An investigation of executive processes in the problem-solving of attention deficit disorder-hyperactive children

Strategy Selection in ADHD Characteristics Children: A Study in Arithmetic

OBJECTIVE

It has been argued that ADHD characteristics children have difficulties in selecting the best strategy when they accomplish cognitive tasks. The detrimental influence of these poor strategy skills may be crucial for several aspects of academic achievement such as mathematical learning.

METHOD

Fourth- and fifth-grade children with ADHD symptoms and matched controls were asked to select the better of two rounding strategies in a computational estimation task (i.e., finding the best estimate of two-digit addition problems).

RESULTS

(a) Both control and ADHD children correctly executed a selected strategy, (b) ADHD children selected the best strategy less often than controls, (c) ADHD took more time to estimate sums of two-digit addition problems and provided poorer estimates, and (d) different factors predicted best strategy selections in each group.

CONCLUSION

These findings have important implications for further understanding the sources of differences in cognitive performance between ADHD and control children. (J. of Att. Dis. 2019; 23(1) 87-98).

PACER Performance of Children Aged 11-14 With Attention-Deficit Hyperactive Disorder

PURPOSE

The purposes of this study were to examine the performance on the progressive aerobic cardiovascular endurance run (PACER) test in children with and without attention-deficit hyperactive disorder (ADHD) over the course of a school year, and also to investigate the possible influence of age, sex, school sport participation, and body mass index on results.

METHODS

Utilizing a repeated measures design, 892 middle school children aged 11-14 years (mean = 12.25, SD = 0.94) including 55 children with ADHD participated. While controlling for age, sex, sports participation, and body mass index, children were tested on the PACER 3 times during the school year. Procedures specified in the FITNESSGRAM test manual were explicitly followed. Hierarchical linear modeling was applied to analyze the data.

RESULTS

Children with ADHD performed 8.6 fewer laps at intercept (baseline), than did healthy children without ADHD (t₈₇₈ = -6.20, P < .001). However, no significant differences emerged for time (slope). In addition, no significant interactions were found for ADHD with age, sex, sports participation, or body mass index.

CONCLUSION

A diagnosis of ADHD, independent of selected predictor variables, explained lower PACER performance.

Social comprehension of children with hyperactivity

From a social cognitive perspective, the social problems of children with hyperactivity could represent failure to attend to certain social cues. To assess the responses of 17 children with hyperactivity and 17 comparisons, 3 taped stories of social problems were presented.

Autism spectrum disorder, attention-deficit hyperactivity disorder and offending

Purpose

– A wealth of research on autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) has led to increased understanding and identification of each of these developmental disorders. Existing literature has sparked controversial discussions regarding whether aspects of ASD and ADHD predispose individuals to criminality. The purpose of this paper is to explore the link between these conditions and offending.

Design/methodology/approach

– A review of the literature on ASD, ADHD and offending was undertaken. This paper looks at the particular focus of the literature on the involvement of individuals with ADHD and ASD within the criminal justice system.

Findings

– There is some evidence of a link between ADHD and criminality. However, the relationship between ASD and offending is a little more difficult to ascertain. Complicating this further is the relatively unexplored subject of comorbid ASD/ADHD and criminal behaviour. This paper found that additional cognitive deficits and conduct problems are associated with comorbid ASD/ADHD, highlighting the need for further research and development of interventions.

Originality/value

– This paper seeks to examine whether predictions can be made with regards to what offending behaviour may look like in an individual with comorbid ASD/ADHD. This paper reviews the literature on offending in relation to both disorders to examine whether predictions can be made with regards to what the offending behaviour of an individual with ASD and ADHD may look like.

