An analysis of the hyperactive syndrome: A comparison of hyperactive,behavior problem,asthmatic, and normal children

In an attempt to determine whether the commonly described deficits associated with hyperactivity — inappropriate activity, short attention span, low frustration tolerance, and impulsivity — are unique to this population, hyperactive, behavior problem, asthmatic, and normal control children were studied. The tests most often used in research with hyperactives were administered. Hyperactives, when compared to normals, did show deficits in the aforementioned areas. However, when compared to the behavior problem and asthmatic children only the attentional deficits clearly differentiated hyperactives from the other children.This research was supported, in part, by grants from the Ontario Ministry of Health (DM-304) and the Ontario Mental Health Foundation (#652-76A).     

Effects of event rate and display time on sustained attention in hyperactive,normal, and control children

Two experiments were conducted to determine whether hyperactive boys have a unique deficit in sustained attention. Groups with DSM-III diagnoses of attention deficit disorder (ADDH), conduct disorder (CD), ADDH+CD, and learning disorder were compared with normal controls on the Continuous Performance Task. In Experiment 1, stimulus presentation rate (stimulus onset asynchrony, SOA) and display time were varied to manipulate attentional demand, and speed and accuracy of performance were measured. The ADDH group was uniquely affected, with less accurate performance at the fastest and slowest SOA. To distinguish the effects of time on task and SOA, the duration of each SOA condition was held constant in Experiment 2. The poorer performance of the ADDH group at the fastest SOA was no longer evident. This finding indicates that the deficit of sustained attention in boys who have ADDH is associated with a greater susceptibility to refractory effects, which is influenced by practice.This research was supported by the Ontario Mental Health and Ruth Schwartz Foundations through a graduate fellowship awarded to P. Chee and a research grant to R. Schachar, G. Logan, and R. Wachsmuth. Dr. Schachar was also supported by the Canadian Psychiatric Research Foundation. This article is based, in part, on a doctoral dissertation submitted by the first author to the Ontario Institute for Studies in Education. The authors thank Dr. John Lovering and the staff of the Departments of Psychiatry and Psychology, The Hospital for Sick Children, for their cooperation in the conduct of this study. This paper was prepared with the assistance of the Medical Publications Department, The Hospital for Sick Children, Toronto.     

Production deficiencies in free recall: A comparison of hyperactive,learning-disabled,and normal children

Free recall of weakly categorizable words was compared in hyperactive (ADDH), reading-disabled, and normal boys. During a baseline trial, hyperactive boys recalled fewer words and showed less category organization than both reading-disabled and normal boys. Following a manipulation designed to encourage semantic encoding of words, hyperactive boys showed an immediate improvement in item recall and organization so that their free-recall performance was similar to that of reading-disabled and normal children. During later trials of a multiple-trial format, hyperactive boys recalled fewer words than did the reading-disabled and normal boys, despite maintaining equality in category organization. Rather than lacking the skill to use semantic organization as a strategy in free recall, hyperactive boys had difficulty in spontaneously generating the organizational strategy in response to instructions to remember and sustaining sufficient effort to task completion.     

Focused attention in pervasively hyperactive children

This experiment was designed to investigate the hypothesized distractibility of hyperactive children in a focused attention task. Distractibility was defined in terms of Shiffrin and Schneider's model of focused attention as the ability to ignore irrelevant in favor of relevant information. Failure to inhibit processing of irrelevant information indicates a focused attention deficit. Task efficiency in all children decreased when irrelevant information was presented. The mean reaction time, within-subject variance of reaction time, and error percentage all increased compared with a nondistraction condition. Thus, the demands of focused attention, as formulated in the model, were measured optimally. Since hyperactives and controls did not differ significantly with respect to task efficiency in the distraction condition, a focused attention deficit in hyperactives was not demonstrated. The hyperactives did nevertheless make more errors and their responding was more variable than the controls. However, the difference in error percentages between hyperactives and controls was associated with the difference in IQ. It is speculated that the variable responding in hyperactives is caused by a less optimal state of performance unrelated to distractibility.The authors wish to thank L. Leertouwer for making the drawings. This research was supported by grants from the Netherlands Foundation for the Advancement of Pure Research (ZWO) and the Professor Duijker Fund.     

Auditory attention switching in hyperactive children

The ability to rapidly reorient attention in the auditory modality was studied in hyperactive children. Hyperactive and nonhyperactive subjects matched on age, sex, and IQ listened to dichotically presented lists for prespecified targets. Reorientation was studied by comparing performance on trials requiring subjects to reorient their attention during a list to performance on trials requiring no switching of attention. The results indicate that although nonhyperactive children were temporarily disrupted by the switch, they eventually reoriented to the cued ear. In contrast, once hyperactive children were disrupted by the switch, they did not reorient to the cued ear. As the pattern in performance comparing hyperactive and nonhyperactive subjects resembles the pattern previously found in comparing younger and older subjects, these results are consistent with the hypothesis that the auditory reorientation skills of hyperactive children are developmentally immature.     

