Teachers' and education students' perceptions of and reactions to children with and without the diagnostic label "ADHD"

Thirty-four elementary school teachers and 32 education students from Canada rated their reactions towards vignettes describing children who met attention-deficit/hyperactivity disorder (ADHD) symptom criteria that included or did not include the label “ADHD.” “ADHD”-labeled vignettes elicited greater perceptions of the child's impairment as well as more negative emotions and less confidence in the participants, although it also increased participants' willingness to implement treatment interventions. Ratings were similar to vignettes of boys versus girls; however, important differences in ratings between teachers and education students emerged and are discussed. Finally, we investigated the degree to which teachers' professional backgrounds influenced bias based on the label “ADHD.” Training specific to ADHD consistently predicted label bias, whereas teachers' experience working with children with ADHD did not.     

Are Motor Inhibition and Cognitive Flexibility Dead Ends in ADHD?

Executive dysfunction has been postulated as the core deficit in ADHD, although many deficits in lower order cognitive processes have also been identified. By obtaining an appropriate baseline of lower order cognitive functioning light may be shed on as to whether executive deficits result from problems in lower order and/or higher order cognitive processes. We examined motor inhibition and cognitive flexibility in relation to a baseline measure in 816 children from ADHD and control families. Multiple children in a family were tested in order to examine the familiality of the measures. No evidence was found for deficits in motor inhibition or cognitive flexibility in children with ADHD or their nonaffected siblings: Compared to their baseline speed and accuracy of responding, children with ADHD and their (non)affected siblings were not disproportionally slower or inaccurate when demands for motor inhibition or cognitive flexibility were added to the task. However, children with ADHD and their (non)affected siblings were overall less accurate than controls, which could not be attributed to differences in response speed. This suggests that inaccuracy of responding is characteristic of children having (a familial risk for) ADHD. Motor inhibition and cognitive flexibility as operationalized with mean reaction time were found to be familial. It is concluded that poorer performance on executive tasks in children with ADHD and their (non)affected siblings may result from deficiencies in lower order cognitive processes and not (only) from higher order cognitive processes/executive functions.     

An Investigation into the Relationship Among ADHD Symptomatology,Creativity, and Neuropsychological Functioning in Children

This paper examined the relationship between creativity and ADHD symptomatology. First, the presence of ADHD symptomatology within a creative sample was explored. Secondly, the relationship between cognitive functioning and ADHD symptomatology was examined by comparing four groups, aged 10–12 years: 1) 29 ADHD children without creativity, 2) 12 creative children with ADHD symptomatology, 3) 18 creative children without ADHD symptomatology, and 4) 30 controls. Creativity, intelligence, processing speed, reaction time, working memory, and inhibitory control were measured. Results showed that 40% of the creative children displayed clinically elevated levels of ADHD symptomatology, but none met full criteria for ADHD. With regard to cognitive functioning, both ADHD and creative children with ADHD symptoms had deficits in naming speed, processing speed, and reaction time. For all other cognitive measures the creative group with ADHD symptoms outperformed the ADHD group. These findings have implications for the development and management of creative children.     

An investigation into the relationship among ADHD symptomatology, creativity, and neuropsychological functioning in children.

This paper examined the relationship between creativity and ADHD symptomatology. First, the presence of ADHD symptomatology within a creative sample was explored. Secondly, the relationship between cognitive functioning and ADHD symptomatology was examined by comparing four groups, aged 10-12 years: 1) 29 ADHD children without creativity, 2) 12 creative children with ADHD symptomatology, 3) 18 creative children without ADHD symptomatology, and 4) 30 controls. Creativity, intelligence, processing speed, reaction time, working memory, and inhibitory control were measured. Results showed that 40% of the creative children displayed clinically elevated levels of ADHD symptomatology, but none met full criteria for ADHD. With regard to cognitive functioning, both ADHD and creative children with ADHD symptoms had deficits in naming speed, processing speed, and reaction time. For all other cognitive measures the creative group with ADHD symptoms outperformed the ADHD group. These findings have implications for the development and management of creative children.     

