The development of selective attention in children with attention deficit hyperactivity disorder

The impact of transcranial direct current stimulation on attention bias modification in children with ADHD

Individuals with attention deficit-hyperactivity disorder (ADHD) struggle with the interaction of attention and emotion. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in this interaction. In the present study, we aimed to explore the effect of stimulation applied over the dlPFC and vmPFC on attention bias in individuals with ADHD. Twenty-three children with ADHD performed the emotional Stroop and dot probe tasks during transcranial direct current stimulation (tDCS) in 3 conditions: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. Findings suggest reduction of attention bias in both real conditions based on emotional Stroop task and not dot probe task. These results were independent of emotional states. The dlPFC and vmPFC are involved in attention bias in ADHD. tDCS can be used for attention bias modification in children with ADHD.

Electrophysiological correlates of attention in the locus coeruleus-prelimbic cortex circuit during the rodent continuous performance test

Sustained attention, the ability to focus on an activity or stimulus over time, is significantly impaired in many psychiatric disorders, and there remains a major unmet need in treating impaired attention. Continuous performance tests (CPTs) were developed to measure sustained attention in humans, non-human primates, rats, and mice, and similar neural circuits are engaged across species during CPT performance, supporting their use in translational studies to identify novel therapeutics. Here, we identified electrophysiological correlates of attentional performance in a touchscreen-based rodent CPT (rCPT) in the locus coeruleus (LC) and prelimbic cortex (PrL), two inter-connected regions that are implicated in attentional processes. We used viral labeling and molecular techniques to demonstrate that neural activity is recruited in LC-PrL projections during the rCPT, and that this recruitment increases with cognitive demand. We implanted male mice with depth electrodes within the LC and PrL for local field potential (LFP) recordings during rCPT training, and identified an increase in PrL delta and theta power, and an increase in LC delta power during correct responses in the rCPT. We also found that the LC leads the PrL in theta frequencies during correct responses while the PrL leads the LC in gamma frequencies during incorrect responses. These findings may represent translational biomarkers that can be used to screen novel therapeutics for drug discovery in attention.

Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease

Background: Children with attention-deficit hyperactivity disorder (ADHD) struggle with impaired attention, leading to impaired executive function and behavioral symptoms. In this study, we aimed to evaluate the effect of attention training on executive functions and behavioral symptoms in children with ADHD, in a tele-cognitive-rehabilitation setting. Methods: Thirty children (mean age: 9.93 ± 1.68 years, 21 boys) with ADHD were randomly assigned to 2 equal groups of attention training and active control group. Attentive Rehabilitation and Improvement of Attention (ARIA) and a class of storytelling were used for intervention in two groups, in an online platform. Continuous performance test, one-back test, Wisconsin card sorting test (WCST), Conner's parent rating scale, and behavioral rating inventory of executive function (BRIEF) were used for assessment in three-baseline, postintervention, and follow-up sessions. Repeated measures analysis of variances were used for analysis. Results: ARIA leads to significant improvement in omission error (P < 0.001), commission error (P = 0.006), and response time (P = 0.005) of continuous performance test, cluster (P = 0.001), but not preservation error (P = 0.110) of WCST, accuracy of NBT (P = 0.004) and the score of Conner's parent rating scale (P < 0.001) and BRIEF (P < 0.001). These results indicate improved attention and executive functions, amelioration of ADHD symptoms, and improved behavioral performance. Conclusion: This study suggests that attention can be trained through tele-cognitive rehabilitation using a remediation program in children with ADHD. The effectiveness of this training can be confirmed by examining the transfer of training effects to other untrained cognitive domains, executive functions, symptoms of ADHD, and behavioral performance.

Impulsivity in Major Depressive Disorder Patients with Suicidal Ideation: Event-related Potentials in a GoNogo Task

Objective

: Suicidal ideation is one of the strongest predictors of suicide, and its relevance to impulsivity in depressed patients has been accumulated. Furthermore, high impulsivity patients show the attenuation of the Nogo amplitude in the GoNogo event-related potential (ERP). The purpose of the current study is to determine the correlation of Nogo ERP to the suicidal ideation depending on the condition of its presence or absence in major depressive disorder (MDD) patients.

Methods

: A total 162 participants (104 patients with suicidal ideation, 31 patients without suicidal ideation, and 27 healthy controls) were recruited, and performed GoNogo tasks during the electroencephalogram measurement. Depression, anxiety, suicidal ideation and impulsivity were assessed by self-rating scales. The clinical measures, behavioral data and Nogo ERP were compared among groups.

Results

: The MDD with suicidal ideation (SI) group showed significantly decreased Nogo P3 amplitudes compared to MDD without SI (Fz and Cz electrodes) and control group (all electrodes). The MDD with SI group also had significantly low accuracy of both Go and Nogo trails, compared to the MDD without group. The Nogo P3 amplitudes showed the negative relation to the scores of impulsivity, depression, anxiety and SI.

Conclusion

: Our results concluded that the Nogo P3 ERP amplitude was decreased in MDD patients with SI compared to MDD patients without SI and controls. These findings suggest that the decreased Nogo P3 amplitude is the one of the candidate biomarker for impulsivity in MDD patients to evaluating SI.

Is the deficit in attention-deficit/hyperactivity disorder a concentration deficit?

Attention-deficit/hyperactivity disorder (ADHD) is comprised of two behavioral clusters of symptoms, inattention and hyperactivity/impulsivity. Numerous studies have attempted to address the underlying neuropsychological mechanism of ADHD. However, there is still no uniform mechanism that can fully explain both inattention and hyperactivity/impulsivity symptoms. This review describes the research findings that have shifted the focus from cognitive selective attention to executive function deficits and notes that the prominence of the attention deficit remains unclear. As ADHD is not consistently explained by cognitive selective attention but rather with cognitive sustained attention/vigilance and executive function deficits, this review suggests that concentration deficit is likely the cause of inattention symptoms. Indeed, considering concentration deficit as the cause of inattention symptoms may better describe the underlying difficulties of maintaining and controlling attention in ADHD. In addition, as concentration, impulsivity, and hyperactivity may share a common cognitive deficit, this shift in focus may help in identifying a single mechanism for all ADHD symptoms.

