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BAOJ Psychology Evangelia Foutsitzi, et al, BAOJ Psychol 2016 1: 2 1: 008

Research

Language-Related Abilities and Visual-Spatial Abilities: Their Relations with Measures of Executive Functioning Evangelia Foutsitzi1, Georgia Papantoniou1* and Despina Moraitou2 University of Ioannina, Greece

1

Aristotle University of Thessaloniki, Greece

2

Abstract Introduction Executive functioning is hypothesized to involve the control and coordination of cognitive operations. Despite the centrality of executive functions in current psychological research, they have been a source of confusion since a number of researchers have speculated that a close relation might exist between executive functioning and fluid intelligence. Therefore this study investigated the pattern of relations between some commonly used measures of executive functioning and established cognitive abilities. Methods The total sample consisted of 279 healthy adults, 83 men and 196 women. Their age ranged between 29-59 years. All participants were tested with a battery of four tasks (two verbal and two visualspatial) tapping general cognitive ability (g): language-related abilities measured through the Synonyms and Opposites Tests and visual-spatial abilities measured through the Toothpicks Test and Paper Folding Test. Executive functioning was measured through the Verbal Fluency Test and the Design Fluency Test of the D-KEFS neuropsychological battery. Results Structural equation modeling analysis showed that the executive functioning measured variables were moderately related to the cognitive abilities constructs. In specific, the Verbal Fluency Test measured variables were related to the Language-related Ability factor and the Design Fluency Test measured variables were related to the Visual-Spatial Ability factor. Conclusion The results of this study suggest that there are similarities in terms of constructs measured across intelligence and neuropsychological test batteries. Keywords: Executive functioning; Language-related cognitive abilities; Visual-spatial cognitive abilities

Introduction Executive functioning has become an important concept in contemporary neuropsychology and is hypothesized to involve the control and coordination of cognitive operations [1]. However, there is little consensus on what executive functioning actually means because of the diversity of the description of its nature. BAOJ Psychology, an open access journal

Executive function was defined as the dimension of human behavior that deals with how behavior is expressed and was conceptualized as having four components: the abilities of goal formation, planning, carrying out goal-directed plans, and effective performance [2,3]. They are generally also described as high-level cognitive functions believed to be mediated by frontal lobes [4]. Certainly, executive functions appear to include an expansive and varied set of component processes namely, formulating goals and plans of action, solving new problems, planning strategic thinking, decision–making, monitoring appropriate sequences of action [5-10], which affect adaptive behaviors and allow the individual to impose organization and structure upon his or her environment [11-13]. Since several of the descriptions of the term executive functioning refer to rather general aspects of thinking, it is thus not surprising that a number of researchers have speculated that a close relation might exist between executive functioning and the concept of fluid intelligence [1], or according to others, both tests of executive functions and tests of cognitive abilities tap a general construct [14-17]. In addition, research has suggested that deficits demonstrated during tests of executive functions are associated with a number of psychological or medical disorders, such as attention-deficit/ hyperactivity disorder, oppositional defiant disorder, learning disabilities and Alzheimer’s disease. These results raise questions about the extent to which executive functions and cognitive abilities are distinct constructs or one term subsumes the other and whether some methods of assessing these constructs most accurately represent them. *Corresponding author: Georgia Papantoniou, Department of Early Childhood Education, School of Education, University of Ioannina, 451 10 Ioannina, Greece, Tel: 0030 265100 5889; Fax: 0030 265100 5802; E-mail: [email protected] Sub Date: October 3, 2016, Acc Date: October 17, 2016, Pub Date: October 19, 2016. Citation: Evangelia Foutsitzi, Georgia Papantoniou and Despina Moraitou (2016) Language-Related Abilities and Visual-Spatial Abilities: Their Relations with Measures of Executive Functioning. BAOJ Psychology 1: 008. Copyright: © 2016 Evangelia Foutsitzi, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Volume 1; Issue 2; 008

Citation: Evangelia Foutsitzi, Georgia Papantoniou and Despina Moraitou (2016) Language-Related Abilities and Visual-Spatial Abilities: Their Relations with Measures of Executive Functioning. BAOJ Psychology 1: 008.