Effects of Symptoms of ADHD, ODD, and Cognitive Functioning on Social Acceptance and the Positive Illusory Bias in Children

Objective: To examine the effects of symptoms of ADHD and ODD and cognitive functioning on social acceptance and positive bias in children. Method: The sample consisted of 86 children (49 girls) between 7 and 13 years old, recruited to reflect a wide range of ADHD symptoms. Parents and teachers reported on ADHD and ODD symptoms and social acceptance. Children reported on social acceptance and were given tasks measuring working memory, inhibition and reaction-time variability. A discrepancy score between child and adult reports of social acceptance was used as a measure of positive bias. Results: Inattention independently explained variance in social acceptance. The cognitive factors were related to social acceptance and the positive bias, but not beyond the ADHD and ODD symptoms. Conclusion: It is primarily disruptive behavior that contributes to external reports of children's social acceptance.     

WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility

This study aimed to investigate the presence of specific cognitive impairments and the diagnostic utility of the WISC-III in children with ADHD. Ninety-eight children with ADHD and 81 children without ADHD matched by age and gender (control group), between the ages of 6 and 12?years, participated in the study. Children with ADHD revealed the most pronounced deficits in the subtests tapping working memory and processing speed. Freedom from Distractibility was the cognitive profile most impaired and that showed the highest diagnostic accuracy to discriminate children with ADHD. The optimal cutoff scores of the most common WISC-III cognitive profiles revealed greater diagnostic accuracy than the traditional approach of full or partial profiles. Taken together, these results suggested that in the context of a comprehensive psychological assessment, the WISC may provide knowledge about the specific cognitive strengths and weaknesses that characterize this disorder and may be useful in the decision-making process relative to ADHD diagnosis.     

Online Story Comprehension among Children with ADHD: Which Core Deficits are Involved?

Children with ADHD have difficulty understanding causal connections and goal plans within stories. This study examined mediators of group differences in story narrations between children ages 7-9 with and without ADHD, including as potential mediators both the core deficits of ADHD (i.e., inattention, disinhibition, planning/working memory) as well measures of phonological processing and verbal skills. Forty-nine children with ADHD and 67 non-referred children narrated a wordless book and completed tasks assessing the core deficits of ADHD, phonological processing, and verbal skills. Results revealed that, although no shorter than those of non-referred children, the narratives of children with ADHD contained fewer elements relating to the story's causal structure and goal plan. Deficits in sustained attention accounted for the most variance in these differences. Results have implications for understanding and ameliorating the academic problems experienced by children with ADHD.     

A critical appraisal of the role of neuropsychological deficits in preschool ADHD

The present study aimed at improving our understanding of the role of neuropsychological deficits in preschool Attention Deficit Hyperactivity Disorder (ADHD). The study included 52 children in the ADHD group and 72 controls (age 4–6 years). Both laboratory measures and teacher reports of executive deficits (i.e., working memory, inhibition, and shifting), delay-related behaviors (i.e., the preference for minimizing delay), and emotional functions (i.e., emotion recognition and regulation) were included. Variable-oriented analyses were complemented with person-oriented analyses (i.e., identifying the proportion of patients considered impaired). Results showed that the ADHD group differed from controls with regard to all measures of executive functioning and most measures of delay-related behaviors, but few differences were found for emotional functioning. A substantial subgroup (23%) of children with ADHD did not have a neuropsychological deficit in any domain. There were subgroups with executive or delay-related deficits only, but no pure emotional subgroup. The overlap between different neuropsychological deficits was much larger when teacher reports were used as opposed to laboratory measures. Regarding functional impairments, large mean differences were found between the ADHD group and controls. However, neuropsychological deficits were not able to explain individual variations in daily life functioning among children with ADHD. In conclusion, the present study identified some important methodological and theoretical issues regarding the role of neuropsychological functioning in preschool ADHD.     

Does a Positive Bias Relate to Social Behavior in Children With ADHD?

