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Children with neurofibromatosis type 1 (NF1) often experience executive dysfunction, attention deficit/hyperactivity disorder (ADHD) symptoms and poor social skills, however, the nature of the relationships between these domains in children with NF1 is unclear. This study investigated these relationships using primary caregiver ratings of executive functions, ADHD symptoms and social skills in children with NF1. Participants were 136 children with NF1 and 93 typically developing (TD) controls aged 3-15 years recruited from 3 multidisciplinary neurofibromatosis clinics in Melbourne and Sydney, Australia, and Washington DC, USA. Mediation analysis was performed on primary outcome variables: parent ratings of executive functions (Behavior Rating Inventory of Executive Function, Metacognition Index), ADHD symptoms (Conners-3/Conners ADHD Diagnostic and Statistical Manual for Mental Disorders Scales) and social skills (Social Skills Improvement System-Rating Scale), adjusting for potential confounders (full scale IQ, sex, and social risk). Results revealed significantly poorer executive functions, elevated ADHD symptoms and reduced social skills in children with NF1 compared to controls. Poorer executive functions significantly predicted elevated ADHD symptoms and poorer social skills. Elevated ADHD symptoms significantly mediated the relationship between executive functions and social skills problems although did not fully account for social dysfunction. This study provides evidence for the importance of targeting ADHD symptoms as part of future interventions aimed at promoting prosocial behaviors in children with NF1.

The relation between sustained attention in the laboratory and behaviors exhibited in naturalistic settings among children with Attention Deficit/Hyperactivity Disorder (ADHD) remains unclear. Additionally, research on stimulant medication effects in these areas and their association with one another remains scarce. Twenty-one children with ADHD and 21 children without ADHD completed a novel continuous performance test (CPT) involving high cognitive demands (e.g., visual search). Participants with ADHD also attended a Summer Treatment Program and received three doses of stimulant medication (placebo, low, and high). Their behavior in classroom and peer settings was observed and recorded, and they completed the CPT in each medication condition. The CPT measures of bias and sensitivity were used in analyses. Results indicated that children with ADHD had impaired overall performance and worse bias during the second half of the task compared to controls. Methylphenidate improved both naturalistic behavior and overall CPT performance but did not specifically improve the sustained attention deficit. Despite improvements in overall CPT performance, medication-related improvement in CPT performance did not mediate medication-related improvement in observed behavior in classroom or recreational settings. As such, our findings suggest that although children with ADHD do demonstrate a sustained attention deficit, salutary psychostimulant effects on CPT performance are not indicative of, or causally linked to, psychostimulant effects on presenting problems in naturalistic settings.

The writing abilities of children with ADHD symptoms were examined in a simple dictation task, and then in two conditions with concurrent verbal or visuospatial working memory (WM) loads. The children with ADHD symptoms generally made more spelling mistakes than controls, and the concurrent loads impaired their performance, but with partly different effects. The concurrent verbal WM task prompted an increase in the phonological errors, while the concurrent visuospatial WM task prompted more non-phonological errors, matching the Italian phonology, but not the Italian orthography. In the ADHD group, the children proving better able to cope with a concurrent verbal WM load had a better spelling performance too. The ADHD and control groups had a similar handwriting speed, but the former group's writing quality was poorer. Our results suggest that WM supports writing skills, and that children with ADHD symptoms have general writing difficulties, but strength in coping with concurrent verbal information may support their spelling performance.

Intra-individual variability (IIV) is defined as systematic within-person variation in performance either across test sessions (e.g., test/retest performance on the same task) or in one session (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV have been noted as a characteristic of neurodevelopmental disorders such as attention deficit/hyperactivity disorder​ (ADHD), but IIV is yet to be investigated in fetal alcohol spectrum disorder (FASD). FASD is a term used to describe a range of conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome/partial fetal alcohol syndrome; 2. static encephalopathy/alcohol exposed; 3. neurobehavioral disorder/alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; 4. typically-developing (TD) age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. The results indicate increased levels of IIV in those with FASD compared to the TD controls. It was found that IIV uniquely contributes to predicting adaptive behavior above and beyond attention, while attention partially mediates the relationship between IIV and adaptive behavior. This is the first study to the authors' knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.

