The IQs of children with ADHD are normally distributed

The purpose of this investigation was to determine whether or not attention-deficit/hyperactivity disorder (ADHD)-when there was an absence of reading problems-was associated with having a high IQ. The vocabulary and block design short forms of the Wechsler Intelligence Scale for Children-Third Edition were administered to 63 children with ADHD, 69 children with reading difficulties (RD), and 68 children with comorbid ADHD + RD. Results indicated that the distributions of estimated Full Scale IQs (FSIQ) for each of the three groups of children did not differ significantly from a normal distribution, with the majority of children (more than 50%) in each group scoring in the average range. The percentage of children with ADHD who scored in the above-average range for FSIQ was not significantly higher than the percentages of children in the other two groups. No significant group differences emerged for estimated FSIQ, vocabulary, or block design. It was concluded that children with ADHD are no more likely to have an above-average IQ than are other children.

Reliability and validity of a parent questionnaire on childhood motor skills

OBJECTIVE

As the consequences of clumsiness in children become better understood, the need for valid measurement tools is apparent. Parent report has the potential for providing historical knowledge of the child's motor skills, as well as perceptions of their children's motor difficulties. The objective was to develop a parent questionnaire to identify motor difficulties in children.

METHOD

A sample of 306 children participated in the development of a 17-item parent questionnaire, called the Developmental Coordination Disorder Questionnaire (DCDQ). Internal consistency, concurrent and construct validity were examined.

RESULTS

The DCDQ proved capable of distinguishing children who had motor problems (as measured by standardized tests) from children without motor problems. Correlations with standardized tests were significant. Two other studies confirmed the construct validity of the DCDQ. Factor analysis revealed four distinct factors, useful in defining the nature of the difficulties.

CONCLUSION

The DCDQ is a succinct and useful measure for use by occupational therapists.

Attributions and perceptions of childhood in women with ADHD symptomatology. Attention-Deficit/Hyperactivity Disorder

Now that it is recognized that Attention-Deficit/Hyperactivity Disorder (ADHD) often persists into adulthood, there are many adults being identified with ADHD who were not diagnosed as children. Individuals identified with ADHD during adulthood may be at risk for maladaptive attributional styles based on the notion that they were exposed to more negative feedback during childhood than adults without identified ADHD. This study examined current attributions and perceptions of childhood of 51 women identified in adulthood with ADHD symptomatology and 51 nonADHD women. Women with ADHD symptomatology had more uncontrollable, stable, and global attributions, reported more dissatisfaction in their childhood parent, peer, and teacher relationships, and felt less in control of negative childhood events as compared with the nonADHD women. Both depression and ADHD contributed significantly to these group differences, suggesting that negative perceptions and attributions are more than reflections of current thinking and mood. ADHD symptomatology also may be an important risk factor for maladaptive attributions.

Absence of significant linkage between phonological coding dyslexia and chromosome 6p23-21.3, as determined by use of quantitative-trait methods: confirmation of qualitative analyses

We recently reported the absence of significant linkage of phonological coding dyslexia (PCD) to chromosome 6p23-p21.3 in 79 families with at least two affected siblings, even though linkage of dyslexia to this region has been found in four other independent studies. Whereas, in our previous analyses, we used a qualitative (affected, unaffected, or uncertain) PCD phenotype, here we report a reanalysis of linkage to the chromosome 6p region, by use of four quantitative measures of reading disability: phonological awareness, phonological coding, spelling, and rapid-automatized-naming (RAN) speed. The phonological-coding and spelling measures were highly correlated with each other and with the qualitative PCD phenotype, whereas the phonological-awareness and RAN-speed measures were only moderately correlated with the other measures. Using two-point and multipoint quantitative-trait sib-pair linkage analyses and variance-components analyses, we were unable to detect significant evidence for a locus in the 6p23-p21.3 region influencing any of the quantitative reading measures, supporting our previous qualitative linkage results. The most likely explanation for our inability to detect linkage between dyslexia and this region is that families with subtypes of dyslexia linked to this region are underrepresented in our sample, because of either chance or varying ascertainment criteria.

