1 Running head: NEUROPLASTICITY IN CHILDREN

Neuroplasticity in Children: A Review of the Neural Bases, Cognitive Effects and Benefits Alison Fietz Student No: 220078965 University of New England

Word count: 1990

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Abstract Research into neuroplasticity in children is revealing how the brain organises itself around the inputs it receives. Beneficial neurobiological shaping can occur with aerobic exercise and learning experiences based on structured, sequential learning. Early environmental experiences can have either negative or positive influences on the brains neuronal circuitry. Programs and interventions are being devised that acknowledge these critical stages of the brains development and malleability in early life such as those within neurorehabilitation.

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Neuroplasticity in Children: A Review of the Neural Bases, Cognitive Effects and Benefits Neuroplasticity recognises that changes in brain architecture are strongly influenced by the environment in the postnatal, childhood and adolescent periods of development and continues throughout the lifespan (Huttenlocher, 1990). Environmental influences such as physical exercise and repetitive experience-dependent learning have shown beneficial influences on cognitive abilities in children. Exposure to enriched environments has revealed neuroanantomical changes in both human and animal studies (van Praag, Kempermann & Gage, 2000). Compensatory processes in neural plasticity in children with challenges and disabilities are being explored within neurorehabilitation. Research using both animals and humans has demonstrated beneficial changes in cognition and brain morphology following exercise. Rodents show increased neurogenesis (the forming of new neurons) and improved retention of spatial memory due to aerobic activity (van Praag, 2008). Hillman et al. (2008) demonstrated positive effects on childrens cognitive abilities. Greater aerobic fitness levels were linked with larger hippocampal volumes and elevated event-related brain potential indices of executive function. Results from functional neuroimaging studies and in vivo imaging markers (cerebral blood flow) show differences between aerobically fit and less fit participants. Particularly in cortical areas related to control and allocation of attention, such as the dorsal lateral prefrontal cortex and anterior cingulate (Pereira et al., 2007). Studies on aerobic fitness and the subcortical brain area of the basal ganglia, using magnetic resonance imaging suggest increased fitness is linked to greater dorsal striatal volumes (Chaddock et al., 2010). The high fit children showed improved performance on the flanker task, a selective attention paradigm which examines interference control, an aspect of executive control. These results have practical implications for health and education, particularly in relation to the rise in childhood obesity rates and

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sedentary lifestyles. Exercise in children can have a positive effect on structural volumes of the basal ganglia and the hippocampus, which are involved in cognitive control and learning, essential ingredients for academic success. Studies examining enriched rearing environments in animals have revealed enhanced functioning. Rodents reared in enriched cages with wheels, plastic tubes and room to explore, following exposure to early stress, showed neuroanatomical changes. This included gains in brain size and weight, increased dendritic branching and synaptic size and number. They showed improvements on spatial memory tasks such as the T maze and the Morris water maze (Nithianantharajah & Hannan, 2006). The hippocampus, the brain region related to stress regulation and memory has been demonstrated to be of larger volume in school-aged children who were observed to have strong maternal support in early childhood ( Luby et al., 2012).This study found that observing maternal support while doing a moderately stressful interactive task in early childhood was an instigator of larger hippocampal volume in both hemispheres at school age. Neuroimaging at school age revealed that early maternal support had beneficial hippocampal influence in non-depressed children. Champagne et al. (2008) explored how adult rodents that had minimal maternal care as newborns expressed synaptic changes with improved learning under stressful conditions. When the rats were adults if they had either high levels of maternal support, specifically licking and grooming (LG) to low levels in the first week of life they were measured for contextual fear conditioning. They were put in an extremely stressful learning paradigm, where the rat gets an electric shock upon being put into the test chamber. The amount of time which the rat freezes when it is next put in the test chamber is used as a measurement of fear learning. Low-LG rats expressed a greater time freezing than high-LG rats in a hippocampusdependent version of the learning paradigm, where the shock was delayed to allow the rats to acquire a spatial image of the test chamber. This suggests that low-LG rats had greater

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contextual fear learning. The study suggests that events that occur in early life, such as moderate deprivation and stress can have long-term effects. This could also be seen as a positive outcome in that moderate stress in early development may prepare animals or humans to deal with the tough situations that arise later in life. Shonkoff ,Boyce & McEwen (2009) suggest that stress effects over time may be cumulative and that chronic exposure to moderate stressors may reveal negative consequences of adaptive neural plasticity in the developing brain. Research has established children raised in institutionalized settings, especially in developing countries where there is a neglectful lack of stimulation, attention and individualized care showed neuropsychological deficits. The study by Pollack et al., (2010) on postinstitutionalized (PI) adopted children revealed specific neural areas to show vulnerability to early postnatal experience. Reductions on tests of visual attention and memory, visual related learning and inhibition control were found. Children adopted after 12 months were linked to problems in school readiness and cognitive functioning. Non human primate studies reveal that the prefrontal cortex (PFC) and related systems are particularly vulnerable to early experience and are related to cognitive functions (Sanchez, Ladd & Plotsky, 2001). Further studies have revealed neuronal organization in the dorsolateral prefrontal cortex changes substantially until 5-7 years then slows down ( Fox et al., 2010). This condensed period of PFC development could be to allow for experience-dependent detailing of memory, learning, emotion and attention systems. Tests on Romanian PI children using diffusion tensor imaging suggested diminished white matter areas between the anterior temporal and frontal lobes. Initial electroencephalograms revealed reductions in brain activity. Children that were put in good quality foster care before 2 years old revealed significant improvements in the electroencephalogram (Chugani et al., 2001). Exploring studies on neural deficits in children