Children with fetal alcohol spectrum disorders (FASD) exhibit difficulties in many cognitive and behavioral domains and also have high comorbidity with other disorders such as attention deficit/hyperactivity disorder (ADHD) and conduct disorder as well as autism. Although the FASD profile is shown to be distinct from ADHD and conduct disorder, far less is known about the commonalities with autism. The current study used a parent-rated questionnaire containing an autism subscale to explore the autistic-like features that children with FASD exhibit.Studied were 25 children with FASD (age: M = 10.3 years) and 17 normal controls (NCs; age: M = 10.2 years). As part of a larger study, all parents/caregivers completed the Social Skills Improvement System (SSIS; GreshamElliot, 2008), which in addition to evaluating social skills and behavior problems globally, includes an Autism subscale.Between-group comparisons showed the FASD group not only scored significantly lower in social skills and significantly higher in behavior problems than the NC group but children with FASD also scored significantly higher on the Autism subscale. Item analysis revealed they showed the most difficulty in terms of social and communicative functioning and the least in repetitive and restrictive behaviors.Current findings signify that FASD and autism share similarities with regard to social and communicative functioning. These findings, which further our knowledge of the FASD phenotype, may be useful in specifying the particular interventions these children need.

The present study investigates intraindividual variability (IIV) in the Color-Stroop test and in a simple reaction time (SRT) task. Performance level and variability in reaction times (RTs)-quantified with different measures such as individual standard deviation (ISD) and coefficient of variation (ICV), as well as ex-Gaussian parameters (mu, sigma, tau)-were analyzed in 24 children with attention deficit/hyperactivity disorder (ADHD) and 24 typically developing children (TDC). Children with ADHD and TDC presented equivalent Color-Stroop interference effects when mean RTs were considered, and the two groups did not differ in the SRT task. Interestingly, compared to TDC, children with ADHD were more variable in their responses, showing increased ISD and ICV in the Color-Stroop interference condition and in the SRT task. Moreover, children with ADHD exhibited higher tau values-that is, more frequent abnormally long RTs-in the Color-Stroop interference condition than did the TDC, but comparable tau values in the SRT, suggesting more variable responses. These results speak in favor of a general deficit in more basic and central processes that only secondarily may affect the efficiency of inhibitory processes in children with ADHD. Overall the present findings confirm the role of IIV as a cornerstone in the ADHD cognitive profile and support the search for fine-grained analysis of performance fluctuations.

The Test of Everyday Attention for Children (TEA-Ch) is a reliable neuropsychological assessment of attention control in children. Methylphenidate (MPH) is an effective treatment to improve attentional difficulties in children with attention deficit/hyperactivity disorder (ADHD). Previous studies investigating the effects of MPH on attention performance of children with ADHD have produced mixed results and prior MPH usage may have confounded these results. No previous study has tested the effects of MPH on the entire TEA-Ch battery. This study investigated the effects of MPH on attention performance using the entire TEA-Ch in 51 medication-naïve children with ADHD compared with 35 nonmedicated typically developing children. All children were tested at baseline and after 6 weeks: The children with ADHD were medication-naïve at baseline, received MPH for 6 weeks and were tested whilst on medication at the second testing session. A beneficial effect of MPH administration was found on at least one subtest of each of the three forms of attention (selective, sustained, and attentional control) assessed by the TEA-Ch, independent of practice effects. MPH aided performance on the TEA-Ch tasks that were inherently nonarousing and that might require top-down control of attention. It is recommended that the TEA-Ch measures--Sky Search Count (selective attention),Score! (sustained attention), Creature Counting Time Taken for older children (attentional control), and Same Worlds (attentional control) be prioritized for use in future pharmacological studies using MPH.

