Components of Attention in Children with Complex Partial Seizures With and Without ADHD

Summary: Purpose: To evaluate attentional difficulties in children with complex partial seizures, we reviewed the records of 12 children with complex partial seizures with attention deficient hyperactivity disorder (CPS/ADHD); 21 children with CPS without ADHD (CPS); 22 children with ADHD; and 15 control children.
Methods: Each child completed a computerized performance test (CPT), which evaluated sustained attention, inhibition of response, response time, and consistency of response. The ADHD groups also completed the CPT after a dose of methylphenidate.
Results: The results found poorest performance on the CPT by the CPS/ADHD group. Particular difficulty in attention was found for children with epilepsy regardless of the ADHD diagnosis. When methylphenidate was administered to the ADHD groups, both groups improved in performance on the CPT.
Conclusions: Epilepsy may predispose children to attention problems that can significantly interfere with learning. Similar improvement for children with CPS/ADHD was found with methylphenidate compared with baseline as for children with ADHD but without CPS.     

Training of Working Memory in Children With ADHD

Working memory (WM) capacity is the ability to retain and manipulate information during a short period of time. This ability underlies complex reasoning and has generally been regarded as a fixed trait of the individual. Children with attention deficit hyperactivity disorder (ADHD) represent one group of subjects with a WM deficit, attributed to an impairment of the frontal lobe. In the present study, we used a new training paradigm with intensive and adaptive training of WM tasks and evaluated the effect of training with a double blind, placebo controlled design. Training significantly enhanced performance on the trained WM tasks. More importantly, the training significantly improved performance on a non-trained visuo-spatial WM task and on Raven's Progressive Matrices, which is a nonverbal complex reasoning task. In addition, motor activity - as measured by the number of head movements during a computerized test - was significantly reduced in the treatment group. A second experiment showed that similar training-induced improvements on cognitive tasks are also possible in young adults without ADHD. These results demonstrate that performance on WM tasks can be significantly improved by training, and that the training effect also generalizes to non-trained tasks requiring WM. Training improved performance on tasks related to prefrontal functioning and had also a significant effect on motor activity in children with ADHD. The results thus suggest that WM training potentially could be of clinical use for ameliorating the symptoms in ADHD.     

Psychological Disorders in Crippled Children. A Comparative Study of Children With and Without Brain Damage

A detailed standardised study was made of all crippled children aged between five and 15 years and of normal intelligence on the local-authority lists of handicapped children in three London boroughs. Psychiatric disorder was twice as common in children whose crippling was due to cerebral disease or damage rather than some peripheral lesion. As the groups were well matched in terms of physical incapacity and social background, it was concluded that brain damage was responsible for the children's increased vulnerability to emotional problems. Brain damage was also associated with a marked increase in reading difficulties and a lowering of intelligence within the normal range. Psychiatric disorder was found to be related not only to cerebral injury but also to various types of family disturbance. It is concluded that emotional and behavioural disturbance stemmed from both an increased biological vulnerability and psychosocial hazards.     

Service Utilization among Ethnic Minority Children with ADHD: A Model of Help-Seeking Behavior

Despite a significant increase in the number of children and adolescents who receive clinical services for attention deficit hyperactivity disorder (ADHD), there is still a considerable level of unmet need. Children of ethnic minority status continue to lag well behind their non-minority counterparts in the rate of diagnosis and treatment for the disorder. Racial/ethnic disparities in service use are the result of a combination of access barriers and individual, cultural, and societal factors. The ADHD Help-Seeking Behavior Model is proposed as a framework for understanding factors that may be predictive of service use. Variables specific to ADHD and ethnic-minority populations are integrated within the framework of a four-stage pathway model encompassing problem recognition, decision to seek help, service selection, and service use. The authors argue that by systematically addressing factors related to service use for each ethnic minority group, more effective intervention initiatives can be developed to improve identification and treatment for ADHD among underserved children.     

Social Referencing Gaze Behavior During a Videogame Task: Eye Tracking Evidence from Children With and Without ASD

The purpose of this study was to understand the social referencing behaviors of children with and without autism spectrum disorder (ASD) while visually attending to a videogame stimulus depicting both the face of the videogame player and the videogame play action. Videogames appear to offer a uniquely well-suited environment for the emergence of friendships, but it is not known if children with and without ASD attend to and play videogames similarly. Eyetracking technology was used to investigate visual attention of participants matched based on chronological age. Parametric and nonparametric statistical analyses were used and results indicated the groups did not differ on percentage of time spent visually attending to any of the areas of interest, with one possible exception.     

A Comparison of Eating Behaviors Between Children with and Without Autism

Although clinicians typically assume that feeding problems co-exist with a diagnosis of autism, no previous research has compared the eating behavior of children with autism to typically developing children. This study compared caregiver report of eating problems of children with and without autism on a standardized questionnaire. The questionnaire included items pertaining to food refusal and acceptance patterns as well as food presentation requirements. Caregivers were also asked to complete a food inventory that indicated the number of foods eaten within each food group for both the child and the family. Results indicated children with autism have significantly more feeding problems and eat a significantly narrower range of foods than children without autism.     

Social Networks and Friendships at School: Comparing Children With and Without ASD

Self, peer and teacher reports of social relationships were examined for 60 high-functioning children with ASD. Compared to a matched sample of typical children in the same classroom, children with ASD were more often on the periphery of their social networks, reported poorer quality friendships and had fewer reciprocal friendships. On the playground, children with ASD were mostly unengaged but playground engagement was not associated with peer, self, or teacher reports of social behavior. Twenty percent of children with ASD had a reciprocated friendship and also high social network status. Thus, while the majority of high functioning children with ASD struggle with peer relationships in general education classrooms, a small percentage of them appear to have social success.     

