Thesis (MEdPsych)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The labelling and marginalisation practices implemented and sustained by conventional methods of education and psychology motivated the research curiosity. The significance of the learner's own experiences, the learner's own meaning-making through his/her own story-telling or the stories others tell about him/her and the constituting effects of alternative identity conclusions are explored as means of creating more preferred identity conclusions In engaging in the re-tellings of a learner's experiences at home and school, a qualitative research practice has been apllied, revealing meaning-making of alternative stories. Feminist theory and post-modern ideas and discourses have assisted me, and the participant, in the deconstruction of ADHD, depression, identity and divorce which contributed to the marginalisation of a learner due to dominant discourses within culture, education and psychopathology. Narrative approaches to therapy and an ethic of participation have guided us to emphasise the necessity of recognising a learner's preferred ways of understanding his/her experiences and what that tells about the person. Pseudonyms have been used to respect the participant's privacy. / AFRIKAANSE OPSOMMING: Die ettikettering en marginaliserende praktyke wat gebasseer en onderhou word deur konvensionele opvoedkundige en sielkundige diskoerse, het die navorsingsnuuskierigheid by my ontlok. Die beduidenheid van 'n leerder se eie ervarings en pogings tot betekenismaking deur die oorvertel van sy/haar eie stories en die aanhoor van ander se stories oor hom/haar word uitgelig. Die konstitusionerende aard van hierdie alternatiewe identiteitskonklusies word geeksploreer om meer verkose identiteitskonsepte daar te stel. Met my deelname aan die oorvertelling van die leerder se ervarings by sy huis en skool, is 'n kwalitatiewe navorsingsbenadering gevolg, wat die betekenismaking van alternatiewe stories kan uitlig. Feministiese teorie, postmoderne denke en diskoerse was die sleutels wat gebruik is deur my en die deelnemers, om die betekenis van ADHD, depressie, identiteit en egskeiding te ontsluit en te dekonstrueer. Die marginaliserende praktyke wat in die naam van hierdie fenomene gepleeg word binne die dominante kultuur, opvoedkundige praktyke en psigopatologie word bevraagteken. 'n Narratiewe benadering tot terapie en 'n etiek van deelname het ons gelei om die nodige erkenning aan die leerder se verkose maniere om sy ervaringe te verwoord en wat dit omtrent sy identiteit impliseer. Pseudoname is gebruik om die deelnemer se privaatheid te respekteer.

Nonverbal Learning Disability (NVLD) is a syndrome characterized by impaired social perception, visual-spatial skills, fine motor coordination, and mathematics abilities. Researchers have found that children with NVLD often have significant symptoms of inattention, and there is evidence that the majority of children with NVLD also meet clinical criteria for Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Subtype (ADHD:PI) (Brown, 2000; Gross-Tsur & Shalev, 1995; Voeller, 1996). Although significant overlap is observed between NVLD and behavioral symptoms of ADHD, little research has focused on the specific attention problems of children with NVLD. Given the high incidence of co-morbid attention problems with NVLD (Brown, 2000), many researchers have proposed that overlapping neural regions are responsible for the similarity in attention impairments observed in both NVLD and ADHD:PI (Denckla, 2000; Stefanatos, 2001). Other researchers suggest that there are distinct neurological impairments in children with NVLD and both subtypes of ADHD that result in attention problems. Specifically, Rourke (1995) suggested a developmental sequence that results in generally intact auditory attention with impaired attention for visual stimuli in children with NVLD. This study sought to reconcile the discrepancy between conceptualizations of attention problems in children with NVLD. It was hypothesized that children with NVLD would exhibit distinct profiles of strengths and weaknesses on neuropsychological measures of attention compared to children with ADHD, Predominantly Inattentive Subtype (ADHD:PI) and ADHD, Combined Subtype (ADHD:C). Specifically, it was expected that the three diagnostic groups would differ on the neuropsychological measures depending on the attention modality (auditory vs. visual). Extant neuropsychological data from 88 children between the ages of 9 and 15 years of age with diagnoses of NVLD, ADHD:PI, and ADHD:C were analyzed. Neuropsychological measures of processing speed, working memory, vigilance, and inhibition were examined to compare specific domains of attention functioning in the three groups. Evidence from the current study supported the model in which NVLD and the two ADHD subtypes represent a continuum of dysfunction dependant on overlapping neural regions. Moreover, specific attention strengths and weaknesses in children with NVLD compared to children with ADHD:PI, ADHD:C, and normative data were identified in order to inform clinical diagnosis and intervention. / text

