This paper presents an analysis of five scholarly articles on Attention Deficit Hyperactivity Disorder (ADHD) in children.
The first article reviewed is based on the study of long-term effects persistently present after a 14-month treatment of ADHD children using Multimodal Treatment Study of children with ADHD (MTA) (Molina et al., 2009). The study aims to observe any possible difference between the MTA children with their non-ADHD peers (Molina et al., 2009). Randomly selected ADHD children were selected for the MTA procedure and then were compared to non-ADHD children after twelve months. The researchers used a mixed regression model to assess a wide range of variables that were determined by parents, teachers, and other reports (Molina et al., 2009). Then the next follow-up that the researchers did was three years after enrolment of the MTA children. This particular study demonstrates the effect on children 6 to 8 years after they were randomly selected for the treatment. The range of age of the sampled group is 13 to 18 years.
The researchers studied children based on three sets. The first, i.e., intent to treat analyses, showed no significant difference among the randomly selected children. However, the researchers found a strong effect of ADHD in childhood in children in both 6 and 8 years cases (Molina et al., 2009). Finally, the study also demonstrated that the performance of the MTA children was poorer than the non-ADHD children (Molina et al., 2009). Overall, the researchers showed that when treatment is relaxed for ADHD children over the longer-term, the performance would be negatively affected. Therefore, they suggested that ADHD children should be kept under monitoring over a long period.
The second research article studied the effect on the brain structure and map of children affected with ADHD (Wang et al., 2009). The main aim of the researchers was to study the topological changes that occurred in the brain of subjects who have ADHD (Wang et al., 2009). The sample selected was 19 children with ADHD from whom “functional magnetic resonance images” (fMRI) were obtained to contrast it with the brain functioning networks with non-ADHD children (Wang et al., 2009, p. 639). For the study, 56 children participated, of whom 29 were ADHD children (Wang et al., 2009). The fMRI report was used to study the brain networks of ADHD children. It helped in constructing a correlation matrix of “90 cortical and sub cortical” units that helped in theorizing the finding with the aid of graphs (Wang et al., 2009, p. 640). The experiment demonstrated that the functional networks of both the groups showed similar small-world topology, however, ADHD children demonstrated changed functional networks when they were compared to the non-ADHD children (Wang et al., 2009).
As pointed out by Wang et al., “modal efficiency was profoundly affected at several regions of prefrontal, temporal, and occipital cortices, which were compatible with previous studies in ADHD.” (Wang, et al., 2009, p. 645). Another important differentiation between ADHD and non-ADHD groups was that the former demonstrated an altered topology, which indicated a declined capacity of the brain to function efficiently. Further, an increase in the local efficiency in the brains of ADHD children also declined the global efficiency of the brain in regular networks. Therefore, ADHD affects nodal efficiency. In addition to this, the study also demonstrated that the presence of ADHD in children profoundly affects the functional networks in their brains (Wang et al., 2009).
The third study we have analyzed studied the children with ADHD in childhood and were examined (Massetti et al., 2008). Massetti et al. studied the “predictive validity of symptoms” in a different category of ADHD children who were diagnosed at a very early age. The academic achievement of the children was measured using seven different methods in children of age eight years who showed symptoms of ADHD at an early age of 4 to 6 years. In total, there were 255 children, of which 125 were ADHD children, and 130 were non-ADHD children recruited to compare the findings of the ADHD children. The researchers administered the NIMH Diagnostic Interview Schedule to the biological mother of the children to gather information regarding “oppositional defiant disorder (ODD), anxiety disorder, tic disorder, and mood disorders” (Massetti et al., 2008, p. 402). Their experiment outcome was demonstrated after controlling intelligence and other variables. To measure cognitive ability and academic intelligence, the researchers used 1 and 2 waves of the standard Short Form of the Stanford-Binet Intelligence Scale (Massetti et al., 2008). The academic achievement was assessed using “Letter-Word Identification, applied Problems, and Dictations” (Massetti et al., 2008, p. 403).
The study demonstrated that the hypothesis has initially taken by the researchers that children with a higher degree of ADHD problem were more inattentive and, therefore, would have difficulties in achieving success in academics, was not significantly true. Further, the study also demonstrated that children with “modified criteria for predominantly hyperactive-impulsive and combined subtypes of ADHD at 4-6 years of age did not have lower academic test scores” (Massetti et al., 2008, p. 407). Further, the study also showed that children who scored higher on scale 1 demonstrated higher academic inclination.
