The relative effects of classwide peer tutoring and peer coaching on the positive social behaviors of children with ADHD

This study investigates the effects of Classwide Peer Tutoring (CWPT) and peer coaching on the peer social behaviors of children with ADHD. A single-subject, multiple-baseline design is used with three elementary-school students in Grades 3 and 4. Following a baseline period, CWPT is implemented in each student's classroom. During the second intervention phase, CWPT is continued and peer coaching is added. Peer social behaviors are observed in both academic and social settings, with a primary focus on intervention effects on the latter setting. Results suggest that students participating in CWPT are actively and positively engaged with their peers while carrying out the CWPT program in the academic setting. However, when only CWPT is implemented, increases in positive peer social behaviors are not observed in social settings. The addition of peer coaching results in enhanced social behaviors during recess and lunch.     

WISC-IV and WISC-III profiles in children with ADHD

Wechsler Intelligence Scale for Children, 3rd and 4th editions (WISC-III n = 586 and WISC-IV n = 118), profiles were compared for children with ADHD and normal intelligence. Mean Verbal Comprehension Index (VCI) and Perceptual Organization/Perceptual Reasoning Index (POI/PRI) scores were significantly higher than Freedom From Distractibility/Working Memory Index (FDI/WMI) and Processing Speed Index (PSI), and Symbol Search was higher than Coding. FDI/WMI and PSI scores were similar on both tests, but VCI and POI/PRI were higher on the WISC-IV than on the WISC-III. Therefore, index discrepancies were greater for the WISC-IV, suggesting that the WISC-IV might be better than the WISC-III in delineating the strengths and weaknesses of children with ADHD. All children in the WISC-IV sample scored lowest on WMI or PSI, whereas only 88% of the WISC-III children scored lowest on FDI or PSI. Thus, the WISC-IV may be more helpful in diagnosing ADHD than the WISC-III.     

Time reproduction in children with ADHD: motivation matters.

The primary goal of this study was to examine whether children with ADHD have a true deficit in subjective time sense, or whether their impairment reflects a motivational deficit. Thirty children with ADHD and 30 matched control children completed two versions of a time reproduction paradigm ("Regular" and "Enhanced") in which motivational level was manipulated by the addition of positive sham feedback and the prospect of earning a reward. A secondary goal was to investigate performance on measures of working memory and behavioural inhibition, and how those constructs relate to time reproduction in the context of Barkley's (1997a) model of ADHD. Children with ADHD performed significantly better on the motivating 'Enhanced' versus the Regular time reproduction paradigm, although they continued to perform significantly worse than controls on both tasks. Control children exhibited no reliable change in performance between versions of the task. Significant group differences were also observed on the working memory and behavioural inhibition tasks. We discuss the impact of motivation, working memory, and behavioural inhibition on time reproduction performance.     

Classroom behavior and children with mental retardation: Comparison of children with and without ADHD

Thirty-four children (ages 6–12 years) with moderate to borderline mental retardation were studied in a laboratory classroom setting to determine whether children identified as having attention deficit hyperactivity disorder on the basis of Conners Questionnaires differed in classroom behavior. Half of the children scored 15 or greater on both the Parent and Teacher Conners; the remaining children scored 11 or less. All were participants in a Saturday Education Program serving children with mental retardation. Direct observation of the laboratory classroom documented significant differences between groups on measures of on-task behavior and fidgetiness, especially during situations where little direct teacher feedback or supervision was available. Saturday Education Program staff, while blind as to group designation, rated the two groups as differing significantly on all scales of two standardized behavior problem checklists. Checklists by parents and teachers appear to be valid measures of classroom behavior of children with moderate to borderline mental retardation.This research was supported by a grant to the first author from the National Institutes of Child Health and Human Development, U.S. Department of Health and Human Services, grant No. 1R29HD26186-01A1. The authors gratefully acknowledge the assistance of the staff of Children's Hospital of Pittsburgh's Saturday Education Program: Nancy Hall, Aimee Hart, Phyllis Loeffler, Robin Nelson, Christina Poljak, Kelley Sacco, Sarah Stewart, and Mary Zuberbuehler.     

