[W1] - CH14

Question 1

Attention as a Baseline

Answer 1

Attention is not only a baseline for sensorimotor functions, but also higher order processes such as language skills, memory and learning, and visual-spatial processing.

Attentional problems are often a symptom of underlying neurological disabilities. Indeed, it is common for children to have attentional processing disorders if they have compromised brain functioning as a result of other neurodevelopmental disorders, exposure to environmental toxins, TBIs, etc.

Question 2

Mirsky’s Taxonomy of Attention Functions

Answer 2

• Focus/execute
• Sustain and stabilize
• Shift
• Encode (now seen as a measure of working memory)

Question 3

Posner and Peterson’s Three Attentional System

Answer 3

• Orienting
• Selection
• Alerting or sustained attention

Question 4

Selective/Focused Attention

Answer 4

(Mirsky’s focus/execute) The ability to scan an array of stimuli and selectively respond.

Focused attention is the ability to scan an array of stimuli, whilst the execute component refers to the ability to make a response. The contemporary interchangeable term used in current literature is selective attention - the ability to maintain a cognitive set in the presence of background ‘noise’ or ‘distraction’.

An example of a neuropsychological test measuring selective attention is the Stroop Color-Word Test (SCWT) [selectively attend to the colour of the ink]

Question 5

Sustained Attention

Answer 5

The ability to stay on task in a vigilant manner for a prolonged period of time.

Classic test of sustained attention…
Child is asked to attend to a “target” event (e.g., press a button when an X is followed by an O), while ignoring all other events over a prolonged period of time.

Question 6

Attentional Capacity

Answer 6

Attentional capacity has a direct relationship with the cognitive capacity or load required on memory tasks. As the length of the stimuli to be recalled increases, and the semantic loading increases from words to sentences to stories, there are concurrent changes in the attentional demands of tasks .

Typical test measuring attentional capacity…
Digit span test (child asked to recall a series of digits increasing in length)

Such tests obviously have a strong memory component, but they incorporate substantial attentional demands also.

Question 7

The Neuroanatomy of Attention

Answer 7

Subcortical portions of the brain (e.g.,
the reticular activating system) = help regulate and maintain arousal.

Higher
cortical regions (e.g., prefrontal lobes and anterior cingulate cortex) = help allocate attentional resources, selectively attend, and regulate response inhibition.

Selective/Focused Attention:
- Mirsky = superior temporal cortex, inferior parietal cortex, corpus striatum structures
- Peterson & Posner = anterior cingulate and supplemental motor areas

Sustained Attention:
- Mirsky = subcortical rostral midbrain structures (incl. tectum, mesopontine, reticular formation, and midline and reticular thalamic nuclei)
- Peterson & Posner = right side of brain, particularly the anterior and prefrontal areas.

Perhaps some of the variability in linking
specific attentional processes with specific neuroanatomical structures can be attributed to differences in neuroimaging techniques; adult versus child populations; and tasks which required more “bottom-up” versus “top-down” attentional processes.
[Orbitofrontal, dorsolateral and anterior cingulate cortex consistently activated]

Question 8

Divided Attention

Answer 8

The ability to attend to more than one stimulus at a time

Question 9

Neglect

Answer 9

The failure to respond to visual, auditory, or tactile stimuli presented
in the hemispace contralateral (opposite side of the body) to a brain lesion that cannot be attributed to
primary sensory or motor deficits [hemispatial milder than unilateral]

Question 10

Neuropsychological Processing
Concerns Checklist for Children and Youth (NPCC-3) Attention Items

Answer 10

Selective or Sustained Attention Difficulties:

• Seems to get overwhelmed with difficult tasks.
• Difficulty paying attention for a long period of time.
• Seems to lose place in an academic task (e.g., reading, writing, math).
• Mind appears to go blank or loses train of thought.
• Inattentive to details or makes careless mistakes.

Question 11

Integrated SNP/CHC Model Classifications
of Attentional Facilitators/Inhibitors

Answer 11

Broad:
- Allocating and
maintaining
attention
facilitators/
inhibitors.

Second Order: (6)
- Selective/focused
attention.
- Sustained Attention.
- Response Inhibition.
- Attentional Capacity.
- Qualitative Behaviors.
- Behavioral Rating Scales.

