BACKGROUND: Decades of research have firmly established that cognitive health and cognitive treatment services are a key need for people living with psychosis. However, many current clinical programs do not address this need, despite the essential role that an individual\'s cognitive and social cognitive capacities play in determining their real-world functioning. Preliminary practice-based research in the Early Psychosis Intervention Network early psychosis intervention network shows that it is possible to develop and implement tools that delineate an individuals\' cognitive health profile and that help engage the client and the clinician in shared decision-making and treatment planning that includes cognitive treatments. These findings signify a promising shift toward personalized cognitive health.
METHODS: Extending upon this early progress, we review the concept of interindividual variability in cognitive domains/processes in psychosis as the basis for offering personalized treatment plans. We present evidence from studies that have used traditional neuropsychological measures as well as findings from emerging computational studies that leverage trial-by-trial behavior data to illuminate the different latent strategies that individuals employ.
UNASSIGNED: We posit that these computational techniques, when combined with traditional cognitive assessments, can enrich our understanding of individual differences in treatment needs, which in turn can guide evermore personalized interventions.
CONCLUSIONS: As we find clinically relevant ways to decompose maladaptive behaviors into separate latent cognitive elements captured by model parameters, the ultimate goal is to develop and implement approaches that empower clients and their clinical providers to leverage individual\'s existing learning capacities to improve their cognitive health and well-being.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary small vessel disease of the brain characterized by progressive white matter lesions, subcortical infarcts, and cognitive decline. This autosomal dominant disorder is caused by mutations in the NOTCH3 gene located on chromosome 19, resulting in the accumulation of granular osmiophilic material within the walls of small arteries and arterioles. Clinically, CADASIL typically manifests in mid-adulthood with recurrent ischemic events, migraine with aura, mood disturbances, and cognitive impairment. Neuroimaging plays a crucial role in the diagnosis of CADASIL, with characteristic findings including white matter hyperintensities particularly in the anterior temporal lobe and external capsule.

Elizabeth Spelke\'s What Babies Know is a scholarly presentation of core knowledge theory and a masterful compendium of empirical evidence that supports it. Unfortunately, Spelke\'s principal theoretical assumption is that core knowledge is simply the innate product of cognitive evolution. As such, her theory fails to explicate the developmental mechanisms underlying the emergence of the cognitive systems on which that knowledge depends.

Some core knowledge may be rooted in - or even identical to - well-characterized mechanisms of mid-level visual perception and attention. In the decades since it was first proposed, this possibility has inspired (and has been supported by) several discoveries in both infant cognition and adult perception, but it also faces several challenges. To what degree does What Babies Know reflect how babies see and attend?

Core knowledge systems play an important role in theories of cognitive development. However, recent studies suggest that fundamental principles of the object and agent systems can be revised by adults and preschoolers, when given small amounts of counterevidence. We argue that not all core knowledge systems are created equal, and they may be subject to revision throughout development.

Spelke\'s What Babies Know masterfully describes infants\' impressive repertoire of core cognitive concepts, from which the suite of human knowledge is eventually built. The current commentary argues for the existence of a core concept that Spelke claims preverbal infants lack: social goal. Core social goal concepts, operative extremely early in human development, underlie infants\' basic abilities to interpret and evaluate entities within the moral world; such abilities support claims for a core moral domain.

Spelke\'s sweeping proposal requires greater precision in specifying the place of language in early cognition. We now know by 3 months of age, infants have already begun to forge a link between language and core cognition. This precocious link, which unfolds dynamically over development, may indeed offer an entry point for acquiring higher-order, abstract conceptual and representational capacities.

There is no room for pragmatic expectations about communicative interactions in core cognition. Spelke takes the combinatorial power of the human language faculty to overcome the limits of core cognition. The question is: Why should the combinatorial power of the human language faculty support infants\' pragmatic expectations not merely about speech, but also about nonverbal communicative interactions?

Twenty-five commentaries raise questions concerning the origins of knowledge, the interplay of iconic and propositional representations in mental life, the architecture of numerical and social cognition, the sources of uniquely human cognitive capacities, and the borders among core knowledge, perception, and thought. They also propose new methods, drawn from the vibrant, interdisciplinary cognitive sciences, for addressing these questions and deepening understanding of infant minds.

Questions can be raised about the central status that evolutionarily ancient core knowledge systems are given in Spelke\'s otherwise very compelling theory. So, the existence of domain-general learning capacities has to be admitted, too, and no clear reason is provided to doubt the existence of uniquely human cognitive adaptations. All of these factors should be acknowledged when explaining human thought.