Time-based prospective memory difficulties in children with ADHD and the role of time perception and working memory

Time-based prospective memory (PM) is the ability to remember to perform an intended action at a given time in the future. It is a competence that is crucial for effective performance in everyday life and may be one of the main causes of problems for individuals who have difficulty in planning and organizing their life, such as children with attention deficit/hyperactivity disorder (ADHD). This study systematically examines different aspects of time-based PM performance in a task that involves taking an action at a given future time in a group of 23 children with ADHD who were compared with a matched group of typically-developing (TD) children. The children were asked to watch a cartoon and then answer a questionnaire about its content (ongoing task). They were also asked to press a key every 2 minutes while watching the cartoon (PM task). The relationships of time perception and verbal working memory with PM performance were examined by administering appropriate tasks. The results showed that the children with ADHD were less accurate than the TD children in the PM task and exhibited less strategic time-monitoring behavior. Time perception was found to predict PM accuracy, whereas working memory was mainly involved in time-monitoring behavior, but this applied more to the TD group than to the ADHD group, suggesting that children with ADHD are less able to use their cognitive resources when meeting a PM request.     

Working memory – not processing speed – mediates fluid intelligence deficits associated with attention deficit/hyperactivity disorder symptoms

Attention deficit/hyperactivity disorder (ADHD) is a psychological condition characterized by inattention and hyperactivity. Cognitive deficits are commonly observed in ADHD patients, including impaired working memory, processing speed, and fluid intelligence, the three of which are theorized to be closely associated with one another. In this study, we aimed to determine if decreased fluid intelligence was associated with ADHD, and was mediated by deficits in working memory and processing speed. This study tested 142 young adults from the general population on a range of working memory, processing speed, and fluid intelligence tasks, and an ADHD self‐report symptoms questionnaire. Results showed that total and hyperactive ADHD symptoms correlated significantly and negatively with fluid intelligence, but this association was fully mediated by working memory. However, inattentive symptoms were not associated with fluid intelligence. Additionally, processing speed was not associated with ADHD symptoms at all, and was not uniquely predictive of fluid intelligence. The results provide implications for working memory training programs for ADHD patients, and highlight potential differences between the neuropsychological profiles of ADHD subtypes.     

Perception of speech and nonspeech stimuli by children with and without reading disability and attention deficit hyperactivity disorder

The auditory temporal deficit hypothesis predicts that children with reading disability (RD) will exhibit deficits in the perception of speech and nonspeech acoustic stimuli in discrimination and temporal ordering tasks when the interstimulus interval (ISI) is short. Initial studies testing this hypothesis did not account for the potential presence of attention deficit hyperactivity disorder (ADHD). Temporal order judgment and discrimination tasks were administered to children with (1) RD/no-ADHD (n=38), (2) ADHD (n=29), (3) RD and ADHD (RD/ADHD; n=32), and (4) no impairment (NI; n=43). Contrary to predictions, children with RD showed no specific sensitivity to ISI and performed worse relative to children without RD on speech but not nonspeech tasks. Relationships between perceptual tasks and phonological processing measures were stronger and more consistent for speech than nonspeech stimuli. These results were independent of the presence of ADHD and suggest that children with RD have a deficit in phoneme perception that correlates with reading and phonological processing ability. (c) 2002 Elsevier Science (USA).     

A comparison of working memory profiles in children with ADHD and DCD

The main objective of present study was to investigate whether the patterns of working memory performance differ as a function of attention and motor difficulties, and whether children with ADHD and DCD could be reliably discriminated on the basis of their memory deficits. A related aim was to investigate the link between their working memory profiles and academic attainment. Fifty children with ADHD-Combined, 55 children with DCD, and an age-matched group of 50 typically developing children with average working memory were assessed on standardized measures of working memory, IQ, and academic attainment (reading, spelling, comprehension, and math). The normal controls performed significantly better than both clinical groups on all working memory tests. Specific patterns emerged in the memory profile of the clinical groups: The children with DCD had a depressed performance in all working memory tests, with particularly low scores in visuospatial memory tasks; children with ADHD performed within age-expected levels in short-term memory but had a pervasive working memory deficit that impacted both verbal and visuospatial domains. The clinical groups could reliably be discriminated on the basis of their short-term memory scores. Their learning profiles were similar. It is possible that the working memory profiles of the children with ADHD and DCD are influenced by distinct underlying cognitive mechanisms, rather than a general neurodevelopmental delay. Despite these distinctive patterns of memory performance, both clinical groups performed similarly on academic attainments, suggesting that memory may underlie learning difficulties, independent of related clinical disorders.     