Absence of linkage of phonological coding dyslexia to chromosome 6p23-p21.3 in a large family data set

Previous studies have suggested that a locus predisposing to specific reading disability (dyslexia) resides on chromosome 6p23-p21.3. We investigated 79 families having at least two siblings affected with phonological coding dyslexia, the most common form of reading disability (617 people genotyped, 294 affected), and we tested for linkage with the genetic markers reported to be linked to dyslexia in those studies. No evidence for linkage was found by LOD score analysis or affected-sib-pair methods. However, using the affected-pedigree-member (APM) method, we detected significant evidence for linkage and/or association with some markers when we used published allele frequencies with weighting of rarer alleles. APM results were not significant when we used marker allele frequencies estimated from parents. Furthermore, results were not significant with the more robust SIMIBD method using either published or parental marker frequencies. Finally, family-based association analysis using the AFBAC program showed no evidence for association with any marker. We conclude that the APM method should be used only with extreme caution, because it appears to have generated false-positive results. In summary, using a large data set with high power to detect linkage, we were unable to find evidence for linkage or association between phonological coding dyslexia and chromosome 6p markers.

Deficits in long-term memory are not characteristic of ADHD. Attention Deficit Hyperactivity Disorder

To separate the influence of inattentiveness from memory, we examined savings scores on material previously learned in 53 children with Attention Deficit Hyperactivity Disorder (ADHD), 63 with a reading disability (RD), 63 with both ADHD and RD combined, and 112 controls. Children with reading disabilities were impaired in their ability to remember previously-learned material unless it was repeated over four trials, whereas children with only ADHD performed as well as the controls for material presented only once. Children with ADHD did perform poorly on three subtests that are sensitive to attention/ concentration. We conclude that ADHD is associated with impaired initial learning due to attention deficits, but that long-term retention of learned material is normal.

Absence of an association between IgE-mediated atopic responsiveness and ADHD symptomatology

There are mixed research results in the literature regarding a possible association between Attention Deficit Hyperactivity Disorder (ADHD) and atopic disorders. If such an association were supported, the implications for underlying pathophysiology would be significant. We evaluated level of atopic responsiveness (based on IgE-mediated response to skin prick tests) in 312 referrals to a pediatric allergist. Based on the atopy code, children were categorized as non-atopic, or moderately or severely atopic. Parents completed the Child Behavior Checklist (CBCL). Univariate analyses on the eight CBCL subscales revealed no differences between the atopic groups. Our results do not support an association between IgE-Mediated atopic responsiveness and ADHD, but they do not rule out an association between allergic symptoms and ADHD based on some other mechanism.

The influence of systemic lupus erythematosus on fetal development: cognitive, behavioral, and health trends

In 1985, Gualtieri and Hicks proposed the immunoreactive theory to explain the higher prevalence of childhood neurodevelopmental disorders in males. The theory claimed that male fetuses are more antigenic to mothers, resulting in increased immunologic attack on the developing central nervous system, and increased probability of atypical brain development. Individuals with systemic lupus erythematosus (SLE) provide a unique situation in which to investigate this theory. We evaluated the parent-reported prevalence of five developmental problems (stuttering, other speech problems, hyperactivity, attention deficit, and reading problems) in two groups: 154 individuals ages 8-20 years born to women with SLE, drawn from six cities, and 154 controls of comparable age and sex whose mothers did not have SLE. Controls were drawn from a comparison group ascertained from randomly selected schools in one of the cities. Questions about handedness, immune disorders, and pregnancy and birth complications were also evaluated. Children of SLE mothers were shown to have more evidence of developmental difficulties, immune related disorders, and nonrighthandedness. For developmental problems, these findings were most marked in male children of SLE mothers. These results suggest that maternal immunoreactivity, as represented by women with SLE, may present a special risk factor for subsequent learning difficulties in their children, particularly males.

Polyps and polypoid lesions of the jejunum and ileum. Clinical aspects

Polyps and polypoid lesion of the small intestine present a major challenge to the surgeon. In contrast to similar lesions in the large intestine, small bowel polyps present late in their course and are difficult to diagnose. Small bowel tumors produce vague symptoms and screening tests are poor. Most of these polyps are found at autopsy or during exploration for another cause. In this article, the authors outline the problem as well as discuss the diagnosis and treatment options.

