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Wu ZM, Wang P, Zhong YY, Liu Y, Liu XC, Wang JJ, Cao XL, Liu L, Sun L, Yang L, Zang YF, Qian Y, Cao QJ, Wang YF, Yang BR. The underlying neuropsychological and neural correlates of the impaired Chinese reading skills in children with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02422-w. [PMID: 38662058 DOI: 10.1007/s00787-024-02422-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/15/2024] [Indexed: 04/26/2024]
Abstract
Impaired basic academic skills (e.g., word recognition) are common in children with Attention Deficit Hyperactivity Disorder (ADHD). The underlying neuropsychological and neural correlates of impaired Chinese reading skills in children with ADHD have not been substantially explored. Three hundred and two children with ADHD (all medication-naïve) and 105 healthy controls underwent the Chinese language skill assessment, and 175 also underwent fMRI scans (84 ADHD and 91 controls). Between-group and mediation analyses were applied to explore the interrelationships of the diagnosis of ADHD, cognitive dysfunction, and impaired reading skills. Five ADHD-related brain functional networks, including the default mode network (DMN) and the dorsal attention network (DAN), were built using predefined regions of interest. Voxel-based group-wise comparisons were performed. The ADHD group performed worse than the control group in word-level reading ability tests, with lower scores in Chinese character recognition (CR) and word chains (WS) (all P < 0.05). With full-scale IQ and sustained attention in the mediation model, the direct effect of ADHD status on the CR score became insignificant (P = 0.066). The underlying neural correlates for the orthographic knowledge (OT) and CR differed between the ADHD and the control group. The ADHD group tended to recruit more DMN regions to maintain their reading performance, while the control group seemed to utilize more DAN regions. Children with ADHD generally presented impaired word-level reading skills, which might be caused by impaired sustained attention and lower IQ. According to the brain functional results, we infer that ADHD children might utilize a different strategy to maintain their orthographic knowledge and character recognition performance.
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Affiliation(s)
- Zhao-Min Wu
- Shenzhen Childrens Hospital, Shenzhen, China.
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen, China.
| | | | | | - Yun Liu
- Shenzhen Childrens Hospital, Shenzhen, China
| | | | - Jiu-Ju Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | | | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Yang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yu-Feng Zang
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Ying Qian
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Qing-Jiu Cao
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Yu-Feng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Friedman LM, Eckrich SJ, Rapport MD, Bohil CJ, Calub C. Working and short-term memory in children with ADHD: an examination of prefrontal cortical functioning using functional Near-Infrared Spectroscopy (fNIRS). Child Neuropsychol 2024; 30:462-485. [PMID: 37199502 DOI: 10.1080/09297049.2023.2213463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
Working memory impairments are an oft-reported deficit among children with ADHD, and complementary neuroimaging studies implicate reductions in prefrontal cortex (PFC) structure and function as a neurobiological explanation. Most imaging studies, however, rely on costly, movement-intolerant, and/or invasive methods to examine cortical differences. This is the first study to use a newer neuroimaging tool that overcomes these limitations, functional Near Infrared Spectroscopy (fNIRS), to investigate hypothesized prefrontal differences. Children (aged 8-12) with ADHD (N = 22) and typically developing (N = 18) children completed phonological working memory (PHWM) and short-term memory (PHSTM) tasks. Children with ADHD evinced poorer performance on both tasks, with greater differences observed in PHWM (Hedges' g = 0.67) relative to PHSTM (g = 0.39). fNIRS revealed reduced hemodynamic response among children with ADHD in the dorsolateral PFC while completing the PHWM task, but not within the anterior or posterior PFC. No between-group fNIRS differences were observed during the PHSTM task. Findings suggest that children with ADHD exhibit an inadequate hemodynamic response in a region of the brain that underlies PHWM abilities. The study also highlights the use of fNIRS as a cost-effective, noninvasive neuroimaging technique to localize/quantify neural activation patterns associated with executive functions.
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Affiliation(s)
| | - Samuel J Eckrich
- Department of Psychology, University of Central Florida, Orlando, FL, USA
- Department of Neuropsychology, Kennedy Krieger/Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mark D Rapport
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Corey J Bohil
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Catrina Calub
- Department of Psychiatry, University of California, Sacramento, CA, USA
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Lee CSC. Executive functions underlie word reading and reading fluency in Chinese children with attention deficit/hyperactivity disorder, reading disabilities, and comorbid attention deficit/hyperactivity disorder and reading disabilities. Child Neuropsychol 2024; 30:60-86. [PMID: 36794401 DOI: 10.1080/09297049.2023.2179981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
The current study examined the executive function (EF) deficits and their roles in reading in one hundred and four Cantonese-speaking children with typical development, reading disabilities (RD), ADHD, and comorbid ADHD and RD (ADHD + RD). Children's EF and reading skills were measured. Analysis of variance results showed that all children with disorders manifested deficits in verbal and visuospatial short-term and working memory and behavioral inhibition. Moreover, children with ADHD and ADHD + RD also exhibited deficits in inhibition (IC and BI) and cognitive flexibility. These findings demonstrated that the EF deficits in Chinese children with RD, ADHD, and ADHD + RD are similar to those in their counterparts using alphabetic languages. However, children with ADHD + RD displayed more severe deficits in visuospatial working memory compared to children with RD and ADHD, which was inconsistent with that observed in children using alphabetic languages. Regression analysis results showed that verbal short-term memory was a significant predictor for both word reading and reading fluency in children with RD and ADHD + RD. Moreover, behavioral inhibition significantly predicted reading fluency in children with ADHD. These findings also agreed with previous studies. Collectively, the results of the current study showed that the EF deficits and their roles in reading found in Chinese children with RD, ADHD, and ADHD + RD are mainly consistent with children using alphabetic languages. However, more studies are still needed to confirm these findings, especially comparing the severity of working memory among these three disorders.
