Motor dysfunctions in ADHD and DCD: an examination of the error correction mechanisms

A high incidence of overlap between ADHD and DCD suggests that they may be related. However, different deficits may underlie the disorders. ADHD has response inhibition deficit whereas DCD has efference copy deficit. The present study examines the presence of these deficits in the respective disorders and within the ADHD subtypes. The ability of children to amend their hand movements during target perturbation is investigated in a double-step tracking task. Participants were children aged 10 to 12. The ADHD symptoms were screened by Australian Disruptive Behaviours Scale, Conner's Parent Rating Scale-Revised:L and Conner's Parent Rating Scale-Revised:L; DCD symptoms were screened by Developmental Coordination Disorder Questionnaire and McCarrson Assessment of Neuromuscular Development measure. ADHD-PI only, ADHD-C only, ADHD-PI with DCD, ADHD-C with DCD, DCD only, and a comparison group were studied. The participants were required to capture a target that skipped twice in succession. Compared to other groups, control children were able to adjust the initial response amplitude as a function of the time between a superseding stimulus and initiation of a response. The corrective response furthermore was accurate with respect to the final step position. The results are discussed in terms of an error averaging mechanism underlying tracking performance

The use of the Developmental Coordination Disorder Questionnaire in Australian children

The effectiveness of the Developmental Coordination Disorder Questionnaire (DCDQ) as a screening tool was investigated in an Australian sample. Using the DCDQ, 129 children aged 9 to 12 years old were screened for Developmental Coordination Disorder (DCD), with a follow-up assessment of movement ability using the McCarron Assessment of Neuromuscular Development (MAND) as the criterion measure. The overall decision agreement between the two measures in identifying DCD was .64. The DCDQ had a sensitivity of .55 and a specificity of .74. The low sensitivity suggests that many children with DCD are not being identified by the DCDQ despite the inclusion of children with a suspect score on the DCDQ. As a screening tool, the DCDQ was accurate in identifying children with moderate or severe DCD but identified less than half of the children with mild DCD

ADHD and DCD comorbidity: the associated problems

Attention Deficit-Hyperactivity Disorder (ADHD) has a high comorbidity with Development Coordination Disorder (DCD). On their own, these disorders are often associated with many other behavioural and emotional problems. However, studies investigating associated problems in this comorbid group are limited. This study examined these associated problems in children with comorbid ADHD and DCD using the Conners' Parent and Teachers' Rating Scales (CPRS-R:L; CTRS-R:L). A total of 109 participants (82 males; 27 females) with age ranging from 9.8 to 12.7 (M=11.16; SD=0.79) participated in this study. Participants were placed into 4 groups: Controls (n=41), ADHD (n=29), DCD (n=17) and comorbid ADHD/DCD (n=22), based on the scores from the Australian Disruptive Behaviours Scale, the Developmental Coordination Disorder Questionnaire and the McCarron Assessment Neuromuscular Development measure. A multivariate analysis of variance was conducted on the parent-rated and the teacher-rated Conners' test variables Anxious-Shy, Perfectionism, Social Problems and Psychosomatic separately. Results revealed that parents reported significant social problems seen in children with ADHD and comorbid ADHD/DCD. These children have few friends, experience low self-esteem and self-confidence, and they also feel emotionally distant from peers. However, teachers only reported significant social problems seen in children with comorbid ADHD/DCD. In addition, parents reported significant psychosomatic symptoms seen in children with ADHD. No significant group differences were found for the variables Anxious-Shy and Perfectionism. These findings imply that children with comorbid ADHD/DCD experience more significant social problems compared to children with only ADHD or DCD

Motor dysfunctions in ADHD and DCD: an examination of the error correction mechanisms

A high incidence of overlap between ADHD and DCD suggests that they may be related. However, different deficits may underlie the disorders. ADHD has response inhibition deficit whereas DCD has efference copy deficit. The present study examines the presence of these deficits in the respective disorders and within the ADHD subtypes. The ability of children to amend their hand movements during target perturbation is investigated in a double-step tracking task. Participants were children aged 10 to 12. The ADHD symptoms were screened by Australian Disruptive Behaviours Scale, Conner's Parent Rating Scale-Revised:L and Conner's Parent Rating Scale-Revised:L; DCD symptoms were screened by Developmental Coordination Disorder Questionnaire and McCarrson Assessment of Neuromuscular Development measure. ADHD-PI only, ADHD-C only, ADHD-PI with DCD, ADHD-C with DCD, DCD only, and a comparison group were studied. The participants were required to capture a target that skipped twice in succession. Compared to other groups, control children were able to adjust the initial response amplitude as a function of the time between a superseding stimulus and initiation of a response. The corrective response furthermore was accurate with respect to the final step position. The results are discussed in terms of an error averaging mechanism underlying tracking performance

