How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism?

Background: The objective of this study is to identify intact and deficient cognitive processes in children with attention deficit hyperactivity disorder (ADHD) and children with high functioning autism (HFA). Method: Three rigorously diagnosed groups of children aged between 6 and 12 years (54 ADHD, 41 HFA, and 41 normal controls) were tested on a wide range of tasks related to five major domains of executive functioning (EF): inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. In addition, the role of comorbid oppositional defiant disorder (ODD) and comorbid conduct disorder (CD) in ADHD was investigated by directly comparing 20 children with ADHD and 34 children with comorbid ADHD + ODD/CD. Results: ADHD was associated with EF deficits in inhibiting a prepotent response and verbal fluency. Children with HFA demonstrated deficits in all EF domains, except interference control and working memory. The HFA group showed more difficulties than the ADHD group with planning and cognitive flexibility. The comorbid ADHD + ODD/CD group did not show a distinctive pattern of performance on the EF tests compared to the ADHD group. Conclusion: The present study indicates that children with HFA exhibit more generalised and profound problems with EF tasks compared to children with ADHD. © Association for Child Psychology and Psychiatry, 2004

Neuropsychological Assessment Using Virtual Environments: Enhanced Assessment Technology for Improved Ecological Validity

Abstract. Although today’s neuropsychological assessment procedures are widely used, neuropsychologists have been slow to embrace technological advancements. Two essential limitations have resulted from this refusal of techno-logical adaptation: First, current neuropsychological assessment procedures repre-sent a technology that has barely changed since the first scales were developed in the early 1900s. Second, while the historical purpose of clinical neuropsychology was differential diagnosis of brain pathology, technological advances in other clinical neurosciences have changed the neuropsychologist’s role to that of mak-ing ecologically valid predictions about the impact of a given patient’s neurocog-nitive abilities and disabilities on everyday functioning. After a brief discussion of current applications of computer-based neuropsychological assessment, there is a discussion of an increasingly important topic in recent decades—the design of ecologically valid neuropsychological instruments to address real world out-comes. Finally, there is an exploration of virtual reality environments for ecologi-cally valid neuropsychological assessments that make use of current technological advances. It is concluded that a future possible virtual reality-based neuropsy-chological assessment battery will combine the control and rigor of technologi-cally advanced computerized laboratory measures, the psychometric rigor (i.e., veridicality) of traditional paper-and-pencil assessments, and verisimilitude ap-proximating real life situations.