Parents' attributions for achieving compliance from attention-deficit-disordered children

Ninety-one parents provided reasons for the compliance and noncompliance of either their attention-deficit-disordered, hyperactive (ADDH) or non-ADDH child in six different situations. These attributions were rated on Weiner's (1979) dimensions of locus, stability, and controllability. While parents used the same categories to explain the reasons for their children's complaince behavior, they used different dimensional ratings for these explanations. Mothers rated attributions for noncompliance as more external than did fathers. Mothers of ADDH children viewed the causes of their children's behavior to be more unstable than did mothers of control children. Also, ADDH parents had lower expectations of achieving future compliance from their child than did non- ADDH parents. Results were discussed in terms of parental experiences, the need to consider an idiosyncratic approach to attributional meaning, and treatment implications.     

Short-term serial recall in ADDH,normal, and reading-disabled boys

Short-term retention of verbal items of span and subspan length was examined in hyperactive (ADDH), normal and non-ADDH reading-disabled boys. Performance of ADDH and normal boys did not differ on three measures of verbal serial recall. Thus, it appears that the cognitive deficits of ADDH children cannot be attributed to deficient retention of stimuli. In contrast, reading-disabled (RD) boys performed significantly more poorly than both normal and ADDH boys when required to recall verbal items following filled delay intervals in which the children were required to perform a competing verbal activity. The results suggest that verbal encoding of RD children is particularly vulnerable to interference from other verbal stimuli. ADDH and RD children may represent subsamples of children demonstrating academic difficulties, with each group showing a characteristic pattern of cognitive deficits.This article is based on a doctoral dissertation submitted to the Faculty of Graduate Studies and Research of McGill University. Special thanks are due to Rhonda Amsel for her help and advice.     

Allergic disorders and attention deficit disorder in children

It has been suggested that children with attention deficit disorder-hyperactivity (ADDH) are likely to show allergic disorders, and that both ADDH and allergic disorders may share a common biological background. In a large sample of children from the general population we found no association between parent, teacher, and self-reports of ADDH behaviors and a history of allergic disorders (asthma, eczema, rhinitis, and urticaria) at ages 9 or 13 years. Similarly, reports of ADDH behaviors at age 13 years were not related to level of atopic responsiveness by skin test or serum IgE levels. Our findings call into question the hypothesis that there is a relationship between ADDH and allergic disorder.The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Health Research Council of New Zealand, and involves several departments of the University of Otago. The authors are indebted to the many people whose contributions made this study possible, and in particular the members of the sample and their parents.     

The normalizing effects of methylphenidate on the classroom behavior of ADDH children

This study examined whether methylphenidate normalizes the behavior of hyperactive children (ADDH). Twenty-eight ADDH children were treated for 8 weeks with a mean dose of 41.5 mg/d of methylphenidate. Their classroom behavior and that of normal children was recorded by observers who were blind to diagnosis and treatment. Before treatment, all measures significantly differentiated the ADDH and normal children. After treatment, the two groups were indistinguishable on measures of gross and minor motor movement, noncompliance, interference, and overall hyperactivity. ADDH children were significantly improved on measures of attention but continued to be significantly less attentive. In many ways, the ADDH children were not only improved but indistinguishable from their normal peers.This paper was supported by NIMH grants 30822 and 18579. We gratefully acknowledge the assistance of Beth Landa, Ph.D., who performed the statistical analyses.     

Peer relationships in ADDH and normal children: A developmental analysis of peer and teacher ratings

Peer and teacher perceptions of younger and older ADDH and normal children were compared. Peer nominations on the Pupil Evaluation Inventory revealed that ADDH children received more nominations on the Aggression factor and fewer on the Likability factor. ADDH boys received more nominations on the Withdrawal factor. Generally, older children received fewer nominations, but age did not interact with diagnosis; that is, younger and older ADDH children were perceived by peers as equally deviant. Discriminant analyses showed that peer ratings were useful in discriminating between ADDH and normal boys, but not between ADDH and normal girls. Teacher ratings of peer behavior suggested that older ADDH girls were perceived as less disturbed than younger girls. However, teacher ratings of boys revealed no age by diagnosis interactions. Low to moderate correlations were found between peer and teacher ratings of ADDH boys, and the pattern of relationship varied with age.During the writing of this report, Charlotte Johnston was supported by a Sir James Lougheed Fellowship, Alberta Heritage Scholarship Fund.     