Working Memory Deficits in Boys with Attention-deficit/Hyperactivity Disorder (ADHD): The Contribution of Central Executive and Subsystem Processes

The current study investigated contradictory findings from recent experimental and meta-analytic studies concerning working memory deficits in ADHD. Working memory refers to the cognitive ability to temporarily store and mentally manipulate limited amounts of information for use in guiding behavior. Phonological (verbal) and visuospatial (nonverbal) working memory were assessed across four memory load conditions in 23 boys (12 ADHD, 11 typically developing) using tasks based on Baddeley's (Working memory, thought, and action, Oxford University Press, New York, 2007) working memory model. The model posits separate phonological and visuospatial storage and rehearsal components that are controlled by a single attentional controller (CE: central executive). A latent variable approach was used to partial task performance related to three variables of interest: phonological buffer/rehearsal loop, visuospatial buffer/rehearsal loop, and the CE attentional controller. ADHD-related working memory deficits were apparent across all three cognitive systems--with the largest magnitude of deficits apparent in the CE--even after controlling for reading speed, nonverbal visual encoding, age, IQ, and SES.     

Working memory deficits in boys with attention deficit/hyperactivity disorder (ADHD): An examination of orthographic coding and episodic buffer processes

The episodic buffer component of working memory was examined in children with attention deficit/hyperactivity disorder (ADHD) and typically developing peers (TD). Thirty-two children (ADHD = 16, TD = 16) completed three versions of a phonological working memory task that varied with regard to stimulus presentation modality (auditory, visual, or dual auditory and visual), as well as a visuospatial task. Children with ADHD experienced the largest magnitude working memory deficits when phonological stimuli were presented via a unimodal, auditory format. Their performance improved during visual and dual modality conditions but remained significantly below the performance of children in the TD group. In contrast, the TD group did not exhibit performance differences between the auditory- and visual-phonological conditions but recalled significantly more stimuli during the dual-phonological condition. Furthermore, relative to TD children, children with ADHD recalled disproportionately fewer phonological stimuli as set sizes increased, regardless of presentation modality. Finally, an examination of working memory components indicated that the largest magnitude between-group difference was associated with the central executive. Collectively, these findings suggest that ADHD-related working memory deficits reflect a combination of impaired central executive and phonological storage/rehearsal processes, as well as an impaired ability to benefit from bound multimodal information processed by the episodic buffer.     

Use of peer-mediated intervention in children with attention deficit hyperactivity disorder

The present experiment extended and replicated the use of functional analysis and a peer-mediated intervention to decrease disruptive behavior displayed by children diagnosed with attention deficit hyperactivity disorder in an afterschool program. After determining that the participants displayed off-task behavior maintained by peer attention via a functional analysis, peer-implemented differential reinforcement of other behavior with extinction was effective in reducing participants' off-task behaviors. The use of peers as behavior-change agents is discussed, as are avenues for future research.     

Functional analysis and treatment of elopement for a child with attention deficit hyperactivity disorder

We conducted a functional analysis of elopement in an outdoor setting for a child with a diagnosis of attention deficit hyperactivity disorder. A subsequent treatment consisting of noncontingent attention and time-out was demonstrated to be effective in eliminating elopement. Modifications of functional analysis procedures associated with the occurrence of elopement in a natural setting are demonstrated.     

