Browsing by Subject "Attention Deficit Disorder with Hyperactivity"
Now showing 1 - 13 of 13
- Results Per Page
- Sort Options
Item ADHD and Medical Correlates of Bullying of Pediatric Neurofibromatosis Patients(2016-08-25) Patel, Sarita; Holland, Alice A.; Faith, Melissa A.; Silver, Cheryl H.Neurofibromatosis Type 1 (NF1) is an autosomal dominant disorder that involves nervous system tumor growth, and it is one of the most frequently occurring genetic disorders. NF1 is a multisystem disease with a complex phenotype. Given the range in severity of presentation in NF1, research has shown that disease severity could impact children's social-emotional functioning. Physical deformities such as tumor growth often are associated with NF1, and as a result, children and adolescents with NF1 may be at greater risk for being victims of bullying by peers. Children with NF1 also tend to have higher rates of Attention-Deficit/Hyperactivity Disorder (ADHD) as compared to children without NF1 (Barton & North, 2004; Martin et al., 2012). Common issues experienced by children with ADHD, such as social immaturity and behavioral dysregulation, may put them at higher risk for both bullying and peer victimization (Wiener & Mak, 2009; Unnever & Cornell, 2003). Overall, the current study found that parentreported ADHD symptoms predicted parent-reported but not self-reported bullying. Furthermore, the current study found that parent-reported ADHD symptoms were more predictive of being bullied than provider-rated severity of physical deformity. Since the present study was the first to examine whether physical appearance and ADHD symptoms may be associated with bullying in children with NF1, the novel information gained from the study may be used to direct future research, educate parents and teachers, and inform the development of interventions specific to the NF1 population.Item ADHD Subtypes and the Convergent Validity of the Brief Three-Factor Approach and D-KEFS Color-Word Interference Test(2014-05-02) Oasay, Larry M. K.; Silver, Cheryl H.; Glasier, Paul; Stavinoha, Peter L.Deficits in executive functioning (EF) often translate to significant impairment in real-life situations. EF can be assessed by performance-based tests or through the use of behavior ratings; however, most research has found little to no associations between performance-based EF tests and parent ratings. ADHD is a neurodevelopmental disorder characterized by EF deficits, but some studies have found differences on EF measures between subtypes of ADHD. The first aim of this study is to examine the convergent validity between the D-KEFS CWIT, a performance-based EF task, and the recently revised three-factor BRIEF. The second aim of this study is to examine whether there are differences between ADHD-I and ADHD-HI/C subtypes on either of these EF measures. A sample of 49 children with ADHD, aged 6 to 12 years, were administered the D-KEFS CWIT and their parents were given the BRIEF to complete. No significant correlations between Condition 3 of the CWIT and the new Self-Monitor and Inhibit subdomains of the BRIEF were obtained, but the Shift subdomain of the BRIEF significantly correlated with Condition 3. Participants with ADHD-HI/C were rated by parents as having greater executive dysfunction compared to participants with ADHD-I. No significant differences between subtypes were observed on the CWIT after controlling for symptoms of inattention. It would be beneficial to continue developing EF measures with the goal of greater convergent validity between performance-based and informant-report measures. Also, more research should be conducted in identifying differences between ADHD subtypes in their EF profiles as it can potentially aid in improving evaluation and treatment of this disorder.Item Assessment of Attention and Motion in Children with an Oral Language Disorder and Attention-Deficit/Hyperactivity Disorder Following Language Intervention(2010-07-12) Bolanos, S. Gina; Hughes, Carroll W.Children diagnosed with an oral language disorder (OLD) and attention deficit/hyperactivity disorder (ADHD) have been identified to have symptom overlap of core ADHD symptoms, thus misdiagnoses or true symptom overlap must be examined. Additionally, given that stimulant medication is the most popular treatment for children diagnosed with ADHD, the role of medication in remediating attention and movement in children with OLD and OLD/ADHD should be explored. Core ADHD symptoms in children with OLD and ADHD can be identified objectively using the QuotientTM, an objective CPT designed to measure core symptoms of ADHD (i.e., inattention, impulsivity, and movement). In 2009, Baker found the QuotientTM to be a useful diagnostic tool in the assessment of children with OLD and OLD/ADHD given its ability