Laterality and selective attention in hyperactive children

Laterality and selective attention were investigated in a group of 20 hyperactive children and their matched controls using a dichotic listening task. There was a strong rightear advantage for both groups indicating that hyperactive children were not different from normal children in hemispheric specialization for verbal stimuli. In the selective attention experiment hyperactive children were again not different from normal children in their ability either to select the input designated as relevant or to resist the distraction of input designated irrelevant. Both groups gave more correct responses from the right ear than from the left ear, and more intrusions from the right ear than from the left. The results do not suggest abnormalities of lateralization for verbal material or indicate the existence of a selective attentional deficit. It is suggested that such reported deftcits may be situation or taskspecific.     

A divided attention experiment with pervasively hyperactive children

Task performance of 12 pervasive hyperactives and controls was studied in a divided attention reaction time experiment. The two groups differed with respect to task efficiency. The hyperactives were slower than controls, had more variable reaction times, and made more frequent errors. Task inefficiency could not be explained by a deficiency in divided attention or impulsive responding in the hyperactive group. Further, the observed differences in IQ between the groups could not account for the differential performance finding. It is concluded that input and/or output processes, probably in combination with energetical factors, might be disturbed in hyperactive children.The authors wish to thank L. Leertouwer for making the drawings, and the students Ellie Wekking and Sipke Boorsma for their selection procedure work. This research was supported by a grant from the Netherlands Foundation for the Advancement of Pure Research (ZWO) and by the Professor Duijker Fund.     

Incidental learning,distraction, and sustained attention in hyperactive and control subjects

Thirty-two children designated as hyperactive (ADD) were compared with an equal number of control subjects who were matched for age, sex, and verbal IQ. The subjects were tested on (1) a component selection task, measuring serial memory and incidental learning and (2) a cancellation task, assessing attentional variables and distractibility. No straightforward group differences were found on the component selection task, whereas hyperactive subjects made more omission and commission errors than controls on the cancellation task. It was concluded that a deficit in sustained attention and impulsivity best described the group differences. Age was also found to influence performance on a number of variables, including incidental learning on the component selection task and response rate and omission errors on the cancellation task. Because subjects in the hyperactive group were rated as extreme on a number of subscales not necessarily related to hyperactivity, the data were reexamined by multiple regression analyses. Subscales considered to be related both to hyperactivity and to conduct disorder were associated with different performance variables, indicating that each of these subscales provided some unique information.This study was supported by a grant from the Medical Research Council of New Zeland to the first author. The authors would like to thank the pupils and staff of Mt. Eden Normal Primary School and Newmarket School for taking part in the study, and the Auckland Education Board for granting approval for the study. We also thank Prof. J. S. Werry, Dr. J. Reeves, and Mrs. G. Elkind for assistance in locating some of the control subjects. Special thanks goes to Gail Elkind for assistance with the statistical analysis.     

Relation of attention control and school performance in normal children

This study examined the relation of attention control and school performance in a sample of 113 school children (51 boys, 62 girls), ages 9 to 12 years (M = 10.86, SD = 0.91). Children and parents completed the Attention Control Scale for Children, which measures children's ability to focus and shift attention, and also a scale for assessing symptoms of Attention-Deficit Hyperactivity Disorder. Teachers provided a global rating of children's school performance. Analysis indicated that attention control correlated positively with school performance.     

Visual and auditory attention performance in hyperactive children: Competence or compliance

The effect of self-control and compliance on the attentional performance of hyperactive children was assessed. Visual and auditory attention tasks were presented in conditions in which the experimenter was either absent and therefore not imposing external control, or present and therefore imposing some degree of control. There was no difference in performance between hyperactives and controls when the experimenter was present, but the hyperactives' performance showed a greater deterioration than controls when the experimenter was absent. The amount of movement displayed during the tasks was greater for hyperactives and increased more for this group during experimenter-absent conditions. The results support the contention that noncompliance is a major contributor to the poor performance of hyperactive children, which can be seen as an application deficit rather than an ability deficit. These findings have relevance for the current debate on the association between hyperactivity and conduct disorder, and from an applied perspective they serve to stress the importance of situational contributors to the problem behaviors of hyperactive children.     