Somatosensory evoked potential monitoring during carotid surgery

Controversy exists over the value of intraoperative monitoring and shunting in patients undergoing carotid endarterectomy. Although it is widely believed that contralateral carotid occlusion and previous stroke mandate intraoperative shunting, the susceptibility of these two groups of patients to cerebral ischemia during carotid artery endarterectomy is not well defined. Somatosensory evoked potentials (SSEPs) were monitored in 113 carotid artery endarterectomy patients. Of these, 32 (28.3%) had a previous stroke, 24 (21.2%) had a contralateral carotid occlusion and 33 (29.2%) were diabetic. There were no deaths and only one perioperative stroke (0.9%). Cerebral ischemia occurred in 14 patients (12.4%). Six of these patients had a contralateral carotid occlusion. Some 29 patients (25.7%) were shunted, including 10 with contralateral carotid occlusions that did not have major SSEP changes. In the latter half of the study, 14 patients with contralateral carotid occlusions were selectively shunted (six shunted, eight not shunted) with no neurological complications. Thirty-two patients with prior strokes were selectively shunted (nine shunted, 23 not shunted); of these, one shunted patient undergoing combined carotid artery endarterectomy and coronary artery bypass grafting had a perioperative stroke. Intraoperative monitoring with SSEPs accurately identifies cerebral ischemia secondary to carotid clamping as well as patients requiring shunts. With use of intraoperative SSEP monitoring, selective shunting may be safely performed in patients with a contralateral carotid occlusion or a previous stroke.

Use of the Bruininks-Oseretsky test of motor proficiency in occupational therapy

OBJECTIVE

In addition to the need for good measurement tools in occupational therapy, there is a need for the tools to be used knowledgeably. The purpose of this article is to investigate the usefulness of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for both descriptive (diagnostic) and evaluative (change over time) purposes.

METHOD

The typical profile of subtest scores for children with mild motor problems revealed that certain subtests of the BOTMP may be better indicators of motor problems for these children than others. An analysis also was performed to compare the use of raw (point) scores with standard (age-adjusted) scores in evaluating change.

RESULTS

Four subtests that provide a greater degree of discrimination between children with and without motor problems were identified. Raw (points) scores were found to provide a more valid measure of change over time than standard (age-related) scores.

CONCLUSION

We recommend that, for clinical use, the BOTMP subtest standard scores be used for diagnostic purposes and that the raw scores be used for evaluative purposes.

The GBG model: is there more to consider than handedness?

It is peculiar that Bryden and his colleagues admit to the inadequacy of handedness as an index for cerebral anomalous dominance and then attack a model of anomalous dominance using primarily handedness data. In reality, the GBG model (which was intended to be "a hypothesis and program for research," to quote the exact titles of the 1985 articles) is not nearly as narrow as Bryden's worldview. We present here the rest of the literature on the link between immune disorders and language disorders which Bryden et al. neglected and argue that the data are sufficient to have warranted a +2 in their evaluation. The strength of this link is worthy of further investigation, even though the hormonal mechanism proposed in the GBG model may be erroneous.

Are families of children with reading difficulties at risk for immune disorders and nonrighthandedness?

This study used questionnaire data to examine immune disorders and nonrighthandedness in the families of children enrolled in a learning disabilities school and children attending regular classrooms in public schools. Groups were organized according to their performance on a standardized test of reading comprehension to avoid overlap. In total, 468 questionnaires were returned, from which we were able to derive a final sample of carefully matched subjects: 55 subjects undergoing remediation for reading problems and 55 age- and sex-matched control subjects. The results indicated that children with reading problems and their families more frequently suffered from some immune and autoimmune disorders, particularly those involving the gastrointestinal tract and the thyroid gland. In addition, symptoms of attention deficit hyperactivity disorder were associated with Crohn's disease and migraine headache in the families. There was no evidence of an elevated prevalence of nonrighthandedness in the children with reading problems and their families.

Preventing tap water scalds: do consumers change their preset thermostats

One goal of the regulatory approach to tap water scald prevention is the installation of hot water heaters at thermostat settings considered safe. In this strategy, it is assumed that consumers will not change preset thermostat settings, an assumption evaluated in a study of 62 families. It was found that 60% of the sample did not change their preset thermostats. Surprisingly, some of those families (27%) who did not increase their settings still had unsafe (> 54 degrees C) water temperatures.