Electrophysiological correlates of attention in the locus coeruleus - anterior cingulate cortex circuit during the rodent continuous performance test

Sustained attention, the ability to focus on an activity or stimulus over time, is significantly impaired in many psychiatric disorders, and there remains a major unmet need in treating impaired attention. Continuous performance tests (CPTs) were developed to measure sustained attention in humans, non-human primates, rats, and mice, and similar neural circuits are engaged across species during CPT performance, supporting their use in translational studies to identify novel therapeutics. Here, we identified electrophysiological correlates of attentional performance in a touchscreen-based rodent CPT (rCPT) in the locus coeruleus (LC) and anterior cingulate cortex (ACC), two inter-connected regions that are implicated in attentional processes. We used viral labeling and molecular techniques to demonstrate that neural activity is recruited in LC-ACC projections during the rCPT, and that this recruitment increases with cognitive demand. We implanted male mice with depth electrodes within the LC and ACC for local field potential (LFP) recordings during rCPT training, and identified an increase in ACC delta and theta power, and an increase in LC delta power during correct responses in the rCPT. We also found that the LC leads the ACC in theta frequencies during correct responses while the ACC leads the LC in gamma frequencies during incorrect responses. These findings may represent translational biomarkers that can be used to screen novel therapeutics for drug discovery in attention.

The effects of first-dose methylphenidate on the neural signatures of visual selective attention in children with attention-deficit/hyperactivity disorder

Although methylphenidate (MPH) has been shown to significantly improve selective attention in children with attention-deficit/hyperactivity disorder (ADHD), the neural mechanism of this effect remains unclear. We investigated the effects of first-dose MPH on the neural signatures of visual selective attention in children with ADHD. We measured the impact of first-dose MPH on electrophysiological indexes from eighteen children with ADHD (8.9-15.2 years; 15 boys) while they performed a visual search task. MPH was administered in a double-blind placebo-controlled crossover design. MPH led to decreases in behavioral error rates and reaction times. For the electrophysiological indexes, MPH significantly increased the target-elicited N2pc amplitude and posterior P3 amplitude during the selective attention process. The trial-based correlation analysis revealed that the enhanced N2pc (more negative) and P3 (more positive) promoted the behavioral response speed for children with ADHD. The lower individual P3 amplitude was associated with higher severity of inattention symptoms. The severer inattention symptoms were related to weaker MPH effect on N2pc amplitude. These findings suggest that N2pc and P3 are closely related to the mechanism of MPH in the ADHD treatment.

Assessment of 'Cool' and 'Hot' Executive Skills in Children with ADHD: The Role of Performance Measures and Behavioral Ratings

Executive dysfunction is an underlying characteristic of Attention Deficit/Hyperactivity Disorder (ADHD). Therefore, this study explored which measures of executive functions (EF) may lead to a better diagnostic prediction and evaluated whether participants were adequately assigned to the ADHD group based on the identified predictors. Seventeen 6- to 10-year-old children with ADHD were matched with 17 typically developing peers (TD) by age, gender, and non-verbal intelligence. Performance-based measures and behavior ratings of 'cool' and 'hot' EF were used. As expected, there was a significant group effect on the linear combination of measures, indicating that children with ADHD showed significant difficulties with EF compared to the TD group. In fact, significant differences were found in measures of short-term and working memory, planning, delay aversion, and EF-related behaviors, as reported by parents and teachers. However, the discriminant function analysis only revealed three significant predictors: the General Executive Composite of the Behavior Rating Inventory of Executive Function (Parent and Teacher Forms) and the Delay of Gratification Task, with 97.1% correct classifications. These findings highlight the importance and contribution of both behavioral ratings and 'hot' measures of EF for the characterization of ADHD in children.

Assessing sustained attention of children with ADHD in a class flow video task

OBJECTIVE

The aim of the study was to evaluate sustained attention performance of children with ADHD and effect of distractors on sustained attention through an eye-tracking during a class-flow video task.

METHOD

Data were collected using an eye-tracking during a class-flow task conducted with 60 children (ADHD and control groups). Two areas of interest were determined in the task, these are relevant (teacher and whiteboard) and irrelevant (any regions outside the relevant area) areas. The task also included distractors in relevant and irrelevant areas, comprising a brief conversation and dropping of a pencil, respectively. Proportion of total fixation duration on areas of interest (PFDAOI) was used to assess sustained attention.

RESULTS

Children with ADHD had lower PFDAOI in the relevant area during the whole class than children in the control group. After the relevant area distractor, PFDAOI increased in relevant area in ADHD group, indicating these children may have better attention after the distractor. However, children with ADHD also showed increased PFDAOI in the irrelevant area following the irrelevant area distractor, indicating that it negatively affected them. There was no significant change in the control group following the distractors.

CONCLUSION

These findings indicate that children with ADHD have poor sustained attention performance during the whole class. Moreover, distractors in distinct areas could affect children with ADHD differently. Thus, students with ADHD could benefit from increased stimuli in the relevant area and this can be a guide for classroom arrangements to improve the academic functionality of these children.

UCancellation: A new mobile measure of selective attention and concentration

Measuring selective attention in a speeded task can provide valuable insight into the concentration ability of an individual, and can inform neuropsychological assessment of attention in aging, traumatic brain injury, and in various psychiatric disorders. There are only a few tools to measure selective attention that are freely available, psychometrically validated, and can be used flexibly both for in-person and remote assessment. To address this gap, we developed a self-administrable, mobile-based test called “UCancellation” (University of California Cancellation), which was designed to assess selective attention and concentration and has two stimulus sets: Letters and Pictures. UCancellation takes less than 7 minutes to complete, is automatically scored, has multiple forms to allow repeated testing, and is compatible with a variety of iOS and Android devices. Here we report the results of a study that examined parallel-test reliability and convergent validity of UCancellation in a sample of 104 college students. UCancellation Letters and Pictures showed adequate parallel test reliability (r = .71–.83, p < 0.01) and internal consistency (ɑ = .73–.91). It also showed convergent validity with another widely used cancellation task, d2 Test of Attention (r = .43–.59, p < 0.01), and predicted performance on a cognitive control composite (r = .34–.41, p < 0.05). These results suggest that UCancellation is a valid test of selective attention and inhibitory control, which warrants further data collection to establish norms.

Atypical Developmental Trajectories of Early Perception Among School-Age Children With Attention Deficit Hyperactivity Disorder During a Visual Search Task

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by cognitive deficits associated with attention. Prior studies have revealed the potential impact of ADHD on basic perception and cognitive ability in patients with ADHD. In this study, bilateral posterior P1 and N1 were measured in 122 Chinese children aged 7-12 years (64 with ADHD) to investigate the developmental characteristics of early perception during visual processing in school-age children with ADHD. For children with ADHD, a larger P1 activity with an atypical developmental pattern was evoked and observed for the visual search performance. These findings offer new insights into the mechanisms of cognitive developmental deficits and intervention techniques in children with ADHD.

