Search PubMed⌕ Search

Biomedical subjects

J van der Meere

Publications and source records attributed to J van der Meere.

At least 19 recordsLinked to original sources

Behavioural correlates of early-treated congenital hypothyroidism.

UNLABELLED: Parents' and teachers' ratings were used to evaluate the behavioural characteristics of children with early-treated congenital hypothyroidism (CH). Comparisons were made between 63 children with early-treated CH and 34 healthy controls at the ages of 7.5 and 9.5 y. Additional comparisons were made between the two largest CH subgroups (thyroid agenesis, thyroid dysgenesis) and controls. The most marked differences were found on the introversion cluster and the motor clumsiness scale within it. Children with CH, particularly those with thyroid agenesis, showed introversion and motor clumsiness rather than social negativity and inattention. It is suggested that this behavioural profile may well have its origins in the often-reported inefficient motor behaviour of these children. Results are discussed in the light of recent findings suggesting an association between thyroid hormone problems and attention deficit hyperactivity disorder. CONCLUSION: Early-treated CH is associated with introversion rather than with social negativity.

Age Factors↗

Motor control and state regulation in children with ADHD: a cardiac response study.

The goal of the current study was to investigate whether poor motor control in children with Attention-Deficit Hyperactivity Disorder (ADHD) was associated with a state regulation deficit. For this purpose, 28 ADHD and 22 healthy children carried out two Go No-Go tests: one with a fast stimulus presentation rate, and the other with a slow stimulus presentation rate. Groups were compared on RT performance and on specific cardiac measures, reflecting arousal, motor activation/inhibition, and effort allocation. No group difference in the arousal measure (mean heart rate) was found. Further, groups did not differ with respect to response inhibition: in both the fast and slow condition, ADHD children made comparable numbers of errors of commission to the control group, and the groups did not differ with respect to the heart rate deceleration after the onset of the No-Go signal, reflecting motor inhibition. Group differences were found with respect to motor activation and effort allocation in the condition with a slow presentation rate. In this condition: (1) ADHD children reacted more slowly to Go signals than control children, suggesting poor motor activation; (2) the heart rate deceleration before the onset of Go signals, which is believed to reflect motor preparation, was less pronounced in the ADHD children; (3) after Go signals, where a response was given, the cardiac shift from deceleration to acceleration, indicating response initiation, was delayed in ADHD children; and (4) ADHD children had greater heart rate variability (0.10 Hz component) than the control group, indicating that less effort was allocated. No group differences in motor activation and effort allocation were found in the condition with a fast presentation rate of stimuli. We conclude, therefore, that a slow presentation rate of stimuli brings the ADHD child in a non-optimal activation state.

Arousal↗

Visual behaviour of ADHD children during an attention test: an almost forgotten variable. Attention-Deficit Hyperactivity Disorder.

The goal of this study was to examine whether looking away behaviour of ADHD children interferes with their test performance. ADHD and normal children carried out two continuous performance tests (CPTs): one with a regular interstimulus interval (ISI), and the other with an irregular ISI. Children were instructed to push a response button when a target stimulus was presented on the monitor. The children's visual behaviour was recorded and scored offline. A micro-analysis of the visual behaviour indicated that ADHD children timed their looking away behaviour in the regular CPT: i.e. they looked away from the monitor and back in the interval between two succeeding stimuli. As a result they did not miss stimuli. Timing of looking away was less possible in the CPT with the irregular ISI. In this condition, looking away interfered with the ADHD children's task accuracy. In sum, looking away behaviour had a negative effect on the accuracy of test performance of ADHD children when stimuli were unpredictable. Looking away behaviour was not associated with the slower reaction times of the ADHD children. Hence, the often reported slowness of ADHD children is not to be explained by their visual behaviour.

Attention↗

The effect of methylphenidate and clonidine on response inhibition and state regulation in children with ADHD.

The goal of this study was to evaluate the effect of methylphenidate (MPH) and clonidine in comparison with placebo on response inhibition and state regulation in children with Attention Deficit Hyperactivity Disorder (ADHD). The study utilised a double-blind cross-over design in which children were randomly assigned without replacement to placebo, MPH, and clonidine following baseline assessment. The primary dependent measures were derived from children's performance (reaction time and errors) on a GO-NO GO task under three conditions that altered the inter-stimulus interval (ISI) for presented GO-NO GO stimuli: ISI of 1 sec (fast condition), 4 sec (medium condition), and 8 sec (slow condition). Findings indicated no difference in task performance between groups treated for 7 weeks with placebo, MPH, and clonidine. We concluded that the state regulation problem in ADHD is resistant to MPH and clonidine.

Arousal↗

Heart rate variability and sustained attention in ADHD children.

The major goal of the current study was to investigate the association between continuous performance tests (CPTs) and the heart rate variability (HRV) of attention deficit hyperactivity disorder (ADHD) children. The HRV, specifically the 0.10-Hz component, may be considered to be a psychophysiological index of effort allocation (motivation): The less effort the subject allocates, the greater the 0.10-Hz component. Results indicated that, compared to controls, ADHD subjects had a greater 0.10-Hz component, which was associated with poor test performance over time. Thus, using a psychophysiological measure, we were able to confirm the clinical concept of ADHD from a motivational perspective.

