Browsing by Subject "ADHD"
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Item A Case Study of the College Experiences of a Mexican-American Student with Attention Deficit Hyperactive Disorder: A Conversation between Mother and Son(2013-08-30) Carrillo, Alicia A.The purpose of this study was to conduct an in-depth look into the perceptions of the college experiences of a male, Mexican-American student with Attention Deficit Hyperactivity Disorder to add his voice to the literature. For the methodology, I followed a qualitative case study framework. The main participant in this study, chosen by purposive sampling, was my son. I served as the second participant. The primary method for data collection occurred through open-ended interviews. Additionally, educational and medical records and my own journal reflections were also included as data. Results of my study revealed four themes that included: (a) the pervasiveness of ADHD through years of education, (b) external and internal barriers in postsecondary education, (c) a desire to be like everybody else, and (d) teacher attitudes. I found that Juan faced internal and external barriers because of the ADHD which was complicated by a co-existing learning disability in math. This caused tremendous challenges for Juan when he was faced with teachers who were unwilling to accommodate their instruction for him. My study adds to the body of research that points to the benefit that students with disabilities can receive from instruction on self-determination skills as part of their high school curriculum. Additionally, the college systems developed to serve students with disabilities in higher education served to hamper this student?s success by requiring him to continually prove that his disability exists.Item Attention-deficit / hyperactivity disorder: teacher knowledge and referral for assessment(Texas A&M University, 2006-10-30) Macey, Katherine DeGeorgeAttention-Deficit / Hyperactivity Disorder (ADHD) continues to be one of the most commonly diagnosed disorders in school-aged children As teachers are important gatekeepers for referring students who are in need of special services or classroom modifications, understanding what teachers know about ADHD and the factors that may lead to referral are important. First, the present study examined whether or not teachers were sensitive to academic achievement when making special education referrals. Second, the present study also examined if teachers could differentiate between ADHD behaviors and non-ADHD behaviors. Third, it examined the role of general teaching self-efficacy and self-efficacy related to teaching students with ADHD in making referrals and fourth, what are the sources of information teacher access for information about ADHD.Item Combined factor analysis of the WISC-III and CMS: does the resulting factor structure discriminate among children with and without clinical disorders?(Texas A&M University, 2006-10-30) Siekierski, Becky MayesThe Wechsler Intelligence Scale for Children ?????? Third Edition (WISC-III; Wechsler, 1991) and the Children??????s Memory Scale (CMS; Cohen, 1997) are frequently used measures of children??????s cognitive ability and memory, respectively. They are often used together to assess a child??????s strengths and weaknesses to individualize recommendations for assisting them in the educational setting. However, research suggests that there may be some overlap in the abilities assessed by these instruments, making complete administration of both somewhat redundant. Furthermore, previous studies have been equivocal with regard to the assessment of children with Attention- Deficit/ Hyperactivity Disorder (ADHD) on the WISC-III. Support for the applicability of the four-factor structure of the WISC-III has been questioned, particularly in terms of its utility in the diagnosis of ADHD based on the Freedom from Distractibility Index (FFD). A combined confirmatory factor analysis was conducted on the WISC-III and CMS to determine whether a combination of their subtests could be used in lieu of complete administration of each test. The combined WISC-III/ CMS standardization sample was obtained from the Psychological Corporation for use in the confirmatory factor analyses. One-, six-, and seven-factor models were initially proposed for the analyses. Results of the combined confirmatory factor analyses indicated that all three models failed to fit the data as well as a new five-factor model that was created during modification of the six-factor model. Once the five-factor model was specified as the most appropriate model, a clinical sample from a research study was analyzed on the model to find out whether there were age and gender performance differences and also to determine how accurately the new factors differentiated between clinical and nonclinical subsamples. Results indicated that males and females performed significantly differently on the Processing Speed factor but there were no age differences. There were significant differences between the ADHD and no