Difficulties In Sustained Attention Research Articles

Can attention-deficit/hyperactivity disorder be considered a form of cerebellar dysfunction?

Attention-deficit/hyperactivity disorder (ADHD) is a heterogenous disorder, commonly described for presenting difficulties in sustained attention, response inhibition, and organizing goal-oriented behaviors. However, along with its traditionally described executive dysfunction, more than half of the children diagnosed with ADHD have been reported to show difficulties with gross and fine motor skills, albeit motor impairments in ADHD continue to be a neglected area of clinical attention. The rapidly growing field of the clinical cognitive neuroscience of the cerebellum has begun to relate cerebro-cerebellar circuits to neurodevelopmental disorders. While the cerebellum's role in motor function, such as balance, motor coordination, and execution, is well recognized, ongoing research has evidenced its additional and fundamental role in neurocognitive development and executive function, including attention and social cognition, which are all areas of impairment commonly found in ADHD. Interestingly, neuroimaging studies have consistently shown differences in cerebellar volume and functional connectivity between ADHD and typically developing children. Furthermore, methylphenidate is known to act at the cerebellar level, as intrinsic cerebellar dopaminergic systems involved in attention and motor function have been identified. This article reviews some of the main findings linking cerebellar dysfunction to ADHD behavioral symptoms and incorporates the cerebellum as a possible neurological basis and differentiating indicator within the condition. We suggest considering more rigorous assessments in future ADHD studies, including cerebellar-associated skill evaluations to correlate with symptom severity and other detected outcomes, such as executive dysfunction, and study possible associative patterns that may serve as more objective measures for this diagnosis.

Characterisation of ASD traits among a cohort of children with isolated fetal ventriculomegaly

Fetal ventriculomegaly is the most common antenatally-diagnosed brain abnormality. Imaging studies in antenatal isolated ventriculomegaly demonstrate enlarged ventricles and cortical overgrowth which are also present in children with autism-spectrum disorder/condition (ASD). We investigate the presence of ASD traits in a cohort of children (n = 24 [20 males/4 females]) with isolated fetal ventriculomegaly, compared with 10 controls (n = 10 [6 males/4 females]). Neurodevelopmental outcome at school age included IQ, ASD traits (ADOS-2), sustained attention, neurological functioning, behaviour, executive function, sensory processing, co-ordination, and adaptive behaviours. Pre-school language development was assessed at 2 years. 37.5% of children, all male, in the ventriculomegaly cohort scored above threshold for autism/ASD classification. Pre-school language delay predicted an ADOS-2 autism/ASD classification with 73.3% specificity/66.7% sensitivity. Greater pre-school language delay was associated with more ASD symptoms. In this study, the neurodevelopment of children with isolated fetal ventriculomegaly, associated with altered cortical development, includes ASD traits, difficulties in sustained attention, working memory and sensation-seeking behaviours.

Link Between Topographic Memory and the Combined Presentation of ADHD (ADHD-C): A Pilot Study.

Background: Topographic memory is the ability to reach various places by recognizing spatial layouts and getting oriented in familiar environments. It involves several different cognitive abilities, in particular executive functions (EF), such as attention, working memory, and planning. Children with attention deficit hyperactivity disorder (ADHD) show impairments in inhibitory control, regulation of attention, planning, and working memory.Aim: The aim of this study was to evaluate the topographic memory in children with ADHD-combined subtype (ADHD-C).Method: Fifteen children (8–10 years) with a diagnosis of ADHD-C (DSM-5) (ADHD-C group) were compared to 15 children with typical development (TD group) of the same age. All children performed Raven's colored progressive matrices (CPM) test to obtain a measure related with cognitive functioning. The walking Corsi test (WalCT), a large-scale version of the Corsi block-tapping test, was used to assess topographic memory in experimental environment.Results: A higher impairment was observed in ADHD-C than TD with significant differences in the WalCT, in particular on the topographic short-term memory (TSTM) task, on the topographic learning (TL) task, and on the repetition number (RN) task during the TL task. Perseverative errors were reported in performing the square-sequence in the WalCT. Zero-order correlations showed a positive correlation between TSTM and auditory attention, and memory of design of NEPSY-II and digit span of WISC-IV. No statistically significant differences were found between the ADHD-C group and TD group in the TL task in the WalCT condition.Conclusion: In ADHD-C, initial topographic learning was compromised whereas the long-term retention of learned topographical material seemed to not be impaired. In particular, these impairments seem to be linked with difficulties in sustained attention, in spatial memory for novel visual materials, in a poor working memory, and in perseverative behaviors.

