Parents Influence the Visual Learning Environment Through Children's Manual Actions

The present research studied children in the second year of life (N = 29, M_age  = 21.14 months, SD = 2.64 months) using experimental manipulations within and between subjects to show that responsive parental influence helps children have more frequent sustained object holds with fewer switches between objects compared to when parents are either not involved or over-involved. Regardless of parental involvement, sustained holds were visually rich, based on the size, centeredness, and dominance of the held object relative to other objects. These findings are important because they suggest not only that the child's body creates visually rich scenes across play contexts but also that a responsive parent can increase the frequency of these visually rich and informative moments.

High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD

OBJECTIVE

To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks.

METHOD

We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according to their IQ level (IQ ≥ 110-ADHD group with more elevated IQ, and IQ < 110-ADHD group with standard IQ).

RESULTS

The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 ( p = .000) and 3 ( p = .000), Trail Making Test (TMT) B ( p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors ( p = .022) and failures to maintain set ( p = .020), Continuous Performance Test (CPT)-omission errors ( p = .005) and commission errors ( p = .000), and Frontal Assessment Battery (FAB)-conceptualization ( p = .016). The ADHD group with more elevated IQ presented only impairments in the CPT-commission errors ( p = .019) when compared with the control group.

CONCLUSION

Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a precise clinical diagnosis.

Analyzing Digit Span Components for Assessment of Attention Processes

The Digit Span (DS) subtest of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) is thought to be a measure of attention, concentration, sequencing, number facility, and auditory short-term memory. An optional WISC-III subtest and part of the Freedom from Distractibility (FD) factor, DS assesses several cognitive constructs, yet its utility in differential diagnosis has been questioned because poor DS or FD performance has been inconsistently associated with attention processes. In this study of 195 children referred for comprehensive neuropsychological evaluations, Digits Forward (DF) and Digits Backward (DB) component scores were found to be differentially predictive of attention, executive function, and behavior rating measures. Results suggest that DB is associated with attention and executive function processes, not the short-term rote auditory memory processes tapped by DF.

Ecological Validity of the Conners' Continuous Performance Test II in a School-Based Sample

The ecological validity of the Conners' Continuous Performance Test II (CPT-II) was examined using a sample of 206 first- and second-grade children. Children's CPT-II scores were correlated with observations of inattentive/hyperactive behavior during CPT-II administration, observations of children's behavior during analogue academic task, classroom observations, and parent/teacher reports. CPT-II scores showed moderate correlations with test session behavior but low correlations with external measures of inattention/hyperactivity. On the other hand, test session observations, analogue task observations, classroom observations, and teacher reports showed moderate and significant intercorrelations. Furthermore, test session observations predicted a significant amount of variance in children's classroom behavior above and beyond CPT-II scores alone. Results suggest that psychologists should supplement CPT-II scores with observational data to estimate children's functioning outside the test setting.

Effects of aging on the relationship between cognitive demand and step variability during dual-task walking

A U-shaped relationship between cognitive demand and gait control may exist in dual-task situations, reflecting opposing effects of external focus of attention and attentional resource competition. The purpose of the study was twofold: to examine whether gait control, as evaluated from step-to-step variability, is related to cognitive task difficulty in a U-shaped manner and to determine whether age modifies this relationship. Young and older adults walked on a treadmill without attentional requirement and while performing a dichotic listening task under three attention conditions: non-forced (NF), forced-right (FR), and forced-left (FL). The conditions increased in their attentional demand and requirement for inhibitory control. Gait control was evaluated by the variability of step parameters related to balance control (step width) and rhythmic stepping pattern (step length and step time). A U-shaped relationship was found for step width variability in both young and older adults and for step time variability in older adults only. Cognitive performance during dual tasking was maintained in both young and older adults. The U-shaped relationship, which presumably results from a trade-off between an external focus of attention and competition for attentional resources, implies that higher-level cognitive processes are involved in walking in young and older adults. Specifically, while these processes are initially involved only in the control of (lateral) balance during gait, they become necessary for the control of (fore-aft) rhythmic stepping pattern in older adults, suggesting that attentional resources turn out to be needed in all facets of walking with aging. Finally, despite the cognitive resources required by walking, both young and older adults spontaneously adopted a "posture second" strategy, prioritizing the cognitive task over the gait task.

