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Sluggish cognitive tempo : a unique subtype of ADHD-PI or just a symptom?Shepard, Katherine Noelle 23 October 2009 (has links)
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly
diagnosed of child clinical syndromes and is associated with poor academic achievement,
poor peer and family relations, and an elevated risk for anxiety, depression, and conduct
disorder (Barkley ,1990; Barkley, Guevremont, Anastopoulos, DuPaul, & Shelton, 1993;
Barkley, Murphy, & Kwasnik, 1996; Beiderman, Faraone, & Lapey, 1992; Fischer,
Fischer, et al., 1990; Hinshaw, 1994; Nadeau 1995; Weiss & Hechtman, 1993).
Although ADHD is one of the most commonly diagnosed and widely researched
disorders, the diagnostic criteria and defining characteristics of ADHD remain
controversial (Wolraich, 1999).
The current diagnostic formulation, as specified by the DSM-IV-TR, includes
three distinct subtypes: Attention Deficit Hyperactivity Disorder- Predominantly
Hyperactive Impulsive Type (ADHD-H), Attention Deficit Hyperactivity Predominantly
Inattentive Type (ADHD-PI) and Attention Deficit Hyperactivity Disorder- Combined Typed (ADHD-C). Perhaps the most controversial aspect of the current nosology is the
inclusion of the inattention symptoms within the family of ADHD diagnoses (Milich,
Balentine, Lynam, 2001). Researchers and clinicians have further posited that ADHD-PI
represents a distinct disorder with two subtypes: inattentive-disorganized and sluggish
cognitive tempo. This study explored the relation between reading fluency, sluggish
cognitive tempo symptoms, disorganized symptoms, processing speed and ADHD
diagnosis.
This study examined performance of children diagnosed 77 children diagnosed
with ADHD (i.e. 53 participants met criteria for ADHD-PI and 24 participants met
criteria for ADHD-C) on measures of cognitive functioning, processing speed, behavioral
reports, sluggish cognitive tempo, disorganization and reading fluency. Significant group
differences did not emerge on measures of processing speed, sluggish cognitive tempo
symptoms or disorganized symptoms.
Path analysis was employed to examine the simultaneous effects of processing
speed on inattention symptoms, hyperactive/impulsive symptoms, SCT symptoms, DO
symptoms, reading fluency, and internalizing symptoms. In addition, the paths from SCT
symptoms, DO symptoms, inattention symptoms, and hyperactive/impulsive symptoms
to reading fluency and internalizing symptoms were also be examined. Processing speed
had a significant direct effect on SCT symptoms, Inattention Symptoms and Reading
Fluency. In addition, SCT symptoms had a significant direct effect on anxiety symptoms.
In summary, findings from the study provide important information about the link
between processing speed, attention written, and reading fluency. Limitations of the study
and implications for future research and practice are discussed. / text
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The Impact of Peer Tutoring and Self-Monitoring on Oral Reading Fluency for Children who Exhibit Symptoms of Attention-Deficit/Hyperactivity DisorderLeis, Shannon M 22 February 2005 (has links)
This study examined the effects of peer tutoring and self-monitoring interventions on the oral reading performance of students exhibiting symptoms of AttentionDeficit/Hyperactivity Disorder: Predominantly Inattentive Type. A multiple baseline across participants design was used to evaluate the effectiveness of the peer tutoring and self-monitoring interventions with four second grade students who were tutored by fourth grade students. Results indicated that the median number of words read correct per minute as measured by curriculum-based measurement reading probes increased from baseline to intervention phases for three of the four tutee participants. In addition, the median number of errors from baseline to intervention phases decreased for three of the four participants. However, data were highly variable for three of the four participants. In addition, the percentage of intervention data points that overlapped baseline data was higher than the percentage of non-overlapping data points. Consumer satisfaction was rated positively by tutee and teacher participants. All tutee participants rated peer tutoring as a fair intervention and agreed that this intervention would help them do better in school. In addition, teacher ratings indicated that peer tutoring was an acceptable and beneficial intervention for students. The teachers reported that they liked the procedures used in this intervention. Teacher ratings also indicated that these teachers would recommend this intervention to other teachers and would implement this intervention with other students. These teachers also strongly agreed that this intervention would be appropriate for a variety of students. Implications for future research and practice are discussed.