This study examines whether positively biased self-perceptions relate to social behaviors in children with attention-deficit/hyperactivity disorder (ADHD) as compared to control children. The social behaviors of children with ADHD (n = 87) were examined relative to control children (CTL; n = 38) during a laboratory-based dyadic social interaction task. Children with ADHD were subgrouped into those with a positive illusory bias (PIB) in their self-perceptions (ADHD + PIB) versus those without such a bias (ADHD – PIB). Using a behavioral coding system adapted for this study, ADHD + PIB, ADHD – PIB, and CTL participants were compared on objectively coded social behaviors occurring within the context of the social interaction task. Whereas both ADHD groups displayed more disruptive behavior than controls, only the ADHD + PIB group displayed less prosocial behavior and less effortful behavior. This study breaks new ground by examining positively biased self-perceptions as they relate to social behavior in children with ADHD and provides promising new insight into the social problems experienced by these children.     

Visuo-Spatial Working Memory Span: A Sensitive Measure of Cognitive Deficits in Children With ADHD

Working memory (WM) has been hypothesised to be impaired in attention-deficit/hyperactivity disorder (ADHD). However, there are few studies reported on tests measuring visuo-spatial WM (VSWM) in ADHD. Some of these studies used paradigms including episodic memory, others only used low memory loads. In the present study we used a VSWM test that has not been used previously in ADHD research. The sensitivity of the VSWM test and a choice reaction time (CRT) test was evaluated in a pilot study by comparing them to two commonly used tests in ADHD-research; the Continuous Performance Test (CPT) and a Go/no-go test, in children with and without ADHD. The groups differed significantly in performance on the VSWM test (P<.01) and CRT (P<.05) but not on the CPT (P>.1) or on the Go/no-go test (P>.1). The results from the VSWM and CRT tests were replicated in a larger sample of participants (80 boys; 27 boys with ADHD and 53 controls, mean age 11.4 years). The difference between the groups was significant for both the VSWM test (P<.01) and the CRT test (P<.01). The effect size (ES) of the VSWM test was 1.34. There was a significant age-by-group interaction on the VSWM test, with larger group differences for the older children (P<.01). Our results show that the VSWM test is a sensitive measure of cognitive deficits in ADHD and it supports the hypothesis that deficits in VSWM is a major component of ADHD.     

Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots?

Emotional Lability (EL) is a source of impairment in multiple mental disorders of children, including attention-deficit/hyperactivity disorder (ADHD). It has been proposed that the overlap between EL and ADHD symptoms is the result of common neuropsychological deficits. The aim of the present study was to test this hypothesis by using a multi-method approach. In a mixed sample of 61 children (49 community sample and 12 children with an ADHD diagnosis) aged between 8 and 12 years, we examined the relationship between parental reports of ADHD and EL, real-time children’s emotional expressions in an experimental context, children’s performance on neuropsychological tasks and parental ratings of neuropsychological functioning. Parental EL ratings were significantly predicted by task-based reaction time variability and by questionnaire measures of Self-Direction & Organization and Arousal Regulation. Parental EL ratings were also significantly related to both ADHD symptom dimensions. After controlling for shared neuropsychological factors, ADHD symptoms no longer predicted parental EL ratings. Neuropsychological task performance was not significantly related to real time emotional expressions. However, positive emotional expressions were significantly predicted by higher parental ratings of Cognition and negative emotional expressions by parental ratings of low Effort engagement – accounting for some of the correlation with ADHD symptoms. The current results highlight the plausible role of cognitive energetic processes in explaining the EL and ADHD symptom association.

     

两亚型注意缺陷多动障碍(ADHD)儿童的内隐注意定向

研究探讨注意缺陷障碍儿童与正常儿童之间,混合型与注意缺陷型ADHD儿童之间在内源与外源注意定向功能的差异。ADHD儿童及与之匹配的正常儿童对照组分别参与了两个实验,实验一采用了内源性内隐注意定向任务,实验二采用了外源性内隐注意定向任务。研究表明：（1）ADHD儿童与正常儿童相比,在注意定向过程（注意解除、转移与施加）上有一定缺陷。（2）ADHD儿童注意定向网络功能有缺陷,与反应水平上动作准备有关的注意功能可能受损。（3）两种亚类型儿童注意定向功能缺陷模式不同。在内原定向上,混合型与注意缺陷型相比较,混合型ADHD儿童表现为有较强的反应冲动性;注意缺陷型儿童,主要表现为注意加工过程比较缓慢,注意更易涣散。在外源定向上,混合型儿童在反应的运动准备及运动控制方面的缺陷要大于注意缺陷型儿童     

The heterogeneity of attention‐deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition,emotion regulation,emotionality, and disorganized attachment

This study examined the contributions of several important domains of functioning to attention‐deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.     

