Motor control and sequencing of boys with Attention-Deficit/Hyperactivity Disorder (ADHD) during computer game play

The motor control of 49 unmedicated boys clinically diagnosed with ADHD, case‐matched with 49 non‐ADHD boys, was assessed while playing Crash Bandicoot I, a Sony^TM Playstation platform computer video game. In Crash Bandicoot participants control the movements of a small‐animated figure through a hazardous jungle environment. Operationally defined measures of motor control were designated by (1) the stage of the game completed (ie, the number of obstacles successfully passed) before losing the figure's ‘life’, (2) the level of complexity that the stage represented and (3) the time taken to get to that point during the video game play. These measures were assessed under contrasting conditions of low or high working memory and distracter loads. Four tasks were administered (totalling 12 trials), incorporating both with and without distracter conditions. For those trials with the distracter, a segment of the television show The Simpsons was simultaneously played on a television screen adjacent to the computer game monitor. A 5‐way MANOVA revealed that ADHD boys took less time to complete their trials under the direct condition (ie, no working memory load) on Crash Bandicoot, compared to their matched non‐ADHD peers. When the task required additional working memory, however, the ADHD boys took significantly longer. Cumulative frequency plots of game performance revealed that in terms of the number of obstacles completed, the control participants successfully navigated more obstacles on the low working memory load task than the ADHD participants, but that the performance of the two groups was less distinguishable on the high working memory load task. The findings have implications for assessment and management of children with ADHD.     

Deaf children and children with ADHD in the inclusive classroom: working memory matters

This study compared the working memory functioning of deaf children, children with ADHD and typically developing children. Working memory is involved in the storage and mental manipulation of information during classroom learning activities that are crucial for the acquisition of complex skills and knowledge. Thus, it is important to determine how these groups compare in this regard as this has implications for teaching them together in an inclusive classroom. Simple and complex visuo-spatial and verbal working memory were assessed in 24 children with ADHD and 20 control children with no diagnosed ADHD, to determine whether any differences existed between these groups. A second comparison occurred between the simple and complex visuo-spatial working memory of the latter two groups, as well as 24 deaf children, all matched on age, gender and home language. The control group scored significantly higher than the deaf children and the children with ADHD on all components of simple and complex working memory. The implications of this finding are that children with ADHD and deaf children may share similar working memory profiles, making it easier to accommodate both sets of children together in the inclusive classroom. Suggestions are given for how educators could assist these children by reducing the demands on working memory.     

Memory modality differences in children with Attention Deficit Hyperactive Disorder with and without learning disabilities

This study assesses information processing and memory functioning in 50 children diagnosed with Attention Deficit Hyperactive Disorder (ADHD) with and without learning disabilities (LD). Mode of presentation (visual vs. auditory), type of memory processing (immediate, short-term, and long-term), and order of recall (ordered vs. unordered) were assessed using the Learning Efficiency Test-II (LET-II). Both groups demonstrated difficulty with auditory ordered recall and lost substantial information from immediate memory to short-term and long-term memory stores. The ADHD/LD group also demonstrated more difficulty with ordered recall than the ADHD only group. While there were no differences between the two groups in regard to immediate recall, the ADHD/LD group demonstrated more problems transferring information into short-term and long-term memory stores than the ADHD only group. Verbal interference effects significantly decreased retention for both visual and auditory processing. Results indicate that ADHD alone presents significant problems in information processing, but the comorbid effects of a learning disability further intensify the negative impact of ADHD. © 1996 John Wiley & Sons, Inc.     

Verbal skills in children with ADHD

The present study examined whether ADHD children exhibit low verbal IQ (VIQ) and distinguishable test profile on the Verbal comprehension (VC) and Freedom from distractibility (FFD) factors, and whether gender influences their verbal abilities. At the Laboratory of Neuropsychology of the Department of Special Education, University of Thessaly, WISC‐III verbal scales were administered to 69 ADHD children (50 boys and 19 girls) and controls who were matched for age and sex. Mean scores for all WISC‐III verbal scales, VIQ, VC and FFD of ADHD children were significantly lower than controls. FFD was found lower than VC and it correlated statistically significantly with VC in ADHD children. No gender differences were found among ADHD children.     

