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Zhou Q, Ye X, Wei C, Wu Y, Ren P, Lin X, Li L, Xiang W, Xiao L. Network Analysis of ADHD Symptoms and Cognitive Profiles in Children. Neuropsychiatr Dis Treat 2023; 19:1207-1219. [PMID: 37223654 PMCID: PMC10202214 DOI: 10.2147/ndt.s409503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose Although many studies have reported the cognitive profiles in attention-deficit/hyperactivity disorder (ADHD), the interactions between ADHD symptoms and the patients' cognitive profiles have not been carefully examined through the network analysis. Here, in this study, we systematically analyzed the ADHD patents' symptoms and cognitive profiles, and identified a set of interactions between ADHD symptoms and cognitive domains using the network approach. Patients and Methods A total of 146 children with ADHD, 6 to 15 years of age, were included in the study. All participants were assessed by the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) test. The patients' ADHD symptoms were evaluated by the Vanderbilt ADHD parent and teacher rating scales. GraphPad Prism 9.1.1 software was used for descriptive statistics and R 4.2.2 was used for network model construction. Results The ADHD children in our sample showed lower scores for full scale intelligence quotient (FSIQ), verbal comprehension index (VCI), processing speed index (PSI) and working memory index (WMI). Among all the ADHD core symptoms and comorbid symptoms, the academic ability, inattention symptoms and mood disorder showed direct interaction with the cognitive domains of WISC-IV. In addition, oppositional defiant of the ADHD comorbid symptoms, and perceptual reasoning of the cognitive domains exhibited the highest strength centrality in the ADHD-Cognition network based on parent ratings. Classroom behaviors of the ADHD functional impairment, and verbal comprehension of the cognitive domains exhibited the highest strength centrality in the network based on teacher ratings. Conclusion We highlighted the importance of considering the interactions between the ADHD symptoms and cognitive properties when designing the intervention plans for the ADHD children.
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Affiliation(s)
- Qionglin Zhou
- Hainan Medical University, Haikou, People’s Republic of China
| | - Xiaoshan Ye
- Hainan Medical University, Haikou, People’s Republic of China
| | - Chongxia Wei
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Yufan Wu
- Hainan Medical University, Haikou, People’s Republic of China
| | - Pengcheng Ren
- Hainan Medical University, Haikou, People’s Republic of China
| | - Xuewei Lin
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Ling Li
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Wei Xiang
- Hainan Medical University, Haikou, People’s Republic of China
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Le Xiao
- Hainan Medical University, Haikou, People’s Republic of China
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
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2
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Wiggs KK, Froehlich TE, Becker SP. Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research. CNS Drugs 2023; 37:293-304. [PMID: 37061629 DOI: 10.1007/s40263-023-00999-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/17/2023]
Abstract
Although the study of cognitive disengagement syndrome (CDS; previously called sluggish cognitive tempo) first emerged in the 1980s, very little is known about treating CDS or its impact on evidence-based interventions for attention-deficit/hyperactivity disorder (ADHD) with which it frequently co-occurs. The objective of this leading article was to investigate the existing evidence on medication treatment and CDS, including studies that have examined CDS response to medication and CDS as a moderator of ADHD treatment response. A total of seven studies were identified. At present, the limited existing literature suggests that psychostimulants such as methylphenidate and lisdexamfetamine, as well as atomoxetine, may improve CDS symptoms, although replication and research on related medications is needed. However, there are indications that CDS symptoms may predict a reduced response to methylphenidate in children with ADHD. Although untested, research on the neurobiological, neuropsychological, and behavioral correlates of CDS point to a possible benefit of other ADHD medications (e.g., guanfacine), medications that treat narcolepsy (e.g., modafinil), and medications traditionally used to treat depression and anxiety (e.g., viloxazine, bupropion, fluvoxamine), some of which have also recently been used in ADHD management. The article concludes with recommendations for future research on pharmacologic treatment and CDS.
