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Divided attention, selective attention and drawing: processing preferences in Williams syndrome are dependent on the task administered.

The visuo-spatial abilities of individuals with Williams syndrome (WS) have consistently been shown to be generally weak. These poor visuo-spatial abilities have been ascribed to a local processing bias by some [R. Rossen, E.S. Klima, U. Bellugi, A. Bihrle, W. Jones, Interaction between language and cognition: evidence from Williams syndrome, in: J. Beitchman, N. Cohen, M. Konstantareas, R. Tannock (Eds.), Language, Learning and Behaviour disorders: Developmental, Behavioural and Clinical Perspectives, Cambridge University Press, New York, 1996, pp. 367-392] and conversely, to a global processing bias by others [Psychol. Sci. 10 (1999) 453]. In this study, two identification versions and one drawing version of the Navon hierarchical processing task, a non-verbal task, were employed to investigate this apparent contradiction. The two identification tasks were administered to 21 individuals with WS, 21 typically developing individuals, matched by non-verbal ability, and 21 adult participants matched to the WS group by mean chronological age (CA). The third, drawing task was administered to the WS group and the typically developing (TD) controls only. It was hypothesised that the WS group would show differential processing biases depending on the type of processing the task was measuring. Results from two identification versions of the Navon task measuring divided and selective attention showed that the WS group experienced equal interference from global to local as from local to global levels, and did not show an advantage of one level over another. This pattern of performance was broadly comparable to that of the control groups. The third task, a drawing version of the Navon task, revealed that individuals with WS were significantly better at drawing the local form in comparison to the global figure, whereas the typically developing control group did not show a bias towards either level. In summary, this study demonstrates that individuals with WS do not have a local or a global processing bias when asked to identify stimuli, but do show a local bias in their drawing abilities. This contrast may explain the apparently contrasting findings from previous studies.

Adult↗

Two attentional deficits in serial target search: the visual attentional blink and an amodal task-switch deficit.

When monitoring a rapid serial visual presentation at 100 ms per item for 2 targets among distractors, viewers have difficulty reporting the 2nd target (T2) when it appears 200-500 ms after the onset of the 1st letter target (T1): an attentional blink (AB; M. M. Chun & M. C. Potter, 1995b; J. E. Raymond, K. L. Shapiro, & K. M. Arnell, 1992). Does the same deficit occur with auditory search? The authors compared search for auditory, visual, and cross-modal targets in 2 tasks: (a) identifying 2 target letters among digits (Experiments 1-3 and 5) or digits among letters (Experiment 6), and (b) identifying 1 digit among letters and deciding whether an X occurred among the subsequent letters (Experiment 4). In the experiments using the 1st task, the standard AB was found only when both targets were visual. In the 2nd task, with a change in selective set from T1 to T2, a task-switching deficit was obtained regardless of target modality.

Adult↗

Which anxiety disorders may differentiate attention deficit hyperactivity disorder, combined type with dysthymic disorder from attention deficit hyperactivity disorder, combined type alone?

OBJECTIVE: Attention deficit hyperactivity disorder, combined type (ADHD-CT), dysthymic disorder, and anxiety disorders frequently co-occur in primary school age children, although there have been no published data describing their association. We investigated the association of anxiety, defined from a parent or child perspective, with primary school-age children with ADHD-CT with and without dysthymic disorder. METHOD: One hundred and forty-six medication naïve children with ADHD-CT were studied. Two groups with and without dysthymic disorder were formed to compare parent and child reports of anxiety, using categorical and continuous measures of anxiety, using logistic regression. RESULTS: Separation anxiety disorder and social phobia were associated with primary school-age children with ADHD-CT and dysthymic disorder, compared to children with ADHD-CT without dysthymic disorder. CONCLUSIONS: The recognition of dysthymic disorder and anxiety disorders and their management in primary school-age children with ADHD-CT is generally poorly understood. The identification and elucidation of composite anxiety and depressive phenomena that may be systematically investigated through longitudinal studies of epidemiologically derived samples is needed in this particular group of children.

Anxiety Disorders↗

Response to methylphenidate in children with attention deficit hyperactivity disorder and manic symptoms in the multimodal treatment study of children with attention deficit hyperactivity disorder titration trial.

