Multi-Source Interference Task paradigm to enhance automatic and controlled processes in ADHD

A contribute to the default-interventionist and parallel accounts in deductive reasoning. The effect of decisional styles on logic and belief

Classical theories of reasoning equate System 1 with biases and System 2 with correct responses. Refined theories of reasoning propose the parallel model to explain the two systems. The first purpose of the present article is to give a contribution to the debate on the parallel and default-interventionfist models: we hypothesized when logic and belief conflict both logical validity and belief judgments will be affected with greater level of response errors and/or longer response times. The second purpose of this article is to assess the relationship between decisional styles and performance in deductive reasoning. Seventy-two participants participated in the experiment and completed 64 modus ponens and modus tollens syllogistic reasoning tasks. Accordingly, we found that belief and logic judgments were affected by the conflict condition, both in easy syllogisms (i.e., modus ponens) and in complex syllogisms (i.e., modus tollens). Findings showed also that participants with a rational decision-making style were more strongly influenced by logic than belief, whereas those with an intuitive decision-making style were more strongly influenced by belief than logic.

Effect of cesarean section on the risk of autism spectrum disorders/attention deficit hyperactivity disorder in offspring: a meta-analysis

PURPOSE

This study was conducted to investigate the relationship between cesarean section (CS) offspring and autism spectrum disorders (ASD)/attention deficit hyperactivity disorder (ADHD).

METHODS

Searching of the databases (PubMed, Web of Science, Embase, and Cochrane Library) for studies on the relationship between mode of delivery and ASD/ADHD until August 2022. The primary outcome was the incidence of ASD/ADHD in the offspring.

RESULTS

This meta-analysis included 35 studies (12 cohort studies and 23 case-control studies). Statistical results showed a higher risk of ASD (odds ratio (OR) = 1.25, P < 0.001) and ADHD (OR = 1.11, P < 0.001) in CS offspring compared to the VD group. Partial subgroup analysis showed no difference in ASD risk between CS and VD offspring in sibling-matched groups (OR = 0.98, P = 0.625). The risk of ASD was higher in females (OR = 1.66, P = 0.003) than in males (OR = 1.17, P = 0.004) in the CS offspring compared with the VD group. There was no difference in the risk of ASD between CS under regional anesthesia group and VD group (OR = 1.07, P = 0.173). However, the risk of ASD was higher in the CS offspring under general anesthesia than in the VD offspring (OR = 1.62, P < 0.001). CS offspring developed autism (OR = 1.38, P = 0.011) and pervasive developmental disorder-not otherwise specified (OR = 1.46, P = 0.004) had a higher risk than VD offspring, but there was no difference in Asperger syndrome (OR = 1.19, P = 0.115). Offspring born via CS had a higher incidence of ADHD in different subgroup analyses (sibling-matched, type of CS, and study design).

CONCLUSIONS

In this meta-analysis, CS was a risk factor for ASD/ADHD in offspring compared with VD.

Advancing theorizing about fast-and-slow thinking: The interplay between fast and slow processing

We agree with the author's working model, but we suggest that (a) the classical distinction between fast and slow processes as separable processes can be softened, and (b) human performance might result from an interplay between fast and slow processing and these processes may be mediated by systems that evolve to satisfy the need for operation in a complex environment.

The Influence of Smartphone Use on Tweens' Capacity for Complex Critical Thinking

The spread of modern technologies exposes many people to a high level of ambiguous and misleading information that can impact people's judgments and worldviews. This happens especially in a phase of life such as preadolescence when children are particularly sensitive to external conditioning. Critical thinking can be seen as the first line of defense against misleading information. However, little is known about the consequences of media use on the critical thinking skills of tweens. In this study, we evaluated the effects of problematic smartphone use on the various stages of critical thinking, comparing high and low tween smartphone users. The results confirm the main hypothesis, namely, that problematic smartphone use is related to the ability to think critically. There was a significant difference between high and low users in the third phase of critical thinking: evaluation of sources.

Relationship Between Inhibitory Control and Arithmetic in Elementary School Children With ADHD: The Mediating Role of Working Memory

OBJECTIVES

To test if inhibitory control was a significant predictor for arithmetic in children with ADHD and if the relationship between inhibitory control and arithmetic was mediated by working memory.

METHODS

Eighty-four children (ADHD, n = 54; Non-ADHD, n = 30) were tested on their interference control, behavioral inhibition, working memory, and arithmetic. Regression analysis was used to test the predictive role of inhibitory control in arithmetic. Moreover, mediation analysis was done to test whether working memory mediated the relationship between inhibitory control and arithmetic memory.