diagnosis groups on three factors: Verbal Comprehension, Working Memory, and Processing Speed; there were no differences on the factors between ADHD subtypes. Together, the five factors were able to correctly classify 66% of children with ADHD. Implications of these results are discussed and suggestions for future research are provided.Item Diagnosis and Assessment of Adult Attention Deficit Hyperactivity Disorder: Symptom Severity and Performance on Cognitive and Achievement Testing(2014-11-11) Sowell, Morgan MAttention Deficit Hyperactivity Disorder (ADHD) is typically diagnosed in childhood with the individual continuing to exhibit behavioral patterns associated with ADHD throughout their lifespan. Deficits in the ability to inhibit impulse control are a hallmark of ADHD in children and adults. This research study looks at the relationship of a common inhibitory control measure Conners' Continuous Performance Test - II (CCPT-II) and its relationship to self and observer reports of ADHD symptoms, cognitive ability, and achievement scores. This study included 103 adult male and female individuals who were found to meet DSM-IV-TR criteria for ADHD through full individual assessments conducted at a doctoral training clinic located at a major university. Results of this study do not indicate a strong relationship between the CCPT-II and behavior rating scales, cognitive ability, and achievement. This study did find that self-report of ADHD behaviors related to inattention, memory, and self-concept were associated with achievement scores. It was also found that self and observer reports of ADHD behaviors were highly correlated. Within one area related to impulsivity and emotional regulation, observers were more likely to rate the individual as more severe than the individual rated themselves.Item Dichotomizing spelling errors to examine language and executive function abilities in children at risk of reading failure(2011-08) Kayser, Kimberly Anne; Nussbaum, Nancy; Carlson, Cindy I., 1949-; Allen, Greg; Beretvas, Tasha; Lasater, LisaSubstantial evidence emphasizing the importance of linguistic systems in reading acquisition, as well as emerging literature identifying the contribution of executive function to linguistic-based difficulties, underscores the importance of clarifying the neurocognitive mechanisms affecting reading performance. Research demonstrating the interrelationship between reading and spelling, coupled with neurocognitive theories of spelling, suggests that analysis of children’s spelling attempts may capture more subtle differences in their understanding of how to decode text. This study aimed to determine the utility of applying a spelling error analysis system as a method for differentiating between reading difficulties resulting from executive dysfunction or language deficits in a sample of children at risk for reading failure. The present study examined the relationship between executive function, language, and spelling achievement in a sample of 82 children aged 6-15 years identified as having a reading deficit and/or diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Hierarchical regression analyses indicated language-based skills, particularly word reading, and age significantly predicted the phonemic equivalency of misspellings. Tasks of executive functioning were not found to significantly contribute to performance on phonological spelling; however, analysis of group differences suggest that ADHD and Reading Deficit groups demonstrated unique cognitive profiles, including distinct performances on executive functioning tasks. Exploratory analyses also revealed that ADHD and Reading Deficit groups differed significantly in phonological spelling performance. Results from the current study provide evidence for the presence of two distinct underlying cognitive processes affecting spelling and, in effect, reading. Current findings have implications for the need to further examine characteristic deficits in language and executive functioning affecting children at risk for reading failure. Findings also provide support for the validity of further investigating the potential to infer differential diagnostic categories using a phonological spelling analysis. The use of an analysis of spelling errors as a diagnostic data source holds promise for a better understanding of reading failure and, ultimately, may contribute to more effective intervention practices.Item Differentiation in the foreign language classroom : including students with disabilities in secondary foreign language classes(2015-05) Trawick, Jessie Elisabeth; Horwitz, Elaine Kolker, 1950-; Tackett, Kathryn KlinglerForeign language teachers are not generally given information about how to work with students with disabilities. However, it is important for these students to have access to FL classes, both for the cognitive benefits that they offer and for path to higher education. This report offers my reflections on how to differentiate instruction in foreign language reading and writing to students with disabilities as well as typically developing students. I believe that both groups will benefit from the practices I describe here.Item Does time perception underlie delay discounting?