Effectiveness of a computer-facilitated interactive social skills training program for boys with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) are at significant risk for a variety of comorbid conditions, including social skills deficits. Although interventions addressing various aspects of social difficulties with these children have been developed, few researchers have integrated new technology with existing social skills intervention literature and investigated such approaches empirically. The purpose of this study was to investigate the effectiveness of a computer-mediated social skills training program for children diagnosed with ADHD. The program presented specific social skill sequences to four children with ADHD in a variety of computer-facilitated formats with video peer modeling, social problem-solving, and reinforcement components. Participants' abilities to demonstrate specific social problem-solving skills effectively in a behavioral analogue environment were evaluated. The study used a multiple-probe variation of the multiple-baseline design (MBD) across participants. All participants demonstrated improvements in ability to demonstrate effective social problem-solving skills in analogue role-play assessments with live peers. Follow-up data at 3 and 6 week intervals indicated that participants maintained their gains over time. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Injury risk factors in children with attention deficit hyperactivity disorder.

Processes related to injury in children with Attention Deficit Hyperactivity Disorder (ADHD) were examined. Two groups of 7–11-year-old boys (14 ADHD and 16 controls) watched a videotape simulating play activities in order for them to identify risky behaviors and then answered questions about risky scenes. Groups did not differ in ability to identify hazards, but children with ADHD anticipated less severe consequences following risky behavior and reported fewer active methods of preventing injury than did controls. Cognitive factors, including lower expectations of personal risk in hazardous situations and less ability to generate prevention strategies and safety rules, may contribute to increased injury liability in boys with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative electroencephalographic profiles of children with attention deficit disorder

Quantitative electroencephalogram (QEEG) was obtained from 407 children with attention deficit disorder. These QEEGs were compared to those of 310 normal children. Discriminant analysis resulted in a specificity of 88% and a sensitivity of 93.7% for distinguishing normal children from those with attention deficit disorder. Two major neurophysiological subtypes were evident within the 92.6% abnormal QEEG profiles encountered. The first showed varying degrees of EEG slowing, especially in frontal regions, whereas the second showed an increase in EEG activity, especially in frontal regions. Deviations from normal development rather than maturational lag were present as the source of the neurophysiological abnormality in the majority of these children. In conjunction with recent magnetic resonance imaging, positron emission tomography, and regional cerebral blood flow studies, these results indicate neurophysiological dysfunction within the cortical and subcortical structures that serve the frontal/striatal system. Models suggesting both hypo- or hyperarousal of these structures are supported.     

Families of children with attention deficit hyperactivity disorder: a review

OBJECTIVES: 1) To review the evidence of attention deficit hyperactivity disorder (ADHD) and other conditions in family members (siblings and parents) of children with ADHD and determine the importance of genetic and environmental factors in this condition. 2) To describe the prospective 10-year follow-up of 65 families with ADHD children and 43 families of matched normal controls. 3) To review various studies that have looked at parent-child interactions with ADHD children on and off stimulant medication, and such interactions over time. The paper thus provides an overview of family pathology and functioning of families of ADHD children over time. METHOD: The paper outlines twin, sibling, family and adoption studies with regard to possible genetic and environmental factors in ADHD. It also presents data of a prospective 10-year follow-up of 65 families with ADHD children and 43 families of normal controls. This family study evaluated sociocultural factors, child rearing practices, health of family members and relationships, as well as the parental view of the child's functioning over time. RESULTS: A review of the literature suggests that ADHD has a strong genetic component, but that environmental factors also play an important role. Families of children with ADHD have more problems than families of normal controls, but these problems improve as the child with ADHD grows up and leaves home. Families of ADHD subjects can appreciate positive as well as negative changes in their children over time. Generally, family interactions with children with ADHD are problematic but improve when the child is on medication and when the child becomes an adult. CONCLUSIONS: This condition has strong genetic underpinnings; therefore, diagnosing and treating family members (parents and siblings) as well as the child with ADHD is important in improving parent-child interactions and better long-term outcome for the child and his or her family.     

Play therapy with children exhibiting symptoms of attention deficit hyperactivity disorder.

