Browsing by Subject "Attention-deficit hyperactivity disorder"
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Item Analysis of the caudate nucleus and attention in children with 18q- treated with growth hormone(2006) More, Susannah Jaeger; Semrud-Clikeman, MargaretThis study investigated the caudate nucleus, attention, and externalizing problems in children with 18q- before and after growth hormone (GH) treatment. Children with 18q- were referred for participation in this study by the Chromosome 18 Clinical Research Center. Thirteen participants with 18q- and 12 controls participated in the study. Volumetric analysis of the caudate nucleus using MRI revealed no significant differences in caudate volume and asymmetry among the 18q- participants pre and post treatment and controls. The 18q- participants and controls showed caudate symmetry (L = R), which is contrary to the L > R asymmetry expected in controls and post growth hormone participants. The 18q- participants, pre and post treatment, showed greater attention problems, although mild, than the control group. There was no difference in externalizing problems among the groups. No change in behavioral functioning with GH treatment was found in the 18q- participants. Caudate volumes were found to decrease with age in controls, but this age-related decrease was not observed in 18q- participants. This finding suggests a disruption in the neural system that likely has functional implications requiring further investigation. Results of this study will contribute to a greater understanding of the relationship between brain morphology and cognitive and behavioral functioning in 18q-.Item Attention-deficit/hyperactivity disorder (ADHD) symptoms and academic performance among undergraduates : the combined influence of deficiencies in academic coping and executive functioning(2007-12) Mosko, Orion Amadeus, 1974-; Tucker, David M., 1953-; Holahan, Charles J.Current findings indicate that the symptom clusters of inattention and hyperactivity-impulsivity, the primary behavioral characteristics of AttentionDeficit/Hyperactivity Disorder (ADHD), serve as risk factors for reduced academic performance in postsecondary educational settings. The proposed investigation is designed to clarify the extent and mechanisms through which these associated symptoms clusters predict reduced academic performance in an undergraduate sample. This investigation tests four hypotheses: (a) ADHD symptoms predict inversely undergraduates' academic performance; (b) deficiencies in academic coping partially mediate the relationship between undergraduates' ADHD symptoms and academic performance; (c) deficiencies in undergraduates' executive functioning partially mediate the association between students' ADHD symptoms and their academic coping; and (d) the predictive association between students' ADHD symptoms and academic performance is more fully explained by their level of academic coping and executive functioning. To achieve these goals, 111 undergraduates from The University of Texas with variable levels of ADHD symptoms were recruited for participation in this study. Participants' academic performance (i.e., concurrent and cumulative semester grade point average, number of problem credit hours, and number of completed credit hours) will be compared to their level of self-reported ADHD symptoms (i.e., current and childhood ADHD symptoms). The hypothesized mediating effect of academic coping on this relationship was evaluated using two questionnaires of academic coping that separately assess students' general academic coping strategies and more specific academic coping behaviors. Further, the anticipated mediating effect of executive functioning on the relation between ADHD symptoms and academic coping was investigated using two neuropsychological tests of attentional control and planful problem solving. Results did not support the proposed model although several study hypotheses received partial support. A data-derived alternative explanatory model is presented and clinical implications are discussed.Item Cognitive and memory performance patterns associated with ADHD subtypes(2004) O'Donnell, Louise; Semrud-Clikeman, MargaretThis study investigated whether there were unique cognitive and memory patterns attributable to Attention Deficit Hyperactivity Disorder Combined or Inattentive subtypes (ADHD C or ADHD-I) or whether the patterns were common to ADHD regardless of subtype. Children ages 8-16 diagnosed with ADHD-C (n= 26) and children diagnosed with ADHD-I (n=30) formed the two clinical groups, and 31 non-clinical children served as control participants. The areas of neurocognitive functioning investigated included verbal working memory, verbal short-term memory, verbal organization and effort, sustained visual attention, and visual processing speed This study did not find verbal working deficits in the ADHD-C group using the WISC-III Arithmetic and Digit Span backwards portion of Digit Span as a working memory task. As predicted, no differences in short-term verbal memory were found, suggesting that children with ADHD regardless of subtype do not have difficulties with encoding verbally presented material. Children with ADHD did not evidence difficulties relative to controls on a CVLT-C learning task. However because the construct validity of the CVLT-C as a measure of executive function is unclear, the finding of no differences in verbal working memory performance across groups may reflect instrumentation error rather than reflect the true absence of group differences. The hypothesis that children with ADHD-C would evidence significantly more errors of commission, have elevated response risk-taking and less perceptual sensitivity to the task on the CCPT than children with ADHD-I and controls was not confirmed. While children with ADHD-C did have significantly fewer correct hits when compared with controls, their performance did not differ significantly from children