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Avaliação da influência de complicações perinatais na etiologia do transtorno de déficit de atenção/hiperatividade com predomínio de desatençãoSouza, Carla Ruffoni Ketzer de January 2008 (has links)
Introdução O transtorno de déficit de atenção/hiperatividade (TDAH) afeta entre 3 e 10% das crianças em idade escolar, ocasionando prejuízos no funcionamento individual, acadêmico e social na infância e adolescência. Apesar disso, sua etiologia ainda não é totalmente conhecida. A alta herdabilidade do TDAH leva a crer que fatores genéticos exerçam papel fundamental na predisposição para o transtorno. Entretanto, a ocorrência da patologia vai depender ainda da interação de genes com fatores de risco ambientais. Restam muitas questões a serem esclarecidas, uma delas é se há relação entre os fatores de risco ambientais e a expressão fenotípica, resultando nos diferentes subtipos do TDAH. Objetivo O objetivo do presente estudo é investigar a associação entre complicações perinatais (complicações ocorridas nos períodos pré, peri e pós-natal imediato - CPPs) e TDAH do subtipo desatento (TDAH-D). Método Participaram desse estudo, crianças e adolescentes entre 6 e 17 anos, provenientes de doze escolas estaduais e de um ambulatório especializado em TDAH de Porto Alegre. Após a realização de extensa avaliação diagnóstica, foram incluídas 124 crianças e adolescentes com o diagnóstico de TDAH-D e 124 controles sem o transtorno, pareados por idade e sexo. Informações sobre complicações ocorridas durante os períodos pré, peri e pós-natal imediato, assim como sobre potencias confundidores, foram coletadas diretamente com as mães biológicas dos sujeitos. Resultados A análise de regressão logística condicional mostrou que, para as crianças e adolescentes cujas mães apresentaram maior número de complicações perinatais, o risco de TDAH-D foi significativamente mais elevado (p = 0.005; OR= 1.25; IC95%: 1.1 – 1.5). Conclusões Em um estudo de caso-controle, foi possível expandir para o TDAH predominantemente desatento os achados prévios que sugeriam a associação entre fatores perinatais e TDAH sem um subtipo específico. / Introduction Attention-deficit/hyperactivity disorder (ADHD) affects between 3% and 10% of school aged children, leading to impaired individual, academic and social functioning in childhood and adolescence. Despite of that, the etiology of ADHD remains unclear. The high heritability points to a large genetic contribution to the etiology of ADHD. However, the development of the disorder will also depend of an interaction between genetic and environmental risk factors. Many questions remain to be answered, such as the association between the ADHD phenotypic heterogeneity and the environmental risk factors, leading to different subtypes of the disorder. Objective The objective of the present study is to investigate the association between pre-, peri-, and early postnatal complications (PDPC) and ADHD predominantly inattentive type (ADHD-I). Method: Children and adolescents between 6 and 17 years old from 12 public schools, and from an ADHD outpatient program both in Porto Alegre were assessed. After an extensive diagnostic evaluation, 124 ADHD-I cases and 124 non-ADHD controls, matched by sex and age, were included in the study. Informations about prenatal, delivery and early postnatal complications, as well as potential confounders were obtained by direct interview with biological mothers. Results: Conditional logistic regression analysis showed that children and adolescents whose mothers presented more PDPC had a significant higher risk for ADHD-I (p = 0.005; OR= 1.25; CI95%: 1.1 – 1.5). Conclusions: In a case-control study, we expanded to ADHD-I previous findings suggesting the association between perinatal factors and broadly defined ADHD.
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Avaliação da influência de complicações perinatais na etiologia do transtorno de déficit de atenção/hiperatividade com predomínio de desatençãoSouza, Carla Ruffoni Ketzer de January 2008 (has links)
Introdução O transtorno de déficit de atenção/hiperatividade (TDAH) afeta entre 3 e 10% das crianças em idade escolar, ocasionando prejuízos no funcionamento individual, acadêmico e social na infância e adolescência. Apesar disso, sua etiologia ainda não é totalmente conhecida. A alta herdabilidade do TDAH leva a crer que fatores genéticos exerçam papel fundamental na predisposição para o transtorno. Entretanto, a ocorrência da patologia vai depender ainda da interação de genes com fatores de risco ambientais. Restam muitas questões a serem esclarecidas, uma delas é se há relação entre os fatores de risco ambientais e a expressão fenotípica, resultando nos diferentes subtipos do TDAH. Objetivo O objetivo do presente estudo é investigar a associação entre complicações perinatais (complicações ocorridas nos períodos pré, peri e pós-natal imediato - CPPs) e TDAH do subtipo desatento (TDAH-D). Método Participaram desse estudo, crianças e adolescentes entre 6 e 17 anos, provenientes de doze escolas estaduais e de um ambulatório especializado em TDAH de Porto Alegre. Após a realização de extensa avaliação diagnóstica, foram incluídas 124 crianças e adolescentes com o diagnóstico de TDAH-D e 124 controles sem o transtorno, pareados por idade e sexo. Informações sobre complicações ocorridas durante os períodos pré, peri e pós-natal imediato, assim como sobre potencias confundidores, foram coletadas diretamente com as mães biológicas dos sujeitos. Resultados A análise de regressão logística condicional mostrou que, para as crianças e adolescentes cujas mães apresentaram maior número de complicações perinatais, o risco de TDAH-D foi significativamente mais elevado (p = 0.005; OR= 1.25; IC95%: 1.1 – 1.5). Conclusões Em um estudo de caso-controle, foi possível expandir para o TDAH predominantemente desatento os achados prévios que sugeriam a associação entre fatores perinatais e TDAH sem um subtipo específico. / Introduction Attention-deficit/hyperactivity disorder (ADHD) affects between 3% and 10% of school aged children, leading to impaired individual, academic and social functioning in childhood and adolescence. Despite of that, the etiology of ADHD remains unclear. The high heritability points to a large genetic contribution to the etiology of ADHD. However, the development of the disorder will also depend of an interaction between genetic and environmental risk factors. Many questions remain to be answered, such as the association between the ADHD phenotypic heterogeneity and the environmental risk factors, leading to different subtypes of the disorder. Objective The objective of the present study is to investigate the association between pre-, peri-, and early postnatal complications (PDPC) and ADHD predominantly inattentive type (ADHD-I). Method: Children and adolescents between 6 and 17 years old from 12 public schools, and from an ADHD outpatient program both in Porto Alegre were assessed. After an extensive diagnostic evaluation, 124 ADHD-I cases and 124 non-ADHD controls, matched by sex and age, were included in the study. Informations about prenatal, delivery and early postnatal complications, as well as potential confounders were obtained by direct interview with biological mothers. Results: Conditional logistic regression analysis showed that children and adolescents whose mothers presented more PDPC had a significant higher risk for ADHD-I (p = 0.005; OR= 1.25; CI95%: 1.1 – 1.5). Conclusions: In a case-control study, we expanded to ADHD-I previous findings suggesting the association between perinatal factors and broadly defined ADHD.
