Moment-to-moment dynamics of ADHD behaviour

BACKGROUND: The behaviour of children with Attention-Deficit / Hyperactivity Disorder is often described as highly variable, in addition to being hyperactive, impulsive and inattentive. One reason might be that they do not acquire complete and functional sequences of behaviour. The dynamic developmental theory of ADHD proposes that reinforcement and extinction processes are inefficient because of hypofunctioning dopamine systems, resulting in a narrower time window for associating antecedent stimuli and behaviour with its consequences. One effect of this may be that the learning of behavioural sequences is delayed, and that only short behavioural sequences are acquired in ADHD. The present study investigated acquisition of response sequences in the behaviour of children with ADHD. METHODS: Fifteen boys with ADHD and thirteen boys without, all aged between 6–9 yr, completed a computerized task presented as a game with two squares on the screen. One square was associated with reinforcement. The task required responses by the computer mouse under reinforcement contingencies of variable interval schedules. Reinforcers were cartoon pictures and small trinkets. Measures related to response location (spatial dimension) and to response timing (temporal dimension) were analyzed by autocorrelations of consecutive responses across five lags. Acquired response sequences were defined as predictable responding shown by high explained variance. RESULTS: Children with ADHD acquired shorter response sequences than comparison children on the measures related to response location. None of the groups showed any predictability in response timing. Response sequencing on the measure related to the discriminative stimulus was highly related to parent scores on a rating scale for ADHD symptoms. CONCLUSION: The findings suggest that children with ADHD have problems with learning long sequences of behaviour, particularly related to response location. Problems with learning long behavioural sequences may ultimately lead to deficient development of verbally governed behaviour and self control. The study represents a new approach to analyzing the moment-to-moment dynamics of behaviour, and provides support for the theory that reinforcement processes are altered in ADHD

Concurrent Deficits in Behavior Inhibition, Non-verbal Working Memory and Psychological Sense of Time in ADHD

According to the Hybrid Model of Executive Function for Attention Deficit Hyperactivity Disorder (ADHD), hyperactive and combined types, a delay in behavior inhibition causes secondary deficits in four executive function; non-verbal working memory, verbal working memory, reconstitution and self-regulation of affect/motivation/arousal. The deficit in non-verbal working memory causes a deficit in psychological sense of time, which in tum impairs self-regulation in those with ADHD. This single case study investigated concurrent deficits in behavior inhibition, non-verbal working memory and psychological sense of time in a 1O-year-old male with ADHD, combined type. Three interrelated components of behavior inhibition were measured by the Continuous Performance Test-II, The Wisconsin Card Sorting Test, and the Stroop Test. Non-verbal working memory was measured by using the Rey-Complex Figure Test and Recognition Trial, and the psychological sense of time was measured by the Time Perception Test, which is a time reproduction task. The results of this case study supports the Hybrid Model of Executive Function as concurrent deficits in behavior inhibition, non-verbal working memory and psychological sense of time were found in a subject with ADHD, combined type. The implications of these findings for treatment and future research are discussed

MAGNITIVE: Effectiveness and Feasibility of a Cognitive Training Program Through Magic Tricks for Children With Attention Deficit and Hyperactivity Disorder. A Second Clinical Trial in Community Settings.

Previous studies have explored the impact of magic tricks on different basic cognitive processes yet there is a need of examining effectiveness of a cognitive training program through magic tricks for children with attention deficit hyperactivity disorder (ADHD). The present study examines the effectiveness and feasibility of the MAGNITIVE program, a manualized intervention for cognitive training through the learning of magic tricks. A total of 11 children with ADHD (from 8 to 12 years) participated in separated groups of two different community settings (hospital center and school), and were assessed at pre-treatment, post-treatment, and a 3-month later follow-up in different tasks involving processing speed, sustained attention, selective attention, and mental flexibility. Using non parametric statistical analyses and Reliable Change Index, the results showed that these children receiving MAGNITIVE particularly improved their performance in sustained attention, shifting attention, and mental flexibility, changes were also observed in processing speed performance yet further research is needed in terms of selective attention and inhibition, given the great individual differences within this sample. Changes were maintained when the program was finished. In terms of viability, the study proved a good treatment integrity in different contexts (hospital and school setting), adherence to the curriculum (attendance and some practice at home), and high levels of engagement satisfaction. In this second clinical trial, MAGNITIVE program appears to be a feasible training program for children with ADHD, as an alternative for medication when possible.pre-print1543 K

Can Motivation Normalize Working Memory and Task Persistence in Children with Attention-Deficit/Hyperactivity Disorder? The Effects of Money and Computer-Gaming

Visual-spatial Working Memory (WM) is the most impaired executive function in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Some suggest that deficits in executive functioning are caused by motivational deficits. However, there are no studies that investigate the effects of motivation on the visual-spatial WM of children with- and without ADHD. Studies examining this in executive functions other than WM, show inconsistent results. These inconsistencies may be related to differences in the reinforcement used. The effects of different reinforcers on WM performance were investigated in 30 children with ADHD and 31 non-ADHD controls. A visual-spatial WM task was administered in four reinforcement conditions: Feedback-only, 1 euro, 10 euros, and a computer-game version of the task. In the Feedback-only condition, children with ADHD performed worse on the WM measure than controls. Although incentives significantly improved the WM performance of children with ADHD, even the strongest incentives (10 euros and Gaming) were unable to normalize their performance. Feedback-only provided sufficient reinforcement for controls to reach optimal performance, while children with ADHD required extra reinforcement. Only children with ADHD showed a decrease in performance over time. Importantly, the strongest incentives (10 euros and Gaming) normalized persistence of performance in these children, whereas 1 euro had no such effect. Both executive and motivational deficits give rise to visual-spatial WM deficits in ADHD. Problems with task-persistence in ADHD result from motivational deficits. In ADHD-reinforcement studies and clinical practice (e.g., assessment), reinforcement intensity can be a confounding factor and should be taken into account. Gaming can be a cost-effective way to maximize performance in ADHD

