Intratask distractibility in hyperkinetic and nonhyperkinetic children

Previous laboratory studies that have either introduced extraneous environmental stimulation or tested children in cubicles have failed to provide support for the common clinical notion that hyperkinetic children are highly distractible. Based on the Rosenthal and Allen (1978) proposal, distractibility was investigated by introducing irrelevant information within the task context. Intratask distractibility was examined by comparing the performance of hyperkinetic and nonhyperkinetic children on a speeded classification task. Errors were measured for responses to slides containing either zero, constant, one varying, or two varying irrelevant stimulus dimensions. Dimensional salience of the three dimensions used in the study was measured for each child. The data indicate that hyperkinetics made more errors than nonhyperkinetics when constant irrelevant or two varying irrelevant dimensions were presented, but the two groups made equal errors when there was no irrelevant information presented within the stimulus array. No group differences in distractibility were found when the irrelevant dimension was low salience. It was concluded that salience of distractors presented within the task context may be useful in specifying the particular task conditions in which hyperkinetic children exhibit high distractibility. This study is based on the first author's Ph.D. thesis in the Department of Psychology, Vanderbilt University, Nashville, Tennessee. The authors wish to thank the many administrators, teachers, and students in the Metropolitan Nashville Public Schools for their cooperation, including Dr. Thomas Vandever, Mr. V. N. Nicholson, Dr. Jesse Cabler, Mrs. Elizabeth Wortham, and Mr. W. J. Officer.     

A review of psychophysiological research with hyperkinetic children

A number of studies have appeared which focus on the issue of whether hyperactive children are psychophysiologically different from normal children and what impact the stimulant drugs may have on psychophysiological characteristics of these children. The present paper reviews these studies under the type of measures that were employed. In general, the results suggest that hyperactive children are probably not under- or overaroused in their resting levels of autonomic functions, although some children may display resting cortical underarousal. However, the findings of studies on the impact of stimulation on autonomic or central functions intimate that some hyperactive children are probably underreactive to environmental stimulation, or are "underarousable." Indeed, where differences between hyperactive and normal children are found in such evoked-response studies, they are consistently in this direction of "underarousability." Results for the effects of stimulant drugs suggest that these drugs energize or increase the "arousal" of these children and enhance the impact of stimulation on the nervous system. The implications of these results for current theories of hyperactivity and for future research are discussed.     

Comparing psychological and pharmacological treatments for hyperkinetic boys and their classmates

This study compares the short-term effects of methylphenidate and of teacher consultation on the on task behavior of diagnosed hyperkinetic outpatient boys and selected classmates. Statistically significant treatment effects were found for both drug treated and behaviorally treated hyperkinetic boys; the size of these effects did not differ between the two types of treatment. Within the behavioral group, the treatment effect spilled over, so that there was also a significant treatment effect on overactive classmates of the behaviorally treated hyperkinetic children and a trend toward a significant treatment effect on their average classmates. Some implications of the findings are discussed.This study was supported by grant number MH-22659 from the National Institute of Mental Health.     

Biasing of hyperkinetic behavior ratings by diagnostic reports

Two preschool children, one hyperkinetic and one normal, were observed by 4 pairs of raters over a 10-day interval Raters who were given diagnostic reports suggesting hyperkinesis in the child they observed produced significantly higher ratings of hyperkinesis on a published, somewhat objective, rating scale than raters who were not provided with diagnostic reports. In addition, it was found that the level of perceived hyperkinesis decreased over successive ratings. The results of the study are discussed in terms of the potential impact of diagnoses on hyperkinetic children and the implications for intervention studies.The authors would like to extend their appreciation to the students who so ably served as raters in the present study and the staff of the Precision Positive Early Education Program, in which the research was conducted.     

Waking ultradian rhythms of performance and motility in hyperkinetic and normal children

Waking ultradian rhythms in a visual performance task (detections and false positives) and in motility (global body movements and segmental limb movements during the task, and segmental limb movements during off-task periods) were examined in groups of nonmedicated hyperkinetic (HK) children (N = 11) and matched normal controls (N = 11). Testing was conducted for 5 minutes every 15 minutes (with 10-minute "rest periods") over a 6-hour period on 2 consecutive days. Increased limb movement (p less than .01) during off-task periods on both days. Increased limb movement in HK subjects during the task was marginally significant (p less than .06) on one day. False positives and global body movements failed to differentiate the groups. With regard to ultradian rhythmicity, some subjects in both groups showed evident ultradian peaks, which were present across a wide range of frequencies in one or more variables. There were no significant differences in the incidence of the period of evident ultradian peaks between the two groups.     

