INTRODUÇÃO: A apatia constitui o transtorno neuropsiquiátrico mais prevalente na doença de Alzheimer (DA) e se relaciona com uma série de desfechos deletérios. Sua neurobiologia ainda é pouco compreendida, e alguns autores postulam sua associação com disfunção de circuitos fronto-estriatais. A maior parte da evidência disponível sobre essa relação provém de estudos em que foram avaliados pacientes com DA leve a moderada. OBJETIVO: Investigar a associação entre apatia e disfunção executiva em estágios bastante iniciais do processo de declínio cognitivo no contexto da DA. MÉTODOS: Foram avaliados 87 indivíduos, sendo 28 deles com DA leve, 26 com Comprometimento Cognitivo Leve de subtipo amnéstico (CCLa) e 33 controles. Os participantes foram submetidos a uma bateria de avaliações da qual constavam a Bateria Breve de Rastreio Cognitivo (BBRC-Edu), o Mini-Exame do Estado Mental (MEEM), a Entrevisa Executiva (EXIT-25), a Bateria de Avaliação Frontal (BAF), a Escala de Avaliação de Demência (DRS), o Teste de Aprendizagem Auditivo Verbal de Rey (RAVLT), a Escala de Avaliação de Incapacidade na Demência (DAD) e a Escala de Apatia (EA). Explorou-se correlações entre o desempenho nos testes empregados e os escores aferidos pela EA, nos grupos com comprometimento cognitivo (DA ou CCLa), e em grupos constituídos a partir da combinação deles, considerando os pacientes com CCLa conversores à DA no seguimento. RESULTADOS: O grupo de pacientes com DA apresentava média de idade de 81,9 ± 4,8 anos e escolaridade média de 2,5 ± 2,0 anos. O grupo com CCLa apresentava média de idade de 80,8 ± 3,7 anos e escolaridade média de 3,7 ± 2,8 anos. O grupo dos controles apresentava média de idade de 79,5 ± 3,5 anos e escolaridade média de 3,7 ± 3,3 anos. Os três grupos não se distinguiam significativamente quanto às suas características sociodemográficas. Não foram observadas correlações entre o desempenho em quaisquer dos testes de função executiva empregados e os escores obtidos por meio da EA. Observou-se correlação forte entre o desempenho funcional auferido através da DAD e os escores na EA (rho= -0,7; p<0,001) no grupo DA. Documentou-se correlação moderada entre a sintomatologia apática e o desempenho na subescala Atenção da DRS (rho= -0,59; p<0,01) e em tarefas de evocação tardia nos testes de memória episódica da BBRC (rho=-0,37; p<0,05) e do RAVLT (rho= -0,47; p< 0,001), quando analisados em conjunto os pacientes com DA e aqueles com CCLa que converteram para DA. CONCLUSÃO: Nesta amostra de indivíduos com baixa escolaridade, composta por pacientes com DA leve e CCLa, não se observou associação entre o desempenho em testes de função executiva e a sintomatologia apática medida pela EA / INTRODUCTION: Apathy is the most prevalent neuropsychiatric disorder in Alzheimer disease (AD), and has been related to several deleterious outcomes. Its neurobiology is still poorly understood, and some studies have suggested an association with frontostriatal circuits dysfunction. Most of this evidence comes from studies with mild to moderate AD patients. OBJECTIVE: To investigate the association between apathy and executive dysfunction in the very early stages of cognitive impairment in the context of AD. METHODS: 87 subjects were evaluated, being 28 with mild AD, 26 with amnestic Mild Cognitive Impairment (aMCI) and 33 controls. The participants were submitted to a comprehensively evaluation consisting on the Brief Cognitive Screening Battery (BCSC), the Mini-Mental State Examination (MMSE), the Executive Interview (EXIT-25), the Frontal Assessment Battery (FAB), the Mattis Dementia Rating Scale (DRS), the Rey Auditory Verbal Learning Test (RAVLT), the Disability Assessment in Dementia (DAD), and the Apathy Scale (AS). Correlations were investigated between AS scores and the performance in the cognitive measures within the two cognitively impaired groups (AD or aMCI) and also within combinations of them, considering aMCI convertion to AD. RESULTS: The AD group had mean age of 81.9 ± 4.8 years, and 2.5 ± 2.0 mean years of formal education, while the aMCI group had mean age of 80.8 ± 3.7 years and a mean of 3.7 ± 2.8 years of schooling. Controls were aged 79.5 ± 3.5 years, with 3.7 ± 3.3 years of education. The three groups did not differ statistically from each other regarding the main sociodemographic features. There was no correlation between any executive measure and AS scores. We found strong correlations between AS scores and functional performance evaluated with the DAD (rho= -0.70; p <0.001) in the AD group. There were also modest to moderate correlations between AS scores and DRS Attention subscale (rho= -0.59; p<0.01), and with delayed recall tasks of episodic memory tests from the BCSB (rho=-0.37; p<0.05) and the RAVLT (rho= -0.47 ; p< 0.05), when AD and aMCI converters were analysed toghether as a group. CONCLUSION: In this sample consisting of mild AD and aMCI subjects, with very low educational level, we failed to find any association between executive function tests performance and apathy symptoms measured with the AS

INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associação entre função executiva e grupos de sintomas depressivos no primeiro mês após o acidente vascular cerebral isquêmico e como objetivo secundário investigar a associação entre função executiva e grupos de sintomas depressivos em adultos jovens. MÉTODOS: Foram triados consecutivamente 343 pacientes admitidos na enfermaria da neuroclínica do Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. Fizeram parte o estudo 87 pacientes que preencheram os critérios de inclusão e exclusão e foram incluídos no estudo. Eles foram submetidos aos testes neuropsicológicos que consistiu em: teste Fluência verbal fonêmica para as letras (F.A.S.), Dígitos Ordem Direta e Ordem Inversa, subteste da Escala Weschler de Inteligência para Adultos (WAIS-III-R) e as 03 partes do Stroop Teste. A avaliação psiquiátrica consistiu na entrevista estruturada para o diagnóstico pelo DSM-IV, no manual estruturado para entrevista da Escala Hamilton para Depressão, na versão 31 itens. Nós usamos o Índice de Barthel, para avaliar o comprometimento nas atividades de vida diária e o grau de gravidade do acidente vascular cerebral foi mensurado pela escala para acidente vascular cerebral do Natitonal Institutes of Health.A média do intervalo de tempo entre o AVC e as avaliações foi de 12,4; (dp±3,8) dias. Equações de regressão linear múltipla foram montadas usando os sete domínios dos sintomas depressivos da HAM-D-31 como variável independente e os testes neuropsicológicos como variável dependente. Os resultados foram ajustados para idade sexo e grau de instrução. RESULTADOS: Nós encontramos associação inversa entre o grupo de sintomas depressivos de retardo e o teste de fluência verbal (t=-3,46; p=0,001; IC 95% -4,46:-0,81), e associação positiva com as três partes do Stroop, SR (t=3,32; p=0,002; IC 95% 1,63:6,72), SP(t=3,05; p=0,004; IC 95% 1,68:8,21) e SC (t=3,01; p=0,005; IC 95% 3,22:16,39). Para a subamostra de pacientes com idade 60 anos foi encontrada associação inversa entre o teste de fluência verbal fonêmica (FAS) com o grupo de sintomas retardo ( t= -3,13; p= 0,003; IC 95% -4,72: -1,27). CONCLUSÃO: Nossos resultados suportam a hipótese que a disfunção executiva depressiva descrita para idosos pode ocorrer em pacientes com idade 60 anos e é uma associação específica da função executiva e o grupo de sintomas depressivos de retardo / BACKGROUD: The association between depressive symptoms and cognitive impairment after ischemic stroke has been described in several studies. Recently, studies have focused on the association of depressive symptoms and executive function. Actually, the hypothesis of a Depression Executive dysfunction in stroke patients has been investigated. However, it is not known whether such association occurs with any specific depressive group of symptoms and also if it occurs among the non elderly. Thus, the main objective this study is to investigate the association between executive function and domains of depressive symptoms in the first month after an ischemic stroke. As a secondary objective we investigated whether this association existed for those with below 60 years old. METHODS: We screened 343 patients consecutively admitted to the neurological unit of the Clinics Hospital of the University of São Paulo School of Medicine. Eight seven patients satisfied the inclusion and exclusion criteria and were included in the study. They were submitted to neuropsychological tests including the Phonemic Verbal Fluency for letters (F.A.S.); digits forwards and backwards, the subtest of the Weschler Adult Intelligence Scale (WAIS-III-R) and 3 parts of the Stroop Test. The psychiatric evaluation included the structured Clinical Interview for DSM-IV and the 31-item version of the Hamilton Rating Scale for Depression. We used the Barthel Indices to assess the impairment in activities of daily living and the severity of the stroke was assessed with the stroke Scale of the National Institutes of Health. The mean time interval between the stroke and the assessments were 12.4 (SD±38) days. Equations of multiple linear regression were performed using the seven domains of depressive symptoms of the HAM-D-31 as independent variable and the neuropsychological tests as the dependent variable. Results were adjusted for age, gender and educational level. RESULTS: We found an inverse association between the retardation domain of depressive symptoms and the verbal fluency test FAS (t = -3.46; p = 0.001; 95%CI -4.46, - 0.81) and a positive association with the three parts of the stroop test SR (t = 3.32; p= 0.002; 95%CI 1.63:6.72) SP (t = 3.05; p=0.004; 95% CI 1.68:8.21) and SC (t = 3.01; p = 0.005; 95%CI 3.22:16.39). For the subsample of patients with age 60 years old we found an inverse association between the verbal fluency test (FAS) with the domain of depressive symptoms retardation (t = -3.13; p = 0.003; 95%CI -4 .72: -1.27). CONCLUSION: Our results support the hypothesis that executive depressive dysfunction described for the elderly also occur for stroke survivors with age < 60 years old and that there is a specific association of executive function with the depressive domain of retardation