(2013-08) Berman, Rachel Elisabeth; Tucker, David M., 1953-; Carlson, Caryn L.Delay discounting, the belief that rewards decline in value over time, is a phenomenon observed in several clinical disorders, including Attention Deficit / Hyperactivity Disorder (ADHD), substance abuse disorders, and other impulse control disorders. Delay discounting behavior is characterized by a tendency to choose smaller, more immediate rewards over larger, more delayed rewards. This tendency has been associated with behavioral impulsivity and inability to delay gratification observed in the aforementioned clinical disorders. It has been suggested that time perception may be a salient feature of delay discounting. If the larger, longer-term reward is perceived as being more temporally remote, its relative value decreases and is associated with greater cost, and one becomes more likely to choose the more immediate reward over the longer-term (though optimal) choice. Time perception has been studied in clinical populations, with increased variability of responses as well as both under-production and overestimation of time intervals observed in those with ADHD and other disorders associated with impulsivity. The present study used informational feedback via a metronome to change belief regarding duration of a second--either increasing or decreasing it by approximately 20%. Participants were 132 college-aged students with and without a diagnosis of ADHD. Measures of impulsivity and ADHD symptomatology were collected as well, and participants completed several cognitive tasks measuring working memory and processing speed to explore the impacts of these measures on delay discounting and time perception. While participants were able to reliably incorporate the altered second belief into short estimations of time (i.e., less than a minute), the manipulation failed to generalize to longer-duration temporal estimations, and it did not affect delay discounting. Neither ADHD symptomatology, impulsivity, nor performance on the cognitive tasks were related to delay discounting behaviors, though a working memory measure was correlated with baseline (pre-manipulation) time and one longer duration estimation. This lends support to a relationship between working memory and temporal perception, though the relationship between temporal perception and delay discounting remains elusive. Directions for future studies to clarify the role of temporal processing and ADHD in delay discounting are discussed.Item The effect of internalizing symptomatology on executive functioning performance and processing speed in children with ADHD(2010-08) Christopher, Gina B.; Nussbaum, Nancy; Carlson, Cindy I., 1949-; Keith, Timothy Z.; Sander, Janay B.; Bunner, MelissaAttention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood psychological disorders with prevalence estimates ranging from 3%-7% (APA, 2000) and one of the most thoroughly studied child neurocognitive disorders. Children with ADHD have consistently shown executive functioning and processing speed deficits on a variety of measures (Berlin, Bohlin, Nyberg, & Janols, 2004; Geurts, Verté, Oosterlaan, Roeyers & Sergeant, 2004; Nigg, 1999; Nigg, Blaskey, Huang-Pollock & Rappley, 2002). The research on executive functioning deficits in other childhood disorders has been comparatively lacking. There is some research that suggests that internalizing disorders, such as anxiety and depression, can also have a detrimental effect on certain executive functioning domains (Airaksinen, Larsson, & Forsell, 2005; Christopher, & MacDonald, 2005; Emerson, Mollet, & Harrison, 2005). It is unclear how these internalizing symptoms will impact executive functioning, processing speed and fine motor control in children with ADHD. The purpose of this study is to determine whether the presence of internalizing symptoms impacts the ability of children with ADHD to perform executive functioning, processing speed, and fine motor control tasks. In order to assess this, the predictive ability of gender, ADHD subtype, parent ratings of anxiety, and parent ratings of depression were examined for processing speed, working memory, response inhibition, vigilance and fine motor control tasks. Gender was found to predict differences in working memory, response inhibition and fine motor control. ADHD subtype was found to predict differences in response inhibition. Parent ratings of anxiety were found to interact with ADHD subtype to predict some aspects of vigilance. Parent ratings of anxiety and of depression were found to predict differences in other aspects of vigilance looking across gender and subtype. Finally, teacher ratings of anxiety were found to predict differences in working memory.Item The effect of semantic features on gist and verbatim memory in young adults with language-learning disabilities(2013-05) Blau, Megan