The North American Perspective On Attention Deficit Hyperactivity Disorder

The purpose of the present paper is to (1) provide an overview of the nature of attention-deficit hyperactivity disorder (ADHD) as it seems to be viewed by North American clinicians and clinical scientists; (2) describe its diagnostic criteria as they are applied in that region; (3) discuss the prevalence of ADHD in the region; and (4) briefly present a new theoretical model of the authors emerging from that North American perspective. Some of the critical issues related to these matters will be raised along the way. Given the thousands of scientific papers on this topic, however, an overview of these various topics is all that space here can afford. Readers wishing a more thorough treatment of these topics as well as those pertaining to history, developmental courses, associated risks, assessment, and treatments for ADHD are directed to other writings by the author (Barkley, 1990).

Are language production problems apparent in adults who no longer meet diagnostic criteria for attention-deficit/hyperactivity disorder?

In this study, we examined sentence production in a sample of adults (N = 21) who had had attention-deficit/hyperactivity disorder (ADHD) as children, but as adults no longer met DSM-IV diagnostic criteria (APA, 2000). This "remitted" group was assessed on a sentence production task. On each trial, participants saw two objects and a verb. Their task was to construct a sentence using the objects as arguments of the verb. Results showed more ungrammatical and disfluent utterances with one particular type of verb (i.e., participle). In a second set of analyses, we compared the remitted group to both control participants and a "persistent" group, who had ADHD as children and as adults. Results showed that remitters were more likely to produce ungrammatical utterances and to make repair disfluencies compared to controls, and they patterned more similarly to ADHD participants. Conclusions focus on language output in remitted ADHD, and the role of executive functions in language production.

Priming sentence production in adolescents and adults with attention-deficit/hyper-activity disorder

Theoretical accounts of attention-deficit/hyperactivity disorder (ADHD) posit a prominent role for problems in response inhibition (Nigg 2006). A key avenue for impulsivity in children with ADHD is inappropriate language expression. In this study, we sought to determine whether poor inhibitory control affects language production in adolescents and adults with ADHD. One hundred and ninety-five participants (13-35 years old; 65% male) were presented with two pictures and a verb, and their task was to form a sentence. If deficits in response inhibition affect language production, then participants with ADHD should be more likely than non-ADHD controls to begin speaking before having formulated a plan that will allow a grammatical continuation. The results showed that the ADHD-combined subtype, in particular, was more likely to produce an ungrammatical sequence. Effects were not moderated by age or gender. These data suggest that response suppression deficits in ADHD adversely affect the basic processes of sentence formation.

Separable/integral classification by hyperactive and normal children

This research tested the hypothesis that information-processing deficits associated with hyperactivity implicate a self-regulatory dysfunction. Hyperactive and control children were compared on nonspeeded classification tasks. In Studies 1 and 2, children classified sets of either three (triads) or four (tetrads) stimuli. The stimuli varied simultaneously on size and brightness or on length and density. They could be classified analytically (separably) on the basis of identical values for one dimension and holistically (integrally) on the basis of overall similarity. Control children made an equal number of dimensional classifications for triads and for tetrads. As predicted, however, hyperactive children made fewer dimensional classifications for tetrads, suggesting that they apparently resorted to less effortful holistic responding under the increased processing load. In an unexpected finding in Study 1, older hyperactive children appeared to behave like younger controls, making more dimensional classifications when size, rather than brightness, was the shared dimension. Study 3 explored the possibility that hyperactive children lagged behind the controls in their responding to the shared dimensions. Three age groups of normal children (mean ages: 5, 8, and 11 years) and adults were asked to classify stimuli that varied on size and brightness. Consistent with the lag hypothesis, normal preschoolers behaved like the young hyperactive children in Study 1, classifying equally on the basis of size and brightness. The discussion focuses on the contribution of processing load and stimulus salience to the cognitive deficits of hyperactive children.