The Relationship between Cognitive Abilities and Executive Functions It has been found that child and adult versions of the Wechsler intelligence scales [18] contain subtests that measure the same factors as subtests from neuropsychological test batteries designed to assess components of executive functions, such as working memory [19-21], nonverbal or spatial reasoning [20-22] and attention and concentration [21]. The typically uniform positive relations between measures of cognitive abilities and measures of executive functions as well as the similarities between the descriptions of executive functions, some specific cognitive abilities, and the general factor have led researchers to suggest a confluence of these constructs. Floyd, Bergeron, Hamilton & Parra [23] examined the relations among executive functions, the general factor, and specific cognitive abilities consistent with the Cattell-Horn-Carroll (CHC) theory of cognitive abilities. Delis-Kaplan Executive Function System (D-KEFS) [24] was employed to obtain measures of executive functions and Woodcock-Johnson III Tests (WJ III) [25] were employed to assess a broad range of cognitive abilities. The results of their study suggest that measures of executive functions and measures of CHC theory’s cognitive abilities are not easily distinguished. Instead, results reveal that every D-KEFS test or condition measures the general factor as well as broad ability factors outlined in CHC theory, suggesting that it is possible that true executive function factor is the CHC theory’s general factor, as postulated by several other scholars as well [26, 27]. Furthermore, Salthouse [1] examined the pattern of relations among a variety of variables hypothesized to assess executive functioning, reasoning ability and perceptual speed, finding them being strongly correlated. The outcomes of these analyses suggest that measures used of neuropsychologists to assess executive functioning reflect the same dimensions of differences assessed by traditional cognitive tests. Similarly, analyses on performance on other traditional measures of executive functioning and on measures of intelligence have concluded that both groups of tests essentially measure general intellectual abilities [28]. According to the findings of Duff, Schoenberg, Scott, Russell & Adams [29] there is a strong relation between executive functioning and memory capacity as measured by standardized neuropsychological tests. Their analyses indicated that the two cognitive domains shared more than 50% of variance, revealing that intellectual functioning is strongly related to both executive functioning and memory. These suggestions, however, have been challenged by researchers who propose that there exists a distinction between psychometric g-factor and executive functions. Ardila, Pineda & Rosselli [30] found that psychometric intelligence tests are not sensitive to frontal lobe deficits (“executive dysfunctions”), enhancing the assumption that traditional intelligence tests do not appropriately evaluate executive functions. This finding is also enhanced by BAOJ Psychology, an open access journal

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the results of Ardila, Galeano & Rosselli [31] previous study, presenting no correlation between Wisconsin Card Sorting Test (WCST) and Verbal Performance tests or Full Scale IQ, with the exception of Verbal Fluency tests which presented a low, but significant correlation, with some verbal subtests of the Wechsler Adult Intelligence Scale (WAIS). Research has associated frontal damage with executive dysfunction resulting in evident deficits in self-regulation and control of cognition [30]. However, it was somehow surprising to be observed that patients with ventrolateral and dorsolateral frontal lesions constantly preserved the cognitive abilities required to perform the various intellectual tasks (WAIS-R) [18,32], indicating that psychometric intelligence tests are not sensitive to frontal lobe deficits. This finding supports the assumption that psychometric intelligence tests are not appraising abilities (concept formation, act purposefully) that, from a neuropsychological perspective, should be understood as the most important elements in cognition. The idea of the independence of executive functions from psychometric intelligence may also be conjectured by the results of Welsh, Pennington & Groisser’s [33] study. Analyzing the association between executive function measures and psychometric intelligence test scores, they found that most of the executive function tasks (Visual Search [34], Verbal Fluency [35], Motor Planning [36], Tower of Honoi [37], Wisconsin Card Sorting Test [38], Matching Familiar Figures test [39] administrated to children were uncorrelated to IQ. Despite the lack of clarity concerning either the definition or the possible subcomponents and the variables that measure executive functions, there is a relative agreement in terms of the importance of executive functioning. Executive abilities allow us to shift our mind set quickly and adapt to diverse situations while at the same time inhibit inappropriate behaviors. They mediate the ability to organize our thoughts in a goal-directed way and therefore are essential for success in school and work situations, as well as everyday living [40]. The Present Study The primary goal of the present study was to investigate the pattern of relations between some commonly used measures of executive functioning and established cognitive abilities, using Confirmatory Factor Analysis (CFA). With reference to the results of the investigation of the construct validity of several commonly used measures of executive functioning including the tests of verbal and design fluency [20,21,23,41], where the variance common to the executive functioning variables was very strongly related to other cognitive ability constructs, we assumed that there should be relationships between measured variables which reflect executive functioning to cognitive abilities latent factors (H1). More specifically we formulated the hypothesis that part of the variance of Verbal Fluency Test measured variables would be also explained by the Verbal Ability latent variable (factor) (H1a) and respectively, part of the variance of Design Fluency Test measured variables would be also explained by the Visual-Spatial latent variable (factor) (H2b). Volume 1; Issue 2; 008


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Methods

Kit of Factor-Referenced Cognitive Tests

Participants

To assess cognitive abilities we employed Kit of Factor-referenced Cognitive Tests [42], which provides a reference basis for different researchers in their combined efforts to conceptualize and develop a theory and structure of human abilities and temperament. It is consisted of 72 tests that can serve as markers for well established factors.