Johanna; Sheng, Li, Ph. D.This thesis is an expansion of an ongoing examination of gist and verbatim memory in young adults with language-learning disabilities (LLD) using the DRM paradigm (Deese, 1959; Roediger & McDermott, 1995). This study uses lists based on situation semantic features in addition to DRM lists based on backwards associative strength (BAS), which were categorized as strong-, mid-, and low-BAS (Stadler, Roediger, & McDermott, 1999). Items in each list (e.g., bacon, toast, cereal, muffin) related to a non-presented word (e.g., breakfast): the critical lure (CL). BAS is a measure of the likelihood that a list item will elicit the CL. Thirty young adults participated in this study and were divided into three groups: true LLD, compensated LLD, and typically developing (TD). Participants listened to word lists and verbally recalled the words they remembered hearing. Accurate recall was an indicator of verbatim memory; CL recall was an indicator of gist memory. The true LLD group recalled CL at a significantly higher rate than the other groups in the case of the situation lists; additionally, the compensated LLD group recalled CL for the low-BAS lists at a significantly higher rate than the other groups. These findings suggest that the LLD participants may process semantic information differently or may rely on gist memory to a greater extent than the TD controls. Results also indicated list type differences for both verbatim and gist recalls, supporting the effects of both semantic features and BAS together with other factors.Item Executive function processes: inhibition, working memory, planning and attention in children and youth with Attention Deficit Hyperactivity Disorder(Texas A&M University, 2006-04-12) Wolfe, Monica EileenThis study examines the roles of inhibition, attention, working memory, and planning in youth with and without ADHD. As conceptualized in theories of attention, inhibition, and working memory, difficulties with these executive processes interact to manifest in the behavioral syndrome(s) of ADHD. Barkley (1997) proposed disinhibition as the primary deficit of ADHD. Rapport, Chung, Shore, Denney, & Isaacs, (2000) theorized that ADHD results from a primary deficit in working memory. Mirsky (1987) proposed a model of attention which children with ADHD have deficits in abilities to focus/execute, encode and sustain attention. Posner and Petersen (1990) proposed that three attentional networks are responsible for attentional processes and those children with ADHD have deficits in the vigilance network. To investigate the contributions of inhibition, working memory, attention, and planning in executive dysfunction in children with ADHD, measures were selected from factor analytic studies. Children with ADHD-Combined Type demonstrated poorer inhibition and working memory than children with no diagnosis after controlling for IQ effects. No differences in planning and attention were indicated after controlling for IQ effects. However, a predictive discriminant analysis indicated that none of the executive processes contributed to the prediction of group membership. Given correlational and predictive discriminant analysis results, further analyses were conducted to investigate the contribution of the measures selected for the domains. The theoretical model did not represent a good fit of the data. A three-factor model indicated the best representation suggesting that inhibition and attention were not separable. There were no group differences with the revised measurement model for inhibition/attention, working memory and planning. Taken together, results indicated measures originally selected to tap executive function may not be clean measures of inhibition, working memory, planning, or attention processes. In addition, recently proposed theories overlap and conceptualize the multiple constructs involved in ADHD with a variety of methodologies, further contributing to difficulties in interpreting results and measurement issues.Item Gender and ethnicity referral bias for ADHD: the school's view(Texas A&M University, 2006-10-30) Rollins, Dahl AnnetteIn school, all children at some time have been disruptive; however, there are a select few who are continually disruptive and identified by school personnel as those who may have a disruptive behavior disorder such as ADHD. Many times these children are boys and of a minority group (Root & Resnick, 2003). Information collected from school teachers and parents most often provides the basis for diagnosing ADHD, whether reliable or objective. The purpose of the study was to investigate any differences in the way in which teachers respond to behavioral difficulties associated with ADHD for African American girls and boys as compared to White girls and boys, with control for SES and perceived school climate as potential confounds. These results are promising in that teachers?????? responses suggest similarity in perceptions of children??????s behavior regardless of children??????s socioeconomic status, gender and ethnicity. The