Executive+Functions+and+ADHD-Complete+Annotated+Bibliography

//Heather, Beckan, Dev, Victoria R// **Annotated Bibliographies** **//“Executive Functioning within ADHD”//** **Fundamentals of Cognitive Development Spring 2011**
 * Growing Minds’ Team**

**Heather Van Horn** **//Planning/Organization//** Elliot, Rebecca (2003). Executive functions and their disorders. British Medical Bulletin, 51-54. The article explains the term executive function in which complex cognitive processing requiring the co-ordination of several sub-processes 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. Neuro-imaging, 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 characterized 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 reorganization within executive networks.

Riccio, Cynthia A., Wolfe Monica E., Romine Cassandra, Davis Brandon, Sullivan Jeremy (2004). The Tower of London and neuropsychological assessment of ADHD in Adults. Arch Clinical Neuropsychology, 661-71. The article defines executive function and the various of behaviors and abilities related to planning and strategy use. It also explores the maintenance of attention and behavior in the obtaining the some goal. The Tower of London (TOL) is one task used in the assessment of executive function. 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 showed correlation minimally, but significantly, with cognitive ability, perceptual skills, Matrix Reasoning, Processing Speed, and immediate memory. Processing Speed also significantly correlated with Total Time and Time Violations. These results suggest that while the TOLDX measures aspects of ability not tapped by other measures, which shows that planning can be difficult for some individuals.

Moore, Sammi, Dupaul, George, White, George. (2003). The Effects of Self-Management in General Education Classrooms on the Organizational Skills of Adolescents With ADHD, Behavior Modification Journal, 159-183. The article defines self-management procedures which 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 then faded. Results were consistent across the 3 participants in enhancing classroom behaviors.

Figarola, Patricia M., Gunter, Phillip, Reffel, Julia, Worth, Susan, Hummal, John, Gerber, Brian. (2001). Effects of Self-Graphing and Goal Setting on the Math Fact Fluency of Students with Disabilities. ABA International, 36-41. The article evaluates 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. The results are discussed in terms of implications and future directions for increasing the use of evaluation components in classrooms for students who need self-monitoring/ goal setting. Godlwitzer, P., Gawrilow C., Oettingen G., (2010). The Power of Planning: Self-Control of Effective Goal-striving. Self Control in Society, Mind, and Brain, 5, 10-11. The article explores if self-regulation and self-control can override unwanted thoughts, feelings and behaviors when goal planning. The research argues if goal attainment is effective when people plan out their goals in advance. It also suggests that effectively regulating goal striving by making if- then plans for the individual. The article also explores if it is reliable and successful way to achieve self- control. The research does find that if-then plans can be effective, as long as the participants are motivated and capable of making these plans.

**Beckan Gehan** **//Inhibition//**

Suskauer S., Simmonds D., Fotedar, S., Blankner, J., Denkla, M., Pekar, J., and Mostofsky, S. (2008)Functional magnetic resonance imaging, evidence for abnormalities in response selection in attention deficit hyperactivity disorder: Differences in activation associated with response inhibition but not habitual motor response. //Journal of Cognitive Neuroscience// 20 (3) 478-493. This imaging study examined the regional deviations in neurobiology and circuitry underlying the action of inhibition in a "classic go/ no-go" research design. Evidence was found indicating that there is an underlying neurobiological deviation in individuals with ADHD, as observed in fMRI imaging of the medial- frontal PFC. In this study, investigators employed 25 children who were diagnosed with having ADHD, between the ages of 18-13 years old. Controls were sex, age, and IQ matched, and all co-morbid conditions were exempt from the study except those with Operational Defiant Disorder (a somewhat typical age graded condition associated with normative adolescent development). Methods of this study emulated a "Classic Go/ No-Go" paradigm, in which children were asked to respond to colored visual stimuli by pressing a button (go for one color and no/go for another). fMRI imaging analysis evidenced "diminished recruitment" of circuitry associated with inhibition in motor, pre-motor, and medial- frontal PFC regions.

Dickstein, S., Bannon, K, Xavier C.,Milham M., (2006)The neural correlates of attention deficit hyperactivity disorder: an ALE meta-analysis. //Journal of Child Psychology & Psychiatry//. 47 (10) 1051-1062   This meta-analysis might examines the global regional similarities characteristic in ADHD, as well as those associated with inhibition, independently. This analysis provides a rich basis for which ADHD can be troubleshot in the classroom based on evidence of a true deficit in cortical regions found to be of importance in this analysis. For this paper, investigators collaborated to analyze 16 individual fMRI studies of ADHD subjects' regional activation. This meta-analysis provided statistically significant evidence that there exists cortical activation deficits in the Inferior Prefrontal Cortex, Medial wall Regions, and the Pre-central Gyrus. As such, associated structure:function relationships should be examined for the purpose of task modification, accommodation of students with ADHD, and alternative forms of measurement when necessary.

