Relationship between School-aged Executive Functions and Oral Narrative Skills

1. Relationship between School-aged Executive Functions and Oral Narrative Skills By: Sarah Lambeth Eastern Illinois University Faculty Mentors: Mrs. Jill Fahy Dr. Rebecca Throneburg

2. Executive Functions • Metacognitive skills necessary for successful goal achievement (Jurado & Rosselli, 2007). • Cognitive Processes: • Attention • Working Memory • Key components: • Intentional determination • Planning and organization • Initiation and persistence • Flexibility/shifting • Inhibitory control • Self-monitoring and regulation (Gioia, Isquith, Guy, & Kenworthy, 2000; Jurado & Rosselli, 2007)

3. Development of Executive Functions and Narrative Skills • Executive function development • Emerge during early childhood • Spurts similar to prefrontal cortex development • Prefrontal structures of the brain are involved in executive function skills (Jurado & Rosselli, 2007, Anderson, 2002). • Prefrontal activation is also associated with narrative comprehension and production tasks (Mar, 2004).

4. Previous Research • Differences in executive function profiles of different groups (e.g., language impaired verses typical) • Relationships between individual language skills and isolated executive function abilities measured in nonfunctional laboratory tasks. • Carlson, Davis, & Leach, 2005; Carlson, 2005; Im-Bolter, Johnson, & Pascual-Leone, 2006; Cohen, Vallance, Barwick, Im, Menna, Horodesky, & Isaacson, 2000; Hoffman & Gillam, 2004; Marton, & Schwartz, 2003 • Relationship between specific aspects of language and behavioral executive functions as displayed in everyday environments, in preschoolers, school-age children, and adolescents. • Hughes, Turksta, & Wulfeck, 2009; Trainor, 2010; Liesen, 2011 • Behavior Rating Inventory of Executive Function (BRIEF)

5. Relationship exists between executive functions and written narrative ability in school-age children • Hooper, Swartz, Wakely, Kruif, & Montgomery, 2002 • Research investigating narratives and ADHD has indicated a significant relationship between specific executive functions (working memory, planning, attention, inhibition) and narrative skills • Purvis & Tannock, 1997; Tannock, Purvis, & Schacher, 1993; Milch-Reich, Campbell, Pelham, Connelly, & Geva, 1999; Renz et al., 2003; Flory et al., 2006; Luo & Timler, 2008 • Only one study has used functional measures of both executive functions and language. • Trainor, 2010 • BRIEF (executive functions) and Renfrew Bus Story (narrative skills)

6. Research Questions 1. What is the relationship between executive function skills and narrative production and comprehension abilities? 2. What is the relationship between executive function skills and microstructural elements of narrative language abilities, specifically productivity and complexity?

7. Subjects • All in a general education classroom at a Central Illinois public school

8. Subject Description: Language Measures

9. Measure of Executive Functions:Behavioral Rating Inventory of Executive Functions—Parent Form (BRIEF) • Parents rated their child’s executive function skills in the natural environment • Behavioral Regulation Index • Inhibit Control • Shift Control • Emotional Control • Metacognition Index • Initiate • Working Memory • Plan/Organize • Organization of Materials • Monitor • Global Executive Composite • T-scores of 65 and above indicate clinical significance/area of concern

10. Measure of Narrative Skills:Test of Narrative Language (TNL) • Tasks: comprehend, retell, and generate stories • Story comprehension questions (3 tasks) • Story production (3 tasks) • Story retell without picture • Story generation with picture sequence • Story generation with single picture • Standardized measure of: • Oral Narration (Expressive) • Narrative Comprehension (Receptive) • Total Narrative Language Index

11. Microstructure:Index of Narrative Microstructure (INMIS) • INMIS Complexity • Syntactic organization • Subcomponents • Mean Length of T-units-Morphemes (MLT-M) • Proportion of Complex T-units (PROPCOMP) • INMIS Productivity • Total word output and the degree of lexical diversity • Subcomponents: • Total Number of Words (TNW) • Number of Different Words (NDW) Productivity= -1.60 + ( -0.0010 x MLT-W) + ( = -0.21 x PROPCOMPLEX) + (0.017 x NDW) + ( -0.00054 x TNW) + (0.014 x COORD) + (0.0072 x SUBORD) + (0.0094 x LENGTH) + (0.068 x COMPLEX). Complexity= -2.84 + (0.21 x MLT-W) + ( -0.0027 x TNW) + (0.028 X COORD) + (0.026 x SUBORD) + ( -0.085 x LENGTH) + (0/14 x COMPLEX).

