Module Overview18.html
Other Cognitive Domains
Foundational and Higher-Level Abilities
Modules Six and Eight of this course covered memory and language functions. However, the course resources do not fully describe many other cognitive domains. This module reviews the remaining cognitive functions. It emphasizes attention and executive functions. These cognitive domains are affected by different disorders. A neuropsychological assessment typically will assess all these cognitive domains to do the following:
Identify the extent to which they have been affected by a diagnosis.
Identify the strengths and weaknesses in other cognitive areas.
Make a diagnosis.
Provide treatment recommendations.
Think of the collection of cognitive abilities as a pyramid, with the foundational abilities at the base. Attention and processing speed are among these base abilities. If one of those abilities is impaired, most other cognitive functions will also be negatively affected. For example, if attention is impaired, one cannot attend to a stimulus long enough to encode it into memory. Language, memory functions, and visual-spatial skills are higher on the pyramid, above attention and processing speed. At the top are the executive functions, the most complex abilities and the last to develop in humans. Problems with base skills can affect higher-level abilities. Similarly, impairment can also be top-down, such as when impaired executive functioning negatively affects memory retrieval. Therefore, all cognitive abilities can be, to some extent, interrelated.
Speed of information processing, or processing speed, refers to motor response speed (or reaction time) and the speed at which mental activities are performed (Lezak et al., 2004). Timed tasks typically measure processing speed. This cognitive process is related to the myelination of axons, with better myelination lending to quickened processing speed (Blumenfeld, 2010). Therefore, the development of processing speed is linked to myelination in early childhood. Some research suggests that information processing speed across the lifespan in part accounts for age-based changes in other skills. These include attention and resistance to interference (Saito et al., 2022).
Processing speed is also a basic measure of cognitive load. Think about how much effort it takes to read a very technical passage on an unfamiliar topic, such as one related to neuroanatomy. Because more cognitive burden is used, the task is performed more slowly. Processing speed is also one of the most sensitive domains to organic brain damage. Thus, this is a commonly impaired domain in cases of dementia or head trauma (Groth-Marnat, 2003).
Attention is another foundational process. It can be divided into four types. Focus, or selective attention, refers to the ability to attend to a simple stimulus while not attending to other stimuli in the environment. Sustained attention, or vigilance, is the ability to focus on a task over longer periods. Divided attention is the ability to focus on multiple tasks at once. Alternating attention is the ability to quickly shift attention from one task to another (Lezak et al., 2004). Just as attention may contribute to many types of memory impairment, slowed processing speed commonly contributes to poor attention.
Visual-spatial skills include the following:
Perceptual organization skills
Visual reasoning
Construction (the ability to draw or construct with physical objects, such as when working on a jigsaw puzzle)
These skills are generally more right (nondominant) hemisphere skills and generally occur in the parietal lobe.
Finally, the executive functions are a collection of skills housed in the frontal lobes. The frontal lobes occupy a large portion of the cortex in humans. They are related to the functions of the following:
Motor control and planning
Speech production (Broca’s area)
Emotional regulation
Metacognition (the ability to think about thinking)
Energization (initiation and sustaining activity)
The executive functions (Stuss, 2011)
A simplistic model of functional neuroanatomy is that the medial frontal cortex involves functions of energization or apathy. The orbitofrontal cortex involves behavioral inhibition and impulsivity. The dorsolateral prefrontal cortex houses the executive functions (Miller & Cummings, 2007). In contrast to sensory and motor skills that develop first in childhood, the executive functions are the last set of skills to develop. They fully mature when people are in their early twenties.
Many different models of executive functioning skills have been proposed. In general, the skills relate to how or whether one does something, as opposed to what or how much they do (Lezak et al., 2004). The executive functions typically include the following:
Volition (the ability to choose and initiate a response)
Planning
Resistance to interference
Monitoring
Adjusting activity to feedback
Abstract reasoning
The use of strategies
Novel problem-solving
References
Blumenfeld, H. (2010). Neuroanatomy through clinical cases (2nd ed.). Sinauer Associates.
Groth-Marnat, G. (2003). Handbook of psychological assessment (4th ed.). John Wiley & Sons, Inc.
Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment (4th ed.). Oxford University Press, Inc.
Miller, B. L., & Cummings, J. L. (2007). The human frontal lobes (2nd ed.). The Guilford Press.
Saito, D. N., Fujisawa, T. X., Yanaka, H. T., Fujii, T., Kochiyama, T., Makita, K., Tomoda, A., & Okazawa, H. (2022). Development of attentional networks during childhood and adolescence: A functional MRI study. Neuropsychopharmacology Reports, 42(2), 191–198. https://doi-org.ezproxy.snhu.edu/10.1002/npr2.12246.
Stuss, D. T. (2011). Functions of the frontal lobes: Relation to executive functions. Journal of the International Neuropsychological Society, 17, 759–765. https://doi-org.ezproxy.snhu.edu/10.1017/S1355617711000695.
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