The use of the Developmental Coordination Disorder Questionnaire in Australian children

The effectiveness of the Developmental Coordination Disorder Questionnaire (DCDQ) as a screening tool was investigated in an Australian sample. Using the DCDQ, 129 children aged 9 to 12 years old were screened for Developmental Coordination Disorder (DCD), with a follow-up assessment of movement ability using the McCarron Assessment of Neuromuscular Development (MAND) as the criterion measure. The overall decision agreement between the two measures in identifying DCD was .64. The DCDQ had a sensitivity of .55 and a specificity of .74. The low sensitivity suggests that many children with DCD are not being identified by the DCDQ despite the inclusion of children with a suspect score on the DCDQ. As a screening tool, the DCDQ was accurate in identifying children with moderate or severe DCD but identified less than half of the children with mild DCD

Australian Aboriginal perspectives of attention deficit hyperactivity disorder

[Extract] The diagnosis of attention deficit hyperactivity disorder (ADHD) has been based on a western concept of health, a concern when considering a non-western culture such as Australian Aboriginal and Torres Strait Islander peoples. The lack of statistical data on the extent of ADHD in the Aboriginal community is another concern, a situation similar to many other mental health problems in the Indigenous population. Furthermore, no Australian studies have mentioned specific information on the prevalence of ADHD in Aboriginal communities. The WA Aboriginal Child Health Survey, however, reported that Aboriginal children had a higher risk of hyperactivity problems (15.8%) when compared to 9.7% for non-Aboriginal children (Zubrick et al., 2005)

Coupling online control and inhibitory systems in children with Developmental Coordination Disorder: Goal-directed reaching

For children with Developmental Coordination Disorder (DCD), the real-time coupling between frontal executive function and online motor control has not been explored despite reported deficits in each domain. The aim of the present study was to investigate how children with DCD enlist online control under task constraints that compel the need for inhibitory control. A total of 129 school children were sampled from mainstream primary schools. Forty-two children who metre search criteria for DCD were compared with 87 typically developing controls on a modified double-jump reaching task. Children within each skill group were divided into three age bands: younger (6–7years), mid-aged (8–9), and older (10–12). Online control was compared between groups as a function of trial type (non-jump, jump, anti-jump). Overall, results showed that while movement times were similar between skill groups under simple task constraints (non-jump), on perturbation (or jump) trials the DCD group were significantly slower than controls and corrected trajectories later. Critically, the DCD group was further disadvantaged by anti-jump trials where inhibitory control was required; however, this effect reduced with age. While coupling online control and executive systems is not well developed in younger and mid-aged children, there is evidence of age-appropriate coupling in older children. Longitudinal data are needed to clarify this intriguing finding. The theoretical and applied implications of these results are discussed

The open abdomen : Part 2 : Management of the open abdomen using temporary abdominal closure

Management of the open abdomen is a complex undertaking, as it not only involves difficult wound healing but also the prevention of many serious local and systemic complications. In this article the different types of temporary wound closure methods and their pros and cons are discussed. It appears from our experience that specific negative-pressure dressings produce the best outcomes with regard to morbidity and mortality, as they are adapted to address the particular needs of different grades of open abdomen.http://www.woundhealingsa.co.za/index.php/WHS

A Clinical Investigation of Motivation to Change Standards and Cognitions about Failure in Perfectionism

Background: Clinical perfectionism is a transdiagnostic process that has been found to maintain eating disorders, anxiety disorders and depression. Cognitive behavioural models explaining the maintenance of clinical perfectionism emphasize the contribution of dichotomous thinking and resetting standards higher following both success and failure in meeting their goals. There has been a paucity of research examining the predictions of the models and motivation to change perfectionism. Motivation to change is important as individuals with clinical perfectionism often report many perceived benefits of their perfectionism; they are, therefore, likely to be ambivalent regarding changing perfectionism. Aims: The aim was to compare qualitative responses regarding questions about motivation to change standards and cognitions regarding failure to meet a personal standard in two contrasting groups with high and low negative perfectionism. Negative perfectionism refers to concern over not meeting personal standards. Method: A clinical group with a range of axis 1 diagnoses who were elevated on negative perfectionism were compared to a group of athletes who were low on negative perfectionism. Results: Results indicated that the clinical group perceived many negative consequences of their perfectionism. They also, however, reported numerous benefits and the majority stated that they would prefer not to change their perfectionism. The clinical group also reported dichotomous thinking and preferring to either keep standards the same or reset standards higher following failure, whilst the athlete group reported they would keep standards the same or set them lower. Conclusions: The findings support predictions of the cognitive behavioural model of clinical perfectionism