Methylphenidate improves some but not all measures of ATTENTION,as measured by the TEA-Ch in medication-naïve children with ADHD

The Test of Everyday Attention for Children (TEA-Ch) is a reliable neuropsychological assessment of attention control in children. Methylphenidate (MPH) is an effective treatment to improve attentional difficulties in children with attention deficit/hyperactivity disorder (ADHD). Previous studies investigating the effects of MPH on attention performance of children with ADHD have produced mixed results and prior MPH usage may have confounded these results. No previous study has tested the effects of MPH on the entire TEA-Ch battery. This study investigated the effects of MPH on attention performance using the entire TEA-Ch in 51 medication-naïve children with ADHD compared with 35 nonmedicated typically developing children. All children were tested at baseline and after 6 weeks: The children with ADHD were medication-naïve at baseline, received MPH for 6 weeks and were tested whilst on medication at the second testing session. A beneficial effect of MPH administration was found on at least one subtest of each of the three forms of attention (selective, sustained, and attentional control) assessed by the TEA-Ch, independent of practice effects. MPH aided performance on the TEA-Ch tasks that were inherently nonarousing and that might require top-down control of attention. It is recommended that the TEA-Ch measures—Sky Search Count (selective attention),Score! (sustained attention), Creature Counting Time Taken for older children (attentional control), and Same Worlds (attentional control) be prioritized for use in future pharmacological studies using MPH.     

Decision Making with Uncertain Reinforcement in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

Reward-related processes are impaired in children with ADHD. Whether these deficits can be ascribed to an aversion to delay or to an altered responsiveness to magnitude, frequency, valence, or the probability of rewards still needs to be explored. In the present study, children with ADHD and normal controls aged 7 to 10 years performed a simple probabilistic discounting task. They had to choose between alternatives where the magnitude of rewards was inversely related to the probability of outcomes. As a result, children with ADHD opted more frequently for less likely but larger rewards than normal controls. Shifts of the response category after positive or negative feedback, however, occurred as often in children with ADHD as in control children. In children with ADHD, the frequency of risky choices was correlated with neuropsychological measures of response time variability but unrelated to measures of inhibitory control. It is concluded that the tendency to select less likely but larger rewards possibly represents a separate facet of dysfunctional reward processing, independent of delay aversion or altered responsiveness to feedback.     

Neurodevelopmental Disorders Across the Lifespan: A Neuroconstructivist Approach.

Objectives. To investigate neuropsychological and neurobehavioral outcome in children with arterial ischemic stroke (AIS).

Background. Childhood stroke can have consequences on motor, cognitive, and behavioral development. We present a cross-sectional study of neuropsychological and neurobehavioral outcome at least one year poststroke in a uniquely homogeneous sample of children who had experienced AIS.

Method. Forty-nine children with AIS aged 6 to 18 years were recruited from a specialist clinic. Neuropsychological measures of intelligence, reading comprehension, attention, and executive function were administered. A triangulation of data collection included questionnaires completed by the children, their parents, and teachers, rating behavior, executive functions, and emotions.

Key Findings. Focal neuropsychological vulnerabilities in attention (response inhibition and dual attention) and executive function were found, beyond general intellectual functioning, irrespective of hemispheric side of stroke. Difficulties with emotional and behavioral regulation were also found. Consistent with an “early plasticity” hypothesis, earlier age of stroke was associated with better performance on measures of executive function.

Conclusions. A significant proportion of children poststroke are at long-term risk of difficulties with emotional regulation, executive function, and attention. Data also suggest that executive functions are represented in widespread networks in the developing brain and are vulnerable to unilateral injury.     

Investigating the Relationship Between Attention and Working Memory in Clinical and Community Samples

The first aim of the present study was to investigate whether differences in core deficits in ADHD subtypes lead to dissociable working memory profiles. The second aim was to compare the working memory profiles of inattentive students with those identified as having poor working memory, as they exhibit very similar behavioral profiles. Finally, the relationship between working memory and academic attainment in these groups were also of interest. Four groups of 9-year-olds were recruited: a community sample of children with inattentive symptoms, a clinically diagnosed group of children with ADHD-Combined, children with low working memory, and a healthy comparison group. They were assessed on measures of working memory, IQ, academic attainment, and sustained attention. The findings indicated that the combined and inattentive subtypes could not be distinguished on the basis of their working memory profile. In contrast, those with inattentive symptoms did better on the short-term memory tasks than the low working memory group. The majority of all three atypical groups performed very poorly in reading and math. This pattern can be interpreted as reflecting the link between working memory and academic attainment, even in those with attention problems.     