Daley D., Birchwood, J. (2010) ADHD and academic performance: why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? //Child: Care, Health and Development// 36(4) 2010 This important literature reviews ADHD and associated academic performance, as well as current educational intervention strategies. While it is not immediately associated with my area of interest, it will be quite useful in reviewing how ADHD and associated academic impairment is being addressed. Areas discussed are training working memory, one on one (peer) tutoring, strategy formation, task/ instruction modifications. The literature suggests that working memory training can lead to better response inhibition. Interestingly, there seems to be a relationship between inhibition and working memory, as there are many journals that address both simultaneously.

Gawrilow, C., and Gollwitzer, P. (2008) Implementation intentions facilitate response inhibition in children with ADHD. //Cognitive Therapy & Research// 32 (2) 261-280 This journal reviews a study that aimed to investigate the question of whether or not forming and implementing a specific intention in school- aged children, can have positive effects (response) inhibition. This translational research design also contends that combined behavioral and pharmacologic interventions might be the best route of intervention among children with ADHD. This might tie into BT-3: Designing the Learning Experience (modifications and additional learning goals for children with positive diagnosis for ADHD)

Imhof, M. (2004) Effects of color stimulation on handwriting performance of children with ADHD, without, and with additional learning disabilities. European Child and Adolescent Psychiatry (13) 191-198 This journal presented a thorough review of the hypothesized etiology of ADHD, as it pertains to Behavioral Inhibition as the focal point of the disorder. Setting the stage with a literature review characterizing evidence that there clearly exists a deficit in cortical activation in individuals with ADHD, this study highlighted many previous studies that aim to find a correlation between environmental stimuli and academic performance in reading, writing, mathematics, behavior, and especially- for the purpose of this review- graphomotor control. This study examined the effects of color stimulation in 66 2nd and 3rd grade students with ADHD. To eliminate confounds, any classroom with a student with ADHD performed the activities as typical classroom activities, and data was later analyzed using only those children with ADHD and age, gender, and IQ matched controls. This experiment called for students' cooperation in copying text that was presented using a projection screen on either white or colored paper. Two of these tasks were preformed by all classes one week apart; and in between color paper was used so as to limit the confound of "novelty effects." Measures were then taken of letter formation, alignment, neatness, slant, and spacing. As hypothesized, students with ADHD who were administered the colored paper to write on, demonstrated a global improvement on graphomotor skills.

Daley, D., and Birchwood, J. (2010) ADHD and academic performance: Why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? //Child: Care, Heath, and Development// 36 (4) 1-10 This journal presents ADHD with a starting point of the neurobiology of the disorder, theoretical foundations of underlying issues, and moves into a literature review of statistical analyses. This literature review presents an extensive collection of research statistics regarding cognitive achievement amongst primarily, school aged children with ADHD. The review addresses the severity of impact on cognitive achievement in numeracy, literacy, academic readiness, and developmental outcomes such as special education placement, graduation rates, and adolescent behavioral diagnostics (ODD, CD, substance abuse), and persistence of associated behaviors into adulthood. Academic intervention strategies that aim to tap into Executive Function are addressed from the same perspective of previously evidenced statistical analyses. Focus on 1:1 interactions is highlighted in this review, as well as peer tutoring and task modifications that have been evidenced as being positively correlated with improved academic outcomes. Emphasis is placed on not only the aforementioned strategies, but also the necessity of maintaining individualized functional assessments, parent involvement, and self monitoring for students.

Cauda, F., Giuliano, G., Federico, D., Sergio, D., Katiuscia, S. (2010) Discovering the somatropic organization of the motor areas of the medial wall using low frequency bold fluctuations. //Human Brain Mapping// 1-14 This journal provides insight to the regional functionality of the medial wall, which in previous studies has been characterized in those with ADHD, as having activation deficits. This fMRI study examined the somatotropic organization of the M1 motor area and found that there is a high significant correlation between the activation of the medial wall and body/ leg regions, as well as hand/ finger regions. In addition to this imaging study, which employed 16 healthy subjects, this journal provided a comprehensive metaanalysis of 28 other studies that also found the medial wall region to be heavily associated with hand and foot movements. The relevance of this study clearly provides insight to the delay in response time or graphomotor control that is frequently observed in individuals with ADHD.