Neurofeedback in Residential Children and Adolescents with Mild Mental Retardation and ADHD Behavior

Neurofeedback (NFB) research has reported improved concentration and attention in children with attention deficit/hyperactivity disorder (ADHD) and progress maintained over time. Would that also apply to children with an IQ between 50 and 70 (mild mental retardation [MMR]) and an IQ between 70 and 85 (borderline retardation [BR]) with characteristics of ADHD? To our knowledge this is the first NFB treatment study with long-term follow-up in this particular group. Ten adolescents with MMR and BR and ADHD received 30 sessions of quantitative electroencephalogram (QEEG)-based NFB. QEEG differences with a gender- and age-matched group without mental handicap and ADHD (data provided by BRAINnet) were investigated, at pre- and posttreatment and at 6-month follow-up. Neuropsychological functioning was tested administering the Bourdon-Vos, and the Amsterdam Neuropsychological Testing Program subscales SA DOTS and SSV. Pretreatment eyes-closed EEGs were not statistically different in the children with MMR compared to the controls. With eyes open higher amplitudes were found in the lower frequencies in the children with MMR, normalizing over time. The neuropsychological tests improved for reaction times and errors. On the complex tasks in the SSV a number of errors remained. The subjects perceived an improvement in ADHD and increasingly enjoyed the study. After NFB treatment, attention and concentration in children with MMR and BR have improved. Task span and effort also increased, although impulse control remained weak. This may be explained by a limited working memory capacity. The subjective reports may have been affected by situational factors and should be interpreted with caution. This study is limited by its nonrandomized design.     

Co-Ordination Screening For Children With And Without Moderate Learning Difficulties: Further Experience With Gubbay''S Tests

Modified Gubbay tests, assessing various aspects of motor performance, were administered to 885 Manchester children in mainstream primary education, and centile tables were drawn up by age. Children who had performed badly on one of the four tests were retested two years later, when they were found to have 'caught up' with controls. The primary-school children reached a ceiling in their performance by the age of nine or 10 years. A further 482 children, aged eight years to 16 years 11 months and attending schools for children with moderate learning difficulties, were assessed. These children showed continuing improvement up to the age of 14, after which little further improvement was seen. Thus this ceiling occurred some five years later than for the children in mainstream schools. On the more complex tests performance was worse than would have been predicted by general intelligence. Implications for policies of integration into mainstream schooling are discussed.     

A Comparison of Haloperidol and Behavior Therapy and Their Interaction in Autistic Children

Haloperidol and behavior therapy, and the interaction of the two treatments were critically assessed with respect to their effects on symptoms and language acquisition in 40 autistic children aged 2.6 to 7.2 years. The children were randomly assigned to four treatment groups in a factorial design. The study was placebo controlled and double-blind, using multiple independent raters who assessed treatment effects under three types of rating conditions. Haloperidol was found to be significantly superior to placebo in decreasing certain symptoms, depending on the age group. The combination of the two treatments was most effective in facilitating the acquisition of imitative speech. Optimal dosage of haloperidol ranged from 0.5 to 4.0 mg./day; the most common untoward effect was excessive sedation, which was clearly a function of dosage.     

Laughter Differs in Children with Autism: An Acoustic Analysis of Laughs Produced by Children With and Without the Disorder

Few studies have examined vocal expressions of emotion in children with autism. We tested the hypothesis that during social interactions, children diagnosed with autism would exhibit less extreme laugh acoustics than their nonautistic peers. Laughter was recorded during a series of playful interactions with an examiner. Results showed that children with autism exhibited only one type of laughter, whereas comparison participants exhibited two types. No group differences were found for laugh duration, mean fundamental frequency (F₀) values, change in F₀, or number of laughs per bout. Findings are interpreted to suggest that children with autism express laughter primarily in response to positive internal states, rather than using laughter to negotiate social interactions.     

Adolescent Siblings of Individuals With Intellectual Disabilities With and Without Comorbid Mental Health Problems: A Preliminary Comparison of Sibling Perceptions

Introduction: The presence of comorbid mental illness in individuals with intellectual and developmental disabilities (IDD) has been shown to have additional negative impact on parents and caregivers. However, the impact of such dual diagnoses on typically developing siblings has yet to be examined. Methods: Parents and typically developing adolescent siblings of a child with IDD from 49 families completed online surveys about the presence or absence of comorbid mental illness, target-child behavior problems, impact on the family, and sibling emotions toward the child with IDD. T-tests were used to compare results of families with a child with both IDD and MI and families with a child with IDD only. Results: Parents reported more behavior problems in children with comorbid IDD and MI, and a greater overall impact on the family. Adolescent siblings in the comorbid IDD/MI group reported higher levels of hostility, anxiety, and dysphoria toward their sibling, though there were no group differences in positive affect. Hierarchical linear regression results found that group membership was uniquely related to sibling dysphoria beyond target-child behavior problems. Conclusions: Having a brother or sister with comorbid mental illness and IDD seems to contribute to more negative feelings from adolescent siblings, though the absence of MI does not relate to more positive feelings. Results suggest that families of children with IDD/MI may need to be more proactive in fostering healthy sibling relationships.