RESULTS

Interference control but not behavioral inhibition was a significant predictor for arithmetic. In addition, interference control had direct and indirect effects via working memory on arithmetic.

CONCLUSIONS

Results demonstrated that inhibitory control contributed to arithmetic in children with ADHD. Furthermore, interference control had direct and indirect effects via working memory on arithmetic, suggesting interventions for arithmetic difficulties should involve training on both inhibition and working memory.

Pathogenesis of Comorbid ADHD and Chinese Developmental Dyslexia: Evidence From Eye-Movement Tracking and Rapid Automatized Naming

BACKGROUND

ADHD and Chinese developmental dyslexia (DD) have a very high comorbidity rate; however, which cognitive deficits characterize the comorbidity and when they occur during cognitive processing are still under debate.

METHODS

Rapid automatic naming (RAN) tasks with eye-movement tracking were conducted with 75 children who were typically developing, had comorbid ADHD and DD, had only ADHD, and had only DD.

RESULTS

The clinical groups had longer first fixation durations than the control for RAN digits. Temporal eye-movement measures, such as gaze duration and total reading time, were found to vary between the comorbidity and ADHD groups. Spatial eye-movement measures, such as regression probability and incoming saccade amplitude, differed between the comorbidity and DD groups.

CONCLUSIONS

These results indicate that investigation with eye-movement measures combined with RAN tasks can strengthen the understanding of the pathogenesis of comorbid ADHD and DD.

Prevalence Models to Support Participation: Sensory Patterns as a Feature of All Children’s Humanity

Purpose

Research about children tends to consider differences from expected patterns problematic, and associates differences with disabilities [e.g., Autism, attention deficit hyperactivity disorder (ADHD)]. When we focus on disabilities and consider differences automatically problematic, we miss the natural variability in the general population. The International Classification of Functioning, Disability and Health (ICF 11) acknowledges that the experience of disability results from interactions between “environmental” and “personal” factors which determine the person’s capacity to participate. The purpose of this study was to examine sensory patterns across a national sample of children in the general population and samples of children with disabilities to investigate the extent to which differences in sensory processing are representative of natural variability rather than automatically problematic or part of a disability.

Materials and Methods

We employed descriptive statistics and chi-square tests to examine sensory processing patterns in children in the general population and autistic children and children with ADHD. We used standardization and validity data from the Sensory Profile 2 to conduct analyses.

Results

Consistent sensory patterns exist across all groups. Children in all groups had different rates of certain patterns.

Conclusion

Since children in all groups have certain sensory patterns, we cannot associate differences with problematic behaviors. Children participating successfully with all sensory patterns might provide insights for universal design that supports participation of all children.

Problematic Smartphone Use Leads to Behavioral and Cognitive Self-Control Deficits

Excessive use of smartphones has been associated with a number of negative consequences for individuals. Some of these consequences relate to many symptoms of behavioral addiction. The present study aims to investigate whether participants with high levels of smartphone usage may have difficulty with their ability to wield the self-control that is needed to restrict smartphone usage compared to participants with lower levels of smartphone addiction. Specifically, we expect that people with high levels of smartphone usage may have problems in refraining from using a smartphone. In addition, we expect people with a high level of smartphone use may show deficiencies in cognitive tasks such as memory, executive control, and visual and auditory attention. An ABA design was applied to analyze the effects of smartphone withdrawal. The first A refers to baseline measurements: Visual RT, Auditory RT, Go/No-Go RT and N-Back RT and Eriksen flanker RT. The B refers to 3 days of smartphone withdrawal, whereas the second A refers to the same measurements used in the baseline. In addition, several standardized scales were administered, among them: Smartphone addiction scale-short version (SAS-SV), Fear of missing out scale (FoMOs), Procrastination scale, and Psychological General Well-Being Index. One hundred and eleven participants took part in the study. Based on median split they were divided into two groups: high level and low level smartphone users. Moreover, thanks to an app installed on the participants' smartphones, it was possible to measure levels of compliance with the task. Results indicate that participants with low levels of smartphone usage show less difficulty in their ability to wield the self-control needed to withdraw smartphone use and faster reaction times on cognitive tests than participants with high levels of smartphone usage. Moreover, the profile of participants with high levels of smartphone usage shows higher scores on the FoMOs and Procrastination scale, and lower scores in the Psychological General Well-Being Index. The results are discussed in light of self-regulation theory.

Visual-motor attention in children with ADHD: The role of automatic and controlled processes

BACKGROUND

there are evidence that children with ADHD exhibit a deficit both in automatic and controlled processes.

AIMS

the present study aimed to examine the visual-motor attention and the influence of cognitive load through a dual task paradigm in children with ADHD compared with typical developing children (TD).