Verbal learning and memory as measured by the Rey-Auditory Verbal Learning Test: ADHD with and without learning disabilities

The primary purpose of the present study is to examine the effects of attention deficits, learning disability, and the combined effects of both on the learning and memory processes, as measured by the Rey Auditory Verbal Learning Test (AVLT). Thirty children (age range 12–17) diagnosed with attention deficit/hyperactivity disorder (ADHD), 18 children (age range 11–17) diagnosed with learning disabilities (LD), and 64 children (age range 12–17) diagnosed with ADHD as well as with LD, and 28, 18, and 62 matched controls, respectively, participated in this study. It was found that the children diagnosed with ADHD did not differ in any of the verbal learning and memory measures derived from the Rey AVLT. The group with LD was impaired in the overall number of words recalled across the learning phase. Performance of the children diagnosed with ADHD +LD showed a similar impairment as the group with LD (i.e., overall amount of words learned) and, in addition, their retrieval efficiency was also impaired. In conclusion, this study indicates that verbal memory is preserved in children with ADHD if they have no LD and their intelligence is in the normal range or above. LD by itself leads to difficulties in acquisition, but the combination of ADHD+LD leads to additional impairment in retrieval processes.     

The Contribution of Executive Skills to Reading Comprehension

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9–15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD.     

Executive function outcomes of children with traumatic brain injury sustained before three years

Traumatic brain injury (TBI) is a common cause of disability in childhood. While the outcomes of TBI sustained in school years has been heavily researched, very little is known about the impact of TBI in infants and young children. The aim of this study was to investigate the impact of TBI on executive function (EF) in children who sustained a TBI before 3 years of age. A group of 55 children, 19 with a mild TBI, 16 children with a moderate-severe TBI, and 20 uninjured comparison children participated. The EF of children aged 3 to 6 years were compared using child-based measures of attentional control and information processing. Parents completed questionnaires rating their child's EF. Severity groups differed on the child-based EF measure of attentional control with children with TBI performing below the control group. There were no significant group differences for information processing or parent-rated EF. It appears that children who sustain a TBI before the age of 3 years display impairments in some areas of attentional control 3–4 years postinjury. The findings fit with the existing EF literature for older children.     

A normative study of the Children’s Color Trails Test (CCTT) in the Cypriot population

Background: The Children’s Color Trails Test (CCTT) is a neuropsychological test that measures attention, divided attention, and speed of mental processing. It has been increasingly used in the assessment of children in cross-cultural environments for neurological and psychiatric disorders such as seizures and closed head injuries, learning and/or language disabilities, attention deficit/hyperactivity disorder, children with manganese exposure, and children diagnosed with HIV virus. However, there is a paucity of studies presenting normative data. The aim of the present study was to provide normative data for the CCTT in the Cypriot population. Methods: A total of 709 native Cypriot children aged 7–16 years, recruited from various public schools across the island, took part in the study. Exclusion criteria involved the existence of neurological, psychiatric, cardiological, and metabolic diseases, premature birth, history of maternal alcohol and drug abuse during pregnancy, low birth weight, hearing loss, visual problems, native language other than Greek, and abnormality in fine-motor movements. Results: Age and gender were found to be important factors for the interpretation of scores in all CCTT variables. Older children required less time and exhibited fewer errors, near misses, and prompts compared to younger children. There was a consistent pattern of a 3–4 seconds improvement (less time in seconds) in the CCTT completion time as age increased. Conclusions: CCTT is a promising tool for the measurement of attention in the native Cypriot population. Further research is needed in children diagnosed with various neurological and psychiatric diseases in order to estimate validity of the CCTT in clinical populations.     

Charting the Developmental Trajectories of Attention and Executive Function in Chinese School-Aged Children

Attention is a complex domain that has reawakened research interest in recent years. There are relatively few studies that have examined age-related changes across different attention subcomponents, such as selection, maintenance, and control, using large samples covering a wide age range. The present study assessed performance in 466 participants in order to identify the ages at which mature performance was reached across differing attention subcomponents. Furthermore, we investigated whether the nature of the attentional demands or task difficulty predicted the age at which stable levels of performance were reached. The results supported the former rather than the latter alternative.     

Simultaneous attentional guidance by working-memory and selection history reveals two distinct sources of attention

Recent theories of attention have proposed that selection history is a separate, dissociable source of information that influences attention. The current study sought to investigate the simultaneous involvement of selection history and working-memory on attention during visual search. Experiments 1 and 2 used target feature probability to manipulate selection history and found significant effects of both working-memory and selection history, although working-memory dominated selection history when they cued different locations. Experiment 3 eliminated the contribution of voluntary refreshing of working-memory and replicated the main effects, although selection history became dominant. Using the same methodology, but with reduced probability cue validity, both effects were present in Experiment 4 and did not significantly differ in their contribution to attention. Effects of selection history and working-memory never interacted. These results suggest that selection history and working-memory are separate influences on attention and have little impact on each other. Theoretical implications for models of attention are discussed.