The present study was conducted as a part of the doctoral thesis of the first author. The aim of the thesis was the investigation of the relationships among cognitive abilities, executive functioning, tacit knowledge, and effectiveness of Greek teachers of Secondary Education. Therefore, all participants were senior high-school teachers varied in amount of experience teaching, ranging from 5 to 15 years and, collectively, represented all subject areas. The total sample consisted of 279 adults, 83 men (29.7%) and 196 women (70.3%). Participants’ age ranged between 29-59 years. Instruments Delis-Kaplan Executive Function System (D-KEFS) Executive functioning was measured through D-KEFS [24]. In particular, D-KEFS provides a new set of standardized tests for assessing higher-level cognitive functions, such as inhibition, flexibility, and switching ability, in both children and adults. It is composed of nine tests that measure a wide spectrum of verbal and non verbal executive functions, two of which are the Verbal Fluency Test and the Design Fluency Test. Each test is a standalone instrument, which can be administered individually or with other D-KEFS tests. (a) The D-KEFS Verbal Fluency Test is composed of three conditions. For the Letter Fluency condition, the examinee is asked to rapidly generate words that begin with a particular letter. In the Category Fluency condition, the examinee is asked to generate words that belong to a designated semantic category as quickly as possible. In the Category Switching condition the examinee is asked to generate words, alternating between two different semantic categories as quickly as possible. For each trial of each condition, the examinee is allowed 60΄΄ (seconds). Verbal Fluency Test measures the ability to generate words fluently in an effortful, phonemic format (Letter Fluency), from overlearned concepts (Category Fluency) while simultaneously shifting between over-learned concepts (Category Switching). (b) The Design Fluency Test is also composed of three conditions. For each condition the examinee is presented rows of boxes each containing an array of dots that the examinee must connect, with four lines only, to make a different design. For Condition 1, Filled Dots, the response boxes contain only filled dots, and the examinee is asked to draw as many different designs as possible, in 60΄΄ (seconds) by connecting those dots. For Condition 2, Empty Dots, the response boxes contain filled and unfilled dots; the examinee is required to connect only the unfilled dots so as to inhibit the previous response of connecting the filled dots, producing as many different designs as possible, again in 60΄΄ (seconds). In Condition 3, Switching, the response boxes contain both filled end empty dots; the examinee is asked to draw the designs by alternately connecting filled and empty dots. Design Fluency Test measures design fluency (Filled Dots), response inhibition (Empty Dots) and cognitive flexibility (Switching). BAOJ Psychology, an open access journal

Both The Synonyms and The Opposites Tests, administered at present study, are measuring language related abilities (associational fluency), while the Paper Folding Test and the Toothpicks Test are measuring visual-spatial abilities (visualization and figural flexibility, respectively). (a) The Synonyms Test measures the ability of the examinee to produce rapidly words which share a given area of meaning or some other common semantic area. The task is to write as many synonyms as possible for each of the 10 words given in 3΄ (minutes) time. The score is the number of the words written that are related to the stimulus word. (b) The Opposites Test has a similar structure to the one of the Synonyms Test. The examinee is asked to write up to as many antonyms as possible for each of the 10 words given, in 3΄ (minutes). The score is the number of the correct antonyms written. It seems likely that participants will score higher on both the aforementioned tests if they have more associations tied to a word and more flexibility in interpreting similarity or difference. (c) The Paper Folding Test is measuring visual-spatial abilities. More specifically, it measures the ability of the examinee to manipulate or transform the image of spatial patterns into other arrangements. For each of the 10 items of the test, successive drawings illustrate 2 or 3 folds made in a square sheet of paper. The final drawing of the folded paper shows where a hole is punched in it. The examinee selects one of the five drawings to show how the punched sheet would appear when fully reopened. The length of the task is 3΄ (minutes). (d) The Toothpicks Test is measuring figural flexibility. More specifically, it measures the ability to change set in order to generate new and different solutions to figural problems. The examinee is asked to present up to 5 different arrangements of toothpicks according to sets or specified rules. The length for the total of the 10 items of the task is 3΄ (minutes).