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Affiliation(s)
- Kelsey K Wiggs
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45206, USA
| | - Tanya E Froehlich
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45206, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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3
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Kim K, Lee JH. The effect of feedback in virtual attention training on orienting attention in individuals with sluggish cognitive tempo. J Atten Disord 2022; 26:1640-1652. [PMID: 35491754 DOI: 10.1177/10870547221090664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was conducted to assess the effectiveness of feedback in a virtual attention training program to improve the attentional characteristics of sluggish cognitive tempo (SCT). METHOD The SCT group (N = 60) and control group (N = 30) were identified, and the attention network test-revised (ANT-R) was performed to measure attention characteristics. Based on this result, a virtual reality (VR) feedback attention training program was developed to improve the efficiency of engagement and disengagement of attention in SCT. Sixty participants with SCT were recruited and grouped into two conditions: VR feedback (n = 30) and no-feedback (n = 30) conditions. RESULTS The results show that the VR attention training program with feedback significantly improves the attention-orienting network. CONCLUSION This suggests that it is necessary to provide immediate feedback for effective attention training for SCT and continuous intervention may be possible when feedback is provided together.
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Affiliation(s)
- Kyunghwa Kim
- College of Social Science, Chung-Ang University, Seoul, South Korea
| | - Jang-Han Lee
- College of Social Science, Chung-Ang University, Seoul, South Korea
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4
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Children with Autism Spectrum Disorder of All Ages, Levels of Symptom Severity and General Cognitive Ability Display Low Processing Speed Index Scores Warranting Special Educational Assistance. J Autism Dev Disord 2021; 52:3668-3675. [PMID: 34453226 PMCID: PMC9296421 DOI: 10.1007/s10803-021-05249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
The processing speed index (PSI) of the Wechsler intelligence scale for children (WISC-IV) has been found to predict a child's level of academic functioning. The consistently reported PSI weakness in children with autism spectrum disorder (ASD) therefore warrants special assistance and attempts at compensation for the disadvantages associated with these children's low PSI. We investigated the association of PSI scores with age, general cognitive ability [as measured by full-scale IQ (FSIQ)], symptom severity and discrepancy between the WISC-IV indices verbal comprehension (VCI) and perceptual reasoning (PRI) in 101 school children with ASD. The PSI weakness in children with ASD was not related to age, FSIQ, VCI-PRI discrepancy or any of the symptom measures. These findings suggest that school children with ASD independent of their age, level of cognitive ability, VCI-PRI profile and most notably independent of their symptom severity should be entitled to special assistance and compensation in educational settings.
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5
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Peterson RK, Jones K, Jacobson LA. [Formula: see text]The contribution of sluggish cognitive tempo to processing speed in survivors of pediatric brain tumors. Child Neuropsychol 2021; 27:960-972. [PMID: 33866922 DOI: 10.1080/09297049.2021.1917529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sluggish Cognitive Tempo (SCT) describes a pattern of under-activity, poor initiation, and slowness. It was first reported within the Attention Deficit Hyperactivity Disorder (ADHD) literature and found to be positively associated with the inattentive symptoms of ADHD and negatively or not significantly associated with the hyperactivity/impulsivity symptoms of ADHD. SCT has since been considered applicable to the pediatric oncology population given the emergence of inattentive, sluggish symptoms secondary to cancer treatment. The present study examined the unique contribution of SCT to various processing speed skills in a clinical sample of pediatric brain tumor (BT) survivors in order to determine the degree to which SCT explained timed "cognitive" processing components. Measures included speeded naming, graphomotor speed, and speeded inhibition. Hierarchical linear regression analyses were used to predict performance-based measures of processing speed. After controlling for verbal ability and inattention, SCT, particularly Daydreamy SCT (β = -0.698, p = 0.023), explained 28% of variance in speeded inhibition. SCT did not add significantly to the prediction of speeded naming or graphomotor speed. Findings suggest that the "daydreamy" aspect of SCT, rather than "sluggishness" per se, may be related to more complex, cognitively-demanding tasks with greater executive functioning burdens in BT survivors. Implications for intervention for oncology survivors as well as future research directions are discussed.
