Literacy and Numeracy Underachievement in Boys and Girls With ADHD

Written language achievement in children and adolescents with neurofibromatosis type 1 and Plexiform Neurofibromas

Neurofibromatosis type 1 (NF1) is associated with below average writing achievement. However, little is known about specific aspects of written language impacted by NF1, changes in writing over time, and associations between cognitive aspects of the NF1 phenotype and writing. At three timepoints over six years, children with NF1 and plexiform neurofibromas (PNs) completed Woodcock-Johnson tests of writing mechanics (Spelling, Punctuation & Capitalization, handwriting), written expression of ideas (Writing Samples), writing speed (Writing Fluency), and tests of general cognitive ability, executive function, memory, and attention. Children (N = 76, mean age = 12.8 ± 3.4 years) completed at least one baseline writing subtest. Overall writing scores were in the Average range (M = 93.4, SD = 17.4), but lower than population norms (p = 0.002). Scores were highest on Writing Samples (M = 95.2, SD = 17.3), and lowest for Punctuation & Capitalization (M = 87.9, SD = 18.8, p = 0.034). Writing scores were mostly stable over time. Nonverbal reasoning was related to some tests of writing mechanics and written expression of ideas. Short-term memory and inattention explained additional variance in Writing Samples and Spelling. Poor handwriting was associated with writing content beyond the impact of cognitive factors. Children with NF1 and PNs may benefit from early screening and writing support. Interventions should address the contribution of both cognitive and handwriting difficulties in written language.

Meta-analysis of the effects of physical activity on executive function in children and adolescents with attention deficit hyperactivity disorder

BACKGROUND

Executive function is a core deficit in children with attention deficit hyperactivity disorder (ADHD). This study systematically reviewed the evidence for the effects of physical activity (PA) interventions on executive function in children and adolescents with ADHD and explored the moderating effects of key variables of PA on executive function.

METHODS

Relevant literature in four electronic databases, Pubmed, Web of Science, Cochrane Library, and Embase, were systematically searched. Revman 5.4 was used for data analysis, and combined effect sizes, heterogeneity tests, subgroup analyses, and sensitivity analyses were calculated. Egger's test in Stata 15.0 was used for publication bias testing.

RESULTS

A total of 24 articles with 914 participants were included. Meta-analysis showed that PA interventions improved inhibitory control (SMD = -0.50, 95%CI [-0.71, -0.29], P < 0.00001), working memory (SMD = -0.50, 95%CI [-0.83, -0.16], P = 0.004) and cognitive flexibility in children and adolescents with ADHD (SMD = -0.45, 95%CI [-0.81, -0.09], P = 0.01). Subgroup analysis revealed a moderating effect of intervention intensity, motor skill type, sessions of PA, and weekly exercise volume on executive function.

CONCLUSION

PA interventions had positive effects on improvements in core executive functions in children and adolescents with ADHD and were influenced by intervention intensity, type of motor skill, sessions of PA, and amount of exercise. This has practical implications for the formulation of PA interventions programs.

Relationship Between Inhibitory Control and Arithmetic in Elementary School Children With ADHD: The Mediating Role of Working Memory

OBJECTIVES

To test if inhibitory control was a significant predictor for arithmetic in children with ADHD and if the relationship between inhibitory control and arithmetic was mediated by working memory.

METHODS

Eighty-four children (ADHD, n = 54; Non-ADHD, n = 30) were tested on their interference control, behavioral inhibition, working memory, and arithmetic. Regression analysis was used to test the predictive role of inhibitory control in arithmetic. Moreover, mediation analysis was done to test whether working memory mediated the relationship between inhibitory control and arithmetic memory.

RESULTS

Interference control but not behavioral inhibition was a significant predictor for arithmetic. In addition, interference control had direct and indirect effects via working memory on arithmetic.

CONCLUSIONS

Results demonstrated that inhibitory control contributed to arithmetic in children with ADHD. Furthermore, interference control had direct and indirect effects via working memory on arithmetic, suggesting interventions for arithmetic difficulties should involve training on both inhibition and working memory.

The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review

Objectives

Children with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age.

Methods

Systematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD.

Results

The findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality.

Conclusion

A larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.

The relationship between cognition and mathematics in children with attention-deficit/hyperactivity disorder: a systematic review

Cognitive processes play an imperative role in children's mathematics learning. Difficulties in cognitive functioning are a core feature of Attention Deficit Hyperactivity Disorder (ADHD) in children, who also tend to show lower levels of mathematics attainment than their typically developing peers. This review (registration number: CRD42020169708) sought to aggregate findings from studies assessing the relationship between cognition and mathematics in children with a clinical ADHD diagnosis aged 4-12 years. A total of 11,799 studies published between 1992 and August 2020 were screened for eligibility using various database (PsycINFO, PubMed, SCOPUS, EMBASE, ERIC, Web of Science, and additional sources), from which four studies met inclusion criteria. A narrative synthesis was conducted on the correlations between mathematics and cognitive domains, including an evaluation of the risk of bias within the studies. Across four studies meeting inclusion criteria, memory, inhibitory control, and processing speed were assessed. The results showed a positive association between cognition and mathematics performance in this population. The strength of associations across these studies varied as a function of the cognitive domain in question, means by which mathematics performance was assessed, as well as whether confounding factors such as age and IQ were controlled for. Collectively, this review demonstrates a lack of research in this area and points to various methodological considerations for identifying the association between cognition and mathematics performance in ADHD.

