Development of executive functions in children with frontal lobe lesions

执行功能(Execution Functions，EF)，指的是解决问题、灵活思考、抽象思维和注意力集中的能力。EFS对于管理日常生活活动是必不可少的。大脑的额叶被认为在协调EFS方面起着重要作用。在儿童时期，额叶区域发育迅速，由于儿童在其环境中正常运作的能力受损，干扰了新的学习和推理等适应功能，损害可能会影响正在进行的发展。儿童的执行功能障碍表现为组织混乱、冲动、注意力不集中和不适当的行为。由于高度结构化的环境以及父母和照顾者在日常活动中的支持，这些问题通常在幼儿时期就被掩盖了。然而，随着儿童的成熟，对独立的期望增加，执行缺陷变得更加明显(即。孩子“长大后”会遇到这些问题)。适当的治疗和管理取决于：(1)改进对有这种后遗症风险的患者的早期识别；(2)确定行政缺陷对持续发展的长期后果。这项研究旨在促进我们对EFS及其在儿童时期的发展的理解，无论是在健康儿童还是患有脑损伤的儿童中，都被认为是EFS的归属区(即额叶)。虽然有轶事病例数据可用，但据我们所知，没有其他研究试图使用纵向分组设计来做到这一点。具体预测包括：(I)与其他脑区受损的儿童和健康儿童相比，额叶受损的儿童在EF测量上的表现更差；(Ii)额叶受损的儿童在EF任务上的缺陷将随着时间的推移而增加，反映出无法在预期的时间框架内获得执行技能，与额叶以外的大脑区域局限性受损的儿童相比，以及健康儿童。

Executive functions (EF), refer to the ability to problem solve, think flexibly and in abstract terms and pay attention. EFs are essential for managing daily life activities. The frontal lobes of the brain are believed be important in coordinating EFs. In childhood, frontal areas are developing rapidly and damage may affect ongoing development due to impairments in a child's capacity to function normally within their environment, interfering with adaptive functions such as new learning and reasoning. Executive dysfunction in children manifests as disorganisation, impulsivity, inattention and inappropriate behaviour. Such problems are often masked in early chilhood, due to highly structured environments and support of parents and care-givers in day-to-day activities. However, as children mature, expectations of indepence increase and executive deficits become more apparent (ie. child 'grows into' these problems). Appropriate treatment and management is dependent on (i) improvement in early identification of patients at risk for such sequelae; (ii) establishing long-term consequences of executive deficits to ongoing development. This research aims to advance our understanding of EFs and their development through childhood, both in healthy children and children with cerebral lesions to regions believed to subsume EFs(ie the frontal lobes). While anecdotal case data is available, to our knowledge, no other study has attempted to do this using a longitudinal group design. Specific predictions include; (i) Children with frontal lobe damage will perform more poorly on EF measures, in comparison to children with damage to other cerebral areas and healthy children; (ii) Children with frontal lobe damage will show increasing deficits on EF tasks over time, reflecting an inability to acquire executive skills in the expected time frame, when compared with children with localised damage to cerebral areas excluding the frontal lobes, and healthy children.