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Parke EM, Thaler NS, Etcoff LM, Allen DN. Intellectual Profiles in Children With ADHD and Comorbid Learning and Motor Disorders. J Atten Disord 2020; 24:1227-1236. [PMID: 25808309 DOI: 10.1177/1087054715576343] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: Neurodevelopmental disorders, including Reading Disorder, Disorder of Written Expression, and Developmental Coordination Disorder, often co-occur with ADHD. Although research has identified increased functional impairment in the presence of these comorbid diagnoses, few direct comparisons of intellectual profiles have been conducted. Thus, the present study examined Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) profiles of children with ADHD alone and with comorbid neurodevelopmental disorders. Method: Participants included 296 children with ADHD, ADHD with Developmental Coordination Disorder, and ADHD with Reading Disorder and/or Disorder of Written Expression. Results: Comparisons of these groups suggests children with ADHD and language-based Learning Disorders have poorer working memory than children with only ADHD. Furthermore, children with ADHD and Developmental Coordination Disorder perform relatively better on verbal compared with perceptual reasoning indexes. Conclusion: These intellectual profiles may have utility in identifying cognitive weaknesses inherent to these disorders and may be used to guide treatment intervention.
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Affiliation(s)
| | - Nicholas S Thaler
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
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Margolis AE, Broitman J, Davis JM, Alexander L, Hamilton A, Liao Z, Banker S, Thomas L, Ramphal B, Salum GA, Merikangas K, Goldsmith J, Paus T, Keyes K, Milham MP. Estimated Prevalence of Nonverbal Learning Disability Among North American Children and Adolescents. JAMA Netw Open 2020; 3:e202551. [PMID: 32275324 PMCID: PMC7148441 DOI: 10.1001/jamanetworkopen.2020.2551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Nonverbal learning disability (NVLD) is a neurodevelopmental disorder characterized by deficits in visual-spatial processing but not in reading or verbal ability; in addition, problems in math calculation, visual executive functioning, fine-motor skills, and social skills are often present. To our knowledge, there are no population-based estimates of the prevalence of NVLD in community samples. OBJECTIVE To estimate the prevalence of the NVLD cognitive profile in 3 independent samples of children and adolescents from studies centered around brain imaging in the US and Canada. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from 2 samples recruited from the community and overselected for children with psychiatric disorders (Healthy Brain Network [HBN], January 1, 2015, to December 31, 2019, and Nathan Kline Institute-Rockland Sample [NKI], January 1, 2011, to December 31, 2018) and 1 community-ascertained population sample (Saguenay Youth Study [SYS], January 1, 2003, to December 31, 2012) overselected for active maternal smoking during pregnancy. MAIN OUTCOMES AND MEASURES Prevalence of NVLD. Criteria for NVLD were based on clinical records of deficits in visual-spatial reasoning and impairment in 2 of 4 domains of function (fine-motor skills, math calculation, visual executive functioning, and social skills). Sample weighting procedures adjusted for demographic differences in sample frequencies compared with underlying target populations. Inflation factor weights accounted for overrepresentation of psychiatric disorders (HBN and NKI samples). RESULTS Across 3 independent samples, the prevalence of NVLD was estimated among 2596 children and adolescents aged 6 to 19 years (mean [SD] age, 12.5 [3.4] years; 1449 male [55.8%]). After sample and inflation weights were applied, the prevalence of NVLD was 2.78% (95% CI, 2.03%-3.52%) in the HBN sample and 3.9% (95% CI, 1.96%-5.78%) in the NKI sample. In the SYS sample, the prevalence of NVLD was 3.10% (95% CI, 1.93%-4.27%) after applying the sample weight. Across samples and estimation strategies, the population prevalence of NVLD was estimated to range from 3% to 4%. When applied to the US population younger than 18 years, 2.2 million to 2.9 million children and adolescents were estimated to have NVLD. CONCLUSIONS AND RELEVANCE The findings suggest that the prevalence of NVLD in children and adolescents may be 3% to 4%. Given that few youths are diagnosed with NVLD and receive treatment, increased awareness, identification of the underlying neurobiological mechanisms, and development and testing interventions for the disorder are needed.
