Design Fluency in Children with ADHD and Comorbid Disorders (original) (raw)
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Journal of Clinical Medicine
Background: Tourette syndrome (TS) can be accompanied by neurocognitive impairment. Only a few studies have focused on executive function assessment in TS using design fluency, providing preliminary results. This study aimed to characterize the detailed design fluency profile of children with TS compared with neurotypical children, while addressing the central concern of frequent comorbidities in studies on TS by considering tic severity and attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis. Methods: Sixty-one children aged between 6 and 15 years participated and were divided into a TS group (n = 28 (with ADHD n = 15)) and a control group (n = 33). Our objective was addressed by examining a wide range of measures of the Five-Point-Test, presumably sensitive to frontostriatal dysfunction. The total number of designs, repetitions, repetition ratio, unique designs, and numerical, spatial, and total strategies were examined for the total duration of the test (global...
Iranian journal of psychiatry, 2014
The aim of this study was to examine the differences between ADHD subtypes in executive function tasks compared to themselves and normal controls. In this study, 45 school aged children with Attention Deficit Hyperactivity Disorder (ADHD) and 30 normal children who were matched based on age and IQ score in Wechsler Intelligence Scale for Children-Revised (WISC-R) were compared in terms of executive function. We used Wisconsin Sorting Card Test to assess executive function in both groups. We also used children's scores in Children Symptom Inventory-4 (CSI-4) for diagnosing ADHD and specifying ADHD subtypes. Data were entered in SPSS-17 and analyzed by T-test and ANOVA static tests to clarify the differences between ADHD and controls and between ADHD subtypes. Scheffe's test was also used to identify which groups were different from one another. The mean and standard divisions (SD) were used for descriptive analysis. ADHD subtypes are significantly different in terms of persev...
Neurocognitive Predictors of ADHD Outcome: a 6-Year Follow-up Study
Journal of abnormal child psychology, 2016
Although a broad array of neurocognitive dysfunctions are associated with ADHD, it is unknown whether these dysfunctions play a role in the course of ADHD symptoms. The present longitudinal study investigated whether neurocognitive functions assessed at study-entry (mean age = 11.5 years, SD = 2.7) predicted ADHD symptom severity and overall functioning 6 years later (mean age = 17.4 years, 82.6 % = male) in a carefully phenotyped large sample of 226 Caucasian participants from 182 families diagnosed with ADHD-combined type. Outcome measures were dimensional measures of ADHD symptom severity and the Kiddie-Global Assessment Scale (K-GAS) for overall functioning. Predictors were derived from component scores for 8 domains of neurocognitive functioning: working memory, motor inhibition, cognitive inhibition, reaction time variability, timing, information processing speed, motor control, intelligence. Effects of age, gender, and pharmacological treatment were considered. Results showed...
Construct Validity and Diagnostic Utility of the Cognitive Assessment System for ADHD
Journal of Attention Disorders, 2013
ADHD is one of the most common disorders of childhood with prevalence estimates ranging from 3% to 7% according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) and the Centers for Disease Control and Prevention (2005). ADHD is a disorder that includes developmentally inappropriate impulsivity, inattention, and overactivity. Frazier, Youngstrom, Glutting, and Watkins (2007) reported on the significant impact ADHD can have on the academic and occupational achievement. School psychologists are often involved in assessments where attention problems, impulsivity, and overactivity are key features of children's learning and behavioral difficulties. Assessments for ADHD may include structured diagnostic interviews, teacher and parent report behavior rating scales, direct observations, neuropsychological tests, and cognitive tests. The American Academy of Child & Adolescent Psychiatry (2007) noted the use of structured diagnostic interviews and behavior rating scales as best practices in clinical assessment of ADHD. Cognitive ability or intelligence tests and their resulting profiles have been recommended in assessment of ADHD (
Neuropsychology, 2004
Cognitive measures are used frequently in the assessment and diagnosis of attention-deficit/hyperactivity disorder (ADHD). In this meta-analytic review, the authors sought to examine the magnitude of differences between ADHD and healthy participants on several commonly used intellectual and neuropsychological measures. Effect sizes for overall intellectual ability (Full Scale IQ; FSIQ) were significantly different between ADHD and healthy participants (weighted d ϭ .61). Effect sizes for FSIQ were significantly smaller than those for spelling and arithmetic achievement tests and marginally significantly smaller than those for continuous performance tests but were comparable to effect sizes for all other measures. These findings indicate that overall cognitive ability is significantly lower among persons with ADHD and that FSIQ may show as large a difference between ADHD and control participants as most other measures.
Journal of Attention Disorders, 2016
Objective-Measurement reliability is assumed when executive function (EF) tasks are used to compare between groups or to examine relationships between cognition and etiologic and maintaining factors for psychiatric disorders. However, the test-retest reliabilities of EF tasks have rarely been examined in young children. Further, measurement invariance between typicallydeveloping and psychiatric populations has not been examined. Method-Test-retest reliability of a battery of commonly-used EF tasks was assessed in a group of children between the ages of 5-6 years old with (n=63) and without (n=44) ADHD. Results-Few individual tasks achieved adequate reliability. However, CFA models identified two factors, working memory and inhibition, with test-retest correlations approaching 1.0. Multiple indicator multiple causes (MIMIC) models confirmed configural measurement invariance between the groups. Conclusion-Problems created by poor reliability, including reduced power to index change over time or to detect relationships with functional outcomes, may be mitigated using latent variable approaches. There is increasing recognition that behaviorally-based diagnostic categories, such as those used in DSM-5, result in the creation of groups that are phenotypically and mechanistically heterogeneous (Insel et al., 2010; Sanislow et al., 2010). To resolve the issues created by diagnostic heterogeneity, researchers have increasingly turned to endophenotype measures and biomarkers (Kendler & Neale, 2010; Lenzenweger, 2013; Nolen-Hoeksema & Watkins, 2011). Neurocognitive processes, such as working memory, inhibition, and other executive functions (EF), have been specifically highlighted by the recent NIMH Research Domain Criteria Initiative (RDoC) as potential endophenotypes or biomarkers that may help elucidate mechanisms of psychiatric disorders, aid in treatment matching, and facilitate development of novel treatments (Insel et al., 2010; Nolen-Hoeksema & Watkins, 2011; Sanislow et al., 2010). However, the psychometric properties of these measures may limit their use for these purposes, especially when used with young children.
