Sensitivity of the test of memory and learning to attention and memory deficits in children with ADHD

Movement Patterns in Students Diagnosed with ADHD, Objective Measurement in a Natural Learning Environment

Attention deficit hyperactivity disorder is the most common neuropsychological disorder in childhood and adolescence, affecting the basic psychological processes involved in learning, social adaptation and affective adjustment. From previous research, the disorder is linked to problems in different areas of development, with deficiencies in psychological processes leading to the development of the most common characteristics of the disorder such as inattention, excess of activity and lack of inhibitory control. As for the diagnosis, in spite of being a very frequent disorder, there are multiple controversies about which tools are the most suitable for evaluation. One of the most widespread tools in the professional field is behavior inventories such as the Strengths and Difficulties Questionnaires for Parents and Teachers or the ADHD Rating Scale-V. The main disadvantage of these assessment tools is that they do not provide an objective observation. For this reason, there are different studies focused on recording objective measures of the subjects' movement, since hyperkinesia is one of the most characteristic symptoms of this disorder. In this sense, we have developed an application that, using a Kinect device, is capable of measuring the movement of the different parts of the body of up to six subjects in the classroom, being a natural context for the student. The main objective of this work is twofold, on the one hand, to investigate whether there are correlations between excessive movement and high scores in the inventories for the diagnosis of ADHD, Rating Scale-V and Strengths and Difficulties Questionnaire (SDQ) and, on the other hand, to determine which sections of the body present the most significant mobility in subjects diagnosed with ADHD. Results show that the control group, composed of neurotypical subjects, presents less kinaesthetic activity than the clinical group diagnosed with ADHD. This indicates that the experimental group presents one of the main characteristics of the disorder. In addition, results also show that practically all the measured body parts present significant differences, being higher in the clinical group, highlighting the head as the joint with the highest effect size.

Assessing Neuropsychological Functions in Middle Childhood: a Narrative Review of Measures and Their Psychometric Properties Across Context

Background

There is a significant number of neuropsychological measures for use among children aged 6–12 years. However, most of these tests have been developed in high-income contexts (HICs). To avoid or to at least to minimize bias in assessment, most researchers carry out cultural adaptations of these tools. In selecting sub-tests to adapt before using the entire test battery, researchers would benefit from having a reference source summarizing available tools and how easily they can be used in different context. This is where the paper makes a contribution. This narrative review has a twofold aim: first, to identify tools commonly used among 6–12-year-olds; second, to summarize the psychometric properties of these tools especially emphasizing their usage across different cultural contexts.

Methods

We searched the literature from 1 January 1987 to 31 December 2017 for tools used among children aged 6 to 12 years. An extensive search of PubMed, Psych Info and Web of Science using the keywords (i) neuropsychological or neurocognitive with (ii) assessment or test was done.

Results

A hundred and forty-five papers out of 306 reported on psychometric properties of different tools including Behavior Rating Inventory of Executive Functioning—BRIEF (count = 6), Visual-Motor Integration—VMI (count = 6), the Test of Memory Malingering—TOMM (count = 6), MSVT (count = 6) and Continuous Performance Tests—CPT (count = 6). Forty-six percent of the papers reported studies conducted in the USA. Most of these studies were based in high-income countries, which further highlights the need to validate these measures for use in lower- and middle-income countries. Psychometric check was adequate in most tests for measuring executive functioning such as BRIEF, although tests such as CPT that measure complex attention had mixed findings. Moreover, we found that these studies addressed certain aspects of validity and or reliability while leaving out others; thus, a comprehensive picture is lacking.

Conclusion

We propose further studies to thoroughly investigate and report the psychometric properties of these measures, especially in lower- and middle-income countries.

Comparative analysis of the WISC-IV in a clinical setting: ADHD vs. non-ADHD

BACKGROUND

The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is a useful tool for revealing differences in cognitive ability. Using the WISC-IV, the study investigated the intelligence profile of Turkish children diagnosed with ADHD and compared their profile with that of a non-ADHD clinical sample.

METHOD

On the basis of the records of 257 drug-naïve patients (6-12years of age), ADHD (n=154) and non-ADHD (n=103) clinical groups were compared with respect to sociodemographic variables and WISC-IV scores.

RESULTS

The non-ADHD clinical group had higher full scale, index, and subtest scores, except for their scores in the Comprehension subtest. The scores on Working Memory, Processing Speed Indices, Similarities, and Matrix Reasoning subtests were especially lower in the ADHD group than in the non-ADHD group. The Similarities, Matrix Reasoning, and Digit Span subtests classified 83% of the children as having ADHD and identified 43.7% of the non-ADHD clinical controls.

