Validation of the Self-Report Version of the German Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN-DE-SB).

Adults with attention-deficit/hyperactivity disorder (ADHD) experience impairing levels of inattention and/or hyperactivity-impulsivity, while individuals without ADHD experience these symptoms to a lesser extent. Yet, ADHD self-report scales so far hardly captured continuous distributions across the general population. In addition, they focused on weaknesses and ignored strengths. To address these shortcomings, we present here the Strengths and Weaknesses of ADHD and Normal-Behavior Scale Self-Report (SWAN-DE-SB). The normal distribution of the data collected and the scale's internal consistency, and factorial and convergent validity were assessed using data from a general population sample. Its clinical utility was evaluated by comparing scores from a clinical sample and a sample of individuals without ADHD and by calculating optimal cut-off values for specificity and sensitivity. The SWAN-DE-SB demonstrated normal distribution of the data collected, high internal consistency, and factorial and convergent validity. It reliably discriminated individuals with and without ADHD, with high specificity and sensitivity. It should therefore be considered a psychometrically convincing measure to assess strengths and weaknesses of ADHD symptoms and normal behavior in clinical and general population samples.

Day-to-day variation in students' academic success: The role of self-regulation, working memory, and achievement goals.

Self-regulation was found to be positively associated with school performance. Interrelations between self-regulation, working memory (WM), and achievement goals, in particular mastery goals, have been established, as well as associations with academic outcomes. It stands to reason that self-regulation, WM, achievement goals, and academic success are related on a daily level. However, previous research rarely considered this level of analysis. Here, we therefore addressed the relations of daily self-regulation, WM, and achievement goals, and their relevance for daily and general academic success. Data were obtained through ambulatory assessments in 90 students before (Study 1; Mage  = 9.83, SDage  = 0.50) and 108 students after their transition to secondary school (Study 2; Mage  = 10.12, SDage  = 0.45) across 20 school days. Students reported about daily achievement goals prior to school, self-regulation at school, and perceived academic success after school, as well as report card grades. Daily WM was assessed at school. Study 1 showed positive associations between daily mastery goals and self-regulation, but not with WM. Together, daily performance-approach goals and self-regulation, but not other goals or WM uniquely contributed to daily perceived academic success. Study 2 showed positive associations between daily mastery goals and self-regulation, but not with WM. Average daily mastery goals predicted daily WM. Together, daily mastery goals and self-regulation, but not WM, uniquely contributed to daily perceived academic success. In both studies, average levels of WM, but not achievement goals or self-regulation predicted report card grades. Results thus corroborate theoretical considerations on the importance of distinguishing self-regulation processes at between- and within-person levels. RESEARCH HIGHLIGHTS: Analyses of intensive longitudinal data on daily self-regulation, working memory, and achievement goal orientations in the school context of 9- to 11-year-olds. In primary and secondary school, days with higher mastery goals and self-regulation are days with higher academic success. In primary and secondary school, days with higher mastery goals are days with higher self-regulation. In secondary school, students with higher average mastery goals show better daily WM performance. Average working memory performance predicts report card grades beyond the influence of prior grades and achievement goal orientations.

Homeschooling during the SARS-CoV-2 pandemic: the role of students' trait self-regulation and task attributes of daily learning tasks for students' daily self-regulation.

As a means to counter the SARS-CoV­2 pandemic, schools were closed throughout Germany between mid-March and end of April 2020. Schooling was translocated to the students' homes where students were supposed to work on learning tasks provided by their teachers. Students' self-regulation and attributes of the learning tasks may be assumed to have played important roles when adapting to this novel schooling situation. They may be predicted to have influenced students' daily self-regulation and hence the independence with which they worked on learning tasks. The present work investigated the role of students' trait self-regulation as well as task difficulty and task enjoyment for students' daily independence from their parents in learning during the homeschooling period. Data on children's trait self-regulation were obtained through a baseline questionnaire filled in by the parents of 535 children (M age  = 9.69, SD age  = 2.80). Parents additionally reported about the daily task difficulty, task enjoyment, and students' learning independence through 21 consecutive daily online questionnaires. The results showed students' trait self-regulation to be positively associated with their daily learning independence. Additionally, students' daily learning independence was shown to be negatively associated with task difficulty and positively with task enjoyment. The findings are discussed with regard to students' daily self-regulation during the homeschooling period. Finally, implications for teaching practice during the pandemic-related school closures are derived.

