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PubMed1987

A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems.

Tourette syndrome (TS) is a common, hereditary, neurobehavioral disorder of childhood. To determine the frequency of various behavioral manifestations, we have compared 47 random normal controls to 246 patients with TS, 17 with attention-deficit disorder (ADD), and 15 with ADD secondary to a TS gene (ADD 2(0) TS). All subjects were examined prospectively with a 425-item questionnaire based on the Diagnostic Interview Schedule and the Diagnostic and Statistical Manual of Mental Disorders (DSM III). The TS patients were divided into grade 1 (too mild to treat [17.5%]), grade 2 (requiring treatment [58.9%]), and grade 3 (severe [23.6%]). Patients in all three grades of TS were significantly different from controls for DSM III symptoms of inattention, impulsivity, and hyperactivity. Sixty-two percent of TS patients had ADD, compared with 6.3% of controls; and 48.8% had ADD with hyperactivity (ADDH), compared with 4.2% of controls. In the majority of TS patients, the natural history of the disease was to start with ADDH and 2.4 years later develop motor and vocal tics. Among TS patients, 39% had previously received medication for ADDH or behavior problems, compared with 2% of the controls. Although stimulants can occasionally exacerbate tics, there was no evidence that stimulants cause TS and they are often a valuable adjunct to the treatment of TS. It is estimated that 10%-30% of ADDH is due to or associated with the presence of a TS gene. TS patients had a significantly increased frequency of (1) attending classes for the educationally handicapped, (2) placement in classes for the severely emotionally disturbed, (3) attending any special classes, (4) severe test anxiety, (5) stuttering, (6) letter, number, or word reversal, (7) reading very slowly, and (8) poor retention of material read. A reading-problem score (dyslexia) greater than or equal to 3 was present in 26.8% of TS patients, compared with 4.2% of controls. Number reversal, word reversal, and poor retention were significant even for the TS patients with tics too mild to treat. The multiple ways in which TS impacts school performance, as well as potential remedies, are discussed.

Adolescent↗
PubMed2003

Neuropsychologic characteristics of children with attention-deficit hyperactivity disorder (ADHD), learning disorder, and tic disorder on the Rey-Osterreith Complex Figure.

This study examined the performance of Korean children diagnosed with attention-deficit hyperactivity disorder (ADHD), learning disorder, ADHD with learning disorder, and tic disorder on the Rey-Osterreith Complex Figure. The clinical group consisted of 57 children between the ages of 6 and 13 years (15 with ADHD, 13 with learning disorder, 15 with ADHD + learning disorder, and 15 with tic disorder), and the control group included 20 children recruited from an elementary school. Rey-Osterreith Complex Figure productions were scored according to the Developmental Scoring System. The children in the control group showed a clear developmental trend--organization score increasing with age--that was similar to the performance of American children. No such age-related effect was found in the three clinical groups. The organization scores of the children with ADHD were lower than those of other groups, suggesting an organizational deficit in ADHD. Performance on the immediate recall condition was poorest in the tic disorder and ADHD + learning disorder groups, suggesting the presence of nonverbal memory problems in those groups.

Adolescent↗
PubMed1989

Learning disorders.

Learning disorders, not explained by low intelligence, are common in children. They include difficulties in reading, spelling and mathematics and are often associated with overactivity and poor concentration. Prenatal perinatal and postnatal factors may be aetiologically important and treatment should be aimed at the cause.

England↗
PubMedDate not supplied

A comparison of neuropsychological test profiles of children with attention deficit-hyperactivity disorder and/or learning disorder.

The study compared 8-year-old children with pure attention deficit-hyperactivity disorder (ADHD) (n = 21), specific learning disorder (LD) (n = 12), and both (ADHD + LD) (n = 27) on a comprehensive set of neuropsychological measures. The tests were mainly derived from a new neuropsychological instrument, the Neuropsychological Assessment of Children. The children with ADHD were specifically impaired in the control and inhibition of impulses; the children with LD were impaired in phonological awareness, verbal memory span, and storytelling, as well as in verbal IQ. Children with both showed all of these deficiencies; they also had more pervasive attention problems and more visual-motor problems than the two other groups. All groups exhibited impaired performance in tasks of visual-motor precision and name retrieval. The latter finding may involve two different mechanisms, one related to linguistic impairment and possibly contributing to reading and spelling problems, and the other related to attentional problems.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

A controlled family history study of Tourette's syndrome, I: Attention-deficit hyperactivity disorder and learning disorders.