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Affiliation(s)
- Rachel K Peterson
- Kennedy Krieger Institute Neuropsychology Department.,Johns Hopkins School of Medicine Department of Psychiatry and Behavioral Sciences
| | - Kelly Jones
- Kennedy Krieger Institute Neuropsychology Department
| | - Lisa A Jacobson
- Kennedy Krieger Institute Neuropsychology Department.,Johns Hopkins School of Medicine Department of Psychiatry and Behavioral Sciences
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6
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Kim K, Kim HJ. Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo. Int J Clin Health Psychol 2020; 21:100199. [PMID: 33363582 PMCID: PMC7753035 DOI: 10.1016/j.ijchp.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/20/2020] [Indexed: 11/23/2022] Open
Abstract
Background/objective: Sluggish Cognitive Tempo (SCT) is an attentional disorder characterized by the symptoms of slowness in behavior or thinking, a lack of en.ergy, difficulty initiating and sustaining effort, daydreaming, and drowsiness. The aim of the present study was to investigate the distinctive attentional characteristics of SCT as compared to Attention-Deficit/Hyperactivity Disorder (ADHD). Method: A total of 110 adults were recruited and divided into four groups: SCT+ADHD, SCT, ADHD, and healthy controls. The Revised version of Attention Networks Test was used to investigate each group’s attentional profile. Results: The results revealed that the two SCT groups (SCT+ADHD and SCT) showed a significantly weaker orienting network due to the problems of engaging and disengaging attention than the other two groups. Additionally, the two ADHD groups (SCT+ADHD and ADHD) showed a significantly weaker executive control network than the other two groups. Conclusions: The findings demonstrate an attentional distinction between the SCT and the ADHD groups with a greater dysfunction in the orienting network in the SCT group as compared to the ADHD group. Furthermore, a greater executive control dysfunction was observed in the ADHD group as compared to the SCT group.
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Affiliation(s)
- Kiho Kim
- Department of Psychology of Counseling, Sejong Cyber University, Seoul, South Korea
| | - Hyo-Jeong Kim
- Department of Psychology, Seoul National University, Seoul, South Korea
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7
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Kofler MJ, Irwin LN, Sarver DE, Fosco WD, Miller CE, Spiegel JA, Becker SP. What cognitive processes are "sluggish" in sluggish cognitive tempo? J Consult Clin Psychol 2019; 87:1030-1042. [PMID: 31613137 PMCID: PMC6814302 DOI: 10.1037/ccp0000446] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Sluggish cognitive tempo refers to a constellation of symptoms that include slowed behavior/thinking, reduced alertness, and getting lost in one's thoughts. Despite the moniker "sluggish cognitive tempo," the evidence is mixed regarding the extent to which it is associated globally with slowed (sluggish) mental (cognitive) information processing speed (tempo). METHOD A well-characterized clinical sample of 132 children ages 8-13 years (M = 10.34, SD = 1.51; 47 girls; 67% White/non-Hispanic) were administered multiple, counterbalanced neurocognitive tests and assessed for sluggish cognitive tempo symptoms via multiple-informant reports. RESULTS Bayesian linear regressions revealed significant evidence against associations between sluggish cognitive tempo and computationally modeled processing speed (BF01 > 3.70), and significant evidence for associations with slower working memory manipulation speed. These findings were consistent across parent and teacher models, with and without control for attention-deficit/hyperactivity disorder inattentive symptoms and IQ. There was also significant evidence linking faster inhibition speed with higher parent-reported sluggish cognitive tempo symptoms. CONCLUSIONS These findings provide strong evidence against characterizing children with sluggish cognitive tempo symptoms as possessing a globally sluggish cognitive tempo. Instead, these symptoms appear to be related, to a significant extent, to executive dysfunction characterized by working memory systems that are too slow and inhibition systems that are too fast. Behaviorally, these findings suggest that requiring extra time to rearrange the active contents of working memory delays responding, whereas an overactive inhibition system likely terminates thoughts too quickly and therefore prevents intended behaviors from starting or completing, thereby giving the appearance that children are absent-minded or failing to act when expected. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | - Dustin E. Sarver
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, 2500 North State Street, Jackson MS 39216, USA
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson MS 39216, USA
| | - Whitney D. Fosco
- Center for Children and Families, Florida International University, Miami, FL 33199, USA
| | | | | | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
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8
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Thorsen AL, Meza J, Hinshaw S, Lundervold AJ. Processing Speed Mediates the Longitudinal Association between ADHD Symptoms and Preadolescent Peer Problems. Front Psychol 2018; 8:2154. [PMID: 29487545 PMCID: PMC5816923 DOI: 10.3389/fpsyg.2017.02154] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/27/2017] [Indexed: 12/02/2022] Open
Abstract
We investigated the relation between dimensional aspects of inattention and hyperactivity-impulsivity in childhood and peer problems 4 years later, as well as the potential mediating effects of intellectual function. The sample included 127 children (32 with attention-deficit/hyperactivity disorder). Symptoms of inattention and hyperactivity-impulsivity were assessed via parent and teacher reports on Swanson Nolan and Pelham-IV questionnaire. Peer problems were assessed by parent reports on the Strengths and Difficulties Questionnaire, and children's intellectual functioning by the third edition of the Wechsler Intelligence Scale for Children. Linear regressions showed a significant effect of inattention on future peer problems, partially mediated by slow processing speed. These effects remained significant when ADHD status was covaried. Findings highlight the importance of processing speed in explaining the predictive relation between childhood inattention and later peer problems. Inattention and processing speed in early childhood are potentially malleable factors influencing adolescent social functioning.