METHODS AND PROCEDURES

113 children with ADHD: 40 with subtype inattentive (ADHD- I group), 16 with subtype hyperactive (ADHD-H group), 57 with subtype combined (ADHD-C group), and 113 TD children (TD group) were recruited. We used a dual-task paradigm in which the primary task was a figure-tracing test whereas the second task was a digit span test. A figure-tracing test was used to evaluate visual motor attention. Based on the length and intersection of the lines, the figures of the primary task were categorized into simple and complex.

OUTCOMES AND RESULTS

the ADHD groups compared to the TD group showed a worse accuracy of performance in both condition with and without cognitive load.

CONCLUSIONS AND IMPLICATIONS

The findings were discussed in light of the relationship between automatic and controlled processes involved in the visual-motor attention.

A network perspective on abnormal child behavior in primary school students

Abnormal child behavior is a complex entity including among others disorders such as ADHD, a neuropsychiatric disorder interfering with the normal development of the child, and combining many comorbidities. There are no specific tools designed to assess abnormal child behavior, although well-known ADHD screening tools such as the CTRS-R:S go beyond the disorder itself and cover the wider construct. This can be understood as the complex system of mutually influencing entities, that is why the aim of this study was to investigate the items of the CTRS-R:S as a psychological network. We analyzed a data set of 525 children in French-speaking primary schools from Belgium, and estimated a Bayesian Gaussian Graphical Model with a Bayes Factor of 30. We identified highly connected nodes from each community of the CTRS-R:S to build an additional network of communities. In the domain network, Oppositional and Cognitive skills share the strongest connection in the network. The 28-item network was overall positively connected albeit the presence of some negative connections. The spinglass algorithm identified eight domains in the CTRS-R:S network that causally influence each other. The network approach is a useful framework to investigate the domains of abnormal child behavior as well as the interplay between individual symptoms.

Cognitive interference processing in adult survivors of childhood acute lymphoblastic leukemia using functional magnetic resonance imaging

BACKGROUND

Childhood acute lymphoblastic leukemia (ALL) is associated with cognitive impairment in adulthood. Cognitive interference processing and its correlated functional magnetic resonance imaging (fMRI) activity in the brain have not yet been studied in this patient group.

MATERIAL

Twenty-six adult childhood ALL survivors (median [interquartile range {IQR}] age, 40.0 [37.0-42.3] years) were investigated at median age (IQR), 35.0 (32.0-37.0) years after treatment with intrathecal and intravenous chemotherapy as well as cranial radiotherapy (24 Gy) and compared with 26 matched controls (median [IQR] age, 37.5 [33.0-41.5] years).

METHODS

Cognitive interference processing was investigated in terms of behavioral performance (response times [ms] and accuracy performance [%]) and fMRI activity in the cingulo-fronto-parietal (CFP) attention network as well as other parts of the brain using the multisource interference task (MSIT).

RESULTS

ALL survivors had longer response times and reduced accuracy performance during cognitive interference processing (median [IQR] interference effect, 371.9 [314.7-453.3] ms and 6.7 [4.2-14.7]%, respectively) comparedwith controls (303.7 [275.0-376.7] ms and 2.3 [1.6-4.3]%, respectively), but did not exhibit altered fMRI activity in the CFP attention network or elsewhere in the brain.

CONCLUSION

Adult childhood ALL survivors demonstrated impaired behavioral performance but no altered fMRI activity when performing cognitive interference processing when compared with controls. The results can be used to better characterize this patient group and to optimize follow-up care and support for these individuals.

Static and Dynamic Assessment of Intelligence in ADHD Subtypes

There is a debate about the measure of IQ in children with ADHD. Some studies report that, compared to static assessment procedures, dynamic assessment of intelligence can better measure cognitive modifiability and plasticity. The present study was designed to examine children belonging to different ADHD subtypes (inattentive, hyperactive/impulsive, and combined) in terms of both static (WISC scores) and dynamic measures (Modifiability index). Thirty-four children (12 ADHD-I, 10 ADHD-H, and 12 ADHD-C) were compared to a sample of 27 typically developing children. Results indicate that only the inattentive and the combined subtypes, compared with the normative sample, show lower IQ scores. The ADHD-I group presents generally low WISC scores and ADHD-H presents generally high WISC scores. Moreover, the ADHD-C group shows a low static score and a high dynamic score, indicating a wide breadth of Vygotskian children’s zone of proximal development. Static and dynamic measurements together can indeed be considered a comprehensive examination of intelligence levels in ADHD children and may be essential in predicting learning capacities.

