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Attention Sets in ADHD: a consideration
of executive and frontal function, and the locus of control
Oades, R. D., Schepker, R.,
Schulte, A., & Slusarek, M.
13th Eunethydis Meeting, 4th - 6th October 2002,
Cagliari, Sardinia, Italy.
The appearance of some impairment
of executive function in ADHD (reviews:
Pennington & Ozonoff, 1996; Sergeant et al. 2002) would be expected
from the asymmetric development of activation patterns these children
show in the frontal lobes (Oades et al., 1996; Rubia, 1999).
But not all executive functions are impaired and there is controversy
over which are poorly expressed (e.g. Working memory impaired and helped
by methylphenidate, Barnett ea 2001 vs. not impaired if IQ considered,
Kuntsi et al., 2001), and if this is significant for ADHD (Denckla,
1996).
Shallice and colleagues (2002) have suggested that evidence, martialled
in support of poor inhibitory control in ADHD (Barkley, 1997; Quay,
1997), more powerfully argues for a role of the
frontal lobes, and may have more explanatory power in the context
of an attentional system disorder (Swanson
et al., 1998).
It is evident that some dissection
is necessary (as some of the reports above suggest) - a consideration
of a) components contributing to inhibition,
b) sub-systems of executive control, c)
quantity and quality of comorbid problems in the children studied.
We take attentional set as a
starting point, as this is a fundamental pre-requisite for organising
adaptive behaviour under changing conditions. This is also reasonable
given the sensitivity of ADHD to methylphenidate and that attention-related
mechanisms of switching and tuning of information are under catecholaminergic
control (Oades, 1985).
From the standpoint of clinical neuropsychology Stroop
tests include a key demand on selective attention (Stuss and
Levine 2002) - exogenous control, through instruction and stimulus perception,
of the dominant response (colour naming over word reading). While the
colour-Stroop emphasises the activation of central (semantic) tendencies
through instruction, the number-Stroop shifts the emphasis to the perceptual
control of the activation of central tendencies.
The introduction of priming to these tasks is informative about whether
the control is more exogenous (perceptual) or endogenous (monitoring).
We present initial data on the negative priming
impairment in children with ADHD compared to those without this diagnosis.
A/ Negative priming is absent in ADHD,
B/ The Stroop interference effect is relatively normal (but not colour
naming),
C/ Medication tends to normalise differences to a very small degree,
D/ But medication does increases the ability to switch set on the trails
B-A test.
1/
Barkley, 1997 Psychol. Bull., 121, 65-94. . . . . . . . . .
8/ Quay, 1997 J. abnorm. Child Psychol., 25, 7-13.
2/ Barnett et al., 2001 Psychol. Med.,
31, 1107-1115. . . 9/ Rubia 1999 Am. J.
Psychiat, 156, 891-896.
3/ Denckla 1996 Dev. Neuropsychol. 12,
5-15. . . . . . . 10/ Sergeant et al.,
2002 Behav. Brain Res., 130, 3-29.
4/ Kuntsi et al. 2001 JCPP, 42,
199-210. . .
. . . . . . . . . 11/ Shallice et al.
2002 Dev. Neuropsychol., 21, 43-71.
5/ Oades
et al., 1996 Biol. Psychol., 43, 163-185 .
. . . . 12/ Stuss & Levine 2002 Ann. Rev. Psychol., 53, 401-433.
6/ Oades,
1985 Neurosci. Biobehav. Rev., 9, 261-283.
. 13/ Swanson et al., 1998 In "The
attentive Brain", 445-460, MIT press
7/
Pennington & Ozonoff 1996 JCPP, 37, 51-87
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