OBJECTIVE: Recent reports raise concern that children with attention deficit hyperactivity disorder (ADHD) and some manic symptoms may worsen with stimulant treatment. This study examines the response to methylphenidate in such children. METHODS: Data from children participating in the 1-month methylphenidate titration trial of the Multimodal Treatment Study of Children with ADHD were reanalyzed by dividing the sample into children with and without some manic symptoms. Two "mania proxies" were constructed using items from the Diagnostic Interview Schedule for Children (DISC) or the Child Behavior Checklist (CBCL). Treatment response and side effects are compared between participants with and without proxies. RESULTS: Thirty-two (11%) and 29 (10%) participants fulfilled criteria for the CBCL mania proxy and DISC mania proxy, respectively. Presence or absence of either proxy did not predict a greater or lesser response or side effects. CONCLUSION: Findings suggest that children with ADHD and manic symptoms respond robustly to methylphenidate during the first month of treatment and that these children are not more likely to have an adverse response to methylphenidate. Further research is needed to explore how such children will respond during long-term treatment. Clinicians should not a priori avoid stimulants in children with ADHD and some manic symptoms.

Attention Deficit Disorder with Hyperactivity↗

Functional dissociation of attentional selection within PFC: response and non-response related aspects of attentional selection as ascertained by fMRI.

In this experiment using a color-word Stroop task, we explored whether different regions of prefrontal cortex bias selection of response-related processes as compared with non-response-related processes. To manipulate demands at the level of response selection, we varied the degree of overlap between stimulus-response mappings in a manual Stroop task. To vary demands at a non-response level, we compared activation for incongruent trials (e.g. the word 'purple' in blue ink) that contain two color representations, one in the word and one in the ink color, to neutral trials (e.g. the word 'drawer' in blue ink), which contain only one color representation, that in the ink color. These manipulations had differential effects within prefrontal cortex. Both a region of right inferior frontal cortex and caudal regions of the cingulate were sensitive to the selection demands at the response-level and insensitive to demands at the non-response level. In contrast, a more anterior region of left dorsolateral prefrontal cortex was sensitive to the number of color representations (i.e. incongruent versus neutral trials), but not to the overlap in stimulus-response mappings. Therefore, this study indicates a functional differentiation for implementing attentional control within prefrontal cortex.

Adult↗

The Texas Children's Medication Algorithm Project: Report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Attention-Deficit/Hyperactivity Disorder. Part I. Attention-Deficit/Hyperactivity Disorder.

OBJECTIVES: Expert consensus methodology was used to develop evidence-based, consensually agreed-upon medication treatment algorithms for attention-deficit/hyperactivity disorder (ADHD) in the public mental health sector. Although treatment algorithms for adult mental disorders have been developed, this represents one of the first attempts to develop similar algorithms for childhood mental disorders. Although these algorithms were developed initially for the public sector, the goals of this approach are to increase the uniformity of treatment and improve the clinical outcomes of children and adolescents with ADHD in a variety of treatment settings. METHOD: A consensus conference of academic clinicians and researchers, practicing clinicians, administrators, consumers, and families was convened to develop evidence-based consensus algorithms for the pharmacotherapy of childhood ADHD. After a series of presentations of current research evidence and panel discussion, the consensus panel met and drafted the algorithms along with guidelines for implementation. RESULTS: The panel developed consensually agreed-upon algorithms for ADHD with and without specific comorbid disorders. The algorithms consist of systematic strategies for psychopharmacological interventions and tactics to ensure successful implementation of the strategies. While the algorithms focused on the medication management of ADHD, the conference emphasized that psychosocial treatments are often a critical component of the overall management of ADHD. CONCLUSIONS: Medication algorithms for ADHD can be developed with consensus. A companion article will discuss the implementation of these algorithms.

Adrenergic alpha-Agonists↗

The Texas Children's Medication Algorithm Project: Report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Attention-Deficit/Hyperactivity Disorder. Part II: Tactics. Attention-Deficit/Hyperactivity Disorder.

OBJECTIVES: Expert consensus methodology was used to develop a medication treatment algorithm for attention-deficit/hyperactivity disorder (ADHD). The algorithm broadly outlined the choice of medication for ADHD and some of its most common comorbid conditions. Specific tactical recommendations were developed with regard to medication dosage, assessment of drug response, management of side effects, and long-term medication management. METHOD: The consensus conference of academic clinicians and researchers, practicing clinicians, administrators, consumers, and families developed evidence-based tactics for the pharmacotherapy of childhood ADHD and its common comorbid disorders. The panel discussed specifics of treatment of ADHD and its comorbid conditions with stimulants, antidepressants, mood stabilizers, alpha-agonists, and (when appropriate) antipsychotics. RESULTS: Specific tactics for the use of each of the above agents are outlined. The tactics are designed to be practical for implementation in the public mental health sector, but they may have utility in many practice settings, including the private practice environment. CONCLUSIONS: Tactics for psychopharmacological management of ADHD can be developed with consensus.

