RESUMEN
In the present study, 50 preschoolers were formally and independently classified using both the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and third edition-revised (DSM-III-R) criteria for attention-deficit hyperactivity disorder (ADHD). The sample consisted of 25 preschoolers classified as having ADHD and 25 typically developing preschoolers for comparison; the sample was matched on gender, age, and socioeconomic status. All 50 preschoolers were without neurologic or neurodevelopmental disorders, oppositional defiant disorder, or language delay. There were four key findings: first, of the 25 preschoolers with ADHD, DSM-IV classification was as follows: hyperactive-impulsivity type (68%), combined type (28%), and inattentive type (4%). Second, the DSM-IV profiles showed that several symptoms were either infrequently endorsed by parents, reflecting limited applicability to preschoolers with ADHD, or frequently endorsed by parents of typically developing preschoolers, thus reducing their diagnostic value. Third, of the 25 preschoolers classified as having ADHD using DSM-IV criteria, 16% would not have been classified as having ADHD using the DSM-III-R criteria. The DSM-IV criteria therefore appear to be more lenient than the DSM-III-R criteria for this age group. Fourth, two symptoms that were not included in the DSM-IV, but were part of the DSM-III-R, were found to have clinical value for differentiating preschoolers with ADHD from their typically developing peers.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Escalas de Valoración Psiquiátrica/normas , Atención , Estudios de Casos y Controles , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Conducta Impulsiva/psicología , Pruebas del Lenguaje , Masculino , Valor Predictivo de las PruebasRESUMEN
Fifty preschoolers participated in this study. Twenty-five preschoolers classified as ADHD were matched with 25 typically developing preschoolers, and assessed using three tests of attention (two vigilance tests, one visual-search test). Their behavior exhibited during these attention tests was also assessed. Compared to their peers, preschoolers classified as ADHD exhibited significantly more omission and commission errors on the visual attention test. On the visual-search attention test, preschoolers classified as ADHD exhibited significantly more commission errors, and they took significantly longer to complete it. They did not exhibit significantly more omission or commission errors on the auditory attention test. The preschoolers classified as ADHD were also more vocal, more often off-task and out-of-seat, and they required more adult redirectives to return to task. Discussion is focused on the clinical value of developmentally appropriate attention tests and behavioral observation systems in the early clinical assessment of attention in very young children.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Atención , Desarrollo Infantil , Percepción Visual , Factores de Edad , Percepción Auditiva , Estudios de Casos y Controles , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/psicología , Preescolar , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Escalas de Valoración PsiquiátricaRESUMEN
Sixteen preschoolers, (8 with Attention-Deficit/Hyperactivity Disorder [ADHD], 8 matched controls) were assessed twice, 5 months apart. Preschoolers with ADHD were rated by their parents as significantly more inattentive, exhibited more behavior problems, fewer age-appropriate social skills, made more errors of omission on both the visual and auditory attention tests, and more errors of commission on both the visual attention and the visual-search cancellation tests. Preschoolers with ADHD were then treated with stimulant medication and exhibited improved behavior as well as significantly reduced errors of omission on visual and auditory preschool vigilance tests, and fewer errors of commission on the visual-search preschool cancellation test. Developmentally appropriate direct measures of attention, in conjunction with parental ratings of child behavior, can be used to assess the efficacy of pharmacological treatment of preschoolers with ADHD.