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Objective: Little is known about the cortisol awakening response (CAR) in children with attention deficit hyperactivity disorder (ADHD). Here, we examined the CAR in children with ADHD and their mothers before, immediately after, and 4months after an intensive summer treatment program (STP)., Methods: Participants were 37 children aged 7-12years who completed the STP in 2009 and 2010, and their mothers. Daily saliva samples for cortisol measurement were collected twice daily at awakening and 30min afterwards at pre-STP, post-STP, and during a follow-up measurement period. ADHD symptom scores were evaluated by parents, and participants completed the Kid-KINDL R QOL questionnaire., Results: CAR was low in children with ADHD before the STP, and increased to the control range 4months after STP. Maternal CAR also tended to increase after STP. Changes in the CAR in children tended to correlate with an improved ADHD inattention scores (p=0.091), physical health (p=0.070), and school life subscales scores in the Kid-KINDL R (p=0.079)., Conclusion: We demonstrated that STP improved the behavior and QOL of children with ADHD. Our results indicate that STP could lead to improvements in HPA axis function, as reflected by increased CAR after STP., (Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Objective: The aim of this study was to investigate the developmental trajectories of attention, short-term memory, and working memory in school-aged children using a 10 min test battery of cognitive function., Methods: Participants comprised 144 typically developing children (TDC) aged 7-12 years and 24 healthy adults, divided according to age into seven groups (12 males and 12 females for each age group). Participants were assessed using CogHealth, which is a computer-based measure composed of five tasks. We measured attention, short-term memory, and working memory (WM) with visual stimulation. Each task was analyzed for age-related differences in reaction time and accuracy rate., Results: Attention tasks were faster in stages from the age of 7-10 years. Accuracy rate of short-term memory gradually increased from 12 years of age and suddenly increased and continued to increase at 22 years of age. Accuracy rate of working memory increased until 12 years of age. Correlations were found between the ages and reaction time, and between ages and accuracy rate of the tasks., Conclusion: These results indicate that there were rapid improvements in attention, short-term memory, and WM performance between 7 and 10 years of age followed by gradual improvement until 12 years of age. Increase in short-term memory continued until 22 years of age. In our experience CogHealth was an easy and useful measure for the evaluation of cognitive function in school-age children., (Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Objective: Previous eye-tracking studies using an eye mark recorder have reported that disturbances in exploratory eye movements in adult schizophrenic patients are associated with social functioning. The current study sought to determine whether exploratory eye-movement disturbances are present in children with Asperger's syndrome (AS) compared with typically developing (TD) children. MATERIALS/PARTICIPANTS: The participants were 23 children with AS and 23 age-matched TD children. We measured exploratory eye movements using an EMR-8B eye mark recorder and an exploratory eye movement-measuring device., Method: Eye movements were recorded while participants freely observed a geometric figure (free viewing task), and while they complied with the instructions of an experimenter (repeat-comparison task). We assessed eye fixation points (EFPs) and total eye scanning length (TESL) in all tasks, and measured the responsive search score (RSS) in the repeat-comparison task., Results: In the free viewing task, children with AS exhibited significantly shorter TESL compared with TD children. In the repeat-comparison task, children with AS exhibited significantly lower RSS. Autism Spectrum Screening Questionnaire scores were negatively correlated with both EFP and TESL, but not RSS., Conclusion: The current results revealed that children with AS exhibited dysfunction in exploratory eye movements. Thus, assessing exploratory eye movements in a repeat-comparison task may be useful for detecting social impairment among children with AS., (Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