Gilles de la Tourette's syndrome (TS) is a common, hereditary neuropsychiatric disorder. While its diagnostic feature is the presence of suppressible motor and vocal tics, a wide range of impulsive, compulsive, attentional, learning, mood, and anxiety disorders are also present in many patients. To determine if attentional and learning problems are part of the expression of the Gts gene (or genes), the authors analyzed family histories of 130 TS probands with 1851 relatives and 25 control probands with 541 relatives--a total of 2392 relatives. The frequency of attention-deficit hyperactivity disorder (ADHD) or learning disorders was significantly increased in the relatives of the TS probands. The data on first-degree relatives suggest that when the Gts gene is expressed in this form, in two thirds of the cases tics are also present and in one third they are not. These observations are consistent with the proposal that ADHD and learning disorders form an integral part of the expression of the Gts gene or genes.

Adolescent↗
PubMed1991

Association between attention deficit-hyperactivity disorder and learning disorders.

This article discusses the relationship between attention deficit-hyperactivity disorder (ADHD) and learning disability (LD). The relevant literature is outlined, and empirical data are presented from a prospective follow-up study of 600 speech/language-impaired children. The data show an increased prevalence of both LD and ADHD among children with early speech/language impairments. Furthermore, LD was strongly associated with ADHD in both the initial and follow-up samples. Also, the children with LD had increased rates of other psychiatric disorders (e.g., behavior disorders, mood disorders, anxiety disorders). The implications of these data are discussed with regard to the possible etiology of the ADHD-LD association, treatment for children with LD and ADHD, and promising hypotheses for future research.

Attention Deficit Disorder with Hyperactivity↗
PubMed1991

A model for collaborative service delivery for students with language-learning disorders in the public schools. Committee on Language Learning Disorders American Speech-Language-Hearing Association.

Collaborative service delivery can augment traditional methods for serving students with language-learning disorders in the public schools. In collaborative service delivery, the speech-language pathologist is an integral member of a transdisciplinary team consisting of educators, parents, and the student. Team members collaborate to formulate a single educational program for each student. The team devises all treatment goals, assessment methods, intervention procedures, and documentation systems to enhance the student's academic and social functioning in the school environment. All team members are aware of the student's entire curriculum, and team members typically share responsibility for specific educational goals. Most special services, as well as regular instruction, take place within the classroom. Administrative support is crucial to the implementation of collaborative service delivery. Effective collaboration requires that team members be allotted time to meet outside of their classroom duties. In addition, cooperation among team members is essential. Potential team members must be willing to pool their expertise and abandon notions of professional "turf." The implementation of collaborative service delivery may require some adjustment in the way speech-language pathologists and other educators perceive their roles in public school settings. However, this service delivery model holds great promise for providing services to maximize the functional potential of students with language-learning disorders.

American Speech-Language-Hearing Association↗
PubMed1993

Familial relationship between Gilles de la Tourette's syndrome, attention deficit disorder, learning disabilities, speech disorders, and stuttering.

OBJECTIVE: This study examined the familial relationship between Gilles de la Tourette's syndrome (GTS) and attention deficit disorder (ADD), learning problems, speech disorders, and stuttering. METHOD: This family study consisted of 338 first degree relatives of 85 GTS probands and 113 controls. All available relatives were personally assessed using structured interviews, and family history information was collected from all family members. Best-estimate diagnoses were assigned for GTS, ADD, learning problems, speech disorders, and stuttering. Analyses examined whether ADD, learning problems, speech disorders, and stuttering by themselves represent genetically variant expressions of GTS. RESULTS: There was no evidence that ADD, learning problems, speech disorders, or stuttering represent variant expressions of GTS. However, relatives with GTS were at increased risk for ADD regardless of the ADD diagnosis of the GTS proband. CONCLUSIONS: ADD, learning problems, stuttering, and speech problems by themselves are not variant forms of GTS. However, GTS and ADD may be etiologically related in some persons. There may be two types of individuals with GTS and ADD: ones in whom ADD is independent of GTS, and others in whom ADD is secondary to occurrence of GTS.