Question 12

Third Order Classifications of Selective/focused attention

Answer 12

Auditory; Visual

Question 13

Third Order Classifications of Sustained attention

Answer 13

Auditory; Visual; Auditory and Visual

Question 14

Third Order Classifications of Response Inhibition

Answer 14

Verbal; Motoric

Question 15

Third Order Classifications of Attentional Capacity

Answer 15

Memory for… numbers, letters, or
visual sequences; words and sentences; stories

Question 16

Testing Selective/Focused and Sustained Attention

Answer 16

Ideally, tests designed to measure selective/focused attention would be different from tests designed to measure sustained attention; however,
this is the exception instead of the rule. Many of the tests designed to measure
attention comingle the two types of attention.

Some tests, such as CPTs (continuous performance tasks - responding to a target event repeatedly over time
while ignoring distracters) are specifically designed to measure sustained attention.

Examples: - Auditory Attention and Response Set
test on the NEPSY-II
- The Test of Everyday Attention for Children—Second Edition (TEA-Ch2)

Question 17

Understanding Performance Deficits on Attentional Capacity Tasks

Answer 17

The patterns of performance that a clinician looks for across the attentional
capacity tasks are:

• Does the student perform well on recalling short strings of information (e.g., digit recall) but performance drops significantly when too
  many strings of numbers are presented?
• Does the student’s performance worsen as words, sentences, and finally
  stories are presented? In other words, as the semantic cues increase
  does that cause information overload?
• Does the student not perform well on the simple digit or letter recall
  tasks but performs much better as the semantic cues are increased from
  words, to sentences, to stories?

[Some children need the added contextual cues and increased meaning to capture and maintain their attentional focus; whereas other children (particularly
children with ADHD) shut down their learning when too much information is
presented]

Question 18

Qualitative Behaviors of Attention

Answer 18

On the NEPSY-II, the frequency of two qualitative behaviors such as inattentive/
distracted off-task behaviors and out-of-seat/physical movements are recorded
and base rates compared to the student’s same-aged group or to one of the clinical
validation sample groups can be generated.

Question 19

Define Working Memory

Answer 19

A memory system that underpins our capacity to ‘keep
things in mind’ when performing complex tasks.

Information placed in working memory may come from sensory
memory, short-term memory, or from long-term memory. The key component
of a working memory task is the requirement for ACTIVE MANIPULATION of the
information.

Working memory has been shown to be a required cognitive process for components of reading, mathematics, and writing achievement.

Question 20

The components of Baddeley’s Current Model of Working Memory - Central Executive System (also called SAS)

Answer 20

Central Executive: The overarching control system

Visuospatial sketchpad: Temporarily stores visual/spatial information. The long-term memory linkage here allows for the
acquisition of visual-spatial information.

Phonological Loop: Temporarily stores speech-like information. The long-term memory linkage here allows for the acquisition
of language

Episodic Buffer: A multidimensional system of storage that can hold a limited amount (four chunks) of information. Acts as a link between the phonological loop and the
visuospatial sketchpad - with input from long-term memory and perceptual processing. The mental workplace.

Question 21

Neuroanatomy of Working Memory

Answer 21

Supramarginal gyrus (temporal-parietal gradient) / [lateral frontal, superior temporal, and inferior parietal] = phonological working memory.

(Right) parietal occipital region = visuospatial sketchpad (e.g., struggle with WISC-V Integrated
Spatial Span Backwards Test)

Question 22

Working Memory Items From the Neuropsychological
Processing Concerns Checklist for Children and Youth (NPCC-3)

Answer 22

Working Memory Difficulties:

• Frequently asks for repetitions of instructions/explanations.
• Trouble following multiple step directions.
• Loses track of steps/forgets what they are doing amid task.
• Loses place in the middle of solving a math problem.
• Loses train of thought while writing.
• Trouble summarizing narrative or text material.
• Trouble remembering facts or procedures in mathematics.

Question 23

Integrated SNP/CHC Model Classifications of
Working Memory Facilitator/Inhibitor

Answer 23

Broad:
Working Memory
Facilitator/Inhibitor

Second-Order:
Working Memory

Third Order:
Verbal; Visual; Qualitative Behaviors