Attention deficit/hyperactivity disorder (ADHD) has been associated with deficits in self-regulatory cognitive processes, some of which are thought to lie at the heart of the disorder. Slowing of reaction times (RTs) for correct responses following errors made during decision tasks has been interpreted as an indication of intact self-regulatory functioning and has been shown to be attenuated in school-aged children with ADHD. This study attempted to examine whether ADHD symptoms are associated with an early-emerging deficit in posterror slowing.A computerized two-choice RT task was administered to an ethnically diverse sample of preschool-aged children classified as either "control" (n = 120) or "hyperactive/inattentive" (HI; n = 148) using parent- and teacher-rated ADHD symptoms. Analyses were conducted to determine whether HI preschoolers exhibit a deficit in this self-regulatory ability.HI children exhibited reduced posterror slowing relative to controls on the trials selected for analysis. Supplementary analyses indicated that this may have been due to a reduced proportion of trials following errors on which HI children slowed rather than due to a reduction in the absolute magnitude of slowing on all trials following errors.High levels of ADHD symptoms in preschoolers may be associated with a deficit in error processing as indicated by posterror slowing. The results of supplementary analyses suggest that this deficit is perhaps more a result of failures to perceive errors than of difficulties with executive control.

Slower and more variable reaction times to computerized tasks have been documented in children diagnosed with attention deficit/hyperactivity disorder (ADHD). Recent research supports a role for attentional lapses in generating abnormally variable and slow responses. However, given the association between ADHD and impairments in motor control, we hypothesized that slower or more variable reaction times might also correlate with motor development. The aim of this case-control study was to explore the relationship between motor function, reaction speed and variability, and ADHD. After comprehensive educational and clinical assessments, motor skill development was evaluated in 35 children ages 9 to 14 (19 with ADHD) using the Physical and Neurological Examination for Subtle Signs (PANESS) test battery. Finger-sequencing speed and variability were quantified with goniometers. Reaction times were measured with 20 trials each of computerized simple and choice (binary) tasks. Compared to healthy controls, children with ADHD had slower and more variable reaction times, and these findings correlated with impaired motor development (PANESS) and slow and variable finger sequencing (goniometers). Further studies of motor development in ADHD may identify factors influencing speed and variability of reaction times.

In order to achieve further insight into the comorbidity of reading disorder (RD) and attention deficit/hyperactivity disorder (ADHD), lexical processing and rapid naming were studied in RD and ADHD. The Dual Route Cascaded model postulates that lexical processing contains two parallel processes: lexical route processing and sublexical route processing. An orthographic decision task and a phonological decision task were used to measure lexical and sublexical route processing, respectively. In addition, a rapid naming task was used to compare 27 children with RD, 18 children with ADHD, 20 children with ADHD+RD, and 29 controls. RD and ADHD shared impairments in accuracy of orthographic and phonological decision making as well as in rapid naming, which suggest that RD and ADHD may be overlapping disorders that share deficits in both lexical route and sublexical route processing. RD was dissociated from ADHD by being slower in both orthographical and phonological decision making that indicates unique deficits in RD on lexical and sublexical speed. © 2012 Psychology Press.

This study investigated the role of inattention and working memory in predicting academic achievement in 145 adolescents aged 13 to 18 referred for attention deficit/hyperactivity disorder (ADHD). Path analysis was used to examine whether auditory-verbal and visual-spatial working memory would mediate the relationships between classroom inattention symptoms and achievement outcomes. Results provide support for the mediational model. Behavioral inattention significantly predicted both auditory-verbal and visual-spatial working memory performance. Auditory-verbal working memory was strongly associated with adolescents' achievement in reading and mathematics, while visual-spatial working memory was only associated with achievement in mathematics. The path from inattention symptoms to reading was partially mediated by the working memory variables, but the path from inattention to mathematics was not mediated by working memory. The proposed model demonstrated a good fit to the data and explained a substantial amount of variance in the adolescents' achievement outcomes. These findings imply that working memory is a risk factor for academic failure for adolescents with attentional problems.