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Affiliation(s)
- Clara Shuk-Ching Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Russell KMH, Redmond SM, Ash AC. Psycholinguistic profiling of children with sluggish cognitive tempo. CLINICAL LINGUISTICS & PHONETICS 2023; 37:828-844. [PMID: 35748339 PMCID: PMC9789211 DOI: 10.1080/02699206.2022.2092422] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 05/27/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
Language disorders are frequently comorbid with attention deficit/hyperactivity disorder (ADHD). Sluggish cognitive tempo (SCT), a second attention disorder, may potentially explain some of the links between language disorders and ADHD. In this study we examined the psycholinguistic abilities of 207 children (mean age 7;10) with and without clinically significant levels of SCT symptoms to determine the degree to which symptoms of language disorder co-occur in cases of SCT. Analyses of children's tense-marking, nonword repetition, and sentence recall indicated that deficits in these areas were not associated with SCT. Instead, SCT appears to be more closely aligned with features of social (pragmatic) communication disorder.
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Affiliation(s)
- Kirsten M Hannig Russell
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
| | - Sean M Redmond
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
| | - Andrea C Ash
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
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Shin HJ, Lee HJ, Kang D, Kim JI, Jeong E. Rhythm-based assessment and training for children with attention deficit hyperactivity disorder (ADHD): a feasibility study protocol. Front Hum Neurosci 2023; 17:1190736. [PMID: 37584031 PMCID: PMC10423996 DOI: 10.3389/fnhum.2023.1190736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/07/2023] [Indexed: 08/17/2023] Open
Abstract
Background The timing-related deficits in individuals with attention deficit hyperactivity disorder (ADHD) contribute to the symptom-related difficulties and cognitive impairments. Current assessment and training measurement only target specific aspects of the timing ability, highlighting the need for more advanced tools to address timing deficits in ADHD. The aim of this study is to develop and validate a rhythm-based assessment and training (RAT) program, which intends to provide a comprehensive understanding of and enhancement to the time-related abilities of children with ADHD, thereby demonstrating its clinical efficacy. Methods We will use randomized crossover trials in this study, with participants being randomly assigned to either start with the RAT and then proceed to cognitive training or start with cognitive training and then proceed to the RAT. Both groups will undergo pre- and post- evaluations. The evaluation will be administered immediately before and after the 4-week training period using diagnostic questionnaires, cognitive evaluation tools, and resting electroencephalography (EEG) measurements. Notably, EEG measurements will be conducted concurrently with the RAT evaluations. Discussion This study develops and evaluates the feasibility and effectiveness of a RAT while using EEG measurements to elucidate the underlying therapeutic mechanism of auditory rhythm at varying levels of complexity. The study will investigate the potential of RAT as a supplementary or alternative approach for managing ADHD. The multifaceted data collected will yield valuable insights to customize training agendas based on individual developmental stages and prognoses.
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Affiliation(s)
- Hye Jin Shin
- Department of Music and Science for Clinical Practice, Graduate School, Hanyang University, Seoul, Republic of Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University Medical Center, Seoul, Republic of Korea
- College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Dahyun Kang
- Institute of Mental Health, Hanyang University, Seoul, Republic of Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Eunju Jeong
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul, Republic of Korea
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Chan ES, Shero JA, Hand ED, Cole AM, Gaye F, Spiegel JA, Kofler MJ. Are Reading Interventions Effective for At-Risk Readers with ADHD? A Meta-Analysis. J Atten Disord 2023; 27:182-200. [PMID: 36278436 PMCID: PMC9913889 DOI: 10.1177/10870547221130111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Utilizing a multi-level meta-analytic approach, this review is the first to systematically quantify the efficacy of reading interventions for school-aged children with ADHD and identify potential factors that may increase the success of reading-related interventions for these children. METHOD 18 studies (15 peer-reviewed articles, 3 dissertations) published from 1986 to 2020 (N = 564) were meta-analyzed. RESULTS Findings revealed reading interventions are highly effective for improving reading skills based on both study-developed/curriculum-based measures (g = 1.91) and standardized/norm-referenced achievement tests (g = 1.11) in high-quality studies of children with rigorously-diagnosed ADHD. Reading interventions that include at least 30 hours of intervention targeting decoding/phonemic awareness meet all benchmarks to be considered a Level 1 (Well-Established) Evidence-Based Practice with Strong Research Support for children with ADHD based on clinical and special education criteria. CONCLUSIONS Our findings collectively indicate that reading interventions should be the first-line treatment for reading difficulties among at-risk readers with ADHD.
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Caldani S, Acquaviva E, Moscoso A, Peyre H, Delorme R, Bucci MP. Reading performance in children with ADHD: an eye-tracking study. ANNALS OF DYSLEXIA 2022; 72:552-565. [PMID: 35920972 DOI: 10.1007/s11881-022-00269-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
Reading disabilities have a profound impact on the academic performance and achievement of children. Although oculomotor pattern abnormalities during reading in children with dyslexia are well known, those in individuals with attention deficit and hyperactive disorders (ADHD) - who also frequently exhibit a reading impairment - remain largely undetermined. The objective of the present study was to evaluate the peculiarities of oculomotor pattern abnormalities during a reading task. An eye-tracker was used to record eye movements in four distinct groups of children with neurodevelopmental disorders: children with dyslexia, children with ADHD with and without comorbid dyslexia, and in a group of typically developing children (TD). Ninety-six children participated in the study (24 children per group, IQ- and age-matched groups). The duration of fixation, the total reading time, and the number of forward and backward saccades were similar in children with dyslexia and ADHD + dyslexia, but were significantly different from those observed in children with ADHD and with TD. Our findings suggest a link between dyslexia and oculomotor reading impairments in both children with dyslexia and children with ADHD + dyslexia, indicating that the oculomotor pattern in children with ADHD without comorbid dyslexia is similar to that observed in TD children. We suggest that an objective eye movement recording during a reading task could help clinicians to better evaluate the possible presence of comorbid dyslexia in children with ADHD. Furthermore, children with ADHD with and without comorbid dyslexia could also have working memory deficiencies. Further studies are needed to confirm this finding.