with ADHD-I. Children with ADHD-I evidenced significantly more errors of omission and had significantly fewer correct hits compared with controls. A unique finding of this study was that severity of inattentive symptoms was significantly related to a restricted risk taking on the CCPT and poorer performance on the WISC-III Coding subtest. These results suggest that when diagnosing ADHD using behavioral checklists, it is important to consider symptom severity as well as the presence or absence of the behavioral symptoms.Item Cognitive processes of inattention in attention deficit hyperactivity disorder subtypes(2003) Booth, Jane Elizabeth; Carlson, Caryn L.The primary objective of this study was to compare and evaluate attention in children with attention deficit hyperactivity disorder, predominantly inattentive (ADHD/IA) and combined (ADHD/C) types and comparison controls on the Attention Networks Test (ANT), a computer task designed to assess cognitive processes of alerting, orienting, and conflict, associated with three anatomically distinct networks of attention. A secondary aim was to examine the utility of sluggish cognitive tempo (SCT) as a classification variable for identifying a more cognitively homogeneous subgroup of children with ADHD/IA. Performance results on the ANT demonstrated an attentional distinction between the subtypes, a greater alerting effect ADHD/IA relative to ADHD/C groups. This finding suggests that the cognitive functioning of ADHD subtypes can be distinguished by the efficiency of the alerting network of attention. Groups did not differ on measures of orienting or conflict. Findings for the utility of SCT as a classification variable in this sample were mixed. Several items presumed to measure this construct did not distinguish between the ADHD subtypes. High SCT in ADHD/IA, as determined by scores on a two-item composite, was associated with slower task performance and a greater alerting effect, though these effects were nonsignificant and small. Results provide support for the neurocognitive distinction of ADHD/IA and ADHD/C subtypes and suggest further consideration of SCT symptoms in subtype classification.Item Comparison of children with and without ADHD on measures of neurocognitive ability and androgen exposure(2007) Westhafer, John Gregory, 1969-; Carlson, Caryn L.; McFadden, Dennis, 1940-Boys with Attention-Deficit/Hyperactivity Disorder (ADHD) were recruited from a local neuropsychology office with controls recruited from the community to assess the relationship between prenatal androgen exposure and ADHD, as well as the possible cognitive correlates of this exposure. Putative physiological markers of prenatal androgen exposure that were measured for each child included several types of otoacoustic emissions (OAEs) as well as finger-length ratios (FLRs). Neurocognitive measures included tasks which assessed components of attention, general intelligence, reading ability, and visuospatial skills. Several other variables which may also be related to androgen exposure were included (e.g., sleep disturbance, handedness, number of older brothers) in the analyses. Children ranged in age from 7 to 12 years old with 13 controls, 19 children with ADHD/Combined Type (ADHD/C), 10 with ADHD/Inattentive Type (ADHD/IA), and an additional 11 children with ADHD/IA who were rated by their parents as having relatively high levels of an experimental construct (sluggish cognitive tempo; SCT). Because more boys than girls are diagnosed with ADHD, it was hypothesized that ADHD may be associated with prenatal masculinizing hormones (i.e., androgens), and that children with ADHD would appear more masculine on markers of androgen exposure (OAEs and FLRs) than controls. However, in our current study children with ADHD did not differ from controls on these measures. There was some evidence that children with SCT may represent a more homogenous group of children within the ADHD/IA diagnostic group, and that they may share a deficit in alerting attention. Consistent with theories suggesting subtype differences in attention, children with ADHD/C did not appear to have a deficit in alerting attention, but rather appeared more cognitively impulsive and to have a deficit in auditory attention. Children with SCT were more likely to be rated by their parents as having disrupted sleep.Item Different time course of negative priming in the subtypes of ADHD(2005) Shin, Misung; Carlson, Caryn L.Item Executive functioning : a way to differentiate ADHD/C from ADHD/PI(2008-08) Walkowiak, Jenifer Lin, 1977-; Semrud-Clikeman, Margaret; Keith, Timothy, 1952-ADHD is a childhood onset disorder with the cardinal features of inattention, impulsivity, and hyperactivity. Research has verified the validity of two subtypes of ADHD, Inattentive type (ADHD/PI) and Combined type (ADHD/C), which have unique differences in behavioral, emotional, and social impairment. The question remains, however, as to whether the ADHD subtypes actually represent two separate and distinct disorders. Results from studies examining executive functioning ability in ADHD have provided inconsistent and confusing results; however, several studies have shown poorer performance on certain measures of executive function for children with ADHD. Additional research on ADHD suggests that ADHD/PI and ADHD/C may have specific executive functioning deficits. The majority of previous research exploring the executive functioning deficits of ADHD has focused on ADHD/C or has neglected to differentiate between the subtypes, resulting in limited or inconsistent findings. Thus, the exact relationship between executive functioning and the ADHD subtypes is understudied and unclear. This study attempted to identify the differential patterns in the executive functioning of children with ADHD by subtype. Using executive functioning tasks of inhibition, planning, and working memory, this study sought to determine whether children with ADHD/C and ADHD/PI