Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent conditions among school children. Executive function deficits representing difficulties in maintaining an appropriate problem set for the attainment of future goals are reported to be the major deficit in ADHD populations. There is a high rate of co-morbidity of learning disabilities and ADHD, with empirical evidence indicating an association with math and reading difficulties, but there is little research on the written expression of this population. There is a body of emergent research indicating that written expression is mediated by executive function. Written expression is a complex task that is affected by motivation, working memory, cognitive processes and long term memory, factors which are reported to be compromised in ADHD populations. This study evaluated the working memory and fluid reasoning in children with (combined and predominantly inattentive types) and without ADHD. Second, it explored the relationship between working memory and fluid reasoning on written expression in children with and without ADHD. Finally, the possible link between the executive functions of working memory and fluid reasoning, with written expression of children with and without ADHD was examined. The findings of this study indicate that children with the combined type of ADHD had lower written expression and working memory scores compared to children with the inattentive type of ADHD. The results of this study also indicated an association between disinhibition and working memory deficits on written expression performance. This research will serve to contribute to an understanding of the functional impact of ADHD on academic performance. Findings from this study could potentially help with interventions for deficits in written expression among school children.

Attention Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) are among the most common childhood disorders (American Psychiatric Association, 2000) and co-occur significantly more frequently than expected by chance (Dykman & Ackerman, 1991; Semrud-Clikeman et al., 1992). Similar processing deficits are seen in children with ADHD and children with RD, one of which is rapid automatized naming (RAN) (Denckla & Cutting, 1999). These continuous performance tasks require quick naming of visually represented stimuli. Uncertainty about what RAN actually measures, however, makes drawing conclusions about relations to ADHD and RD difficult (Tannock, 1998). By better understanding the cognitive processes involved in RAN, and how those processes relate to ADHD and RD symptoms, the relations among RAN, ADHD, and RD might be better understood. The current study sought to identify variables that would help explain ADHD and RD children’s difficulty with RAN. Five fundamental, neurocognitive skills were hypothesized to be related to RAN performance, ADHD, and reading disability. The effect of children’s phonological awareness, processing speed, working memory, fine-motor speed, and reaction time on their RAN performances was measured. The extent to which these same variables were related to inattention symptoms severity and word-reading ability was also assessed. Finally, the extent to which RAN mediated the effects of neurocognitive skills on inattention symptoms and word-reading ability was measured. By simultaneously measuring the hypothesized relations among variables, the processing deficits responsible for ADHD and RD children’s problems on RAN may be revealed. Structural equation modeling was used to analyze assessment data (i.e., neurocognitive, RAN, and word-reading performance scores; parent-report of inattention symptoms) of 183 children who received neuropsychological evaluations. Results indicated the following significant direct effects: phonological awareness and working memory on word-reading ability, processing speed and working memory on RAN, and RAN on word-reading ability. A possible significant mediation effect of processing speed on word-reading ability through RAN was also shown. Significant effects of study variables on inattention symptoms were not shown, which limited conclusions about RAN’s relation to ADHD. Results are of practical importance in RD assessment because the relation between RAN and word-reading ability was shown to involve processes beyond phonology. / text

