, Nolan, and Pelham IV scale (SNAP-IV)-Teacher Form were examined in this study. Method: Community samples of 1296 children (Grade 1-9, boys 52.9%) were collected from public elementary/middle schools in suburban areas. Teachers rated their children's behavior using Japanese version of SNAP-IV-Teacher Form and Strength and Difficulties Questionnaire (SDQ). Results: A three-factor structure model, which was equivalent with AD/HD symptoms subscales (inattention, hyperactivity/impulsivity) and oppositional-defiant disorder symptoms subscale was obtained and confirmed in an explorative/confirmative factorial analysis (Goodness-of-Fit Index = 0.913, Comparative Fit Index = 0.959, root mean square error of approximation = 0.056). The current version of the SNAP-IV-Teacher Form demonstrated good test retest reliability (intra-class correlation = 0.752-0.822), high internal consistency (Cronbach's a = 0.933-0.952), significant correlations with relevant subscales of Japanese version of SDQ, and typical effects of age and gender on those subscales. Conclusion: The current study indicates that the Japanese version of SNAP-IV-Teacher Form is a reliable and valid instrument for rating symptoms related to AD/HD and ODD. (C) 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.