Attention deficit/hyperactivity disorder (ADHD) has been associated with a deficit in working memory across both verbal and spatial domains, but the precise nature of this deficit is poorly understood. The dual-component model postulates that working memory capacity consists of two dissociable components: maintenance in primary memory (PM) and recall from secondary memory (SM). Participants diagnosed with ADHD (n = 32) and age-matched controls (n = 31) performed both verbal and spatial free-recall tasks, and subsets of these two samples were selected for further comparison based on their use of a “recency” order-of-report strategy. The primary results showed that maintenance in PM appears to be largely intact whereas recall from SM appears to be deficient in ADHD relative to age-matched controls. Similar outcomes were observed across both task domains. Implications for understanding both the underlying pathology and treatment of ADHD are discussed.

Thirteen children with attention deficit/hyperactivity disorder (ADHD: DSM-IV-TR) participated in the pilot study. They carried out a Go/No-Go test with a short (2 seconds) and long (6 seconds) interstimulus interval (ISI) when on placebo and a therapeutic dose of methylphenidate (MPH). For the long-ISI placebo condition the responses were slow and inaccurate. This pattern of response may be due to underactivation of the readiness-to-respond state that is not fully controlled by effort allocation. Speed of response and accuracy were enhanced during the short-ISI placebo condition and the long-ISI MPH condition. However, the combined effect (short ISI and MPH) resulted in a fast but inaccurate response style. This pattern of response may be due to overactivation of the readiness-to-respond state. The data of the pilot study support the stimulus shift hypothesis: MPH administration result in deterioration on tests on which children had previously done well (short ISI plus placebo versus short ISI plus MPH). In addition, the data support the idea that ADHD is associated with poor state regulation rather than motivational (delay aversion) theories or temporal-processing/time-estimation theories of ADHD. The pilot study defined empirically an issue for further study with the larger controlled sample.

The study is designed to investigate response inhibition in children with conduct disorder and borderline intellectual functioning. To this end, children are compared to a normal peer control group using the Alertness test. The test has two conditions. In one condition, children are instructed to push a response button after a visual "go" signal is presented on the screen. In a second condition the "go" signal is preceded by an auditory signal, telling the child that a target stimulus will occur soon. Compared to the control group, the group carrying the dual diagnosis made many preliminary responses (responses before the presentation of the "go" signal), especially in the condition with an auditory signal. This impulsive response style was controlled for attention deficit/hyperactivity disorder characteristics of the children.

The ability to remember intentions (prospective memory) is fundamental to the organization of goal-directed actions in everyday life. Successful prospective remembering involves forming, retaining, initiating, and executing an intention. Although previous research has demonstrated prospective memory impairments in children with attention deficit/hyperactivity disorder (ADHD), this has largely focused on the intention initiation and execution stages. In this study, we investigate the performance of 20 children with ADHD and 20 matched controls at each of the four stages of prospective memory, using a computer multitask paradigm. Results suggest that children with ADHD may demonstrate difficulties forming delayed intentions, as indicated by impulsive planning, and that this may have further implications for the retention and implementation of these delayed intentions. While children with ADHD showed comparable multitask switching, this appeared to be at the expense of intention execution as they made more performance errors than controls. Implications for day-to-day functioning are discussed.

The research was designed to determine whether the purported hemispheric asymmetries that are associated with attention deficit/hyperactivity disorder (ADHD) affect performance on a selective attention visual search task, and whether any obtained asymmetry will be modulated by methylphenidate. Two groups of children (8-15 years) with ADHD, one with methylphenidate treatment (ADHD+) and one without (ADHD+), were compared to matched controls on a two-stage visual search task. The task assessed right-left visual field asymmetries and the effects of changing a previous distractor into a target. Such a procedure, related to latent inhibition (LI; poorer performance to a previously irrelevant stimulus than to a novel one), can provide evidence for dysfunctional processing of irrelevant stimuli. All three groups exhibited the LI effect. The ADHD group, however, exhibited less LI for left- than right-side targets, an effect absent in the control and ADHD+ groups, suggesting a lateralized attentional deficit for ADHD+ that was normalized by methylphenidate.