to discriminate OLD from OLD/ADHD children on variables of movement. The current study aimed to replicate the Baker (2009) findings by examining one year follow-up data. The current study also aimed to identify the effects of medication on attention and movement. The sample for the present study consisted of 35 children, between 6 and 13 years, with an oral language disorder. Twenty-two of the total sample also met diagnostic criteria for ADHD. Results of repeated measure analysis of variance (ANOVA) with a factor for groups (OLD vs. OLD/ADHD or On Meds/Off Meds), a factor for time (T1 and T2), and a factor that represents the interaction term (Groups by Time) revealed significant diagnostic group differences in movement, significant medication condition group differences for attention and movement, significant improvements in attention and body control over time (i.e., 1 year), and significant improvements over time in an attention variable and a movement variable for children on medication testing. Suggestions addressing limitations of the current study are discussed for future direction.Item Attention-Deficit/Hyperactivity Disorder and Executive Functions : Potential Vulnerabilities for Bully/Victimization Behaviors(2006-08-11) Kulesza, Krista; Silver, Cheryl H.Children diagnosed with Attention-Deficit/Hyperactivity Disorder can present with numerous difficulties in several areas of life, and particularly within the social realm. These interpersonal problems are linked to deficits in executive functions, which are the most prominent neuropsychological defects found in children with Attention-Deficit/Hyperactivity Disorder. Previous literature highlights the specific components of executive functions often problematic in children with Attention-Deficit/Hyperactivity Disorder including inhibition, set-shifting, working memory, planning, verbal fluency, and emotional regulation. Further, problems in executive functions appear to exacerbate the unsatisfactory interpersonal relationships these children experience. Additionally, Attention-Deficit/Hyperactivity Disorder is more prevalent among children identified as bullies and victims, and literature indicates that certain interpersonal problems children with Attention-Deficit/Hyperactivity Disorder experience, also increase the risk for involvement in bully/victimization behaviors. This involvement in bully/victimization behaviors among children with Attention- Deficit/Hyperactivity Disorder also appears to be related to deficits in executive functions. A group of children diagnosed with Attention-Deficit/Hyperactivity Disorder were assessed with performance-based executive functioning measures and self-reported questionnaires on bully/victimization behaviors. Parents completed a measure of emotional regulation, and the child's teacher completed an informant-rating scale on executive functions and equivalent measures on bully/victimization behaviors. Analyses of the data demonstrated that several of the teacher-reported executive function measures were related to, and predictive of, the teacher-reported bully/victimization behaviors. The performancebased executive function measures routinely demonstrated non-significant correlational and predictive findings with the bully/victimization measures. Additionally, the self-reported bullying measures had no significant relationships with any of the executive functioning measures. These results were consistent with literature questioning the validity of these types of measures. The results did show that executive functions, particularly those related to social skills, and emotional regulation, and the symptoms of Attention-Deficit/Hyperactivity Disorder, predict involvement with bully/victimization behaviors. Additional research is needed on the complex relationship among Attention- Deficit/Hyperactivity Disorder, executive functions, and bully/victimization behaviors. Specifically, potential studies should focus on utilizing a broader sample of participants, informants, and measures of executive functions and bully/victimization. Future research investigating the relationship among Attention-Deficit/Hyperactivity Disorder, executive dysfunction, and bully/victimization should focus on advancing beneficial interventions to comprehensively address these conditions in order to improve the child.s overall quality of life.Item Emotional Control and Reaction Time in Children with Internalizing Disorders and Attention-Deficit Hyperactivity Disorder(2016-12-16) Turner, Melissa Dawn; Wilkinson-Smith, Alison; Brewer-Mixon, Karen; Rose, LindseyBACKGROUND: Prior literature indicates that children with slower reaction times on neurocognitive attention measures are more likely to respond more slowly to stop signals in real world situations. Taking longer