RESUMEN
OBJECTIVE: Youth with attention deficit hyperactivity disorder (ADHD) often show reduced post-error slowing (PES) compared to typically developing controls. This finding has been interpreted as evidence that children with ADHD have error recognition and adaptive control impairments. However, several studies report mixed results regarding PES differences in ADHD, and among healthy controls, there is considerable debate about the cognitive-behavioral origin of PES. METHODS: We tested competing hypotheses aimed at clarifying whether reduced PES in children with ADHD is due to impaired error detection, deficits in adaptive control, and/or attention orienting to novelty. Children aged 7-11 years with a diagnosis of ADHD (n = 74) and controls (n = 30) completed four laboratory-based computer tasks with variable cognitive loads and error types. RESULTS: ADHD diagnosis was associated with shorter PES only on a task with high cognitive load and low error-cuing, consistent with impaired error recognition. In contrast, there was no evidence of impaired adaptive control or heightened novelty orienting among children with ADHD. CONCLUSIONS: The cognitive-behavioral origin of PES is multifactorial, but reduced PES among children with an ADHD diagnosis is due to impaired error recognition during cognitively demanding tasks. Behavioral interventions that scaffold error recognition may facilitate improved performance among children with ADHD.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Niño , Humanos , Pruebas Neuropsicológicas , Tiempo de Reacción , Reconocimiento en PsicologíaRESUMEN
Pathogenic disruptions to the activity-dependent neuroprotector homeobox (ADNP) gene are among the most common heterozygous genetic mutations associated with autism spectrum disorders (ASDs). Individuals with ADNP disruptions share a constellation of medical and psychiatric features, including ASD, intellectual disability (ID), dysmorphic features, and hypotonia. However, the profile of ASD symptoms associated with ADNP may differ from that of individuals with another ASD-associated single gene disruption or with ASD without a known genetic cause. The current study examined the ASD phenotype in a sample of representative youth with ADNP disruptions. Participants (N = 116, ages 4-22 years) included a cohort with ADNP mutations (n = 11) and three comparison groups with either a mutation to CHD8 (n = 11), a mutation to another ASD-associated gene (other mutation; n = 53), or ASD with no known genetic etiology (idiopathic ASD; n = 41). As expected, individuals with ADNP disruptions had higher rates of ID but less severe social affect symptoms compared to the CHD8 and Idiopathic ASD groups. In addition, verbal intelligence explained more variance in social impairment in the ADNP group compared to CHD8, other mutation, and idiopathic ASD comparison groups. Restricted and repetitive behaviors in the ADNP group were characterized by high levels of stereotyped motor behaviors, whereas the idiopathic ASD group showed high levels of restricted interests. Taken together, these results underscore the role of ADNP in cognitive functioning and suggest that social impairments in ADNP syndrome are consistent with severity of verbal deficits. Autism Res 2018, 11: 1300-1310. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Disruptions to the ADNP gene (i.e., ADNP syndrome) have been associated with autism spectrum disorder (ASD). This article describes intellectual disability, mild social difficulties, and severe repetitive motor movements in a group of 11 youth with ADNP Syndrome. We found lower rates of ASD than previously reported. Verbal skills explained individual variability in social impairment. This pattern suggests that the ADNP gene is primarily associated with learning and memory, and level of social difficulties is consistent with level of verbal impairment.
Asunto(s)
Trastorno del Espectro Autista/fisiopatología , Proteínas de Homeodominio/genética , Discapacidad Intelectual/complicaciones , Proteínas del Tejido Nervioso/genética , Fenotipo , Trastorno de Comunicación Social/complicaciones , Trastorno de Movimiento Estereotipado/complicaciones , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Discapacidad Intelectual/genética , Discapacidad Intelectual/fisiopatología , Masculino , Trastorno de Comunicación Social/genética , Trastorno de Comunicación Social/fisiopatología , Trastorno de Movimiento Estereotipado/genética , Trastorno de Movimiento Estereotipado/fisiopatología , Síndrome , Adulto JovenRESUMEN
This study addressed the causal direction of a previously reported relation between preschoolers' gesturing and their executive functioning on the Dimensional Change Card Sort (DCCS) sorting-switch task. Gesturing the relevant dimension for sorting was induced in a Gesture group through instructions, imitation, and prompts. In contrast, the Control group was instructed to "think hard" when sorting. Preschoolers (Nâ¯=â¯50) performed two DCCS tasks: (a) sort by size and then spatial orientation of two objects and (b) sort by shape and then proximity of the two objects. An examination of performance over trials permitted a fine-grained depiction of patterns of younger and older children in the Gesture and Control conditions. After the relevant dimension was switched, the Gesture group had more accurate sorts than the Control group, particularly among younger children on the second task. Moreover, the amount of gesturing predicted the number of correct sorts among younger children on the second task. The overall association between gesturing and sorting was not reflected at the level of individual trials, perhaps indicating covert gestural representation on some trials or the triggering of a relevant verbal representation by the gesturing. The delayed benefit of gesturing, until the second task, in the younger children may indicate a utilization deficiency. Results are discussed in terms of theories of gesturing and thought. The findings open up a new avenue of research and theorizing about the possible role of gesturing in emerging executive function.
Asunto(s)
Función Ejecutiva , Gestos , Orientación Espacial , Percepción Espacial , Preescolar , Femenino , Humanos , Masculino , Pruebas NeuropsicológicasRESUMEN
OBJECTIVE: The objective of this research is to assess the feasibility of an interdisciplinary team diagnostic assessment model for autism spectrum disorder (ASD). METHOD: Medical records from 366 patients evaluated for ASD at the Seattle Children's Autism Center (SCAC) were reviewed. ASD diagnostic outcomes, provider satisfaction, engagement in follow-up care, billed time, and reimbursement amounts were compared in patients evaluated through an interdisciplinary team approach (n = 91) with those seen in multidisciplinary evaluations led by either a psychologist (n = 165) or a physician (n = 110). RESULTS: Diagnostic determination was made in 90% of patients evaluated through the interdisciplinary team model in a single day. Rates of ASD diagnosis were similar across the 3 tracks, ranging from 61% to 72%. Demographic characteristics did not impact the likelihood of ASD diagnosis. Rates of patient follow-up care and provider satisfaction were significantly higher in interdisciplinary versus multidisciplinary teams. Interdisciplinary team evaluations billed 1.8 fewer hours yet generated more net hourly clinic income compared with psychology-led multidisciplinary evaluations. CONCLUSION: An interdisciplinary team approach, focusing on ruling-in or ruling-out ASD, was sufficient to determine ASD diagnosis in most patients seen at the SCAC Interdisciplinary teams generated more clinic income and decreased the time spent in evaluation compared with a psychology-led approach. They did so while maintaining consistency in diagnostic rates, demonstrating increased provider satisfaction and an increased likelihood of engagement in follow-up care.