results indicated that a significant difference exists in that teachers would talk to the counselor about the child??????s behavior based on the child??????s ethnicity, gender, and SES. When controlling for school climate, there was a significant difference in teacher responses to unusualness of inattention, which indicated that the better the school climate, the more unusual the inattention was perceived. Also, results indicated that the teacher??????s ethnicity and/or ethnicity and gender affected how they perceived the child??????s behavior.Item Health-Related Quality of Life and Family Impact in Children with Attention-Deficit/Hyperactivity Disorder and Co-Morbid Psychiatric Conditions(2011-08-08) Limbers, Christine AshleyAttention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent chronic disorders in childhood. The measurement of health-related quality of life (HRQOL) can compliment ADHD behavior rating scales and provide a more comprehensive understanding of the impact of ADHD and its treatment on the child's overall daily functioning and well-being. The purpose of the current study was to assess HRQOL from the perspective of pediatric patient self-report and parent proxy-report and family impact from the perspective of parents in children with ADHD ages 5 to 18 years being seen at a Pediatric Psychiatric Clinic utilizing the PedsQL(TM) 4.0 Generic Core Scales and Family Impact Module. For all PedsQL(TM) 4.0 Generic Core Scales, pediatric patients with ADHD and their parents reported statistically significant worse HRQOL than healthy children, with large effect sizes across all domains. More impaired generic HRQOL was significantly correlated with more severe ADHD symptoms as measured by the NICHQ Vanderbilt Total ADHD Symptom Score for parent proxy-report but not child self-report. More impaired family functioning was significantly correlated with more severe ADHD symptoms. Intraclass Correlations (ICC) between pediatric patient self-report and parent proxy-report across the PedsQL(TM) 4.0 Generic Core Scales were in the poor to fair agreement range. These findings have implications for future research and clinical practice with pediatric patients with ADHD and co-morbid psychiatric conditions and their families. Given the large effect sizes reported between the present sample and healthy children across all HRQOL domains, it is important that interventions designed for children with ADHD and co-morbid psychiatric conditions not only address psychosocial difficulties, but also the physical impairments that may result from medications and/or co-morbid psychiatric diagnoses such as anxiety or depression. Given our finding that greater ADHD symptomatology was significantly associated with greater negative family impact, interventions for this population should focus on mitigating the negative impact of ADHD and co-morbid psychiatric conditions on families, particularly related to the areas of parental worry, family relationships, and daily family activities.Item Listening comprehension difficulties in children with co-occurring language impairment and ADHD(2011-05) Shaw, Whitney Nicole; Bedore, Lisa M.; Pena, ElizabethThe purpose of this report is to explore whether listening comprehension difficulties are due to receptive language impairment or attention deficits in school-age children. This evidence-based practice brief analyzes research within this population and gives suggestions on clinical implications for practicing speech-language pathologists related to intervention. Results show that listening comprehension is impaired in children whether or not they have co-occurring language impairment. However, ADHD does not further impair a child with a language disorder. Intervention for this population should focus on increasing the child’s understanding of causal connections, making inferences, and effective ways to study.Item Measuring the validity of two continuous performance tests: different parameters and scoring indices(Texas A&M University, 2006-10-30) Homack, Susan RaeToday, there are numerous versions of the continuous performance test (CPT) used in clinical and research settings. Although CPTs may constitute a similar group of tasks with a common paradigm, they are very different in the parameters they measure (Conners, 1995). To learn more about the effects of different CPT versions as well as the numerous scoring indices, two very different CPTs, the Conners?????? Continuous Performance Test-Second Edition (CCPT-II) and the Gordon Diagnostic System (GDS), were compared with a population of children and adolescents exhibiting ADHD and normal controls. Major findings were as follows: (a) the CCPT-II and GDS measures were not able to separate children with ADHD from normal controls; (b) individual variables from neither the CCPT-II nor the GDS were able to adequately differentiate children with ADHD and normal controls; and (c) score profiles obtained from the overall group of children and adolescents did not successfully separate the ADHD group from normal controls