Objectives: Available studies largely and consistently indicate that children with Attention Deficit Hyperactivity Disorder (ADHD) experience significantly impaired quality of life (QoL). More research is required to enable an enhanced understanding of factors which contribute to the QoL of children with this diagnosis. In relation to children with ADHD, this thesis had two main aims: to review the extent to which children and their parents agree in their assessments of the child’s QoL; and to examine the impact of parent stress on the child’s QoL from both parent and child perspectives. Method: A systematic review of studies reporting matched parent-proxy reported and child self-reported quantitative QoL measures is described in journal article 1. Journal article 2 presents the findings from a cross-sectional, quantitative study involving a matched sample of 45 children with a diagnosis of ADHD, and their parents. Correlation and multiple regression analyses examine the relationship between parent stress and each of the informants’ ratings of the child’s QoL. Results: The findings of the systematic review indicated that in a clear majority of studies, children rated their QoL more highly than their parents. However, cautious interpretation is required as some of the studies were of poor methodological quality. In the empirical study, parent stress emerged as a significant predictor of parent proxy-ratings of child QoL, but not of self-rated QoL. Parents who rated their child’s QoL lower that their children had higher perceived stress than parents who rated their child’s QoL higher than their children. There were no significant differences in self-rated or parent-rated QoL between children with ADHD and children with a learning disability or with an Autism Spectrum Disorder. In line with some previous research, agreement was poorer on psychosocial domains than physical domains. However, due to the relatively small sample size, the empirical study requires replication. Conclusions: The results of the systematic review suggest that parent and child ratings of the child’s QoL are not interchangeable in the context of ADHD. Possible explanations for this trend are discussed. The empirical study suggests that parent stress negatively impacts on children with ADHD, and that it is likely that children’s self-reports are affected by their impaired reflective capacity. Clinical implications and recommendations for future research are discussed in relation to both articles.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a commonly occurring neurodevelopmental disorder in children, affecting 3-7% of children (APA, 2000). Despite the high prevalence of ADHD, conceptualization of its subtypes, ADHD-PI and ADHD-C, remains under debate. One method of describing psychopathology is through the use of personality traits. The current study evaluated relationships between ADHD subtypes, ADHD symptoms, and the Big Five in 83 children between 8 and 12 years of age. Children with ADHD were consistently rated as having lower Agreeableness, Conscientiousness, and Openness than children without ADHD. Additionally, children with ADHD-PI had the lowest Openness, and children with ADHD-C had the lowest Conscientiousness, although these results differed by rater. When evaluating the symptom domains of ADHD, Extraversion, Conscientiousness, and Emotional Instability were associated with H/I, whereas only Conscientiousness was associated with inattention. Hyperactivity, specifically, was related to Extraversion, Conscientiousness, and Emotional Instability, whereas impulsivity was related to Conscientiousness and Emotional Instability only. Last, connections between the Emotional Regulation, Emotional Instability, and H/I are discussed. Implications regarding the use of personality measures to describe psychopathology in childhood are discussed, as are the challenges of using multiple raters in clinical populations.

The current study explored the relationship between middle frontal gyrus (MFG) volume and working memory in children with Attention-Deficit/Hyperactivity Disorder (ADHD) and dyslexia (RD). it was hypothesized that there would be group differences in middle frontal gyrus volume and working memory performance, and that there would be a relationship between middle frontal gyrus volume and working memory performance. Results indicated that there was a trend of smaller left hemisphere middle frontal gyrus volumes in the RD groups compared to the non-RD groups. In addition, when total brain volume, Passage Comprehension and Attention Problems were included as covariates, Sequences, a verbal working memory task, significantly predicted left MFG volume. Finally, when exploratory analyses were conducted, Passage Comprehension significantly predicted both left and right MFG volumes when both Reading Fluency and Letter Word Identification were also included in the model as predictors. Little research has been conducted on the relationship between MFG volumes and RD and ADHD groups. Significant findings and trends reported here related to RD groups and reading-related tasks indicate that further research exploring the relationship between complex working memory tasks like Passage Comprehension and MFG volumes is warranted.