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-14T18:15:35Z No. of bitstreams: 1 lucienebandeirarodriguesdemelo.pdf: 2519536 bytes, checksum: 8efc05845c9ae6f4510a1fc453949e1b (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:18:10Z (GMT) No. of bitstreams: 1 lucienebandeirarodriguesdemelo.pdf: 2519536 bytes, checksum: 8efc05845c9ae6f4510a1fc453949e1b (MD5) / Made available in DSpace on 2016-09-26T20:18:10Z (GMT). No. of bitstreams: 1 lucienebandeirarodriguesdemelo.pdf: 2519536 bytes, checksum: 8efc05845c9ae6f4510a1fc453949e1b (MD5) Previous issue date: 2011-02-17 / A classificação de função executiva, que corresponde a um sistema gerenciador que tem como atributo organizar uma sequência de ações a fim de atingir um objetivo, tem sido amplamente estudada por dois conceituados autores, quais sejam, Joaquin Fuster e Alan Baddeley. O objetivo deste trabalho teórico é propor uma fusão entre as ideias destes dois neurocientistas. Fuster postulou que a função executiva opera por meio de redes neurais interativas e sobrepostas (cógnitos), distribuídas nos córtices de associação (principalmente o córtex pré-frontal), que alimentam o ciclo percepção-ação, constituindo assim as unidades básicas do processamento executivo. As atividades de ordenação dos cógnitos e programação temporal das ações em novas e complexas sequências de comportamento se dá por meio da integração de estímulos externos (sensoriais) e estímulos internos (memórias), tornando possível a integração temporal de ações para o cumprimento de metas. Fuster divide a função executiva de integração temporal do córtex pré-frontal em três sub-funções cognitivas: ajuste preparatório, controle inibitório e memória de trabalho. Baddeley, por outro lado, propôs o modelo multicomponente para a memória de trabalho (MT) que é composto por um executivo central, uma alça fonológica, um esboço visuoespacial e um buffer episódico. Sendo a atenção um pré-requisito para o armazenamento temporário de uma informação, Baddeley propôs que a MT depende de um sistema atencional de supervisão, o executivo central. Contudo, é possível que o executivo central seja análogo à função de controle inibitório proposta por Fuster, não se caracterizando como um elemento de memória, uma vez que ele não armazena nenhum tipo de informação. Assim, propomos uma nova classificação da função executiva que engloba os modelos de Fuster e de Baddeley. Desta forma, a função executiva (caracterizada pela função de integração temporal), ficaria subdividida em: controle inibitório, ajuste preparatório e memória de trabalho. E a memória de trabalho (que integra a função executiva) seria composta pela alça fonológica, o esboço visuoespacial e o buffer episódico. / The classification of the executive function, which corresponds to a system manager that has the attribute organize a sequence of actions to achieve a goals, has been widely studied by two respected authors, namely, Joaquim Fuster and Alan Baddeley. The objective of this theoretical work is to propose a merger between the ideas of through interactive and overlapping neural networks (learning), distributed in association cortices (especially the prefrontal cortex) that fuel the perception-action and thus constitute the basic units of processing executive. The activities of ordering occurs through the integration of external stimuli (sensory) and internal stimuli (memories), making possible the temporal integration of actions to accomplish goals. Fuster divides the executive function of temporal integration of the prefrontal cortex into three sub-cognitive functions: setting preparatory, inhibitory control and working memory (WM) which consists of a central executive, a phonological loop, a visuospatial sketch and an episodic buffer. Attention being a prerequisite for the temporary storage of information, Baddeley proposed that WM depends on a supervisory attentional system, the executive central. However, it is possible that the central executive function is analogous to the inhibitory control proposed by Fuster, be characterized as a memory element, since it does not store any kind of information. Therefore, we propose a new classification of executive function which includes models Fuster and Baddeley. Thus, the executive function (characterized by the function of integration time), would be subdivided into inhibitory control, set preparatory and working memory. And the working memory (which includes the executive function) would be made by phonological loop, visuospatial sketch and the episodic buffer.