Antrop, I., Buysse, A, Roeyers, H., and Van Oost, P. (2005) Activity in children with ADHD during waiting situations in the classroom. //British Journal of Educational Psychology// (75) 51-69 This journal addresses the function of "stimulation seeking behavior" commonly associated with etiological expression of ADHD. This study examined the effects of waiting versus non-waiting classroom environments among children with ADHD with temporal and non-temporal stimulation conditions. The experimental methodology was to   execute the study in a naturalistic setting where stimulation seeking behavior is disruptive and can lead to off-task behavior, excessive movement, attention allocation issues, and ultimately lessened cognitive achievement. As hypothesized, the effects of waiting during and in between daily classroom activity is positively correlated with more anxious, restless, and vocalization behavior in the subjects with ADHD as compared to their matched controls. (This study presents the validation of Brain Targets 1-3 with regard to temporal and non-temporal stimulation and the necessary for activation of cortical regions associated with the disorder via environmental and interpersonal stimuli placement in classroom organization).

Barkley, R. (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. //Psychological Bulletin, American Psychological Association.// (2)1 65-94 This literature proposes that ADHD is essentially a "deficit in behavioral inhibition." The notion that inhibition is the core process that linearly delineates deficits in four principle executive functions is explored. A review of executive function deficits associated with ADHD gives rise to the construct that there exists a linear model of ADHD in which inhibition is the underlying developmental component to the proper functionality of working memory, internalization of speech, self regulation motivation arousal, reconstitution, and motor control. A thorough review of each component of the proposed linear model supports an evidenced based model that inhibition, working memory, motivation, and motor control are the most salient pieces to this model.

**Dev Sharma** **//Working Memory//** Article #1-Dendy, C.A.Z., Executive Function...What is this anyway? //Attention Magazine//, February 2002, 1 When intellectually gifted children fail at school, deficits in vital cognitive skills known as executive functioning may be responsible. This means that children afflicted with ADD or ADHD may have problems processing information, staying focused, controlling emotions, self-advocating and generally being able to function effectively within the classroom and society. Working memory, the ability to hold facts in one’s mind while processing information and retrieving facts stored in long-term memory, is one of several elements within executive functioning. Deficits in working memory may manifest as: forgetfulness, inability to hold information, approximating 7 numbers, in the mind for longer than 20 seconds. The implications for students are: •   Inability to remember and follow instructions. • • • • • • • •   Memorizing math facts, dates, spelling etc. Performing mental computations. Difficulty following multistep directions. Problems paraphrasing and summarizing. Failure to turn in assignments. Low self esteem Poor time management skills. Difficulty planning for the future. Compensatory strategies: • • • • • • • • •   Verbatim reading (human/screen) for entire or selected sections of the text. Using visuals, graphic organizers. Using a peer tutor. Using mnemonics Infusing instructional technology Chunking of information. Shorten assignments. Modify testing Use of highlighters

Working memory #2 Thorne, Glenda //What Can A Student Do To Increase His Memory?// Retrieved on Jan29, 2011 from //http://www.cdl.org/resource-library/articles/ memory_pt3.php// Dr.Thorne advocates several strategies that students can use to improve their working memory. Assessment: Thorne developed a self-test to establish a memory profile overview. Among the memory improvement strategies purported by Thorne are: • • • • • • • •   Differentiating between remembering and understanding. Activating prior knowledge. Teaching maintenance rehearsal versus elaborative rehearsal. Using multisensory and multi instructional modes. Examining proactive and retroactive interference. Encoding and retrieval practice. Providing mnemonic strategies. Assisting students with meta -memory strategies.

Document# 3 Hardiman, M., //The Brain Targeted Teaching Model// retrieved on January 29, 2011 from http://www.braintargetedteaching.org/mastery.cfm In //Teaching for Mastery//, Hardiman argues that students need to be taught in ways that target more than just their working memories. Hardiman asserts that students need to be   able to build new knowledge from knowledge and skills they acquire, and for this process, they need their long-term memory. To facilitate a transition for information from the working memory to the long-term memory, teachers have to be able to create multiple modalities that will form and sustain more permanent memory. By providing students with multiple means to manipulate content, practices skills and analyze concepts, teachers address the wide range of needs present within the classroom while promoting long term memory.

Working memory #4 Schwabe, L. & Wolf, O. //Neurobiology of Learning and Memory//. Retrieved on January, 30, 2011 from http://www.cog.psy.ruhr-uni-bochum.de/papers/ 2010/YNLME5497.pdf Learning can be adversely impacted by stress. Findings from a study suggest that memory formation is affected when people are under stress. While stress seems to affect both men and women to the same extent, women performed better than men in the test of free recall. The researchers conclude that stress mainly affects the encoding process. They speculate that at a neural level, there may be a hippocampus deactivation induced by stress (Khalili-Mahani, Dedovic, Engert, Pruessner, &Pruessner, in press; Pruessner et.al., 2008).