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Affiliation(s)
- Simona Caldani
- UMR 7114, MoDyCo, CNRS Université Paris Nanterre, 92001, Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Ana Moscoso
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Hugo Peyre
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- Paris University, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- Paris University, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Maria Pia Bucci
- UMR 7114, MoDyCo, CNRS Université Paris Nanterre, 92001, Nanterre, France.
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, Paris, France.
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Rapport MD, Friedman LM, Pothoven C, Calub C. Attention-Deficit/Hyperactivity Disorder (ADHD) and Forgetfulness: Does Time-Related Decay Reflect Deficient Rehearsal? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Parks KMA, Moreau CN, Hannah KE, Brainin L, Joanisse MF. The Task Matters: A Scoping Review on Reading Comprehension Abilities in ADHD. J Atten Disord 2022; 26:1304-1324. [PMID: 34961391 DOI: 10.1177/10870547211068047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A broad range of tasks have been used to classify individuals with ADHD with reading comprehension difficulties. However, the inconsistency in the literature warrants a scoping review of current knowledge about the relationship between ADHD diagnosis and reading comprehension ability. METHOD A comprehensive search strategy was performed to identify relevant articles on the topic. Thirty-four articles met inclusion criteria for the current review. RESULTS The evidence as a whole suggests reading comprehension is impaired in ADHD. The most prominent effect was found in studies where participants retell or pick out central ideas in stories. On these tasks, participants with ADHD performed consistently worse than typically developing controls. However, some studies found that performance in ADHD improved when reading comprehension task demands were low. CONCLUSION Results suggest that performance in ADHD depends on the way reading comprehension is measured and further guide future work clarifying why there are such discrepant findings across studies.
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Friedman LM, Rapport MD, Fabrikant-Abzug G. Consistently Inconsistent Working Memory Performance Among Children with ADHD: Evidence of Response Accuracy Variability (RAV). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09967-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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ADHD symptoms and school impairment history in parents of ADHD children are a fundamental diagnostic and therapeutic clue. Ital J Pediatr 2022; 48:50. [PMID: 35346326 PMCID: PMC8962016 DOI: 10.1186/s13052-022-01240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Attention Deficit and Hyperactivity Disorder (ADHD) is a multi-factorial condition, with inheritance playing a major role. Recognizing parents’ ADHD represents a clue not only for an earlier diagnosis of the disease in their children, but also to optimize psycho-educational therapy outcomes, by addressing the impairment of parenting related to untreated ADHD. This study aimed to assess the frequency of features suggestive of ADHD during childhood among parents of affected children, and the presence of school and emotional impairment.
Methods
We administered the Wender Utah Rating Scale-25, a self-assessment tool for the retrospective identification of symptoms consistent with ADHD during childhood, to a cohort of 120 parents of 60 children with ADHD, and to a consistent number of “controls”.
Results
The WURS-25 proved positive in 49.1% of fathers and 30.0% of mothers of ADHD patients, compared to 1.7% of fathers and 1.7% of mothers of non-ADHD patients (p < 0.0001).
The questions addressing learning and emotional impairment provided significantly higher scores in parents with an overall positive test compared to those with negative test (p < 0.0001).
Conclusions
This study demonstrates a remarkably high rate of symptoms consistent with ADHD during childhood in parents of affected children. Physicians should be aware that this is a relevant anamnestic clue and, given the relevance of parents’ role in the management of children with ADHD, an important issue to address in order to optimize patients’ treatment.
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Calub CA, Rapport MD, Irurita C, Eckrich SJ, Bohil C. Attention Control in Children With ADHD: An Investigation Using Functional Near Infrared Spectroscopy (fNIRS). Child Neuropsychol 2022; 28:1072-1096. [PMID: 35285411 DOI: 10.1080/09297049.2022.2047913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Attention problems are a predominant contributor to near- and far-term functional outcomes in attention-deficit/hyperactivity disorder (ADHD); however, most interventions focus on improving the alerting attentional network, which has failed to translate into improved learning for a majority of children with ADHD. Comparatively less is known regarding the executive attentional network and its overarching attention control process, which governs the ability to maintain relevant information in a highly active, interference-free state, and is intrinsic to a broad range of cognitive functions. This is the first study to compare attention control abilities in children with ADHD and typically developing (TD) children using the Visual Array Task (VAT) and to simultaneously measure hemodynamic functioning (oxyHb) using functional Near-Infrared Spectroscopy (fNIRS). Nineteen children with ADHD Combined type and 18 typically developing (TD) children aged 8 to 12 years were administered the VAT task while prefrontal activity was monitored using fNIRS. Results revealed that children with ADHD evinced large magnitude deficits in attention control and that oxyHb levels in the left dorsal lateral prefrontal cortex (dlPFC) were significantly greater in children with ADHD relative to TD children. These findings suggest that poor attention control abilities in children with ADHD may be related to increased left dlPFC activation in response to an underdeveloped and/or inefficient right dlPFC. The need to design interventions that target and strengthen attention control and its corresponding neural network is discussed based on the likelihood that attention control serves as the potential quaesitum for understanding a wide array of ADHD-related deficits.