Attentional networks, vigilance, and distraction as a function of attention-deficit/hyperactivity disorder symptoms in an adult community sample

Attentional difficulties are a core axis in attention-deficit/hyperactivity disorder (ADHD). However, establishing a consistent and detailed pattern of these neurocognitive alterations has not been an easy endeavour. Based on a dimensional approach to ADHD, the present study aims at comprehensively characterizing three key attentional domains: the three attentional networks (alerting, orienting, and executive attention), two components of vigilance (executive and arousal vigilance), and distraction. To do so, we modified a single, fine-grained task (the ANTI-Vea) by adding irrelevant distractors. One hundred and twenty undergraduates completed three self-reports of ADHD symptoms in childhood and adulthood and performed the ANTI-Vea. Despite the low reliability of some ANTI-Vea indexes, the task worked successfully. While ADHD symptoms in childhood were related to alerting network and arousal vigilance, symptoms in adulthood were linked to executive vigilance. No association between ADHD symptom severity and executive attention and distraction was found. In general, our hypotheses about the relationships between ADHD symptoms and attentional processes were partially supported. We discuss our findings according to ADHD theories and attention measurement.

Clinical presentations of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents: comparison of neurocognitive performance

This study aimed to compare performance in working memory (WM), processing speed (PRS), and attention measures in children and adolescents with typical development (TD) and with Attention deficit hyperactivity disorder (inattentive [ADHD-I] or combined [ADHD-C]) presentations, and to determine the predictive ability of the measures mentioned to discriminate between ADHD presentations and TD. 260 children and adolescents, 138 with ADHD (70 ADHD-I and 68 ADHD-C) and 122 TD in two age cohorts (8-12 years; 13-16 years), were assessed with WM and PRS indexes of Wechsler Intelligence Scale for Children (WISC-IV) and the d2 attention test. Significant differences between ADHD and TD groups in the WISC-IV GAI scores were found in children but not in adolescents. Children and adolescents with both ADHD presentations performed poorly on the PRS index, while on the WM index only children exhibited difficulties. In the attention test, children with ADHD-C showed more impulsivity and more difficulties for processing speed, concentration and accuracy than ADHD-I and TD. In addition, both ADHD presentations had higher inattention scores than TD. ADHD adolescents performed worse than TD in processing speed, concentration and accuracy. ADHD groups showed more impulsivity and inattention than TD. Digit Span and Symbol Search (WISC-IV) and processing speed and accuracy (d2) successfully classified ADHD and TD in children, but in adolescents, only coding (WISC-IV) and accuracy (d2) successfully classified ADHD presentations and TD. The WISC-IV and d2 yield neuropsychological profiles which reflect age-related cognitive changes and may allow the adaptation of more tailored early interventions for ADHD.

Visual Gender Cues Guide Crossmodal Selective Attending to a Gender-Congruent Voice During Dichotic Listening

Visual input of a face appears to influence the ability to selectively attend to one voice over another simultaneous voice. We examined this crossmodal effect, specifically the role face gender may have on selective attention to male and female gendered simultaneous voices. Using a within-subjects design, participants were presented with a dynamic male face, female face, or fixation cross, with each condition being paired with a dichotomous audio stream of male and female voices reciting different lists of concrete nouns. In Experiment 1a, the female voice was played in the right ear and the male voice in the left ear. In Experiment 1b, both voices were played in both ears with differences in volume mimicking the interaural intensity difference between disparately localized voices in naturalistic situations. Free recall of words spoken by the two voices immediately following stimulus presentation served as a proxy measure of attention. In both sections of the experiment, crossmodal congruity of face gender enhanced same-gender word recall. This effect indicates that crossmodal interaction between voices and faces guides auditory attention. The results contribute to our understanding of how humans navigate the crossmodal relationship between voices and faces to direct attention in social interactions such as those in the cocktail party scenario.

Thalamus is a common locus of reading, arithmetic, and IQ: Analysis of local intrinsic functional properties

Neuroimaging studies of basic achievement skills - reading and arithmetic - often control for the effect of IQ to identify unique neural correlates of each skill. This may underestimate possible effects of common factors between achievement and IQ measures on neuroimaging results. Here, we simultaneously examined achievement (reading and arithmetic) and IQ measures in young adults, aiming to identify MRI correlates of their common factors. Resting-state fMRI (rs-fMRI) data were analyzed using two metrics assessing local intrinsic functional properties; regional homogeneity (ReHo) and fractional amplitude low frequency fluctuation (fALFF), measuring local intrinsic functional connectivity and intrinsic functional activity, respectively. ReHo highlighted the thalamus/pulvinar (a subcortical region implied for selective attention) as a common locus for both achievement skills and IQ. More specifically, the higher the ReHo values, the lower the achievement and IQ scores. For fALFF, the left superior parietal lobule, part of the dorsal attention network, was positively associated with reading and IQ. Collectively, our results highlight attention-related regions, particularly the thalamus/pulvinar as a key region related to individual differences in performance on all the three measures. ReHo in the thalamus/pulvinar may serve as a tool to examine brain mechanisms underlying a comorbidity of reading and arithmetic difficulties, which could co-occur with weakness in general intellectual abilities.

The Relationship Between Response-Inhibitory Event-Related Potentials and Symptoms of Attention-Deficit/Hyperactivity Disorder in Adult Patients with Major Depressive Disorder

OBJECTIVE

Attention-deficit and poor impulse control have frequently been observed in major depressive disorder (MDD) and attention-deficit and hyperactivity disorder (ADHD). Altered event-related potential (ERP) performance, such as GoNogo tasks, has been regarded as a neurocognitive process associated with attention and behavioral inhibition. The aim of this study was to investigate the association between Nogo ERP and adult ADHD in MDD.

METHODS

A total of 64 participants with MDD (32 comorbid with ADHD) and 32 healthy controls aged 19-45 years were recruited; they performed GoNogo paradigms during electroencephalogram measurement. Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and the Adult ADHD Self-Report Scale (ASRS) were evaluated. Clinical measures and GoNogo ERP were compared between three groups: depression with ADHD, depression without ADHD, and healthy controls.

RESULTS

MDD subjects with ADHD showed significantly decreased Nogo P3 amplitude at frontal electrode, compared with those without ADHD and healthy controls. MDD subjects with ADHD showed significantly longer Nogo N2 latency at frontal and frontocentral electrodes, compared with those without ADHD and healthy controls. In MDD subjects with ADHD, the Nogo P3 amplitude at the frontal electrode was negatively correlated with the ASRS score and inattention. The Nogo N2 latency at the frontal electrode was positively correlated with false alarm rate.

CONCLUSION

The decreased Nogo P3 amplitude in the frontal area might be a potential biological marker for inattention in depressed patients with ADHD.