Procedure Participants were recruited from 50 different schools of the islands of Creta and Cyclades, and the town of Thessaloniki, in Greece, after being explained that their participation in the survey was voluntary. Participants were informed about the aim of the study and were reassured about confidentiality of all results. For all the participants written informed consent was obtained and then they completed an individual–demographics form. They were examined by the first author, either individually or in groups of 3-4 persons, in a quite environment –in the area of the school building (school library, teachers’ office) where each participant teacher Volume 1; Issue 2; 008


served– so as to minimize the presence of any disruptions and disturbances. Tests were administered in a randomized order and testing was typically conducted in 30΄ (minutes). No incentives or compensation were offered to participants. Statistical Analysis We used Confirmatory Factor Analysis to investigate the pattern of relations between Verbal Fluency Test measured variables, Design Fluency Test measured variables, Synonyms and Opposites tests as well as Toothpicks and Paper Folding tests measured variables. Structural equation models were conducted in EQS 6.1. and performed on covariance matrix using the Maximum Likelihood (ML) estimation procedure. The Wald test was used to suggest more restricted models [43]. The classic goodness-of-fit index is χ2. A statistically significant χ2 (latent variable software programs provide the exact probability value of the model χ2) indicates that the model estimates do not sufficiently reproduce the sample variances and co-variances (i.e., the model does not fit the data well) [44]. A non-statistical significance of the χ2-test indicates that the implied theoretical model significantly reproduces the sample variance-covariance relationships in the matrix. Since this test is sensitive to sample size, model fit was also evaluated by using the root mean squared error of approximation (RMSEA). The RMSEA tests how well the

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model would fit the population covariance matrix. A rule of thumb is that RMSEA < .06 indicates close approximate fit [44]. The Comparative Fit Index (CFI) which is one of the indexes assessing the relative improvement in fit of the researcher’s model compared with a baseline model was also used. A rule of thumb for the CFI is that values close to .95 or greater may indicate reasonably good fit of the researcher’s model [44]. In addition, model fit was evaluated by using the standardized root mean squared residual (SRMR). The SRMR is a measure of the mean absolute correlation residual, the overall difference between the observed and the predicted correlations. Values of the SRMR less than .08 are generally considered favorable [44].

Results Initially, CFA verified a three-factor (latent variable) structure for executive functioning: a Verbal Fluency factor, a Category Switching factor, and a Design Fluency factor. Both performance on condition 1 (Letter Fluency), and condition 2 (Category Fluency), loaded on Verbal Fluency factor (Cronbach’s α = .80). Performance on both conditions of Category Switching loaded on Category Switching factor (Cronbach’s α = .94). Finally, performance on all three Design Fluency Conditions loaded on Design Fluency factor (Cronbach’s α = .64). The estimated threefactor model (Model A) is illustrated in Figure 1.

Figure 1: The underlying structure for the Executive Functioning measured variables (Model A) BAOJ Psychology, an open access journal

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The figure of the aforementioned model includes (a) performance on D-KEFS tests and conditions, which are measured variables represented by rectangles on the left side of the figure. The numbers next to the longer straight, single-headed arrows are the standardized factor loadings; (b) the squared error terms, which are the unexplained variance for each task attributable to unique aspects of the task as well as measurement error, represented by the numbers at the ends of the shorter straight, single-headed arrows; (c) the first order executive functioning factors (latent variables), which are represented by ellipses to the right of the rectangles. The numbers next to the double-headed arrows are the estimated intercorrelations between the three factors. The fit indices for Model A were excellent. In addition to a non significant chi-square χ2 (12, Ν = 279) = 11.33, p = .50, the CFI value of 1.00 was above the criterion of .95, the SRMR value of .04

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was well below the criterion of .08, and the RMSEA value of .00 was also well below the criterion of .06 with the confidence interval [CI] of .00 to .06. [44]. According to the suggestions of the Wald test, all the parameters of this model were statistically significant, except for the residual of one of the measured variables, namely the residual of the total score for Category Fluency (p = .05). Then, scores of performance on cognitive tests (Synonyms and Opposites tests as well as Toothpicks and Paper Folding tests) were added, as measured variables, to the aforementioned Model A in order for us to be able to estimate their factor structure as well as the part of the common variance between them and the Executive Functioning measured variables. The final model (Model B) reflecting the structure of both executive functioning and cognitive abilities tasks is illustrated in Figure 2. The construction of Model B is based on model A, with the addition