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Affiliation(s)
- Catrina A Calub
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Mark D Rapport
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Carolina Irurita
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Samuel J Eckrich
- Department of Neuropsychology, Kennedy Krieger Institute/Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corey Bohil
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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Roles of reading anxiety and working memory in reading comprehension in English as a second language. LEARNING AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.lindif.2021.102092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Which 'Working' Components of Working Memory aren't Working in Youth with ADHD? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:647-660. [PMID: 31989344 DOI: 10.1007/s10802-020-00621-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary 'working' subcomponents of the working memory system in these children. Children ages 8-13 with (n = 45) and without (n = 41) ADHD (40% female; Mage = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF10 = 4.64 × 105; d = 1.34) and updating (BF10 = 9.49; d = 0.64), but not dual-processing (BF01 = 1.33; d = 0.37). Overall, 67%-71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%-57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.
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Irwin LN, Soto EF, Chan ES, Miller CE, Carrington-Forde S, Groves NB, Kofler MJ. Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD). Child Neuropsychol 2021; 27:468-490. [PMID: 33459154 PMCID: PMC8035253 DOI: 10.1080/09297049.2020.1866521] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Most children with ADHD have impaired working memory abilities. These working memory deficits predict impairments in activities of daily living (ADLs) for adults with ADHD. However, our understanding of the relation between pediatric ADHD and ADLs is limited. Thus, this study aimed to examine (1) the extent to which pediatric ADHD is associated with ADL difficulties; and if so (2) the extent to which these difficulties are related to their well-documented working memory difficulties and/or core ADHD inattentive and hyperactive/impulsive symptom domains. A well-characterized, clinically evaluated sample of 141 children ages 8-13 years (M = 10.36, SD = 1.46; 51 girls; 70% White/non-Hispanic) were administered a battery of well-validated working memory tests and assessed for ADHD symptoms (teacher-ratings) and ADL difficulties (parent-ratings); cross-informant reports were used to control for mono-informant bias. Children with ADHD exhibited medium magnitude difficulties with ADLs (d = 0.61, p < .005, 38% impaired). Results of the bias-corrected, bootstrapped conditional effects model indicated that lower working memory predicted reduced performance of age-expected ADLs (β =0.28) and greater ADHD inattentive (β = -0.40) and hyperactive/impulsive symptoms (β = -0.16). Greater inattentive, but not hyperactive/impulsive, symptoms predicted greater ADL difficulties (β = -0.36) even after controlling for working memory. Interestingly, working memory exerted a significant indirect effect on ADLs via inattentive (indirect effect: β = 0.15, effect ratio = .54) but not hyperactive/impulsive symptoms. These findings implicate ADHD inattentive symptoms as a potential mechanism underlying ADL difficulties for children with ADHD, both independently and via working memory's role in regulating attention.
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Affiliation(s)
| | - Elia F. Soto
- Florida State University, Department of Psychology
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Schmitt JC, Justi FRDR. A Influência de Variáveis Cognitivas e do TDAH na Leitura de Crianças. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo O estudo investigou a influência de variáveis cognitivas na leitura de crianças com desenvolvimento típico e em crianças com Transtorno de Déficit de Atenção e Hiperatividade (TDAH). Participaram 70 crianças do 2° ao 7° anos do Ensino Fundamental, divididas nos grupos: TDAH e controle. Foram aplicadas tarefas de consciência fonológica, memória de trabalho fonológica, nomeação seriada rápida, vocabulário, quociente de inteligência (QI), atenção, flexibilidade cognitiva e leitura (precisão, fluência e compreensão). Análises de regressão linear múltipla indicaram que a nomeação seriada rápida e a consciência fonológica contribuíram fortemente para a precisão, a fluência e a compreensão de leitura. O TDAH influenciou somente na compreensão. Argumentou-se que provavelmente os componentes da função executiva são os responsáveis pela relação entre TDAH e compreensão de leitura.
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Family and developmental history of ADHD patients: a structured clinical routine interview identifies a significant profile. Eur Arch Psychiatry Clin Neurosci 2020; 270:1047-1061. [PMID: 31399866 DOI: 10.1007/s00406-019-01047-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/23/2019] [Indexed: 12/28/2022]
Abstract
Similar to other neurodevelopmental disorders, the diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on clinical and psychosocial assessment. This assessment is performed in clinical practice using the clinical routine interview technique. Domains of the clinical routine interview are, among others, present symptoms, history of present illness and family and developmental history. Family and developmental history are important parts in the diagnostic process of ADHD. In contrast to the domains of present symptoms and history of present illness, there are currently no structured interviews or rating scales available to thoroughly assess family and developmental history in ADHD. The aim of the study was to assess the profile of operationalized data from a structured clinical routine interview addressing family and developmental history from ADHD patients and control participants. A structured interview to assess family and developmental history was derived from the guidelines used at different university hospitals for Child and Adolescent Psychiatry as well as from the descriptions in leading textbooks. Based on these guidelines and descriptions, the interview was an optimization of possible questions. Clinical data were obtained from parents of male patients who had the diagnosis of ADHD between the ages of 12-17 years (n = 44), and of healthy controls (n = 41). Non-metric data were operationalized into three categories, 0-normal behavior, 1-minor pathological behavior, 2-major pathological behavior. ADHD patients express a profile that significantly differs from control participants. Comparison of significant items with the empirical ADHD literature indicates strong agreement. Our findings support the importance and feasibility of the clinical routine interview in family and developmental history in the context of diagnosing ADHD.
