Relationship between reaction time variability and motor skill development in ADHD

Slower and more variable reaction times to computerized tasks have been documented in children diagnosed with attention deficit/hyperactivity disorder (ADHD). Recent research supports a role for attentional lapses in generating abnormally variable and slow responses. However, given the association between ADHD and impairments in motor control, we hypothesized that slower or more variable reaction times might also correlate with motor development. The aim of this case-control study was to explore the relationship between motor function, reaction speed and variability, and ADHD. After comprehensive educational and clinical assessments, motor skill development was evaluated in 35 children ages 9 to 14 (19 with ADHD) using the Physical and Neurological Examination for Subtle Signs (PANESS) test battery. Finger-sequencing speed and variability were quantified with goniometers. Reaction times were measured with 20 trials each of computerized simple and choice (binary) tasks. Compared to healthy controls, children with ADHD had slower and more variable reaction times, and these findings correlated with impaired motor development (PANESS) and slow and variable finger sequencing (goniometers). Further studies of motor development in ADHD may identify factors influencing speed and variability of reaction times.     

Processing Speed Weakness in Children and Adolescents with Non-Hyperactive but Inattentive ADHD (ADD)

DSM-IV-TR defines ADHD-Predominantly Inattentive as allowing up to five symptoms of hyperactivity/impulsivity, while theories of the inattentive type usually assume a group that is hypoactive and characterized by processing speed and cognitive interference deficits. In a community-recruited sample of 572 children and adolescents, a pure inattentive subtype of ADHD (ADD) was defined as those who met DSM-IV-TR criteria for ADHD-PI but had two or fewer hyperactive/impulsive symptoms. Processing and output speeds of those with ADD were compared to those identified with DSM-IV-TR ADHD combined type and non-ADHD controls. These results were then contrasted with those found when DSM-IV-TR defined ADHD-PI was compared with ADHD-C and controls. Processing and output speed were assessed with the Trailmaking A and B and the Stroop Naming Tests. Cognitive interference control was assessed with the interference score from the Stroop Task. Slower cognitive interference speed was found in the ADD vs. ADHD-C and controls comparisons, but not the ADHD-PI versus ADHD-C and controls comparisons. On output speed measures, ADD exhibited the slowest performance, significantly different from controls and the effect size for the set-shifting speed contrast (Trailmaking B) was double that of the ADHD-PI vs. control comparison. ADHD-Inattentive type as defined by the DSM-IV-TR is a heterogeneous condition with a meaningful proportion of those affected exhibiting virtually no hyperactive/impulsive symptoms. This subgroup may represent a distinct inattentive condition characterized by poor cognitive interference control and slow processing or output speed.     

Inattention,working memory,and academic achievement in adolescents referred for attention deficit/hyperactivity disorder (ADHD)

This study investigated the role of inattention and working memory in predicting academic achievement in 145 adolescents aged 13 to 18 referred for attention deficit/hyperactivity disorder (ADHD). Path analysis was used to examine whether auditory-verbal and visual-spatial working memory would mediate the relationships between classroom inattention symptoms and achievement outcomes. Results provide support for the mediational model. Behavioral inattention significantly predicted both auditory-verbal and visual-spatial working memory performance. Auditory-verbal working memory was strongly associated with adolescents' achievement in reading and mathematics, while visual-spatial working memory was only associated with achievement in mathematics. The path from inattention symptoms to reading was partially mediated by the working memory variables, but the path from inattention to mathematics was not mediated by working memory. The proposed model demonstrated a good fit to the data and explained a substantial amount of variance in the adolescents' achievement outcomes. These findings imply that working memory is a risk factor for academic failure for adolescents with attentional problems.     

Assessment of children's receptive vocabulary using event-related brain potentials: Development of a clinically valid test

The combined verbal and motor impairments characteristic of children with disorders such as Cerebral Palsy (CP) frequently compromise the accuracy of standard psychometric assessments. What is needed is a test to measure language that does not require verbal or motor responses. This study was designed to determine whether single-word receptive vocabulary could be assessed in young children without CP, using an ERP-compatible test based on Form M of the Peabody Picture Vocabulary Test-Revised (PPVT-R). Fifteen 10-year-old children with normal levels of psychometric intelligence participated. Ninety pictures were selected from the PPVT-R (Form M), representing three levels of single-word receptive vocabulary (Preschool, Child-Adolescent, Adult). Each picture was presented twice (pseudo-random), once paired with a spoken word that was semantically congruent with the picture and once paired with a semantically incongruent word. The children's N400 was significantly larger to incongruent than to congruent pairs, but only when the vocabulary was within their repertoire. The results are discussed in terms of electrophysiologic correlates of acquired language and the clinical use of this ERP test as an adjunct to assessing patients with moderate to severe communication and/or motor impairments (e.g., cerebral palsy, autism, head injury).     

Bacterial Melanin Improves Cognitive Impairment Induced by Cerebral Hypoperfusion in Rats

The effect of bacterial melanin (BM) solution on learning and memory impairment induced by chronic cerebral hypoperfusion in rats was studied. Male rats were injected intramuscularly with BM solution on the second day after bilateral permanent occlusion of the common carotid artery. Rats received 6 mg/ml (170 mg/kg) BM and performed significantly better in cognition tests compared with controls. The present findings demonstrate that the beneficial effects of BM injection on cognitive functions may be due to preventing neuropathological alterations, suppressing the inflammation process, stimulating vascularization and inhibiting oxidative damage. Obtained data suggest that BM has therapeutic potential for the treatment of neurodegeneration caused by ischemia.     

Is the impaired N170 print tuning specific to developmental dyslexia? A matched reading-level study with poor readers and dyslexics

Left N170 print tuning has been associated with visual expertise for print and has been reported to be impaired in dyslexics, using age matched designs. This is the first time N170 print tuning has been compared in adult dyslexics and adult poor readers, matched in reading level. Participants performed a lexical decision task using both word-like stimuli and symbol strings. In contrast to dyslexics, poor readers displayed similar N170 tuning to control expert readers, suggesting that impaired N170 specialization is a hallmark of developmental dyslexia. Our findings provide electrophysiological support for dyslexia being the result of abnormal specialization of the left occipito-temporal areas involved in the expert processing of print. Furthermore, as shown by correlations data and in accordance with the phonological mapping deficit theory, the impaired visual expertise for print described in dyslexics may have been caused by their core phonological deficits.     

Dealing with Object Loss

The nature and outcome of working through an object loss depend on the proportions in which the lost relationship involved developmentally earlier (prestructural) and more advanced (poststructural), aspects. The two groups of elements are dealt with by entirely different methods, which are presented and discussed in this paper. For this purpose, some aspects of internalization are discussed and distinguishing a new form of internalization is proposed. The additional loss of objects following a major one are also briefly discussed.