Deficiency in executive functioning is a core symptom of attention deficit hyperactivity disorder (ADHD). The brain part responsible for executive functions is the prefrontal cortex (PFC). Although drug-based interven...Deficiency in executive functioning is a core symptom of attention deficit hyperactivity disorder (ADHD). The brain part responsible for executive functions is the prefrontal cortex (PFC). Although drug-based interventions can improve PFC activity, reports on PFC activity being improved by behavioral treatment are lacking. We evaluated whether a summer treatment program (STP) administering comprehensive behavioral treatment would increase PFC activity in children with ADHD. We examined behavioral and neural changes in 20 children before and after the STP, conducted over a 2-week period. We asked the parents/guardians to complete the Swanson, Nolan, and Pelham IV scale to assess severity of ADHD. The main task evaluating executive control was the reverse Stroop task. To examine changes in physiological indices, we used near-infrared spectroscopy to measure changes in PFC activity. Subjective assessments by parents/guardians indicated that ADHD symptoms improved significantly. There was also significant improvement in the number of correct responses and interference rates in the reverse Stroop task. Furthermore, post-intervention PFC activity was significantly higher. These results suggest that the STP improved inhibitory control in executive function, which is considered as a key symptom of ADHD. The increase in PFC activity further suggests that the STP improves cognition through neural function.展开更多
The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（A...The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.展开更多
Background： Accumulating evidence indicates that attention deficit hyperactivity disorder （ADHD） is associated with core deficits in executive function （EF） which predicts poorer academic and occupational functio...Background： Accumulating evidence indicates that attention deficit hyperactivity disorder （ADHD） is associated with core deficits in executive function （EF） which predicts poorer academic and occupational functioning. This makes early intervention targeting EF impairments important to prevent long-term negative outcomes. Cognitive training is a potential ADHD treatment target. The present study aimed to explore the efficacy, feasibility, and acceptability of a cognitive training program （targeting child＇s multiple EF components and involving parent support in daily life）, as a nonpharmacological intervention for children with ADHD. Methods： Forty-four school-age children with ADHD and their parents participated in 12 sessions of EF training （last for 12 weeks） and 88 health controls （HC） were also recruited. Training effects were explored using both neuropsychological tests （Stroop color-word test, Rey-Osterrieth complex figure test, trail making test, tower of Hanoi, and false-belief task） and reports of daily life （ADHD rating scale-IV, Conners＇ parent rating scale, and behavior rating inventory of executive function [BRIEF]） by analysis of paired sample t-test and Wilcoxon signed-rank test. The differences on EF performances between children with ADHD after training and HC were explored using multivariate analysis. Results： The results （before vs. after EF training） showed that after intervention, the children with ADHD presented better performances of EF both in neuropsychological tests （word interference of Stroop： 36.1 ± 14.6 vs. 27.1 ± 11.1, t = 4.731, P 〈 0.001 ; shift time of TMT： 194.9 ± 115.4 vs. 124.8 ± 72.4, Z = -4.639, P 〈 0.001 ; false-belief task： χ^2 = 6.932, P = 0.008） and reports of daily life （global executive composite of BRIEF： 148.9 ± 17.5 vs. 127.8 ± 17.5, t =6.433, P 〈 0.001）. The performances on EF tasks for children with ADHD after EF training could match with the level of HC children. The ADHD symptoms （ADHD rating scale total score： 32.4 ± 8.9 vs. 22.9 ± 8.2, t = 6.331, P 〈 0.001） and behavioral problems of the children as reported by parents also reduced significantly after the intervention. Participants reported that the EF training program was feasible to administer and acceptable. Conclusions： The EF training program was feasible and acceptable to children with ADH D and parents. Although replication with a larger sample and an active control group are needed, EF training program with multiple EF focus and parent involving in real-life activities could be a potentially promising intervention associated with significant EF （near transfer） and ADHD symptoms improvement （far transfer）.展开更多
Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA pr...Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA procedures and,in turn,BIPs because of lack of time,insufficient training,and multiplicity of beliefs.Thus,it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans.This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions.This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs.Using the descriptive-analytical approach,a questionnaire targeting difficulties and barriers was admi-nistered to 209 public school teachers from specialized ADHD programs in Saudi Arabia.The results revealed that the difficulty level of applying FBA in ADHD programs was high.The level of barriers in implementing BIPs was moderate.Finally,the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA.The results suggest the importance offinding better practices,restructuring the provision of ADHD programs,training teachers,improving assessment tool availability,and ensuring cooperation between school administrators and teachers.展开更多
Attention deficit hyperactivity disorder(ADHD)is one of the most prevalent neurodevelopmental disorders,which is characterized with significant difficulties in attention regulation,hyperactivity,and impulsivity.These ...Attention deficit hyperactivity disorder(ADHD)is one of the most prevalent neurodevelopmental disorders,which is characterized with significant difficulties in attention regulation,hyperactivity,and impulsivity.These symptoms profoundly affect daily functioning and overall quality of life,and frequently persist into adulthood.1,2 ADHD's global prevalence among children and adolescents is estimated at approximately 5%to 6%,3 a statistic echoed by research conducted in China.4 The societal burden imposed by ADHD is profound,affecting educational systems,workplace productivity,and family dynamics.展开更多
目的研究学龄前注意缺陷多动障碍儿童认知与行为的特征,为实施有针对性的家庭行为管理宣教提供依据。方法选取4-6岁学龄前注意缺陷多动障碍儿童(ADHD组)50例和正常健康儿童(正常健康组)51例进行韦克斯勒幼儿智力量表(Wechsler preschool...目的研究学龄前注意缺陷多动障碍儿童认知与行为的特征,为实施有针对性的家庭行为管理宣教提供依据。方法选取4-6岁学龄前注意缺陷多动障碍儿童(ADHD组)50例和正常健康儿童(正常健康组)51例进行韦克斯勒幼儿智力量表(Wechsler preschool and primary scale of intelligence,WPPSI)测试,家长填写Conners父母量表(Parent Symptom Questionnaire,PSQ),比较两组间认知及行为分值。结果①品行问题、冲动-多动、多动指数得分ADHD组高于正常健康组,差异均有统计学意义(P<0.01);学习问题、心身障碍、焦虑得分ADHD组与正常健康组差异均无统计学意义(P>0.05)。②总智商及语言智商得分ADHD组均低于正常健康组,差异均有统计学意义(P<0.01);操作智商得分ADHD组与正常健康组差异无统计学意义(P>0.05)。③算术和理解得分ADHD组均明显低于正常健康组,差异均有统计学意义(P<0.05或<0.01);问答、词汇、类同得分ADHD组与正常健康组差异无统计学意义(P>0.05)。④填图得分ADHD组明显低于正常健康组,差异有统计学意义(P<0.01);动物房、迷宫、图形和木块得分ADHD组与正常健康组差异无统计学意义(P>0.05)。结论学龄前ADHD儿童外显的多动冲动行为问题较为突出,认知特征已表征儿童的部分学习问题,家庭行为管理的健康教育关注行为矫正,也要预告其对学习的影响,以取得家长重视,尽早干预。展开更多
文摘Deficiency in executive functioning is a core symptom of attention deficit hyperactivity disorder (ADHD). The brain part responsible for executive functions is the prefrontal cortex (PFC). Although drug-based interventions can improve PFC activity, reports on PFC activity being improved by behavioral treatment are lacking. We evaluated whether a summer treatment program (STP) administering comprehensive behavioral treatment would increase PFC activity in children with ADHD. We examined behavioral and neural changes in 20 children before and after the STP, conducted over a 2-week period. We asked the parents/guardians to complete the Swanson, Nolan, and Pelham IV scale to assess severity of ADHD. The main task evaluating executive control was the reverse Stroop task. To examine changes in physiological indices, we used near-infrared spectroscopy to measure changes in PFC activity. Subjective assessments by parents/guardians indicated that ADHD symptoms improved significantly. There was also significant improvement in the number of correct responses and interference rates in the reverse Stroop task. Furthermore, post-intervention PFC activity was significantly higher. These results suggest that the STP improved inhibitory control in executive function, which is considered as a key symptom of ADHD. The increase in PFC activity further suggests that the STP improves cognition through neural function.
基金supported by a Project of Shanghai Municipal Health and Family Planning Commission (201540114)a Key Specialty Project of Shanghai Municipal Health and Family Planning Commission grant for Child Psychiatry (ZK2015B01)a Research Project of the Shanghai Changning Health and Family Planning Commission grant (20164Y013)
文摘The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.