CONCLUSION

In our study, we found differences in the WISC-IV profiles of the Turkish patients with ADHD. Moreover, the WISC-IV profile of the non-ADHD clinical group was different than that of the ADHD group. More prospective studies with larger groups of ADHD patients and further evaluations of executive function deficits can help clinicians better understand the differences in WISC-IV profiles.

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents. People who have this disorder are characterized by presenting difficulties in the processes of sustained attention, being very active, and having poor control of their impulses. Despite the high prevalence of this disorder and the existence of various tests used for its diagnosis, few data are available regarding the usefulness and diagnostic validity of these tools. Given the difficulties that these subjects present in executive functions, the aim of this study was to evaluate whether the Neuropsychological Assessment of Executive Functions battery for Children (ENFEN, for its acronym in Spanish, Portellano et al., 2009) allows to establish specific profiles of executive performance for people with attention-deficit hyperactivity disorder (ADHD). The sample was made up of 197 participants of both sexes, aged between 6 and 12 years age (134 with a clinical diagnosis and 63 without pathology). A nonexperimental design was followed, using a comparative descriptive study method. The results indicated that the scales of phonological fluency, color path, rings, and interference are the most associated with the diagnosis of ADHD, providing data on inhibition, mental flexibility, sustained and selective attention, planning, verbal fluency, and working memory, among others. The practical implication of these results is in line with providing support in the clinical diagnosis that is carried out in children's mental health units. In addition, the ENFEN tool can be valued as a suitable psychometric instrument in the psychoeducational field, helping professionals in a school environment to be more aware of the areas of cognitive development in which a student diagnosed with ADHD will have more difficulties and, in doing so, providing more adjusted and effective psychopedagogical measures when it comes to supporting students in their adaptation to the school environment.

WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD

OBJECTIVE

The current study investigated the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) cluster profiles of children with ADHD to examine the association between IQ profiles and diagnostic frequency, symptomatology, and outcome in this population.

METHOD

Hierarchical cluster analysis was conducted on 189 children with a diagnosis of ADHD-inattentive (ADHD-I) and ADHD-combined (ADHD-C) subtypes. Clusters were then compared across symptom rating scale factor scores, behavioral rating scales, and achievement scores.

RESULTS

A five-cluster solution was extracted. One cluster was identified to have reduced processing speed relative to other WISC-IV indexes and significantly higher ratings of inattention and incidence of ADHD-I diagnosis. A second cluster had impairments in processing speed and working memory and was associated with impaired behavioral functioning.

CONCLUSION

Findings support a relationship between reduced processing speed and inattention and provide evidence that WISC-IV profiles may be helpful in predicting symptomatology and outcome in children with ADHD.

Assessment of the learning curve from the California Verbal Learning Test-Children's Version with the first-order system transfer function

A mathematical model is proposed to measure the learning curve in the California Verbal Learning Test-Children's Version. The model is based on the first-order system transfer function in the form Y = B3*exp[-B2*(X-1)]+B4*{1-exp[-B2*(X-1)]}, where X is the trial number, Y is the number of recalled correct words, B2 is the learning rate, B3 is interpreted as readiness to learn and B4 as the ability to learn. Children's readiness to learn and ability to learn were lower than adults. Modeling revealed that girls had greater readiness to learn and ability to learn than boys.

Memory functioning in children and adolescents with autism

OBJECTIVE

Memory functioning in children and adolescents ages 5-19 with autism (n = 50) and typically developing controls (n = 36) was assessed using a clinical assessment battery, the Test of Memory and Learning (TOMAL).

METHOD

Participant groups were statistically comparable in age, nonverbal IQ, handedness, and head circumference, and were administered the TOMAL.

RESULTS

Test performance on the TOMAL demonstrated broad differences in memory functioning in the autism group, across multiple task formats, including verbal and nonverbal, immediate and delayed, attention and concentration, sequential recall, free recall, associative recall, and multiple-trial learning memory. All index and nearly all subtest differences remained significant even after comparing a subset of the autism group (n = 36) and controls that were matched for verbal IQ (p > .05). However, retention of previously remembered information after a delay was similar in autism and controls.

CONCLUSIONS

These findings indicate that performance on measures of episodic memory is broadly reduced in autism, and support the conclusion that information encoding and organization, possibly due to inefficient cognitive processing strategies, rather than storage and retrieval, are the primary factors that limit memory performance in autism.