Subject(s)
Adolescent Behavior/drug effects , Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/administration & dosage , Child Behavior/drug effects , Drug Substitution , Faculty , Methylphenidate/administration & dosage , Parents/psychology , Adolescent , Adult , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Child , Delayed-Action Preparations , Drug Administration Schedule , Germany , Humans , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
Recently published studies on the effects of neuropsychological training in children with attention-deficit hyperactivity disorder (ADHD) reflect our present knowledge about the pathogenesis of the disorder. This review article collects the results of published treatment studies drawn from a MEDLINE search. Because of the restricted number of available studies we considered randomized studies as well as studies with a lower evidence level, including case reports. Due to the heterogeneous nature of the study samples, we restrict our interpretation of the study results to the application of various diagnostic criteria, to different levels of effect measurement, and to diverse, only partially comparable treatment contents and length. Despite these limitations, neuropsychological training may be effective in reducing some specific cognitive deficits in ADHD. In a next step replication studies on homogeneous samples would be required under application of comparable training modules.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Behavior Therapy/methods , Computer-Assisted Instruction/methods , Neuropsychological Tests/statistics & numerical data , Adolescent , Attention , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Child , Combined Modality Therapy , Disruptive, Impulse Control, and Conduct Disorders/diagnosis , Disruptive, Impulse Control, and Conduct Disorders/psychology , Disruptive, Impulse Control, and Conduct Disorders/therapy , Evidence-Based Medicine , Humans , Mental Recall , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: We report the effects of a computer-based neuropsychological training in children with Attention-Deficit Hyperactivity Disorder (ADHD). We hypothesized that a specific training focusing on attentional dysfunction would result in an improvement of inattention, observable in test performance, behavior and performance during experimental school lessons and in parent and teacher ratings of the related core symptom. METHOD: We chose a within-subject-control-design with a 4 week baseline period and subsequent 12 to 15 weekly training-sessions. 30 children (6 to 13 years old) with a diagnosis of ADHD (ICD 10: F 90.0) and no other comorbidities participated in the study. RESULTS: The training revealed significant improvement in training parameters of the neuropsychological training and in the symptoms of inattention and deportment as rated during experimental school lessons. However, generalization of training effects as measured by parent and teacher ratings was not detected. CONCLUSIONS: We conclude that neuropsychological training could be helpful as one adjunct module in the complex treatment of ADHD but to prove clinical value, similar training programs must focus more strongly on individually existing neuropsychological deficits. Training programs should be more intensive and should eventually be combined with home based training access.