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

The goal of the current study was to investigate the social skills of a community sample of children that would vary in their level of ADHD symptomatology (e.g., inattention and hyperactivity), with a specific focus on their communication patterns and pragmatic language use (PLU). The study explored whether PLU was associated with, and perhaps accounted for, the social skills problems children with different degrees of ADHD symptomatology experience. Pragmatic language use, ADHD symptomatology, and social skills were examined with traditional standardized measures as well as a detailed investigation of communication patterns and PLU obtained from sampling behaviors from a semi-structured dyadic communication task. A community sample of 54 children between the ages of 9 and 11 years participated. Pragmatic language use partially mediated the relation between ADHD symptomatology and social skills. These results indicate that although the correlation between ADHD and social skills drops from r = -.649, p < .01 to r = -.478, p < .01, when PLU is entered in the model, the correlation between ADHD and social skills still remains significant. Further, ADHD symptomatology and PLU both predicted social skills scores, and although ADHD symptomatology and PLU were related to one another, PLU provided a unique contribution in the estimate of children’s social skills of 10.5% above and beyond the contribution of ADHD symptomatology. However, ADHD symptomatology was the most influential predictor in uniquely accounting for approximately 19% of the differences in social skills outcomes above and beyond the contribution of PLU. Possible explanations as to why PLU mediates the relation between ADHD symptomatology and social skills are discussed. Implications and future research are discussed in terms of children with ADHD and peer relations.

This study examined the emotion recognition of children (ages 7-9 years) with and without Attention Deficit Hyperactivity Disorder (ADHD). Children completed two emotion recognition measures, the Diagnostic Analysis of Nonverbal Accuracy 2 (DANVA2) and the Child and Adolescent Social Perception measure (CASP). Children and their parents also completed an assessment of children’s social skills, the Social Skills Improvement System (SSIS). Children with ADHD reported a significantly greater level of depressive symptoms and had significantly lower full scale IQ scores than children without ADHD. When these differences were accounted for, children with ADHD continued to show a handful of deficits in emotion recognition. They demonstrated difficulties in emotion recognition on the DANVA2 regarding specific emotions, fear and sadness. On the CASP, children with ADHD made significantly more errors than children without ADHD due to a tendency to make up information to explain how they were able to identify feelings. Children’s performance on the emotion recognition measures did not significantly mediate the relation between their diagnostic status and social skills (as rated by parents). In summary, additional evidence was found regarding the deficits in emotion recognition experienced by children with ADHD, however, further work needs to be done to determine if these deficits relate to the peer difficulties experienced by these children.

Children with developmental coordination disorder (DCD) find academic and performing age-appropriate perceptual-motor skills more difficult than their peers. According to research, children classified as learning disabled often show signs of one or more syndromes of developmental disorders rather than an isolated, discrete disability. The more common learning disorders include disabilities related to verbal communication development, reading disorders, gross and fine motor dysfunction and motor hyperactivity. Attention disorders, including or excluding hyperactivity, are not considered learning disabilities in themselves. However, because attention problems can gravely interfere with school performance, they are often associated with problems concerning academic skills Literature further reveals that boys are more inclined to motor problems, learning disabilities and ADHD, compared to girls. With regards to racial diversity, limited information is available, even though some literature implies that certain racial diversities differ to some extent regarding motor problems (DCD). The purpose of this study was to examine the relationship between DCD, learning disabilities and ADHD of children (N = 99) in the age group 6 to 7 years in Potchefstroom in the NW province. A second purpose was to examine the differences between gender and certain racial groups in the age group 6 to 7years in Potchefstroom with regards to to DCD, learning disabilities and ADHD. Two grade one classes were randomly selected from three selected schools in the Potchefstroom district proportionally representing the different racial groups [white (n = 37), black (n = 50), Coloured (n = 12)]. In this group, 48 boys and 53 girls were evaluated with the Movement ABC (MABC) (Henderson & Sugden, 1992), the Aptitude test for school beginners (ASB) (Swart et a/., 1994), the Modified Conner's abbreviated teacher and the Taylor Hyperactivity checklist (Lowenberg & Lucas, 1999). The Statistics for Windows computer package was used for analyzing the data. The group of children without DCD showed a statistically significant higher total ASB scores than the DCD group (p ≤ 0.00). A multiple regression analysis showed a statistically significant interaction between DCD, learning disabilities and ADHD which varied between 22% and 36%. Analysis of differences in the ASB of boys and girls with and without DCD showed no significant interactions, although racial interactions (p < 0.001) were found with the DCD group (p < 0.025). Boys with DCD did not perform as well as the girls in the coordination subtest, and their ADHD totals indicate more symptoms than those of the girls. Black children's numerical skills, verbal communication and the ASB total appeared to be considerably lower than the values of the white children. Overall, the conclusion can be made that DCD has an effect on 6 to 7-year old children's learning abilities and to a lesser extent on their ADHD status. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2007.

