Dorte Damm

Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ?

OBJECTIVE The study investigates behavioural, academic, cognitive, and motivational aspects of functioning in school-age children with attention-deficit/hyperactivity disorder (ADHD) with and without an executive function deficit (EFD). METHOD Children with ADHD--EFD (n = 22) and children with ADHD + EFD (n = 26) were compared on aspects of ADHD behaviour, school functioning, general cognitive ability, intra-individual response variability, affective decision-making, and delay aversion. RESULTS Children with ADHD--EFD and children with ADHD + EFD were comparable in terms of ADHD symptomatology and school functioning. However, children with ADHD + EFD had significantly lower IQ and more intra-individual response variability than no EFD counterparts. Children with ADHD alone appeared more delay averse on the C-DT task than children with ADHD + EFD. CONCLUSIONS Some children with ADHD were primarily characterised by problems with executive functions and variability others by problems with delay aversion supporting multiple pathway models of ADHD. Given the exploratory nature of the study, results are in need of replication.

Executive Dysfunction in School-Age Children with ADHD.

Objective: The study examined executive function deficits (EFD) in school-age children (7 to 14 years) with ADHD. Method: A clinical sample of children diagnosed with ADHD (n = 49) was compared to a population sample (n = 196) on eight executive function (EF) measures. Then, the prevalence of EFD in clinical and non-clinical children was examined at the individual level according to three methods previously applied to define EFD, and a fourth method was included to control for the effect of age on performance. Results: Children with ADHD were significantly more impaired on measures of EF than children without ADHD at the group level. However, only about 50% of children with ADHD were found to have EFD at the individual level, and results appeared relatively robust across methods applied to define EFD. Conclusion: As a group, children with ADHD displayed more problems on neuropsychological measures of EF than non-clinical children; at the individual level, there appeared to be heterogeneity in EF impairment.

Developmental profiles on the basis of the FTF (Five to Fifteen) questionnaire: Clinical validity and utility of the FTF in a child psychiatric sample

The Five to Fifteen parent questionnaire (FTF) was developed to offer a neuropsychological dimension to the assessment of children with Attention Deficit/Hyperactivity Disorder and other child psychiatric disorders. The domains included in the FTF were motor skills, executive functions, perception, memory, language, social skills and learning, in addition to a domain for emotional and behavioural problems. The aim of the present study was to test the clinical validity and utility of the FTF with a main focus on discriminant and criterion validity. The clinical sample consisted of 155 clinically diagnosed children (ICD-10 criteria), 102 were tested with WISC-III. The parents rated their children independent of the diagnostic evaluation. The results were presented as profiles. These clinical profiles were compared to those of a Swedish norm sample consisting of 854 children from the age of five to fifteen. Results demonstrated that the profiles for the clinical groups were similar in forms and levels to those of the upper 10 percent of the norm sample (those with most difficulties). Five out of eight FTF domains discriminated significantly between diagnostic groups in the clinical sample. Influence of IQ, gender and age on the results were low. Three out of four relevant FTF domains correlated significantly with corresponding WISC-III indexes/measures. The clinical utility of individual children’s profiles were demonstrated. On the whole, the findings supported the clinical validity and utility of the FTF.

Gilles de la Tourette syndrome in a child with congenital deafness.

Abstract We present the case of a 10-year-old boy, Sam, with congenital deafness and Gilles de la Tourette Syndrome (GTS). GTS is characterised by multiple motor tics and one or more vocal tics that wax and wane. Due to his deafness Sam never developed vocal language but instead used sign language from the age of four. His tic disorder rapidly accelerated from the age of seven over a six-month period and soon sign language was incorporated into tics as complex “vocal” tics. Bursting out “words”in sign language would also occur in front of people unfamiliar with sign language and often with an obscene content although this was not evident to someone not trained in sign language.To our knowledge this is the first reported case of a congenital deaf child with GTS. The case presented here supports previously published work that the intentional share of the tics in GTS is very small. This case also questions former theories on which regions and circuits of the brain are involved in GTS.

The Parental Emotional Response to Children Index: A Questionnaire Measure of Parents’ Reactions to ADHD

Objective: The current study introduces the Parental Emotional Response to Children Index (PERCI), a new questionnaire specifically designed to measure parents’ emotional response to ADHD and related behaviors (delay discounting and delay aversion). Method: The PERCI was completed by parents of 6- to 14-year-old children with (n = 126) and without (n = 160) ADHD. Results: Factor analysis confirmed five separate subscales with acceptable psychometric properties. Parents of children with ADHD reported a stronger emotional response to ADHD behaviors than parents of typically developing children and inattention symptoms evoked the strongest emotional response in parents regardless of child diagnostic status. Conclusion: Parents’ emotional responses appear to be differentiated in terms of specific ADHD-related triggers mapping onto the different domains of ADHD and delay-related responses. Further research is required to understand changes in parental emotional responses over time and their impact on children’s developmental trajectories.