Delis-Kaplan Executive Function System

The purpose of the current study was to examine the performance of children with and without ADHD in time reproduction tasks involving varying durations and modalities. Twenty children with ADHD and 20 healthy controls completed time reproduction tasks in three modalities (auditory, visual, and a unique combined auditory/visual condition) and six durations (1 second, 4 seconds, 12 seconds, 24 seconds, 48 seconds, and 60 seconds). Consistent with our predictions, we found main effects of group (participants with ADHD were significantly less accurate than those without ADHD), duration (accuracy decreased as temporal duration increased), and modality (responses in the combined condition were more accurate than those in the auditory condition, which in turn were more accurate than those in the visual condition). Furthermore, predicted interactions between group and duration (the discrepancy in performance between the two groups grew as temporal duration increased), and group and modality (the modality effect was of greater for participants with ADHD) were supported. A marginal, nonsignificant interaction between group, modality, and duration was also found. These findings are discussed in relation to current theory on the nature of cognitive deficits evident in individuals with ADHD, and methodological limitations are noted.     

Impulsivity facets and cognitive distortions associated with problem gambling: Differences between ADHD and non-ADHD gamblers

ObjectiveTo compare the association between (1) impulsivity facets or cognitive distortions, and (2) problem gambling between male gamblers with versus without self-reported Attention-Deficit/Hyperactivity Disorder (ADHD).MethodIn 287 male gamblers recruited online, we assessed problem gambling (South Oaks Gambling Screen; cut-off ≥ 3), Adult ADHD Self-report Scale-V1.1 (ADHD), impulsivity facets (UPPS Impulsive Behavior Scale-short version) and gambling-related cognitions (Gambling-Related Cognitions Scale).ResultsThe prevalence of self-reported ADHD was 21.6%. In both ADHD and non-ADHD groups, problem gambling was associated with negative urgency, positive urgency and the same cognitive distortions. Sensation seeking and lack of premeditation were associated with problem gambling, but only in non-ADHD gamblers (significant interaction effect).ConclusionDifferent impulsivity facets, but not different cognitive distortions, are associated with problem gambling in male gamblers with or without ADHD. Emotion dysregulation (positive and negative urgency) and cognitive distortions are involved in both groups, but sensation seeking and lack of premeditation may be specific to non-ADHD problem gamblers.     

Cognitive Load Differentially Impacts Response Control in Girls and Boys with ADHD

Children with attention-deficit hyperactivity disorder (ADHD) consistently show impaired response control, including deficits in response inhibition and increased intrasubject variability (ISV) compared to typically-developing (TD) children. However, significantly less research has examined factors that may influence response control in individuals with ADHD, such as task or participant characteristics. The current study extends the literature by examining the impact of increasing cognitive demands on response control in a large sample of 81children with ADHD (40 girls) and 100 TD children (47 girls), ages 8–12 years. Participants completed a simple Go/No-Go (GNG) task with minimal cognitive demands, and a complex GNG task with increased cognitive load. Results showed that increasing cognitive load differentially impacted response control (commission error rate and tau, an ex-Gaussian measure of ISV) for girls, but not boys, with ADHD compared to same-sex TD children. Specifically, a sexually dimorphic pattern emerged such that boys with ADHD demonstrated higher commission error rate and tau on both the simple and complex GNG tasks as compared to TD boys, whereas girls with ADHD did not differ from TD girls on the simple GNG task, but showed higher commission error rate and tau on the complex GNG task. These findings suggest that task complexity influences response control in children with ADHD in a sexually dimorphic manner. The findings have substantive implications for the pathophysiology of ADHD in boys versus girls with ADHD.     