Sixty elementary school age children qualified as symptomatic of attention deficit/hyperactivity disorder (ADHD) were randomly assigned to 1 of 2 treatment conditions: child-centered play therapy (CCPT) or reading mentoring (RM). All children participated in 16 individual 30-min sessions in the schools. Results indicated that children who participated in 16 sessions of CCPT and RM demonstrated statistically significant improvement on the ADHD and student characteristics domains, as well as the Anxiety/Withdrawal and Learning Disability subscales of the Index of Teaching Stress and the ADHD Index of the Conners Teacher Rating Scale--Revised: Short Form. Children who participated in CCPT demonstrated statistically significant improvement over RM children on the student characteristics domain and on the Emotional Lability and Anxiety/Withdrawal subscales of the Index of Teaching Stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The generalization effects of parent training across stimulus settings

Five parents of nonverbal children were trained in two home settings to modify antecedents and consequences to their children's vocalizations. Generalization effects of the parent training on both the parent's and children's behaviors under different stimulus conditions were investigated using multiple-baseline designs. Increases in parent prompting and reinforcing their children's vocalizations generalized only minimally to a new setting in the home where parent training had not occurred. Child increases in vocalizations produced by the parents in the training settings did generalize to this new setting in the home. There was minimal generalization of child vocalizations to a free-play setting at school. In a formal speech session conducted by a behavior specialist at school, only one child showed definite increases in acquisition rate as a function of the parents starting to train the sound at home.     

Trauma exposure among children with oppositional defiant disorder and attention deficit–hyperactivity disorder.

Consecutive admissions to an outpatient child psychiatry clinic diagnosed with oppositional defiant disorder (ODD), attention deficit-hyperactivity disorder (ADHD), or adjustment disorder were assessed for trauma exposure by a structured clinical interview and parent report. Controlling for age, gender, severity of internalizing behavior problems, social competence, family psychopathology, and parent–child relationship quality (assessed by parent report), an ODD diagnosis, with or without comorbid ADHD, was associated with increased likelihood of prior victimization (but not nonvictimization) trauma. ADHD alone was not associated with an increased likelihood of a history of trauma exposure Traumatic victimization contributed uniquely to the prediction of ODD but not ADHD diagnoses. Children in psychiatric treatment who are diagnosed with ODD, but not those diagnosed solely with ADHD, may particularly require evaluation and care for posttraumatic sequelae. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual slow brain potentials in children with attention deficit disorder

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640-900 msec slow wave) and (2) greater right parietal than left parietal negativity (430-750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700-900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.     

Evaluating attention deficit hyperactivity disorder using multiple informants: The incremental utility of combining teacher with parent reports.

In a sample of students referred to a school-based Pupil Assistance Committee, the Inattention and Hyperactivity–Impulsivity factors of the Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV were used to predict diagnostic status, determined by a parent-reported diagnostic interview and teacher rating scale. Results of logistic regression and receiver operating curve analyses indicated that the Inattention and Hyperactivity–Impulsivity factors differentiated students with ADHD from controls and distinguished children with different ADHD subtypes. Symptom utility estimates demonstrated that a single informant approach was best suited for ruling out ADHD, whereas a combined informant method was optimal for positively diagnosing this disorder. Methods for determining the incremental utility of combining teacher with parent reports were demonstrated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of story structure on the recall of stories in children with attention deficit hyperactivity disorder.

This study explored influences of story structure properties on recall of story events by children with and without attention deficit hyperactivity disorder (ADHD). Participants listened to and retold 2 stories. Two properties of the stories' causal structure were derived: the number of causal connections an event has to other events and whether an event is on the causal chain linking events from beginning to end. The extent to which causal properties and the more subjective property of perceived importance predicted recall in the 2 groups of children was examined. Each property predicted recall, but there were group differences in sensitivity to causal structure that were moderated by intelligence level and gender. Variations in amount and allocation of cognitive resources applied to comprehension contributed to performance of children with ADHD. There are implications for understanding academic and social difficulties common in children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social skills training for withdrawn unpopular children with physical disabilities: A preliminary evaluation.

Examined changes in self-concept, perceptions of support from close friends and classmates, and loneliness in 11 8.6–14.6 yr old withdrawn unpopular children with cerebral palsy or spina bifida who had been involved in a social skills training program. The program targeted 5 basic skills: interpersonal problem solving, verbal and nonverbal communication, initiating interactions with peers, conversational skills, and coping with difficult others. To assess the impact of the program, Ss were evaluated before the intervention, after the 10-wk intervention, and at a 6-mo follow-up. Findings indicate that group social skills training may be effective in decreasing feelings of loneliness and increasing perceptions of social acceptance in children who are withdrawn and unpopular at school. Ss' feelings of loneliness were associated with lower ratings of social acceptance and lower ratings of classmate support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Legal rights of students with attention deficit disorder.

Discusses the enforcement activity of federal agencies and legal rights of children with attention deficit disorder (ADD) to receive appropriate special education services. Federal agencies that enforce special education laws have found that children with ADD are eligible for special education services and are protected by the elaborate procedural safeguards established by law. Many school districts do not have procedures to identify children with ADD and to ensure appropriate services and procedural protections. A case example and a model policy are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder.