Psychology / M.A. (Psychology)

Nesta tese objetivamos analisar a compreensão de professoras de escolas públicas sobre o Transtorno de Déficit de Atenção e Hiperatividade (TDAH) e as suas práticas pedagógicas, junto a alunos com esta necessidade especial. Os esforços compilados no presente estudo nasceram da nossa prática profissional, num processo de múltiplas experiências e observações em ambientes escolares onde atuamos diretamente, somados a carência de profissionais habilitados sobre a temática, na área da Educação. Por isso, buscamos compreender como os professores têm trabalhado pedagogicamente com seus alunos com TDAH. Apesar dos muitos cursos de formação docente, os nossos professores têm poucas oportunidades de conhecer melhor o TDAH, em especial no Estado da Paraíba, onde este tema não é suficientemente discutido. O TDAH tem como principal característica a ausência de auto controle ocasionada por fatores orgânicos. Neste trabalho trouxemos a discussão sobre o TDAH, desde seus conceitos às práticas de interação apresentadas por diferentes autores. Realizamos uma pesquisa nas escolas do município de João Pessoa, junto a oito professoras, que tinham tido alunos com TDAH em suas classes, as quais responderam às questões em uma entrevista semiestruturada. Seis entre as oito professoras entrevistadas haviam concluído curso superior, no entanto, nenhuma delas realizou curso na área da Educação Especial ou para lidar com pessoas com TDAH. Os relatos dessas professoras revelaram que o trabalho com as crianças com TDAH, em geral, não diferia dos demais alunos da classe. Contudo, algumas professoras mostraram uma certa flexibilidade, como por exemplo, oferecendo outras atividades para as crianças com TDAH, quando esses alunos conseguiam concluir suas tarefas com mais rapidez. Foi verificado que o aluno com TDAH chegava à sala de aula sem nenhum suporte profissional, com exceção do esperado trabalho do professor. Conforme constatamos, poucas professoras tinham conhecimento prévio de que seu aluno possuía diagnóstico do TDAH. No entanto, isso não motivou as professoras ou a escola a buscar subsídios para que o aluno com TDAH fosse direcionado adequadamente. Para Benczik e Bromberg (2003), a presença de professores compreensivos, que colaborem com a criança, é imperativo para o desenvolvimento do potencial do aluno com TDAH. Como discutido, este transtorno envolve três tipos: o desatento, o hiperativo e o impulsivo. Isto nos levou a perceber que as atividades precisariam ser mais especificas, pois cada tipo de TDAH apresenta peculiaridades diferenciadas, ou seja, que cada um deles apresenta necessidades educacionais especiais específicas que demandam atendimento diferenciado. É relevante, portanto, que sejam realizados estudos que pontuem e trabalhem cada tipo de TDAH enfatizando suas especificidades visando um melhor desenvolvimento acadêmico e social destes alunos. / In this thesis we had as objective to analyze the understanding of public school teachers about the Attention Deficit Hyperactivity Disorder (ADHD) as well as their pedagogical practices with students with this special need. The efforts for the present study raised from our professional practice, in a process of multiple experiences and observations in school settings where we worked, added to the lack of professionals specialized in this theme among the area of Education. Therefore, we seek to understand how teachers have been working pedagogically with their students with ADHD. In spite of many teacher formation courses, our teachers have few opportunities to know more about the ADHD, especially in the State of Paraiba, where this theme is not sufficiently discussed. In this work we brought the discussion about ADHD, from its concept to the interaction practices presented by different authors. We undertook a research in schools of the City of Joao Pessoa, with eight teachers who had in their classes, students with ADHD, who answered questions in a semi-structured interview. Six among the eight teachers interviewed had concluded higher education, however, none had done any courses in the area of Special Education or geared to deal with persons with ADHD. The reports of these teachers showed that the work with ADHD children, in general, was not different that with the other students of the class. But some teachers showed a certain flexibility, for example, offering other activities for children with ADHD when these students were able to finish their tasks more quickly. It was verified that the student with ADHD arrived at the classroom without any professional support, with the exception of the expected work of the teacher. As we were able to notice, few teachers had previous knowledge that the student had ADHD diagnosis. However, this fact was not enough to motivate them or the school to search for subsidies in order for the student with ADHD to be adequately directed. For Benczik and Bromberg (2003), the presence of understanding teachers who collaborate with the child, is very important for the students with a ADHD potential development. As discussed, this disorder involves three types: non attentive, the hyperactive, and the impulsive. This lead us to perceive that the activities should be more specific, since each type of ADHD presents different peculiarities, that is, each one of them presents specific educational special needs that demand differential treatment. It is relevant, therefore, that be undertaken studies that focus and work each ADHD type, with emphasis in their specificities in order to achieve a better academic and social development for this students.