Neuropsychological Deficits in Adult ADHD: Evidence for Differential Attentional Impairments, Deficient Executive Functions, and High Self-Reported Functional Impairments

Objective: This study is aimed to investigate neuropsychological deficits in adult ADHD. Method: Neuropsychological deficits in terms of executive functions, divided, selective, and sustained attention, were investigated in a group of adults with ADHD using a series of neuropsychological tests as well as electroencephalography (EEG). Subjective ratings of everyday life attention and memory problems were also collected. Results: Adults with ADHD showed impairments in executive functions, divided attention and sustained attention, compared with adult controls. Performance on selective attention tasks in adults with ADHD was instead no different from control participants' performance. EEG results confirmed neuropsychological findings by showing a selective impairment on P3 event-related potential (ERP) amplitude indicative of sustained attention deficits. Higher subjective ratings of everyday attentional and memory problems were also found in the ADHD group compared with the control group. Conclusion: This pattern of results suggests differential impairments of attentional skills. Impaired executive functions and higher subjective functional impairments were also found.

Physical Fitness and Dynamic Balance in Medication Naïve Turkish Children with ADHD

This study investigated physical fitness levels and dynamic balance in medication-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). Participants were 24 medication-naïve Turkish children with ADHD (4 girls, 20 boys) and 19 typically developing (TD) Turkish children (4 girls, 15 boys). We measured physical fitness levels with the Eurofit Test Battery, body composition with the Inbody 720 Body Composition Analyzer, cognitive attention with the Stroop Test, and dynamic balance with the Y-Balance Test. We found significantly poorer dynamic balance and both upper extremity and running fitness problems among the medication-naïve Turkish children with ADHD compared to the TD group (p = 0.002; p = 0.032; p = 0.002). It may be important to adress dynamic balance and physical fitness when treating children with ADHD.

Using virtual reality to define the mechanisms linking symptoms with cognitive deficits in attention deficit hyperactivity disorder

The mechanisms underpinning attentional deficits are only partially understood. Here we ask if shifts in a child's field of view (FOV) act as a mediator between symptoms of attention deficit hyperactivity disorder (ADHD) and associated cognitive anomalies, particularly in attentional processes. Real time measurement of shifts in FOV were obtained on 85 children (mean age 9.4 (SD 1.9) years; 45 with DSM 5-defined ADHD) as they completed the continuous performance task in a "virtual classroom". We extracted measures reflecting focused and selective attention across the task, along with diffusion modelling of latent cognitive processes of information uptake, response conservativeness and non-decision time. Mediation analyses showed that shifts in FOV partially mediated the relationship between hyperactive impulsive symptoms and both poor focused attention and information uptake. Performance accuracy decreased and shifts in FOV increased during the task, but these changes over time did not differ by symptom severity. Employing virtual reality and mediation analysis, we implicate shifts in FOV as a mechanism linking symptoms of ADHD and deficits in focused attention and in the gathering of information to make decisions. The identification of mediating mechanisms might provide new targets for intervention.

The use of remote microphone systems in unilateral hearing loss: a preliminary study among Brazilian children and teenagers

Due to the large number of individuals with Unilateral Hearing Loss (UHL) and the recommendation to use hearing assistive devices, studies are required to define possibilities of intervention for this population.

OBJECTIVE

To evaluate the performance of the Remote Microphone System (RMS) in children with UHL.

METHODOLOGY

Prospective clinical study with a convenience sample. Eleven children (mean age of 9.2 years) with severe and profound sensorineural UHL, hearing aid users and enrolled in regular schools participated in the study. They were evaluated using the Hearing in Noise Test (HINT), the Classroom Participation Questionnaire (CPQ), and the Sustained Auditory Attention Ability Test (SAAAT) with RMS.

RESULTS

HINT results were analyzed using variance to three criteria of repeated measures, which revealed differences between intervention, position, and time factors and significant interaction between these three factors. The comparative analysis of the results from CPQ showed significant differences in the statistical t-test (p=<0.001) for all subscales. The analysis of variance at two repeated measures criteria used in the study of SAAAT revealed a difference between intervention and time, and both interacted significantly.

CONCLUSION

The RMS associated with a hearing aid was effective for individuals with UHL.

The Impact of Concurrent Noise on Visual Search in Children With ADHD

OBJECTIVE

The purpose of this study was to investigate the impact of a concurrent "white noise" stimulus on selective attention in children with ADHD.

METHOD

Participants were 33 children aged 7 to 14 years, who had been previously diagnosed with ADHD. All children completed a computer-based conjunction search task under two noise conditions: a classroom noise condition and a classroom noise + white noise condition. The white noise stimulus was sounds of rain, administered using an iPhone application called Sleep Machine.

RESULTS

There were no overall differences between conditions for target detection accuracy, mean reaction time (RT), or reaction time variability ( SD). The impact of white noise on visual search depended on children's medication status.

CONCLUSION

White noise may improve task engagement for non-medicated children. White noise may be beneficial for task performance when used as an adjunct to medication.

Effect of methylphenidate on visual responses in the superior colliculus in the anaesthetised rat: Role of cortical activation

The mechanism of action of psychostimulant drugs in the treatment of Attention Deficit Hyperactivity Disorder is still largely unknown, although recent evidence suggests one possibility is that the drugs affect the superior colliculus (SC). We have previously demonstrated that systemically administered d-amphetamine attenuates/abolishes visual responses to wholefield light flashes in the superficial layers of the SC in anaesthetised rats, and the present study sought to extend this work to methylphenidate (MPH). Anaesthetised rats were administered MPH at a range of doses (or saline) and subjected to monocular wholefield light flashes at two intensities, juxta-threshold and super-threshold. In contrast to d-amphetamine, systemic MPH produced an enhancement of visual activity at both intensities. Methylphenidate was also found to produce activation of the cortical EEG in anaesthetised rats. Furthermore, cortical activation induced by electrical stimulation of the pons was found to enhance visual responses in superficial layers of the SC, and when MPH was paired with pontine-induced cortical activation, the response-enhancing effects of MPH were substantially attenuated. Taken together, the results suggest that the enhancement of visual responses in the superficial layers of the SC by MPH in the anaesthetised rat is an artefact of the drug's interaction with cortical arousal.

Linking ADHD to the Neural Circuitry of Attention

Attention deficit hyperactivity disorder (ADHD) is a complex condition with a heterogeneous presentation. Current diagnosis is primarily based on subjective experience and observer reports of behavioral symptoms - an approach that has significant limitations. Many studies show that individuals with ADHD exhibit poorer performance on cognitive tasks than neurotypical controls, and at least seven main functional domains appear to be implicated in ADHD. We discuss the underlying neural mechanisms of cognitive functions associated with ADHD, with emphasis on the neural basis of selective attention, demonstrating the feasibility of basic research approaches for further understanding cognitive behavioral processes as they relate to human psychopathology. The study of circuit-level mechanisms underlying executive functions in nonhuman primates holds promise for advancing our understanding, and ultimately the treatment, of ADHD.