using the CCPT-II and GDS.Item The mediating effects of rapid automatized naming on children's inattention symptoms and word-reading ability(2011-05) Smith, Stephen William, 1981-; Keith, Timothy, 1952-; Carlson, Cindy; Nussbaum, Nancy; Sander, Janay; Tucker, DavidAttention Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) are among the most common childhood disorders (American Psychiatric Association, 2000) and co-occur significantly more frequently than expected by chance (Dykman & Ackerman, 1991; Semrud-Clikeman et al., 1992). Similar processing deficits are seen in children with ADHD and children with RD, one of which is rapid automatized naming (RAN) (Denckla & Cutting, 1999). These continuous performance tasks require quick naming of visually represented stimuli. Uncertainty about what RAN actually measures, however, makes drawing conclusions about relations to ADHD and RD difficult (Tannock, 1998). By better understanding the cognitive processes involved in RAN, and how those processes relate to ADHD and RD symptoms, the relations among RAN, ADHD, and RD might be better understood. The current study sought to identify variables that would help explain ADHD and RD children’s difficulty with RAN. Five fundamental, neurocognitive skills were hypothesized to be related to RAN performance, ADHD, and reading disability. The effect of children’s phonological awareness, processing speed, working memory, fine-motor speed, and reaction time on their RAN performances was measured. The extent to which these same variables were related to inattention symptoms severity and word-reading ability was also assessed. Finally, the extent to which RAN mediated the effects of neurocognitive skills on inattention symptoms and word-reading ability was measured. By simultaneously measuring the hypothesized relations among variables, the processing deficits responsible for ADHD and RD children’s problems on RAN may be revealed. Structural equation modeling was used to analyze assessment data (i.e., neurocognitive, RAN, and word-reading performance scores; parent-report of inattention symptoms) of 183 children who received neuropsychological evaluations. Results indicated the following significant direct effects: phonological awareness and working memory on word-reading ability, processing speed and working memory on RAN, and RAN on word-reading ability. A possible significant mediation effect of processing speed on word-reading ability through RAN was also shown. Significant effects of study variables on inattention symptoms were not shown, which limited conclusions about RAN’s relation to ADHD. Results are of practical importance in RD assessment because the relation between RAN and word-reading ability was shown to involve processes beyond phonology.Item Observing relationships between hyperactivity and impulsivity and language performance in typically developing 5-year-olds(2016-05) Reeves, Alison Margaret; Booth, James R.; Sheng, LiThis study seeks to observe connections between hyperactivity/impulsivity or inattention with expressive or receptive language performance in typically developing five year olds. The hypothesis of the study is that higher hyperactivity/impulsivity is related to lower scores in expressive language and higher inattention is related to lower scores in receptive language. The study was performed by comparing results of the Clinical Evaluation of Language Fundamentals - Fifth Edition (CELF-5) with the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) Parent Report. No significant correlations were observed between hyperactivity/impulsivity or inattention with the expressive or receptive composite scores of the CELF-5. However, two CELF-5 subtests, Following Directions and Recalling Sentences, were significantly correlated with inattention, suggesting a relationship with working memory. Future studies may include children who have been diagnosed with ADHD or Specific Language Impairment (SLI) to observe whether or not more salient differences in hyperactivity/impulsivity, inattention, receptive language, or expressive language produce significant correlations between these measures.Item Perplexities in Discrimination of Attention Deficit Hyperactivity Disorder (ADHD): Specific Behaviors that may hold some Answers(2010-07-14) Harrison, Judith R.Attention deficit hyperactivity disorder (ADHD) is a source of diagnostic and intervention confusion and uncertainty for practitioners and parents. Questions creating some of the confusion were answered in a series of three studies. The sample was parent and teacher behavioral ratings for 389 children and 502 adolescents with ADHD and 3131 children and 3161 adolescents without ADHD in public and private schools and mental health clinics in forty states. In the first study, data was derived from participant T-scores on the Behavior Assessment System for Children (2nd ed.) to evaluate the construct validity using first and second order factor analyses. Sufficient construct validity was established. In the second study, descriptive