Attention deficit-/hyperactivity disorder (ADHD) is a psychiatric condition that can affect both children and adults. It is characterised by behavioural and attention difficulties. Sleep deficits are a prominent characteristic of the disorder and some of the core symptoms of ADHD are known characteristics of sleep deprivation. The circadian clock is integral to determining the rhythm of the sleep/wake cycle. Furthermore the two main forms of pharmacological treatment for ADHD, namely the psychostimulant methylphenidate, and the non-stimulant atomoxetine, along with the targets of these drugs noradrenaline and dopamine, appear to both interact and be under the regulation of the circadian clock. This thesis aimed firstly to develop a non-invasive technique for the real time RT- PCR quantification of circadian clock gene expression in the human oral mucosa. Secondly to address how circadian clock functioning may be disturbed in adult ADHD via measurement of a number of molecular, endocrine and behavioural markers, for which real-time RT-PCR, ELISA and actigraphy techniques were employed. Thirdly to examine the effects of ADHD medication upon circadian clock protein expression in the rodent brain using immunohistochemistry methods. Here it is demonstrated that disturbances in the rhythmic secretion of endocrine factors that are key outputs and regulators of the master circadian pacemaker, the circadian clock gene expression of a peripheral oscillator and the actigraphic measures of circadian organization of gross behaviour are associated with adult ADHD. Furthermore, both atomoxetine and methylphenidate are shown to effect circadian clock protein expression. Collectively this data suggests a key role for the circadian clock not only in the pathophysiology of adult ADHD but also indicates a role for pharmacological treatments in the modulation of the circadian clock.

Attention deficit and hyperactivity disorder (ADHD) is characterised by a range of behaviours that include excessive motor activity and distractibility. Motor coordination problem is often a feature. It is therefore likely that motor control mechanisms are implicated in ADHD and then executive function associated with it. After a literature review on the correlation between cognition and movement (chapter 1), the novel VSWM (chapter 2) and sequential learning (chapter 3) tasks are introduced. Based on the typical Corsi tapping task, participants were instructed to either move their hand to the stimulus presented on the computer screen or tap the keyboard when they saw it, while trying to remember the location and order of the stimuli. The results suggest that movements deteriorate VSWM in both ADHD and control groups (chapter 2) while they had a tendency to improve learning performance in healthy but not ADHD participants (chapter 3). It was posited that the results from both tasks could have been influenced by differences in the ability to concentrate on the task and difficulty in controlling movements. Two other experiments were used to test this assumption and eliminate any confounds from the memory and learning tasks. The results from chapter 4, which looks at divided attention, indicate a significantly higher response rate in the ADHD compared to the healthy participants, while showing no significant deficit in fine motor but rather on the attentional control (chapter 5) in ADHD participants. These findings are summarised in chapter 6 and discussed in terms of 1) the relationship between movement and cognitive function, 2) the causation of the VSWM deficit in ADHD, and 3) the potential use these tasks may have in a clinical setting as an assessment tool or cognitive training program for people with ADHD.