Perspectivas teóricas y evidencia empírica sobre la estructura de la inhibición

<p>Desde el punto de vista teórico la inhibición ha sido un mecanismo relevante para explicar cómo las personas seleccionan información relevante y descartan información irrelevante. A su vez, parece estar fuertemente implicada en el dominio y adquisición de competencias sociales, emocionales y comportamentales. De manera inversa,  los fallos en esta habilidad se asocian a diferentes síndromes y a la emergencia de comportamientos no deseados, como por ejemplo el abuso de sustancias, los problemas atencionales, el sobrepeso, entre otros.  Aunque, actualmente existe acuerdo sobre la importancia de la inhibición, existen divergencias en cuanto a su definición conceptual y operativa. Principalmente, existe un fuerte debate en torno a si la inhibición es un constructo unitario o debería fragmentarse en un conjunto de procesos. El objetivo de este  trabajo, es por tanto, describir los hallazgos y posturas más relevantes en relación a las problemáticas en el abordaje del constructo inhibitorio. Para ello, en primer lugar se expondrá una propuesta explicativa del control de la interferencia basada en un enfoque no inhibitorio. En segundo lugar, se describirán los modelos más representativos, de uno, dos y tres factores para finalmente, exponer algunos de los aportes y hallazgos propuestos como principal fuente de evidencia a favor del enfoque fragmentado.</p>

Establishing the Attention-Distractibility Trait

Failures to focus attention will affect any task engagement (e.g., at work, in the classroom, when driving). At the clinical end, distractibility is a diagnostic criterion of attention-deficit/hyperactivity disorder (ADHD). In this study, we examined whether the inability to maintain attentional focus varies in the overall population in the form of an attention-distractibility trait. To test this idea, we administered an ADHD diagnostic tool to a sample of healthy participants and assessed the relationship between ADHD symptoms and task distraction. ADHD symptom summary scores were significantly positively associated with distractor interference in letter-search and name-classification tasks (as measured by reaction time), as long as the distractors were irrelevant (cartoon images) rather than relevant (i.e., compatible or incompatible with target names). Higher perceptual load during a task eliminated distraction irrespective of ADHD score. These findings suggest the existence of an attention-distractibility trait that confers vulnerability to irrelevant distraction, which can be remedied by increasing the level of perceptual load during the task.

Cognitive computer training in children with attention deficit hyperactivity disorder (ADHD) versus no intervention: study protocol for a randomized controlled trial

BACKGROUND

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by symptoms of inattention and impulsivity and/or hyperactivity and a range of cognitive dysfunctions. Pharmacological treatment may be beneficial; however, many affected individuals continue to have difficulties with cognitive functions despite medical treatment, and up to 30 % do not respond to pharmacological treatment. Inadequate medical compliance and the long-term effects of treatment make it necessary to explore nonpharmacological and supplementary treatments for ADHD. Treatment of cognitive dysfunctions may prove particularly important because of the impact of these dysfunctions on the ability to cope with everyday life. Lately, several trials have shown promising results for cognitive computer training, often referred to as cognitive training, which focuses on particular parts of cognition, mostly on the working memory or attention but with poor generalization of training on other cognitive functions and functional outcome. Children with ADHD have a variety of cognitive dysfunctions, and it is important that cognitive training target multiple cognitive functions.

METHODS/DESIGN

This multicenter randomized clinical superiority trial aims to investigate the effect of "ACTIVATE™," a computer program designed to improve a range of cognitive skills and ADHD symptoms. A total of 122 children with ADHD, aged 6 to 13 years, will be randomized to an intervention or a control group. The intervention group will be asked to use ACTIVATE™ at home 40 minutes per day, 6 days per week for 8 weeks. Both intervention and control group will receive treatment as usual. Outcome measures will assess cognitive functions, symptoms, and behavioral and functional measures before and after the 8 weeks of training and in a 12- and 24-week follow-up.

DISCUSSION

Results of this trial will provide useful information on the effectiveness of computer training focusing on several cognitive functions. Cognitive training has the potential to reduce cognitive dysfunctions and to become a new treatment option, which can promote a more normal neural development in young children with ADHD and thus reduce cognitive dysfunctions and symptoms. This could help children with ADHD to perform better in everyday life and school.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01752530 , date of registration: 10 December 2012.

Developmental trajectories for attention and working memory in healthy Japanese school-aged children

OBJECTIVE

The aim of this study was to investigate the developmental trajectories of attention, short-term memory, and working memory in school-aged children using a 10 min test battery of cognitive function.

METHODS

Participants comprised 144 typically developing children (TDC) aged 7-12 years and 24 healthy adults, divided according to age into seven groups (12 males and 12 females for each age group). Participants were assessed using CogHealth, which is a computer-based measure composed of five tasks. We measured attention, short-term memory, and working memory (WM) with visual stimulation. Each task was analyzed for age-related differences in reaction time and accuracy rate.

RESULTS

Attention tasks were faster in stages from the age of 7-10 years. Accuracy rate of short-term memory gradually increased from 12 years of age and suddenly increased and continued to increase at 22 years of age. Accuracy rate of working memory increased until 12 years of age. Correlations were found between the ages and reaction time, and between ages and accuracy rate of the tasks.

CONCLUSION

These results indicate that there were rapid improvements in attention, short-term memory, and WM performance between 7 and 10 years of age followed by gradual improvement until 12 years of age. Increase in short-term memory continued until 22 years of age. In our experience CogHealth was an easy and useful measure for the evaluation of cognitive function in school-age children.

Methylphenidate and environmental enrichment ameliorate the deleterious effects of prenatal stress on attention functioning

Either pre- or post-natal environmental factors seem to play a key role in brain and behavioral development and to exert long-term effects. Increasing evidence suggests that exposure to prenatal stress (PS) leads to motor and learning deficits and elevated anxiety, while enriched environment (EE) shows protective effects. The dopaminergic system is also sensitive to environmental life circumstances and affects attention functioning, which serves as the preliminary gate to cognitive processes. However, the effects of methylphenidate (MPH) on the dopaminergic system and attentional functioning, in the context of these life experiences, remain unclear. Therefore, we aimed to examine the effects of EE or PS on distinct types of attention, along with possible effects of MPH exposure. We found that PS impaired selective attention as well as partial sustained attention, while EE had beneficial effects. Both EE and MPH ameliorated the deleterious effects of PS on attention functioning. Considering the possible psychostimulant effect of MPH, we examined both anxiety-like behavior as well as motor learning. We found that PS had a clear anxiogenic effect, whereas EE had an anxiolytic effect. Nevertheless, the treatment with both MPH and/or EE recovered the deleterious effects of PS. In the motor-learning task, the PS group showed superior performance while MPH led to impaired motor learning. Performance decrements were prevented in both the PS + MPH and EE + MPH groups. This study provides evidence that peripubertal exposure to EE (by providing enhanced sensory, motor, and social opportunities) or MPH treatments might be an optional therapeutic intervention in preventing the PS long-term adverse consequences.