Relationships between cognition and literacy in children with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis

Evidence suggests that cognitive and literacy difficulties are common for children with Attention‐Deficit/Hyperactivity Disorder (ADHD). The current systematic review and meta‐analysis investigated the relationship between cognition and literacy in children with ADHD. Ten thousand and thirty‐eight articles were screened against the inclusion criteria and six eligible studies were retained for final review. Where two or more studies used comparable measures of cognition and literacy, a meta‐analysis of the relationship between these measures was undertaken. A narrative synthesis of all included studies was also completed. There were medium effect sizes between working memory and aspects of reading, and small effect sizes between processing speed and reading. Inhibition and attention had differential relationships with aspects of literacy with varying effect sizes. This systematic review demonstrates differential relationships between aspects of literacy and cognition in children with ADHD. Further examination of these relationships is warranted to support intervention development.

Inattention, hyperactivity/impulsivity, and academic competence: Findings from three cohorts

BACKGROUND

Attention-deficit hyperactivity disorder (ADHD) is a risk for learning. Because ADHD commonly includes behaviours of inattention and behaviours of hyperactivity/impulsivity, how the two types of behaviours independently affect children's academic competence remains poorly understood.

AIMS

To investigate the impact of behaviours of inattention and behaviours of hyperactivity/impulsivity on Chinese students' academic competence.

SAMPLES

Parents of 167 preschoolers (Cohort 1), parents of 313 first graders (Cohort 2), and 1,003 high school students (Cohort 3).

METHODS

The ADHD-RS-IV Preschool version (Cohort 1), ADHD-RS-IV Home version (Cohort 2), and BASC-SRP (Cohort 3) were used to measure behaviours of inattention and hyperactivity/impulsivity. Academic competence was operationalized as school readiness (Cohort 1), math and language arts scores at two time points provided by school (Cohort 2), and self-reported academic performance (Cohort 3). Multiple regressions were performed to investigate the relationship between academic performance and behaviours of inattention alone (Step 1), and behaviours of hyperactivity/impulsivity alone (Step 2), and behaviours of inattention together with behaviours of hyperactivity/impulsivity (Step 3).

RESULTS

For each cohort, both types of behaviours were negatively correlated with academic competence. However, regression analyses showed that in Step 3, behaviours of hyperactivity/impulsivity either failed to predict academic competence or predicted better academic competence. Overall, behaviours of inattention alone accounted for a similar amount of variance in academic competence as did behaviours of inattention and hyperactivity/impulsivity combined.

CONCLUSIONS

Behaviours of inattention presented a risk for academic competence but the effect of behaviours of hyperactivity/impulsivity varied. Implications for instructional strategies for behaviours of inattention were discussed.

Validity of the Korean Version of DIVA-5: A Semi-Structured Diagnostic Interview for Adult ADHD

BACKGROUND

This study was to assess the validity of the Korean version of the semi-structured Diagnostic Interview for Adult ADHD, third edition (DIVA-5). The secondary aim was to compare sociodemographic and psychiatric comorbidities in adult patients with and without a diagnosis of ADHD.

METHODS

A total of 279 participants were recruited from nine psychiatric outpatient clinics in Korea. All participants were administered the Mini-International Neuropsychiatric Interview (MINI) Plus v.5.0.0, the Adult ADHD Self-Report Scale v1.1 (ASRS-v1.1) Symptom Checklist, and DIVA-5. Diagnosis concordance between two board-certified psychiatrists and DIVA-5 were analysed.

RESULTS

The DIVA-5 showed a diagnostic accuracy of 92%, a sensitivity of 91.30%, and a specificity of 93.62%. Significant clinical and demographic differences between ADHD and control groups were found.

CONCLUSION

The Korean version of DIVA-5 is a reliable tool for assessing and diagnosing ADHD in adult Korean populations.

[Differential diagnosis of primary and secondary mathematical learning disability – indications from the dyscalculia test Basis-Math 4–8]

Studies in children with AD(H)D without mathematical learning disability (MLD) as well as studies on the effects of methylphenidate on arithmetic have shown that most deficits in mathematics and most error types commonly described as specific to developmental dyscalculia (e. g., finger-counting, fact-retrieval deficit, complex counting, difficulties with carry/borrow procedures, self-corrections) cannot be classified as such and should thus not be used for the differential diagnosis of primary dyscalculia and secondary MLD. This article proposes using the overall score in the dyscalculia test Basis-Math 4-8 (Moser Opitz et al., 2010) as well as implausible subtraction errors as a marker for dyscalculia and the number of self-corrections made during the test as a cognitive marker for attention deficits. Hierarchical cluster analyses were calculated in a sample of 51 clinically referred children with normal IQ and suspicion of MLD, using IQ, years of schooling, overall score of the Basis-Math 4–8 and number of self-corrections in this test as variables. The results revealed a subgroup with primary dyscalculia as well as three subgroups with secondary MLD (two with attention deficit hyperactivity disorder, one with depression and one small subgroup with high IQ). In conclusion, the Basis-Math 4–8 (Moser Opitz et al., 2010) can offer substantial information for the differential diagnosis of dyscalculia and secondary deficits in mathematics due to attention problems and enable optimization of treatment decisions for the different groups.