Attention deficit,conduct, oppositional,and anxiety disorders in children: III. Laboratory differences

Children aged 5–13 years with DSM-III diagnoses of Attention Deficit (ADDH), Anxiety, (ANX), or Conduct plus ADDH (HC) Disorder and matched normal controls were compared on a set of laboratory measures of impulsivity, arousal, motor performance, activity level, and cognition, and on behavior ratings during testing. While ANX patients did not differ from their controls, ADDH and HC patients did on Verbal IQ, most of the behavior ratings, and on about one-third of the test variables. ANX patients were about 1 year older, and more likely to be female, than ADDH and HC patients. When age, sex, and verbal IQ effects were partialed out, very few differences among the three diagnostic groups remained. The importance of precise control of such variables is emphasized and the impact of the failure to do so in past studies is discussed. The question is raised whether the deficit in verbal IQ is not so much a defect of matching as the essential feature of ADDH from which most of the other commonly reported cognitive symptoms stem.This research was supported by the Medical Research Council of New Zealand.     

Evidence of difficulties in sustained attention in children with ADDH

It has been suggested that children with ADDH have specific difficulties in sustained attention. Despite some early studies supporting this position, many recent reports using continuous peformance tests (CPTs) have failed to confirm this hypothesis. Possible reasons for this discrepancy are outlined and an attempt to corroborate and extend an earlier study (Sykes, Douglas, & Morgenstern, 1973) was undertaken. CPT results in normal children indicated that changes in performance over time, although not affected by gender, were influenced by age. Data from ADDH subjects indicated that they performed significantly more poorly with time on task than did controls. These results suggest that the ability to sustain attention increases with age and does not vary by gender. Furthermore, difficultues in the ability to sustain attention can be demonstrated in children with ADDH. Finally, it is suggested that within-age-level comparisons between groups of ADDH and controls would be more clinically sensitive than across-age-group comparisons.This research was supported in part by a Sara Spencer Research Fellowship granted to the first author. Portions of this research were presented at the 17th annual meeting of the International Neuropsychological Society, Vancouver.     

Cognitive training in academically deficient ADDH boys receiving stimulant medication

This study evaluated the effectiveness of a 16-week intensive cognitive training program in stimulant-treated, academically deficient ADDH boys. Cognitive training focused exclusively on academic skills and tasks, and included attack strategy training as well as self-monitoring and self-reinforcement of problem-solving behaviors and response accuracy. Control groups included remedial tutoring plus medication, and medication alone. Despite the scope of the program, the results provided no support for the notion that academically based cognitive training ameliorates the performance and achievement of academically deficient ADDH youngsters. Further, this intervention did not enhance self-esteem or attributional perceptions of academic functioning. There was poor agreement between teacher ratings of academic competence and test score changes. The lack of concordance between measures, and the scarcity of academically deficient ADDH children are discussed.Preparation of this article was supported in part by National Institute of Mental Health Grant MH30822.     

External validation of oppositional disorder and attention deficit disorder with hyperactivity

Validity of the distinction between oppositional disorder (OD) and attention deficit disorder with hyperactivity (ADDH) was examined in a sample of 6- to 12-year-old boys with behavior problems. Problem identification, cognitive/attentional, family context, and behavioral symptom differences were examined among nine boys with OD only, 20 with ADDH, 40 with comorbid OD and ADDH, and 28 with neither disruptive behavior disorder. Systematic comparisons of groups including and excluding the OD and ADDH diagnoses were undertaken to determine the existence of pure OD and pure ADDH disorder effects. The most consistent result was the lack of evidence for either pure OD or pure ADDH effects. Most of the significant findings reflected differences between the nondisruptive (neither) and comorbid groups. The results support the importance of comorbidity, but they provide little support for disorder-specific distinctions between oppositional and attention deficit disorders.     

Are hyperactive children deficient in attentional capacity?

A dual task was used to study attentional capcity in three groups: in 6- to 12- year- old boys with attention deficit disorder plus hyperactivity (ADDH) or with ADDH and conduct disorder, and in normal children. Subjects performed a primary-choice reaction-time task first without and then with a secondary task that also required a response. Our prediction that the reaction time of ADDH subjects to the secondary task would increase more with increasing temporal overlap of the primary and secondary stimuli, if they were deficient in capacity, was not supported. However, the performance of ADDH subjects on the primary task deteriorated more than that of control subjects with the introduction of the secondary task, indicating a greater concurrence cost or a different allocation policy. Moreover, ADDH subjects had longer reaction times to the secondary task, indicating greater refractory effects or difficulty shifting capacity from primary- to secondary-task processes.The authors would like to acknowledge the support of the Ontario Mental Health Foundation and the assistance of Diane Chajczyk. This paper was prepared with the assistance of Medical Publications, The Hospital for Sick Children, Toronto, Ontario.     

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.     