Executive and attentional contributions to Theory of Mind deficit in attention deficit/hyperactivity disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) in children has been associated with attentional and executive problems, but also with socioemotional difficulties possibly associated with deficits in Theory of Mind (ToM). Socioemotional problems in ADHD are associated with more negative prognoses, notably interpersonal, educational problems, and an increased risk of developing other psychiatric disorders that emphasize the need to clarify the nature of their ToM deficits. In this study, we hypothesized that ToM dysfunction in children with ADHD is largely attributable to their attentional and/or executive deficits. Thirty-one children with ADHD (8–12 years, IQ > 85) and 31 typically developing (TD) children were assessed using executive functions (inhibition, planning, and flexibility) and attentional tasks, as well as two advanced ToM tasks (Reading the Mind in the Eyes and Faux Pas) involving different levels of executive control. Children with ADHD performed more poorly than TD children in attentional, executive function, and ToM tasks. Linear regression analyses conducted in the ADHD group indicated that inhibition scores predicted performance on the “Faux Pas” task the best, while attention scores were the best for predicting performance on the Reading the Mind in the Eyes task. When controlled for inhibition and attentional variables, ToM performance in children with ADHD was actually similar to TD children. Contrarily, controlling for ToM scores did not normalize performance for inhibition and attentional tasks in children with ADHD. This unidirectional relationship suggests that deficits in the EF and attentional domains are responsible for ToM deficits in ADHD, which therefore may contribute to their socioemotional difficulties.     

Sequential evaluation of behavioral treatments and methylphenidate dosage for children with attention deficit hyperactivity disorder

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.     

Agreement of parent and teacher rating scales with comprehensive clinical assessments of attention deficit disorder with hyperactivity

Forty-one clinic-referred children were given the DSM-III diagnosis of attention deficit disorder with hyperactivity (ADD/H) based on structured diagnostic interviews of the child and mother and on two teacher and two parent rating scales. The degree of agreement between diagnostic classification of ADD/H based solely on criterion scores on each rating scale and classification based on the comprehensive clinical assessments that included use of the same rating scaleswas assessed by comparing the ratings of the 41 children with ADD/H to those of 47 clinic-referred children given other diagnoses or no diagnosis. The accuracy of classification was highly similar across scales. Increasing the cutoff score increased the acing true positives. Using the point of intersection of these two curves to choose the optimal cutoff scores resulted in 70–75% accurate classification and 25–30% misclassification of children given clinical diagnoses of ADD/H. This rate of misclassification suggests that rating scales alone should not be used to classify ADD/H for most clinical and research purposes, especially because the method of comparison used in this study favored finding a high degree of correspondence.     

经颅直流电刺激在注意缺陷多动障碍治疗中的应用

经颅直流电刺激(tDCS)治疗注意缺陷多动障碍(ADHD)主要是选取患者的背外侧前额叶(DLPFC)作为刺激区域, 通过调节其皮层兴奋性, 从而缓解其ADHD的症状和改善其受损的认知功能。针对tDCS在ADHD治疗研究中的问题, 未来可从有效性、确定最佳刺激参数、个体差异、不同亚型及与其他疗法联合使用等五个方面来进一步研究。     

Temperamental attention and activity, classroom emotional support, and academic achievement in third grade

The purpose of this study is to examine the interplay of children's temperamental attention and activity (assessed when children were 4-and-a-half years old) and classroom emotional support as they relate to children's academic achievement in third grade. Particular focus is placed on the moderating role of classroom emotional support on the relationship between temperament (attention and activity level) and academic achievement. Regression analyses indicated that children's attention and activity level were associated with children's third grade reading and mathematics achievement, and classroom emotional support was associated with children's third grade reading and mathematics achievement. In addition, classroom emotional support moderated the relation between children's attention and reading and mathematics achievement, such that attention mattered most for reading and mathematics achievement for children in classrooms with lower emotional support. Findings point to the importance of understanding how children's temperament and classroom emotional support may work together to promote or inhibit children's academic achievement.     

