The Role of Inattention on Academics, Fluid Reasoning, and Visual–Spatial Functioning in Two Subtypes of ADHD

Review of spatial disability in individuals with attention deficit-hyperactivity disorder: Toward spatial cognition theory

Spatial cognition is the ability to detect, process, integrate, and formulate the spatial aspects of the environment. Spatial abilities, as perceptual doorway of information processing, influence on higher cognitive functions. This systematic review aimed to explore impaired spatial ability in individuals with Attention Deficit-Hyperactivity Disorders (ADHD). The data from 18 empirical experiments that explored at least one factor of spatial ability in individuals with ADHD was collected in accordance with the PRISMA approach. This study discussed several determinants of impaired spatial ability, including factors, domains, tasks, and measures of spatial ability. Furthermore, the impact of age, gender, and comorbidities are discussed. Finally, a model was proposed to explain the impaired cognitive functions in children with ADHD based on spatial abilities.

The shifting role of fluid reasoning in reading among children evaluated for ADHD

Children with attentional difficulties are more likely than their peers to experience challenges in basic reading skills, including phonemic decoding and word recognition. Such challenges may require reliance on higher-order cognitive functions such as fluid reasoning (Gf) to attain reading proficiency. The present study sought to clarify the role of Gf in phonemic decoding and word recognition among children-in grades 1-7 (n = 156)-being evaluated for attention-deficit/hyperactivity disorder (ADHD). Effects of Gf were examined in relation to crystallized knowledge (Gc). Results indicated that Gf exerted a direct effect onto phonemic decoding in early grades (grades 1-2) but not in later grades (grades 3-7). Gf also exerted an indirect effect onto phonemic decoding-through Gc-in later grades (grades 3-7) but not in early grades (grades 1-2). Finally, Gf exerted an indirect effect onto word recognition through phonemic decoding in grades 1-4 but not in grades 5-7. Altogether, findings show that Gf plays a direct role in younger children's phonemic decoding and an indirect role in word recognition (through Gc) in later grades, suggesting a shift in Gf's role across grade levels. Although findings need replication in longitudinal research, current results have implications for both typical and atypical reading development.

Desempenho em Aritmética de Estudantes com e sem Sintomas de TDAH

Resumo O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) é um transtorno que frequentemente acarreta prejuízos ao desempenho acadêmico. O presente estudo teve como objetivo verificar a extensão desses prejuízos no desempenho aritmético, comparando estudantes com sintomas de TDAH com o de seus pares sem TDAH. O desempenho aritmético de 93 estudantes com sintomas de TDAH e 447 estudantes sem TDAH, entre 7 e 16 anos, de escolas públicas de Porto Alegre (3º a 9º ano), foi avaliado pelo Subteste de Aritmética do TDE. Estudantes com sintomas de TDAH apresentaram escores mais baixos e uma quantidade maior de erros de procedimento do que os estudantes sem o transtorno. Os resultados sugerem que sintomas frequentes de TDAH têm relação com maior ocorrência de erros no desempenho em aritmética dos estudantes avaliados neste estudo.

A New Spin on Spatial Cognition in ADHD: A Diffusion Model Decomposition of Mental Rotation

OBJECTIVES

Multiple studies have found evidence of task non-specific slow drift rate in ADHD, and slow drift rate has rapidly become one of the most visible cognitive hallmarks of the disorder. In this study, we use the diffusion model to determine whether atypicalities in visuospatial cognitive processing exist independently of slow drift rate.

METHODS

Eight- to twelve-year-old children with (n = 207) and without ADHD (n = 99) completed a 144-trial mental rotation task.

RESULTS

Performance of children with ADHD was less accurate and more variable than non-ADHD controls, but there were no group differences in mean response time. Drift rate was slower, but nondecision time was faster for children with ADHD. A Rotation × ADHD interaction for boundary separation was also found in which children with ADHD did not strategically adjust their response thresholds to the same degree as non-ADHD controls. However, the Rotation × ADHD interaction was not significant for nondecision time, which would have been the primary indicator of a specific deficit in mental rotation per se.

CONCLUSIONS

Poorer performance on the mental rotation task was due to slow rate of evidence accumulation, as well as relative inflexibility in adjusting boundary separation, but not to impaired visuospatial processing specifically. We discuss the implications of these findings for future cognitive research in ADHD.

Symptom Level Associations Between Attention-Deficit Hyperactivity Disorder and School Performance

Attention-deficit hyperactivity disorder (ADHD) is associated with reduced school performance. To determine which ADHD symptoms and subtypes have the strongest association, we used type and frequency of symptoms on the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) to create symptom scores for inattention and hyperactivity-impulsivity and define subtypes (ADHD-Inattentive [ADHD-I], ADHD-Hyperactive-Impulsive, ADHD-Combined [ADHD-C]). Regression methods were used to examine associations between symptoms and subtype and a composite measure of school performance. Children with ADHD-C and ADHD-I had higher adjusted odds of having reduced overall school performance (ADHD-C = 5.8, 95% confidence interval [CI] = 3.1-10.9; ADHD-I = 5.5, 95% CI = 3.1-10.1) compared with children without ADHD. All inattentive symptoms were significantly related to reduced school performance in reading, writing, and handwriting, while 6 of 9 symptoms were significantly associated in mathematics. Children with ADHD-I were significantly more likely than children with other ADHD subtypes to receive a school-based Individualized Education Program or 504 Plan. ADHD-I symptoms may be broadly linked to reduced school performance.