Adrenergic alpha-Agonists↗

Attention-Deficit/Hyperactivity symptoms in Icelandic schoolchildren: assessment with the Attention Deficit/Hyperactivity Rating Scale-IV.

Four hundred and twenty-seven normal Icelandic children, six and eight years of age, were rated by their parents and three hundred and sixteen children by their teachers with the Teacher and Parent versions of the Attention Deficit/Hyperactivity Disorder Rating Scale-IV (AD/HDRS-IV). For two hundred and sixty-five of the children both parent and teacher ratings were obtained. The factor structures of the AD/HDRS-IV for parents and teachers were in line with theoretical expectations. A Hyperactivity-Impulsivity factor and an Inattention factor were thus well supported. The subscale reliabilities were high. Boys scored higher than girls on all measures and there was a decrease of symptoms with age for boys, as expected. There was evidence of convergent validity for all scales, but discriminant validity of the AD/HDRS-IV subscales is less certain. Generally the instruments seem promising for further research. Some differences are noted in comparison with earlier studies. Thus scores obtained in this study were somewhat lower than those found in American studies, especially for teachers. Also the prevalence of ADHD based on rating scales was lower than in comparable previous studies. The similarity in symptom structure between this and previous studies is emphasized, but the possible role of cultural homogeneity in explaining different results with regard to teachers' ratings of symptoms is suggested.

Attention Deficit Disorder with Hyperactivity↗

Infant visual attention in the paired-comparison paradigm: test-retest and attention-performance relations.

The visual behavior of infants in the paired-comparison paradigm was assessed with multiple discrimination tasks week-to-week at 4 and 7 months and longitudinally from 4 to 7 months. Results indicated that although task-to-task reliability was extremely variable and typically low, most measures of infants' attention averaged across multiple tasks were reliable from 1 week to the next as well as relatively stable over the longer longitudinal period. Across all groups, infants who had shorter fixations (i.e., more fixations per fixed-exposure period) during the familiarization phase showed higher novelty preferences. While infants' shift rate during test phases was a reliable individual characteristic at 7 months, it was not at 4 months; rather, data suggested that the difficulty of the stimulus discrimination may be related to young infants' shift rate.

Attention↗

Spatial attention freezes during the attention blink.

A variant of the rapid serial visual presentation paradigm was used to display sequentially two lateral sequences of stimuli, one to the left and one to the right of fixation, embedding two pairs of target stimuli, T1 and T2. T1 was composed of a pair of alphanumeric characters, and subjects had either to ignore T1 or to encode T1 for a delayed response. T2 was a lateral square of a prespecified color. The square had a small gap in one side, and the task for this stimulus was to report which side had the gap. When subjects were required to ignore T1, the T2-locked ERP produced a clear N2pc, that is, a greater negativity at electrode sites contralateral to the position occupied by T2. This N2pc was followed by a sustained posterior contralateral negativity (SPCN). When subjects were required to monitor T1 in addition to T2, both the N2pc and the SPCN components amplitude depended on the difficulty of the task associated with T1. If T1 was composed of digits that had to be encoded for a delayed same/different judgment, both the N2pc and the SPCN components were entirely suppressed. Although attenuated, such components were present when T1 was composed of a pair of symbols that subjects could disregard. The results suggest that a set of mechanisms subserving the allocation of attention in the spatial domain, resulting in the N2pc, suffer significant interference from concurrent cognitive operations required to encode information into visual short-term memory.

Adult↗

The effects of yoga on the attention and behavior of boys with Attention-Deficit/ hyperactivity Disorder (ADHD).

Boys diagnosed with ADHD by specialist pediatricians and stabilized on medication were randomly assigned to a 20-session yoga group (n = 11) or a control group (cooperative activities; n = 8). Boys were assessed pre- and post-intervention on the Conners' Parent and Teacher Rating Scales-Revised: Long (CPRS-R:L & CTRS-R:L; Conners, 1997), the Test of Variables of Attention (TOVA; Greenberg, Cormna, & Kindschi, 1997), and the Motion Logger Actigraph. Data were analyzed using one-way repeated measures analysis of variance (ANOVA). Significant improvements from pre-test to post-test were found for the yoga, but not for the control group on five subscales of the Conners' Parents Rating Scales (CPRS): Oppositional, Global Index Emotional Lability, Global Index Total, Global Index Restless/Impulsive and ADHD Index. Significant improvements from pre-test to post-test were found for the control group, but not the yoga group on three CPRS subscales: Hyperactivity, Anxious/Shy, and Social Problems. Both groups improved significantly on CPRS Perfectionism, DSM-IV Hyperactive/ Impulsive, and DSM-IV Total. For the yoga group, positive change from pre- to post-test on the Conners' Teacher Rating Scales (CTRS) was associated with the number of sessions attended on the DSM-IV Hyperactive-Impulsive subscale and with a trend on DSM-IV Inattentive subscale. Those in the yoga group who engaged in more home practice showed a significant improvement on TOVA Response Time Variability with a trend on the ADHD score, and greater improvements on the CTRS Global Emotional Lability subscale. Results from the Motion Logger Actigraph were inconclusive. Although these data do not provide strong support for the use of yoga for ADHD, partly because the study was under-powered, they do suggest that yoga may have merit as a complementary treatment for boys with ADHD already stabilized on medication, particularly for its evening effect when medication effects are absent. Yoga remains an investigational treatment, but this study supports further research into its possible uses for this population. These findings need to be replicated on larger groups with a more intensive supervised practice program.