Predicting the response of hyperkinetic children to stimulant drugs: A review

The present review examines 36 previous research reports involving over 1,400 hyperkinetic children in an effort to determine which variables have proven useful in predicting which hyperkinetic children will respond favorably to stimulant drugs. The research is summarized under eight types of predictor variables: (1) psychophysiological, (2) neurological, (3) familial, (4) demographic/sociological, (5) diagnostic category, (6) parent/teacher/clinician ratings, (7) psychological, and (8) profile types. The results of this review indicate that, to date, measures of attention span or concentration and its correlates have proven to be the most useful predictors of the response of hyperactive children to drugs. The results also suggest that hyperkinetic children are heterogeneous with respect to levels of CNS arousal and that this variable may prove useful in predicting their response to stimulant drugs. Problems involved in drawing conclusions in a review of this area of research as well as directions which future research might pursue also are briefly discussed.     

Involuntary vocalisations and a complex hyperkinetic movement disorder following left side thalamic haemorrhage

A variety of involuntary speech phenomena as for example palilalia have been described as consequences of neurological disorders. Palilalia is the involuntary repetition of syllabels, words and phrases in ongoing speech. We describe a 73 year old woman who suffered from a hypertensive thalamic haemorrhage. MRI revealed that the lesion was predominantly located within the pulvinar, extending to the lateroposterior thalamic nuclei and to the pretectal area with possible involvement of the medial geniculate body. Few months after the event she developed involuntary vocalisations with whole words and meaningless syllables being rapidly reiterated. In contrast to typical palilalia these vocalisations were not meaningfully related to the ongoing speech of the patient. In addition, the patient developed a complex hyperkinetic movement disorder with right-sided painful hemidystonia and bilateral clonic jerks and a right-sided postural tremor.     

Peer and self-rating: Children's perception of behavior relevant to hyperkinetic impulse disorder

Children answered a yes/no 50-item questionnaire on child behavior for each of 23 classroom peers. Cluster analysis of the data facilitated the organization of the items into six scales, each of which showed high internal consistency. The emergence of a cluster of items corresponding to the clinical concept of hyperkinetic impulse disorder was particularly clear, and the derived scale showed substantial convergent and discriminant validity when peer and self ratings were compared. This finding refutes the view that hyperactivity is merely a pejorative term used by adults about child behavior. Clusters describing clearly approved and disapproved behavior (Popular and Bully) did not show such validity. Crossvalidation of peer ratings against those of teachers and parents, on previously defined measures, was more limited. However, the higher correlation between peer and teacher ratings of behaviors relevant to hyperactivity than between peer and parent or teacher and parent ratings supports the view that hyperactiveinattentive behavior is determined interactively by the person and the situation, rather than being a context-general trait.This article is based on a paper presented to the 14th Annual Conference of the Australian Psychological Society, Hobart, Tasmania, August 1979. Preparation of the paper was supported by the Nuffield Foundation, England.     

Relative efficacy of methylphenidate and behavior modification in hyperkinetic children: An interim report

Children reported to be hyperactive in school and with behavior difficulties at home were randomly assigned to methylphenidate, behavior therapy and placebo, or behavior therapy with methylphenidate for an 8-week period. Rating scales were obtained from teachers and parents. Independent blind observers rated childrens' classroom behavior on a weekly basis. A behavior therapy program was implemented in the home and at school. Methylphenidate dosage was individualized. Ratings of behavior deviance were significantly reduced by all treatments. However, a significant advantage for the groups receiving methylphenidate was found over the group receiving behavior therapy and placebo. No significant differences between methylphenidate alone and methylphenidate combined with behavior therapy were obtained. Global ratings of improvement done by teachers favored the combined treatment of behavior therapy and methylphenidate over behavior therapy and placebo. No differences among treatments were found in the mothers' global ratings of improvement. The results indicate that though all three treatments were effective, methylphenidate was significantly superior to behavior therapy alone.This study was supported in part by grant MH 18579, and by grant No. 3-621 from the Long Island Jewish-Hillside Medical Center. The authors wish to thank the behavior therapists, Drs. Jeffrey Felixbrod and Marion Pheterson, as well as Ms. Patricia Ramsey, who was responsible for data analysis.     