The objective of the present study was to investigate Amen's formulations of subtypes of AD/HD initially identified by brain imaging techniques, through the use of behavioral checklist data. And in testing Amen's theory of six separate subtypes of AD/HD, to identify and differentiate the subtypes based on symptom presentation. Data was obtained through retrospective chart reviews (N=161) of children between the ages of 5 and 12 who met the criteria for the major symptoms observed in AD/HD and were referred for a previous comprehensive AD/HD evaluation. Data from behavioral checklist (CBCL and DBRS-IV) were matched to Amen's Subtype Symptom Checklist and each subject was given a percentage score for six subtype symptoms. Cluster analysis reliably found six clusters and each subject was labeled according to their symptom presentation. The clusters found were labeled as AD/HD - Combined Type, AD/HD - Predominately Inattentive Type, AD/HD - Predominately Hyperactive-Impulsive Type, Ad/HD - Combined Type with Obsessive-Compulsive features, AD/HD - Combined Type with Obsessive/Compulsive and Conduct Disorder features and Undifferentiated AD/HD. However, the present study did not find evidence of subtypes that corresponded to Amen's Temporal Lobe ADD or Limbic ADD. Discriminant function analysis of the six clusters found that the variables in the model (symptom percentage scores) significantly discriminated the subtype classification. Also, 76% of all cases were correctly classified according to their symptom presentation. Potential limitations of the sample and the data used for interpretation were discussed. Limitations of the study warrant further investigation making use of multi-modal assessment tools which relate well with brain imaging techniques, such as neuropsychological measures of attention and concentration, laboratory based measures of activity, continuous performance tests measuring inattention and impulsivity, and QEEG data measuring brain wave information. A multi-modal approach to investigating symptom subtypes of AD/HD would likely provide increased reliability and validity of differential diagnosis, and therefore, more effective treatment of children with the presenting symptomology of AD/HD. The diagnostic and clinical implications' of each cluster subtype symptomology found in the present study was discussed as well.

The proposed study examined differences in self-concept between ADHD (n = 61) and non-ADHD boys and girls. Participants included 108 children between 6 and 11 years old. Children completed the Self Description Questionnaire-I, and teacher reports of child competence were obtained. Girls reported lower physical ability and mathematics self-concept than boys. The results also indicated that ADHD girls may be more susceptible to low physical ability and mathematics self-concept than control children or ADHD boys. Teachers also rated ADHD girls as having lower scholastic competence than the other three groups. Teachers reported significant differences in level of competence based on ADHD status. The implications of the current study and directions for future research will be presented.

The aim of this study was to describe occupational therapists’ experience of prescribing cognitive assistive technology for adults with ADHD. Semi-structured interviews were conducted with eight occupational therapists who worked in a region in central Sweden. A qualitative content analysis was used to analyze the data and resulted in four categories; Interview the client regarding their daily activities to assess their needs of cognitive assistive technology, the importance of adapting strategies based on the client’s abilities, the importance of client participation and individualized routines to follow-up cognitive assistive technology. The results showed that occupational therapists used different approaches to assess the client's daily activities prior to prescribing cognitive assistive technology. An important approach was to customize strategies based on the client's prerequisites and to promote its motivation and participation. Furthermore, the result showed that prescribing cognitive assistive technology is a time-consuming process.

African American families of youth with Attention-deficit/hyperactivity disorder (ADHD) traditionally have lower rates of ADHD treatment compared to nonminority groups. These treatment disparities underscore the importance of better understanding the barriers to treatment for these families. Therefore, in a sample of 67 African American caregivers of children with ADHD, the current study examined (1) factors that predict barriers to treatment for African American families of children with ADHD and (2) whether caregiver impairment mediates comorbid behavior problems and barriers to treatment for African American youth with ADHD. Analyses revealed that caregiver impairment predicted barriers to treatment and mediated the relationship between comorbid behavior problems and barriers to treatment. These findings highlight how caregiver impairment may play a significant role in preventing African American families from engaging in ADHD treatment for their child. Furthermore, targeting caregiver impairment in treatment may be particularly beneficial for African American families of youth with ADHD.