Plugging the attention deficit: perceptual load counters increased distraction in ADHD

OBJECTIVE

Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities.

METHOD

We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials).

RESULTS

The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ηp² = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls.

CONCLUSIONS

These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it.

No behavioral or ERP evidence for a developmental lag in visual working memory capacity or filtering in adolescents and adults with ADHD

Attention-deficit/hyperactivity disorder (ADHD) patients have both working memory (WM) and attention problems. Good attention skills are important for WM performance; individuals have higher WM capacity when being able to prevent storage of irrelevant information through efficient filtering. Since it is unknown how filtering ability is associated with WM performance in ADHD, this was investigated in the present study. A visuospatial working memory (VSWM) change detection task with distracting stimuli was administered to adolescents (12–16 years old) and adults (20–46 years old) with and without ADHD matched on education/IQ. Besides performance, contralateral delay activity (CDA) was measured; a neural correlate of the number of targets and distracters encoded and maintained in WM during the retention interval. Performance data showed similar WM-load, WM-distracter interference and developmental effects in ADHD and control groups. Adolescents’ performance on the WM task deteriorated more than that of adults in the presence of distracters and with higher WM-load, irrespective of Diagnosis. The CDA data suggested that initially all groups encoded/maintained distracting information, but only adults were able to bounce this information from memory later in the retention interval, leading to better WM performance. The only effect of Diagnosis was a smaller CDA in adolescents and adults with ADHD than in age/IQ-matched controls when maintaining a low 1-item load, which was possibly related to an inability to keep attention focused at cued stimuli with low task demands. Overall, the development of filtering efficiency and VSWM storage capacity in adolescents with ADHD was not different from that in typically developing peers.

Abnormal centroparietal ERP response in predominantly medication-naive adolescent boys with ADHD during both response inhibition and execution

Abnormal event-related potential (ERP) responses have been reported in children and adolescents with attention deficit hyperactivity disorder (ADHD) and a medication history compared with in healthy controls during tasks of response control and conflict inhibition. This study reports neurophysiologic correlates of a task dependent on these cognitive functions in a large, predominantly medication naive, group of adolescents with ADHD compared with that in healthy age- and intelligence quotient (IQ)-matched controls using area-under-the-curve (AUC) analysis. Fifty-four adolescents with ADHD and 55 healthy comparisons completed a hybrid conflict and response inhibition Go/NoGo ERP task. The performance data showed that children with ADHD compared with controls had deficits in both the inhibitory measures (higher commission errors) and the Go process of the task (slower reaction times and enhanced omission errors). The ERP data showed significant impairments in brain function in the ADHD relative to the control group for late, endogenous ERPs (N2, P3a, and P3b), whereas no group differences were found for the earlier P200. All findings remained when a minority of children with medication history was excluded. Furthermore, deficits were not specific to the inhibitory processes of the task but were equally observed during the execution functions. Group differences were particularly pronounced over central and centroparietal sites across all time points, presumably reflecting the midline attention system mediated by anterior and posterior cingulate that is important for generic, condition-independent visual-spatial attention and response selection processes. The findings demonstrate that adolescents with ADHD have abnormal ERP responses not only during inhibitory, but also execution-related processes and, furthermore, that these deficits are independent from medication history.

An Examination of Developmental Trajectories for Attention Skills in Children

The present study aimed to investigate the development of attention skills through middle childhood and to document developmental trajectories associated with tasks of increasing attentional demands. The sample comprised 57 children (aged 5–12 years) who were divided, according to age, into three groups. Performance differences between the groups were compared on two measures, each including four subtests of increasing complexity and tapping both speed and accuracy: CogState, a computerised measure, and The Contingency Naming Test, a paper-and-pencil test. We predicted that there would be: (1) improvements in performance with increasing age, (2) deceases in performance with increasing task complexity and (3) parallel increments in performance on computer-based and paper-and-pencil measures. The results indicated that there were rapid improvements in performance on both computer-based and paper-and-pencil measures between the ages of 5 and 8 years indicated by changes in both response speed and response accuracy. In contrast, more moderate improvements were identified between the ages of 9 to 12 years and occurred mainly in the domain of speed.

Which behavioral and personality characteristics are associated with difficulties in selective attention?

OBJECTIVE

The present study investigated the behavioral and personality profile associated with difficulties in selective attention.

METHOD

A group of participants with ADHD were assessed for ADHD behaviors. Adults with ADHD (n=22) and without ADHD (n=84) were tested on the conjunctive visual-search task for selective attention and behavioral measures, including ADHD behaviors, Big Five dimension of personality, obsessive compulsive disorder (OCD) symptoms, and sensation-seeking behavior.

RESULTS

Correlations and multiple regression analysis (group was dummy coded) showed that ADHD behaviors were not related to search performance. However, poorer search performance was related to greater neuroticism, agreeableness, introversion, lower sensation seeking, and, marginally, to OCD symptoms.

CONCLUSION

The study findings suggested that difficulties in selective attention are probably not associated with ADHD behaviors, but rather with personality traits characterized by preserving and avoiding high-stimulation behaviors.

Abnormal spatial asymmetry of selective attention in ADHD

BACKGROUND

Evidence for a selective attention abnormality in children with attention deficit hyperactivity disorder (ADHD) has been hard to identify using conventional methods from cognitive science. This study tested whether the presence of selective attention abnormalities in ADHD may vary as a function of perceptual load and target lateralisation. Given evidence of right-hemisphere dysfunction in ADHD we predicted increased interference effects for right, but not left-sided target displays, particularly under low perceptual load.

METHOD

Fourteen children with ADHD-C and 14 typically developing children were tested on a modified flanker task under low and high perceptual load. We also sought evidence for our hypothesis in a re-analysis of an independent data set (42 ADHD; 34 typically developing) in which load effects on selective attention in ADHD were previously examined (Huang-Pollock, Nigg, & Carr, 2005).

RESULTS

As predicted, all children showed evidence of greater interference by flankers under low compared with high perceptual load conditions. Crucially, however, children with ADHD showed the greatest interference effect for right-sided target displays under low but not high perceptual load. In contrast, typically developing children showed the greatest interference for left-sided target displays. The magnitude of interference for right-sided targets was also positively correlated with ADHD symptom levels. Re-analysis of an independent data set (Huang-Pollock et al., 2005) further confirmed our findings.