Green, Miller, Fassbender, and Schweitzer researched to ascertain if working memory training of ADHD children reduces the core dysfunctional behavior in them and affects their academic performance (Green, Miller, Fassbender, & Schweitzer, 2012). The methodology adopted for the study was a comparison of the computerized working memory with the non-standardized placebo condition in 26 children with ADHD.
The study demonstrated that the placebo-controlled training of children with ADHD demonstrated that there was an improved performance (Green, Miller, Fassbender, & Schweitzer, 2012). The main concern of the researchers was to quantify the improvements in the performance of the children. The research showed that training had a great effect on the subjects, especially in the category that showed if the ADHD child looked away from work after training, therefore, indicating that the training had successfully improved attention span in ADHD children (Green, Miller, Fassbender, & Schweitzer, 2012). Further, the researchers also demonstrated a lowering in the off-tasks and played with objects, which were not related o the task given to the child (Green, Miller, Fassbender, & Schweitzer, 2012). The research also demonstrated that there was a significant effect of training on the “ecologically valid measures,” however, there were several limitations. The research also showed that training improved the performance of the children in terms of behavior, off-task category, and attention. However, a significant difference was found between the group, i.e., not all the members of the groups showed similar results post-training after the researchers administered the computerized training. This finding was different from a previous finding and demonstrated that there was less scope to demonstrate improvement scale in the case of the participants in the research.
The study conducted by Holes, Gathercole, Place, Dunning, Hilton, and Elliott (2010) aimed to study two effects – first, the effect of training and second that of stimulant medication on working memory of ADHD children. The experiment was conducted on 25 children between the age of 8 and 11 years (Holmes et al., 2010). These children were trained in working memory skills for 20 days, and once they had completed the training, they were put through an appraisal. Every participant was asked to complete four sets of assessments during individual testing, while their medication was stopped at least 24 hours before the appraisal.
The appraisal of the children of working memory and IQ after the training presented the effect of the training on ADHD children (Holmes et al., 2010). Then another experiment was done on ADHD children by prescribing drugs to them and watching them closely. This experiment showed that the visual-spatial memory of the children improved considerably, and training led to considerable improvement in all-round working memory skills. The study confirmed that the performance of ADHD children could be improved through two simultaneous therapeutic interventions – training in working memory and stimulating medication (Holmes et al., 2010). The study confirms that the most success rate in ADHD children can be observed when both these interventions are applied simultaneously in the children, improving their performance dramatically. All the assessed characters of working memory showed significant improvement. Fifteen children were studied for the experiment, who participated in the appraisal (Holmes et al., 2010). Four showed that they could concentrate on the given information harder with their eyes closed (Holmes et al., 2010). Ten other children also were reported to have employed a varied range of strategies such as “rehearsing the information or tracing the patters on the computer screen with their eyes” to concentrate on the given task (Holmes et al., 2010, p. 834). The medication helped in gaining greater control over their attention while handling verbal material.
Green, C. T.-M., Miller, M. R., Fassbender, C., & Schweitzer, J. B. (2012). Will working memory training generalize to improve off-task behavior in children with attention-deficit/hyperact disorder? Neurotherapeutics 9(3) , 639-648.
Holmes, J., Gathercole, S. E., Place, M., Dunning, D. L., Hilton, K. A., & Elliott, J. G. (2010). Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD. Applied Cognitive Psychology 24(6), 827-836.
Massetti, G. M., Lahey, B. B., Pelham, W. E., Loney, J., Ashley Ehrhardt, S. S., & Kipp, H. (2008). Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4–6 years of age. Journal of Abnormal Child Psychology 36(3), 399-410.
Molina, B. S., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello, B., Jensen, P. S., & Epstein, J. N. (2009). The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child & Adolescent Psychiatry 48(5), 484-500.
Wang, L., Chaozhe Zhu, Y. H., Zang, Y., Cao, Q., Zhang, H., Zhong, Q., & Wang, Y. (2009). Altered small‐world brain functional networks in children with attention‐deficit/hyperactivity disorder. Human Brain Mapping 30(2), 638-649.