Transient and Long-Term Improvements in Cognitive Processes following Video Games: An Italian Cross-Sectional Study

The aim of the present study is to compare the short- and long-term effects of video-gaming by using the same measurements. More precisely, habitual and occasional video-gamers were compared so as to analyze the long-term effects. An ABABABA design was used to analyze the short-term effects. The first A refers to baseline measurements: Visual RT, Auditory RT, Aim trainer RT, Go/No-Go RT and N-Back RT. The first B refers to 30 min of gaming, the second A refers to the measurements used in the baseline, the second B refers to 60 min of a video game, the third A refers to the same measurements used in the baseline, the third B refers to a 30-min rest, and finally, the fourth A refers to the measurements used in the baseline. Seventy participants, twenty-nine habitual video-gamers and forty-one occasional video-gamers, participated in the study. The results showed a temporary improvement of cognitive functions (Visual RT, Auditory RT, Aim trainer RT, Go/No-Go RT and N-Back RT) in the short term and a strong enhancement of cognitive functions in the long term. The results are discussed in light of Flow Theory and the automatization process. Contribution of the study: The contribution of this research is to highlight that despite there being a transient enhancement of executive and cognitive functions through the use of mobile video games in the short-term period, with a decrease of performance after a 30-min rest, there is a strong increase of cognitive performance in the long-term period. Flow Theory and the automatization process together can explain this apparent inconsistency between the positive increase of long-term performance and the transient increase of short-term performance. One limitation of the present research is that it is not possible to distinguish whether the long-term enhancements can be attributed either to continued practice in the use of video games compared to non-gamers, or to the possibility that gamers are already predisposed to video game playing. Future research should address this issue.

Cognitive interference processing in adults with childhood craniopharyngioma using functional magnetic resonance imaging

PURPOSE

To assess cognitive interference processing in adults with childhood craniopharyngioma (CP), with and without hypothalamic injury, respectively, in terms of behavioral performance and functional magnetic resonance imaging (fMRI) activity, using the multi-source interference task (MSIT).

METHODS

Twenty-eight CP patients (median age 34.5 [29.0-39.5] years) were investigated at median 20.5 (16.3-28.8) years after treatment with surgical resection and in some cases additional radiotherapy (n = 10) and compared to 29 matched controls (median age 37.0 [32.5-42.0] years). The subjects performed the MSIT during fMRI acquisition and behavioral performance in terms of response times (ms) and accuracy performance (%) were recorded.

RESULTS

The MSIT activated the cingulo-fronto-parietal (CFP) attention network in both CP patients and controls. No differences were found in behavioral performance nor fMRI activity between CP patients (interference effect 333.9 [287.3-367.1] ms and 3.1 [1.6-5.6]%, respectively) and controls (309.1 [276.4-361.0] ms and 2.6 [1.6-4.9]%). No differences were found in behavioral performance nor fMRI activity between the two subgroups with (332.0 [283.6-353.4] ms and 4.2 [2.3-5.7]%, respectively) and without hypothalamic injury (355.7 [293.7-388.7] ms and 2.1 [1.0-5.2]%, respectively), respectively, and controls.

CONCLUSION

Adults with childhood CP performed cognitive interference processing equally well as controls and demonstrated no compensatory fMRI activity in the CFP attention network compared to controls. This was also true for the two subgroups with and without hypothalamic injury. The results can be useful to better characterize this condition, and to optimize treatment and support for these individuals.

The role of automatic and controlled processes in the positivity effect for older adults

BACKGROUND

The positivity effect can be defined as an age-related attentional preference for positive information. The age differences are due to an attentional bias in which the young focused more intently on the negative stimuli, whereas the older attend to capture positive stimuli. There are two cognitive-emotional models that can explain the positivity effect: the socio-emotional selectivity theory (SST) and the dynamic integration theory (DIT). The SST states that in the older the positivity effect is related to controlled attentional processes, on the opposite, the DIT states that the positivity effect is related to automatic processes.

AIMS

The main aim of the present study was to examine automatic and controlled attentional orienting of young and older adults in the positivity effect.

METHODS

To reach these goals and to verify the generalization of the previous results, we used two experimental paradigms: the dot-probe task and the visual discrimination task with facial stimuli with positive (happy and surprise), negative (fair and angry) and neutral emotional expressions. 50 older and 35 young adults participated in this study.

RESULTS

The older adults reacted faster to positive emotions than neutral or negative ones. They had similar RTs for the three types of emotions in both automatic and controlled attention.

DISCUSSION

The findings are discussed in light of SST and DIT theories.

CONCLUSIONS

This study confirms the positivity effect for the older subjects and support the idea that both automatic and controlled processes play a key role in this effect.