Sensitivity of Four Subtests of the Test of Everyday Attention for Children (TEA‐Ch) to Stimulant Medication in Children with ADHD

Children with attention deficit hyperactivity disorder (ADHD) were examined on four subtests of the Test of Everyday Attention for Children (TEA‐Ch) when on and off stimulant medication. Performance was assessed relative to 18 individually age‐matched controls. Children with ADHD performed significantly worse on TEA‐Ch measures when off compared to when on stimulant medication. This was found in both predominantly inattentive (n = 6) and combined inattentive and hyperactive‐impulsive (n = 12) subtypes. The age‐matched controls significantly improved with repeated testing on most TEA‐Ch measures. Significant differences were found between the unmedicated children with ADHD and age‐matched controls on sustained attention (Score! and Walk Don’t Walk) and attention control measures (Same and Opposite Worlds). When the ADHD group was on stimulant medication, with the exception of the Walk Don’t Walk subtest, no significant differences were found between them and the age‐matched controls. Unlike the TEA‐Ch subtests, the significant differences between the two groups on the Test of Word Reading Efficiency (TOWRE) subtests remained when attentional status was altered in the children with ADHD. The study supports further investigations of the TEA‐Ch as a measure sensitive to changes in stimulant medication in children with ADHD.     

Visual Attention to and Comprehension of Television in Attention-Deficit Hyperactivity Disordered and Normal Boys

This study examined the effects of distracters on the television viewing of diagnosed ADHD (n = 19) and normal (n = 20) boys who ranged in age from 6 to 12 years. Subjects were videotaped watching four 7-min segments of "3-2-1 Contact," once in the presence and once in the absence of highly appealing toys. The results indicated that, while in the presence of toys, ADHD boys spent one-half as much time as control boys attending to the television. However, when toys were absent, there were no significant differences in visual attention between ADHD and normal boys. The effect of the toy manipulation was most dramatic with younger children of both groups. Recall of didactic content by ADHD boys and normal subjects did not differ significantly, even when the attention of ADHD boys was reduced. These findings suggest that ADHD children, like their normal counterparts, are active and strategic viewers of television.     

Body movements of boys with Attention Deficit Hyperactivity Disorder (ADHD) during computer video game play

The type and severity of body movements exhibited by 79 (unmedicated) boys clinically diagnosed with ADHD (30 Predominantly Inattentive Type and 49 Combined Type), and 67 non-ADHD boys were recorded while playing Crash Bandicoot I, a Sony Playstation platform computer video game. In Crash Bandicoot, participants control the movements of a small animated figure (CB) through a hazardous jungle environment. Two tasks totaling 12 trials were administered, each of which incorporated with and without Distractor conditions. For those trials with the Distractor, a segment of the television show "The Simpsons" was simultaneously played on a television screen adjacent to the computer game monitor and at an equal volume. Contrary to theory and expectations an analysis of the data did not reveal any statistically significant differences in the frequency, type and severity of body movements between the ADHD and non-ADHD boys, or between the ADHD subtypes during computer video game play. These findings have important implications for assessment and teaching processes in both classroom and therapeutic contexts.     

ADHD and reading disability in male adults: is there a connection?

The present study examined the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and reading disability (RD) in male adults. Participants were 120 men, of whom 24 were classified as having ADHD. The basis for the diagnosis was two self-report scales validated by interviews and background data. An extensive battery was used to assess phonological abilities and various aspects of reading skills. No differences were obtained between adults with and without ADHD on measures of either phonological processing skills or word decoding, indicating a low comorbidity with RD. This finding was valid even when different criteria were used to diagnose RD. However, the two groups differed in reading comprehension, with individuals with ADHD performing poorly in tests of reading comprehension. These results are compatible with the view that reading comprehension involves many of the higher cognitive control functions assumed to be impaired in ADHD. However, these attentional control functions are not critical to word recognition, which is determined by a more encapsulated phonological processing module. The pattern of associations between ADHD and RD observed in the present study is explained with reference to the differential attentional demands of the two aspects of reading.     

Role of working memory in explaining the performance of individuals with specific reading comprehension difficulties: A meta-analysis

It is well established that working memory is related to reading comprehension ability. However, its role in explaining specific reading comprehension difficulties is still under debate: the issue mainly concerns whether the contribution of working memory is dependent on task modality (verbal tasks being more predictive than visuo-spatial tasks) and/or on the attentional control implied in working memory tasks (tasks requiring storage/manipulation being more predictive than storage-only tasks, regardless of task modality). Meta-analysis is used here to examine the relevance of several working memory measures in distinguishing between the performance of poor and good comprehenders in relation to the modality of the working memory task, and the involvement of controlled attention required by such a task. Our results demonstrate that memory tasks that are demanding in terms of attentional control and that require verbal information processing are best at distinguishing between poor and good comprehenders, suggesting that both domain-specific factors as well as general factors of working memory contribute to reading comprehension performance. The implications for different models of working memory in relation to reading comprehension are discussed.     