International Clinical Neuroscience Journal, 2021
Introduction Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children whose symptoms were first described by Heinrich Hoffmann in 1863. 1 It is characterized by disruption of inattention, conduct disorder, poor social communication, and hyperactivity/impulsivity. Inattention causes an inability to remain focused on schoolwork, seeming not to listen, and losing things at school more frequently than what is consistent with the child's developmental level. Hyperactivity and impulsivity, on the other hand, result in excess activity, fidgeting, trouble remaining seated, disturbing others' activities, and trouble waiting for one's turn. 2,3 ADHD tends to overlap with other common externalizing disorders in children, such as oppositional disorder and conduct disorder. 4,5 If the condition persists until adulthood, it often leads to social performance deficit as well as educational and professional dysfunctions. 6 Although hyperactivity subsides with age, attention deficit increases in most patients. 7 In most cultures, demographic surveys report a prevalence of nearly 5% and 2.5% in children and adults, respectively. 8 Overall, the disorder affects boys more than girls, with 1.2% and 1.6% higher occurrence during childhood and adulthood, respectively. However, girls are more prone to displaying inattention symptoms. 9 Evidence from various studies in neuropsychology, 10 pathophysiology, 11 genetics, 12 and phenotypes, 13 suggest that several factors with varying levels of intensity manifest clinically as attention deficit and hyperactivity. Since the 1970s, numerous studies have identified impairments in executive functioning as the core cause of ADHD in adolescents. 14 These impairments lead to deficits in essential cognitive abilities for complex goaloriented behaviors and adjusting to a range of changes and environmental demands. 9 several authors 15,16 believed that some, but not all, children with ADHD suffer from significant impairments in several areas of executive functioning; however, other authors such as Brown 17 discussed that ADHD is fundamentally a developmental disorder that affects executive functions (EFs) in all cases. Thus, this paper focuses exclusively on this issue. The aim of this study is to review existing research on cognitive impairments in children with ADHD with a focus on EFs.
Arquivos de Neuro-Psiquiatria, 2010
Objective: To perform a complete Intelligence quotient (IQ) measurement (verbal, performance, and total) and subsequently, to compare executive function (EF) measurements in subgroups of children with attention deficit-hyperactivity disorder (ADHD) with a control group. Method: We studied a group of children from 7-12 years of age from public elementary schools. Children were selected by means of Diagnostic and Statistical Manual of Mental Disorders-IV-Revised (DSM-IV-R) parent and teacher questionnaires for ADHD. EFs were screened by Weschler Intelligence Scale for Children (WISC-R) performance intelligence quotient (IQ) determination of the following sub-tests: picture completion; block designs, and object assembly tests. Simultaneously, total (T-), performance (P-), and verbal (V-) IQs were measured for each patient. Results: We studied 26 control subjects, and 35 children with ADHD. Numbers of children in each ADHD subtype group were as follows: 15 in the combined group (-C), 13 in the inattentive group (-I), and 7 in hyperactivity group (-H). We found significant lower EF scores in picture arrangement (F=3.76, df 3,57, p=0.01), block design (F=4.55, df 3,57, p<0.01), and object assembly (F=4.52, df 3,57, p<0.01). Post-hoc analysis showed that differences were located among ADHD-C, ADHD-I, and ADHD-H groups when compared with controls. We found significantly lower cognitive scores in the ADHD-I group as follows: P-IQ (F=3.57, df 3,57, p=0.02), and T-IQ (F=2.90, df 3,57, p=0.04). Conclusion: Our results showed that screening of EF alteration in children with ADHD is easy and rapid by means of certain P-IQ determination sub-scales of the WISC test; moreover, complementary IQ determination can be measured simultaneously. Overall, children with ADHD exhibited an EF alteration. ADHD-I children demonstrated lower P-IQ, and T-IQ scores than control children.
Journal of Abnormal Child Psychology, 2002
The aim of this prospective study was to examine whether neurocognitive performance of children aged 5–6 years distinguished children who were later diagnosed with attention deficit/hyperactivity disorder (ADHD) or “borderline ADHD” from children without ADHD after adjustment for behavioral measures and to examine the influence of comorbid psychopathology. Out of a general population of 1,317 children, 366 children were selected on the basis of their scores on the Child Behavior Checklist (CBCL). Eighteen months later, the parents were interviewed using a standardized child psychiatric interview: 33 children were classified as ADHD and 75 children as borderline ADHD, and there were 258 children without ADHD. Children with rated ADHD were significantly impaired on measures of visuomotor ability and working memory compared to children without ADHD after adjustment for CBCL results. The performance of borderline ADHD children was in between that of children with and without ADHD. In addition, 4 groups of children were analyzed: 9 ADHD, 24 ADHD with comorbid oppositional defiant disorder/conduct disorder (ODD/CD), 59 ODD/CD, and 274 controls. Children with rated comorbid ADHD and ODD/CD performed significantly worse on these tasks compared to children with rated ODD/CD and control children while they did not differ from ADHD children. Our results imply that neurocognitive measures can contribute to the early identification of ADHD with and without comorbid ODD/CD.