Attention↗

Epilepsy and attention deficit hyperactivity disorder: is methylphenidate safe and effective?

OBJECTIVE: To study the safety and efficacy of methylphenidate in children with the dual diagnosis of epilepsy and attention deficit hyperactivity disorder (ADHD). STUDY DESIGN: Thirty children, aged 6.4 to 16.4 years, with epilepsy and ADHD were studied during a 4-month period. During the initial 2 months of the study, the children were treated with antiepileptic drugs (AEDs) only, and for the remaining 2 months, methylphenidate was added at a morning dose of 0.3 mg/kg. They underwent neurologic assessment, brain computed tomography, IQ testing, and assessment with the Childhood Behavior Checklist at baseline before methylphenidate therapy. Electroencephalography, AED determinations, and the continuous-performance task (CPT) test were done at baseline and after 2 months of methylphenidate therapy. A double-blind, crossover design was used to compare the effects of methylphenidate versus placebo on an electroencephalogram, AED levels, and the CPT. On the 2 days of testing, the child received AEDs and a capsule containing either placebo or methylphenidate. RESULTS: None of the 25 children of this sample who were seizure free had attacks while taking methylphenidate. Of the 5 children with seizures, 3 had an increase in attacks, whereas the other 2 showed no change or a reduction. There were no significant changes in AED levels or electroencephalographic findings. Methylphenidate benefited 70% of children according to parental report; methylphenidate also enhanced performance on the CPT. Side effects of methylphenidate were mild and transient. CONCLUSION: Methylphenidate is effective in treating children with epilepsy and ADHD and safe in children who are seizure free. Caution is warranted for those still having seizures while receiving AED therapy.

Adolescent↗

Epilepsy and attention deficit hyperactivity disorder: is methylphenidate safe and effective?

OBJECTIVE: To study the safety and efficacy of methylphenidate in children with the dual diagnosis of epilepsy and attention deficit hyperactivity disorder (ADHD). STUDY DESIGN: Thirty children, aged 6.4 to 16.4 years, with epilepsy and ADHD were studied during a 4-month period. During the initial 2 months of the study, the children were treated with antiepileptic drugs (AEDs) only, and for the remaining 2 months, methylphenidate was added at a morning dose of 0.3 mg/kg. They underwent neurologic assessment, brain computed tomography, IQ testing, and assessment with the Childhood Behavior Checklist at baseline before methylphenidate therapy. Electroencephalography, AED determinations, and the continuous-performance task (CPT) test were done at baseline and after 2 months of methylphenidate therapy. A double-blind, crossover design was used to compare the effects of methylphenidate versus placebo on an electroencephalogram, AED levels, and the CPT. On the 2 days of testing, the child received AEDs and a capsule containing either placebo or methylphenidate. RESULTS: None of the 25 children of this sample who were seizure free had attacks while taking methylphenidate. Of the 5 children with seizures, 3 had an increase in attacks, whereas the other 2 showed no change or a reduction. There were no significant changes in AED levels or electroencephalographic findings. Methylphenidate benefited 70% of children according to parental report; methylphenidate also enhanced performance on the CPT. Side effects of methylphenidate were mild and transient. CONCLUSION: Methylphenidate is effective in treating children with epilepsy and ADHD and safe in children who are seizure free. Caution is warranted for those still having seizures while receiving AED therapy.

Adolescent↗

Changing a response set in normal development and in ADHD children with and without tics.

The current study was designed to provide a rigorous investigation of the locus of task-inappropriate (impulsive) responding in ADHD children with and without tics. For this purpose we used a variant of Sternberg's (1969) response bias task. The task measures a set of mental operations, namely, preparing a planned response, carrying out or stopping a planned response, and preparing to execute an alternative response. In the first study, we determined the effect of age in a normal sample. As expected, task performance improved as a function of age. Younger children had problems changing a response set. In the second experiment, we compared ADHD children with and without tics with normal children. Unexpectedly, the noticeable task inefficiency of the patient groups was not related to (a) a hasty scan of the display, (b) an inability to change response set, or (c) a speed-accuracy trade-off. Implications for and a discussion about the response inhibition hypothesis in ADHD are discussed.

Attention Deficit Disorder with Hyperactivity↗

Sustained attention, activation and MPH in ADHD: a research note.

Sustained attention was studied in children with attention deficit hyperactivity disorder (ADHD) and normal controls using a continuous performance task with slow presentation of stimuli and carried out with an experimenter-present and absent condition. Children with ADHD were slower than controls, with performance deteriorating over time, particularly in the experimenter-absent condition. Both the slowness and deterioration normalized when the children received MPH. Hence the rate of stimuli presentation and the presence or absence of experimenter are both crucial factors in the performance of children with ADHD. MPH is able to ameliorate the performance decrement seen under these conditions.

Attention↗

A motor presetting study in hyperactive, learning disabled and control children.