The study of latency aged boys diagnosed with attention- deficit hyperactivity disorder and the effectiveness of play therapy, 1997

The objective of this study was to identify the effectiveness of play therapy on a latency diagnosed child with Attention-Deficit Hyperactivity Disorder(ADHD). In order to attain this objective, the following areas were addressed (a) a definition for ADHD, (b) history of ADHD, (c) emotional and mental difficulties for ADHD children (d) why the latency stage is an imperative age in diagnosis, (e) common interventions, and (f) effectiveness of play therapy in shaping behavior. The single systems design was used to determine if play therapy was beneficial to an ADHD child in long term mental health facility. One latency ADHD child residing in Charter, a longer term mental health facility, was selected to represent the target population

Web Health Application for ADHD Monitoring (WHAAM): Context-Driven Framework

The Framework (FW) summarizes the experiences and vision of the WHAAM project partners, providing the basis for the development of the WHAAM app and online services. There are many approaches to the treatment of ADHD, with excellent resources available. This FW is a working tool based on partners' experiences, inspiring subsequent project activities. It is divided into three parts: part A explores general issues related to ADHD, focusing on key life contexts such as school, family, and social relationships. Each context is explored in terms of assessment, intervention and support. Part B delves into the relationship between ICT use and ADHD treatment. Finally, Part C briefly explains the main features of the WHAAM app, including functionality and interfaces. The WHAAM project considers the app and online service accessible via PC and mobile devices as a significant advancement in monitoring process management

Long -term episodic memory in children with Attention -Deficit /Hyperactivity Disorder

Research on Attention-Deficit/Hyperactivity Disorder (ADHD) has indicated that diagnosed children show considerable memory deficits. The majority of tasks that have supported such deficits have focused on working memory and school/semantic-related abilities. Although there is a small body of literature related to long-term memory in children with ADHD, no studies appear to focus on long-term episodic memory, including personal-event memory. This is the case despite clinical and anecdotal evidence suggesting that children with ADHD might show enhanced long-term episodic memory abilities in comparison to those without. Twenty-one children with ADHD (5 females and 16 males) and 31 children without ADHD (14 females and 17 males) in the 4th--8 th grades (mean age 12.1 years) were administered five memory tasks assessing short-term, working memory and long-term episodic memory. Additionally, one parent for each child completed a 22-item questionnaire assessing their child\u27s memory abilities. The following main questions were addressed: (1) do children with ADHD exhibit superior long-term episodic memory performance when compared with controls, (2) among ADHD children, is performance on long-term episodic memory tasks superior to performance on short-term working memory tasks, and (3) how do parents perceive their child\u27s memory abilities? Although parents rated children with ADHD as having poor memory abilities for a number of factors, parents believed their children with ADHD had the best memories in the family for past experiences. Consistent with this profile, children with ADHD showed deficits in working memory compared to controls but showed equal or enhanced performance on long-term episodic tasks. When discussing a special-event in their life, children with ADHD provided lengthier and more descriptive narratives. These results provide the first empirical support for anecdotal evidence suggesting children with ADHD have more elaborate episodic memory ability compared to controls. This is the first study to document strengths in children with ADHD, where weaknesses have always been the focus. Although replication is needed, these results may shed some light on the memory processes of children with ADHD and may be used to help these children succeed both in and out of the classroom. Future directions and limitations are discussed

Movement Interventions for Children with Autism and Developmental Disabilities: An Evidence-Based Practice Project

This review explored the following question: Are the comprehensive treatment models Makoto Therapy, Brain Gym, and Interactive Metronome effective interventions for improving occupational performance including improving executive function, academic performance, and physical coordination in children and adolescents with Autism Spectrum Disorder (ASD)? Because current research on Interactive Metronome, Brain Gym®, and Makoto Therapy fails to address children and adolescents with autism spectrum disorder, presents multiple flaws in research design, and does not measure occupational outcomes such as occupational performance, we recommend that these interventions should not be used as comprehensive treatment models in occupational therapy. We recommend that more occupational-based, methodologically-sound research involving youth with ASD be conducted before implementing these interventions in occupational therapy practice

Tolerance to Psychostimulant Medication Among Children with ADHD

Medication is the most commonly received treatment for childhood Attention-Deficit/Hyperactivity Disorder (ADHD) with 90% of children with ADHD having received it at some point in their lives (Danielson et al., 2018). Central Nervous System (CNS) stimulant medication is a well-established short-term treatment for childhood ADHD (Pliszka, 2007). However, there is little support in the literature for long-term benefit of psychostimulants. One possible explanation for this lack of sustained effect is the development of tolerance to the drug. The current study aimed to examine possible evidence of short-term tolerance to stimulant medication, methylphenidate (MPH). Additionally, we investigated previous stimulant medication treatment as a potential predictor of developing indicators of tolerance during the study. Overall, results demonstrate that therapeutic effects of stimulant medication on academic productivity and rule following behavior do not significantly dissipate over three weeks among most children with ADHD. There was one exception in that children who had received a high dose of psychostimulant treatment from their community provider prior to the initiation of the current study showed weakened effects of medication over time as measured by academic productivity but not by rule following behavior