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Affiliation(s)
- Anders L Thorsen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jocelyn Meza
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Stephen Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,K.G. Jebsen Center for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
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9
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Posserud M, Hysing M, Helland W, Gillberg C, Lundervold AJ. Autism traits: The importance of "co-morbid" problems for impairment and contact with services. Data from the Bergen Child Study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:275-283. [PMID: 26826893 DOI: 10.1016/j.ridd.2016.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Co-occurring problems are common in individuals with clinical autism spectrum disorder (ASD) but their relevance for impairment and contact with health services in ASD is largely unexplored. AIMS We investigated the extent of co-occurring problems in children with high ASD traits from a total population sample. We explored the contribution of co-occurring problems to impairment and service contact, and whether there were children without co-occurring problems in this group; as proxy for "ASD only". METHODS AND PROCEDURES Children screening positive on the Autism Spectrum Screening Questionnaire (ASSQ) were used as proxy for ASD. Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) were operationalised using symptom counts. A parent or teacher report above the 95th percentile counted as "problem" present for other symptom domains. OUTCOMES AND RESULTS 92% of ASSQ high-scorers had a minimum of two other problems. Emotional problems, ADHD symptoms and learning problems were the most commonly reported problems, also predicting impairment and contact with services. CONCLUSIONS AND IMPLICATIONS Co-occurring problems were common in ASD screen positive children and contributed strongly to both impairment and to contact with services. Gender differences indicated that female symptoms were perceived as less impairing by parents and teachers.
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Affiliation(s)
- M Posserud
- Department of Child and Adolescent Mental Health, Division of Psychiatry, Haukeland University Hospital, Norway.
| | - M Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
| | - W Helland
- Section of Research and Innovation Helse Fonna HF, Haugesund, Norway; Department of Speech and Language Disorders, Statped Vest, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - C Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
| | - A J Lundervold
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
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10
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Meisinger RE, Lefler EK. Pre-service teachers' perceptions of sluggish cognitive tempo. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2017; 9:89-100. [PMID: 27804023 DOI: 10.1007/s12402-016-0207-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/22/2016] [Indexed: 10/20/2022]
Abstract
Sluggish cognitive tempo (SCT) is characterized by a passive form of inattention that may not overtly disrupt classroom goals. Due to the nature of these symptoms, children with SCT may be "falling through the cracks" in schools. The current study examined pre-service teachers' perceptions of SCT in the classroom. Undergraduate education majors (n = 161) read vignettes describing fictitious fourth-grade boys presenting with symptoms of SCT, attention-deficit/hyperactivity disorder (ADHD), or a non-ADHD-related control: social anxiety disorder (SA), and rated each of the vignettes in terms of their perceptions of the boy described. Results were analyzed using repeated measures ANOVAs and paired-sample t tests. Pre-service teachers viewed all three sets of symptoms as concerning, but viewed ADHD behaviors as the most problematic. These results are promising, as they suggest that pre-service teachers are concerned about both hyperactive (i.e., ADHD) and non-hyperactive behavioral problems (i.e., SCT and SA). Implications and future directions are discussed.
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Affiliation(s)
- Rachel E Meisinger
- Department of Psychology, University of Northern Iowa, Cedar Falls, IA, 50614-0505, USA.,Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Elizabeth K Lefler
- Department of Psychology, University of Northern Iowa, Cedar Falls, IA, 50614-0505, USA.