to respond may also suggest a tendency to take longer to process emotional cues in real time, thus possibly resulting in vulnerability towards emotional dyscontrol. The present study examined differences between reaction time and the parental ratings of emotional control and internalizing symptomatology in three distinct pediatric populations: those with Attention-Deficit Hyperactivity Disorder (ADHD), those with internalizing disorders such as anxiety and depression, and those with comorbid ADHD and internalizing disorders. SUBJECTS: A sample of 64 children and adolescents who were patients at the Neuropsychology Service at Children's Medical Center Dallas Texas from November 2011 through July 2014 was derived. All patients received neuropsychological evaluations and were assessed for attentional and emotional disorders. METHOD: Approval for the study was obtained from the Institutional Review Board at UT Southwestern Medical Center. Data was obtained via examination of medical records. Reaction time was measured via the Conners' Continuous Performance Test II (CPT II) Overall Hit Reaction Time (RT) variable. Parent rating forms from the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control subscale (EC) and the Behavioral Assessment Scale for Children, Second Edition (BASC-2) Internalizing Problems Composite score (IP) were used as a measure of participants' emotional control capacity. A multivariate analysis of covariance (MANCOVA) was employed to assess for significant differences between all three groups for CPT II RT, BRIEF EC, and BASC-2 IP, controlling for age, education, sex, and race. RESULTS: The MANCOVA yielded a significant overall model for group [F (6, 26) = 6.89, p < .01], controlling for age (p = .08), education (p < .01), sex (p = .13), and race (p = .02). There was a significant main effect for CPT II RT [F (2) = 8.31, p < .01] and BASC-2 IP [F (2) = 3.96, p < .04], with respectable effect sizes (η2 = .56 and .35, respectively). There was a moderately significant main effect for BRIEF EC [F (2) = 3.65, p = .051] with a moderate effect size (η2 = .33). Post hoc analyses revealed significant differences between the internalizing disorder and comorbid groups (p = .048) for CPT II RT, with slower reaction times in the internalizing disorders than comorbid groups. Significant differences were also observed between the ADHD and internalizing disorders groups (p < .01) as well as between the ADHD and comorbid groups (p = .03) for BASC-2 IP, with greatest elevation in the internalizing disorders, followed by the comorbid and ADHD groups. There were significant differences between the ADHD and the internalizing disorder groups (p = .04) as well as between the ADHD and comorbid groups (p = .01) for BRIEF EC. Of note, mean CPT II RT performance was in the normal range across the groups. All other pairwise comparisons were nonsignificant. DISCUSSION: In this study we explored associations between cognitive inefficiency and emotional dysregulation in order to further our understanding of the ways in which emotional and executive functions are related. We focused on differences between groups of three specific populations (i.e., ADHD, internalizing disorders and comorbid ADHD and internalizing disorders). The co-occurrence of ADHD and internalizing disorders may have important implications for assessment and treatment. Results such as these could be useful in determining whether treating one type of internalizing symptomatology may improve the other, and can allow providers to make more informed decisions about how to better assist children with comorbid conditions.Item Executive Functioning in Children with ADHD : Relationships Between Rating Scales and Standardized Tests(2005-05-11) Gehrmann, Helena Ruth; Silver, Cheryl H.Impairment of executive functioning is exhibited in children with Attention-Deficit/Hyperactivity Disorder. Executive functioning has traditionally been measured with standardized tests such as the Wisconsin Card Sorting Test. However, two rating scales to measure executive dysfunction have been developed and may be a useful adjunct to traditional measures. This study proposes to examine two such scales, the Brief Rating Inventory of Executive Function and the Children's Executive Functions Scale, as well as measure their relationship with two standardized measures. Implications of possible outcomes of the study are then discussed.Item Identification of Attention-Deficit/Hyperactivity Disorder in Children with an Identified Oral Language Disorder: The Diagnostic Utility of the Quotient/ADHD System and the impact of Executive Function and Working Memory on Diagnosis(2009-09-04) Baker, Kristine Genovese; Hughes, Carroll W.Common symptomatology in oral language disorders and attention-deficit/hyperactivity