Steven K. Shapiro

Experimental analysis of childhood psychopathology: A laboratory matching analysis of the behavior of children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD)

The behavior of children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) has been hypothesized to involve differential sensitivity to parameters of reward and punishment. However, support for these theories has been limited because, in part, of the methods used to investigate them. The current study examined the behavior of six ADHD children and six comparison children on a computer task designed to present different parameters of reinforcement by using concurrent reinforcement schedules. A quantitative analysis of the sensitivity to changing contingencies of reinforcement was conducted by examining the performance of the children across five experimental conditions. Results suggest that although there may have been several mediating variables, children diagnosed with ADHD may show less sensitivity to changing parameters of reinforcement rate as measured by response ratios and time allocation to two concurrently available alternatives. Implications of these results are discussed in terms of the utility of such experimental methods in the study of childhood behavior disorders.

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.

Combining Visual and Auditory Tasks in the Assessment of Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is the diagnostic label in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) (DSM-III-R) (American Psychiatric Association, 1987) that is characterized by developmentally inappropriate hyperactivity, impulsivity, and inattention. Although empirical research has provided various suggestions regarding possible etiology, appropriate assessment practices, and relatively effective intervention strategies, considerable controversy still exists. Changes in diagnostic labels and conceptualization of core symptoms, as well as the use of inconsistent criteria to select subjects, have impinged on establishing the validity of various aspects of ADHD. According to Rutter (1989, p. 20), “we are not yet at a stage where there can be consensus on precisely how this concept should be operationalized, nor do we adequately understand the mechanisms involved.” The development of reliable and valid assessment techniques has been of particular interest to clinical researchers in an attempt to go beyond the criteria established in DSM-III-R and to utilize a multimethod psychometric approach. Thus, research has continued to delineate laboratory-based assessment strategies that possess concurrent, predictive, and ecological validity, the latter referring to the degree to which the test results are representative of “real-world” behavior (Barkley, 1991).

Behavior Checklists and Rating Forms

A number of checklists exist for the assessment of phobic and anxiety disorders in children. Generally, the instruments are designed to be completed by lay persons (e.g., parent, teacher, or peer), and include a range of items tapping several constructs, of which phobic and anxiety disorders are a few. The purpose of this chapter is to review the research and clinical utility of selected behavior checklists in the assessment of phobic and anxiety disorders in children. General psychometric issues are addressed first; selected instruments are then briefly reviewed.

Evaluation of learning-disabled students with the Differential Ability Scales (DAS)

Abstract This study examined the performance characteristics of 83 school-identified learning-disabled (LD) children on the Differential Ability Scales (DAS). As a group, the children scored low on many subtests relative to normative data. Correlations between the DAS and archival Wechsler Intelligence Scale for Children-Revised (WISC-R) and achievement tests provided further evidence for DAS validity, although differences in the cognitive processes measured remain. Sixty percent showed a significant standard score discrepancy between the General Conceptual Ability (GCA) and at least one achievement test, based on the simple difference approach. Based on DAS ability-achievement discrepancy patterns, comparisons between more homogeneously defined groups yielded few differences that were independent of group definition criteria. The results from a cluster analysis (Wards method) yielded two subgroups that differed in terms of their ability-achievement discrepancy. Numerical auditory-sequential recall (Recall of Digits) appeared to be equally problematic for the two subgroups. Overall, compared with previous DAS studies, fewer implications regarding cognitive processes underlying learning disability can be made with findings from this study. It remains unclear whether the cognitive characteristics measured by the DAS will facilitate or improve the educational diagnostic and intervention processes currently utilized with LD children.

Koppitz scoring system as a measure of Bender-Gestalt performance in behaviorally and emotionally disturbed adolescents.

Data are presented to assess the use of the Koppitz scoring system for the Bender-Gestalt Test in a sample (N = 87) of behaviorally and emotionally disturbed adolescents. Results suggested that age was modestly related to Koppitz Developmental scores, an indication that visual-motor skills continue to develop beyond age 11. Scores were related to spatial perception skills as measured on the WISC-R. Gender, primary psychiatric diagnosis, educational tests, and MMPI scores were not related to Bender performance. Findings are discussed in terms of a need for additional research into the utility of the Bender as a measure of visual-motor skills in adolescents.

Patterns and Predictors of Performance on the Bender-Gestalt and the Developmental Test of Visual Motor Integration in a Sample of Behaviorally and Emotionally Disturbed Adolescents

A sample of 78 behaviorally and emotionally disturbed adolescents was used to evaluate the degree of similarity between the Bender-Gestalt and the VMI-3R and to investigate the factors involved in performance on these visual-motor tests, using measures of cognitive ability and a self-report personality measure. Results indicated a signify cant relationship between age and VMI-3R scores, which reflects the sensitivity of this measure to continued visual-motor development beyond age 11. VMI-3R performance was correlated with most cognitive ability subtests, which, in conjunction with age, accounted for 57% of the variance. Bender performance showed less developmental sensitivity and considerably fewer relationships with comparison measures. Findings are discussed in terms of the utility of each measure with adolescents and the implications for prediction of performance.

Transition to College and Adherence to Prescribed Attention Deficit Hyperactivity Disorder Medication

Objective: As youth with attention deficit hyperactivity disorder (ADHD) transition to adulthood, they must learn how to manage their ADHD treatment independently. This may be challenging because many of the skills necessary to adhere to treatment (e.g., organization, planning) are impaired in those with ADHD. Using electronic monitoring, we examine trajectories of adherence to medication in a cohort of college students with ADHD. Further, we examine the effect of transitioning to college and executive functioning on adherence. Methods: Electronic monitors tracked adherence for 51 undergraduate students with ADHD across an academic semester. Multilevel modeling examined individual trajectories in monthly adherence and the role of transition status and self-reported executive functioning on these trajectories. Results: Overall, participants adhered to 53.53% of prescribed doses. Transition status predicted the linear slope in adherence (&bgr; = −8.95, standard error [SE] = 3.61, p < .05), with lower initial adherence among undergraduates transitioning to independence (34.17%) compared with post-transition undergraduates (67.63%; &bgr; = 33.46, SE = 8.00, p < .001). Adherence demonstrated a curvilinear change (&bgr; = −7.23, SE = 1.25, p < .001). It increased from the beginning of the semester to midterms before subsequently declining through the rest of the semester, including during final exams. Executive functioning did not predict adherence (&bgr; = −.10, SE = .02, p = .54). Conclusion: Only half of all doses were taken as prescribed. Adolescents transitioning to independence demonstrated the lowest levels of adherence, suggesting that the transition to independence is a high-risk period for poor self-management of ADHD.

Using a Naturalistic Sport Context to Train Social Skills in Children

ABSTRACT Researchers have utilized sports activities to deliver social skills training (SST) programs to children. Using a multiple-baseline across behaviors design, we examined whether a brief SST program delivered during a soccer camp would increase social skills and athletic competencies. Each participant’s self-concept, and his interest in soccer were evaluated. Results suggest that the SST procedure effectively increased targeted social skills. Further, participants reported increased interest in soccer and higher overall self-concept. Our results suggest that similar effects can be achieved in a relatively short, but intense, camp that utilizes SST and sports-skill training components. Limitations and implications are discussed.