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11
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Eilertsen T, Thorsen AL, Holm SEH, Bøe T, Sørensen L, Lundervold AJ. Parental socioeconomic status and child intellectual functioning in a Norwegian sample. Scand J Psychol 2017; 57:399-405. [PMID: 27589048 DOI: 10.1111/sjop.12324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Abstract
Socioeconomic status (SES) in childhood has been linked to cognitive function and future academic and occupational success in studies from several countries. However, previous Nordic studies have shown inconsistent results regarding the strength of this link. We therefore investigated the association between SES and cognitive functioning in a sample of 255 Norwegian children, including 151 typically developing children and 104 children with a psychiatric diagnosis. The third edition of the Wechsler Intelligence Scale for Children (WISC-III) to assess cognitive function was used. SES was defined from maternal and paternal education and family income of typically developing children and of a subsample of children with a psychiatric diagnosis. Multiple adjusted regression analyses were used to investigate the relation between SES and cognitive functioning. The analyses showed that SES explained a significant part of the variance of the full-scale WISC-III score and two WISC-III indices (Verbal Comprehension and Freedom from Distractibility). Overall, the strength of the relations was weaker than expected from reports from other non-Nordic countries. Parental education was the only significant individual predictor, suggesting that income was of minor importance as a predictor of cognitive functioning. Further studies should investigate how diverse political and socioeconomic contexts influence the relation between SES and cognitive functioning.
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Affiliation(s)
- Thomas Eilertsen
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | | | | | - Tormod Bøe
- The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Lin Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Norway.,K. G. Jebsen Center for Research on Neuropsychiatric Disorders, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Norway.,The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.,K. G. Jebsen Center for Research on Neuropsychiatric Disorders, Bergen, Norway
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12
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Lundervold AJ, Stickert M, Hysing M, Sørensen L, Gillberg C, Posserud MB. Attention Deficits in Children With Combined Autism and ADHD: A CPT Study. J Atten Disord 2016; 20:599-609. [PMID: 22940852 DOI: 10.1177/1087054712453168] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate characteristics of attention in children with the combination of autism spectrum disorder (ASD) and ADHD. METHOD Four groups of 8- to 10-year-old children were compared on the Conners' Continuous Performance Test-Second Edition (CCPT-II): (a) ASD + ADHD (n = 11), (b) ASD only (n = 9), (c) ADHD only (n = 38), and (d) no diagnosis (n = 134). RESULTS There was an overall effect of group on the Continuous Performance Test (CPT) index and measures of hit reaction time, accuracy, response style, variability, and consistency. The ASD + ADHD group, much like the ADHD only group, had a more risky response style, a higher variability, and a lower consistency than the ASD only group. The impact of intellectual function on CCPT-II performance was considerable in children within the ASD subgroups. CONCLUSION The findings underscore the importance of including measures of attention and intellectual function when assessing children with the combination of ASD and ADHD.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Norway Uni Research, Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
| | - Marte Stickert
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Mari Hysing
- Department of Biological and Medical Psychology, University of Bergen, Norway Uni Research, Bergen, Norway
| | - Lin Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Christopher Gillberg
- Uni Research, Bergen, Norway Gillberg Neuropsychiatric Centre, University of Gothenburg, Sweden
| | - Maj-Britt Posserud
- Uni Research, Bergen, Norway Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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13
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Tillman C, Brocki KC, Sørensen L, Lundervold AJ. A longitudinal examination of the developmental executive function hierarchy in children with externalizing behavior problems. J Atten Disord 2015; 19:496-506. [PMID: 23676626 DOI: 10.1177/1087054713488439] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Using a 4-year longitudinal design, we evaluated two hypotheses based on developmental executive function (EF) hierarchy accounts in a sample of children with externalizing problems. METHOD The participants performed EF tasks when they were between 8 and 12 years (M = 9.93), and again approximately 4 years later when they were between 12 and 15 years (M = 13.36). RESULTS Inhibition in middle childhood predicted working memory (WM) 4 years later. Further, deficits in inhibition and sustained attention were more prominent in middle rather than late childhood, whereas poor WM was salient throughout these periods. CONCLUSIONS These findings support the hypotheses that EFs develop hierarchically and that EF deficits in ADHD are more prominent in actively developing EFs. They also emphasize ADHD as a developmental disorder.