Flexible brain transitions between hierarchical network segregation and integration associated with cognitive performance during a multisource interference task

Cognition involves locally segregated and globally integrated processing. This process is hierarchically organized and linked to evidence from hierarchical modules in brain networks. However, researchers have not clearly determined how flexible transitions between these hierarchical processes are associated with cognitive behavior. Here, we designed a multisource interference task (MSIT) and introduced the nested-spectral partition (NSP) method to detect hierarchical modules in brain functional networks. By defining hierarchical segregation and integration across multiple levels, we showed that the MSIT requires higher network segregation in the whole brain and most functional systems but generates higher integration in the control system. Meanwhile, brain networks have more flexible transitions between segregated and integrated configurations in the task state. Crucially, higher functional flexibility in the resting state, less flexibility in the task state and more efficient switching of the brain from resting to task states were associated with better task performance. Our hierarchical modular analysis was more effective at detecting alterations in functional organization and the phenotype of cognitive performance than graph-based network measures at a single level.

Association of Attention Deficit/Hyperactivity Disorder With Events Occurring During Pregnancy and Perinatal Period

Background: The relationship of events occurring during pregnancy and perinatal period with attention deficit/hyperactivity disorder (ADHD) is not clear. Thus, the focus of the current study was to examine the effects of events occurring during pregnancy and perinatal period on ADHD.

Methods: A two-phase cross-sectional study was performed across 13 schools in Changsha and Yiyang cities from March to December, 2014. We preliminarily screened all students using CBCL and established the diagnosis using Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A total of 3,418 questionnaires were effectively completed in this study.

Results: History of threatened abortion (TA) [odds ratio (OR): 1.707 (1.201–2.426)] (vs. No-TA) and neonatal asphyxia (NA) [OR: 2.497(1.225–5.09)] (vs. health) showed a positive association with ADHD. On subgroup analysis, TA [OR: 2.216 (1.458–3.369)] (vs. No-TA) was a risk factor for ADHD without comorbidity; instrumental delivery [OR: 2.748 (1.057–7.142)] (vs. natural birth) and NA [OR: 2.789 (1.222–6.361)] (vs. health) were risk factors for ADHD in the subgroup of ADHD with comorbidity; TA (vs. no-TA) and NA (vs. health) were risk factors for ADHD among male students [ORs: 2.232 (1.439–3.462) and 2.808 (1.115–7.068), respectively], while low birth weight (LBW) (vs. normal birth weight) was a risk factor [OR: 2.054 (1.063–3.967)] for ADHD among female students.

Conclusion: TA was a risk factor for ADHD in the absence of comorbid conditions; instrumental delivery and NA were risk factors for ADHD in the subgroup of ADHD with comorbidity; TA and NA were risk factors for ADHD among male students. LBW was a risk factor for ADHD among female students.

The relationship between theory of mind and sluggish cognitive tempo in school-age children with attention deficit and hyperactivity disorder

Sluggish cognitive tempo (SCT) is considered as a cognitive-emotional style. Theory of mind (ToM) skills form the basis of human cognition and social behavior. The aim of this study is to contribute to SCT literature by examining the relationship between SCT and cognitive and affective ToM in school-age children with attention deficit and hyperactivity disorder (ADHD). Fifty school-age children with ADHD (43 boys and seven girls) and 40 typically developing children (34 boys and six girls) were assessed using Parent-rated Barkley Child Attention Scale and Child Behavior Checklist/6-18, cognitive (first- and second-order ToM) and affective ToM (Reading Mind in the Eyes Test and Unexpected Outcomes Test (UOT)) tests. Multiple linear regression analysis was performed to determine the variables that may predict SCT levels in children with ADHD. Attention deficit and hyperactivity disorder-inattention (Exp(B) = .334, p = .027), internalization (Exp(B) = .305, p = .006), and UOT scores (Exp(B) = .933, p = .015) significantly predicted SCT severity in children with ADHD. SCT severity was significantly associated with impaired cognitive ToM skills as measured by second-order ToM (Exp(B) = 1.933, p = .045). Our findings may indicate that affective ToM developing with age, and impaired cognitive ToM skills are associated with increasing SCT severity.