Speech-language characteristics of children with Sotos syndrome

The purpose of this research study was to evaluate the communication of individuals with Sotos syndrome in order to better characterize common speech and language patterns. Sixteen children with Sotos syndrome received an in-depth communication assessment using standardized procedures. Assessments of speech skills, language skills, voice, fluency, and social-pragmatic interactions were completed. Results of the evaluations indicated that individuals with Sotos syndrome are prone to: (a) language impairments (particularly expressive), (b) speech sound production impairments, (c) voice impairments, (d) dysfluencies (stuttering), and (e) average social-behavioral pragmatic interaction characteristics.

Early focused attention predicts outcome for children born prematurely

There is evidence that early focused, but not casual, attention to objects reflects concurrent regulation of attention and active learning. Because attentional abilities are of particular relevance in preterm infants, we evaluated whether early focused attention would be a better predictor of later attention and cognitive function than casual attention in 55 children born at very low birth weight. Participants were tested initially at 7 months and then at 2, 3, and/or 4/5 years of age. Focused attention was defined as the duration of concentrated examination of objects during independent play. Outcome measures were maternal ratings on standard attention-deficit hyperactivity disorder rating scales and standardized cognitive assessments. Results indicate that 7-month focused attention was predictive of reported problems in hyperactivity/impulsivity at age 4/5 years and cognitive abilities at 2, 3, and 4/5 years; casual attention measures were not related to these outcomes. Early focused attention appears continuous with later attentional skills in at-risk infants and is related to cognitive abilities through the preschool years.

Thought disorder in attention-deficit hyperactivity disorder

OBJECTIVE

This study compared thought disorder and associated cognitive variables in attention-deficit hyperactivity disorder (ADHD) and schizophrenia.

METHOD

Speech samples of 115 ADHD, 88 schizophrenic, and 190 normal children, aged 8 to 15 years, were coded for thought disorder. A structured psychiatric interview, the WISC-R, the Continuous Performance Test, and the Span of Apprehension task were administered to each child.

RESULTS

The ADHD and schizophrenic groups had thought disorder compared with the normal children. However, the subjects with ADHD had a narrower range of less severe thought disorder than did the schizophrenic subjects. The younger children with ADHD and schizophrenia had significantly more thought disorder than did the older children with these diagnoses. IQ, attention, and working memory were associated with thought disorder in the ADHD but not the schizophrenic group.

CONCLUSIONS

Thought disorder in childhood is not specific to schizophrenia and reflects impaired development of children's communication skills.

Evolutionary recasting: ADHD, mania and its variants

This paper reviews clinical observations and evolutionary theory in relation to attention deficit hyperactivity disorder (ADHD) on the one hand and mania and its variants on the other. Both groups of disorders resemble each other in regard to high levels of motor activity, perhaps occurring together more often than not, and are confounded in most existing research. Making distinctions requires isolating the contribution of activity level from other characteristics such as those of flawed executive functions for ADHD or grandiosity and lapses in reciprocity for mania. High activity level is an asset throughout nature except in extreme intensities or when it amplifies the characteristics of psychopathology. Fitness, social displays, and behavioral adaptations for survival are clues to some aspects of hypomania and ADHD. While hypomania can be a competitive advantage in certain niches, it appears there can be few opportunities for ADHD to do so. Indeed, the impulsiveness seen in ADHD is probably the outcome of flaws in executive functions rather than being the cause of them. Neither lapses in executive functions nor in reciprocity are apt to be domain general but may interact sharply with each person's repertoire of psychological adaptations. The author submits that a theoretical orientation as outlined here would not only help in better understanding the disorders under consideration, but could be useful in providing new directions to treatment decisions.