The role of adolescent peer affiliations in the continuity between childhood behavioral adjustment and juvenile offending

This research reports on a structural equation model analysis of the relationships between childhood behavioral adjustment, adolescent peer affiliations, and adolescent offending using data gathered during the course of a 16-year longitudinal study of a birth cohort of New Zealand children. The model developed contained parameters that estimated (a) the continuities between early behavior and later offending, (b) the associations between early behavior and adolescent peer affiliations, and (c) the potentially reciprocal relationship between adolescent peer affiliations and adolescent offending behaviors. This analysis suggested that, when due allowance was made for reporting error, there was evidence of relatively strong continuity (r= .50) between early behavior and later offending. The model estimates suggested that these continuities arose from both direct continuities in behavior over time and from the effects of adolescent peer affiliations in reinforcing and sustaining earlier behavioral tendencies. The implications of the analysis for the understanding of the role of adolescent peer affiliations in behavioral continuities and discontinuities are discussed. These research has been funded by grants from the Health Research Council of New Zealand, the National Child Health Research Foundation, and the Canterbury Medical Research Foundation.     

Sensitization and habituation of motivated behavior in overweight and non-overweight children

The rate of habituation to food is inversely related to energy intake, and overweight children may habituate slower to food and consume more energy. This study compared patterns of sensitization, as defined by an initial increase in operant or motivated responding for food, and habituation, defined by gradual reduction in responding, for macaroni and cheese and pizza in overweight and non-overweight 8- to 12-year-old children. Non-overweight children habituated faster to both foods than overweight children (p = .03). All children recovered motivated responding for a new food (chocolate). Overweight children consumed more energy than non-overweight children (p = .0004). Children who showed a sensitization in responding consumed more food (p = .001), and sensitization moderated the effect of overweight on habituation, with slower habituation for overweight children who sensitized (p < .001). This study replicates previous data on overweight/non-overweight differences in habituation of food and energy intake, and provides new information that individual differences in sensitization and habituation of motivated responding to obtain food may be associated with a sustained motivation to eat, resulting in greater energy intake.     

Behavioral effects of sucrose on preschool children

Despite speculation that sucrose consumption affects behavior, little empirical information is available. Accordingly, this study investigated the effect of sucrose consumption on the behavior of eight preschool children. Children were tested individually using a double-blind, crossover design. On separate mornings each child received 6 ounces of juice, sweetened on one morning with sucrose and on the other with an artificial sweetener. Children were observed for 90 minutes following the drinks, alternating between 15-minute sessions of work on structured tasks and 15-minute sessions of free play. Following the sucrose drink the children showed a decrement in performance in the structured testing situation, and they demonstrated more inappropriate behavior during free play. These differences in behavior were most pronounced approximately 45 to 60 minutes after the drinks. Thus, the study provides objective evidence in young children of a rather subtle, yet significant, time-dependent behavior effect of sucrose ingestion.This research was funded in part by grants from the General Research Grants Committee, University Hospital, Boston University Medical Center, and from the University of Connecticut Research Foundation. The project was conducted at the Clinical Research Center, Massachusetts Institute of Technology (National Institute of Health/General Clinical Research Center Grant 5M01-RR00088-20). We would like to express our appreciation to the many staff members of the Clinical Research Center for their extensive cooperation in helping us to plan and carry out this study, and to the director and staff of Technology Children's Center for their assistance in helping us to reach interested families. We also would like to thank the parents and children who participated in the study. Portions of this paper were presented at the annual meeting of the American Psychological Association, Toronto, August 1984.     

OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT

Despite widespread use of behavioral observations to evaluate child feeding behaviors in research and clinical practice, few studies have comprehensively characterized mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Mealtime observations were conducted for 18 children with avoidant restrictive food intake disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Most behaviors were observed across both clinical and nonclinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviors relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. The comparability of behaviors across clinical and nonclinical groups suggests that eating behaviors exist on a continuum from “normal” to “abnormal,” with group differences relating to frequency rather than type of behavior. The behavioral differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape‐maintained behaviors will lead to underrecognition of families in need of clinical support.     

Direct versus indirect response-reinforcer relationships in teaching autistic children

One possibility suggested by the literature for maximizing the efficiency of behavior modification procedures concerns the relationship between target behaviors and their reinforcers. Therefore, in this experiment three severely autistic children were taught a total of six new target behaviors (in a multiple baseline design) employing two different response-reinforcer relationships: (1) those where the target behaviors were a direct part of the response chain required to procure a reinforcer (e.g., opening the lid of a container to obtain a food reward inside the container); and (2) those where the target behavior was an indirect part of the chain leading to the reinforcer (e.g., the therapist handing the child a food reward after the child had opened the lid of an empty container). In all cases, the results showed rapid acquisition only when the target behavior was a direct part of the chain leading to the reinforcer. The results are discussed in terms of several possible conceptualizations concerning efficient reinforcement contingencies, and in terms of their implications for teaching autistic children.This investigation was supported by U.S. Public Health Service Research Grants MH 28210 and MH 28231, and by U.S. Office of Education Research Grant G007802084 from the Bureau for the Education of the Handicapped. Portions of the results described in this article were discussed in a presentation at the 13th Annual AABT Convention in San Francisco, 1979. The authors are particularly grateful to Andrew Egel, Roberta Elman, Janis Costello, and Karen Britten, for their helpful comments, and to Jody Fisher and Gina Richman, for their assitance in the data collection.     

