Executive dysfunctions in children with attention deficit hyperactivity disorder.

One hundred and twenty-four male children ranging in age from seven to 12 years-old were selected. The sample was divided into two groups: (1) sixty-two with attention deficit hyperactivity disorder (ADHD) children; and (2) sixty-two normal matched controls (N-ADHD). Three tests were individually administered: (1) Wisconsin Card Sorting Test (WCST); (2) Verbal fluency and semantics (animals and fruits); and, (3) Picture Arrangement subtest of the WISC-R. For all the test scores, statistically significant differences were found between both ADHD and N-ADHD groups. Two separate factor analyses were performed, using the normal and ADHD groups. Four factors were found for the N-ADHD group, which accounted for 85.7% of the variance. The factor structure presented some similarities in both groups: Factor 2, 3 and 4 in the control group corresponded to factors 1, 2 and 3 in the ADHD group. Nonetheless, in the ADHD group Factor 1 (Abstraction and Flexibility Factor) was absent. Results are interpreted as supporting the hypothesis of executive dysfunction in children with ADHD.

[1]  M. Denckla Research on executive function in a neurodevelopmental context: Application of clinical measures , 1996 .

[2]  G. Hynd,et al.  Neuropsychological development of nonverbal behaviors attributed to “frontal lobe” functioning , 1987 .

[3]  C. Best,et al.  Cognitive processing deficits in reading disabilities: A prefrontal cortical hypothesis , 1989, Brain and Cognition.

[4]  R. Barkley,et al.  The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. , 1990, Journal of consulting and clinical psychology.

[5]  W. Grant Willis,et al.  Executive functions in school‐aged children: Potential efficacy of tasks in discriminating clinical groups , 1994 .

[6]  E. Drewe,et al.  The effect of type and area of brain lesion on Wisconsin card sorting test performance. , 1974, Cortex; a journal devoted to the study of the nervous system and behavior.

[7]  V. Douglas,et al.  Attention deficit hyperactivity disorder and the frontal lobe syndrome , 1992, Brain and Cognition.

[8]  D. Stuss,et al.  Neuropsychological studies of the frontal lobes. , 1984, Psychological bulletin.

[9]  M. Denckla Executive function, the overlap zone between attention deficit hyperactivity disorder and learning disabilities , 1989 .

[10]  K. Pribram THE PRIMATE FRONTAL CORTEX - EXECUTIVE OF THE BRAIN , 1973 .

[11]  R. W. Jones,et al.  Behaviors analogous to frontal lobe dysfunction in children with attention deficit hyperactivity disorder , 1989 .

[12]  M. Russell Harter,et al.  Separate verbal memory and naming deficits in attention deficit disorder and reading disability , 1987, Brain and Language.

[13]  M. Dennis Frontal lobe function in childhood and adolescence: A heuristic for assessing attention regulation, executive control, and the intentional states important for social discourse , 1991 .

[14]  S. Zecker,et al.  The Go-No Go Test in Attention Deficit Disorder Is Sensitive to Methylphenidate , 1991, Journal of child neurology.

[15]  D. Benson,et al.  The Role of Frontal Dysfunction in Attention Deficit Hyperactivity Disorder , 1991, Journal of child neurology.

[16]  D. Stuss,et al.  The Frontal Lobes , 1986 .

[17]  F. Lhermitte,et al.  Human autonomy and the frontal lobes. Part II: Patient behavior in complex and social situations: The “environmental dependency syndrome” , 1986, Annals of neurology.

[18]  M. Mishkin,et al.  Projections from behaviorally-defined sectors of the prefrontal cortex to the basal ganglia, septum, and diencephalon of the monkey. , 1968, Experimental neurology.

[19]  J. Stroop Studies of interference in serial verbal reactions. , 1992 .

[20]  P. Goldman-Rakic,et al.  Brainstem innervation of prefrontal and anterior cingulate cortex in the rhesus monkey revealed by retrograde transport of HRP , 1982, The Journal of comparative neurology.

[21]  Monica Rosselli,et al.  Developmental norms for the wisconsin card sorting test in 5-to 12-year-old children. , 1993, The Clinical neuropsychologist.

[22]  Bruce F. Pennington,et al.  Assessing frontal lobe functioning in children: Views from developmental psychology , 1988 .

[23]  G. Hynd,et al.  Attentional control systems and the Attention Deficit Disorders (ADD) , 1989 .

[24]  A. Ramier,et al.  [Respective rôles of frontal lesions and lesion lateralization in "verbal fluency" deficiencies]. , 1970, Revue neurologique.

[25]  H. Barbas,et al.  Organization of afferent input to subdivisions of area 8 in the rhesus monkey , 1981, The Journal of comparative neurology.

[26]  A. Ardila,et al.  Linguistic abilities in patients with prefrontal damage , 1987, Brain and Language.