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Introduction Occupational therapists are concerned with enabling people to perform the daily life tasks they need, want, or are expected to perform for fullest possible integration into community living and participation in society. Children with mild disabilities have problems performing personal and instrumental activities of daily living (ADL) tasks at home or school, and that can limit their full integration and participation in their homes and school lives. There is a need, therefore, to identify their specific problems with ADL task performance so as to be able to develop effective interventions. Not only, there is a need for evidence related to effectiveness of occupational therapy interventions for children with mild disabilities, but also a need for valid occupational-therapy-specific evaluation tools for use with children. Purpose The purpose of this thesis was to contribute evidence to support the valid use of the Assessment of Motor and Process Skills (AMPS) with children, including children living in Middle Europe. More specifically, I aimed to evaluate validity evidence from different sources related to the use of the AMPS in occupation-based and occupation-focused evaluation and intervention. Method This thesis consisted of four studies, implemented in two phases. Phase one focused on evaluation of a) validity evidence of the AMPS scales in relation to internal structure and stability of item difficulty calibration values for a Middle European sample compared to samples from other world regions (Study I); b) the stability of the mean AMPS measures between typically-developing children from Middle Europe and from other world regions (Study II); and c) the sensitivity of the AMPS measures to discriminate between typically-developing children and children with and at risk for mild disabilities (Study III). Participants for phase one were from both Middle Europe and from other world regions and they were selected from the AMPS database, Ft. Collins, Colorado, USA. Data were analyzed using many-facet Rasch analyses, ANOVAs, regression analyses, related post-hoc tests, and effect size calculations. Phase two of the research project focused on evaluating validity evidence for the use of the AMPS as a standardized, occupation-based, and occupation-focused evaluation tool in the context of a feasibility study with children with mild disabilities implemented in a Swiss setting (Study IV). Data were analyzed based on feasibility objectives and the principles of deductive content analysis. The evaluation of validity evidence of the AMPS in relation to consequences of testing and test fairness was a focus of all studies (Studies I to IV). Results In Study I, data for 1346 participants from Middle Europe and 144,143 participants from other world regions were analyzed. The participants were between the ages of 3 and 103 years, and they were well or had a variety of diagnoses. The results revealed that overall the item difficulty calibration values of the AMPS remained stable and that only one out of 36 ADL items of the AMPS demonstrated DIF, but this DIF did not lead to DTF (i.e., all measures fell within 95% confidence bands). In Study II, data for 11,189 typically-developing children from Middle Europe and other world regions who were between the ages of 2 and 15 were analyzed. The results of ANOVAs revealed significant effects for mean ADL motor and for ADL process ability measures by region and a significant age by region interaction effect for mean ADL process ability. Out of 168 estimated contrasts between Middle Europe and the other world regions for mean ADL motor and ADL process ability, only seven were statistically significant (4.17%), and only two were more than ±1 SE from the international means. In Study III, regression analyses of data for 10,998 children, 4 to 15 years, who were typically-developing or with mild disabilities, revealed significant age by group interaction effects. Post hoc t tests revealed significant group differences in ADL ability at all ages beyond the age of 4. ADL process ability effect sizes were moderate to large at all ages and ADL motor ability effect sizes were mostly moderate to large age 6 and above. In Study IV, the use of the AMPS within the context of a feasibility study based on data of 17 Swiss children with mild disabilities was evaluated. The analyses revealed several strengths and problems that were related to the time, equipment, and materials for administering the AMPS, the adherence to standardized administration procedures, the scope of the AMPS as a test of ADL performance, and the reliable rating by the blinded rater. Conclusion This thesis provided evidence to support the validity of the AMPS measures and scales when used to evaluate quality of ADL task performance of persons from Middle Europe. Additionally, this thesis provided evidence that the international age-normative means of the AMPS are likely applicable to children from Middle Europe. Moreover, the findings supported the sensitivity of the AMPS measures to discriminate between typically-developing children and children with and at risk for mild disabilities. When it comes to implementation of the AMPS in the context of a feasibility study, the findings indicated both strengths and problems in using the AMPS as an outcome measure that need to be considered when planning further studies.

Thesis (M.Tech.: Homeopathy)-Dept. of Homeopathy, Durban University of Technology, 2007 xxxii, 285 leaves / The epidemic proportion of ADD/ADHD diagnosis is gaining widespread attention from parents, educators, doctors and other health care providers. Parents are seeking alternatives, as they are concerned about the use and side effects of methylphenidate hydrochloride (e.g. Ritalin®, Adaphen®, Concerta®) and other conventional drugs used to treat the symptoms of ADD/ADHD (Badat, 2004 and Picton, 2004). The aim of this research was to document the current practices of registered homoeopathic practitioners, with regard to Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). In addition, their perceptions regarding aeitiology, treatment, management and success rate was investigated. This research took the form of a qualitative-quantitative survey (questionnaire) targeting homoeopaths practicing in the Johannesburg Metropolitan Area