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Affiliation(s)
- Amy E. Margolis
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Jessica Broitman
- International Control Mastery Therapy Center, Berkeley, California
| | - John M. Davis
- Department of Educational Psychology, California State University, Hayward
| | - Lindsay Alexander
- Center for the Developing Brain, Child Mind Institute, New York, New York
| | - Ava Hamilton
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Zhijie Liao
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Banker
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Lauren Thomas
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Bruce Ramphal
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Giovanni A. Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Kathleen Merikangas
- Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Jeff Goldsmith
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Tomas Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Michael P. Milham
- Center for the Developing Brain, Child Mind Institute, New York, New York
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
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Weyandt LL, Oster DR, Gudmundsdottir BG, DuPaul GJ, Anastopoulos AD. Neuropsychological functioning in college students with and without ADHD. Neuropsychology 2017; 31:160-172. [PMID: 27831696 PMCID: PMC5280458 DOI: 10.1037/neu0000326] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. METHOD The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. RESULTS Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. CONCLUSION College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University
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Abstract
OBJECTIVE As an exploratory study, this article investigated the relationship between ADHD symptoms and the style of language use of undergraduate college students in Korea. METHOD For this study, participants were asked to use stream-of-consciousness writing about any topic. Then, each participant's piece of writing was analyzed by the Korean Linguistic Inquiry and Word Count (KLIWC), a language analysis program. RESULTS The findings in this study demonstrated that college students with ADHD symptoms used significantly less "clauses per sentence," "morphemes per sentence," "numeral pronouns," "English," and "home," whereas they used significantly more "sentences," "adjectives," and "TV and movie" in their consciousness writing. CONCLUSION This study indicates that college students with ADHD traits have a different language style from their non-ADHD cohorts. Further research studies should be conducted to replicate our findings and develop specific interventions accordingly.
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Affiliation(s)
| | - Seongjik Lee
- Yongmoon Graduate School of Counseling Psychology, Korea
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Lindstrom W, Nelson JM, Foels P. Postsecondary ADHD Documentation Requirements: Common Practices in the Context of Clinical Issues, Legal Standards, and Empirical Findings. J Atten Disord 2015; 19:655-65. [PMID: 24131894 DOI: 10.1177/1087054713506262] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the information postsecondary institutions require when determining disability service eligibility for students with reported ADHD. METHOD ADHD documentation requirements of 200 U.S. institutions were surveyed by reviewing guidelines posted on disability services websites. RESULTS Whereas virtually all institutions required documentation, findings revealed significant variability in requirements across institutions. Required variables most often included a qualified evaluator (80%), diagnostic statement (75%), and identification of substantial limitations (73%), but only 5 of 46 evaluated variables were required by at least 50% of institutions. Supportive data such as diagnostic criteria, standardized assessment results, and rationale for accommodations were rarely required. CONCLUSION The majority of institutions required little to verify ADHD as a disability. Furthermore, there was little agreement on what components are essential for verification. When integrated with research, a large portion of guidelines failed to address identified weaknesses in ADHD diagnosis and disability determination.