[27]  G. Hynd,et al.  Executive function and the Wisconsin card sorting test: Relationship with behavioral ratings and cognitive ability , 1994 .

[28]  Monica Rosselli,et al.  Neuropsychological assessment in illiterates II. Language and praxic abilities , 1990, Brain and Cognition.

[29]  B. Pennington,et al.  Contrasting Cognitive Deficits in Attention Deficit Hyperactivity Disorder versus Reading Disability. , 1993 .

[30]  J. Kozak,et al.  Clinical utility of three measures of frontal lobe dysfunction in neuropsychiatric samples. , 1986, The International journal of neuroscience.

[31]  T. Moffitt,et al.  A comparison of 13-year-old boys with attention deficit and/or reading disorder on neuropsychological measures , 1989, Journal of abnormal child psychology.

[32]  R. Ulrich,et al.  Normative data on Revised Conners Parent and Teacher Rating Scales , 1978, Journal of abnormal child psychology.

[33]  M. Posner Chronometric explorations of mind , 1978 .

[34]  Linda J. Schuerholz,et al.  Attention deficit hyperactivity disorder and executive dysfunction , 1994 .

[35]  W. Beatty,et al.  Performance of children with ADHD on tests sensitive to frontal lobe dysfunction. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[36]  Philip C. Kendall,et al.  Cognitive-behavioral therapy for impulsive children , 1993 .

[37]  J. Halperin,et al.  Children's motor activity: Reliability and relationship to attention and behavior , 1992 .

[38]  A. Luria THE FRONTAL LOBES AND THE REGULATION OF BEHAVIOR , 1973 .

[39]  Donald T. Stuss,et al.  Biological and psychological development of executive functions , 1992, Brain and Cognition.

[40]  Michael I. Posner,et al.  Structures and function of selective attention. , 1988 .

[41]  G. Chelune,et al.  Evaluation of the general sensitivity of the Wisconsin card sorting test among younger and older children , 1987 .

[42]  R. Heaton,et al.  The utility of the Wisconsin Card Sorting Test in detecting and localizing frontal lobe lesions. , 1980, Journal of consulting and clinical psychology.

[43]  Tim Shallice,et al.  The Dominant Action System: An Information-Processing Approach to Consciousness , 1978 .

[44]  A. Luria Higher Cortical Functions in Man , 1980, Springer US.

[45]  M. Posner,et al.  The attention system of the human brain. , 1990, Annual review of neuroscience.

[46]  R. Diamond,et al.  Frontal lobe functioning in boys with attention‐deficit hyperactivity disorder , 1992 .

[47]  D. Stuss,et al.  Motor abilities after frontal leukotomy , 1982, Neurology.

[48]  B. Lahey,et al.  Direct assessment of the cognitive correlates of attention deficit disorders with and without hyperactivity , 1986 .

[49]  R. Reep Relationship between prefrontal and limbic cortex: a comparative anatomical review. , 1984, Brain, behavior and evolution.

[50]  J. Mattes The role of frontal lobe dysfunction in childhood hyperkinesis. , 1980, Comprehensive psychiatry.

[51]  G. Chelune,et al.  Frontal lobe disinhibition in attention deficit disorder , 1986, Child psychiatry and human development.

[52]  D. Ingvar "Memory of the future": an essay on the temporal organization of conscious awareness. , 1985, Human neurobiology.

[53]  A. Ardila,et al.  Development of language, memory, and visuospatial abilities in 5‐ to 12‐year‐old children using a neuropsychological battery , 1994 .

[54]  G. Hynd,et al.  Neuropsychological development of behavior attributed to frontal lobe functioning in children , 1985 .

[55]  E. Gorenstein,et al.  Performance of inattentive-overactive children on selected measures of prefrontal-type function. , 1989, Journal of clinical psychology.

[56]  J. Miller,et al.  Stroke As a Late Sequela of Cranial Irradiation for Childhood Brain Tumors , 1991, Journal of child neurology.

[57]  R. Barkley,et al.  Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report , 1992, Journal of abnormal child psychology.

[58]  J. Fletcher,et al.  Developmental changes in performance on tests of purported frontal lobe functioning , 1991 .

[59]  G. Chelune,et al.  Developmental norms for the Wisconsin Card Sorting test. , 1986, Journal of clinical and experimental neuropsychology.

[60]  Bruce F. Pennington,et al.  A normative‐developmental study of executive function: A window on prefrontal function in children , 1991 .

[61]  P. T. Fox,et al.  Positron emission tomographic studies of the cortical anatomy of single-word processing , 1988, Nature.

[62]  B. Milner Effects of Different Brain Lesions on Card Sorting: The Role of the Frontal Lobes , 1963 .

[63]  D. Norman,et al.  Attention to action: Willed and automatic control , 1980 .

[64]  B. Milner,et al.  Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man , 1982, Neuropsychologia.