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Kofler MJ, Singh LJ, Soto EF, Chan ES, Miller CE, Harmon SL, Spiegel JA. Working memory and short-term memory deficits in ADHD: A bifactor modeling approach. Neuropsychology 2020; 34:686-698. [PMID: 32437194 PMCID: PMC7483636 DOI: 10.1037/neu0000641] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) has been associated with large magnitude impairments in working memory, whereas short-term memory deficits, when detected, tend to be less pronounced. However, confidence in these findings is limited due to task impurity combined with methodological and statistical limitations of the current evidence base. Method: A well-characterized, clinically evaluated sample of 172 children ages 8-13 years (M = 10.30, SD = 1.42; 72 girls; 64% White/non-Hispanic) were administered multiple, counterbalanced working memory tests. Bifactor-(s-1) modeling was used to characterize the presence and magnitude of central executive working memory, phonological short-term memory, and visuospatial short-term memory deficits in pediatric ADHD. Results: ADHD status was associated with very large magnitude impairments in central executive working memory that are present in most pediatric cases (d = 1.63-2.03; 75%-81% impaired), and these deficits covaried with ADHD inattentive and hyperactive/impulsive symptom severity based on both parent and teacher report. There was also evidence for a unique, albeit significantly smaller, impairment in visuospatial short-term memory (d = 0.60; 38% impaired); however, visuospatial short-term memory abilities did not covary with ADHD symptom severity. There was no evidence linking ADHD with phonological short-term memory deficits across either the dimensional or categorical analyses. Conclusion: These findings provide strong evidence that ADHD is associated with marked central executive working memory deficits that covary with their behavioral symptom presentation across settings. In contrast, visuospatial short-term memory deficits, when present, are likely epiphenomenal, and the most parsimonious conclusion appears to be that phonological short-term memory is intact in pediatric ADHD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Elia F. Soto
- Florida State University, Department of Psychology
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Do Working Memory Deficits Underlie Reading Problems in Attention-Deficit/Hyperactivity Disorder (ADHD)? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:433-446. [PMID: 29923160 DOI: 10.1007/s10802-018-0447-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Reading problems are common in children with ADHD and show strong covariation with these children's underdeveloped working memory abilities. In contrast, working memory training does not appear to improve reading performance for children with ADHD or neurotypical children. The current study bridges the gap between these conflicting findings, and combines dual-task methodology with Bayesian modeling to examine the role of working memory for explaining ADHD-related reading problems. Children ages 8-13 (M = 10.50, SD = 1.59) with and without ADHD (N = 78; 29 girls; 63% Caucasian/Non-Hispanic) completed a counterbalanced series of reading tasks that systematically manipulated concurrent working memory demands. Adding working memory demands produced disproportionate decrements in reading comprehension for children with ADHD (d = -0.67) relative to Non-ADHD children (d = -0.18); comprehension was significantly reduced in both groups when working memory demands were increased. These effects were robust to controls for foundational reading skills (decoding, sight word vocabulary) and comorbid reading disability. Concurrent working memory demands did not slow reading speed for either group. The ADHD group showed lower comprehension (d = 1.02) and speed (d = 0.69) even before adding working memory demands beyond those inherently required for reading. Exploratory conditional effects analyses indicated that underdeveloped working memory overlapped with 41% (comprehension) and 85% (speed) of these between-group differences. Reading problems in ADHD appear attributable, at least in part, to their underdeveloped working memory abilities. Combined with prior cross-sectional and longitudinal findings, the current experimental evidence positions working memory as a potential causal mechanism that is necessary but not sufficient for effectively understanding written language.
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Abstract
OBJECTIVE Several studies agree on the link between attention and eye movements during reading. It has been well established that attention and working memory (WM) interact. A question that could be addressed to better understand these relationships is: to what extent can an attention deficit affect eye movements and, consequently, remembering a word? The main aims of the present study were (1) to compare visual patterns of word stimuli between children with Attention Deficit Hyperactivity Disorder (ADHD) and typically developing (TD) children, during a visual task on word stimuli; (2) to examine the WM accuracy of the word stimuli; and (3) to compare the dynamic of visual scan path in both groups. METHOD A total of 49 children with ADHD, age and sex matched with 32 TD children, were recruited. We used eye-tracking technology in which the Word Memory Test was implemented. To highlight the scan path of participants, two measures were used: the ordered direction of reading and the entropy index. RESULTS ADHD groups showed a poorer WM than TD group. They did not follow a typical scan path across the words compared with TD children, but their visual scanning was discontinuous, uncoordinated, and chaotic. ADHD groups showed an index of entropy among the four categories of saccades higher than TD group. CONCLUSIONS The findings were discussed in light of two directions: the relationship between atypical visual scan path and WM and the training implications related to the necessity of redirecting the dynamic of visual scan path in ADHD to improve WM.
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Kofler MJ, Irwin LN, Soto EF, Groves NB, Harmon SL, Sarver DE. Executive Functioning Heterogeneity in Pediatric ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:273-286. [PMID: 29705926 DOI: 10.1007/s10802-018-0438-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Neurocognitive heterogeneity is increasingly recognized as a valid phenomenon in ADHD, with most estimates suggesting that executive dysfunction is present in only about 33%-50% of these children. However, recent critiques question the veracity of these estimates because our understanding of executive functioning in ADHD is based, in large part, on data from single tasks developed to detect gross neurological impairment rather than the specific executive processes hypothesized to underlie the ADHD phenotype. The current study is the first to comprehensively assess heterogeneity in all three primary executive functions in ADHD using a criterion battery that includes multiple tests per construct (working memory, inhibitory control, set shifting). Children ages 8-13 (M = 10.37, SD = 1.39) with and without ADHD (N = 136; 64 girls; 62% Caucasian/Non-Hispanic) completed a counterbalanced series of executive function tests. Accounting for task unreliability, results indicated significantly improved sensitivity and specificity relative to prior estimates, with 89% of children with ADHD demonstrating objectively-defined impairment on at least one executive function (62% impaired working memory, 27% impaired inhibitory control, 38% impaired set shifting; 54% impaired on one executive function, 35% impaired on two or all three executive functions). Children with working memory deficits showed higher parent- and teacher-reported ADHD inattentive and hyperactive/impulsive symptoms (BF10 = 5.23 × 104), and were slightly younger (BF10 = 11.35) than children without working memory deficits. Children with vs. without set shifting or inhibitory control deficits did not differ on ADHD symptoms, age, gender, IQ, SES, or medication status. Taken together, these findings confirm that ADHD is characterized by neurocognitive heterogeneity, while suggesting that contemporary, cognitively-informed criteria may provide improved precision for identifying a smaller number of neuropsychologically-impaired subtypes than previously described.