Working memory in childhood-onset schizophrenia and attention-deficit/hyperactivity disorder

We investigated verbal and spatial working memory in participants with childhood-onset schizophrenia (N=13), attention-deficit/hyperactivity disorder (ADHD; N=31) and age-matched normal children (N=27). The ages of the participants ranged from 9 to 20 years, with an average age of approx. 14 in all groups. Diagnoses were based on structured interviews (Kiddie-Schedule for Affective Disorders and Schizophrenia) with the children and their parents and made using DSM-III-R criteria. Verbal working memory was assessed by the highest number of digits recalled in forward and backward order on the Digit Span subtest of the Wechsler Intelligence Scale. Results showed that normal children recalled more digits than schizophrenic and ADHD children, who did not differ. Spatial working memory was assessed with the Dot Test of Visuospatial Working Memory: The children were presented with a dot on a page for 5 s and asked to mark its location on a blank page immediately after presentation or 30 s later. A distracter task was used during the delay to prevent verbal rehearsal. The average distance between the target dot and the child's mark in the 30-s condition was shorter for normal than for schizophrenic and ADHD children, who did not differ. Thus, both schizophrenic and ADHD children showed deficits in verbal and spatial working memory. These results suggest that in both disorders, the capacity of the sensory buffers may be diminished, and/or the availability and allocation of resources to the central executive may be limited.

Neuropsychological and neurophysiological indices of auditory processing impairment in children with multiple complex developmental disorder

OBJECTIVE

To evaluate whether children with borderline disorder (also referred to as multiple complex developmental disorder) (BD/MCDD) and comorbid attention-deficit hyperactivity disorder (ADHD) demonstrate evidence of abnormal attention and/or auditory processing impairments as indexed by both behavioral and physiological measures.

METHOD

Three groups of children were compared in two different experiments on behavioral rating scales (Conners Parent Rating Scale and Child Behavior Checklist), behavioral accuracy to auditory and visual target detection tasks, selected neuropsychological tests, and brain physiology (event-related potentials) collected during auditory and visual target detection tasks.

RESULTS

The results demonstrate that children with BD/MCDD differ from children with ADHD in the (1) prevalence of internalizing and externalizing behaviors, (2) neuropsychological deficits related to auditory processing, and (3) event-related potential brain physiology associated with auditory cognitive target attention tasks.

CONCLUSION

Some of the pervasive pathology described in children with BD/MCDD may be due to biological vulnerabilities, particularly problems with auditory processing. Auditory processing impairments in such children deserves special attention with respect to both understanding their behavioral symptoms and developing a comprehensive treatment plan.

Language abilities in children with attention deficit hyperactivity disorder, reading disabilities, and normal controls

Research has demonstrated a high prevalence of language impairments (LI) and reading disabilities (RD) in children with attention deficit hyperactivity disorder (ADHD). Since RD is also associated with LI, it is unclear whether the language impairments are specific to ADHD or associated with comorbid RD. The language abilities of ADHD children with and without RD were investigated in a task requiring recall of a lengthy narrative, and in tests assessing knowledge of the semantic aspects of language. The study was conducted with 50 boys--14 ADHD, 14 ADHD + RD, 8 RD, and 14 normal controls, aged 7 to 11. Children with ADHD (ADHD-only, ADHD + RD) exhibited difficulties in organizing and monitoring their story retelling. Children with RD (RD-only, ADHD + RD) demonstrated deficits in receptive and expressive semantic language abilities on the language processing tests. The comorbid group (ADHD + RD) exhibited the deficits of both ADHD and RD children. The deficiencies of ADHD children are consistent with higher-order executive function deficits while the deficits of RD children are consistent with deficits in the basic semantics of language processing.

Methylphenidate and information processing. Part 1: Differentiation between responders and nonresponders; Part 2: Efficacy in responders