CONCLUSIONS

This study demonstrates that interference effects in children with ADHD and typically developing children are spatially asymmetrical but opposite in direction. The pattern of right-sided interference effects in children with ADHD suggests disruption within right hemisphere attentional networks in ADHD.

Development of attentional processes in ADHD and normal children

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder. Typical development of attentional processes is rapid during early childhood. ADHD results in impairment in response inhibition, error monitoring, attentional disengagement, executive attention, and delay aversion and may effect the ongoing development of these processes during childhood. We examined the development of attentional processes in children with ADHD and normal children. Two hundred forty children (120 in each group) in the age range of 6-9 years participated in the study. Four tasks: Stop-Signal, attentional disengagement, attention network, and choice delay task were administered. Stop signal reaction time, switch costs, conflict effect, and percentage choice of short delay reward was higher in ADHD group compared to normal group. Post error of slowing was less in ADHD children. Endogenous orienting effect was more in normal children compared to ADHD children. Different developmental trajectories were observed for control functions in normal children. Major development in response inhibition occurred in 7-8 years, error monitoring in 6-9 years, and attentional disengagement in 7-9 years. Late development in alerting network was observed in normal children at age 9 years. No developmental changes occurred on these control functions in ADHD children aged 6-9 years. Age related changes were observed on delay aversion between 6 and 9 years in normal children, while it changed between 6 and 7 years in ADHD children. Performance was not changed on orienting and conflict attentional networks in both the children except conflict effect reduced between 7 and 9 years in ADHD children under double cue condition. Conflict network was interacted with the alerting and orienting network in normal children; specifically conflict network interacted with the orienting network in younger children (age 6 years) and with alerting network in older children (age 9 years). In ADHD group interaction between alerting and conflict network was observed only in the double cue condition. Together these results indicated that the deficits in control processes accumulate with age in ADHD children Present study favors the conceptual view of ADHD as a stable deficit in cognitive control functions, which are implicated in the pathology of ADHD. These results have theoretical implication for the theories of executive control and ADHD.

ERP correlates of selective attention and working memory capacities in children with ADHD and/or PDD-NOS

OBJECTIVE

We examined whether children (8-11 years) diagnosed with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) or Attention-Deficit/Hyperactivity Disorder (ADHD) showing primarily hyperactive behavior, differed in selective attention and working memory (WM) abilities.

METHODS

Healthy controls and children with ADHD, PDD-NOS or symptoms of both disorders (PDD/HD) (n=15 in each group) carried out a visual selective memory search task while their EEG was recorded from which event-related potentials were derived.

RESULTS

Compared to the control group, all patient groups made more omissions while hyperactive children also exhibited more false alarms. Regarding the process of WM-controlled search, significant group differences in ERP data were found between the control group and each of the clinical groups.

CONCLUSIONS

The results point to less efficient WM-functioning in all patient groups. Whereas the clinical groups differed from each other at the behavioral level as measured by questionnaires, no distinction between the clinical groups could be made with respect to performance or ERP measures of WM capacity and selective attention.

SIGNIFICANCE

The results suggest that a possible differentiation in selectivity and working memory capacities between PDD-NOS and ADHD is hard to find. This may agree with clinical practice, where differential diagnosis is a subject of discussion.

Distractibility in Attention/Deficit/ Hyperactivity Disorder (ADHD): the virtual reality classroom

Nineteen boys aged 8 to 14 with a diagnosis of ADHD and 16 age-matched controls were compared in a virtual reality (VR) classroom version of a continuous performance task (CPT), with a second standard CPT presentation using the same projection display dome system. The Virtual Classroom included simulated "real-world" auditory and visual distracters. Parent ratings of attention, hyperactivity, internalizing problems, and adaptive skills on the Behavior Assessment System for Children (BASC) Monitor for ADHD confirmed that the ADHD children had more problems in these areas than controls. The difference between the ADHD group (who performed worse) and the control group approached significance (p = .05; adjusted p = .02) in the Virtual Classroom presentation, and the classification rate of the Virtual Classroom was better than when the standard CPT was used (87.5% versus 68.8%). Children with ADHD were more affected by distractions in the VR classroom than those without ADHD. Results are discussed in relation to distractibility in ADHD.

Development of Inattention, Impulsivity, and Processing Speed as Measured by the d2 Test: Results of a Large Cross-sectional Study in Children Aged 7–13

The development of three aspects of selective attention was studied in 451 Dutch schoolchildren attending second to sixth grade. Selective attention was measured with the d2 Test of attention. The largest age differences were found for processing speed that continued to improve until the sixth grade. Impulsivity, as measured by the percentage of errors of commission, decreased until the fourth grade. Inattention, measured by the percentage of errors of omission, was stable in all grades. Processing speed and impulsivity were correlated with the score on the Attention Problems subscale of the Child Behavior Checklist. These results imply that selective attention continues to develop, at least, until the end of elementary school. The findings are support for a step-wise model of cognitive development (P. Anderson, 2002).

Sustained selective attention skills of preschool children with specific language impairment: evidence for separate attentional capacities

PURPOSE

The present study was designed to investigate the performance of preschool children with specific language impairment (SLI) and their typically developing (TD) peers on sustained selective attention tasks.

METHOD

This study included 23 children diagnosed with SLI and 23 TD children matched for age, gender, and maternal education level. The children's sustained selective attention skills were assessed with different types of stimuli (visual, nonverbal-auditory, linguistic) under 2 attentional load conditions (high, low) using computerized tasks. A mixed design was used to compare children across groups and performance across tasks.

RESULTS

The SLI participants exhibited poorer performance than their peers on the sustained selective attention tasks presented in the auditory modality (linguistic and nonverbal-auditory) under the high attentional load conditions. Performance was comparable with their peers under the low attentional load conditions. The SLI group exhibited similar performance to their peers on the visual tasks regardless of attentional load.

CONCLUSION

These results support the notion of attention difficulties in preschool children with SLI and suggest separate attentional capacities for different stimulus modalities.

Medications do not necessarily normalize cognition in ADHD patients

OBJECTIVE

Although ADHD medications are effective for the behavioral components of the disorder, little information exists concerning their effects on cognition, especially in community samples.

METHOD

A cross-sectional study of ADHD patients treated with three different ADHD drugs was conducted. Patients' performance on a computerized neurocognitive screening battery was compared to untreated ADHD patients and normal controls (NML). A total of 177 ADHD patients aged 10 to 18, achieved a favorable response to one of the following medications: Adderall XR (AMP), atomoxetine (ATMX), and Concerta (MPH-OROS) compared to 95 untreated ADHD patients and 101 NML.

RESULTS

Significant differences were detected between normals and untreated ADHD patients. Treated patients performed better than untreated patients but remained significantly impaired compared to normal subjects.