disorder, including inattention, hyperactivity, and behavior associated with impaired executive function, impacts the validity of diagnostic evaluations. Research demonstrates that the identification of these disorders can be dependent on evaluation setting and clinicians' field of training. Inaccurate diagnosis predicts inappropriate and/or inadequate intervention, and hence, impaired functioning across multiple domains. Assessment instruments to improve the evaluation of attention-deficit/hyperactivity disorder in the context of impaired oral language are needed. The present study explored the impact of comorbid attention-deficit/hyperactivity disorder on attention, movement, executive function, and working memory in children with an identified oral language disorder. Utility of the Quotient/ADHD SystemTM, a continuous performance test with motion actigraphy, and the Children's Executive Functions Scale, a parent-report of executive function, for the accurate identification of an attention disorder in the context of impaired language was evaluated. The sample consisted of 51 children, between 6 and 13 years, with an orallanguage disorder; 30 child participants met diagnostic criteria for attention-deficit/hyperactivity disorder. Children with and without comorbid attention-deficit/hyperactivity disorder were compared on four domains: attention,movement, executive function, and working memory. Attention and movement were objectively measured with the Quotient/ADHD SystemTM. Executive functioning was assessed using the subscale and Total scores on the Children's Executive Functions Scale. Verbal and visual-spatial working memory were evaluated separately with Digit Span and Spatial Span subtests of the Wechsler Intelligence Scale for Children, Fourth Edition, Integrated. Ingestion of prescribed stimulant medication was delayed until after testing. Results of analyses of variance revealed significant group differences in movement, overall executive functioning, and behavioral inhibition; differences in attention and working memory were not found. Logistic regression and discriminant function analyses supported the use of the Quotient/ADHD SystemTM and the Children's Executive Functions Scale for the identification of an attention disorder in this population. Exploratory analyses raise questions regarding attention-deficit/hyperactivity disorder subtypes and the not otherwise specified category. Findings have important implications for the evaluation of attention-deficit/hyperactivity disorder. Questions regarding the role of attentional mechanisms in oral language disorders and potential new adjunct interventions for improving language are highlighted.Item The Impact of Parenting Stress on the Ecological Validity of Executive Function Testing in Children with ADHD(2008-05-13) Ball, Krystle Paige; Silver, Cheryl H.Measurement of executive functioning is difficult and findings from standardized tests may not have ecological validity. Parent report is one way to achieve ecological validity, but correlations between standardized tests and parent report frequently are low. Greater parental stress may lead to parents reporting more problem behaviors, so higher scores on a measure of parenting stress were expected to impact the relationship between parent report of child executive functioning and child performance on a standardized test of executive functioning. No significant correlations were found between Color-Word Interference scores and the BRIEF and CEFS, controlling for IQ. Many BRIEF and CEFS subscales were correlated with parenting stress. Relationships between the BRIEF or CEFS and the Color-Word Interference Test were not significantly smaller for parents expressing greater stress.Item ImPACT™ Performance of High School Student Athletes with ADHD(2015-08-31) Gomez, Brooke Marie; Silver, Cheryl H.; Resch, Jacob; Cullum, C. MunroBACKGROUND: To date, two studies demonstrate that adolescents with ADHD tend to perform poorer on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT; Lovell, 2013) at baseline than do adolescents without ADHD at baseline (Elbin et al., 2013; Zuckerman, Lee, Odom, Solomon, & Sills, 2013). In an effort to replicate and extend these studies, the baseline and immediate post-concussion performance of high school athletes with and without ADHD were evaluated to identify potential differences between groups on the ImPACT’s domains. SUBJECTS: Student athletes were recruited from a private high school. Baseline testing was conducted biannually to establish pre-injury/baseline levels of individual participants. Thirty-eight students with ADHD and a matched control group of thirty-eight students without ADHD were used to test the first hypothesis. Twenty-three students with ADHD and a matched control group of