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Avaliação da influência de complicações perinatais na etiologia do transtorno de déficit de atenção/hiperatividade com predomínio de desatençãoSouza, Carla Ruffoni Ketzer de January 2008 (has links)
Introdução O transtorno de déficit de atenção/hiperatividade (TDAH) afeta entre 3 e 10% das crianças em idade escolar, ocasionando prejuízos no funcionamento individual, acadêmico e social na infância e adolescência. Apesar disso, sua etiologia ainda não é totalmente conhecida. A alta herdabilidade do TDAH leva a crer que fatores genéticos exerçam papel fundamental na predisposição para o transtorno. Entretanto, a ocorrência da patologia vai depender ainda da interação de genes com fatores de risco ambientais. Restam muitas questões a serem esclarecidas, uma delas é se há relação entre os fatores de risco ambientais e a expressão fenotípica, resultando nos diferentes subtipos do TDAH. Objetivo O objetivo do presente estudo é investigar a associação entre complicações perinatais (complicações ocorridas nos períodos pré, peri e pós-natal imediato - CPPs) e TDAH do subtipo desatento (TDAH-D). Método Participaram desse estudo, crianças e adolescentes entre 6 e 17 anos, provenientes de doze escolas estaduais e de um ambulatório especializado em TDAH de Porto Alegre. Após a realização de extensa avaliação diagnóstica, foram incluídas 124 crianças e adolescentes com o diagnóstico de TDAH-D e 124 controles sem o transtorno, pareados por idade e sexo. Informações sobre complicações ocorridas durante os períodos pré, peri e pós-natal imediato, assim como sobre potencias confundidores, foram coletadas diretamente com as mães biológicas dos sujeitos. Resultados A análise de regressão logística condicional mostrou que, para as crianças e adolescentes cujas mães apresentaram maior número de complicações perinatais, o risco de TDAH-D foi significativamente mais elevado (p = 0.005; OR= 1.25; IC95%: 1.1 – 1.5). Conclusões Em um estudo de caso-controle, foi possível expandir para o TDAH predominantemente desatento os achados prévios que sugeriam a associação entre fatores perinatais e TDAH sem um subtipo específico. / Introduction Attention-deficit/hyperactivity disorder (ADHD) affects between 3% and 10% of school aged children, leading to impaired individual, academic and social functioning in childhood and adolescence. Despite of that, the etiology of ADHD remains unclear. The high heritability points to a large genetic contribution to the etiology of ADHD. However, the development of the disorder will also depend of an interaction between genetic and environmental risk factors. Many questions remain to be answered, such as the association between the ADHD phenotypic heterogeneity and the environmental risk factors, leading to different subtypes of the disorder. Objective The objective of the present study is to investigate the association between pre-, peri-, and early postnatal complications (PDPC) and ADHD predominantly inattentive type (ADHD-I). Method: Children and adolescents between 6 and 17 years old from 12 public schools, and from an ADHD outpatient program both in Porto Alegre were assessed. After an extensive diagnostic evaluation, 124 ADHD-I cases and 124 non-ADHD controls, matched by sex and age, were included in the study. Informations about prenatal, delivery and early postnatal complications, as well as potential confounders were obtained by direct interview with biological mothers. Results: Conditional logistic regression analysis showed that children and adolescents whose mothers presented more PDPC had a significant higher risk for ADHD-I (p = 0.005; OR= 1.25; CI95%: 1.1 – 1.5). Conclusions: In a case-control study, we expanded to ADHD-I previous findings suggesting the association between perinatal factors and broadly defined ADHD.
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