Information processing in hoarding disorder: A systematic review of the evidence

• Information processing difficulties are said to play a role in maintaining hoarding. • There is consistent evidence for deficits in sustained attention and inhibition. • Evidence for deficits in other areas of executive functioning is contradictory. • Research needs to use consistent methods to diagnose hoarding and measure cognition. Hoarding Disorder (HD), conceptualised as difficulties with discarding possessions resulting in distress, the accumulation of items creating a cluttered, unusable environment, and significant impairment in functioning, is reported to affect 1.5% of adults. In addition, evidence suggests that those with HD experience further difficulties in executive functioning, including inhibition, attention, and decision-making. Deficits in executive function and other areas of information processing are hypothesised to play a key role in maintaining HD. This review aimed to systematically review the evidence for impaired information processing in this population when compared to community controls, focusing specifically on studies using clinician-delivered interviews to diagnose HD, and those using primary assessments of neuropsychological function. 12 studies were included in this review. Results suggest consistent evidence for some difficulties in sustained attention, motor inhibition and organisation, however literature on deficits in other areas of executive function is wide ranging, limiting the extent to which firm conclusions can be drawn. Further research is needed to investigate deficits in other areas of information processing in HD, with a focus on consistent methods to diagnose HD and measure neuropsychological function, as these design issues place restrictions on a full understanding of the true deficits associated with HD. Consideration should be given to whether recorded deficits are ‘true’ or are difficulties associated with the emotional context of hoarding. It is hypothesized that future research will reveal more distinct subgroups of people with hoarding difficulties, only some of whom will show true neuropsychological deficits.

The Impact of Bilingualism on the Executive Functions of Autistic Children: A Study of English-Arabic Children.

There is evidence to suggest that certain executive functions are impaired in autistic children, contributing to many daily challenges. Regular use of two languages has the potential to positively influence executive functions, though evidence is mixed. Little is known about the impact of bilingualism on the executive functions of autistic children, with only a handful of studies published worldwide to date. This study investigated the impact of bilingualism on sustained attention, interference control, flexible switching and working memory, in Arabic-English autistic children (n = 27) and their typically developing peers (n = 66), aged 5-12 years old. Groups were matched on age, nonverbal IQ and socioeconomic status, and completed a battery of computerized tests. Results showed an advantage for bilingual autistic children relative to their monolingual peers in sustained attention, and equivalent performance between bilingual and monolingual autistic children on all other executive functions. There were no generalized positive effects of bilingualism, and typically-developing children performed better than autistic children on all measures. The findings indicate that bilingualism does not negatively impact the executive function skills of autistic children, and that it might mitigate difficulties in sustained attention. LAY SUMMARY: Contrary to widespread belief, but in line with previous research, this study showed that speaking two languages did not harm thinking skills in autistic children. The thinking skills evaluated in this study included the ability to focus over a period of time, the ability to resist distractions, the ability to move back and forth between tasks, and the ability to use short-term memory. In fact, speaking two languages might help reduce difficulties that autistic children might face when focusing over a period of time.

Attention, impulsivity, and vigilance in agenesis of the corpus callosum.

Questions regarding the role of the corpus callosum in attention are raised by the reports of attention problems in some persons with agenesis of the corpus callosum (AgCC), as well as by abnormalities in callosal size in persons with attention-deficit/hyperactive disorder. The current study assessed inattention, impulsivity, and vigilance in individuals with AgCC. These domains of attention were assessed using the Conners' Continuous Performance Test II in 18 older adolescents and adults (ages 16-52) with complete AgCC and normal intelligence (full scale intelligence quotient > 80). Scores were converted to T scores using age-specific norms and assessed for departure from the normative sample. Scores were significantly elevated in older adolescents with AgCC for errors of commission (p = .050, d = 0.55) and detectability (p = .03, d = 0.58). Older adolescents were worse than adults for commissions (p = .06, ηp² = .201) and detectability (p = .03, ηp² = .273). Also, male individuals had significantly higher (worse) scores than did female in vigilance (p = .01, ηp² = .337). These results suggest moderate levels of difficulties in sustained attention in AgCC, particularly in maintaining response inhibition and in vigilance, that are modulated by age and sex. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effects of clutter on information processing deficits in individuals with hoarding disorder

Current cognitive behavioral models of hoarding view hoarding as a multifaceted problem stemming from various information processing deficits. However, there is also reason to suspect that the consequences of hoarding may in turn impact or modulate deficits in information processing. The current study sought to expand upon the existing literature by manipulating clutter to examine whether the presence of a cluttered environment affects information processing. Participants included 34 individuals with hoarding disorder. Participants were randomized into a clutter or non-clutter condition and asked to complete various neuropsychological tasks of memory and attention. Results revealed that hoarding severity was associated with difficulties in sustained attention. However, individuals in the clutter condition relative to the non-clutter condition did not experience greater deficits in information processing. Limitations include the cross-sectional design and small sample size. The current findings add considerably to a growing body of literature on the relationships between information processing deficits and hoarding behaviors. Research of this type is integral to understanding the etiology and maintenance of hoarding.

