A developmental analysis of visual and auditory sustained attention and reflection-impulsivity in hyperactive and normal children

Psychometric Screening for Attention Deficit Disorder in a Clinical Setting

There is growing dissatisfaction with the DSM-III definition of Attention Deficit Disorder (ADD) and considerable debate among researchers as to whether ADD is a distinct disorder. Additionally, clinicians have relied on nonobjective behavioral observation to diagnose ADD. The present study attempted to find commonly used tests that could discriminate between an ADD sample and a control group with no DSM-III diagnosis. Subjects were 88 children, 7 to 10 years of age, who had received a battery of psychological tests. Discriminant analysis confirmed that hypothesized attention tests from the WISC-R, ITPA, Detroit, plus the GFW Auditory Selective Attention Test, significantly differentiated between the two groups and classified 74% of the cases correctly. It was concluded that use of these tests might add objective evidence to ADD screening and that the overall results lent support to ADD as a valid diagnostic classification.

The relationship between poor performance on attention tasks and increased suicidal ideation in adolescents

Our goal was to examine the relationship between attention and suicidal ideation in a school-based adolescent population. This cross-sectional study involved 2,462 students from eight high schools in South Korea (1,021 males and 1,441 females, mean age 17.3 ± 0.6 years). The participants completed the Beck Scale for Suicide Ideation (SSI) and the Beck Depression Inventory (BDI) and took part in computerized attention tasks. Participants with high SSI scores (16 or higher) exhibited a higher mean number of omission errors (OEs) and commission errors (CEs) on the visual sustained attention tasks than did participants with low SSI scores (p < 0.001 and p < 0.001, respectively). On the divided attention tasks, the high SSI group exhibited a higher mean number of CEs than the low SSI group did (p < 0.001). In a general linear model adjusting for age, gender, and high BDI (10 or higher), membership in the high OE group in the visual sustained attention tasks was associated with high SSI scores (p = 0.015). Belonging to the high OE or CE group in the divided attention tasks were associated with high SSI scores (p = 0.024 and p = 0.035, respectively). For both the visual sustained and divided attention tasks, interactions between gender and high OE rates were significant (p ≤ 0.001 and p = 0.013, respectively). In the post hoc analysis, membership in the high OE group was associated with high SSI scores for girls. In a multiple linear regression analysis including all participants and controlling for age, gender, and BDI scores, higher numbers of OEs and CEs on the visual sustained attention tasks predicted higher SSI scores (p < 0.001 and p = 0.019, respectively). On the divided attention task, the number of CEs was positively correlated with the SSI score (p = 0.031). The findings of this study indicate an association between attention deficits and increased suicidal ideation in adolescents after controlling for depressed mood. The current results suggest a direct link between attention deficits and increased suicidality independent of depressive symptoms in adolescents.

Focused and shifting attention in children with heavy prenatal alcohol exposure

Attention deficits are a hallmark of the teratogenic effects of alcohol. However, characterization of these deficits remains inconclusive. Children with heavy prenatal alcohol exposure and nonexposed controls were evaluated using a paradigm consisting of three conditions: visual focus, auditory focus, and auditory-visual shift of attention. For the focus conditions, participants responded manually to visual or auditory targets. For the shift condition, participants alternated responses between visual targets and auditory targets. For the visual focus condition, alcohol-exposed children had lower accuracy and slower reaction time for all intertarget intervals (ITIs), while on the auditory focus condition, alcohol-exposed children were less accurate but displayed slower reaction time only on the longest ITI. Finally, for the shift condition, the alcohol-exposed group was accurate but had slowed reaction times. These results indicate that children with heavy prenatal alcohol exposure have pervasive deficits in visual focused attention and deficits in maintaining auditory attention over time. However, no deficits were noted in the ability to disengage and reengage attention when required to shift attention between visual and auditory stimuli, although reaction times to shift were slower.

The ecological validity of laboratory and analogue assessment methods of ADHD symptoms

An important question in the attempt to generalize laboratory findings on attention deficit-hyperactivity disorder (ADHD) children to clinical issues concerning their assessment, diagnosis, outcome, and treatment response is the ecological validity of the commonly used tasks and analogue behavioral observation procedures. This paper examines the concept of ecological validity and issues inherent in its evaluation. The evidence from a variety of sources is then reviewed on the relationship between laboratory methods of assessing inattention, impulsivity, and overactivity and measures of these same constructs in natural settings. Additional findings pertaining to this issue from a recent study of 140 ADHD and normal children and 159 ADHD and normal adolescents using a multimethod battery of tests are also reported. In general, the ecological validity of most methods is of a low to moderate degree, with some traditional laboratory tasks proving unsatisfactory. A few tasks demonstrated acceptable degrees of ecological validity but even these require improvement. It is concluded that future advances in ecological validity are likely to come from: (a) a greater reliance on assessments of the target behaviors in natural settings and (b) combining several of the more promising tasks and analogue methods into a battery that is taken over longer time intervals than has been customary and averaged across repeated administrations.

Reaction time, impulsivity, and attention in hyperactive children and controls: a video game technique

Maturation of sustained attention was studied in a group of 52 hyperactive elementary school children and 152 controls using a microcomputer-based test formatted to resemble a video game. In nonhyperactive children, both simple and complex reaction time decreased with age, as did variability of response time. Omission errors were extremely infrequent on simple reaction time and decreased with age on the more complex tasks. Commission errors had an inconsistent relationship with age. Hyperactive children were slower, more variable, and made more errors on all segments of the game than did controls. Both motor speed and calculated mental speed were slower in hyperactive children, with greater discrepancy for responses directed to the nondominant hand, suggesting that a selective right hemisphere deficit may be present in hyperactives. A summary score (number of individual game scores above the 95th percentile) of 4 or more detected 60% of hyperactive subjects with a false positive rate of 5%. Agreement with the Matching Familiar Figures Test was 75% in the hyperactive group.

The performance of attention-deficit-disordered and normal children on conservation tasks

The present study was designed to investigate whether a specific subgroup of learning-disabled children (attention-deficit-disordered, ADD) differed from their normal counterparts on Piagetian tasks of conservation. The subjects were 34 third-and fourth-grade children. Seventeen children had been diagnosed as ADD; the remaining half were designated as normal. The two groups were equivalent in chronological age, mental age, and intelligence. The results indicated significant differences between the two groups on tasks tapping conservation of substance and number. These results may support the theory of a lag in the development of conservation in children with specific learning disabilities (ADD). Implications of the present research for therapeutic and remedial programs that serve ADD children are also discussed.

Cross-sectional and longitudinal observations of activity level and sustained attention in a normative sample

This study examined developmental changes in playroom observations of activity level and sustained attention among 47 elementary school-age boys. The boys were observed at two different times, approximately 2 years apart. The playroom observations consisted of two 15-minute periods, a relatively unstructured freeplay period and a structured restricted academic period. In general, both cross-sectional and longitudinal analyses suggested developmental improvements in the observed behaviors. Both gross and fine motor activity decreased with increasing age, while the time spent on task increased. Consistent with the selective attention literature, there appeared to be a dramatic increase in the boys' ability of focus attention at around age 11. Finally, most of the behaviors in the restricted academic period showed significant stability over time, whereas few of the free-play behaviors did so.