CONCLUSION

Even with optimal treatment, based on parents' and teachers' opinions, subtle and not-so-subtle neurocognitive impairments persisted in the ADHD patients. Some ADHD patients may require additional educational assistance, even in the face of successful medication treatment.

Effects of methylphenidate in ADHD adults on target evaluation processing reflected by event-related potentials

Attention deficit/hyperactivity disorder (ADHD) is a widely examined disease in childhood. There is evidence that the disease responds well to medication with methylphenidate (MPH). The effect of MPH in adults with ADHD is a question that is often raised, because many adults request such therapy today. As yet, there is a lack of studies on event-related potentials (ERPs) and MPH in ADHD adults. In the present study we examined 10 adults diagnosed with ADHD, with and without MPH medication (30 mg daily), by means of ERP in a visual Go/NoGo experiment to gain information about target evaluation processing in these patients and about the effects on these attentional processes during medication with MPH. Visually, there seem to be differences in the frontal electrodes for the N2 and in the parietal electrodes for the P300. But these differences do not achieve statistical significance. There are also no statistically relevant differences for the N1 or the slow wave. MPH does not seem to have an effect on target evaluation processing, when comparing the ERPs of non-medicated and medicated ADHD adults. Especially the P3 does not appear to be modulated by medication with MPH in these ADHD adults, in contrast to findings in ADHD children.

Proposta de instrumento comportamental para avaliar a atenção auditiva sustentada

A atenção sustentada e vigilância são alguns dos processos que caracterizam a atenção e fundamentais para o desenvolvimento de algumas habilidades. OBJETIVO: Propor um instrumento comportamental simples, de fácil e rápida aplicação para auxiliar na avaliação da habilidade de atenção auditiva sustentada. Estudo prospectivo. MATERIAL E MÉTODO: Crianças voluntárias de 6 a 11 anos de idade, 139 do gênero feminino e 141 do masculino. O teste foi denominado Teste da Habilidade da Atenção Auditiva Sustentada e baseado no Teste de Desempenho Contínuo. Consiste na apresentação biaural e diótica, de uma lista de 100 palavras monossilábicas nas quais estão inclusas 20 vezes o monossílabo que deverá ser identificado. Esta lista é apresentada seis vezes sem interrupção. É realizado em cabina acústica, com auxílio de um CD player acoplado a um audiômetro de dois canais a 50 dBNS e tem uma duração média de 9 minutos.O resultado do teste é obtido pela pontuação total e pelo decréscimo de vigilância. RESULTADOS: A obtenção dos resultados mostrou-se fácil e rápida. Não foi encontrada significância estatística nos resultados para ambos os gêneros, porém significativa diferença foi encontrada entre as idades. CONCLUSÃO: O teste proposto não apresentou qualquer desconforto às crianças participantes e mostrou-se altamente sugestivo para avaliar a habilidade de atenção auditiva sustentada em crianças.

A proposed behavioral tool to assess sustained auditory attention

Sustained attention and vigilance are processeses that characterize attention, and are essential for the development of certain abilities

Aim

a prospective study to propose a simple, easy and quick behavioral tool to support the assessment of sustained auditory attention.

Material and methods

volunteer children aged between 6 and 11 years (139 female and 141 male) were selected. The test was named Sustained Auditory Attention Ability Test, and is based on the Continuous Performance Test. It consist of a binaural and diotic presentation of a list of 100 monosyllabic words in which a target monosyllable is included 20 times. This list was presented six times with no breaks. The test was carried out in a soundproofed room, using a CD player attached to a two-channel audiometer at 50 dBSL during 9 minutes. The test resulted in a total score and a vigilance decrement.

Results

There was no statistically significant difference between genders, but a significant difference was found between ages.

Conclusion

The proposed test had no discomfort for the participants, and was shown to be extremely promising to assess the sustained auditory attention ability in children.

Media Content and Externalizing Behaviors in Latino Toddlers

OBJECTIVE

There has been limited study of the association between media exposure and behavior in children younger than age 3 years. We sought to study this association in toddlers and determine whether the association varied depending on media content.

METHODS

We carried out a secondary analysis of a cohort of Latino mother-infant dyads followed from birth to 33 months. We assessed media exposure at 21 and 33 months with a 24-hour recall diary that included information about the duration and content of each program watched. Behavior was assessed at 33 months by the Child Behavior Checklist.

RESULTS

This analysis included 99 dyads. Results from multiple logistic regression analyses indicated associations of child behavior outcomes with 21-month total media exposure and both 21-month and 33-month exposure to noneducational young child media such as cartoons, after adjusting for maternal education, country of origin, and depressive symptoms, participation in a parenting program, and difficult child temperament. Media exposure has most consistent associations with aggressive behavior and externalizing problems.

CONCLUSIONS

Media exposure was associated with externalizing behavior in Latino toddlers, with the strongest association for media oriented toward young children but without educational content. This finding has importance for both parents of young children and pediatricians as they provide anticipatory guidance.

Revisiting the role of the prefrontal cortex in the pathophysiology of attention-deficit/hyperactivity disorder

Most neural models for the pathophysiology of attention-deficit/hyperactivity disorder (ADHD) have centered on the prefrontal cortex and its interconnections with the striatum and other subcortical structures. However, research only partially supports these models, and they do not correspond with the development of the prefrontal cortex and its interrelated neurocircuitry. The neural and functional development of the prefrontal cortex more closely parallels recovery from ADHD as indicated by the developmental remission of symptomatology. The authors hypothesize that ADHD is due to noncortical dysfunction that manifests early in ontogeny, remains static throughout the lifetime, and is not associated with the remission of symptomatology. Data supporting this neurodevelopmental model of prefrontal cortex function in ADHD are reviewed. Research and treatment implications are discussed.

Training attention-switching ability in adults with ADHD

OBJECTIVE

Children with ADHD show attention-switching impairment. The present study assessed attention-switching ability in adults with ADHD, the extent to which this ability can be improved via targeted training, and the degree to which training extends to novel tasks of attention-switching.

METHOD

Adults with ADHD (n = 16) and adults without ADHD (n = 18) were divided into training and non-training groups. Training groups performed six blocks of four different attention-switching tasks, while non-training groups completed non-switching, "filler" tasks. Lastly, the four groups were tested on two novel attention-switching tasks.

RESULTS

Adults with ADHD showed impaired attention-switching, relative to non-ADHD adults, but training significantly improved attention-switching in both ADHD and non-ADHD training groups. Finally, training effects transferred to new tasks of attention-switching.

CONCLUSION

Adults with ADHD show attention-switching impairments, but deficits may be ameliorated with short-term, targeted training. Research has implications for cognitive training in ADHD.