Attention deficit disorder with hyperactivity and methylphenidate: The effects of dose and mastery level on children's learning performance

This investigation examined the relationship between methylphenidate (MPH) and the learning and recall of paired associations by children with attention deficit disorder with hyperactivity (ADDH). Forty-five children with ADDH were randomly assigned to one of three groups (novel, partial mastery, and mastery learning) that varied in the amount of previous learning of paired associations and participated in a double-blind, placebo-control, repeated-measures-across-dose (crossover) design. Each child received four doses of MPH (5 mg, 10 mg, 15 mg, and 20 mg) and a placebo in a random, counterbalanced sequence. The results indicated that both the rate of acquisition and accuracy in learning paired associations were significantly, but differentially, affected by MPH dose and the degree of learning mastery. The implications of these results for psychopharmacological research and the monitoring of psychostimulant effects on children's learning performance in academic settings are discussed.The authors wish to acknowledge and express their sincere appreciation to the graduate and undergraduate student members of the Children's Learning Clinic.     

Sustained attention in normal and in reading-disabled youngsters with and without ADDH

Three groups of children — one normal, one reading-disabled, and one reading-disabled with an additional diagnosis of attention deficit disorder with hyperactivity (ADDH)-were administered the Continuous Performance Test and compared on correct detections and three types of commission errors. All three groups showed a decline in sustained attention over the course of the task but not differentially according to diagnostic group. When younger and older subgroups were compared, the reading-disabled children were found to make significantly more correct detections with increased age, but not when the reading disability was accompanied by ADDH. The latter group of children also were differentiated by a type of commission error, previously associated with impulsive responding, that remained prominent in the older subgroup of dually diagnosed children. Reading-disabled children were differentiated by a second type of commission error which possibly was associated with inattention or short-term memory deficit and which diminished with age.The author would like to thank the staff of St. Patricks School and in particular its principal Sister Patrick Mary for her able administrative support of the study. The author would also like to thank the administration and staff of the Unitas Clinic for their cooperation.     

Normal versus deviant children

The present study investigated differences between referred and nonreferred children and their families on the basis of home and clinic observations and parent questionnaires. Subjects were 28 families with children between 4 and 8 years of age who had been referred to a clinic for actingout behavior and 28 nonreferred controls matched on several variables. Home observation results indicated that referred children showed significantly more deviant behavior and less prosocial behavior than nonreferred children and that their parents emitted more negative and commanding behavior in contrast to the control group. Systematic observation in the clinic revealed significant differences only in parent negativeness and number of commands. Finally, all five factors of the parent attitude questionnaire yielded large and significant differences between groups. There was considerable overlap between groups on all behavior variables but less overlap on the parent attitude measure. Results from a stepwise discriminant analysis classified 90% of referred children and 90% of nonreferred children correctly on the basis of the parent attitude variable alone. Taken together, these results suggest that child behavior is not always the critical variable in referral and stress the importance of multiple assessment procedures for child-family problems when children are referred for treatment.This research was supported by National Institute of Mental Health Grant MH 19633. The authors would like to express their appreciation to Sheila Eyberg and Orin Bolstad, who assisted in the completion of various aspects of this work.     

The comorbidities of adolescent problem behaviors: A latent class model

The correlations and comorbidities of a series of adolescent problem behaviors were studied in a sample of 739 New Zealand 15-year-olds. This analysis revealed the presence of strong comorbidities between different problem behaviors. The data were modeled using methods of unrestricted latent class analysis and this suggested that the best fitting model to describe the data was one which assumed that adolescent problem behaviors were described by four general classes of children. While the same general four-class model applied to males and females, there were marked gender differences in the rates of problems. Specifically, the predominant problem behaviors in females were those relating to an accelerated transition to adulthood marked by early sexual activity, alcohol abuse, and cannabis use whereas the predominant problems for boys were related to antisocial and law-breaking behaviors. Rates of children with no problems (85%) and with multiple problems (3%) were similar for boys and girls.This research was funded by grants from the Health Research Council of New Zealand, the Canterbury Medical Research Foundation, and the National Child Health Research Foundation.