12. Results: BRIEF and TNL Means & Standard Deviations • Standard scores represented as T-scores: Mean= 50, SD= 10 • T-scores >65 are considered clinically significant (higher score = greater impairment) • Subtest standard scores (SS): Mean= 10, SD= 3. • Total Narrative Language Index: Mean= 100, SD= 15

13. INMIS Means and Standard Deviations • Standard scores represented as Z-scores: Mean= 0, SD= 1

14. Correlation between Executive Functions and Narrative Skills *Indicates significance at the .05 level **Indicates significance at the .01 level

15. Correlation between Executive Functions and Microstructure (INMIS Productivity and Complexity) *Indicates significance at the .05 level **Indicates significance at the .01 level

16. Comparison to previous research • Expressive language tasks were more strongly related to executive functions than receptive language tasks. • Confirms results from Liesen’s study using the CELF-3 (isolated tasks) and the BRIEF • Narrative ability is strongly related to executive functions (shift, plan/organize, and monitor). • Confirms results from Trainor’s study with the preschool population (RENFREW and BRIEF) • Results suggest that narrative productivity is significantly related to the executive components of shifting (flexibility), organization, and planning. • Confirms Trainor’s finding that Sentence Length on the RENFREW was significantly related to BRIEF scores

17. Clinical Implications • Suggests that expressive language skills in applied, narrative tasks engage not only language abilities, but also executive functions. • Narrative language ability is strongly related to the executive components of shifting, planning/organizing, and monitoring. • Overall word output and diversity of vocabulary in narratives may rely more on executive function skills than the length of T-units and degree of syntactic complexity. • Speech-language pathologists should assess executive functions within their testing battery and adjust compensatory strategies that rely on intact executive functions

18. Limitations • Small, homogeneous sample • Indirect measures of executive functions (based on parent report) without direct measures to supplement the data • Few types of narrative tasks were used, including only oral story retell and story generation with a picture sequence and a single picture cue. • Unable to assess macrostructure using the Narrative Scoring Scheme (NSS) • Not normed for the TNL

19. Future Research • Similar study with larger, more diverse sample, including a wider age range • Similar study including children with language disorders • Study using both direct and indirect measures of executive functions • Treatment of executive dysfunction

20. References • Anderson, P. (2002). Assessment and development of executive function (EF) during childhood. Child Neuropsychology, 8, 71-82. • Carlson, S. (2005). Developmentally sensitive measures of executive function in preschool children. Developmental Neuropsychology, 28, 595-616. • Carlson, S., Davis, A., & Leach, J. (2005). Less is more: Executive function and symbolic representation in preschool children. Psychological Science, 16, 609-616. • Cohen, N. J., Vallance, D. D., Barwick, M., Im, N., Menna, R., Horodezky, N. B., & Isaacson, L. (2000). The interface between ADHD and language impairment: An examination of language, achievement, and cognitive processing. J. Child Psychiatry, 41, 353-362. • Flory, K., Milich, R., Lorch, E., Hayden, A., Strange, C., Welsh, R. (2006). Journal of Abnormal Child Psychology, 34, 850-862. • Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of executive function. Child Neuropsychology, 6, 235-238. • Hoffman, L. M., & Gillam, R. B. (2004). Verbal and spatial information processing constraints in children with specific language impairment. Journal of Speech, Language, and Hearing Research, 47, 114-125. doi: 1092-4388/04/4701-0114 • Hooper, S., Swartz, C., Wakely, M., Kruif, R., & Montgomery, J. (2002). Executive functions in elementary school children with and without problems in written expression. Journal of Learning Disabilities, 35, 57-68. • Hughes, D. M., Turkstra, L. S., & Wulfeck, B. B. (2009). Parent and self-ratings of executive function in adolescents with specific language impairment. International Journal of Language and Communication Disorders, 44(6), 901-916 doi: 10.3109/13682820802425693 • Im-Bolter, N., Johnson, J., & Pascual-Leone, J. (2006). Processing limitations in children with specific language impairment: The role of executive function. Child Development, 77, 1822-1841.

21. Jurado, M. B., & Rosselli, M. (2007). The elusive nature of executive functions: A review of our current understanding. Neuropsychology Review, 17, 213-233. doi: 10.1007/s11065-007-9040-z • Liesen, J. (2011). Executive functions and language abilities in grade school children. Unpublished manuscript, Department of Communication Disorders and Sciences, Eastern Illinois University, Charleston, Illinois. • Luo, F., & Timler, G. (2008). Narrative organization skills in children with attention deficit hyperactivity disorder and language impairment: Application of the causal network model. Clinical Linguistics & Phonetics, 22, 25-46. • Mar, R. A. (2004). The neuropsychology of narrative: story comprehension, story production and their interrelation. Neuropsychologia, 42, 1414-1434. • Marton, K., & Schwartz, R. G. (2003). Working memory capacity and language processes in children with specific language impairment. Journal of Speech, Language, and Hearing Research, 46, 1138-1153. doi: 1092-4388/03/4605-1138 • Milch-Reich, S., Campbell, S., Pelham, W., Connelly, L., & Geva, D. (1999). Developmental and individual differences in children’s on-line representations of dynamic social events. Child Development, 70, 413-431. • Purvis, K., & Tannock, R. (1997). Language abilities in children with attention deficit hyperactivity disorder, reading disabilities, and normal controls. Journal of Abnormal Child Psychology, 25, 133-144. • Renz, K., PugzlesLorch, E., Milich, R., Lemberger, C., Bodner, A., & Welsh, R. (2003). On-line story representation in boys with attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 31, 93-104. • Tannock, R., Purvis, K., & Schacher, R. J. (1993). Narrative abilities in children with attention deficit disorder and normal peers. Journal of Abnormal Child Psychology, 21, 103-117. • Trainor, K. (2010). The relationship between preschool executive function skills and oral narrative skills. Unpublished manuscript, Department of Communication Disorders and Sciences, Eastern Illinois University, Charleston, Illinois.