discriminant analyses (DDA) and item level ANOVAs were used to investigate whether behaviors that discriminate between the target (i.e., ADHD) and comparison groups were associated with the primary symptoms, comorbid conditions, functional impairment, or some combination of the three. Analyses were completed using subscale T-scores and individual item scores from the target and comparison groups. Results were compared to determine if the behaviors that discriminated between the groups were consistent across developmental stages and between parents and teachers as raters. Primary symptoms, comorbid conditions, and functional impairment explained the variance as rated by parents and teachers. Primary symptoms were found to be the strongest discriminators of children and adolescents as rated by parents. Atypicality explained the largest variance (72.25%) between children and learning problems explained the largest variance (64.32%) between adolescents when rated by teachers. The third study was a literature review of intervention studies to increase the academic performance of youth with ADHD in light of the statistical significance controversy. Fifty-one single subject and group design studies of academic, behavioral, multimodal and parent training were found. Both sides of the statistical significance controversy were summarized. The method of result reporting for 23 group design studies was investigated. Seventy-seven percent of the studies reported results as ?significant? with 26% reporting effect sizes. Researchers are encouraged to report effect sizes and explicitly compare results to previous studies in order to establish replicability for ease of educator interpretation.Item The relationship between social skills and academic achievement for individuals with ADHD : a literature review and research proposal(2013-05) Lide, Bradley Lanneau; Schallert, Diane L.The following report draws on previous research as a rationale for a proposed study investigating the link between social skills and academic achievement for individuals with attention deficit/hyperactivity disorder (ADHD). The literature lends basis to the hypothesis that social skills may ameliorate the negative outcomes associated with ADHD. ADHD is related to negative outcomes in academic and social domains, including underachievement and exclusion. This is of particular importance because of the prevalence of ADHD and the frequency of social demands. In this report, the literature on academic achievement of individuals with ADHA is reviewed and a study is proposed that would contribute to establishing social skills as a moderator of the relationship between ADHD and academic achievement. Suggestions for other areas of research are also considered.Item Social functioning, social cognition, and executive functioning differences associated with Attention-Deficit/Hyperactivity Disorder subtypes(2012-08) Kerne, Valerie Van Horn; Nussbaum, Nancy; Sherry, Alissa René; McCarthy, Christopher J.; Keith, Timothy Z.; Bunner, Melissa R.ADHD is a well researched disorder in children and is associated with impairments in social functioning (Barkley, 2006). However, little is known about the etiology of social difficulties. An emerging body of literature is beginning to address the possible role social cognition may share in the social functioning outcomes in children with ADHD (Buitelaar et al., 1999; Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002; Sibley et al., 2010; Yuill & Lyon, 2007). Yet, research focusing on social cognition deficits in ADHD that accounts for subtype differences is limited. Some studies evaluated social cognition in CT children only (Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002) while other research utilized behavior ratings or sociometric studies (Matthys et al., 1999; Zentall et al., 2001). Another body of literature has examined the impact executive functioning deficits may have on social functioning (Barkley, 1997; Charman et al., 2001; Chhabildas et al., 2001). The purpose of the current study was to identify factors that predict social functioning impairments in children with ADHD as well as differentiate between ADHD subtypes. Participants included 89 youth with ages ranging from 6 to 16 years (M = 10.19, SD = 2.76). Forty-nine children met the diagnostic criteria for ADHD, Predominantly Inattentive Subtype (PI) and 40 for ADHD, Combined Type (CT). Results indicated CT youth demonstrated more aggressive and rule-breaking behavior than PI youth. Measures of social cognition did not predict ADHD subtype, and when compared to a normative sample, participants performed in the average range on affect recognition and theory of mind tasks. Performance-based measures of executive functioning largely associated with inattention (i.e., vigilance, processing speed, and working memory) best predicted subtype differences with CT youth being more impaired. Executive functioning, not social cognition, was predictive of social maladjustment in CT and PI youth. For CT youth, deficits in emotion control, shift, and