Evidence for unexpected weaknesses in learning in children with attention-deficit/hyperactivity disorder without reading disabilities

This study examined the mechanisms underlying verbal learning in children with and without attention-deficit/hyperactivity disorder (ADHD), none of whom had reading disabilities. Children with ADHD were compared to typically developing children on both process and product scores from the California Verbal Learning Test for Children. The findings indicated that children with ADHD initially learned the same number of words as controls but showed weaknesses recalling the words after delays, suggesting that children with ADHD are less efficient learners. Regardless of ADHD status, boys and girls performed differently. Boys used semantic clustering less frequently and recalled fewer words from the middle region of the list than girls; girls also outperformed boys in terms of overall performance, despite lower verbal IQ scores. These findings show that children with ADHD can exhibit unexpected weaknesses in learning even without a formal learning disability. Gender differences in verbal learning are also illustrated.     

Right hemisphere dysfunction in ADHD: visual hemispatial inattention and clinical subtype

The relationship between right hemisphere dysfunction and attention-deficit/hyperactivity disorder (ADHD) remains controversial. We administered a random letter cancellation test to 58 carefully selected adult patients meeting DSM-IV criteria for ADHD and 29 age- and education-matched controls. Patients with ADHD had a higher mean omission rate on the left side than the controls, and a greater percentage of ADHD patients than controls made more omissions on the left than on the right (L > R errors). ADHD patients who made L > R errors had lower performance IQ scores than ADHD patients who did not make L > R errors. However, ADHD patients who made L > R errors did not differ from ADHD patients who did not make L > R errors in ADHD subtype, medication response, or neuropsychological measures of attention, executive function, verbal memory, nonverbal memory, or academic achievement. Patients without a family history of ADHD were more likely to make L > R errors than patients with a family history of ADHD. This study provides support for the concept of right hemisphere dysfunction in a subset of patients with ADHD. However, ADHD patients who make L > R errors do not appear to represent a distinct clinical subgroup in terms of medication response, ADHD subtype, or neuropsychological test performance.     

Gender,Pair Composition and Computer Versus Paper Presentations of an English Language Task

The aim of the study was to compare the verbal and physical interactions of same-gender pairs and mixed-gender pairs when equivalent tasks were presented on a computer and on paper. Children aged between 13 and 14 years old (24 boys and 24 girls) were placed into either same-gender or mixed-gender pairs and worked on a computer presentation and a paper presentation of an English language task. The main finding of the study was that the children's verbal interactions and manipulation of the physical materials were mediated by the mode of presentation. There were no significant differences between mixed-gender pairs and same-gender pairs in the paper presentation of the task. However, in the mixed-gender computer-based pairs, boys dominated both the amount and type of verbal interaction and the control of the mouse. These findings are explained in terms of gender differences in perceived expertise with computers and theoretical and practical implications are discussed.     

Attention-deficit/hyperactivity disordered and control boys' responses to social success and failure

The behavioral, self-evaluative, and attributional responses of 120 boys with Attention-Deficit/Hyperactivity Disorder (ADHD) and 65 control boys to social success and failure were examined using a dyadic, laboratory get-acquainted task employing child confederates. Objective coders rated boys with ADHD as less socially effective than controls in their interactions, but also as less frustrated and helpless. In terms of self-evaluations, ADHD boys overwhelmingly rated their own performance more favorably than did controls and in some instances, these differences were more apparent following failure. The attributional pattern of ADHD and control boys differed in that ADHD boys were more likely than controls to attribute success to external, uncontrollable factors such as task ease and being lucky; controls, on the other hand, were more likely than ADHD boys to attribute initial failure to not having tried hard enough. Results are discussed in the context of existing literature documenting a positive illusory bias in ADHD boys' self-perceptions.     

Sex differences in object location memory: Some further methodological considerations

Previously it has been reported that female performance on the recall of objects and their locations in a spatial array is superior to that of males. This may reflect underlying information-processing biases whereby males organize information in a self-referential manner while females adopt a more comprehensive approach. The known female advantage in verbal memory may, however, account for this sex difference. In an initial experiment we found no overall sex differences in object or object-location memory. The inclusion of a verbal distracter task revealed gender-congruent biases in performance. A final study examined some methodological issues associated with the design of item arrays. After controlling for differences in item distinctiveness, performance on object-location was found to be substantially influenced by the distance that items were displaced in the array. These findings demonstrate that certain methodological factors can significantly affect the attentional and mnemonic processes that operate when performing tasks of this nature and can negate underlying sex differences in performance.     