Stimulant drugs often have a profound calming effect on overactive and inattentive behaviors in children with attention deficit-hyperactivity disorder (ADHD), but only approximately 75 per cent of these children respond favorably to this treatment (Barkley, 1977). Discrimination of "responding" and "non-responding" groups on the basis of demographic, neurophysiological, or behavioral variables would be beneficial both for clinical (elimination of drug trial) and theoretical (description of subtypes) reasons. Previous researchers have identified many promising predictor variables, but relationships between predictor and criterion variables have generally been modest (although statistically significant) in size, and criterion variables have been poorly delineated. In addition, few multivariate investigations have been reported which take into account the relative predictive weight of these variables. The present study evaluated the multivariate relationship between several predictor variables and response to medication in 336 ADHD children, as measured through both rating scales and longer-term outcome measures. Multiple regression analyses revealed that measures of inattention and overactivity were the best predictors of response to a double-blind stimulant medication trial, as determined through parent and teacher rating scales. For cases in which rating scale data were not available, discriminant function analyses for "yes" versus "no" responders were also carried out, indicating results similar to those above. These relationships were highly significant but have limited clinical utility. Demographic variables were generally unsuccessful at prediction of medication response. Additional findings indicated that the results of the clinical trial (as determined by parent and teacher behavioral ratings) were not strongly related to ultimate placement on medication. Further exploration of this issue is called for. / Graduate

Resumo: Neste trabalho investigamos, por meio de aplicação das Provas Operatórias de Conservação de Quantidades Continuas e Descontinuas do Exame Clinico de Piaget, estruturas cognitivas de 50 crianças, das quais 25 pacientes com idades de 7 a 14 anos com TDAH, seguidos no Ambulatório de Neurologia Infantil da UNESP - Botucatu, e 25 crianças na mesma faixa etária, não TDAH para controle. A equipe multiprofissional avaliou os sujeitos que apresentaram nível intelectual esperado para a faixa etária... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This work investigated, through the application of the Operational Tests of Conservation of Continuous and Discontinuous Quantity of Piaget's Clinical Examination, cognitive strutures of 50 children, 25 of them were ADHD patients whose ages ranged between 7 and 14, followed up in the Pediatric Neurology Clinic of UNESP (São Paulo's State University) - Botucatu campus, and the other 25 children, non-ADHD, belonging to the same age group, composed the control group. The subjects were assessed by a multiprofessional team and the intellectual level they presented was expected according to the age group... (Complete abstract, access undermentioned eletronic address) / Orientador: Tamara Beres Lederer Goldberg / Coorientador: Niura Aparecida Ribeiro de Moura Padula / Banca: Simone Aparecida Capellini / Banca: Patrícia Abreu Pinheiro Crenitte / Mestre

Made available in DSpace on 2014-06-11T19:28:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-01-30Bitstream added on 2014-06-13T18:32:26Z : No. of bitstreams: 1 campos_lga_me_botfm.pdf: 1198269 bytes, checksum: 2d010ec2d7b52fe2fcdd51442bcb5e10 (MD5) / Neste trabalho investigamos, por meio de aplicação das Provas Operatórias de Conservação de Quantidades Continuas e Descontinuas do Exame Clinico de Piaget, estruturas cognitivas de 50 crianças, das quais 25 pacientes com idades de 7 a 14 anos com TDAH, seguidos no Ambulatório de Neurologia Infantil da UNESP - Botucatu, e 25 crianças na mesma faixa etária, não TDAH para controle. A equipe multiprofissional avaliou os sujeitos que apresentaram nível intelectual esperado para a faixa etária... / This work investigated, through the application of the Operational Tests of Conservation of Continuous and Discontinuous Quantity of Piaget's Clinical Examination, cognitive strutures of 50 children, 25 of them were ADHD patients whose ages ranged between 7 and 14, followed up in the Pediatric Neurology Clinic of UNESP (São Paulo's State University) - Botucatu campus, and the other 25 children, non-ADHD, belonging to the same age group, composed the control group. The subjects were assessed by a multiprofessional team and the intellectual level they presented was expected according to the age group... (Complete abstract, access undermentioned eletronic address)