Arbetsterapi är en vårdprofession som arbetar med att förbättra hälsa genom att underlätta för aktivitet i det dagligalivet, genom kompensation, träning och anpassningar. Vardagsaktiviteter är ofta problematiska för personer med den neuropsykiatriska diagnosen ADHD, men det är inte kartlagt vad den arbetsterapeutiska interventionen vid ADHD innehåller. Syftet med litteraturstudien är därför att beskriva den arbetsterapeutiska interventionen för personer med ADHD utifrån åtgärder riktade mot förbättrat aktivitetsutförandetEn integrativ litteraturstudie utfördes baserat på tio artiklar publicerade inom de senaste tio åren som beskriver studier av arbetsterapeutiska interventioner för ökat aktivitetsutförande för personer i åldrarna 3-62 år med ADHD. En deduktiv analys av innehåller i interventionerna utfördes utifrån den arbetsterapeutiska modellen PEO-modellen, som beskriver hur interaktionen mellan person, miljö och aktivitet ger aktivitetsutförandet.Resultatet visar att interventionerna innehåller tydliga mål, träning av personens kognitiva förmågor, kompensatoriska hjälpmedel och att den sociala miljön får en ökad förmåga att stödja samt anpassning av aktivitet så som etablerandet av effektiva rutiner. Resultatet pekar mot att arbetsterapeutiska interventioner innehåller åtgärder inriktade på flera områden och framstår som en lovande behandlingsform för att lösa problem i vardagen som rör utförande av aktiviteter. Men det krävs forskning av högre kvalitet för att säkerställa resultatet.

The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life. We argue that current clinical practice does not sufficiently account for the complex cognitive processes in this population. This is because widely applied pharmacological interventions only rarely account for the complexity of the underlying neuronal mechanisms and do not fit well into possibly powerful “individualized medicine” approaches. Novel treatment approaches targeting deficits in executive functions in seriously ill children could focus on neuronal oscillations, as these have some specific relations to different aspects of executive function. Importantly, such treatment approaches can be individually tailored to the individuals’ deficits and can be transferred into home-treatment or e-health solutions. These approaches are easy-to-use, can be easily integrated into daily life, and are becoming increasingly cost-effective.

The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.

The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life. We argue that current clinical practice does not sufficiently account for the complex cognitive processes in this population. This is because widely applied pharmacological interventions only rarely account for the complexity of the underlying neuronal mechanisms and do not fit well into possibly powerful “individualized medicine” approaches. Novel treatment approaches targeting deficits in executive functions in seriously ill children could focus on neuronal oscillations, as these have some specific relations to different aspects of executive function. Importantly, such treatment approaches can be individually tailored to the individuals’ deficits and can be transferred into home-treatment or e-health solutions. These approaches are easy-to-use, can be easily integrated into daily life, and are becoming increasingly cost-effective.

In Attention Deficit Hyperactivity Disorder (AD(H)D), treatments using methylphenidate (MPH) and behavioralinterventions like neurofeedback (NF) reflect major therapeutic options. These treatments also ameliorate ex-ecutive dysfunctions in AD(H)D. However, the mechanisms underlying effects of MPH and NF on executivefunctions in AD(H)D (e.g. the ability to inhibit prepotent responses) are far from understood. It is particularlyunclear whether these interventions affect similar or dissociable neural mechanisms and associated functionalneuroanatomical structures. This, however, is important when aiming to further improve these treatments. Wecompared the neurophysiological mechanisms of MPH and theta/beta NF treatments on inhibitory control on the basis of EEG recordings and source localization analyses. The data show that MPH and theta/beta NF bothincrease the ability to inhibit pre-potent responses to a similar extent. However, the data suggest that MPH andNF target different neurophysiological mechanisms, especially when it comes to functional neuroanatomicalstructures associated with these effects. Both treatments seem to affect neurophysiological correlates of a‘braking function’ in medial frontal areas. However, in case of the NF intervention, inferior parietal areas are alsoinvolved. This likely reflects the updating and stabilisation of efficient internal representations in order to in-itiate appropriate actions. No effects were seen in correlates of perceptual and attentional selection processes.Notably, reliable effects were only obtained after accounting for intra-individual variability in the neurophy-siological data, which may also explain the diversity of findings in studies on treatment effects in AD(H)D,especially concerning neurofeedback.

The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.