Differentiating ADHD from oral language difficulties in children: role of movements and effects of stimulant medication

BMC Psychiatry

Cheryl Silver¹  Gina Bolanos¹  Kristi Baker³  Joyce Pickering²  Carroll W Hughes³ 

[1] Department of Rehabilitation Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA;Shelton School, Richardson, Texas, USA;Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas 75390-9044, Texas, USA

关键词: Movement detection;    Continuous performance testing;    Cognitive processing;    Language;    Hyperactivity/Impulsivity;    Inattention;    ADHD;    Oral language disorders;   

Others  :  1090535
DOI  :  10.1186/s12888-014-0370-0

 received in 2013-10-24, accepted in 2014-12-18,  发布年份 2014

【 摘 要 】

Background

The current study was designed to test if an objective measure of both attention and movement would differentiate children with Oral Language Disorders (OLD) from those with comorbid Attention Deficit/Hyperactivity Disorder (ADHD) and if stimulant medication improved performance when both disorders were present.

Methods

The sample consisted of thirty-three children with an identified oral language disorder (of which 22 had comorbid ADHD) ages 6 to 13 who were enrolled in a yearlong intensive learning intervention program. Those on a stimulant medication were tested at baseline and again a year later on and off medication.

Results

Objective measures that included an infrared motion analysis system which tracked and recorded subtle movements discriminated children with OLD from those with a comorbid ADHD disorder whereas classic attention measures did not. There were better attention scores and fewer movements in children while on-medication.

Conclusions

Use of an objective measurement that includes movement detection improves objective diagnostic differential for OLD and ADHD and provides quantifiable changes in performance related to medication for both OLD and ADHD.