An Exploratory Investigation of Goal Management Training in Adults With ADHD: Improvements in Inhibition and Everyday Functioning

Background: Adults with attention deficit/hyperactivity disorder (ADHD) are predominantly treated with medication. However, there is also a need for effective, psychologically based interventions. As ADHD is strongly associated with reduced inhibitory control, cognitive remediation approaches should be efficient. Goal management training (GMT) aims at enhancing inhibitory control and has shown positive effects on inhibitory control in non-ADHD patient groups. The aim of the current study was to explore whether GMT would specifically enhance inhibitory control in adults with ADHD, and if such an enhancement would lead to secondary improvements in self-reported everyday functioning. Methods: Twenty-one participants with ADHD (mean age: 39.05 years [SD 11.93]) completed the intervention and assessments pre-, post- and 6 months after the intervention. Measures included neuropsychological tests and self-report questionnaires pertaining to cognitive- and executive functioning, emotion regulation, quality of life, and ADHD symptoms. Results: Compared to baseline, the participants showed enhanced inhibitory control on performance-based measures at post-assessment and 6-month follow-up. The participants also reported increased productivity and reduced cognitive difficulties in everyday life at both assessments post-treatment, as well as improvements in aspects of emotion regulation and a reduction in the severity of core ADHD-symptoms at 6-month follow-up. Conclusion: Our exploratory study showed that GMT seems to specifically improve one of the core executive dysfunctions in ADHD, namely inhibitory control, with a positive effect lasting at least 6 months post-treatment. The adults with ADHD also reported improved self-regulation in their everyday life after completing GMT, providing strong arguments for further investigations of GMT as a treatment option for this group of adults. Clinical Trial Registration: The study is registered under ISRCTN.com (ISRCTN91988877; https://doi.org/10.1186/ISRCTN91988877).

The Association between Prosocial Behaviour and Peer Relationships with Comorbid Externalizing Disorders and Quality of Life in Treatment-Naïve Children and Adolescents with Attention Deficit Hyperactivity Disorder

Several recent studies confirmed that Attention Deficit Hyperactivity Disorder (ADHD) has a negative influence on peer relationship and quality of life in children. The aim of the current study is to investigate the association between prosocial behaviour, peer relationships and quality of life in treatment naïve ADHD samples. The samples included 79 children with ADHD (64 boys and 15 girls, mean age = 10.24 years, SD = 2.51) and 54 healthy control children (30 boys and 23 girls, mean age = 9.66 years, SD = 1.73). Measurements included: The "Mini International Neuropsychiatric Interview Kid; Strengths and Difficulties Questionnaire" and the "Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen". The ADHD group showed significantly lower levels of prosocial behaviour and more problems with peer relationships than the control group. Prosocial behaviour has a weak positive correlation with the rating of the child's quality of life by the parents, both in the ADHD group and in the control group. The rating of quality of life and peer relationship problems by the parents also showed a significant negative moderate association in both groups. The rating of quality of life by the child showed a significant negative weak relationship with peer relationships in the ADHD group, but no significant relationship was found in the control group. Children with ADHD and comorbid externalizing disorders showed more problems in peer relationships than ADHD without comorbid externalizing disorders. Based on these results, we conclude that therapy for ADHD focused on improvement of prosocial behaviour and peer relationships as well as comorbid externalizing disorders could have a favourable effect on the quality of life of these children.

MAGNITIVE: Effectiveness and Feasibility of a Cognitive Training Program Through Magic Tricks for Children With Attention Deficit and Hyperactivity Disorder. A Second Clinical Trial in Community Settings

Previous studies have explored the impact of magic tricks on different basic cognitive processes yet there is a need of examining effectiveness of a cognitive training program through magic tricks for children with attention deficit hyperactivity disorder (ADHD). The present study examines the effectiveness and feasibility of the MAGNITIVE program, a manualized intervention for cognitive training through the learning of magic tricks. A total of 11 children with ADHD (from 8 to 12 years) participated in separated groups of two different community settings (hospital center and school), and were assessed at pre-treatment, post-treatment, and a 3-month later follow-up in different tasks involving processing speed, sustained attention, selective attention, and mental flexibility. Using non parametric statistical analyses and Reliable Change Index, the results showed that these children receiving MAGNITIVE particularly improved their performance in sustained attention, shifting attention, and mental flexibility, changes were also observed in processing speed performance yet further research is needed in terms of selective attention and inhibition, given the great individual differences within this sample. Changes were maintained when the program was finished. In terms of viability, the study proved a good treatment integrity in different contexts (hospital and school setting), adherence to the curriculum (attendance and some practice at home), and high levels of engagement satisfaction. In this second clinical trial, MAGNITIVE program appears to be a feasible training program for children with ADHD, as an alternative for medication when possible.