Examining ODD/ADHD Symptom Dimensions as Predictors of Social, Emotional, and Academic Trajectories in Middle Childhood

The goal of this article is to investigate the symptom dimensions of oppositional defiant disorder (ODD; irritability, defiance) and attention deficit/hyperactivity disorder (ADHD; inattention, hyperactivity-impulsivity) as predictors of academic performance, depressive symptoms, and peer functioning in middle childhood. Children (N = 346; 51% female) were assessed via teacher-report on measures of ODD/ADHD symptoms at baseline (Grades K-2) and academic performance, depressive symptoms, peer rejection, and victimization on 7 occasions over 4 school years (K-2 through 3-5). Self-report and grade point average data collected in Grades 3-5 served as converging outcome measures. Latent growth curve and multiple regression models were estimated using a hierarchical/sensitivity approach to assess robustness and specificity of effects. Irritability predicted higher baseline depressive symptoms, peer rejection, and victimization, whereas defiance predicted higher baseline peer rejection; however, none of these ODD-related effects persisted 3 years later to Grades 3-5. In contrast, inattention predicted persistently poorer academic performance, persistently higher depressive symptoms, and higher baseline victimization; hyperactivity-impulsivity predicted subsequent peer rejection and victimization in Grades 3-5. In converging models, only inattention emerged as a robust predictor of 3-year outcomes (viz., grade point average, depressive symptoms, peer rejection, and relational victimization). Broadly, ODD dimensions-particularly irritability-may be linked to acute disturbances in social-emotional functioning in school-age children, whereas ADHD dimensions may predict more persistent patterns of peer, affective, and academic problems. By examining all 4 ODD/ADHD symptom dimensions simultaneously, the present analyses offer clarity and specificity regarding which dimensions affect what outcomes, and when. Findings underscore the importance of multidimensional approaches to research, assessment, and intervention.

A Pilot Study of the Efficacy of a Cognitive Training Based on Board Games in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Objective: The main aim of this study was to prove the efficacy of an intervention based on board games on executive functions (EFs) and clinical symptoms in children with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A nonblinded randomized controlled trial was conducted with a sample of children with a diagnosis of ADHD (diagnosed by psychiatrists and clinical psychologists in a mental health center). Children were randomly allocated by matching age and sex, into two groups: experimental EF training group (n = 13; mean [M]_age = 9.46, standard deviation [SD] = 1.20; boys = 53.8%) or a wait-list control group (n = 14; M_age = 9.50, SD = 1.09; boys = 71.4%). Measures assessed individually at pretest, posttest, and follow-up intervention included EFs and clinical symptoms. Results: Analysis of covariance repeated measures analysis showed that linguistic short-term memory, F(1,28) = 7.45, p = 0.02, and conduct problems, F(1,28) = 12.51, p = 0.00, significantly improved with larger effects in the board games training group after intervention when compared to the wait-list group. Although nonsignificant effects were reported at the follow-up, large effect sizes were actually found. Conclusion: Although future studies are needed, the results of this study highlight the importance of board games and its efficacy as a possible therapeutic and/or preventive intervention on ADHD.

Fluid reasoning and reading difficulties among children with ADHD

Background: Children with attention-deficit/hyperactivity disorder (ADHD) commonly experience difficulties in reading and in fluid reasoning (Gf). According to Cattell's Investment Theory (1987), Gf is a causal factor in the development of crystallized knowledge (Gc) and academic skills; therefore, the co-occurrence of reading and Gf difficulties within ADHD may not be coincidental. Methods: In the present study with children with both ADHD and reading difficulties (n = 187; 61% male; M_age = 9.2), we utilized mediation analyses to test direct and indirect (through Gc, phonemic awareness, and rapid automatized naming [RAN]) effects of Gf on four basic reading skills: untimed word recognition, untimed phonemic decoding, word reading efficiency, and phonemic decoding efficiency. Results: The direct effect of Gf on all reading skills was nonsignificant; however, significant indirect effects were observed. Specifically, Gf exerted an effect indirectly onto all reading skills through a serial and joint mechanism comprised of Gc and phonemic awareness (i.e., Gf → Gc → phonemic awareness → reading achievement). Gf also exerted an effect indirectly onto untimed word recognition and phonemic decoding through phonemic awareness (i.e., Gf → phonemic awareness → untimed word recognition/untimed phonemic decoding). Conclusion: Results build upon Cattell's Investment Theory by linking Gf with reading difficulties among children with ADHD, suggesting that such difficulties may arise from weaknesses in Gf and insufficient investment of Gf into reading through Gc and phonemic awareness.

Metacognitive interventions in text production and working memory in students with ADHD

This study compared the effects of two metacognitive interventions on writing, working memory (WM), and behavioral symptoms of students with attention-deficit/hyperactivity disorder (ADHD). The disorder was clinically diagnosed by a multidisciplinary team according to DSM-IV criteria. The first approach consisted of a combined intervention in text production and WM while the second focused only on WM. Participants were 47 students from the fifth to ninth grades of two public elementary schools in Porto Alegre (Brazil), randomized to one of the two interventions groups. Writing and WM were assessed before, immediately after, and 3 months after the interventions. The results suggest that both interventions contributed to improving behavior and school performance, whereas only the combined intervention increased the overall quality of narrative text, organization of paragraphs, and denouement.

Focus on fluid reasoning: The relationship between fluid reasoning and the Pattern of Strengths and Weaknesses model

The purpose of this paper is to examine the Fluid Reasoning Index of the Wechsler Intelligence Test for Children, Fifth Edition (WISC-V), and determine how fluid-reasoning skills relate to academic skill acquisition in the classroom setting. We also examine the myriad of ways within which learning and learning disabilities can be defined. Also, we plan to examine a brief review of the definition of a Specific Learning Disability and review some of the leading theories related to the Pattern of Strengths and Weaknesses model.