Moving to Capture Children's Attention: Developing a Methodology for Measuring Visuomotor Attention

Attention underpins many activities integral to a child's development. However, methodological limitations currently make large-scale assessment of children's attentional skill impractical, costly and lacking in ecological validity. Consequently we developed a measure of 'Visual Motor Attention' (VMA)-a construct defined as the ability to sustain and adapt visuomotor behaviour in response to task-relevant visual information. In a series of experiments, we evaluated the capability of our method to measure attentional processes and their contributions in guiding visuomotor behaviour. Experiment 1 established the method's core features (ability to track stimuli moving on a tablet-computer screen with a hand-held stylus) and demonstrated its sensitivity to principled manipulations in adults' attentional load. Experiment 2 standardised a format suitable for use with children and showed construct validity by capturing developmental changes in executive attention processes. Experiment 3 tested the hypothesis that children with and without coordination difficulties would show qualitatively different response patterns, finding an interaction between the cognitive and motor factors underpinning responses. Experiment 4 identified associations between VMA performance and existing standardised attention assessments and thereby confirmed convergent validity. These results establish a novel approach to measuring childhood attention that can produce meaningful functional assessments that capture how attention operates in an ecologically valid context (i.e. attention's specific contribution to visuomanual action).

Convergent validity of the Integrated Visual and Auditory Continuous Performance Test (IVA+Plus): associations with working memory, processing speed, and behavioral ratings

Though the Integrated Visual and Auditory Continuous Performance Test (IVA + Plus) is commonly used by researchers and clinicians, few investigations have assessed its convergent and discriminant validity, especially with regard to its use with children. The present study details correlates of the IVA + Plus using measures of cognitive ability and ratings of child behavior (parent and teacher), drawing upon a sample of 90 psychoeducational evaluations. Scores from the IVA + Plus correlated significantly with the Working Memory and Processing Speed Indexes from the Fourth Edition of the Wechsler Intelligence Scales for Children (WISC-IV), though fewer and weaker significant correlations were seen with behavior ratings scales, and significant associations also occurred with WISC-IV Verbal Comprehension and Perceptual Reasoning. The overall pattern of relations is supportive of the validity of the IVA + Plus; however, general cognitive ability was associated with better performance on most of the primary scores of the IVA + Plus, suggesting that interpretation should take intelligence into account.

The role of multidimensional attentional abilities in academic skills of children with ADHD

Despite reports of academic difficulties in children with attention-deficit/hyperactivity disorder (ADHD), little is known about the relationship between performance on tests of academic achievement and measures of attention. The current study assessed intellectual ability, parent-reported inattention, academic achievement, and attention in 45 children (ages 7-15) diagnosed with ADHD. Hierarchical regressions were performed with selective, sustained, and attentional control/switching domains of the Test of Everyday Attention for Children as predictor variables and with performance on the Wechsler Individual Achievement Test-Second Edition as dependent variables. It was hypothesized that sustained attention and attentional control/switching would predict performance on achievement tests. Results demonstrate that attentional control/ switching accounted for a significant amount of variance in all academic areas (reading, math, and spelling), even after accounting for verbal IQ and parent-reported inattention. Sustained attention predicted variance only in math, whereas selective attention did not account for variance in any achievement domain. Therefore, attentional control/switching, which involves components of executive functions, plays an important role in academic performance.

Do attention deficits influence IQ assessment in children and adolescents with ADHD?

OBJECTIVE

To characterize the relationship between IQ and attention deficits in children with ADHD and to estimate the inattention-related mean influence on IQ when children are tested before stimulant drug treatment has been initiated.

METHOD

Studies of various methodologies are reviewed.

RESULTS

Correlation studies show mostly weak associations between IQ scores and attention deficits. Meta-analyses report the average short-term stimulant treatment effect on IQ in children with ADHD to be 2 to 7 IQ points.

CONCLUSION

The associations between IQ and attention deficits in ADHD are generally modest, with the mean influence on IQ probably amounting to 2 to 5 IQ points. This may serve as a benchmark when clinicians interpret the validity of IQ in this clinical population.