Reexamination of sensory integration treatment: a combination of two efficacy studies

Little empirical support exists for the application of sensory integration treatment (SIT) to assist children with learning problems. Treatment efficacy studies are expensive and difficult to carry out, and they have necessarily employed small samples that are inevitably heterogeneous. We have reanalyzed the efficacy of SIT by combining the data from one study involving 29 children in Alberta and a second study involving 67 children in Ontario. The results from each individual study, and now the results from the combined study, lead one to the conclusion that the therapeutic effect of SIT on children with learning deficits is not greater than other, more traditional methods of intervention.

Unsafe sex: decision-making biases and heuristics

This paper suggests that continued high-risk behavior is the result of the heuristics used to make judgments under uncertainty, and that the same heuristics may be mobilized to increase the use of safer-sex practices. In order to explain why it is that individuals fail to make effective use of the information they may have concerning rates of infection, consequences of infection and their own at-risk status, theory and research in several areas will be considered. Developments in the breadth of areas to which basic research on decision-making has been applied continue to provide new approaches toward understanding and overcoming the processes by which we reason (Kahnemann, 1991). It is worth reminding ourselves that public health campaigns in other areas have led to changes in behavior. Reasoning, even with its biases, is still the route by which we make decisions, most of them effective and self-protective.

The effects of parental immunoreactivity on pregnancy, birth, and cognitive development: maternal immune attack on the fetus?

The effects of parental immunoreactivity were tested in two ways on questionnaire data collected from 468 children and their families. (1) It was found that the presence of learning difficulties in boys was associated with pregnancy and birth complications, as well as with maternal immunoreactivity. Paternal immunoreactivity did not appear to be related to any of the variables in question. (2) The antecedent brother effect, that children, particularly males, with older brothers have higher rates of the same set of variables, was not found. Maternal immunoreactivity emerges as a risk factor for pregnancy, birth, and cognitive development, but not exclusively by the proposed mechanism of maternal immune attack on the fetus.

Reliability and construct validity of the Clinical Observations of Motor and Postural Skills

The Clinical Observations of Motor and Postural Skills (COMPS) is a screening tool for children with motor incoordination. A study of reliability (test-retest, interrater, and internal consistency) and construct validity with 132 children, both with and without developmental coordination disorder, is reported here. Test-retest reliability over 2 weeks was high: .92 for a group of 48 children. Interrater reliability for occupational therapists experienced in pediatrics was also excellent: .87 for a group of 72 children. Internal consistency of the COMPS was high, particularly when one of the seven items (Schilder's arm extension) was deleted. The test discriminates well between children with and without motor problems and has many properties of a good screening test.

Double victims: poor women and AIDS

Women constitute the fastest growing group of people with AIDS; a disproportionate number of poor minority women are affected. Education and prevention campaigns have not been directed at this population. Though intravenous drug users have been identified as "at risk," many American women have been identified as HIV positive only after giving birth to a child who develops AIDS. Combating AIDS in women offers a formidable challenge to social service and public health officials because it mandates consideration of intravenous drug abuse, high rates of unwanted and teenage pregnancies, poverty, discrimination and inadequate education.

Menstrual cycle phase is a potential confound in psychophysiology research

Effects of menstrual cycle phase on physiological levels and reactivity were studied in a within-subject design with 20 women aged 18-30 years. Basal body temperature was monitored daily; follicular and luteal recording sessions occurred before and after the ovulatory temperature rise, respectively. The design consisted of task and rest periods, presented in counterbalanced order across phases. Half the subjects began during their follicular phase and half began during their luteal phase. Follicular and luteal phases were compared for differences between baseline resting levels, as well as for reactivity. The results showed menstrual phase differences in heart rate, pulse transit time, and EEG alpha, particularly during tasks, but no difference in reactivity. Habituation effects in the group that began during the follicular phase often masked luteal activation. In spite of the fact that not all statistical results achieved significance, the consistency of most trends supports the conclusion that physiological recording sessions with women might best be restricted to the follicular phase.