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Affiliation(s)
- Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Lauren N Irwin
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Elia F Soto
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Nicole B Groves
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Sherelle L Harmon
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Dustin E Sarver
- Departments of Pediatrics and Psychiatry, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, USA
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Dong Y, Peng SN, Sun YK, Wu SXY, Wang WS. Reading Comprehension and Metalinguistic Knowledge in Chinese Readers: A Meta-Analysis. Front Psychol 2020; 10:3037. [PMID: 32116868 PMCID: PMC7013083 DOI: 10.3389/fpsyg.2019.03037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
Metalinguistic knowledge has a facilitative effect on reading comprehension. This meta-analysis examined the relationship between metalinguistic knowledge and reading comprehension among Chinese students. By focusing on both Chinese and English scripts' reading comprehension performance, this study synthesized 46 studies with 73 independent samples that represented 10,793 Chinese students from primary school to university levels. We found that in both Chinese and English scripts' reading, morphological awareness had the strongest correlation with reading comprehension, whereas both phonological awareness and orthographical skill had a similar medium correlation with reading comprehension. All three metalinguistic knowledge, which was not significantly influenced by the selected moderators of grade group, area, language type, and assessment, had an independent correlation with reading comprehension. The results suggested that reading stages did not significantly impact the function of metalinguistic knowledge on both Chinese and English scripts' reading comprehension for Chinese students. In addition, for Chinese students, morphological awareness plays a more important role than phonological awareness and orthographical skill in both Chinese and English scripts' reading comprehension.
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Affiliation(s)
- Yang Dong
- Faculty of Education and Science, Jiaying University, Meizhou, China
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Shu-Na Peng
- Faculty of Education and Science, Jiaying University, Meizhou, China
| | - Yuan-Ke Sun
- Department of Science and Environmental Studies, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Sammy Xiao-Ying Wu
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Wei-Sha Wang
- University of Southampton, Southampton, United Kingdom
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Hautala J, Loberg O, Azaiez N, Taskinen S, Tiffin-Richards SP, Leppänen PH. What information should I look for again? Attentional difficulties distracts reading of task assignments. LEARNING AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.lindif.2019.101775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Friedman LM, Rapport MD, Orban SA, Eckrich SJ, Calub CA. Applied Problem Solving in Children with ADHD: The Mediating Roles of Working Memory and Mathematical Calculation. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:491-504. [PMID: 28597131 DOI: 10.1007/s10802-017-0312-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The difficulties children with ADHD experience solving applied math problems are well documented; however, the independent and/or interactive contributions of cognitive processes underlying these difficulties are not fully understood and warrant scrutiny. The current study examines two primary cognitive processes integral to children's ability to solve applied math problems: working memory (WM) and math calculation skills (i.e., the ability to utilize specific facts, skills, or processes related to basic math operations stored in long-term memory). Thirty-six boys with ADHD-combined presentation and 33 typically developing (TD) boys aged 8-12 years old were administered multiple counterbalanced tasks to assess upper (central executive [CE]) and lower level (phonological [PH STM] and visuospatial [VS STM] short-term memory) WM processes, and standardized measures of mathematical abilities. Bias-corrected, bootstrapped mediation analyses revealed that CE ability fully mediated between-group differences in applied problem solving whereas math calculation ability partially mediated the relation. Neither PH STM nor VS STM was a significant mediator. When modeled together via serial mediation analysis, CE in tandem with math calculation ability fully mediated the relation, explained 79% of the variance, and provided a more parsimonious explication of applied mathematical problem solving differences among children with ADHD. Results suggest that interventions designed to address applied math difficulties in children with ADHD will likely benefit from targeting basic knowledge of math facts and skills while simultaneously promoting the active interplay of these skills with CE processes.
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Affiliation(s)
- Lauren M Friedman
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Bldg 99, Orlando, FL, 32816, USA
| | - Mark D Rapport
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Bldg 99, Orlando, FL, 32816, USA.
| | - Sarah A Orban
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Bldg 99, Orlando, FL, 32816, USA
| | - Samuel J Eckrich
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Bldg 99, Orlando, FL, 32816, USA
| | - Catrina A Calub
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Psychology Bldg 99, Orlando, FL, 32816, USA
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Inattentive Behavior in Boys with ADHD during Classroom Instruction: the Mediating Role of Working Memory Processes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:713-727. [PMID: 28825170 DOI: 10.1007/s10802-017-0338-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Children with ADHD exhibit clinically impairing inattentive behavior during classroom instruction and in other cognitively demanding contexts. However, there have been surprisingly few attempts to validate anecdotal parent/teacher reports of intact sustained attention during 'preferred' activities such as watching movies. The current investigation addresses this omission, and provides an initial test of how ADHD-related working memory deficits contribute to inattentive behavior during classroom instruction. Boys ages 8-12 (M = 9.62, SD = 1.22) with ADHD (n = 32) and typically developing boys (TD; n = 30) completed a counterbalanced series of working memory tests and watched two videos on separate assessment days: an analogue math instructional video, and a non-instructional video selected to match the content and cognitive demands of parent/teacher-described 'preferred' activities. Objective, reliable observations of attentive behavior revealed no between-group differences during the non-instructional video (d = -0.02), and attentive behavior during the non-instructional video was unrelated to all working memory variables (r = -0.11 to 0.19, ns). In contrast, the ADHD group showed disproportionate attentive behavior decrements during analogue classroom instruction (d = -0.71). Bias-corrected, bootstrapped, serial mediation revealed that 59% of this between-group difference was attributable to ADHD-related impairments in central executive working memory, both directly (ER = 41%) and indirectly via its role in coordinating phonological short-term memory (ER = 15%). Between-group attentive behavior differences were no longer detectable after accounting for ADHD-related working memory impairments (d = -0.29, ns). Results confirm anecdotal reports of intact sustained attention during activities that place minimal demands on working memory, and indicate that ADHD children's inattention during analogue classroom instruction is related, in large part, to their underdeveloped working memory abilities.