Working memory # 5 Vlach, H., & Sandhofer., C. //The Spacing Effect In Children’s Memory and Category Induction,// Cognition, Retrieved on January 30, 2011 from http:// www.williams.edu/Psychology/Faculty/Kornell/Publications/Vlach.Sandhofer.Kornell. 2008.pdf The Spacing effect described by Vlach et.al, suggests that memory is strengthened when learning events are spaced over time rather than being presented in a successive sequence. These findings are supported by encoding variability theories that argue when learning is staggered in varying contexts, retrieval cues linked to an item increases and consequently, the likelihood of recall increases

Working memory #6 Alloway, T., (2010) //10% Students may have working memory problems: Why does it matter?// Retrieved on February 1, 2011 from http:// www.sharpbrains.com/blog/2009/05/10/10-students-may-have-working-memory- problems-why-does-it-matter/ Alloway views working memory as the ability of an individual to remember something while simultaneously processing sometimes unrelated information. The researcher claims that working memory differences among individuals is impacted by academic skills such as comprehension, reading and mathematics. Alloway’s study further claims that because working memory seems to operate independent of environmental influences such as economic status and parental education, it can measure students’ capacity to learn, rather than what they already know. According to Alloway, a study of over 3000 students, 1 in 10 had working memory difficulties. The findings show that despite the students’ IQ being accounted for, poor working memory adversely impacted learning outcomes in core subject areas as well as general areas such as Art and Music. Another crucial finding of this study is that teachers’ perceptions of these students were that they were often easily distracted, failed to completed tasks and failed to follow instructions. These students take a much longer time to process information than their neuro typical peers. Alloway suggests several tests to measure working memory including the Working Memory Index in the WISC. The researcher also mentions the Automated Working Memory Assessment (AWMA), which allows non-expert teachers to identify students with significant working memory problems.

**Victoria Raskin** Annotated Bibliographies Executive Functioning **//Shifting//**

Hooper, S., Swartz, C., Wakely, M., de Kruif R., Montgomery, J. (2002) Executive functions in elementary school children with and without problems in written expression. //Journal of Learning Disabilities//, 1, 57-6 Executive functions have been deemed critical to the writing process. This research examined the executive functioning and the utility of an executive functioning model of elementary school age children (4th and 5th graders in general education and special education classes) with and without documented problems in written expression. Tasks given included initiation, working memory, set shifting domain, and inhibition/stopping domain measures and written language tests. Though few differences were found between the groups, the two groups did differ in the Word Attack subtest of the Woodcock-Johnson Reading Mastery Test. The findings concluded that the executive functions which encompass initiation and set shifting (problem solving efficiency or cognitive flexibility) and perhaps sustaining, significantly separated good writers from poor writers, although the significant finds generally had weak effect size. (Other variables may co-exist with executive functioning, the most important being reading/ decoding variables). The authors acknowledged that measurement was hindered by a relatively small sample size. These findings point out the importance of executive functions in the written language process for elementary school students, but highlight the need to examine other variables that may be as least as important as executive functioning.

Biederman, J., Monuteaux, M., Doyle, A., Seidman, L., Wilens, T, Ferrero F., Morgan, C., Faraone, S. (2004) Impact of executive function deficits and Attention- Deficit/ Hyperactivity (ADHD) on academic outcomes in children. //Journal of Consulting and Clinical Psychology 72// (5) 757-766. The association between executive function deficits (EFDs) and functional academic outcome was examined among children and adolescents with ADHD. Participants were 6-17 years of age split between boys and girls equally with a fairly large sampling (269 with ADHD and 226 control participants). Their hypothesis was that EFDs (distractibility, planning and organization, inhibition, set shifting, attention, visual scanning and verbal learning) would be more prevalent in children with ADHD relative to control participants without ADHD and would be associated with multiple domains of functioning. The hypothesis that EFDs are associated with multiple domains was not confirmed, but their results document those children and adolescents with ADHD and co-morbid EFDs have significantly worse academic deficits (as measured by achievement scores and measures of school functioning compared with children and adolescents with ADHD without EFDs). They also found that ADHD + EFD were almost 2 times more likely to repeat a grade. Biederman et al suggest that further investigations of their EFD measure and DSM-IV ADHD subtypes could be a subject of additional analyses.