Part 1 of this study attempted to discriminate clinical responders and nonresponders to methylphenidate (MPH) on the basis of neuropsychological deficit profiles. Part 2 addressed the question to what extent MPH might ameliorate these deficits. Hyperactive clinical responders (n = 30) and nonresponders (n = 28) to MPH, were compared to normal controls (n = 27) on selective and sustained attention tasks and on conventional psychological and neurological measures. The responders took part in a randomized double-blind placebo-controlled crossover study. They ingested a placebo (PL) or MPH (0.3-0.6 mg/kg/day) during 4 weeks, and were then tested. After crossover, another period of 4 weeks was concluded by a second test series. Compared to controls, both responders and nonresponders showed attention deficits in encoding, memory search, and decision operations, as well as in focused and sustained attention, vigilance, and use of feedback. These deficits were the most severe in the responders. Anamnestic data, IQ scores, and neurological variables did not discriminate between groups. MPH selectively alleviates attention deficits. MPH did not affect divided attention, except for an increased accuracy of response organization. The drug, however, greatly improved focused and sustained attention, vigilance, impulsivity, and the behavioral adaptivity to feedback.

Narrative abilities in children with attention deficit hyperactivity disorder and normal peers

A story retelling task was used to assess narrative abilities in 30 boys with attention deficit hyperactivity disorder (ADHD) and 30 normally developing boys, matched on age and IQ. Each boy listened to two stories and retold them for another child. Results indicated that the two groups did not differ in their ability to comprehend and extract the main ideas from the stories, but did differ in the production of narratives. Boys with ADHD provided less information overall, and their stories were more poorly organized and less cohesive and contained more inaccuracies. As a result, their stories were often confused and hard to follow. Organization and monitoring of information are functions of executive control. Thus the observed deficits in narrative production in children with ADHD may reflect underlying deficits in executive processes.

Attention deficit hyperactivity disorder and the frontal lobe syndrome

The usefulness of frontal lobe (FL) dysfunction as a conceptual model for Attention Deficit Hyperactivity Disorder (ADHD) was investigated. Twenty-four ADHD and 24 normal control (NC) children were tested using two batteries of tasks. The first was sensitive to FL deficits in motor control and problem solving skills. The second consisted of memory tasks sensitive to temporal lobe dysfunction. ADHD children differed significantly from NCs on measures of FL function, but not on tests of temporal lobe functions. Where norms were available for normal children on the same FL tests, ADHDs performed like 6- to 7-year-olds, despite their mean age of 10 years and minimum age of 8 years. The differential performance of ADHDs on tasks sensitive to FL and temporal lobe dysfunction supports the hypothesis that ADHD deficits are analogous to FL dysfunction and demonstrates that the children's deficits do not reflect generalized cognitive impairment.

Study strategies and story recall in attention deficit disorder and reading disability

The role of metacognition and executive processes in mediating use of study skills was examined in groups of attention deficit disorder with hyperactivity (ADD-H), normal, and non-ADD-H reading-disabled (RD) boys, matched on age and verbal IQ. On a story recall task, ADD-H boys did not differ from normals in their immediate gist recall of a story or in their recall following a study period. RD boys demonstrated inferior recall in both conditions. Study skills of the ADD-H boys were poorer than those of normal boys on all measures. They spent less time studying, expended less effort, and employed more superficial strategies. However, their poor strategies did not appear to reflect a lack of metacognitive awareness. Results are discussed in terms of the impact of motivational variables in modulating strategy use in ADD-H boys and the impact of verbal processing problems in reading disabilities. Implications for treatment and the relationship between ADD-H and RD are discussed.

Supraspan verbal memory in attention deficit disorder with hyperactivity normal and reading-disabled boys

To assess memory problems associated with attention deficit disorder with hyperactivity (ADDH) and reading disability (RD), nonverbal subspan, span, and supraspan measures was administered to 30 ADDH, 30 normal, and 24 RD boys, ages 7 to 12. Results from the supraspan verbal measures, which included word lists and related and unrelated paired associates, are reported. Across all verbal tasks, deficits became most apparent in ADDH boys on measures requiring organized, deliberate rehearsal strategies, sustained strategic effort, and careful consideration of response alternatives. This pattern suggests impaired self-regulatory or "executive" processes. RDs showed more generalized deficits across the verbal measures, suggesting problems with verbal processing. Recent studies supporting this interpretation are reviewed.