displayed unique patterns of executive functioning. Participants included 60 children aged 8-15 years who were classified into three groups: ADHD/C, ADHD/PI, and control. Results from this study revealed significantly poorer performance by the ADHD subtypes on a task of inhibition. Although analyses using the remaining tasks indicated subtype differences on planning, working memory, and inhibition/ cognitive flexibility tasks, these results were not statistically significant. Results are consistent with previous research which has also detected performance differences by the ADHD subtypes on executive functioning tasks; however, not at the clinically significant level. Analyses examining symptom severity indicated a relation between inattentive symptoms and executive functioning performance. Thus, further exploration into executive functioning within the ADHD subtypes is needed for the clarification of the neuropsychological similarities and differences of these two ADHD subtypes. Such research could assist in the establishment of effective interventions and assessment tools to aid in the earlier and more accurate identification of children with ADHD.Item An exploratory study of the implementation and teacher outcomes of a program to train elementary educators about ADHD in the schools(2004) Niznik, Marina Enrica; Tharinger, Deborah; Borich, Gary D.This study explored the implementation and outcomes of a district-wide teacher inservice training program on Attention-Deficit/Hyperactivity Disorder (ADHD). Outcomes with regard to teacher knowledge about ADHD, perceived teacher confidence in working with students with ADHD, and teacher attitudes toward mainstreaming students with ADHD were investigated. Teacher efficacy was also examined. Theoretical linkages among the aforementioned constructs were explored and participant satisfaction with the inservice program was assessed. Participants, elementary school teachers (N=47), responded to several self-report measures prior to, and immediately following, the presented inservice training program. One multiple-choice measure, the Educator ADHD Knowledge Form, was utilized, as were several Likert-type scales, including: Perceived Confidence in Working with Students with ADHD, Teacher Attitudes Toward Mainstreaming Students with ADHD, and the Teacher Efficacy Scale. The Demographic Information Form was used to solicit information describing the participants. The Participant Satisfaction Form was administered to assess the extent to which the training program met the identified needs of the participants. Teacher outcome results of this study demonstrated that teacher knowledge and teacher perceived confidence in working with students with ADHD significantly improved as a result of the training program. Teacher attitudes toward mainstreaming students with ADHD did not improve. With regard to theoretical linkages, results revealed that teacher perceived confidence in working with students with ADHD was significantly correlated to teacher attitudes toward mainstreaming students with ADHD. Additionally, teacher efficacy was found to be significantly correlated to teacher perceived confidence in working with students with ADHD. Relationships among: teacher efficacy and teacher knowledge about ADHD; teacher efficacy and teacher attitudes toward mainstreaming; teacher knowledge and teacher perceived confidence in working with students with ADHD; were not found to be significant. Results also reflected participant satisfaction with the inservice training program presented on ADHD and the extent to which it met their training needs. Limitations and implications for theory and practice are noted. Suggested future research directions include similarly assessing other school staff, assessing additional effects of the training within the classroom setting, and exploring teacher factors with regard to varying degrees of severity of ADHD among students.Item Fluid reasoning, working memory and written expression of 9 to 14 year old children with attention deficit/hyperactivity disorder(2007) Naidoo, Reshma Babra; Semrud-Clikeman, MargaretAttention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent conditions among school children. Executive function deficits representing difficulties in maintaining an appropriate problem set for the attainment of future goals are reported to be the major deficit in ADHD populations. There is a high rate of co-morbidity of learning disabilities and ADHD, with empirical evidence indicating an association with math and reading difficulties, but there is little research on the written expression of this population. There is a body of emergent research indicating that written expression is mediated by executive function. Written expression is a complex task that is affected by motivation, working memory, cognitive processes and long term memory, factors which are reported to be compromised in ADHD populations. This study evaluated the working memory and fluid reasoning in children with (combined and predominantly inattentive types) and without ADHD. Second, it explored the relationship between working memory and fluid reasoning on written expression in children with and without ADHD. Finally, the possible link between the executive functions of working memory and fluid reasoning, with written expression of children with and without ADHD was examined. The findings of this study indicate that children with the combined type of ADHD had lower written expression and working memory scores compared to children with the inattentive type of ADHD. The results of this study also indicated an association between disinhibition and working memory deficits on written expression performance. This research will serve to contribute to an understanding of the functional impact of ADHD on academic performance. Findings from this study could potentially help with interventions for deficits in written expression among school children.Item Functional