Van der Sluis, S., de Jong, P., van der Leij, A. (2004) Inhibition and shifting in children with learning deficits in arithmetic and reading. //Journal of Experimental Child Psychology 87// (3) 239-266. The research examined executive functioning (inhibition and shifting) in children (grades 4 and 5) with specific learning disabilities in either reading or arithmetic, as well as children with deficits in both reading and arithmetic and compared their performance with the performance of a control group with normal reading and arithmetic abilities. For the purpose of the study, they defined shifting as, "Characterized by the disengagement of an irrelevant task set or strategy and the subsequent activation of a more appropriate one. (p.240) The current study shows that reading-disabled children are not characterized by deficits in inhibition or shifting. Arithmetic-disabled children also did not experience problems with inhibition or shifting per se. However, complex executive functioning tasks, which required the combinations of executive functions, did result in performance that was below that of the controls. The reading plus arithmetic-disabled group performed more slowly on the Objects-IS shifting task (a measurement of shifting ability which shared the requirement to monitor and regulate different executive functions simultaneously). The results suggest relations between reading ability and the naming of letters and digits as well as between arithmetic ability and the naming of digits and quantities. The authors raised the issue of task impurity and the use of control tasks when measuring executive functioning ability in the context of learning disabilities.

St. Clair-Thompson, H., Gathercole, S. (2006) Executive Functions and Achievement in School: Shifting, updating, inhibition and working memory. //The Quarterly Journal of Experimental Psychology 59// (4), 745-759. In this study, the executive processes of shifting, visuo-spatial working memory, and inhibition were assessed in 11 and 12 year olds in relationship to their learning abilities and achievement with all participants completing a set of six executive function tasks designed to tap each of the three functions. Shifting was defined as moving backwards and forwards between multiple tasks, operations, or mental sets. Significant partial correlations were found between verbal working memory and English scores and between visuo-spatial working memory and all areas of assessment (English, mathematics and science). Inhibition was significantly associated with achievement in each curricular area. The present study failed to identify the third distinct executive factor —that of shifting. In the discussion section, the authors put forward that mental flexibility may be less differentiated from working memory and inhibition in young children than in adults. The authors suggest that a common classroom task, such as writing a sentence, has a complex structure that requires shifting between lower and higher levels of processing and although shifting did not achieve statistical significance using their measurements, it plays a key role and has important implications for educational practice.

Bull, R., Scerif, G. (2001) Executive functioning as a predictor of children’s mathematic ability: Inhibition, switching and working memory. //Developmental Neuropsychology, 19// (3) 273-293. Children’s mathematical skills were considered in relation to executive functions. In previous research, Bull et al., (1999) found that children (ages 6-9) with poorer math and basic arithmetic skills showed poorer performance of executive functioning. Using multiple measures -- including the Wisconsin Card Sorting Task (WCST), dual task performance, Stroop task and counting span, it was found that mathematical ability was significantly correlated with all measures of executive functioning, with the exception of the dual-task performance. In this study, looking further at inhibition, switching and working memory, the authors found a correlation that for children with lower mathematical ability, their performance on tasks can be tied to a lack of inhibition and poor working memory—which results in problems with switching (e.g., from addition to subtraction procedures) and the ability to evaluate new strategies for dealing with a particular math task. In addition, they found that higher math ability is associated with a lower amount of interference for irrelevant information and is also related to higher working memory. The authors proposed that longitudinal studies would allow for two distinctions: determining whether different levels of skill acquisition and executive functioning become more or less important at different ages and whether an early delay in executive functioning results in a developmental lag in learning skills, such as arithmetic.

Best, J., Jones, L. Executive Functions after age 5: Changes and correlates. (2009) //Developmental Review, 29// (3) 180-200. This review paper outlined the importance of examining executive functioning throughout childhood (particularly grade school and adolescence, whereas previous studies have focused on pre-school children). One advantage of studying EF in school- age children is that brain neuroimagining assessments, critical for showing related changes in brain structure, function and connectivity between brain regions, can be more easily added. They explored executive function (EF) as a construct and examined two key questions. 1. Is EF best thought of as a unitary process or a set of multiple distinct processes? 2. If EF does refer to distinct component processes, how are these processes related and how does the relationship change as the child develops? Their conclusions include that when components emerge and undergo rapid change, this would suggest that they are part of the same ability—that is there is neural support for the unity-but-diversity view of EF. By examining school- aged children, it appears that the EF components appear to be related differentially to various academic subject areas; EF may contribute to children’s variability in strategy use in subject areas. The authors state that it is possible that children acquire the ability to inhibit less effective strategies in favor of new, more efficient strategies and that the children’s abilities to formulate a new plan is closely related to the selection of effective strategies. 