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Affiliation(s)
| | | | - Lin Sørensen
- University of Bergen, Norway Haukeland University Hospital, Bergen, Norway
| | - Astri J Lundervold
- University of Bergen, Norway Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research, Bergen, Norway
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14
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Illum NO, Gradel KO. The Nordic Five to Fifteen questionnaire could provide the basis for a common neurological disability variable. Acta Paediatr 2014; 103:879-85. [PMID: 24799045 DOI: 10.1111/apa.12675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 02/21/2014] [Accepted: 04/28/2014] [Indexed: 11/30/2022]
Abstract
AIMS Assessing disabilities in children is essential and Danish parents provide increasingly important feedback on how their child's disability affects daily living. The Nordic Five to Fifteen (FTF) parent questionnaire is widely used in Nordic countries to detect atypical or delayed development in children. Our study evaluated its internal validity and whether it could be used to generate a common disability variable across childhood neurological disorders and severities. METHODS The 28-statement FTF questionnaire was completed by the parents of children with spina bifida, muscular disorders, spinal atrophy, cerebral palsy, blindness, deafness, mental retardation and disability, who received treatment for brain tumours. Psychometric analysis and Rasch analysis of the five FTF code qualifier level data were carried out. RESULTS A total of 227 of 332 (68.4%) parents participated. The mean qualifier score was 3.06 (standard deviation 0.89, range 2.31-4.26), and the variances mean was 1.57 (range 0.87-2.38). The corrected code-total correlation was 0.65, and reliability was 0.96. The Rasch analysis demonstrated good fit alignment of codes. CONCLUSION The FTF questionnaire can be used with children with neurological disabilities, and the Rasch scale analysis results indicate that it could form the analytical basis for developing a common disability variable.
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Affiliation(s)
- Niels Ove Illum
- H. C. Andersen Children's Hospital; Division of Child Neurology; Odense University Hospital; Odense Denmark
| | - Kim Oren Gradel
- Centre for Clinical Epidemiology; Odense University Hospital and Research Unit of Clinical Epidemiology; Institute of Clinical Research; University of Southern Denmark; Odense Denmark
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Helland WA, Lundervold AJ, Heimann M, Posserud MB. Stable associations between behavioral problems and language impairments across childhood - the importance of pragmatic language problems. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:943-951. [PMID: 24642228 DOI: 10.1016/j.ridd.2014.02.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 02/18/2014] [Accepted: 02/21/2014] [Indexed: 06/03/2023]
Abstract
This study investigated language function associated with behavior problems, focusing on pragmatics. Scores on the Children's Communication Checklist Second Edition (CCC-2) in a group of 40 adolescents (12-15 years) identified with externalizing behavior problems (BP) in childhood was compared to the CCC-2 scores in a typically developing comparison group (n=37). Behavioral, emotional and language problems were assessed by the Strengths and Difficulties Questionnaire (SDQ) and 4 language items, when the children in the BP group were 7-9 years (T1). They were then assessed with the SDQ and the CCC-2 when they were 12-15 years (T2). The BP group obtained poorer scores on 9/10 subscales on the CCC-2, and 70% showed language impairments in the clinical range. Language, emotional and peer problems at T1 were strongly correlated with pragmatic language impairments in adolescence. The findings indicate that assessment of language, especially pragmatics, is vital for follow-up and treatment of behavioral problems in children and adolescents.
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Affiliation(s)
- Wenche Andersen Helland
- Department of Psychiatry, Helse Fonna HF, Stord Hospital, 5414 Stord, Norway; Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway; Department of Speech and Language Disorders, Statped vest, P.O. Box 6039, 5892 Bergen, Norway.
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health; Uni Research, P. O. Box 7800, 5032 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
| | - Mikael Heimann
- Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden; The Swedish Institute of Disability Research, Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden
| | - Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health; Uni Research, P. O. Box 7800, 5032 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
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Lahane S, Shah H, Nagarale V, Kamath R. Comparison of self-esteem and maternal attitude between children with learning disability and unaffected siblings. Indian J Pediatr 2013. [PMID: 23180409 DOI: 10.1007/s12098-012-0915-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare self-esteem and maternal attitude between children with learning disability and their unaffected siblings. METHODS This cross sectional study was conducted at a tertiary care hospital in an urban setting. It comprised of 31 pairs of children with a learning disability, their unaffected siblings and input from their mothers. All children were assessed with Rosenberg self-esteem scale. Mothers were asked to fill Index of parental attitude (IPA) and semi structured proforma with demographic data and questionnaire about her children with a learning disability and his/her unaffected sibling. RESULTS Self-esteem was found to be lower in children with learning disability. They felt they do not have much to be proud of and have a fewer number of good qualities. They are also inclined to consider themselves as failures. In factors affecting self-esteem, index of parental attitude was found to be unfavorable towards children with learning disability. Mothers felt child was interfering with their activities and was getting on their nerves. In addition, they also felt that they do not understand their child, feel like they do not love their child and wished that child was more like others they know off. More academic failures, academic difficulties and negative school report were also perceived by mother as lowering child's self-esteem. CONCLUSIONS Self-esteem was lower in children with learning disability. In factors affecting self-esteem maternal attitude, academic difficulties, academic failure and negative school reports was found to be unfavorable.