The goal of this study was to assess neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder (ADHD). Participants were 156 siblings of ADHD probands with (N?=?40) and without (N?=?116) ADHD (according to criteria of the Diagnostic and Statistical Manual of Mental Disorders [3rd edition, revised; American Psychiatric Association, 1987]) and 118 siblings of non-ADHD normal controls of similar age, IQ, and grade level. Information on attention, executive, and memory functions was obtained in a standardized manner without knowledge of clinical status. Compared with siblings of controls, siblings with ADHD were significantly impaired on the Stroop test and on verbal learning and memory. In contrast, siblings without ADHD were similar to controls on virtually all measures. These data suggest that some executive, attention, and verbal learning deficits are found in nonreferred individuals with ADHD but that neuropsychological deficits are unlikely to constitute an endophenotype to ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thyroid function in a population of children with attention deficit hyperactivity disorder

4-Fluoro-3-nitrobenzoic acid attached to a solid support was shown to react under mild conditions with a wide range of functionalized phenols to yield, after cleavage, the corresponding biaryl ethers in excellent purity. In a similar fashion, biaryl thioethers could be obtained. Further elaboration of immobilized biaryl ethers demonstrates the potential for combinatorial library generation.     

Corpus callosum morphology in children and adolescents with attention deficit hyperactivity disorder: A meta-analytic review.

Several studies have examined corpus callosum (CC) morphology in children and adolescents with attention deficit hyperactivity disorder (ADHD). A meta-analysis of atypical brain morphology in children and adolescents with ADHD by Valera, Faraone, Murray, and Seidman (2006) reported a reduction in the splenium of the CC in this group compared with healthy controls. This meta-analysis undertook a more detailed examination of callosal morphology by also considering comorbid conditions and gender differences. The data from 13 studies were analyzed. Consistent with Valera et al. (2006), the splenium was smaller in children and adolescents with ADHD than in healthy controls. However, this result appears to be the result of a smaller splenium in females with ADHD. In addition, boys exhibited a smaller rostral body. There were no significant differences in CC measurements of studies that included ADHD samples with comorbid conditions. However, comorbidities were not consistently reported, making it difficult to accurately evaluate the impact of comorbidity on CC size. Additional research is needed to investigate whether gender differences reflect different ADHD subtypes. In addition, it is not known if these CC differences persist into adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminative and participant-rated effects of methylphenidate in children diagnosed with attention deficit hyperactivity disorder (ADHD)

Despite the demonstrated beneficial effects of methylphenidate and d-amphetamine for the treatment of attention-deficit hyperactivity disorder (ADHD), the discriminative and subjective effects of these compounds in children are not well understood. This study was designed to characterize such effects in children diagnosed with ADHD. In a series of 3 experiments, 17 children were examined to determine whether methylphenidate (n = 12) and d-amphetamine (n = 5) could be reliably discriminated at doses typically used in clinical practice. Under some conditions (e.g., when they were instructed to attend to the drug effects or when a wide range of doses was used), children discriminated methylphenidate (5.0-30.0 mg) from placebo. Children tested under a range of doses of d-amphetamine (2.5-20.0 mg) were unable to discriminate this drug from placebo reliably. Neither methylphenidate nor d-amphetamine produced reliable participant-rated effects.     

The practical aspects of diagnosing and managing children with attention deficit hyperactivity disorder

AD/HD is a behaviorally defined disorder with specific behavioral criteria. The most recent definitions decrease heterogeneity by defining subtypes although the current treatments tend to be more generic. The main well-established treatments are stimulant medication and behavior modification, which are most effective when used together.     

Neuromotor functioning in children with Tourette syndrome with and without attention deficit hyperactivity disorder

Neuromotor function was assessed in 94 children of normal intelligence with Tourette syndrome, Tourette syndrome and attention-deficit hyperactivity disorder (ADHD), or ADHD only, using the Physical and Neurological Examination of Subtle Signs (PANESS). Time to complete six motor movements was analyzed separately by side (left and right) and complexity (simple and patterned). All groups performed faster on their preferred, dominant side. Although all groups took longer to complete patterned versus simple movements, the group with ADHD had a larger discrepancy for complexity than the other two groups. The speed for simple and patterned tasks was at or faster than age expectations for 54% of tasks in the group with Tourette syndrome but only 15% of tasks in the other two groups. More children in the group with Tourette syndrome (76%) than the groups with Tourette syndrome with ADHD (54%) or ADHD (54%) or ADHD only (65%) performed movements within normal time limits for age. Findings suggest that Tourette syndrome is not associated with motor slowing.