Figure 2: The underlying structure for both the Executive Functioning and the Cognitive Ability measured variables (Model B) VF: Verbal Fluency; V/SF: Verbal Semantic Fluency; EF:VF1: Executive Functions: Verbal Fluency/Letter Category Factor; EF:VF2: Executive Functions: Verbal Fluency/Category Switch Factor; EF:DF: Executive Functions: Design Fluency Factor; L-R abilities: Language-Related Ability Factor; V-S abilities: Visual-Spatial Ability Factor. BAOJ Psychology, an open access journal



of four measured variables (scores on four cognitive ability tests) and two cognitive ability factors (latent variables), namely, the Language-related Ability factor and the Visual-Spatial Ability factor, respectively. As shown in Figure 2, CFA verified a two-factor structure of the cognitive abilities: a Language-related Ability factor (Cronbach’s α = .79), and a Visual-Spatial Ability factor (Cronbach’s α = .61). According to the predictions outlined earlier, part of the variance of Letter Fluency and Category Switching measured variables was also explained by the Language-related Ability factor, indicating that language abilities are clearly involved in the performance of Verbal Fluency Executive Functioning tasks. Moreover, part of the variance of the Design Fluency measured variables was also explained by the Visual–Spatial Ability factor, indicating the involvement of visual-spatial abilities in the performance of Design Fluency Executive Functioning tasks. The fit statistics indicated that Model B, which is illustrated in Figure 2, provided an excellent fit to the data: χ2 (35, Ν = 279) = 30.51, p = .68, CFI = 1.00, SRMR = .04, and RMSEA = .00 (CI90% .00 to .03) [44]. According to the suggestions of the Wald test, all the parameters of this model were statistically significant, except for the residual of one of the measured variables, namely the residual of the total score for Category Fluency (p = .33).

Discussion The study reported in this article examined the relationships among executive functioning, in terms of verbal fluency and design fluency, language-related abilities and visual-spatial abilities. Since, a part of the variance of both D-KEFS Verbal Fluency and Design Fluency tests was found to be explained by cognitive ability factors as well, the results of this study appear to indicate that measures from both tests of executive functions and tests of cognitive abilities measure, in some extension, the same types of abilities. According to prior research, scores from tests like D-KEFS Category Fluency and D-KEFS Letter Fluency have been shown to load on factors associated with verbal or knowledge-related factors and to correlate with related measures [1,45,46]. It is not surprising though, since performance on Category Fluency and Letter Fluency tasks depends on several fundamental cognitive components, including vocabulary knowledge and rapid systematic retrieval of lexical items. Both processes are necessary for the satisfactory execution of either Category Fluency and Letter Fluency tasks or other Language-related abilities tests, like the ones used in present study (Synonyms and Opposites tests). When marker tests of Long-term Storage and Retrieval have also been included in research, it has been shown that Category Fluency and Letter Fluency tests also loaded on these factors [23], which is also no surprise as Category Fluency requires the examinee to retrieve multiple words from a semantic category. Word retrieval entails search of a major portion of a long-term memory lexicosemantic store, namely a process similar to associational fluency [47], which strengthens the performance in Synonyms or Opposites tests. BAOJ Psychology, an open access journal

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Design fluency requires fundamental component skills, including visual attention, motor speed and visual-perceptual skills, as well as higher-level executive functions, such as fluency in generating visual patterns. Similarly, according to Carroll [47,48], figural flexibility requires imagining a figure in relation to a surrounding visual-representational field with the addition of the performance of serial operations and visualization includes spatial ability, figural adaptive flexibility and speed of closure [49]. The similarity of skills affecting the performance on both D-KEFS Design Fluency tasks and spatial abilities tests of Paper Folding and Toothpicks indicates that the visuo-spatial domain is related to executive functioning. As far as the relationships between executive functioning and spatial abilities are concerned, research has shown that SpatialVisualization factor and Spatial Relations factor are similar and hence correlated with one another, in the sense that they rely on both executive functioning and visuo-spatial storage [50]. The contribution of the results of this study is that they offer insight into the relations among executive functions and cognitive abilities, enhancing the conclusions of previous studies suggesting that there are similarities in terms of constructs measured across intelligence and neuropsychological test batteries [1,23,29]. However, it is possible that some results would not be replicated using other samples (e.g. samples of children and adolescents or clinical samples of adults). Furthermore for our sample, the VisualSpatial Ability factor –the measured variables of which were the performance on the Paper Folding Test and the Toothpicks Test– has indicated low reliability. Similarly to many D-KEFS measures [23], the Design Fluency Test has also demonstrated, in the present study, low level of reliability. Therefore, future research should include measures of visual-spatial abilities and executive functions with better reliability as well as more carefully selected samples.

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