Adolescent↗
PubMedDate not supplied

[Observations on the outcome of children with learning disorders].

The learning disorders reach 10% of the school population. They are characterized through an abnormal and persistent difficulty to get the basic acquirements and skills for children without mental or physical heavy handicap. These disturbances may be relieved through the assistance at all levels which interfere in their origin and their persistence (emotional, neurologic, pedagogic or pertaining to family). After de follow-up study over 10 years regarding the children coming from a special scholarship (type 8) and having received all the adapted aids, it seems that a good adaptation has resulted to a good ulterior professional training college. A narcissic fragility and organizing troubles are remaining present and are the origin of an intense strain on the mind. They may generate affective regression and behavioral problems.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

Selective effect of inhibition of literal or numerical irrelevant information in children with attention deficit hyperactivity disorder (ADHD) or arithmetic learning disorder (ALD).

This study investigated reasons why children with attention deficit hyperactivity disorder (ADHD) or arithmetic learning disorder (ALD) have difficulties in solving arithmetic word problems. In particular, the aim of this study was to verify whether these difficulties are due to a working memory deficit and defective inhibition of irrelevant information included in the problem wording. Furthermore, the study was geared to test whether children with ADHD or ALD have a specific disability in recalling and handling numerical or literal information. In an attempt to provide an answer to these questions, three groups of children were tested: children with ADHD, children with ALD, and a group of children achieving at normal levels. They were presented with a battery of arithmetic word problems containing irrelevant information (using either numerical or literal information). Children were asked to recall relevant information within the texts and then solve the problems. Children with ADHD recalled significantly more irrelevant literal information. Both children with ADHD and ALD recalled significantly more irrelevant numerical information. On the other hand, in the phase of problem solving, children with ADHD were more impaired by irrelevant literal information (which overloads memory), whereas children with ALD were more impaired by irrelevant numerical information (which may elicit the execution of wrong arithmetic procedures).

Achievement↗
PubMed2003

[Association between tryptophan hydroxylase gene polymorphisms and attention deficit hyperactivity disorder with or without learning disorder].

OBJECTIVE: To investigate the relationship between two tryptophan hydroxylasec (TPH) gene polymorphisms, A218C and A-6526G polymorphisms, and attention deficit hyperactivity disorder (ADHD) with or without learning disorder (LD). METHODS: Blood samples were taken from 132 trios with probands of ADHD with LD and 221 trios with probands of ADHD without LD. DNA was extracted and PCR was performed to amplify the fragments of A218C amd A-6526G polymorphisms. NheI and MboI were used to detect different alleles of the two polymorphisms separately. transmission disequilibriumtest (TDT) and haplotype analysis were used to test the association of the two polymorphisms of TPH gene and ADHD with or without LD. RESULTS: Haplotype block composed by A218C and A-6526G polymorphisms was related to ADHD with LD (chi(2) = 9.362, df = 3, P = 0.025). The haplotype of 218A/-6526G was significantly untransmitted to the probands with ADHD with LD (chi(2) = 9.252, df = 1, P = 0.002). CONCLUSION: TPH gene and the haplotype of 218A/-6526G may be related to ADHD with LD.

Adolescent↗
PubMedDate not supplied

Learning disorders and delinquency.

Learning disorders of various types are relatively common, and the reaction of the affected child can lead to social problems. The higher the children's intelligence the more frustrated they can become. Lack of self-esteem can cause unacceptable behaviour in trying to counteract this, and boost the child's confidence. There is evidence that learning disabilities are prevalent among those who are delinquent. Theories suggest this may be due directly to the learning difficulties, or to failure at school, starting a series of events leading to delinquency, or to the idea that those with learning difficulties are treated differently, especially when it comes to legal proceedings. Epilepsy can easily lead to learning disorders; particularly if the temporal lobes are involved, there are associated emotional disorders, or side effects of treatment. Also this association is often found amongst children with attention deficit disorders. If the link between learning disorders and delinquency is recognised there is considerable scope for prevention.

Adolescent↗
PubMed2006

Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders.