The origins of aggression warrant extensive investigation given its substantial cost to both victims and perpetrators. However, only recently have researchers begun to understand the prevalence and harm associated with relational aggression, which is behaviour intended to damage another person’s feelings, relationships, or social status, such as social exclusion or spreading rumors. Even with this heightened research interest in relational aggression there is a paucity of studies conducted with children prior to age four, the developmental period in which relational aggression begins to emerge. In this dissertation we ascertain what unique lags in development or blossoming capacities coincide with the emergence of both physical and relational aggression during early childhood. In Study 1, we examined differential predictors (sex, age, prosocial behaviour, internalizing problems, and impulsivity) of teacher-rated aggression style (physically aggressive, relationally aggressive, or combined physically and relationally aggressive) among preschoolers (N = 429; M = 41.29, SD = 8.14) using multinomial logistic regression. Being a boy and being higher on impulsivity were both substantial risk factors for use of physical aggression (alone or combined with relational aggression). In Study 2, we explored longitudinal associations between preschoolers’ (N = 126; Mage = 39.15 months, SD = 6.67) assessed language (receptive and expressive vocabulary), parent-rated working memory, and teacher-rated aggression (physical and relational) across one year using an autoregressive cross-lagged panel model. Longitudinally, physical aggression showed stability and both better working memory and previously higher physical aggression predicted higher relational aggression over one year. There were no longitudinal links between language and aggression when simultaneously accounting for working memory in the model, emphasizing the need to account for working memory in this association in future research. In Study 3, using four, separate multivariate multiple regressions, we examined the linear and interactive effects between negative emotionality and several aspects of self-regulation (inhibitory, emotional [soothability], attentional [attention span], and metacognitive [working memory] control) in the prediction of preschoolers’ (N = 198; M = 33.65 months, SD = 5.02) physical and relational aggression. Poorer inhibitory and metacognitive control were associated with higher physical aggression regardless of trait negative emotionality, highlighting the importance of self-regulation rather than emotional reactivity in models of physical aggression. Poorer inhibitory control was also linked to higher relational aggression. Also, negative emotionality was most strongly linked to relational aggression at higher levels of emotional control or attentional control. In summary, the results of the present dissertation support a skill-deficit model of preschool physical aggression (alone or in combination with relational aggression) and both a skill-deficit and developmental advancement model for preschool relational aggression.

Theory of Mind (ToM) refers to the ability to attribute mental states to oneself and other people. In this thesis, I present a new paradigm, the Self/Other Differentiation task, which was designed to assess ToM abilities – specifically, the ability to attribute belief states to the ‘Self' and ‘Other' – in typically developed, healthy adults. By focussing on fully developed ToM abilities, we aimed to increase understanding of how the ToM mechanism is structured and functions in everyday life, and how individual ToM components may differentially relate to executive functioning (EF) abilities. The Self/Other Differentiation task is a computerized false-belief task utilizing a matched- design to allow direct comparison of self-oriented versus other-oriented belief- attribution processes. Using behavioural (response times/error rates) and electrophysiological (EEG) methods, the work presented in this thesis provides evidence of a clear and distinct differentiation in the processing of ‘Self' versus ‘Other' perspectives in healthy ToM. We established a key role of perspective-shifting in ToM, which we hypothesize plays a crucial role in day-to-day communications; shifting from the Self-to-Other perspective was significantly harder (longer and more error prone) than shifting from the Other-to-Self perspective, suggesting that the ‘Self' forms the stem of understanding the ‘Other'. EEG analysis revealed these effects were present across fronto-lateral and occipital-lateral areas of the brain, particularly across the right hemisphere in parietal regions. We provide evidence of these features as universal, core components of the ToM mechanism, with data collected from both Chinese and Western cultures illustrating similar patterns of results. Results regarding the relationship between ToM and EF were mixed, with one study finding that affective EF positively correlates with ToM task performance, whilst non-affective EF does not, and a further two studies finding no such differential relationship. The Self/Other Differentiation task provides the opportunity to establish the features of ‘typical' ToM processes in healthy adults, to further our understanding of how the mature ToM mechanism functions.