Interactions of task and subject variables among continuous performance tests

BACKGROUND

Contemporary models of working memory suggest that target paradigm (TP) and target density (TD) should interact as influences on error rates derived from continuous performance tests (CPTs). The present study evaluated this hypothesis empirically in a typically developing, ethnically diverse sample of children. The extent to which scores based on different combinations of these task parameters showed different patterns of relationship to age, intelligence, and gender was also assessed.

METHODS

Four continuous performance tests were derived by combining two target paradigms (AX and repeated letter target stimuli) with two levels of target density (8.3% and 33%). Variations in mean omission (OE) and commission (CE) error rates were examined within and across combinations of TP and TD. In addition, a nested series of structural equation models was utilized to examine patterns of relationship among error rates, age, intelligence, and gender.

RESULTS

Target paradigm and target density interacted as influences on error rates. Increasing density resulted in higher OE and CE rates for the AX paradigm. In contrast, the high density condition yielded a decline in OE rates accompanied by a small increase in CEs using the repeated letter CPT. Target paradigms were also distinguishable on the basis of age when using OEs as the performance measure, whereas combinations of age and intelligence distinguished between density levels but not target paradigms using CEs as the dependent measure.

CONCLUSIONS

Different combinations of target paradigm and target density appear to yield scores that are conceptually and psychometrically distinguishable. Consequently, developmentally appropriate interpretation of error rates across tasks may require (a) careful analysis of working memory and attentional resources required for successful performance, and (b) normative data bases that are differently stratified with respect to combinations of age and intelligence.

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.

Relations between visual and auditory continuous performance tests in a clinical population: a descriptive study

Increased interest in auditory continuous performance tests (CPTs) exists despite the absence of a clear understanding about this procedure. The relation between auditory and visual CPTs and associations with IQ, achievement, and memory are evaluated in a referred sample of 634 children, ages 5.5 to 17.9. Age effects are found with CPT performance, regardless of modality. Total number correct or number of commissions correlations across tasks were greater than within-task number correct-number of commissions relations. The mean visual minus auditory correct difference score was 7.01; the mean commission difference score was -.85. Difference scores decreased with age and were not consistently related to other measures. Those with the lowest number correct on both CPTs (<25th percentile) were younger and had weaker short-term auditory memory and verbal learning skills; those falling in the problem quartile on commissions (>75th percentile) were younger and had poorer reading, verbal memory, and verbal learning. Total error scores (omissions + commissions) were inversely related to age. The auditory CPT has clinical utility, but other factors must be considered.

The relationship between intelligence and performance on the test of variables of attention (TOVA)

The present study explored the relationship between the intelligence of young adults and their performance on the Test of Variables of Attention (TOVA). The study also examined whether significant differences existed between adults with and without attention-deficit/ hyperactivity disorder (ADHD) on TOVA errors of omission, errors of commission, mean correct response time, and variability, as well as on performance on the freedom from distractibility (FD) factor on the Wechsler Adult Intelligence Scale-Revised (WAIS-R). Seventy-nine adults participated in the study, including 17 with ADHD and 62 college students without ADHD. Pearson product-moment correlations indicated that none of the correlations between Full Scale IQ (FSIQ) and TOVA variables were significant. Analysis of variance results revealed that adults with ADHD made more errors of omission on the TOVA than did controls. Between-group differences were not found on the remaining dependent variables.

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.

A comparison of the cognitive deficits in reading disability and attention-deficit/hyperactivity disorder

This study used a nonreferred sample of twins to contrast the performance of individuals with reading disability (RD; n = 93), attention-deficit/hyperactivity disorder (ADHD; n = 52), RD and ADHD (n = 48), and neither RD nor ADHD (n = 121) on measures of phoneme awareness (PA) and executive functioning (EF). Exploratory factor analysis of the EF measures yielded underlying factors of working memory, inhibition, and set shifting. Results revealed that ADHD was associated with inhibition deficits, whereas RD was associated with significant deficits on measures of PA and verbal working memory. The RD + ADHD group was most impaired on virtually all measures, providing evidence against the phenocopy hypothesis as an explanation for comorbidity between RD and ADHD.