ADHD+Research

Our Team Project:  Using BTT to Improve Executive Functioning within ADHD

Definition of Executive Functioning: The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior. They include the ability to initiate and stop actions, to monitor and change behavior as needed, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations. The ability to form concepts and think abstractly are often considered components of executive function.

Our team responsibilities: 4 Sub- Categories:

Remember: Each team member must find about 6 pieces of research in the one we each individually pick that somehow relates to education…see below for our areas: Beckan- Inhibition - The ability to stop one's own behavior at the appropriate time, including stopping actions and thoughts. The flip side of inhibition is impulsivity; if you have weak ability to stop yourself from acting on your impulses, then you are "impulsive." (Example: When Aunt Sue called, it would have made sense to tell her, "Let me check the calendar first. It sounds great, but I just need to look at everybody's schedules before I commit the whole family.") Victoria- Initiation - The ability to begin a task or activity and to independently generate ideas, responses, or problem-solving strategies. (Example: Robin thought about calling to check on the date of the reunion, but she just didn't get around to it until her husband initiated the process.) Dev- Working memory - The capacity to hold information in mind for the purpose of completing a task. (Example: Robin could not keep the dates of the reunion in her head long enough to put them on the calendar after her initial phone call from Aunt Sue.) Heather- Planning/Organization - The ability to manage current and future- oriented task demands. (In this case, Robin lacked the ability to systematically think about what the family would need to be ready for the trip and to get to the intended place at the intended time with their needs cared for along the way.) 

Irene M. Loe, MD and Heidi M. Feldman, MD, PHD <span style="font-family: 'Times New Roman',Times,serif;">Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pa. <span style="font-family: 'Times New Roman',Times,serif;">Attention-deficit/hyperactivity disorder (ADHD) is associated with poor grades, poor reading and math <span style="font-family: 'Times New Roman',Times,serif;">standardized test scores, and increased grade retention. ADHD is also associated with increased use of school- <span style="font-family: 'Times New Roman',Times,serif;">based services, increased rates of detention and expulsion, and ultimately with relatively low rates of high <span style="font-family: 'Times New Roman',Times,serif;">school graduation and postsecondary education. Children in community samples who show symptoms of <span style="font-family: 'Times New Roman',Times,serif;">inattention, hyperactivity, and impulsivity with or without formal diagnoses of ADHD also show poor <span style="font-family: 'Times New Roman',Times,serif;">academic and educational outcomes. Pharmacologic treatment and behavior management are associated with <span style="font-family: 'Times New Roman',Times,serif;">reduction of the core symptoms of ADHD and increased academic productivity, but not with improved <span style="font-family: 'Times New Roman',Times,serif;">standardized test scores or ultimate educational attainment. Future research must use conceptually based <span style="font-family: 'Times New Roman',Times,serif;">outcome measures in prospective, longitudinal, and community-based studies to determine which <span style="font-family: 'Times New Roman',Times,serif;">pharmacologic, behavioral, and educational interventions can improve academic and educational outcomes <span style="font-family: 'Times New Roman',Times,serif;">of children with ADHD. Journal of Pediatric Psychology 32(6) pp. 643–654, 2007 doi:10.1093/jpepsy/jsl054
 * <span style="font-family: 'Times New Roman',Times,serif;">Academic and Educational Outcomes of Children With ADHD **