Executive functioning skills are paramount to our ability to purposefully and successfully mediate our actions within our day-to-day environment. Dysfunction of the executive system can result in a multitude of behavioral manifestations in all stages of life. Increasing evidence supports the use of rating scales to obtain a more comprehensive and ecologically valid understanding of an individual’s executive functioning. The current thesis involves two articles examining the use of behavioral rating scales in the assessment of executive functions. Study 1: In response to a recent proliferation of executive functions rating scales, this article reviews and discusses currently available scales for the assessment of executive functions across the lifespan. Study 2: This study derived an executive functions screener from the Behavioral Assessment System for Children (BASC-2-SRP-COL) for use in young adults and evaluated it against a well-known executive function rating scale (the Behavior Rating Inventory of Executive Function-Adult Version). / Graduate / 0622 / 0632 / eduggan@uvic.ca

Language may play a key role in determining the relation between motivation and higher-order cognitive processes, as language has been shown to have a motivational function in preschoolers (Chiu & Alexander, 2000) and has also been implicated in the development of executive functioning (Hughes & Graham, 2002). The particular aspect of language which may best serve to connect these processes is self-directed speech (i.e., private speech) as the production of private speech is an indication of language and thought merging to form a new level of cognitive organization (Berk, 1992; Chiu & Alexander, 2000). Determining if the relation between motivational orientations and executive functioning can be mediated by private speech was examined to provide insight into the way in which motivational orientations and cognitive skills are related. In order to explore the role of private speech as a mediator, 4- to 6-year-old children were administered two EF tasks, the Tinkertoy test and the Tower of Hanoi, during which the impact of various reward contingencies on EF performance and self-directed speech elicitation was investigated. Although relations were found between measures of motivation, private speech, and EF performance, private speech did not act as a generative mechanism through which motivation influenced children’s performance on the EF tasks. This study represents the first attempt to explore such a mediational model in this age group and results provide preliminary information about how private speech, motivation, and EF are related with regard to children’s goal directed behaviors.

The default mode network (DMN) consists of a set of interconnected brain regions supporting autobiographical memory, our concept of the self, and the internal monologue. These processes must be maintained at all times and consume the highest amount of the brain’s energy during its baseline state. However, when faced with an active, externally-directed cognitive task, the DMN shows a small, but significant, decrease in activity. The reduction in DMN activity during the performance of an active, externally-directed task compared to a baseline state is termed task-induced deactivation (TID), which is thought to ‘free-up’ resources required to respond to external demands. However, older adults show a reduced level of TID in the DMN. Recently, it has begun to be appreciated that this decrease in TID may be associated with poorer cognitive performance, especially during tasks placing high demands on executive function (EF). Diminished DMN TID has not only been associated with increasing age but also with multiple age-related neurobiological correlates such as accumulating Alzheimer’s disease (AD) pathology and reductions in white matter (WM) connectivity. However, these biological factors—age, WM connectivity reductions and increasing AD pathology—are themselves related. Based on the literature, we hypothesized that declining WM connectivity may represent a common pathway by which both age and AD pathology contribute to diminished DMN TID. Further, we hypothesized that declines in DMN function and WM connectivity would predict poorer in EF. Three experiments were carried out to test these hypotheses. Experiment 1 tested whether WM connectivity predicted the level of DMN TID during a task requiring a high level of EF. Results from 117 adults (ages 25-83) showed that WM connectivity declined with increasing age, and that this decline in WM connectivity was directly associated with reduced DMN TID during the task. Experiment 2 tested whether declines in WM connectivity explained both age-related and AD pathology-related declines in DMN TID. Results from 29 younger adults and 35 older adults showed that declining WM connectivity was associated with increasing age and AD pathology, and that this decline in WM connectivity was a common pathway for diminished DMN TID associated with either aging or AD pathology. Experiment 3 investigated whether measures of WM connectivity and DMN TID at baseline could predict EF measured using clinically-used tests. Results from 29 older adults from Experiment 2 showed that less DMN TID predicted poorer EF at baseline and diminished WM connectivity at baseline predicted a greater decline in EF after 3 years. Further, WM connectivity explained reductions in EF predicted by baseline AD pathology, as well as further reductions in EF not predicted by baseline AD pathology. Together the results of these studies suggest that WM connectivity is a key pathway for age-related and AD pathology-related patterns of diminished DMN TID associated with poorer EF. Further, WM connectivity may represent a potential therapeutic target for interventions attempting to prevent future declines in EF occurring in aging and AD.