The Deficit of Early Selective Attention in Adults With Sluggish Cognitive Tempo: In Comparison With Those With Attention-Deficit/Hyperactivity Disorder

Sluggish cognitive tempo (SCT) is a cluster of attentional symptoms characterized by slow information processing and behavior, distractibility, mental confusion, absent-mindedness, and hypoactivity. The present study aimed to compare early and late selective attention in the information processing speed of adults with SCT to those with attention-deficit/hyperactivity disorder (ADHD) and adults without any attentional problems. The participants were screened using Barkley Adult ADHD Rating Scale-IV and divided into the following groups: SCT (N = 24), ADHD (N = 24), and controls (N = 25). All participants completed the irrelevant distractor task measuring early and late selective attention under load condition (low vs. high) and distractor condition (no-distractor vs. distractor). The inefficiency index was calculated by subtracting the reaction time of no-distractor condition of correct trials from the reaction time of distractor condition to control the impact of accuracy. Upon analysis, the SCT group showed a lower efficiency compared to the ADHD group under high load, while the ADHD group showed lower efficiency under low load than high load. This meant that the ADHD group had increased efficiency of selective attention with higher load, while the SCT group had low efficiency of selective attention even under high loads. These results suggest that the symptoms of “slow” or “distracted” in SCT could be attributed to the reduced speed and efficiency of selective attention in early information processing and the problem can be pronounced in situations with distractors. The results of the study imply that the attention-deficit-like symptoms shown in those with SCT and ADHD can be distinguished in specific stage of information processing.

Asymmetry in Cortical and Subcortical Structures of the Brain in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

BACKGROUND

Human cognitive and emotional functions are asymmetrical between the left and right hemispheres. In neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) patients, the absence of aberrant asymmetry might serve as a neuroanatomical marker of ADHD. However, few studies have estimated abnormalities in cortical and subcortical asymmetry in children and adolescents of different ADHD subtypes.

METHODS

Data were from the results collected by the Peking University site in the "ADHD-200 sample" dataset, which comprised 31 eligible ADHD (20 inattentive ADHD (ADHD-I), 11 combined ADHD (ADHD-C)) and 31 matched typically developing (TD) individuals. The Asymmetry Indexes (AIs) in cortical thickness, cortical gray-matter volume and subcortical nucleus (SN) volume were calculated based on an automated surface-based approach. The differences in cortical thickness, cortical gray-matter volume, and SN volume AIs were evaluated among groups. We also analyzed the correlation between AIs and the severity of ADHD symptoms.

RESULTS

Compared with the TD group, SN asymmetry in ADHD group did not reveal significant differences. Altered cortical asymmetry of different subtypes in ADHD groups was located in the orbitofrontal and anterior cingulate circuits, including the medial orbitofrontal, paracentral, pars triangularis, caudal anterior cingulate, isthmus cingulate, and superior frontal regions. In the comparisons, cortical gray-matter volume AIs were significantly different in the caudal anterior cingulate, isthmus cingulate, and superior frontal regions between ADHD-I and ADHD-C groups. There were significant correlations between the severity of ADHD symptoms and asymmetric measurements in medial orbitofrontal, paracentral and isthmus cingulate regions.

CONCLUSION

These findings provide further evidence for the altered cortical morphological asymmetry in children and adolescents with ADHD, and these differences are associated (at least in part) with the severity of ADHD symptoms. Brain asymmetry could be an appropriate precursor of morphological alterations in neurodevelopmental disorders.

Attachment and Executive Functions in ADHD Symptomatology-Independent Inputs or an Interaction?

Despite a multitude of research on executive functions and attachment in Attention Deficit Hyperactivity Disorder (ADHD), a synthetic approach to the matter seems to have been lacking. In this review, we attempt to check the available data against two hypotheses: (1) executive functions and attachment influence ADHD symptoms independently; (2) executive functions and attachment interact to produce ADHD symptoms. We found no evidence falsifying the former hypothesis and some evidence to refute the latter. Limitations of current study approaches and suggestions for further research are discussed. Specifically, we propose an attachment representation, rather than attachment style, approach to measuring the mediation thereof between executive dysfunctions and ADHD.

Remote Eye-Tracking for Cognitive Telerehabilitation and Interactive School Tasks in Times of COVID-19

In the attempt to mitigate the effects of COVID-19 lockdown, most countries have recently authorized and promoted the adoption of e-learning and remote teaching technologies, often with the support of teleconferencing platforms. Unfortunately, not all students can benefit from the adoption of such a surrogate of their usual school. We were asked to devise a way to allow a community of children affected by the Rett genetic syndrome, and thus unable to communicate verbally, in writing or by gestures, to actively participate in remote rehabilitation and special education sessions by exploiting eye-gaze tracking. As not all subjects can access commercial eye-tracking devices, we investigated new ways to facilitate the access to eye gaze-based interaction for this specific case. The adopted communication platform is a videoconferencing software, so all we had at our disposal was a live video stream of the child. As a solution to the problem, we developed a software (named SWYG) that only runs at the “operator” side of the communication, at the side of the videoconferencing software, and does not require to install other software in the child’s computer. The preliminary results obtained are very promising and the software is ready to be deployed on a larger base. While this paper is being written, several children are finally able to communicate with their caregivers from home, without relying on expensive and cumbersome devices.