The effects of methylphenidate on various types of activity level and attention in hyperkinetic children

The effects of methylphenidate on a number of objective measures of activity level and attention were assessed on three repeated occasions in four types of settings: free play, movie viewing, testing, and restricted play periods. Subjects were 36 boys between 5 and 12 years of age and of average intelligence. Of these, 18 were diagnosed as hyperkinetic and participated in a double-blind drug-placebo crossover design. The remaining 18 boys, matched in age and IQ with the hyperkinetic children, served as a control group and received no drugs. Results indicated that compared to placebo, methylphenidate significantly reduced wrist, ankle, locomotor, and seat movement activity in the hyperkinetic children regardless of the type of setting in which the measures were taken. Relatively fewer significant drug effects were noted on the measures of concentration or attention. While concentration to reaction time, maze performance, and a movie viewing task improved during drug treatment, the length of attention to toys in free play was not significantly improved. Parental ratings of activity level were also improved by the drug. The hyperkinetic children were also observed to increase their level of task-irrelevant activity over time while control children remained relatively stable in activity over repeated assessment. Despite the positive drug effects, clinical observations suggested that methyl-phenidate may have reduced the interest of some children in their environment.     

The acute effects of caffeine on evoked response,vigilance, and activity level in hyperkinetic children

Seventeen hyperkinetic children who had previously responded to sympathomimetic amines were given three different dosages of caffeine in counterbalanced order (placebo, and low and high doses equivalent to one and three cups of coffee). One hour following ingestions they were tested, double-blind on measures of visual evoked response, alpha time, vigilance, and activity level. There was a significant effect on evoked response. The behavioral measures tended to be affected in a dose-related manner but not to a statistically significant degree. It is concluded that although centrally active, caffeine does not show the congruence between behavioral and central effects that other stimulants useful in behavioral management have shown.     

Agoraphobia and the hyperventilation syndrome

One of the causes of agoraphobic complaints is the fear of having an attack of physical complaints in public places. The Hyperventilation Syndrome (HVS) with its diverse symptoms seems to fit well in this model. Hyperventilation symptoms are threatening, because for most subjects they occur unexpectedly and without a clear reason. An investigation was made into how often the HVS and the agoraphobic syndrome appeared together and into the causal relationship between both syndromes. About 60% of the agoraphobic patients suffered from hyperventilation complaints and about 60% of the HVS patients were agoraphobic. Most patients mentioned the fear of having an attack as an important reason for their agoraphobic complaints, and this applied especially in the case of the HVS.     

Near-death experiences and the physio-kundalini syndrome

Near-death experiences (NDEs), transcendental experiences on the threshold of death with profound implications for both patient care and religious belief, have been hypothesized to be related to the awakening of a biological process known in Eastern traditions as kundalini. In a test of this proposed association between kundalini and NDEs, a sample of near-death experiencers acknowledged significantly more symptoms of a physio-kundalini syndrome than did control subjects.This article is based in part on a presentation at the First Annual Symposium of the Kundalini Research Network in Watsonville, California, on June 18, 1992.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder

Lambek, R., Trillingsgaard, A., Kadesjö, B., Damm, D. & Thomsen, P. H. (2010). Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder. Scandinavian Journal of Psychology 51, 540–447. The aim of the present study was to examine gender differences in children with inattention, hyperactivity, and impulsivity on the Five to Fifteen (FTF) parent questionnaire. First, non‐referred girls (n = 43) and boys (n = 51) with problems of attention and hyperactivity‐impulsivity and then clinic‐referred girls (n = 35) and boys (n = 66) with hyperkinetic disorder (HKD) were compared on the FTF. Results suggested that non‐referred boys were more hyperactive‐impulsive than non‐referred girls, whereas clinic‐referred boys and girl with HKD were more similar than dissimilar on the FTF questionnaire. Secondly, it was examined whether the application of gender mixed norms versus gender specific norms would result in varying proportions of clinic‐referred children with HKD being identified as impaired on the subdomains of the FTF questionnaire. Based on results it was concluded that the use of a gender mixed normative sample may lead to overestimation of impairment in boys with HKD, but the type of sample applied to define impairment on the FTF should depend on the purpose for applying the questionnaire.