twenty-three students without ADHD who sustained a concussion were used to test the second and third hypotheses. Additional analyses were performed on data from four student athletes with ADHD who sustained a concussion. METHOD: Data were used from a larger study conducted by a large public metropolitan university. Variables included demographic information and the ImPACT. All data were stored on an encrypted computer or in a locked file cabinet. RESULTS: Independent samples t-tests revealed significant differences between athletes with ADHD and non-ADHD athletes at baseline on the Impulse Control (t (74) = 2.73, p < .01) and the Total Symptoms (t(74)= 2.63, p < .05) scores of the ImPACT. A multivariate analysis of variance (MANOVA) was conducted on data from two time periods. A statistically significant difference (F(6, 39) = 2.86, p = .02; Wilks’ ? = 0.694; ?2 = .31) in ImPACT performance was found between non-concussed athletes with ADHD tested at baseline and concussed athletes without ADHD tested within 72 hours of injury (M = 1.83 days). Further analysis using independent samples t-tests found that athletes with ADHD at baseline performed significantly better than concussed athletes without ADHD tested within 72 hours of injury, on the following composites: Verbal Memory (t(44)= 2.25, p < .05), Visual Motor Speed (t(44)= 2.33, p < .05), Reaction Time (t(44)= -3.42, p < .01), and Total Symptoms (t(44)= -3.52, p < .01). No significant between-group differences were found on the Visual Memory or Impulse Control composites of the ImPACT. DISCUSSION: These findings indicate that administration of the ImPACT to individuals with ADHD is appropriate. At baseline, both groups performed similarly on Verbal Memory, Visual Memory, Visual Motor Speed and Reaction Time. However, the overlap in ADHD and concussion profiles on Impulse Control and Visual Memory warrant caution in the clinical interpretation of the ImPACT profiles of individuals with ADHD. Nevertheless, these findings suggest that the overall use of normative data within an ADHD population is appropriate, and baseline testing has values for athletes with ADHD.Item Influence of Motor Function on a Continuous Performance Test with Suspected Attention Deficit/Hyperactivity Disorder(2009-06-17) Kandalaft, Michelle Rima; Silver, Cheryl H.Clinicians and researchers have expressed concern about the potential confound of psychomotor skills on Continuous Performance Test variables commonly used in AD/HD assessments. Several studies have addressed this relationship but with limitations. Evidence for this potential influence as well as evidence of slow processing and motor speed in samples of children with known attention and motor deficits are demonstrated in the research. Due to the increasing rate of referrals for AD/HD diagnoses, the increasing use of CPTs, and the lack of knowledge about the influence of psychomotor functioning on these measures, an examination of this relationship is considered necessary to address the use of CPTs in AD/HD evaluations. The sample consisted of 99 children with suspected attention deficits between the ages of 6 and 16 years. Psychomotor functioning was assessed by the WISC-IV Processing Speed Index and the Beery VMI. Attention was measured with the WISC-IV Working Memory Index and subscales of the parent-rated BASC-2. Results of this study revealed that psychomotor and attention measures on the WISC-IV related to and accounted for variance in T.O.V.A. variables to a moderate degree. Stepwise regressions indicated the WISC-IV Processing Speed Index predicted both Response Time and Response Time Variability. In contrast, another measure of psychomotor skills, the Beery VMI, did not predict T.O.V.A. Variables. Interestingly, the Working Memory Index accounted for variance in Commission Errors, a measure of impulsivity, but not Omission Errors, a measure of sustained attention. Also, unexpected, differences among primary T.O.V.A. variables were not found across sub-samples when grouped by BASC-2 scores. These significant but modest results suggest that when evaluating a child for AD/HD, clinical consideration of the influence of psychomotor skills, as measured by the WISC-IV, on T.O.V.A. Response Time and Response Time Variability is warranted. Furthermore, the use of both the WISC-IV Working Memory Index and the T.O.V.A. is useful for assessing varying components of attention, such as focused and sustained attention.Item Mild Traumatic Brain Injury Rehabilitation: A Model for ADHD Treatment(2016-11-18) Yates, Ashley Nicole; Silver, Cheryl H.; Brewer-Mixon, Karen; Fulbright, Richard L.Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects approximately 4.4% of adults in the U.S. (Kessler et al., 2006) and is most commonly treated with psychopharmacological interventions. More recently, non-pharmacological interventions have been developed for ADHD. Cognitive Behavioral Therapy (CBT) has emerged as an efficacious treatment for ADHD and typically consists of training compensatory strategies and the use of external aids. The aims of this thesis were to examine the similarities between ADHD and mild Traumatic Brain Injury (mTBI) as well as review treatment options for mTBI and discuss their possible usefulness in treating ADHD. Based on the literature reviewed, there were striking similarities of deficits between ADHD and mTBI, specifically in the executive functioning of both. It is hypothesized that treatment for mTBI could also be beneficial for ADHD. Currently, some of the techniques used to treat ADHD and mTBI overlap. However in, cognitive rehabilitation (CR) for TBI, there is more emphasis on remediation of deficits compared to treatment of ADHD. Also, cognitive tasks for mTBI are more often completed in a real-life setting or as close to a real-life setting as possible. At this time, the literature regarding cognitive rehabilitation specific to mTBI is somewhat limited because it continues to be a growing field of literature. However, CR in general may be a beneficial treatment for the executive functioning deficits that also commonly affect ADHD.Item Subtypes of Attention-Deficit/Hyperactivity Disorder in Adults and Associated Differences in Vocational Personality Types(2013-01-17) Zavala, Alejandro; Silver, Cheryl H.BACKGROUND: Research continues to grow in the field of Attention-Deficit/Hyperactivity Disorder (ADHD). The focus on adult ADHD has increased in the last decade and exploration of topics such as vocational outcome have become imperative. Research indicates that individuals with ADHD show similar personality traits, but some traits may differ across subtypes of ADHD. Using the Holland vocational personality theory, this study aimed to examine differences in vocationally-related personality traits between subtypes of ADHD. The purpose of this study is to increase understanding of the role of personality in ADHD, as well as its application in the vocational area. SUBJECTS: Records of 57 adults with a diagnosis of ADHD, either Inattentive or Combined subtype, were reviewed. All individuals had undergone a vocational evaluation. METHOD: Results from the Self-Directed Search were obtained and analyzed. RESULTS: Counter to predictions, the Artistic vocational type was found more frequently in the ADHD Inattentive subtype. No other significant differences between ADHD subtypes were revealed for other specific vocational types. Again, counter to predictions, stronger evidence of traits related to the Social vocational type compared with the other vocational types was found in both subtypes of ADHD. DISCUSSION: Individuals with ADHD may have certain vocational personality traits in common, including a preference for activities involving cooperation and social support, but individuals with the Inattentive subtype are more likely than those with the Combined subtype to prefer activities where they can be independent and creative. More research is needed to expand these findings.Item Symptom Presentation in ADHD and Its Association with Inhibitory Control(2014-01-21) Loris, Colin Patrick; Silver, Cheryl H.; Stavinoha, Peter L.; Glasier, PaulAttention-Deficit/Hyperactivity Disorder (ADHD) has been associated with problems in executive functioning (EF). However, subtype difference in EF may exist between the inattentive type of ADHD and the hyperactive/impulsive and combined types of ADHD. As small number of studies, in fact, have found that inhibitory control is more strongly related to symptoms of inattention than symptoms of hyperactivity/impulsivity, suggesting that children with the inattentive type of ADHD may have more deficits in inhibition. The D-KEFS Color Word Interference Test (CWIT) was administered to 35 children, ages 8-17 years, diagnosed previously with ADHD, to examine possible differences in inhibition between a Predominantly Inattentive group and a Combined group (Predominantly Hyperactive-Impulsive and Combined types). Both ADHD group means on the CWIT were within normal limits. Results from a MANOVA showed no differences between groups on the CWIT, except for the word reading condition (Condition 2). Analysis of the CWIT and symptoms of inattention from the Conners Parent Rating Scale-Revised showed no significant relationship between performance on the CWIT and parent report of inattentive behaviors. Contrary to the hypotheses, this study did not provide evidence that children in the Predominantly Inattentive group display more deficits in inhibition than children in the Combined group, or that deficits in inhibition are related to inattentive behaviors.