Executive impairment determines ADHD medication response: implications for academic achievement

Methylphenidate (MPH) often ameliorates attention-deficit/hyperactivity disorder (ADHD) behavioral dysfunction according to indirect informant reports and rating scales. The standard of care behavioral MPH titration approach seldom includes direct neuropsychological or academic assessment data to determine treatment efficacy. Documenting "cool" executive-working memory (EWM) and "hot" self-regulation (SR) neuropsychological impairments could aid in differential diagnosis of ADHD subtypes and determining cognitive and academic MPH response. In this study, children aged 6 to 16 with ADHD inattentive type (IT; n = 19) and combined type (n = 33)/hyperactive-impulsive type (n = 4) (CT) participated in double-blind placebo-controlled MPH trials with baseline and randomized placebo, low MPH dose, and high MPH dose conditions. EWM/ SR measures and behavior ratings/classroom observations were rank ordered separately across conditions, with nonparametric randomization tests conducted to determine individual MPH response. Participants were subsequently grouped according to their level of cool EWM and hot SR circuit dysfunction. Robust cognitive and behavioral MPH response was achieved for children with significant baseline EWM/SR impairment, yet response was poor for those with adequate EWM/ SR baseline performance. Even for strong MPH responders, the best dose for neuropsychological functioning was typically lower than the best dose for behavior. Findings offer one possible explanation for why long-term academic MPH treatment gains in ADHD have not been realized. Implications for academic achievement and medication titration practices for children with behaviorally diagnosed ADHD will be discussed.     

Developmental and individual differences in children's on-line representations of dynamic social events

Developmental and clinical differences in children's on-line understanding of ongoing social events were examined. Boys with (n = 38) and without (n = 41) Attention Deficit Hyperactivity Disorder (ADHD) were compared. Prior social schemes and integrative processes were hypothesized to influence children's representation of incoming social cues. Younger children and children with ADHD were expected to differ from older children and children without ADHD, respectively, in what they encoded and how they organized the encoded information. Differences in on-line representation were postulated to underlie differences in children's recall and social reasoning. Children's prior social schemes, looking time and on-line verbal protocols, recall, and social reasoning were assessed. Younger boys and ADHD boys showed less integrated on-line representations, accounting for poorer recall and reasoning.     

Advocate role in developing district policy for gifted students

This study challenges an existing controversy, whether there are innate differences in competitiveness between boys and girls in general, and among the gifted in particular, or whether competitiveness is context-sensitive. The specific context examined in the study is that of two pullout weekly enrichment gifted programs: one with single-sex classrooms, and the other with co-ed classes. The competitiveness of 129 students was examined in three different areas: motor (running), spatial, and verbal tasks. The results indicate that boys performed better than girls did in all tasks, with the exception of competitive verbal tasks. Girls were more competitive than boys were in verbal tasks, and there were no significant differences in competitiveness between girls in co-ed environments and girls in a single-sex environment. This adds to the literature that views competitiveness as task-sensitive rather than gender-dependent.     

Training boys with ADHD to work collaboratively: Social and learning outcomes

This study examined social participation and strategic problem solving behavior of boys diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) when collaborating on a planning task with a trained peer partner. Twenty-four 9- to 13-year-old boys with ADHD who were receiving a medication intervention, were individually pre-tested to assess their initial ability to plan an errand route task. They were then observed doing an alternate planning task during collaborative sessions with a female peer partner who had received prior training in the task and in facilitating social interaction. Boys with ADHD were then individually post-tested on the original planning task. Observations of the collaborative sessions revealed significant, positive changes across three phases in the quality of social interactions by boys with ADHD, in their planning strategies, and planning efficiency. Findings suggest positive benefits of collaborative learning structures for boys with ADHD when they are placed in a collaborative learning setting with a partner who has received a prior training intervention.     

Sex Differences on the Dutch WISC‐R: a comparison with the USA and Scotland

Sex differences in the Dutch standardisation sample of the WISC‐R are analysed. The results correspond very closely to the sex differences in the Scottish and American standardisation samples. Boys scored significantly higher on the general intelligence factor and on the verbal and visuospatial factors. Girls scored higher on the perceptual speed/memory factor. There was no effect of age on sex differences. One of the causes for the higher scores for boys on the general and verbal factors is the relatively substantial sex difference on the Information subtest.     

Patterns of performance on the Stroop Color and Word Test in children with learning,attentional, and psychiatric disabilities

The study presented here investigated the performance of children with learning, psychiatric, and attentional disabilities on the Stroop Color and Word Test. Forty‐three children diagnosed with a full battery of tests as learning disabled (LD [reading]) in grades K through 6 were matched on age, gender, ethnicity, and grade with 43 normal controls. They were also matched with groups of 43 children with psychiatric disorders and 43 children with attentional problems. All subjects were given the Stroop test, which took about 4 minutes per subject. The results indicated clear differences between the groups, with the LD and the psychiatric/attention deficit/hyperactivity disorder (ADHD) groups generating unique profiles different from the normal controls. The children with LD showed slower reading speed and less interference, while the subjects with ADHD and diagnoses showed impairment only on the Color‐Word score. A discriminant analysis using the three basic Stroop scales was able to significantly differentiate the LD group from the non–learning‐disabled (NLD) group (89%) and the LD group from a joint Psychiatric/ADHD group (86%). However, results were poorer for differentiating a joint LD/ADHD group from the NLD group (68%) and the LD from the ADHD group (59%). © 2002 Wiley Periodicals, Inc.