Cerebellar Cognitive Affective Syndrome in Dandy-Walker Variant Disorder

Cerebellar Cognitive Affective Syndrome in Dandy-Walker Variant Disorder

An Investigation of Executive Functioning, Attention and Working Memory in Compulsive Hoarding

Compulsive Hoarding involves the acquisition of, and failure to discard, a large number of possessions that appear to be useless or of limited value, cluttered living spaces and significant distress or impairment in functioning (Frost and Hartl, 1996). The problem is multifaceted and appears best explained by a cognitive-behavioural framework. This study set out to test one aspect of Frost and Hartl’s (1996) cognitive-behavioural model of compulsive hoarding by investigating theorized cognitive deficits in executive functioning, such as working memory and attention. 24 participants with compulsive hoarding were tested on the Digit Span, Spatial Span and the Wisconsin Card Sorting Tests (WCST). On theWCST, the hoarding group had a significantly higher number of perseveration errors (t=1.67, p=.005) and significantly lower numbers of categories completed (t=−2.47, p=.001) than test norms. Only “failure to maintain set” was significantly correlated with hoarding severity (r=.435, p<.05). These findings lend support to the theory that people who compulsively hoard have executive dysfunction, which impacts on their ability to process information. Deficits relate to difficulties in forming effective strategies, inadequate feedback response, problems in concept formation, and impulsivity. Difficulties in sustained attention also appeared to be a factor in hoarding severity. These findings are important in directing more targeted clinical interventions.

Sustained Attention and Behavioral Characteristics Associated with ADHD in Adults

The goal of the current study was to investigate whether two cognitive functions (i.e., sustained attention and response inhibition) were related to a general model of personality traits and behavioral characteristics associated with attention-deficit hyperactivity disorder (ADHD). To examine these relations, the Conjunctive Continuous Performance Test was used to measure the two cognitive functions, the Mini-Marker was used to measure the Big Five domains of personality, and the Wender Utah Rating Scale (WURS) was used to index ADHD symptoms. Correlations and multiple regression analyses showed that difficulties in sustained attention were associated with the WURS behavioral symptoms of inattention, oppositional/defiant behavior, impulsivity, and Big Five low conscientiousness, but were not associated with emotional problems such as neuroticism or low agreeableness (Big Five). Difficulties in response inhibition were marginally correlated with behavioral symptoms of inattention and low conscientiousness. Surprisingly, response inhibition was also highly correlated with sustained attention. In addition, neuroticism independently was highly associated with the WURS emotional and oppositional/defiant behavior symptoms. The findings suggest that deficient sustained attention relates specifically to the main ADHD behaviors but not to the emotional problems typically associated with the disorder.

Evaluación neuropsicológica en niños con epilepsia: atención y funciones ejecutivas en epilepsia del lóbulo temporal

Attention and executive functions correspond to important areas of cognitive functioning associated with the frontal cortex. The study of attention and executive functions in children with epilepsy has focused on characterizing the group with frontal lobe epilepsy. Still, recent studies have identified deficits in these areas also in children with temporal lobe epilepsy (TLE). To investigate attention and executive functions in a group of children with TLE, also considering the influence of clinical variables (age at onset of epilepsy and evolution of seizures). Attention and executive functions were studied in a group of 24 children with TLE, aged 7-15 years and compared with 24 control children of the same age and socio-cultural level. Subjects were assigned the following tasks: Cancellation Task, Trail Making Test, Tower of London and Phonemic Verbal Fluency. The group with TLE performed significantly lower on selective, sustained and divided attention and on phonemic verbal fluency. In markers concerning commissions and omissions there were no differences between groups in any of the performed tests. A significant slowing of processing speed was reported. In addition, patients with earlier age at onset of epilepsy had more difficulties in sustained attention and planning abilities. These results sustain the need for evaluating and monitoring the area of attention, executive functions and processing speed in children and adolescents with temporal lobe epilepsy, above all those with earlier age at onset of epilepsy.

Response variability in Attention Deficit Hyperactivity Disorder: Evidence for neuropsychological heterogeneity

Response time (RT) variability is a common finding in ADHD research. RT variability may reflect frontal cortex function and may be related to deficits in sustained attention. The existence of a sustained attention deficit in ADHD has been debated, largely because of inconsistent evidence of time-on-task effects. A fixed-sequence Sustained Attention to Response Task (SART) was given to 29 control, 39 unimpaired and 24 impaired-ADHD children (impairment defined by the number of commission errors). The response time data were analysed using the Fast Fourier Transform, to define the fast-frequency and slow-frequency contributions to overall response variability. The impaired-ADHD group progressively slowed in RT over the course of the 5.5min task, as reflected in this group's greater slow-frequency variability. The fast-frequency trial-to-trial variability was also significantly greater, but did not differentially worsen over the course of the task. The higher error rates of the impaired-ADHD group did not become differentially greater over the length of the task. The progressive slowing in mean RT over the course of the task may relate to a deficit in arousal in the impaired-ADHD group. The consistently poor performance in fast-frequency variability and error rates may be due to difficulties in sustained attention that fluctuate on a trial-to-trial basis.

Evidence of difficulties in sustained attention in children with ADDH

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.