Adolescent↗

Cross-modal selective attention: on the difficulty of ignoring sounds at the locus of visual attention.

In three experiments, we investigated whether the ease with which distracting sounds can be ignored depends on their distance from fixation and from attended visual events. In the first experiment, participants shadowed an auditory stream of words presented behind their heads, while simultaneously fixating visual lip-read information consistent with the relevant auditory stream, or meaningless "chewing" lip movements. An irrelevant auditory stream of words, which participants had to ignore, was presented either from the same side as the fixated visual stream or from the opposite side. Selective shadowing was less accurate in the former condition, implying that distracting sounds are harder to ignore when fixated. Furthermore, the impairment when fixating toward distractor sounds was greater when speaking lips were fixated than when chewing lips were fixated, suggesting that people find it particularly difficult to ignore sounds at locations that are actively attended for visual lipreading rather than merely passively fixated. Experiments 2 and 3 tested whether these results are specific to cross-modal links in speech perception by replacing the visual lip movements with a rapidly changing stream of meaningless visual shapes. The auditory task was again shadowing, but the active visual task was now monitoring for a specific visual shape at one location. A decrement in shadowing was again observed when participants passively fixated toward the irrelevant auditory stream. This decrement was larger when participants performed a difficult active visual task there versus fixating, but not for a less demanding visual task versus fixation. The implications for cross-modal links in spatial attention are discussed.

Adolescent↗

Selective attentional delays and attentional capture among simultaneous visual onset elements.

Visual discrimination and detection responses to a single stimulus presented simultaneously with noise stimuli are slower and less accurate than are responses to a single stimulus presented alone. This occurs even though the location of the relevant stimulus (target) is known or visually indicated with stimuli onset. Results showed that noise elements delay focal attending and processing of a target. Furthermore, precuing the target location reduces, and can eliminate, target processing delays. Processing delays were not due to response competition or to random attentional capture by noise. It is suggested that simultaneous stimuli are perceived initially as a single object, and delays in processing a single stimulus are due to difficulties in perceptually segregating this stimulus from noise. Precuing is assumed to facilitate this segregation process.

Adult↗

Development of selective attention: perceptual load influences early versus late attentional selection in children and adults.

The moderating effect of perceptual load on visual selective attention was examined in 2 studies. In Study 1, children and young adults searched displays of varying set size flanked by irrelevant distractors. Children's performance was as efficient as adults' under conditions of high but not low loads, suggesting that early selection engages rapidly maturing neural systems and late selection engages later-maturing systems. In Study 2, 4 age groups were tested, and place markers were set at empty locations to examine perceptual grouping effects. Study 1's pattem was replicated in all age groups, with onset of early selection occurring at lower loads for younger children. Overall, children initiated early selection at lower loads to compensate for immature anterior-system interference control processes.

Adult↗

Disruption of selective attention in the rat following chronic d-amphetamine administration: relationship to schizophrenic attention disorder.

In the blocking paradigm, prior training to one conditioned stimulus (CSA) blocks the ability to attend to a second conditioned stimulus (CSB) when the two form a compound (CSAB) in subsequent training. Blocking is an associative process by which animals learn to ignore CSB because it contains no new information regarding the reinforcing event. Experiment 1 showed that d-amphetamine disrupted rats' ability to ignore the irrelevant CSB: The animals responded equally to both elements of the CSAB compound following five dialy administrations of 4 mg/kg d-amphetamine. In Experiment 2 the disruption of blocking by d-amphetamine was eliminated by concomitant administration of 0.02 mg/kg haloperidol. These results are consistent with previous research showing that d-amphetamine disrupts rats' ability to ignore repeated presentations of a single nonreinforced stimulus in the latent inhibition paradigm. The inability of amphetamine-treated animals to ignore one element of a dual-element compound bears some resemblance to selective attention deficits seen among schizophrenic patients.

Animals↗

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↗