Sluggish Cognitive Tempo as a Transdiagnostic Link Between Adult ADHD and Internalizing Symptoms

Although absent from traditional diagnostic nosologies, Sluggish Cognitive Tempo (SCT) may have transdiagnostic utility given its robust associations with ADHD and internalizing symptoms as well as with cognitive impairments common to these conditions. Within-person variation in SCT symptoms may also serve to link ADHD, cognitive deficits, and internalizing psychopathology, however, few studies have utilized intensive longitudinal designs to probe within-person variation in SCT and its links to cognitive deficits and psychopathology. Ecological Momentary Assessment was used to measure between and within-person variance in SCT 4 times per day across 7 days (28 time-points) in 158 college students (approximately 51% with elevated ADHD and/or internalizing symptoms). Participants also completed ratings of current and childhood ADHD symptoms, cognitive function and internalizing psychopathology. Parameters derived from longitudinal multilevel models indexing between and within person variation in SCT were examined as mediators of the associations between (1) ADHD and internalizing symptoms and (2) self-reported cognitive functioning and internalizing symptoms. Results indicated that between-person differences in SCT, but not within-person variability, linked current and childhood ADHD and internalizing symptoms. Similarly, problems in time-management and organization influenced internalizing psychopathology via between-person differences in SCT. Results found that SCT may be a transdiagnostic link bridging mental health comorbidities, cognitive dysfunction, and internalizing psychopathology.

     

ADHD and Working Memory: The Impact of Central Executive Deficits and Exceeding Storage/Rehearsal Capacity on Observed Inattentive Behavior

Inattentive behavior is considered a core and pervasive feature of ADHD; however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory deficits and inattentive behavior. The current study investigated whether inattentive behavior in children with ADHD is functionally related to the domain-general central executive and/or subsidiary storage/rehearsal components of working memory. Objective observations of children’s attentive behavior by independent observers were conducted while children with ADHD (n?=?15) and typically developing children (n?=?14) completed counterbalanced tasks that differentially manipulated central executive, phonological storage/rehearsal, and visuospatial storage/rehearsal demands. Results of latent variable and effect size confidence interval analyses revealed two conditions that completely accounted for the attentive behavior deficits in children with ADHD: (a) placing demands on central executive processing, the effect of which is evident under even low cognitive loads, and (b) exceeding storage/rehearsal capacity, which has similar effects on children with ADHD and typically developing children but occurs at lower cognitive loads for children with ADHD.     

Fundamental Movement Skills and Children with Attention-Deficit Hyperactivity Disorder: Peer Comparisons and Stimulant Effects

The purpose of this study was to compare the fundamental movement skills of 22 children with attention-deficit hyperactivity disorder (ADHD), from 6 to 12 years of age, to gender- and age-matched peers without ADHD and assess the effects of stimulant medication on the movement skill performance of the children with ADHD. Repeated measures analyses revealed significant skill differences between children with and without ADHD (p ≤ 0.001). Results from the stimulant medication trials indicated no significant effect of medication on the movement skill patterns of children with ADHD. It is concluded that children with ADHD may be at risk for developmental delays in movement skill performance. Potential factors underlying the movement skill difficulties are discussed, with suggestions for future research.     

Language Abilities in Children with Attention Deficit Hyperactivity Disorder, Reading Disabilities, and Normal Controls

Research has demonstrated a high prevalence of language impairments (LI) and reading disabilities (RD) in children with attention deficit hyperactivity disorder (ADHD). Since RD is also associated with LI, it is unclear whether the language impairments are specific to ADHD or associated with comorbid RD. The language abilities of ADHD children with and without RD were investigated in a task requiring recall of a lengthy narrative, and in tests assessing knowledge of the semantic aspects of language. The study was conducted with 50 boys—14 ADHD, 14 ADHD + RD, 8 RD, and 14 normal controls, aged 7 to 11. Children with ADHD (ADHD-only, ADHD + RD) exhibited difficulties in organizing and monitoring their story retelling. Children with RD (RD-only, ADHD + RD) demonstrated deficits in receptive and expressive semantic language abilities on the language processing tests. The comorbid group (ADHD + RD) exhibited the deficits of both ADHD and RD children. The deficiencies of ADHD children are consistent with higher-order executive function deficits while the deficits of RD children are consistent with deficits in the basic semantics of language processing.