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Åsberg Johnels J, Kopp S, Gillberg C. Spelling difficulties in school-aged girls with attention-deficit/hyperactivity disorder: behavioral, psycholinguistic, cognitive, and graphomotor correlates. JOURNAL OF LEARNING DISABILITIES 2014; 47:424-434. [PMID: 23213048 DOI: 10.1177/0022219412467058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Writing difficulties are common among children with attention-deficit/hyperactivity disorder (ADHD), but the nature of these difficulties has not been well studied. Here we relate behavioral, psycholinguistic, cognitive (memory/executive), and graphomotor measures to spelling skills in school-age girls with ADHD (n = 30) and an age-matched group of typically developed spellers (TYPSP, n = 35). When subdividing the ADHD group into those with poor (ADHDPSP, n = 19) and typical spelling (ADHDTYPSP, n = 11), the two subgroups did not differ with regard to inattentive or hyperactive-impulsive symptom severity according to parent or teacher ratings. Both ADHD subgroups also had equally severe difficulties in graphomotor control-handwriting and (parent ratings of) written expression as compared to the TYPSP group. In contrast, ADHDPSP had problems relative to ADHDTYPSP and TYPSP on phonological and orthographic recoding (choice tasks) and verbal memory (digit span) and were more likely to make commissions on a continuous performance task (CPT). Further analyses using the collapsed ADHD group showed that both digit span and the presence of CPT commissions predicted spelling performance independently of each other. Finally, results showed that phonological recoding skills mediated the association between digit span and spelling performance in ADHD. Theoretical and educational implications are discussed.
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Affiliation(s)
| | - Svenny Kopp
- University of Gothenburg, Gothenburg, Sweden
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Miranda A, Baixauli I, Colomer C. Narrative writing competence and internal state terms of young adults clinically diagnosed with childhood attention deficit hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1938-1950. [PMID: 23584087 DOI: 10.1016/j.ridd.2013.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/11/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The first objective of this study was to compare the written expression competence of young adults with attention deficit hyperactivity disorder (ADHD) with that of young adults without ADHD on three types of measures: indicators of the story's microstructure with regard to productivity and morphosyntax; indicators of the macrostructure (story grammar); and expressions of the mental states of the story's characters (internal state language). The second objective consisted of determining the relationships among the different narrative writing measures and the ADHD behavior ratings of inattention and hyperactivity obtained using the family observer report. METHOD The sample was composed of 54 participants, aged from 18 to 24, divided equally into a group with a childhood clinical diagnosis of combined subtype ADHD and a control group without ADHD. Written composition was assessed using a narrative task based on a sequence of images. RESULTS As expected, the young adults with ADHD obtained significantly worse results than the control group on the majority of the parameters of the story's microstructure and macrostructure. Likewise, they included a significantly lower number of terms about the characters' mental states. A correlation was also observed between measures of narrative competence and core symptoms of ADHD, as well as between the use of words with an emotional content and estimations related to core symptoms of ADHD. CONCLUSION The findings of this study point out that expressive writing should be assessed in individuals with ADHD as part of screening and comprehensive evaluation. More research is needed to design and implement effective interventions in this area.
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Affiliation(s)
- Ana Miranda
- Universidad de Valencia, Avd. Blasco Ibáñez, 21, 46010 Valencia, Spain.
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Bledsoe JC, Semrud-Clikeman M, Pliszka SR. Response inhibition and academic abilities in typically developing children with attention-deficit-hyperactivity disorder-combined subtype. Arch Clin Neuropsychol 2010; 25:671-9. [PMID: 20605842 PMCID: PMC2957960 DOI: 10.1093/arclin/acq048] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2010] [Indexed: 11/14/2022] Open
Abstract
Research in Attention-Deficit/Hyperactivity Disorder (ADHD) generally utilizes clinical samples or children with comorbid psychiatric diagnoses. Findings indicated that children with ADHD experience academic underachievement and poor performance on measures of response inhibition (RI). Less is known, about the neuropsychological profile of typically developing children with ADHD. The aim of the current study was twofold: (1) determine if academic skills and RI were impaired in typically developing children with ADHD-combined subtype (ADHD-C) and (2) determine to what extent RI may predict academic abilities. Children with ADHD-C did not differ on any academic domain from controls. Children with ADHD-C performed more poorly than controls on RI measures. Regression analyses suggest that Written Expression ability was significantly influenced by RI. No other academic domain was related to RI. Results suggest that children with ADHD-C may experience impairments in RI despite adequate academic functioning. Impaired RI is not solely responsible for difficulties found in academic skills in ADHD-C.
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Affiliation(s)
- Jesse C Bledsoe
- Department of Psychology, Michigan State University, East Lansing, 48824, USA.
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