The aim of this study was to determine executive function outcomes after an equi-therapy intervention in a group of Tourette syndrome children. Equi-therapy is a new form of therapeutic horse riding, which is related to the stimulation of the vestibular system through sensory integration in the brain. For this study a non-equivalent control group design was implemented. The study consisted of 8 Tourette syndrome children aged between 9 and 15, who were referred after a definite Tourette syndrome diagnosis from various neurologists and paediatricians. Both groups were evaluated on a battery of 6 neuropsychological tests measuring various aspects of executive function before and after receiving the therapeutic horse riding intervention. The tests used were the Wisconsin Card Sorting Test, the Stroop Colour Word Test, the Rey-Osterrieth Complex Figure Test, the Trail Making Test A and B, the Raven’s Standard Progressive Matrices and the Symbol Digit Modalities Test. Qualitative inputs were also included in the study. These consisted of behavioural checklists completed by the participants’ parents, the evaluation of the participants’ copy drawings as ’frontal’ or ’normal’ obtained from the Rey-Osterrieth Complex Figure test, and results of tests that were administered by an occupational therapist as part of the required evaluation for the therapeutic horse riding (equi-therapy) itself. Results of the neuropsychological tests indicated significant differences for the Wisconsin Card Sorting Test, Stroop Colour Word Test and the Symbol Digit Modalities Test, indicating improvements in selective attention, cognitive flexibility, visualspatial constructional ability, visuomotor integration, visual memory and organisational strategies. The qualitative results indicted improvements in emotional and behavioural aspects. Executive abilities are a very complex system and evaluation should always include robust and sensitive neuropsychological tests. It seems as if Tourette syndrome could be directly related to executive dysfunction, but not in a simple manner as aspects may vary due to other more complex factors that may contribute to these dysfunctions. However, for equi-therapy as an alternative form of therapy, the opportunity should not be lost to establish its efficacy because of the possible beneficial outcome. / Thesis (MA (Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

The educational achievement and well-being of looked after children are a priority nationally and locally. The majority of looked after children enter the care system due to abuse and neglect and foster care is the most common placement type (DfE, 2012). Early experience of abuse and neglect is associated with changes to development in the frontal brain regions resulting in executive function difficulty. Executive functions are a collection of interrelated but distinct functions with responsibility for purposeful, goal-directed, problem-solving behaviour (Gioia, Isquith, Guy, & Kenworthy, 2000). Evidence of neural plasticity in the prefrontal cortex suggests executive function development can be supported. The two main methods of support are computer based training, such as in working memory training which yields immediate gains but may not be sustained or generalised (Melby-Lervåg & Hulme, 2013) and ecological executive function interventions, which are promising but are mainly used with pre-school samples (Bryck & Fisher, 2012).Parental involvement in children’s education is promoted nationally (DCSF, 2008) and valued by carers (Cooper & Johnson, 2007). Consultations between carers and professionals can indirectly support fostered children (Osborne & Alfano, 2011) but few studies have evaluated the use of consultation to support executive function development in fostered children (Lansdown, Burnell, & Allen, 2007). A multiple case-study design, with embedded units of analysis, was adopted to qualitatively explore the implementation processes and outcomes of a school-based intervention that adapted conjoint behavioural consultation (CBC) (Sheridan & Kratochwill, 2007) to support executive function development of children in foster care. Both cases consisted of a school-aged fostered child, living in the north west of England, with prior experience of abuse and/or neglect. The participants across cases were two educators and three carers and data gathering consisted of semi-structured interviews and participant-observation. Data analysis utilised thematic analysis (Braun & Clarke, 2006) and a cross-case analysis (Yin, 2009) identified common themes alongside themes pertinent to each case. The findings indicate that an adapted CBC retains the relational objectives which are received positively by participants but outcome objectives are more variable. The limitations of the study and the implications for educational psychologists, stakeholders, and future research are highlighted.