Motor presetting was investigated in hyperactive children, learning disabled children and normal controls. The reaction time of the hyperactive group was more sensitive to increases in interstimulus interval (event rate) than was that of the learning disabled and the controls. This finding indicates that hyperactive children have difficulty with motor presetting.

Aptitude↗

Observations of hyperactive behaviour during vigilance.

A sustained attention deficit implies a deficit originating in the course of a task. A series of studies previously indicated that task inefficiency in hyperactive children is independent of task duration. The present study shows that differences in body activity between hyperactive and control children are also independent of task duration. However, the groups did differ in visual behaviour, i.e. hyperactive children did look away from the task more frequently as time proceeds. This visual behaviour did not interfere with task accuracy. It is argued that the results indicate that hyperactive children may have prevented a further deterioration of task efficiency over time through self stimulation.

Arousal↗

Sustained attention and pervasive hyperactivity.

A sustained attention deficit is defined as a significant decrement in task performance with task duration (time-on-task). Time-on-task effects are reported using a self-paced paper and pencil cancellation test (PPCT) in normals and in subgroups of pervasively hyperactive children. The hyperactive subgroups were pervasively hyperactive both at home and at school. They differed in degree of pervasiveness in three laboratory conditions. Task inefficiency was most pronounced in the most pervasively hyperactive group. There was no evidence in favour of a sustained attention deficit in hyperactivity: no differences were found in decline in task efficiency between the controls and the subgroups of hyperactive children.

Attention↗

Additive factor method applied to psychopathology with special reference to childhood hyperactivity.

A review is made of available studies using the Additive Factor Method (AFM) in clinical research. The paper argues that by using the AFM in studies of psychological dysfunctioning a major contribution can be made: first, in preventing spurious findings, second, distinguishing between group differences with and without information processing deficits, and third, by identifying fundamental processes which may be impaired. This may offer psychodiagnostics an empirical basis on which to define disorders. This paper reviews studies contributing to this endeavour. It further raises the question of how to interpret clinical research, which is conducted in the tradition of information processing but not within the frame of reference of the AFM. It is suggested that such research is useful and complementary to that conducted using the AFM. Further, it is suggested that the role of energetical factors in clinical disorders and in their treatment is an important area for future experimental clinical research.

Arousal↗

The additive factor method: a differential diagnostic tool in hyperactivity and learning disability.

The Additive Factor Method assumes that task performance is the sum of sequential and independent processes. We studied the duration of the central processes (memory search and decision) and the motor decision process in hyperactive and learning-disabled children under so-called divided attention and S-R compatibility conditions. It was found that the learning-disabled were impaired in memory search and decision processes whereas hyperactives were impaired in the motor decision process.

Attention↗

Focused attention in pervasively hyperactive children.

This experiment was designed to investigate the hypothesized distractibility of hyperactive children in a focused attention task. Distractibility was defined in terms of Shiffrin and Schneider's model of focused attention as the ability to ignore irrelevant in favor of relevant information. Failure to inhibit processing of irrelevant information indicates a focused attention deficit. Task efficiency in all children decreased when irrelevant information was presented. The mean reaction time, within-subject variance of reaction time, and error percentage all increased compared with a nondistraction condition. Thus, the demands of focused attention, as formulated in the model, were measured optimally. Since hyperactives and controls did not differ significantly with respect to task efficiency in the distraction condition, a focused attention deficit in hyperactives was not demonstrated. The hyperactives did nevertheless make more errors and their responding was more variable than the controls. However, the difference in error percentages between hyperactives and controls was associated with the difference in IQ. It is speculated that the variable responding in hyperactives is caused by a less optimal state of performance unrelated to distractibility.

Attention↗

Controlled processing and vigilance in hyperactivity: time will tell.

This paper reviews the concept of sustained attention, placing it within a theoretical framework in which deficits of attention are conceived of as deficits of controlled information processing. Two types of deficit of sustained attention are distinguished: perceptual sensitivity and perceptual criterion. These two deficits are linked to a model of human performance that links controlled processes to the energetic pools: arousal and activation. Perceptual sensitivity (d') deficits are said to reflect arousal deficiencies, especially when observed in the early period of a vigil. Perceptual criterion deficits are associated with the activation pool and the response criterion measure beta. Despite clear evidence of perceptual deficiency in the hyperactive children to a greater extent than in the control group, and that performance in d' declined with time on task, a significant interaction failed to occur between group classification and time on task. Thus, the results failed to support the hypothesis of a sustained attention deficit in hyperactives, since if hyperactives have a sustained attention deficit, both d' and beta should have shown a significantly greater decline in the hyperactive group than in the controls with time on task.

Attention↗

What happens after a hyperactive child commits an error?

Children with a diagnosis of attention deficit disorder with hyperactivity can correct errors, just as controls can. They differ from controls in how they adjust the speed of processing on a trial after they have committed an error. Controls are fast in responding after an error when cognitive load is small. When cognitive load is high, however, they take considerable time to ensure, after an error has occurred, that a correct response is given. After an error has been committed, hyperactive children, irrespective of the demands of load, have no response adjustment and maintain a constant rate of processing.

Attention Deficit Disorder with Hyperactivity↗