<span style="font-family: 'Times New Roman',Times,serif;">JOURNAL OF APPLIED BEHAVIOR ANALYSIS 1998, 31, 579–592 NUMBER 4 (WINTER 1998) <span style="font-family: 'Times New Roman',Times,serif;">GEORGE J. DUPAUL <span style="font-family: 'Times New Roman',Times,serif;">RUTH A. ERVIN <span style="font-family: 'Times New Roman',Times,serif;">CHRISTINE L. HOOK <span style="font-family: 'Times New Roman',Times,serif;">KARA E. MCGOEY <span style="font-family: 'Times New Roman',Times,serif;">We investigated the effects of classwide peer tutoring (CWPT) on the classroom behavior <span style="font-family: 'Times New Roman',Times,serif;">and academic performance of students with attention deﬁcit hyperactivity disorder <span style="font-family: 'Times New Roman',Times,serif;">(ADHD). Typical instructional activities were contrasted with CWPT for 18 children <span style="font-family: 'Times New Roman',Times,serif;">with ADHD and 10 peer comparison students attending ﬁrst- through ﬁfth-grade general <span style="font-family: 'Times New Roman',Times,serif;">education classes. CWPT led to increases in active engagement in academic tasks along <span style="font-family: 'Times New Roman',Times,serif;">with reductions in off-task behavior for most participants. Of students with ADHD, <span style="font-family: 'Times New Roman',Times,serif;">50% exhibited improvements in academic performance in math or spelling during CWPT <span style="font-family: 'Times New Roman',Times,serif;">conditions, as measured by a treatment success index. Participating teachers and students <span style="font-family: 'Times New Roman',Times,serif;">reported a high level of satisfaction with intervention procedures. Our results suggest that <span style="font-family: 'Times New Roman',Times,serif;">peer tutoring appears to be an effective strategy for addressing the academic and behav- <span style="font-family: 'Times New Roman',Times,serif;">ioral difﬁculties associated with ADHD in general education settings. <span style="font-family: 'Times New Roman',Times,serif;">DESCRIPTORS: classwide peer tutoring, attention deﬁcit hyperactivity disorder, ac- <span style="font-family: 'Times New Roman',Times,serif;">ademic intervention
 * <span style="font-family: 'Times New Roman',Times,serif;">PEER TUTORING FOR CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER: **
 * <span style="font-family: 'Times New Roman',Times,serif;">EFFECTS ON CLASSROOM BEHAVIOR AND ACADEMIC PERFORMANCE **

<span style="font-family: 'Times New Roman',Times,serif;">RESEARCH REPORT <span style="font-family: 'Times New Roman',Times,serif;">Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder that affects up to 1 in 20 children in the USA. The predomi- <span style="font-family: 'Times New Roman',Times,serif;">nance of American research into this disorder over the past 40 years has led to the impression that ADHD is largely an American dis- <span style="font-family: 'Times New Roman',Times,serif;">order and is much less prevalent elsewhere. This impression was reinforced by the perception that ADHD may stem from social and cul- <span style="font-family: 'Times New Roman',Times,serif;">tural factors that are most common in American society. However, another school of thought suggested that ADHD is a behavioral dis- <span style="font-family: 'Times New Roman',Times,serif;">order common to children of many different races and societies worldwide, but that is not recognized by the medical community, per- <span style="font-family: 'Times New Roman',Times,serif;">haps due to confusion regarding its diagnosis and/or misconceptions regarding its adverse impact on children, their families, and soci- <span style="font-family: 'Times New Roman',Times,serif;">ety as a whole. In this article we present the available data, with a view to determining the worldwide prevalence of ADHD. A total of <span style="font-family: 'Times New Roman',Times,serif;">50 studies were identified from a MEDLINE search for the terms ADHD, ADD, HKD, or attention-deficit/hyperactivity disorder and <span style="font-family: 'Times New Roman',Times,serif;">prevalence combined, for the years 1982 to 2001. 20 were studies in US populations and 30 were in non-US populations. Analysis of these <span style="font-family: 'Times New Roman',Times,serif;">studies suggests that the prevalence of ADHD is at least as high in many non-US children as in US children, with the highest prevalence <span style="font-family: 'Times New Roman',Times,serif;">rates being seen when using DSM-IV diagnoses. Recognition that ADHD is not purely an American disorder and that the prevalence of <span style="font-family: 'Times New Roman',Times,serif;">this behavioral disorder in many countries is in the same range as that in the USA will have important implications for the psychiatric <span style="font-family: 'Times New Roman',Times,serif;">care of children. STEPHENV. FARAONE1,2,3, JOSEPHSERGEANT4, CHRISTOPHERGILLBERG5,6, JOSEPHBIEDERMAN1,2,3
 * <span style="font-family: 'Times New Roman',Times,serif;">The worldwide prevalence of ADHD: is it an American condition? **

<span style="font-family: 'Times New Roman',Times,serif;">World Psychiatry 2:2 -- June 2003

<span style="font-family: 'Times New Roman',Times,serif;">Heather's Articles (thus far):

1. Executive functions and their disorders Rebecca Elliott Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK

The term executive function defines complex cognitive processing requiring the co-ordination of several subprocesses to achieve a particular goal. Neuropsychological evidence suggests that executive processing is intimately connected with the intact function of the frontal cortices. Executive dysfunction has been associated with a range of disorders, and is generally attributed to structural or functional frontal pathology. Neuroimaging, with PET and fMRI, has confirmed the relationship; however, attempts to link specific aspects of executive functioning to discrete prefrontal foci have been inconclusive. Instead, the emerging view suggests that executive function is mediated by dynamic and flexible networks, that can be characterised using functional integration and effective connectivity analyses. This view is compatible with the clinical presentation of executive dysfunction associated with a range of pathologies, and also with evidence that recovery of executive function can occur after traumatic brain injury, perhaps due to functional reorganisation within executive networks.

www.columbia.edu/cu/.../tor/.../**Unity**_**Diversity**_Exec_**Functions**.pdf

2.