significance of corpus callosum anatomy in chronically treated and treatment naïve ADHD(2005) Schnoebelen, Sarah Sue; Semrud-Clikeman, MargaretItem Neuropsychological functioning in subgroups of children with and without social perception deficits and/or hyperactivity/impulsivity(2002-08) Schafer, Vickie Ann, 1972-; Semrud-Clikeman, MargaretItem Rejection sensitivity, self-monitoring, and heterosocial adjustment of young men with attention-deficit/hyperactivity disorder (ADHD)(2004) Canu, William Henry; Carlson, Caryn L.Item The relation between difficulties in empathic responding and reading comprehension performance in children with ADHD: comparisons by subtype(2006) Strassner, Emily Marie; Semrud-Clikeman, MargaretItem The relation between executive functions and written expression in college students with attention deficit hyperactivity disorder(2006) Harder, Lana Lee; Semrud-Clikeman, MargaretAttention deficit hyperactivity disorder (ADHD) is the second most common disability affecting college students today. According to the DSM-IV, ADHD symptoms include a persistent pattern of inattention and/or hyperactivity-impulsivity markedly more frequent and severe than individuals at a comparable level of development. Moreover, ADHD symptoms involve impairment in executive function including planning, organization, inhibition, and integration of cognitive processes. ADHD has been linked to academic difficulty in children, adolescents, and more recently, college students. Written expression is especially important in college as students encounter required courses that involve a major writing component. Because written expression involves many of the neuropsychological abilities compromised for those with ADHD, specifically executive functions, it was hypothesized that college students with ADHD would experience difficulty with educational tasks involving writing. The present study examined the relation between executive function and written expression. Two groups of undergraduate students, aged 19 to 28 years, were recruited. Group one consisted of 31 students diagnosed with ADHD and group two consisted of 27 controls. Four measures of executive function and a measure of written expression were administered. The majority of those ADHD participants on medication went off their medication on the day of the study. A one-way between-groups multivariate analysis of variance (MANOVA) was conducted to investigate differences in executive function and written expression abilities between the ADHD and control groups. No differences were found. A standard multiple regression model including executive function measures, verbal aptitude, and ADHD symptoms was not significant for predicting the SATA Writing Quotient. Exploratory analyses were conducted to examine the individual components of the SATA Writing Quotient. Results showed that the model was not significant for predicting SATA Writing Composition; however, the model was significant for predicting SATA Writing Mechanics. In addition, a measure of inhibition was found to make a statistically significant contribution to the prediction of SATA Writing Mechanics in this model. Findings from the study provide important information about the link between specific executive function abilities and written expression in college students. Limitations of the study and implications for future research and practice are discussed.Item Social perception in children with Attention Deficit / Hyperactivity Disorder: a Rorschach study(2006) Kutz, Alexandra Simone; Semrud-Clikeman, MargaretAttention-Deficit / Hyperactivity Disorder (ADHD) has been long associated with ineffective or inappropriate social interactions and the debate regarding the role of perception in successfully navigating interpersonal interactions is growing. Despite the growing literature in the field of social competence in children with ADHD, few studies have directly examined the role of perception in social interactions regarding children with ADHD. Preliminary evidence suggests that perceptual deficits contribute to the social dysfunction in ADHD/Primarily Inattentive Type (ADHD/PI) whereas production deficits contribute to social dysfunction in ADHD/Combined Type (ADHD/C) (Kaufman, Wilson, Lyle, Semrud-Clikeman, & Young, 2000; Whalen & Henker, 1985; Wheeler & Carlson, 1994). Therefore, the current study was designed to explore the nature of their visual perceptual processes using the Rorschach Inkblot Test to determine the quality of their misinterpretations. It was hypothesized that children with ADHD/PI would demonstrate a restricted stimulus field (Pure F%), visual distortion (X-%), and less interest in others (PureH) compared to ADHD/C and control children. It was also hypothesized that children with both ADHD/PI and ADHD/C would demonstrate more interpersonal difficulties (CDI) compared to control children. Fifty-three participants between 8 and 14 years were recruited from a larger study investigating social competence in children with ADHD. Statistical analyses did not reveal statistical significant differences between the groups. However, clinical analyses indicated that children with both subtypes of ADHD experience difficulties effectively navigating their social interactions (CDI) at a clinically meaningful level despite an appropriate interest in others and their social world (Pure H). Clinical findings suggested that, although the underlying mechanism may differ across the subtypes, stimulus field restriction (Pure F%) coupled with stimulus distortion (X-%) contribute to difficulties successfully navigating the complex social world for children with both subtypes of ADHD. Although the current data does not identify differences in visual perceptual processing in children with ADHD/PI and ADHD/C, it is hoped that the study results have provided useful information as to where to intervene in order to help children with both subtypes of ADHD develop more effective social processing skills.