Working memory and behavioral inhibition in children with attention-deficit/hyperactivity disorder (ADHD): an examination of varied central executive demands,construct overlap,and task impurity

The stop-signal paradigm is the premier metric of behavioral inhibition in contemporary attention-deficit/hyperactivity disorder (ADHD) research. The stop-signal paradigm’s choice-reaction time component, however, arguably places greater demands on working memory processes (e.g., controlled-focused attention) relative to alternative inhibition metrics (i.e., go/no-go (GNG) tasks), and consequently obscures conclusions about inhibition and working memory deficits in affected children. The current study, therefore, aimed to determine whether shared variance between stop-signal behavioral inhibition and working memory performance in children with ADHD reflects overlap between the working memory and inhibition constructs or insufficient specificity of the stop-signal paradigm. Fifty-five children (8–12 years) with and without ADHD were administered established phonological (PH) and visuospatial (VS) working memory measures, as well as stop-signal and GNG tasks that vary with respect to demands on controlled-focused attention. Although working memory and GNG performance each uniquely predicted children’s inattention, stop-signal task performance was not a significant predictor of unique variance in inattention, above and beyond variance associated with working memory. Collectively, these findings suggest that performance on the stop-signal task, compared to the GNG task, is confounded by greater demands associated with working memory and consequently reflects an impure estimate of the inhibition construct.     

Evaluation of pharmacological treatment of impulsivity in children with attention deficit hyperactivity disorder

We used an assessment that involved competing reinforcer dimensions in a concurrent-schedules arrangement to examine the effects of stimulant medication on impulsivity (i.e., sensitivity of choices to reinforcer immediacy relative to rate, quality, and effort) with 4 students with attention deficit hyperactivity disorder. The assessments were administered in the context of a double-blind, placebo-controlled, counterbalanced reversal design. Reinforcer immediacy was the most influential dimension for 3 of the students and the second most influential dimension for 1 of the students across placebo and medication conditions; medication did not affect these sensitivities.     

Assessment of impulsivity and the development of self-control in students with attention deficit hyperactivity disorder.

We examined a combined approach of manipulating reinforcer dimensions and delay fading to promote the development of self‐control with 3 students diagnosed with attention deficit hyperactivity disorder. First, we administered a brief computer‐based assessment to determine the relative influence of reinforcer rate (R), reinforcer quality (Q), reinforcer immediacy (I), and effort (E) on the students' choices between concurrently presented math problems. During each session, one of these dimensions was placed in direct competition with another dimension (e.g., RvI involving math problem alternatives associated with high‐rate delayed reinforcement vs. low‐rate immediate reinforcement), with all possible pairs of dimensions presented across the six assessment conditions (RvQ, RvI, RvE, QvI, QvE, IvE). The assessment revealed that the choices of all 3 students were most influenced by immediacy of reinforcement, reflecting impulsivity. We then implemented a self‐control training procedure in which reinforcer immediacy competed with another influential dimension (RvI or QvI), and the delay associated with the higher rate or quality reinforcer alternative was progressively increased. The students allocated the majority of their time to the math problem alternatives yielding more frequent (high‐rate) or preferred (high‐quality) reinforcement despite delays of up to 24 hr. Subsequent readministration of portions of the assessment showed that self‐control transferred across untrained dimensions of reinforcement.     

Differences in cognitive control in children and adolescents with combined and inattentive subtypes of ADHD

The aim of the present study was to investigate the ability of children with attention deficit/hyperactivity disorder-combined subtype (ADHD-C) and predominantly inattentive subtype (ADHD-PI) to direct their attention and to exert cognitive control in a forced attention dichotic listening (DL) task. Twenty-nine, medication-naive participants with ADHD-C, 42 with ADHD-PI, and 40 matched healthy controls (HC) between 9 and 16 years were assessed. In the DL task, two different auditory stimuli (syllables) are presented simultaneously, one in each ear. The participants are asked to report the syllable they hear on each trial with no instruction on focus of attention or to explicitly focus attention and to report either the right- or left-ear syllable. The DL procedure is presumed to reflect different cognitive processes: perception (nonforced condition/NF), attention (forced-right condition/FR), and cognitive control (forced-left condition/FL). As expected, all three groups had normal perception and attention. The children and adolescents with ADHD-PI showed a significant right-ear advantage also during the FL condition, while the children and adolescents in the ADHD-C group showed a no-ear advantage and the HC showed a significant left-ear advantage in the FL condition. This suggests that the ADHD subtypes differ in degree of cognitive control impairment. Our results may have implications for further conceptualization, diagnostics, and treatment of ADHD subtypes.