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Ramos AA, Hamdan AC, Machado L. A meta-analysis on verbal working memory in children and adolescents with ADHD. Clin Neuropsychol 2019; 34:873-898. [PMID: 31007130 DOI: 10.1080/13854046.2019.1604998] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings are inconsistent. The main objective of this meta-analysis was to investigate the performance of children and adolescents with ADHD in the Digit Span Backwards (DSB) subtest from the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale. We also sought to provide an updated meta-analysis on WM in children and adolescents with ADHD.Method: PubMed, PsyINFO, Scopus, and Web of Science were searched to locate studies published between 1990 and 2016 that report DSB scores both of children and adolescents with ADHD and matched controls. Potential moderator variables were also analyzed.Results: Forty-nine studies comparing children and adolescents with ADHD (n = 4956) against healthy controls (n = 3249) generated a medium-sized effect (Hedges' g) of 0.56 (95% CI [0.49, 0.64]), indicating poorer verbal WM performance in those with ADHD. A subgroup meta-analysis of studies with participants aged 8-16 years only demonstrated low heterogeneity (I2 = 17.06, cf. 55.50 for the main analysis). Moreover, the meta-regression showed a negative association (β = -.05, p = .02) between DSB performance differences and increasing age, indicating that for every one year increase in age the effect size decreased by .05.Conclusion: These results, which emanated from the largest meta-analysis concerning verbal WM in ADHD reported to date, reinforce WM as a key domain of cognitive dysfunction in ADHD, and point to age as the main variable influencing DSB performance difficulties.
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Affiliation(s)
- Ari Alex Ramos
- Department of Psychology, Federal University of Paraná, Curitiba, Brazil.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Liana Machado
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Paula EMSD, Navas AL. Profile of reading difficulties in children with attention deficit hyperactivity disorder: a literature review. REVISTA CEFAC 2018. [DOI: 10.1590/1982-021620182064718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to characterize the reading alterations in individuals with attention deficit hyperactivity disorder. Methods: PubMed and SciELO platforms from 2006 to 2016 with the keywords "reading" and "attention deficit hyperactivity disorder", with their equivalents in Portuguese, were searched. Results: seven hundred ninety articles were found in the two databases, of which 119 were relevant. After a full reading, twenty five articles were selected for the analysis, according to relevance and other exclusion/inclusion criteria. In 21 of the studies, individuals with attention deficit hyperactivity disorder presented worse performance in reading, as compared with their peers. Of these, 14 studies identified a delay in some skills that are important for reading: processing speed, reading accuracy, phonological awareness, comprehension and/or orthographic processing. Conclusion: these results corroborate other studies that have verified the presence of a deficit in academic performance, especially in reading skills, in individuals with attention deficit hyperactivity disorder, that may persist in their adulthood.
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Kofler MJ, Spiegel JA, Austin KE, Irwin LN, Soto EF, Sarver DE. Are Episodic Buffer Processes Intact in ADHD? Experimental Evidence and Linkage with Hyperactive Behavior. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:1171-1185. [PMID: 28952051 PMCID: PMC5871530 DOI: 10.1007/s10802-017-0346-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Working memory deficits are present in a substantial proportion of children with ADHD, and converging evidence links these deficits with ADHD-related behavioral and functional impairments. At the same time, working memory is not a unitary construct, and evidence is lacking regarding the role of several components of this system in ADHD. Preclinical behavioral studies are needed to fractionate the multicomponent working memory system, determine which specific subcomponent(s) are impaired in ADHD, and more importantly link these subcomponent(s) with specific ADHD-related behavioral symptoms/functional impairments. The current study reflects one piece of that puzzle, and focuses on the episodic buffer component of working memory. Across multiple testing days, a well-characterized sample of 86 children ages 8-13 (M=10.52, SD=1.54; 34 girls; 64% Caucasian/Non-Hispanic) with ADHD (n=49) and without ADHD (n=37) completed three counterbalanced working memory tests that were identical in all aspects except the key subcomponent process (phonological, visuospatial, episodic buffer). Gross motor movement during these and control tasks were measured using 4 high-precision actigraphs. There was no evidence of group differences in gender, age, SES, or IQ. Bayesian mixed-model ANOVAs indicated that the ADHD group performed significantly worse on all three working memory tests (d=1.17-1.44) and was significantly more hyperactive than controls (d=0.66-1.05) during the visuospatial and episodic buffer tests. In contrast, the ADHD and Non-ADHD groups were equivalent with regard to effects of episodic buffer demands on performance and hyperactive behavior. The most parsimonious conclusion is that the episodic buffer is likely intact in ADHD, and unrelated to ADHD hyperactivity symptoms.