Visual Search in Chinese Children With Attention Deficit/Hyperactivity Disorder and Comorbid Developmental Dyslexia: Evidence for Pathogenesis From Eye Movements

In this study, a visual search task was conducted on children with comorbid attention deficit/hyperactivity disorder (ADHD) and developmental dyslexia (DD), children with pure ADHD, and typically developing children to explore the pathogenesis of comorbidity between ADHD and DD. Participants searched for the target character from five characters in each trial during the task. The distractors included orthographically similar characters, homophones, unrelated characters, and characters of a different color (i.e., red). Results showed that the clinical groups produced longer first fixation duration than the control group in all types of distractors. Children with ADHD comorbid DD were also more susceptible to characters with the distracting red color in gaze duration and total viewing time than were children with pure ADHD and healthy controls. The implication of comorbidity (ADHD + DD) on the pathogenesis was discussed. These results may be helpful for the diagnosis and treatment of ADHD with comorbid DD.

Hyperacusis in Children with Attention Deficit Hyperactivity Disorder: A Preliminary Study

The association between hyperacusis and developmental disorders such as autism spectrum disorders has been extensively reported in the literature; however, the specific prevalence of hyperacusis in attention deficit hyperactivity disorder (ADHD) has never been investigated. In this preliminary study, we evaluated the presence of hyperacusis in a small sample of children affected by ADHD compared to a control group of healthy children. Thirty normal hearing children with a diagnosis of ADHD and 30 children matched for sex and age were enrolled in the study. All children underwent audiological and multidisciplinary neuropsychiatric evaluation. Hearing was assessed using pure tone audiometry and immittance test; ADHD was diagnosed following the Diagnostic and Statistical Manual of Mental Disorder criteria. Hyperacusis was assessed through the administration of a questionnaire to parents and an interview with children. Hyperacusis was diagnosed in 11 children (36.7%) in the study group and in four children (13.3%) in the control group; this difference was statistically significant (p = 0.03). The preliminary results of this study suggest a higher presence of hyperacusis in children with attention deficit hyperactivity disorder compared to control children. More studies on larger samples are necessary to confirm these results.

A Predictive Model Offor Attention Deficit Hyperactivity Disorder Based on Clinical Assessment Tools

BACKGROUND

At present, clinicians diagnose that the clinical diagnosis of attention deficit hyperactivity disorder (ADHD) in children is mainly on the basis of the information provided by their parents, the behaviour of children in clinical clinics and the assessments of clinical rating scales and neuropsychological tests. Notably, no unified standard exists currently for analysing the results of various measurement tools for diagnosing ADHD. Therefore, clinicians interpret the results of clinical rating scales and neuropsychological tests entirely based on their clinical experience.

METHODS AND SUBJECTS

To provide guidance for clinicians on how to analyse the results of various clinical assessment tools when diagnosing ADHD, this study assessed children with ADHD and children in the control group using two clinical assessment scales-parent rating scale (PSQ) and Child Behavior Checklist (CBCL)-and one neuropsychological test (Integrated Visual and Auditory Continuous Performance Testing). The two-sample t-test (FDR correction) screened the parameters of the three assessment tools with significant inter-group differences. LibSVM was used to establish a classification prediction model for analysing the accuracy of ADHD prediction using parameters of the three assessment tools and weight values of each parameter for classification prediction.

RESULTS

A total of 19 parameters (16 from clinical rating scales, 3 from neuropsychological tests) with significant inter-group differences were screened. The accuracy of classification modelling was higher for the clinical rating scales (61.635%) than for the neuropsychological test (59.784%), whereas the accuracy of classification modelling was higher for the clinical rating scales combined with the neuropsychological test (70.440%) than for the former two parameters alone. The three parameters with the highest weight values were learning problem (0.731), hyperactivity/impulsivity (0.676) and activity capacity (0.569). The three parameters with the lowest weight values are integrated control force (0.028), visual attention (0.028) and integrated attention (0.034).

CONCLUSION

Our study findings indicate that the diagnosis of ADHD should be based on multidimensional assessment. For a more accurate diagnosis of ADHD, assessments and that more assessment parameters should be developed on the basis of different dimensions of physiology or psychology in the future to obtain a more accurate diagnosis of ADHD. Furthermore, the predictive model for ADHD may improve our understanding and help in optimisation of the treatment of such a condition.