It has been suggested that children with ADDH have specific difficulties in sustained attention. Despite some early studies supporting this position, many recent reports using continuous performance tests (CPTs) have failed to confirm this hypothesis. Possible reasons for this discrepancy are outlined and an attempt to corroborate and extend an earlier study (Sykes, Douglas, & Morgenstern, 1973) was undertaken. CPT results in normal children indicated that changes in performance over time, although not affected by gender, were influenced by age. Data from ADDH subjects indicated that they performed significantly more poorly with time on task than did controls. These results suggest that the ability to sustain attention increases with age and does not vary by gender. Furthermore, difficultues in the ability to sustain attention can be demonstrated in children with ADDH. Finally, it is suggested that within-age-level comparisons between groups of ADDH and controls would be more clinically sensitive than across-age-group comparisons.
We sought to determine whether Tourette syndrome (TS) was related to attentional disturbance independent of Attention Deficit Hyperactivity disorder (ADHD) and obsessive-compulsive symptoms (OCS), two comorbid conditions associated with attentional problems in other populations. Participants were 74 children [21 with uncomplicated TS (TS-Only), 14 with TS and ADHD (TS-ADHD), 21 with ADHD, and 18 controls]. Impaired sustained attention and impulsivity on a Continuous Performance Task were uncommon in the TS-Only group, but common in TS-ADHD and ADHD. The TS-ADHD group was less impulsive than the ADHD group, but had a higher rate of whole-body tics than the TS-Only group, raising questions about the diagnosis of ADHD in TS. OCS was not an independent risk factor for attention problems. However, the association of tic severity and impulsivity was consistent with the theory that TS involves dysfunction in cortical-subcortical circuits mediating behavioral inhibition.
Neuropsychological tests are frequently used clinically to predict real-world, or adaptive functioning; however, there are too few data to support such predictions. The relationship between adaptive functioning and, in particular, attention tests, has not been documented. The present study sought to determine the association between several domains of attention and adaptive functioning in a heterogeneous clinical sample of 119 children. A significant omnibus canonical correlation (Rc=.54) indicated that attention and adaptive functioning are correlated even when controlling for intelligence. Tests of attention and adaptive functioning domains that give rise to the overall association are discussed in terms of their clinical utility.
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