The Tower of London and neuropsychological assessment of ADHD in adults Cynthia A. Riccio, Monica E. Wolfe, Cassandra Romine, Brandon Davis and Jeremy R. Sullivan

Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225, USA

Executive function refers to a variety of behaviors and abilities related to planning and strategy use, as well as the maintenance of attention and behavior in the pursuit of some goal; these behaviors are generally deficient in individuals with Attention Deficit Hyperactivity Disorder (ADHD). The Tower of London (TOL) is one task used in the assessment of executive function. For adults with ADHD, there is minimal research on the extent to which they demonstrate impaired performance on tower tasks. With a sample of 102 individuals between the ages of 16 and 33 years, the extent to which performance on the TOL–Drexel Edition (TOLDX) was related to performance on other measures of executive function and diagnostic grouping was investigated. Results indicated that TOLDX variables are not correlated significantly with age or Global Assessment of Functioning (GAF). Of the TOLDX variables, only Rule Violations correlated with multiple other executive function variables. Rule Violations correlated minimally, but significantly, with cognitive ability, perceptual skills, Matrix Reasoning, Processing Speed, and immediate memory. As might be expected, Processing Speed also significantly correlated with Total Time and Time Violations. Notably, scores on the TOLDX did not correlate significantly with behavioral self-report; no between-group (ADHD, Clinical Control, No Diagnosis) differences emerged for any of the TOLDX variables. Further, with this sample, mean scores across the TOLDX variables were well within the average range. Taken together, these results suggest that while the TOLDX measures aspects of ability not tapped by other measures, and may therefore provide additional information on individual functioning, results should not be interpreted as indicative of the presence or absence of a disorder.

Accepted 17 September 2003. Available online 5 December 2003.

3. <span style="font-family: 'Times New Roman',Times,serif;">The Effects of Self-Management in General Education Classrooms on the Organizational Skills of Adolescents With ADHD <span style="font-family: 'Times New Roman',Times,serif;">1. Sammi Gureasko-Moore <span style="font-family: 'Times New Roman',Times,serif;">2. George J. Dupaul <span style="font-family: 'Times New Roman',Times,serif;">3. George P. White

<span style="font-family: 'Times New Roman',Times,serif;">Lehigh University

Abstract: Self-management procedures have been used in school settings to successfully reduce problem behaviors, as well as to reinforce appropriate behavior. A multiple-baseline across participants design was applied in this study to evaluate the effects of using a self-management procedure to enhance the classroom preparation skills of secondary school students with attention-deficit/ hyperactivity disorder (ADHD). Three male students enrolled in a public secondary school were selected for this study because teacher reports suggested that these students were insufficiently prepared for class and inconsistently completed assignments. The intervention involved training in self-management procedures focusing on the improvement of classroom preparation skills. Following the intervention, the training process was systematically faded. Results were consistent across the 3 participants in enhancing classroom preparation behaviors. Implications for practice and future research are discussed.

**http://bmo.sagepub.com/content/30/2/159.short:**

4. Good research article of goal setting with ADHD in relation to Math Fact Fluency:

Effects of Self-Graphing and Goal Setting on the Math Fact Fluency of Students with Disabilities

Patricia M Figarola, Ed.S. Patricia M Figarola, Valdosta City Schools; Philip L Gunter, Ph.D., Julia M Reffel, Ed.D., Susan R Worth, Ph.D., John Hummel, Ph.D., and Brian L Gerber, Ph.D. Brian L Gerber, Valdosta State University;

Abstract: We evaluated the impact of goal setting and students' participation in graphing their own performance data on the rate of math fact calculations. Participants were 3 students with mild disabilities in the first and second grades; 2 of the 3 students were also identified with Attention-Deficit/Hyperactivity Disorder (ADHD). They were taught to use Microsoft Excel® software to graph their rate of correct calculations when completing timed, independent practice sheets consisting of single-digit mathematics problems. Two students' rates of correct calculations nearly always met or exceeded the aim line established for their correct calculations. Additional interventions were required for the third student. Results are discussed in terms of implications and future directions for increasing the use of evaluation components in classrooms for students at risk for behavior disorders and academic failure.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846585/