initiate were related to anxiety, aggressive behavior, and depressed mood. Similarly, emotion control and shift were predictors of aggressive behavior, anxiety, and depressed mood in PI youth with deficits in self-monitoring, initiate, and inhibit as secondary predictors.Item A study of incidence, prevalence, treatment patterns, healthcare utilization, and costs of treatment of Attention Deficit Hyperactivity Disorder (ADHD) among Texas Medicaid preschoolers(2015-12) Singh, Rakesh Ranjeet; Lawson, Kenneth Allen, 1952-; Barner, Jamie C; Richards, Kristin M; Sasane, Rahul; Wilson, James PAttention Deficit Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder diagnosed in children and adolescents, affecting approximately 11% of children in the United States in 2011. Children are often diagnosed with ADHD before seven years of age. Yet, there is very little information about the diagnoses, treatments, healthcare utilization, and costs associated with ADHD in preschool children. The American Academy of Pediatrics recommends behavioral therapy as the first-line therapy for preschoolers, with a recommendation to prescribe medications only if behavioral therapy is unsuccessful in alleviating ADHD-related symptoms. For children in elementary school, combination therapy is recommended. Thus, the goal of the current study was to assess the epidemiology (i.e., prevalence and incidence), treatment patterns (i.e., adherence, persistence, augmentation, and switching), healthcare utilization, and costs in preschoolers diagnosed with ADHD using the Texas Medicaid dataset. Patients < 6 years of age diagnosed with ADHD (ICD-9 codes 314.00, 314.01) with continuous enrollment for a 6-month pre-index period and a 12-month post-index period between 2008 and 2013 were identified from the Texas Medicaid dataset. Epidemiology estimates were calculated for all the patients < 6 years of age diagnosed with ADHD. Treatment patterns, healthcare utilization, and costs were estimated for patients between 2 – 6 years of age. Based on the study inclusion criteria, we identified 10,877 patients in the overall cohort. A subsample from the overall cohort was selected for inclusion in the treatment pattern cohort (n = 8,833). The index date for the overall cohort was the ADHD diagnosis date. The index date for the treatment pattern cohort was the date of the first ADHD prescription. Prevalence and incidence estimates were calculated for all the patients < 6 years of age. Time-to-initiation, healthcare utilization, and costs were analyzed using the overall cohort. Treatment pattern outcomes (i.e., adherence, persistence, augmentation, and switching) were evaluated using the treatment pattern cohort. The study sample was further subcategorized into pharmacotherapy only, psychotherapy only, and combination therapy groups. The study covariates included patient demographic (i.e., age, gender, race/ethnicity, and urban/rural status), clinical (i.e., other psychotropics, other mental health diagnosis, medication duration of action, and medication class), and prior utilization (i.e., pre-index total costs, pre-index psychiatric visits, and pre-index non-psychiatric visits) characteristics. Bivariate and multivariate analyses were used to analyze the data. The prevalence of ADHD in preschoolers was estimated to be between 2.1% and 8.5% from years 2008 to 2012. Incidence estimates were stable and were estimated to be between 2.4% and 2.1% from years 2009 to 2012. Medication adherence, augmentation, and switching rates were higher in the combination therapy group as compared to the pharmacotherapy group. The combination therapy group had significantly higher healthcare utilization in all resource utilization categories except ADHD-related prescriptions, other mental health-related office-based, and inpatient visits. Similarly, medical, prescription, and total healthcare costs were also significantly higher in the combination therapy group as compared to the pharmacotherapy group except for the other mental health-related medical costs. In summary, the prevalence and incidence of ADHD in preschoolers is significant. Most of the patients received medication therapy followed by combination therapy and psychotherapy. A comparison of treatments revealed that combination therapy group had a higher healthcare burden as compared to the pharmacotherapy group. This study adds to the existing literature regarding ADHD in preschoolers, from a Medicaid perspective. Also, since Texas Medicaid provides coverage for nearly 50% of children in Texas these results have important implication for the state of Texas. The results of the current study will help identify the more important healthcare utilization and cost categories so as to develop a more targeted intervention approach for patients with ADHD. Further research is needed to understand the long-term effects of pharmacotherapy, psychotherapy, and combination therapy in preschoolers. More evidence is needed to identify the best treatment option for the management of ADHD in preschoolers.