Heterogeneity in ADHD: Neurocognitive predictors of peer,family, and academic functioning

Childhood attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in peer, family, and academic functioning. Although impairment is required for diagnosis, children with ADHD vary significantly in the areas in which they demonstrate clinically significant impairment. However, relatively little is known about the mechanisms and processes underlying these individual differences. The current study examined neurocognitive predictors of heterogeneity in peer, family, and academic functioning in a well-defined sample of 44 children with ADHD aged 8–13 years (M = 10.31, SD = 1.42; 31 boys, 13 girls; 81% Caucasian). Reliable change analysis indicated that 98% of the sample demonstrated objectively-defined impairment on at least one assessed outcome measure; 65% were impaired in two or all three areas of functioning. ADHD children with quantifiable deficits in academic success and family functioning performed worse on tests of working memory (d = 0.68 to 1.09), whereas children with impaired parent-reported social functioning demonstrated slower processing speed (d = 0.53). Dimensional analyses identified additional predictors of peer, family, and academic functioning. Working memory abilities were associated with individual differences in all three functional domains, processing speed predicted social functioning, and inhibitory control predicted family functioning. These results add to a growing literature implicating neurocognitive abilities not only in explaining behavioral differences between ADHD and non-ADHD groups, but also in the substantial heterogeneity in ecologically-valid functional outcomes associated with the disorder.     

Risky decision-making in children with and without ADHD: A prospective study

Learning from past decisions can enhance successful decision-making. It is unclear whether difficulties in learning from experience may contribute to risky decision-making, which may be altered among individuals with attention-deficit/hyperactivity disorder (ADHD). This study follows 192 children with and without ADHD aged 5 to 10 years for approximately 2.5 years and examines their risky decision-making using the Balloon Emotional Learning Task (BELT), a computerized assessment of sequential risky decision-making in which participants pump up a series of virtual balloons for points. The BELT contains three task conditions: one with a variable explosion point, one with a stable and early explosion point, and one with a stable and late explosion point. These conditions may be learned via experience on the task. Contrary to expectations, ADHD status was not found to be related to greater risk-taking on the BELT, and among younger children ADHD status is in fact associated with reduced risk-taking. In addition, the typically-developing children without ADHD showed significant learning-related gains on both stable task conditions. However, the children with ADHD demonstrated learning on the condition with a stable and early explosion point, but not on the condition with the stable and late explosion point, in which more pumps are required before learning when the balloon will explode. Learning during decision-making may be more difficult for children with ADHD. Because adapting to changing environmental demands requires the use of feedback to guide future behavior, negative outcomes associated with childhood ADHD may partially reflect difficulties in learning from experience.     

Stimulation seeking and hyperactive behavior in children with ADHD: a re-analysis

To examine the stimulation-seeking function of hyperactivity in children with ADHD, Antrop and colleagues analyzed the behavior of 30 hyperactive and 30 nonhyperactive children during a waiting situation, either with or without extra stimulation. The behavior was assessed by frequency measures. In their study it was hypothesized that children with ADHD would show a greater decrease in activity in the presence of stimulation than control children. Since confirmation for this hypothesis was only found for 2 of 25 target behaviors, the present re-analysis included other behavioral measures to assess two relationships: first, how hyperactivity varies under fixed time conditions, using measures of duration and intensity of behavior instead of frequency measures, and second, how the perceived duration of waiting time affects behavior. Analysis indicated that children with ADHD showed a greater decrease in behavior in the presence of stimulation for touching objects and movements of trunk, as reported. Further, children who underestimated the waiting period were more apt to seek additional stimulation in its absence than those who overestimated the waiting period.     

Verbal fluency in children with ADHD: Strategy using and temporal properties

Verbal fluency tasks are commonly used in cognitive and developmental neuropsychology in assessing executive functions, language skills as well as divergent thinking. Twenty-two typically developing children and 22 children with ADHD between the ages of 8 and12 years were examined using verbal fluency tasks, prepotent response inhibition, and working memory tests. The clinical group showed impaired inhibitory and spatial working memory processes. We used different qualitative analyses of verbal fluency tasks to explore the lexical and executive strategies (word clustering and switching), and the temporal properties of the responses. Children with ADHD had a leeway in applying relevant lexical or executive strategies related to difficulties in strategy using. The reduced efficiency of children with ADHD in semantic fluency task is based on suboptimal shifting between word clusters and is related to the lack of ability of producing new clusters of items. The group difference appeared at the level of accessing and/or activating common words; however, the executive process of searching the lexicon extensively is intact.     