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that have had neglectful postnatal care may help in devising strategies and interventions to improve cognitive functioning . Research is exploring neuroplasticity in children who have been involved in remedial instruction intervention for poor reading. Reading is one of the most important skills children will learn that will affect a high percentage of their learning. If it is a problem which is left unremediated, it can result in negative consequences for their academic, emotional, social and economic future. Meyler et al.,(2008) explored the results of rigorous remedial instruction using fMRI on cortical activation on 10 year old children who were considered poor readers. Initially the poor readers had substantially reduced activation compared to good readers, bilaterally in the parietal cortex. They made significant gains after instruction in reading ability revealing increased activation in the left angular gyrus and the left superior parietal lobule. These regions continued to show activation 1 year after post-remediation. Reading skills normally develop throughout the time frame of childhood, different cortical areas may have various roles during reading acquisition. The left parieto-temporal region (including the posterior aspects of the superior and middle temporal gyri, the supermarginal gyrus and the angular gyrus) are assumed to be the main areas that are used in phonological decoding at the level of words. It is also suggested that this area may work as a sound orientated region for storing and composing semantic, phonological and syntactic information in verbal working memory for sentence processing (Keller, Carpenter &Just, 2001). Meyler et al., (2008) demonstrated that interventions based on word-level components that provide a systematic, structured instructional patterning using auditory, kinaesthetic and tactile methods trained poor readers in letter sound identification skills. Plasticity-based training programs may effectively capitalize on the adaptability of childrens brains to improve reading.

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The environmentally induced demands of practicing complex tasks repeatedly may influence the development of childrens brains. Schlaug et al.,(2009) explored the possibility that children aged 5-7 years practicing a complex task like instrumental music learning for 29 months would show training-induced neuroplasticity. Early exposure to music training before 7 years of age reveals in professional musicians larger anterior corpus callosum (CC) areas than those of nonmusicians. The CC is important for musicians as it is the main interhemispheric fiber tract. They use parts of both hemispheres to perform independant but coordinated movements with both hands. Learning an instrument requires bimanual motor skill, complex cognitive functioning and sensory stimulation, a perfect activity to assess changes in the brain due to behavioural learning skills ( Schlaug, Jancke & Huang, 1995). The high practising group in the Schlaug et al, (2009) study showed after an average of 29 months of observation the anterior midbody of the CC (which connects supplementary and premotor areas of the two hemispheres) was larger than the low-practicing group. The children underwent high-resolution TI-weighted MR brain scans, the high-practicing group, the low and non instrumental controls, at base line then at 30 months. The reason for the structural changes in the CC caused by instrumental music training may be due to growth of myelination , axon size and increased formation of axon collaterals. Or it may be the number of transcallosal fibers brought about from the intervening of bimanual activity in the pruning of interhemispheric fibers during development. Prolonged, intensive skill learning in early childhood, leads to neural adaptations. The cortical regions in the CC that showed traversing fibers- the prefrontal cortex, premotor and supplementary motor all participate in planning, motor preparation and motor execution (Bengtsson, Nagy & Skare, 2005). Neurorehabilitation methods are using intense practice to treat children with hemiplegia (paralysis on one side of the body, usually the arm, hand or leg). Constraint-induced movement therapy (CIMT) is a controversial method that is being recognised as a useful

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treatment method. The children may wear a sling on their functioning hand or arm, to secure areas of the brain to perform the movements that are no longer present because of focal injury (Naylor & Bower, 2005). This type of intervention is using specific sensory input with structured motor activity to instigate better motor performance; due to synaptic configuration changes in the brain. Increased neuroplasticity in early childhood means treatment is improved at this stage. Eliasson et al.,(2005) suggest that with critical periods of intense plasticity (neuron circuits getting shaped by experience) in early development there should be apprehension in restraining children too young. To offset these concerns in their study of children from 18 months to 5 years the therapy was modified to reduce the restraint period to 1 hour, a couple of times a week. It is suggested by the neuronal group selection theory (Hadders-Algra, 1999) intervention up to the age of 2 years may enlarge primary neural networks through experience. Interventions with older children try to promote development of a series of varied movements through increasing practice. Most studies in this area are trying to adopt a child-friendly approach. Naylor& Bower ( 2005) used gentle restraint, the therapist held the childs hand and spoke to them encouragingly. Having fun was emphasised in the sessions with rhymes, song and interesting activities. These studies have shown short-term benefits and are being fine-tuned to try to get the same results with less emphasis on restraint and more on the environment used to bring about intense practice. Research into neuroplasticity in children has led to knowledge that can be beneficial for their development, especially in regard to school readiness and success. The way the brain organises itself around the inputs it receives means early intervention can help shape these experiential influences. There is now neurobiological awareness of the benefits of aerobic activity on cognitive functioning and the significance of early environments and their longterm effects .Acknowledging these processes means children, in regard to neurorehabilitation,

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education, health and those in high risk categories of neglect may receive improved services and better lives.

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