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Affiliation(s)
- Sandeep Lahane
- Department of Psychiatry, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai, Maharashtra, India
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Autism, processing speed, and adaptive functioning in preschool children. ScientificWorldJournal 2013; 2013:158263. [PMID: 23766675 PMCID: PMC3673455 DOI: 10.1155/2013/158263] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 04/16/2013] [Indexed: 11/18/2022] Open
Abstract
Objectives. To study cognitive test profiles with a focus on processing speed in a representative group of preschool children with autism spectrum disorder (ASD) and relate processing speed to adaptive functioning. Methods. Cognitive assessments were performed in 190 3.6–6.6-year-old children (164 boys and 26 girls) with ASD, using either Griffiths' developmental scales (n = 77) or the Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III) (n = 113). Cognitive data were related to adaptive functioning as measured by Vineland Adaptive Behavior Scales (VABS). Results. Cognitive profiles were characterized by low verbal skills. Low processing speed quotients (PSQs) were found in 66 (78%) of the 85 children who were able to participate in the processing speed subtests. Except for Socialization, all VABS domains (Communication, Motor Skills, Daily Living Skills, and Adaptive Behavior Composite scores) correlated significantly with PSQ. Multiple regression analysis showed that PSQ predicted 38%, 35%, 34%, and 37% of the variance for Communication, Daily Living Skills, Motor Skills, and total Adaptive Composite scores, respectively. Conclusion. Preschool children with ASD had uneven cognitive profiles with low verbal skills, and, relatively, even lower PSQs. Except for Socialization, adaptive functioning was predicted to a considerable degree by PSQ.
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Lundervold AJ, Adolfsdottir S, Halleland H, Halmøy A, Plessen K, Haavik J. Attention Network Test in adults with ADHD--the impact of affective fluctuations. Behav Brain Funct 2011; 7:27. [PMID: 21794128 PMCID: PMC3168400 DOI: 10.1186/1744-9081-7-27] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 07/27/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Attention Network Test (ANT) generates measures of different aspects of attention/executive function. In the present study we investigated whether adults with ADHD performed different from controls on measures of accuracy, variability and vigilance as well as the control network. Secondly, we studied subgroups of adults with ADHD, expecting impairment on measures of the alerting and control networks in a subgroup with additional symptoms of affective fluctuations. METHODS A group of 114 adults (ADHD n = 58; controls n = 56) performed the ANT and completed the Adult ADHD Rating Scale (ASRS) and the Mood Disorder Questionnaire (MDQ). The latter was used to define affective fluctuations. RESULTS The sex distribution was similar in the two groups, but the ADHD group was significantly older (p = .005) and their score on a test of intellectual function (WASI) significantly lower than in the control group (p = .007). The two groups were not significantly different on measures of the three attention networks, but the ADHD group was generally less accurate (p = .001) and showed a higher variability through the task (p = .033).The significance was only retained for the accuracy measure when age and IQ scores were controlled for. Within the ADHD group, individuals reporting affective fluctuations (n = 22) were slower (p = .015) and obtained a lower score on the alerting network (p = .018) and a higher score on the conflict network (p = .023) than those without these symptoms. The significance was retained for the alerting network (p = .011), but not the conflict network (p = .061) when we controlled for the total ASRS and IQ scores. DISCUSSION Adults with ADHD were characterized by impairment on accuracy and variability measures calculated from the ANT. Within the ADHD group, adults reporting affective fluctuations seemed to be more alert (i.e., less impacted by alerting cues), but slower and more distracted by conflicting stimuli than the subgroup without such fluctuations. The results suggest that the two ADHD subgroups are characterized by distinct patterns of attentional problems, and that the symptoms assessed by MDQ contribute to the cognitive heterogeneity characterizing groups of individuals with ADHD.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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