文摘Background： Accumulating evidence indicates that attention deficit hyperactivity disorder （ADHD） is associated with core deficits in executive function （EF） which predicts poorer academic and occupational functioning. This makes early intervention targeting EF impairments important to prevent long-term negative outcomes. Cognitive training is a potential ADHD treatment target. The present study aimed to explore the efficacy, feasibility, and acceptability of a cognitive training program （targeting child＇s multiple EF components and involving parent support in daily life）, as a nonpharmacological intervention for children with ADHD. Methods： Forty-four school-age children with ADHD and their parents participated in 12 sessions of EF training （last for 12 weeks） and 88 health controls （HC） were also recruited. Training effects were explored using both neuropsychological tests （Stroop color-word test, Rey-Osterrieth complex figure test, trail making test, tower of Hanoi, and false-belief task） and reports of daily life （ADHD rating scale-IV, Conners＇ parent rating scale, and behavior rating inventory of executive function [BRIEF]） by analysis of paired sample t-test and Wilcoxon signed-rank test. The differences on EF performances between children with ADHD after training and HC were explored using multivariate analysis. Results： The results （before vs. after EF training） showed that after intervention, the children with ADHD presented better performances of EF both in neuropsychological tests （word interference of Stroop： 36.1 ± 14.6 vs. 27.1 ± 11.1, t = 4.731, P 〈 0.001 ; shift time of TMT： 194.9 ± 115.4 vs. 124.8 ± 72.4, Z = -4.639, P 〈 0.001 ; false-belief task： χ^2 = 6.932, P = 0.008） and reports of daily life （global executive composite of BRIEF： 148.9 ± 17.5 vs. 127.8 ± 17.5, t =6.433, P 〈 0.001）. The performances on EF tasks for children with ADHD after EF training could match with the level of HC children. The ADHD symptoms （ADHD rating scale total score： 32.4 ± 8.9 vs. 22.9 ± 8.2, t = 6.331, P 〈 0.001） and behavioral problems of the children as reported by parents also reduced significantly after the intervention. Participants reported that the EF training program was feasible to administer and acceptable. Conclusions： The EF training program was feasible and acceptable to children with ADH D and parents. Although replication with a larger sample and an active control group are needed, EF training program with multiple EF focus and parent involving in real-life activities could be a potentially promising intervention associated with significant EF （near transfer） and ADHD symptoms improvement （far transfer）.
基金The author extends his appreciation to the Deanship of Scientific Research at King Saud University for supporting this research work.
文摘Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA procedures and,in turn,BIPs because of lack of time,insufficient training,and multiplicity of beliefs.Thus,it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans.This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions.This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs.Using the descriptive-analytical approach,a questionnaire targeting difficulties and barriers was admi-nistered to 209 public school teachers from specialized ADHD programs in Saudi Arabia.The results revealed that the difficulty level of applying FBA in ADHD programs was high.The level of barriers in implementing BIPs was moderate.Finally,the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA.The results suggest the importance offinding better practices,restructuring the provision of ADHD programs,training teachers,improving assessment tool availability,and ensuring cooperation between school administrators and teachers.
基金supported by the National Natural Science Foundation of China(32200862)the Institute of Psychology,CAS(GJ202005)Beihang University(4304165).
文摘Attention deficit hyperactivity disorder(ADHD)is one of the most prevalent neurodevelopmental disorders,which is characterized with significant difficulties in attention regulation,hyperactivity,and impulsivity.These symptoms profoundly affect daily functioning and overall quality of life,and frequently persist into adulthood.1,2 ADHD's global prevalence among children and adolescents is estimated at approximately 5%to 6%,3 a statistic echoed by research conducted in China.4 The societal burden imposed by ADHD is profound,affecting educational systems,workplace productivity,and family dynamics.
文摘目的研究学龄前注意缺陷多动障碍儿童认知与行为的特征,为实施有针对性的家庭行为管理宣教提供依据。方法选取4-6岁学龄前注意缺陷多动障碍儿童(ADHD组)50例和正常健康儿童(正常健康组)51例进行韦克斯勒幼儿智力量表(Wechsler preschool and primary scale of intelligence,WPPSI)测试,家长填写Conners父母量表(Parent Symptom Questionnaire,PSQ),比较两组间认知及行为分值。结果①品行问题、冲动-多动、多动指数得分ADHD组高于正常健康组,差异均有统计学意义(P<0.01);学习问题、心身障碍、焦虑得分ADHD组与正常健康组差异均无统计学意义(P>0.05)。②总智商及语言智商得分ADHD组均低于正常健康组,差异均有统计学意义(P<0.01);操作智商得分ADHD组与正常健康组差异无统计学意义(P>0.05)。③算术和理解得分ADHD组均明显低于正常健康组,差异均有统计学意义(P<0.05或<0.01);问答、词汇、类同得分ADHD组与正常健康组差异无统计学意义(P>0.05)。④填图得分ADHD组明显低于正常健康组,差异有统计学意义(P<0.01);动物房、迷宫、图形和木块得分ADHD组与正常健康组差异无统计学意义(P>0.05)。结论学龄前ADHD儿童外显的多动冲动行为问题较为突出,认知特征已表征儿童的部分学习问题,家庭行为管理的健康教育关注行为矫正,也要预告其对学习的影响,以取得家长重视,尽早干预。