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Affiliation(s)
- Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Jamie A Spiegel
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Kristin E Austin
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Lauren N Irwin
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Elia F Soto
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Dustin E Sarver
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, USA
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Kofler MJ, Harmon SL, Aduen PA, Day TN, Austin K, Spiegel J, Irwin L, Sarver DE. Neurocognitive and behavioral predictors of social problems in ADHD: A Bayesian framework. Neuropsychology 2018; 32:344-355. [PMID: 29620405 PMCID: PMC5890822 DOI: 10.1037/neu0000416] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Social problems are a key area of functional impairment for children with attention deficit hyperactivity disorder (ADHD), and converging evidence points to executive dysfunction as a potential mechanism underlying ADHD-related social dysfunction. The evidence is mixed, however, with regard to which neurocognitive abilities account for these relations. METHOD A well-characterized group of 117 children ages 8-13 (M = 10.45, SD = 1.53; 43 girls; 69.5% Caucasian/Non-Hispanic) with ADHD (n = 77) and without ADHD (n = 40) were administered multiple, counterbalanced tests of neurocognitive functioning and assessed for social skills via multi-informant reports. RESULTS Bayesian linear regressions revealed strong support for working memory and cross-informant interfering behaviors (inattention, hyperactivity/impulsivity) as predictors of parent- and teacher-reported social problems. Working memory was also implicated in social skills acquisition deficits, performance deficits, and strengths based on parent and/or teacher report; inattention and/or hyperactivity showed strong correspondence with cross-informant social problems in all models. There was no evidence for, and in most models strong evidence against, effects of inhibitory control and processing speed. The ADHD group was impaired relative to the non-ADHD group on social skills (d = 0.82-0.88), visuospatial working memory (d = 0.89), and phonological working memory (d = 0.58). In contrast, the Bayesian ANOVAs indicated that the ADHD and non-ADHD groups were equivalent on processing speed, IQ, age, gender, and socioeconomic status (SES). There was no support for or against group differences in inhibition. CONCLUSIONS These findings confirm that ADHD is associated with impaired social performance, and implicate working memory and core ADHD symptoms in the acquisition and performance of socially skilled behavior. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | | | | | - Lauren Irwin
- Florida State University, Department of Psychology
| | - Dustin E. Sarver
- University of Mississippi Medical Center, Department of Pediatrics,
Center for Advancement of Youth
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Cao P, Xing J, Cao Y, Cheng Q, Sun X, Kang Q, Dai L, Zhou X, Song Z. Clinical effects of repetitive transcranial magnetic stimulation combined with atomoxetine in the treatment of attention-deficit hyperactivity disorder. Neuropsychiatr Dis Treat 2018; 14:3231-3240. [PMID: 30538481 PMCID: PMC6263241 DOI: 10.2147/ndt.s182527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with atomoxetine (ATX) in the treatment of attention-deficit hyperactivity disorder (ADHD). METHODS Sixty-four patients with newly diagnosed ADHD were enrolled from January 2016 to October 2017 from Psychological Centre for Adolescents and Children at 102th Hospital of People's Liberation Army of China. These patients were randomly assigned to three groups according to treatment method: the rTMS group, the ATX group, and the rTMS+ ATX group. Before treatment and 6 weeks after treatment, clinical symptoms and executive functions of ADHD patients were evaluated with the Swanson, Nolan, and Pelham, Version IV (SNAP-IV) Questionnaire, continuous performance test, three subtests (arithmetic, digit span, and coding) of Wechsler Intelligence Scale for Children, as well as Iowa Gambling Tasks (IGT). The effects of treatment were compared among three groups. RESULTS After 6 weeks of treatment, the scores of all factors in the SNAP-IV questionnaire were lower than those before treatment in the three groups; the scores of three subtests of Wechsler Intelligence Scale for Children, continuous performance test, and IGT were also significantly higher than those before treatment. The rTMS+ ATX group had a better improvement in attention deficits and hyperactivity impulse on the SNAP-IV questionnaire compared with the other groups, and also had a higher efficacy on cold and hot executive functions such as arithmetic, forward numbers, coding, and IGT. In addition, the ATX group performed better than the rTMS group in coding and IGT. CONCLUSION rTMS, ATX, and the combination therapy are effective in improving core symptoms and executive function in patients with ADHD. The combined treatment has significant therapeutic advantages over the single treatment groups. Compared with rTMS, the drug therapy has a better improvement in coding and IGT.
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Affiliation(s)
- Pengfei Cao
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China, .,Department of Political Affairs, College of Politics, National Defense University of People's Liberation Army of China, Beijing, China
| | - Jun Xing
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Yin Cao
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Qi Cheng
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xiaojing Sun
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Qi Kang
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Libin Dai
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xianju Zhou
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Zixiang Song
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
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Kofler MJ, Sarver DE, Harmon SL, Moltisanti A, Aduen PA, Soto EF, Ferretti N. Working memory and organizational skills problems in ADHD. J Child Psychol Psychiatry 2018; 59:57-67. [PMID: 28714075 PMCID: PMC5729117 DOI: 10.1111/jcpp.12773] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study tested model-driven predictions regarding working memory's role in the organizational problems associated with ADHD. METHOD Children aged 8-13 (M = 10.33, SD = 1.42) with and without ADHD (N = 103; 39 girls; 73% Caucasian/Non-Hispanic) were assessed on multiple, counterbalanced working memory tasks. Parents and teachers completed norm-referenced measures of organizational problems (Children's Organizational Skills Scale; COSS). RESULTS Results confirmed large magnitude working memory deficits (d = 1.24) and organizational problems in ADHD (d = 0.85). Bias-corrected, bootstrapped conditional effects models linked impaired working memory with greater parent- and teacher-reported inattention, hyperactivity/impulsivity, and organizational problems. Working memory predicted organization problems across all parent and teacher COSS subscales (R2 = .19-.23). Approximately 38%-57% of working memory's effect on organization problems was conveyed by working memory's association with inattentive behavior. Unique effects of working memory remained significant for both parent- and teacher-reported task planning, as well as for teacher-reported memory/materials management and overall organization problems. Attention problems uniquely predicted worse organizational skills. Hyperactivity was unrelated to parent-reported organizational skills, but predicted better teacher-reported task planning. CONCLUSIONS Children with ADHD exhibit multisetting, broad-based organizational impairment. These impaired organizational skills are attributable in part to performance deficits secondary to working memory dysfunction, both directly and indirectly via working memory's role in regulating attention. Impaired working memory in ADHD renders it extraordinarily difficult for these children to consistently anticipate, plan, enact, and maintain goal-directed actions.
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