A group of 69 12–year–old children performed three well-known response interference tasks: the Stroop task, the Eriksen flanker ta sk, and the Simon task. Individual differences in accuracy and speed correlated across the tasks. However, there was no correlation between the interference effects on these three tasks. Stroop interference, but not the Simon or flanker effect, was correlated with workin g memory capacity, as obtained from the WISC-R. These results may help clarify the nature of ADHD, which is characterized by problems with response interference.

Recent research has demonstrated that both brain-injured children and children with attention deficit/hyperactivity disorder (ADHD) suffer from response inhibition deficits. To investigate whether these deficits can be influenced by motivational factors, the stop-signal task was performed with and without reward contingencies for successful inhibition. Three groups of children between 8 and 12 years of age, participated in the study: 31 children with ADHD, 37 with traumatic brain injuries (TBI), and 26 normal controls. Results indicated that, although all groups showed comparable learning effects, reward contingencies had different effects on the groups. Whereas the performance of children with ADHD under reward contingencies were brought up to the performance level of normal controls, rewards were found less effective at improving response inhibition in children with TBI. The results further support a motivational/energetic explanation of the inhibitory deficit in children with ADHD, and of a primary response inhibition deficit due to structural brain damage in children with TBI.

The Diagnostic Rating Scale (DRS) was completed by the parents and teachers of 82 children referred for clinical evaluations, 73 referred children seen twice, and 218 non-referred children from the community. The DRS, which uses a categorical rather than a dimensional rating approach, was 70% to 90% sensitive to diagnoses of Attention Deficit/Hyperactivity Disorder (ADHD) made by blind clinical teams. In research and clinical applications, the DRS could improve screening efficiency, especially in situations where it would be desirable to exclude all children who might have ADHD or identify all children with Hyperactive-Impulsive symptoms. Because of its objectivity and consistency with the Diagnostic and Statistical Manual (DSM)-IV criteria, the DRS could facilitate comparison of participant samples across studies.

The Rey-Osterrieth and Taylor complex figures are considered equivalent measures of visual construction and memory. Some investigators have recently questioned this equivalence in adults. The present investigation addresses the question of equivalence of the two figures for children with Attention Deficit Hyperactive Disorder and for normal children. Thirty hyperactive children of normal intelligence and 20 matched normal controls were administered the two complex designs. Scoring was performed according to the standard itemized procedure (Lezak, 1983) and the organization component of the scoring system described by Waber and Holmes (1985). Results demonstrated no difference between the designs. This suggests that children find them equally difficult both for copy and for recall. The clinical implications of using one or the other of the two scoring approaches are discussed.

The effect of white matter abnormalities on neurobehavioral dysfunction was investigated in 58 children with symptomatic HIV-1 disease, 28 with CT white matter abnormalities and 30 matched (for age, gender, route of infection, and stage of disease) control patients with comparable levels of cortical atrophy, but no white matter abnormalities. Children with white matter abnormalities were more impaired on measures of general level of mental functioning (standard scores of 70.3 vs. 86.1; p < .05). They also scored lower than the group without white matter abnormalities on activities of daily living (76.9 vs. 87.4; p < .05), particularly those requiring self-help skills, and in socialization (79.5 vs. 89.3; p < .05). Furthermore, patients with white matter abnormalities exhibited higher levels of attention deficit/hyperactive behaviors (p < .05) and more severe autistic symptoms (p < .05). White matter abnormalities by themselves were, thus, associated with deficits in cognitive function and socio-e...