In 2005 we established the first American-style summer treatment program (STP) for children with attention deficit hyperactivity disorder (ADHD) located outside North America. This program was based on methods established by professor Pelham and has been used in a number of studies and at a number of sites in the USA. A total of 137 children diagnosed with ADHD, ranging in age from 6 to 12 years, participated in at least one of five annual summer treatment programs in Kurume city, Japan, during 2005-2009. The duration of the STP was 2 weeks in 2005, 2008, and 2009; 3 weeks in 2006 and 2007. A set of evidence-based behavioral modification techniques comprising the STP behavioral program (e.g., point system, daily report card, positive reinforcement, time out) was used. We also assessed the cognitive function of individual children before and after STP using the CogState(R) batteries. Every year, regardless of the duration of the STP, most children showed positive behavioral changes in multiple domains of functioning, demonstrated by significant improvement in points earned daily, which reflect behavior frequencies. Cognitive functions, particularly the rate of anticipatory errors in executive function, significantly improved after the STP, suggesting that STP has positive effects not only on behavioral aspects but also on some cognitive functions. Further studies are necessary to confirm this finding by studying sequential cognitive function of age-matched children who do not attend STP., (Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

To evaluate the development of human visual cognitive function in childhood, we examined exploratory eye movements in 78 healthy subjects using affective pictures. We divided them into six groups, each of which comprised 14 subjects (7 boys or men, 7 girls or women) at the indicated ages. Exploratory eye movements were recorded via gazing points using an eye-mark recorder. The total eye scanning length (TESL) of gaze points increased significantly with age, and the mean eye scanning length, in 4-6-year-olds was significantly shorter than in the others groups. The total number of gaze points (TNGP) on the left half of the screen increased significantly with age. The left TNGP in 4-6-year-olds was significantly smaller than in the other groups. The response search score (RSS) measured in 8 areas of the screen increased significantly with age. It was concluded that exploratory eye movements are useful markers to estimate the development of human visual cognitive function in childhood.

To evaluate the development of visual cognitive function in childhood, we examined exploratory eye movements in 84 healthy subjects viewing picture-based stimuli. Age-defined groups included 4- to 6-year-olds, 7-year-olds, 10-year-olds, 14-year-olds, 16-year-olds, and adults. In each group, 7 subjects were male and 7 were female. Exploratory eye movements, recorded as gaze points using an eye-mark recorder, were analyzed in terms of the total number of gaze points (TNGP); total eye-scanning length of gaze points (TESL); total number of gaze points on the left (l TNGP) and right (r TNGP) of the screen; and responsive search score (RSS) on the left (l RSS) and right (r RSS) of the screen. Both the TESL and TNGP increased significantly with age. The TESL and TNGP of 16-year-olds and adults viewing a repeat-comparison figure were significantly greater than when viewing a comparison figure. During the repeat-comparisons, the TNGP in 4- to 6-year-olds was greater on the right than the left; the opposite was true in 16-year-olds and adults. The RSS in 4- to 10-year-olds was greater on the right than the left; 16-year-olds and adults showed the reverse findings. Thus, in the repeat-comparison task, TNGP, TESL, TNGP, and RSS differences between left and right visual fields are useful biologic markers for estimating the development of visual cognitive function.

To evaluate age and gender differences as well as effects of affection, we examined exploratory eye movements. Exploratory eye movements were recorded in healthy subjects (57 women and 57 men) ranging from 9 to 74 years. All subjects were divided into three groups as pre puberty, young, and older adults to study the influences of age and gonadal hormones. Exploratory eye movements were analyzed for total eye scanning length (TESL), and total numbers of gaze points (TNGP) as subjects viewed neutral or affectively charged pictures. TESL and TNGP in older adults were significantly larger than that in both pre puberty and young adults for crying babies. TESL and TNGP in pre puberty were significantly smaller than that in both young and older adults for circles. TESL and TNGP in pre puberty were significantly smaller than that in older adults for smiling babies. Pre puberty and young adult of both genders for crying babies showed significantly shorter TESL than for when smiling babies. When viewing circles, young adult women had shorter TESL than men. TNGP in young adult women was smaller than in men for circles or crying babies. TNGP of young adult women in the visual right field was significantly smaller than in men. TNGP for crying babies was significantly smaller than that for smiling babies in young adults of both genders for the left field. Exploratory eye movements thus are a useful marker of visual cognitive function. Gender differences were limited to younger adults, suggesting influences of gonadal hormones.