【 授权许可】

   
2014 Hughes et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Toppelberg C, Shapiro T: Language disorders: a 10-year research update review. J Am Acad Child Adolesc Psychiatry 2000, 39(2):143-152.
• [2]APA: Diagnostic and Statistical Manual of Mental Disorders. 4th edition. American Psychiatric Association, Washington, DC; 2000.
• [3]Beitchman J, Nair R, Clegg M, Patel P: Prevalence of speech and language disorders in 5-year-old kindergarten children in the Ottawa-Carleton region. J Speech Hear Disord 1986, 51(2):98-110.
• [4]Cohen NJ, Vallance DD, Barwick M, Im N, Menna R, Horodezky NB, Isaacson L: The interface between ADHD and language impairment: an examination of language, achievement, and cognitive processing. J Child Psychol Psychiatry 2000, 41:353-362.
• [5]Kube D, Peterson M, Palmer F: Attention deficit hyperactivity disorder: comorbidity and medication use. Clin Pediatr (Phila) 2002, 4(7):461-469.
• [6]Shaywitz S, Shaywitz B: Paying attention and reading: the neurobiology of reading and dyslexia. Dev Psychopathol 2008, 20:329-349.
• [7]Gualtieri C, Koriath U, VanBourgondien M, Saleeby N: Language disorders in children referred for psychiatric services. J Am Acad Child Adolesc Psychiatry 1983, 22(2):165-171.
• [8]Pliszka S, Carlson C, Swanson J: ADHD with Comorbid Disorders: Clinical Assessment and Management. Guilford, New York; 1999.
• [9]Bashir A, Scavuzzo A: Children with language disorders: natural history and academic success. J Learn Disabil 1992, 25:593-617.
• [10]Cohen N, Davine M, Meloche-Kelly M: Prevalence of unsuspected language disorders in a child psychiatric population. J Am Acad Child Adolesc Psychiatry 1989, 28:107-111.
• [11]Humphries T, Koltun HM, Malone M, Roberts W: Teacher-identified oral language difficulties among boys with attention problems. J Dev Behav Pediatr 1994, 15:92-98.
• [12]Tannock R, Purvis K, Schachar R: Narrative abilities in children with attention deficit hyperactivity disorder and normal peers. J Abnorm Child Psychol 1993, 21:103-117.
• [13]McInnes A, Humphries T, Hogg-Johnson S, Tannock R: Listening comprehension and working memory are impaired in attention-deficit hyperactivity disorder irrespective of language impairment. J Abnorm Child Psychol 2003, 31:427-443.
• [14]Rhodes S, Coghill D, Matthews K: Acute neuropsychological effects of methylphenidate in stimulant drug-naive boys with ADHD II - broader executive and non-executive domains. J Child Psychol Psychiatry 2006, 47(11):1184-1194.
• [15]Kerstin K, Gunther T, Hanisch C, Herpertz-Dahlmann B: Differential effects of methylphenidate on attentional functions in children with Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2004, 43:191-198.
• [16]Kanaka N, Matsuda T, Tomimoto Y, Noda Y, Matsushima E, Matsuura M: Measurement of development of cognitive and attention functions in children using continuous performance test. Psychiatry Clin Neurosci 2008, 62:135-141.
• [17]Pollak Y, Weiss P, Rizzo A, Weizer M, Shriki L, Shalev R: The utility of a continuous performance test embedded in virtual reality in measuring ADHD-related deficitis. J Dev Behav Pediatr 2009, 30:2-6.
• [18]Corkum P, Siegel L: Is the continuous performance task a valuable research tool for use with children with attention deficit hyperactivity disorder? J Child Psychol Psychiatry 1995, 34:1217-1239.
• [19]Eliason M, Richman L: The continuous performance test in learning disabled and non-disabled children. J Learn Disabil 1987, 20:614-619.
• [20]Inoue K, Nadaoka T, Oiji A, Morioka Y, Totsuka S, Kanbayahshi Y: Clinical evaluation of attention-deficit hyperactivity disorder by objective quantitative measures. Child Psychiatry Hum Dev 1998, 28:179-188.
• [21]Fischer M, Newby R, Gordon M: Who are the false negatives on continuous performance tests? J Child Psychology 1995, 24:427-433.
• [22]Teicher MH, Lowen SB, Polcari A, Foley M, McGreenery CE: Novel strategy for the analysis of CPT data provides new insight into the effects of methylphenidate on attentional states in children with ADHD. J Child Adolesc Psychopharmacol 2004, 14:219-232.
• [23]Teicher M, Polcari A, Foley M, Valente E, McGreenery C, Chang W, McKay G, Midha K: Methylphenidate blood levels and therapeutic response in children with attention-deficit hyperactivity disorder I. Effects of different dosing regimens. J Child Adolesc Psychopharmacol 2006, 16:416-431.
• [24]Ohashi K, Vitaliano G, Polcari A, Teicher M: Unraveling the nature of hyperactivity in children with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 2010, 67(4):388-396.
• [25]Sumner C: New tool for objective assessment of ADHD: the Quotient ADHD system. ADHD Rep 2010, 18(5):6-9.
• [26]Teicher M, Ito Y, Glod C, Barber N: Objective measurement of hyperactivity and attentional problems in ADHD. J Am Acad Child Adolesc Psychiatry 1996, 35(3):334-342.
• [27]Dubard N, Martin M: Teaching Language-Deficient Children. Theory and Application of the Association Method for Multisensory Teaching. Educators Publishing Service, Inc., Cambridge, MA; 2000.
• [28]Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N: Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997, 36:980-988.
• [29]Smith L, Tamm L, Hughes C, Bernstein I: Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficity/hyperactivity. ADHD Attention Deficit Hyperactivity Disorders 2013, 5(1):9-20.
• [30]Baker K: Identification of Attention-Deficity’hyperactivity Disorder in Children with an Oral Language Disorder: The Diagnostic Utility of the Quotient and the Impact of Executive Function and Working Memory on Diagnosis. In Doctoral. University of Texas Southwestern Medical Center, Psychiatry; 2009.
• [31]Bolanos G: Objective assessment of attention and motion in children with an oral language disorder and attention-deficity/hyperactivity disorder follow a language intervention. In Master. University of Texas Southwestern Medical Center, Psychiatry; 2010.
• [32]Green S, Salkind N: Using SPSS for Windows and Macintosh: Analyzing and Understanding Data. 6th edition. Prentice Hall, New York; 2011.
• [33]Mackie S, Shaw P, Lenroot R, Pierson R, Greenstein D, Nugent T: Cerebellar development and clinical outcomei n attention deficit hyperactivity disorder. Am J Psychiatry 2007, 164:647-655.
• [34]Bush G, Valera E, Seidman L: Functional neuroimaging of attention-deficit/hyperactivity disorder: a review and suggested future direction. Biol Psychiatry 2005, 57(11):1273-1284.
• [35]Mostofsky S, Simmonds D: Response inhibition and response selection: two sides of the same coin. J Cogn Neurosci 2008, 20(5):751-761.
• [36]Gordon M, Mettelman B: The assessment of attention: I. Standarization and reliability of behavior-based measure. J Clin Psychiatry 1988, 44:682-690.
• [37]Jacobi-Polishook T, Shorer Z, Melzer I: The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder - double blind randomized control trial. J Neurosci 2009, 280:15-21.