Our objectives were to examine whether children with attention-deficit hyperactivity disorder (ADHD) are impaired on one or more components of working memory (WM) independent of comorbid language learning disorders, and whether WM impairments are more strongly related to symptoms of inattention than to symptoms of hyperactivity-impulsivity. Four groups of children participated: ADHD (n = 62); ADHD+RD/LI (n = 32); RD/LI (n = 15); and a typically developing comparison group (n = 34). Four simple and brief measures of WM were used that varied in modality (auditory-verbal; visual-spatial) and processing demands (temporary storage versus manipulation of information). Children with ADHD without comorbid language learning disorders exhibited deficits in visual-spatial storage and verbal and visual-spatial central executive (C.E.) functions that were independent of comorbid psychiatric disorders. Children with language learning disorders, regardless of comorbidity with ADHD, exhibited impairments in both verbal and spatial storage as well as C.E. domains of WM. Symptoms of inattention, but not symptoms of hyperactivity/impulsivity, predicted performance on verbal and visual-spatial C.E. measures independent of age, verbal cognitive ability, and reading and language performance. Findings are consistent with data implicating neuropsychological impairments in ADHD. The dimensional results are also consistent with prior research demonstrating the neuropsychological impairments are more strongly associated with the inattention symptom dimension than with the hyperactive-impulsive dimension.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

Comorbidity and WISC-III profiles of Greek children with attention deficit hyperactivity disorder, learning disabilities, and language disorders.

The aim of the present study was to (a) examine the prevalence of ADHD and the comorbid difficulties in a sample of 114 children, 3.6 to 17.6 yr. of age (89 boys, 25 girls) referred to our Unit and (b) evaluate the discriminative ability of the WISC-III scores for children with Attention Deficit Hyperactivity Disorder (n = 22), Learning Disability (n = 50), and Language Disorder (n = 42). Analysis showed only 18% of 114 children had an Attention Deficit Hyperactivity Disorder diagnosis. Multivariate analysis of variance and stepwise discriminant function analysis were applied. Vocabulary and similarities were the best predictors for distinguishing between language disorders and the other two groups. Moreover, the Language Disorder group scored significantly lower on all the subtests while the Attention Deficit Hyperactivity Disorder and Learning Disability groups scored lower on coding and information, respectively. Children with Attention Deficit Hyperactivity Disorder and Learning Disability could not be accurately identified from the WISC-III test or their ACID profile.

Adolescent↗
PubMed2006

Learning disorders in epilepsy.

Learning disorders (LD) are disorders interfering with academic performance or with daily living activities requiring reading, writing, or mathematical abilities in subjects with a normal intelligence quotient. The prevalence of LD in the general population has been found to be 2-10% and reading disorders are the most frequent subtype. Epilepsy is one of the commonest neurological disorders in childhood with an estimated prevalence in 4-5/1,000. Epilepsy is considered to be idiopathic or cryptogenic in approximately two-thirds of cases. LD are more common in people with epilepsy than in the general population: about 25% of patients with epilepsy are said to have LD. Various psychosocial, medication-related, and epilepsy-related factors may be associated with LD in epilepsy. LD can be either permanent or state-dependent. Permanent LD are caused by a brain lesion and/or a stable brain dysfunction. In contrast, state-dependent LD are potentially reversible and treatable; they are caused by epilepsy-related factors. If allowed to persist for a long period, a state-dependent LD may become permanent.

Adolescent↗
PubMedDate not supplied

[The neurocognitive profile of non-verbal learning disorder].

INTRODUCTION: Non-verbal learning disorder is a specific type of learning disorder that is characterised by difficulties in social skills, in visuospatial and visual-constructional capabilities, and in motor skills. AIM: To observe the cognitive profile characterising these children. PATIENTS AND METHODS: We evaluated the intelligence, memory, visuospatial functions, instrumental and executive functions of 13 children between 8 and 14 years of age diagnosed with non-verbal learning disorder. RESULTS: All the children displayed an overall intelligence quotient within a range considered to be normal, with a marked difference between the verbal and manipulative intelligence quotients. They all had a good verbal memory. In contrast, they had difficulties in any tasks requiring spatial organisation and sequencing. Spontaneous language was fluent and aprosodic, with poor non-verbal communication. CONCLUSIONS: Good verbal skills and marked deficits in visuospatial skills are the characteristic pattern that has been described in the literature and this coincides with the observations made in the 13 children under study.

Adolescent↗