The purpose of this study was to explore the nature of the relationship between a continuous performance test (CPT) and teachers' ratings of behavior. Assessment data were archival in nature. One hundred-one children from one rural, middle-class, predominately Caucasian school district in a Midwestern state were selected who had taken the Test of Variables of Attention (TOVA) and whose teachers had completed the Attention Deficit Disorders Evaluation ScaleSchool Version (ADDES) and the Child Behavior ChecklistTeacher Report Form (TRF). Of this group 46 had been referred for Attention-Deficit/Hyperactivity Disorder (ADHD) and/or learning difficulties and 55 had participated in a local norming project for the TOVA.Descriptive statistics were found for CPT variables and teachers' ratings of behavior for all participants, boys and girls separately, and referred and nonreferred separately. The research question was investigated using a matrix of partial correlations controlled for age. TOVA variables included Omissions, Commissions, Response Time, Response Time Variability, Anticipatory Responses, and Multiple Responses. Teacher's rating scale variables included the ADDES Total and subscales Inattention, Impulsive, and Hyperactive as well as the TRF Attention Problems, and Aggressive Behavior.Research provided support that TOVA Omissions and Commissions are valid indicators of ADHD as measured by teachers' ratings of behavior. Response Time Variability and Multiple Responses may be valid indicators of generalized behavior dysfunction as measured by teachers' ratings of behavior. Anticipatory Responses and Response Time may aid in distinguishing ADHD with and without hyperactivity but further research is recommended. / Department of Educational Psychology

This thesis presents two manuscripts on motor control in ADHD. The first is a literature review that identifies fine motor control and postural stability as areas of robust abnormality in ADHD. Further, the review suggests that motor performance in adolescence has been understudied, and reveals a paucity of data on sex differences. The second study is an empirical assessment of postural control and fine motor skills in an adolescent ADHD sample, which investigated potential sex differences. This latter study revealed that males with ADHD were especially impaired on fine motor tasks, whereas females with the disorder were particularly impaired on tasks of postural stability. Deficits were most prominent under conditions where visual information was removed, across genders. It is unclear whether motor performance deficits are central features of ADHD or instead artifacts of overlap with Developmental Coordination Disorder and other psychiatric comorbidities.

This thesis presents two manuscripts on motor control in ADHD. The first is a literature review that identifies fine motor control and postural stability as areas of robust abnormality in ADHD. Further, the review suggests that motor performance in adolescence has been understudied, and reveals a paucity of data on sex differences. The second study is an empirical assessment of postural control and fine motor skills in an adolescent ADHD sample, which investigated potential sex differences. This latter study revealed that males with ADHD were especially impaired on fine motor tasks, whereas females with the disorder were particularly impaired on tasks of postural stability. Deficits were most prominent under conditions where visual information was removed, across genders. It is unclear whether motor performance deficits are central features of ADHD or instead artifacts of overlap with Developmental Coordination Disorder and other psychiatric comorbidities.

This study aimed to examine the association between specific maternal characteristics (i.e., parents&rsquo / personality, depression, anxiety, affective state, and coping strategies) and childhood ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) symptoms in children with and without the diagnosis of ADHD. Method: Data was obtained from 231 subjects including mothers of 77 children who were just diagnosed by Child Mental Health Departments of Hacettepe University or IMGE Child Mental Health Center and 154 children without any psychiatric diagnosis, who were receiving education from Nebahat Keskin Elementary School. Among 154 non-diagnosed subjects the ones who match best with the 77 ADHD group participants were chosen, considering ages of the children, income of the family, and education of the mother. Results and Discussion: (1) Psychometric Characteristics of the TBFI and CARSS were examined. The internal consistency coefficients of the TBFI varied from .51 (for Agreeableness) to .75 (for Neuroticism) and all subscales of CARSS had moderate to high degree of internal consistencies ranging from .65 (Conduct Disorder) to .92. (e.g., Attention Deficit). Additionally, concurrent validity of TBFI and criterion validity of CARSS were studied. Results revealed that TBFI had sufficient internal consistency and validity, and also revealed that CARSS was a highly reliable and valid measure, successfully differentiating the diagnosed group from the non-diagnosed group on each subscale. (2) Group differences on maternal characteristics were examined. Compared to non-diagnosed children, children with ADHD had mothers with higher Depression symptoms, higher Negative Affect, higher Neuroticism, lower Positive Affect. (3) Regression analyses, which were conducted separately for each group and the whole group, revealed that different maternal characteristics were associated with symptoms of diagnosed and non-diagnosed children. In general while symptom levels of children, who have ADHD diagnosis, was associated with higher maternal Negative and lower Positive Affect and higher Depression and Anxiety symptoms, and lower Extraversion scores / symptom level of Comparison children was associated more with Conscientiousness. These differences were explained by means of the fit between maternal characteristics and vulnerability, lower tolerance, lower adaptation, and compensation skills of children with ADHD (when compared to Comparison group). Results addressed the importance of maternal factors regarding its association with presence, and the severity of ADHD and comorbid symptoms of children.

Thesis (Ph.D.)--University of Toronto, 2004. / Adviser: Joanne Rovet.