Beliefs about personality change and continuity

Lay conceptions of personality change and continuity were examined in a sample of 112 undergraduates. Participants rated their personal change over 5 years (past or future), the change they perceived to be normative over 10-year age spans between 15 and 65, their beliefs about whether personality is fixed or malleable (“lay theories”) and their beliefs about the causes of personality change and continuity. Beliefs about normative personality change generally corresponded to research evidence on adult trajectories of the Big Five factors, with some age bias, whereas recalled and anticipated personal change tended to be more positive than these norms. Participants tended to endorse environmental causes more for personality change than for continuity. Lay theories were not consistently associated with these causal beliefs, or with beliefs about personal and normative change.     

Evidence for specificity of ERP abnormalities during response inhibition in ADHD children: A comparison with reading disorder children without ADHD

Executive function and working memory deficits are not only present in ADHD, but also in reading disorder (RD). Here, high-density ERPs were recorded during the Stop Signal Task in 53 children and adolescents: An ADHD-combined type group, a group with RD, and a healthy control group. The ADHD-C group displayed unique abnormalities of the frontal N200. Both healthy controls and RD groups showed a success-related right frontal N200 modulation, which was absent in the ADHD group. Second, for Success Inhibition trials, the ADHD-C had smaller right frontal N200 waves relative to healthy controls, while the RD group did not. In contrast, NoGo-P3 abnormalities were present both in the ADHD-C and RD groups. Impaired early response inhibition mechanisms, indexed by the frontal N200, appear to be limited to ADHD-C. In contrast, deficits in later cognitive control and error monitoring mechanisms, indexed by the NoGo-P3, appear to be present in both conditions.     

Evaluation of sensorimotor training in children with ADHD

Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.     

Complex prospective memory in children with ADHD.

The ability to remember intentions (prospective memory) is fundamental to the organization of goal-directed actions in everyday life. Successful prospective remembering involves forming, retaining, initiating, and executing an intention. Although previous research has demonstrated prospective memory impairments in children with attention deficit/hyperactivity disorder (ADHD), this has largely focused on the intention initiation and execution stages. In this study, we investigate the performance of 20 children with ADHD and 20 matched controls at each of the four stages of prospective memory, using a computer multitask paradigm. Results suggest that children with ADHD may demonstrate difficulties forming delayed intentions, as indicated by impulsive planning, and that this may have further implications for the retention and implementation of these delayed intentions. While children with ADHD showed comparable multitask switching, this appeared to be at the expense of intention execution as they made more performance errors than controls. Implications for day-to-day functioning are discussed.     

Assessing ADHD and comorbid disorders in children: the Child Behavior Checklist and the Devereux Scales of Mental Disorders

Evaluated discriminant validity and clinical utility of selected subscales of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) and the Child Behavior Checklist (CBCL; Achenbach, 1991a) in 228 children referred to a clinic for the evaluation and treatment of attention deficit hyperactivity disorder (ADHD). The DSMD is a multiaxial behavior rating scale that measures symptomatology for a broad range of child psychopathology as described in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-R-III] and 4th ed. [DSM-IV]; American Psychiatric Association, 1987, 1994). Discriminant function analyses as well as sensitivity, specificity, and predictive power analyses were computed to evaluate the discriminant validity and clinical utility of selected DSMD and CBCL subscales for assessing ADHD, oppositional defiant disorder (ODD), and anxiety disorders. Results indicated that the DSMD compared very favorably with the CBCL in the ability to discriminate between children with ADHD and those without ADHD and between children with comorbid ODD and anxiety disorders and children who did not meet criteria for these disorders. The DSMD Attention subscale may be somewhat better at ruling in ADHD combined subtype (ADHD-C) and ADHD inattentive subtype (ADHD-I) than the CBCL Attention Problems subscale, but the CBCL Attention Problems subscale may have slightly better utility than the DSMD Attention subscale in ruling out these subtypes. Both the CBCL and DSMD were more useful for ruling out than for ruling in ODD and anxiety disorders.