Dextroamphetamine and placebo practice effects on selective attention in hyperactive children

Three groups of three boys referred to a hospital study unit for evaluation of hyperactive behavior were tested on a classification task involving selective attention while on either dextroamphetamine (D) or placebo (P). In two sessions, groups had D first, P second (DP), or PD, or PP. Amphetamine reduces response times in general and reduces interference due to orthogonally varying irrelevant information. Practice while on placebo improves performance in a subsequent placebo session. Practice while on amphetamine does not, however, improve performance in the subsequent session on placebo. Assessment of the extent of the drug-state-related practice effect is necessary for evaluation of long-term benefits of dextroamphetamine therapy in these children.Thanks go to Ramona Roberts for assistance in running subjects. The University of Maryland Computer Science Center provided the computer facilities for data analysis.     

Performance of disturbed hyperactive and nonhyperactive children on an objective measure of hyperactivity

Twenty hyperactive emotionally disturbed children (6–11 years) and a matched sample of nonhyperactive emotionally disturbed children were selected from the population of a therapeutic day treatment facility on the basis of teacher ratings. They were administered the Matching Familiar Figures Test-20 and were rated on several scales of impulsivity and/or hyperactivity. Each subject was required to perform on the Delay Task of the Gordon Diagnostic System, which required them to inhibit behavioral responding on a temporally based schedule (DRL-6) in order to win points. Children classified as hyperactive, whether by one or more criteria, were relatively unable to refrain from emitting a high number of nonreinforced responses. Moreover, these performance differences persisted regardless of age or IQ and were stable over the 8 minutes required to complete the test.The authors gratefully acknowledge the efforts of the following members of the Institute of Clinical Psychology, University of Virginia: Richard Abidin, Ann Loper, Ronald Reeve, and Sherry Kraft. Data analyses were conducted using STATMANAGER, Hayden Software Company, copyright 1983.     

Factor specific differences in locus of control for emotionally disturbed and normal children.

The Nowicki-Strickland Locus of Control Scale for Children was given to 20 normal and 20 emotionally disturbed children to investigate the differences between the two groups on self-reported locus of control. The locus of control score and scores for each separate factor were calculated. Separate analyses of variance indicated that emotionally disturbed children did not differ from normals on overall locus of control nor on four of the five factors. However, one factor, Helplessness, differentiated the two groups with emotionally disturbed children endorsing more Helplessness items. The results are discussed in terms of factor specific methodology and in regards to the clinical relevance of Helplessness as a key factor.     

Social perspective-taking and adjustment in emotionally disturbed,learning-disabled,and normal children

Preadolescent emotionally disturbed, learning-disabled, and normal boys were compared on social perspective-taking and behavioral measures to examine possible contributions of social cognitive deficits to children's adjustment problems. Antisocial-prosocial and withdrawn-gregarious behavior dimensions were studied through subscales derived from teacher ratings. Results indicated that across all groups, high perspective-taking was associated with significantly less withdrawal than was low perspective-taking; within groups, this finding was significant only for the emotionally disturbed boys. Contrary to theoretical assumptions, antisocial behavior was not significantly related to perspective-taking across the sample. Among emotionally disturbed boys, relatively higher affective perspectivetaking was significantly correlated with higher antisocial behavior. This positive correlation for the emotionally disturbed group was significantly different from the nonsignificant negative correlation between antisocial behavior and perspective-taking among normals. Findings for learning-disabled boys were intermediate. between results for emotionally disturbed and normal boys on both perspectivetaking and behavioral measures, and the learning-disabled group generally did not differ significantly from either other group. Theoretical and clinical implications of the findings are discussed The authors acknowledge the invaluable assistance and cooperation of many teachers and principals in Jefferson County School District in Colorado, especially Ms. Norma Sobesky, coordinator of the program for Significantly Impaired Emotionally and Behaviorally Disturbed Children, and Ms. Beth Young, coordinator of the program for Perceptual and Communicative Disorders.     

A comparison of objective measures of activity and distractibility in hyperactive and nonhyperactive children

In a 15-minute free-play and a 5-minute test session, 13 measures of activity, distractibility, and parental ratings of activity were obtained on three groups of children, consisting of 16 boys referred to a psychological services center for evaluation of possible hyperactivity, 16 referred to that same center for problems other than hyperactivity, and 20 obtained from the local community. Subjects were boys with average intelligence between the ages of 4 and 12 years. Results indicated that the multiple measures of activity and distractibility had significant but relatively low order correlations among themselves. These relationships varied as a function of the subject group. However, there was no sonsistent relationship between the measures of activity and distractibility. The pattern of relationships obtained suggested that both activity level and distractibility are not homogeneous, unidimensional constructs. Results also indicated that boys referred for hyperactivity displayed greater wrist activity in free play, tended to display greater ankle activity in free play, had significantly correlated wrist and ankle activity, and were rated by their parents as more active than other children. This pattern suggested a global restlessness in children referred for hyperactivity that distinguishes them from other children.