Examining the relevance of basic numerical skills for mathematical achievement in secondary school using a within-task assessment approach.

Previous research repeatedly found basic numerical abilities (e.g., magnitude understanding, arithmetic fact knowledge, etc.) to predict young students' current and later arithmetic achievement as assessed by achievement tests - even when controlling for the influence of domain-general abilities (e.g., intelligence, working memory). However, to the best of our knowledge, previous studies hardly addressed this issue in secondary school students. Additionally, they primarily assessed basic numerical abilities in a between-task approach (i.e., using different tasks for different abilities). Finally, their relevance for real-life academic outcomes such as mathematics grades has only rarely been investigated. The present study therefore pursued an approach using one and the same task (i.e., a within-task approach) to reduce confounding effects driven by between-task differences. In particular, we evaluated the relevance of i) number magnitude understanding, ii) arithmetic fact knowledge, and iii) conceptual and procedural knowledge for the mathematics grades of 81 students aged between ten and thirteen (i.e., in Grades 5 and 6) employing the number bisection task. Results indicated that number magnitude understanding, arithmetic fact knowledge, and conceptual and procedural knowledge contributed to explaining mathematics grades even when controlling for domain-general cognitive abilities. Methodological and practical implications of the results are discussed.

Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD).

Attention-deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder normally diagnosed in childhood and persisting into adulthood in up to two-thirds of the patients. Its core symptoms comprise inattention and hyperactive-impulsive behaviours. Several studies suggest that patients with ADHD show alterations in self-regulation and self-monitoring. So far, it has not been described whether these deficits also affect the awareness of one's own bodily signals, that is, interoceptive awareness. To investigate possible alterations in interoceptive awareness, 14 adult patients with ADHD and 16 healthy controls performed a heartbeat detection task, in which they had to count their heartbeat without any external help (e.g. visualization on a screen). As an indicator of the individual interoceptive awareness ability, a score based on the comparison between recorded and counted heart beats was calculated. Our results showed that patients with ADHD performed significantly worse on this task than controls, which indicates that they were less aware of internal bodily signals while additionally experiencing deficits in regulating and monitoring their own (overt) behaviours.

The interplay of delay aversion, timing skills, and impulsivity in children experiencing attention-deficit/hyperactivity disorder (ADHD) symptoms.

Impulsive behaviours occurring as a central deficit in connection with attention-deficit/hyperactivity disorder (ADHD) are associated with social and academic impairment in children. Whereas impulsivity was shown to be related to both delay aversion and deficient timing skills, the mutual relation between the latter two has hardly been investigated. The present study therefore examined the interplay of delay aversion, timing skills, and impulsivity in a sample of eighty-eight children aged between seven and fourteen, twenty-one of them diagnosed with ADHD. Children participated in a delay aversion and a tapping task, while parents reported about their impulsiveness. The results showed that both delay aversion and deficient timing skills were related to impulsivity. Contrasting prior assumptions, delay aversion and timing skills were also shown to be related, even when controlling for impulsivity. Implications for interventions aiming to reduce children's impulsivity as well as methodological considerations regarding whether to view ADHD as a category or a continuum are discussed.

Near-Infrared Spectroscopy-Based Frontal Lobe Neurofeedback Integrated in Virtual Reality Modulates Brain and Behavior in Highly Impulsive Adults.

Based on neurofeedback (NF) training as a neurocognitive treatment in attention-deficit/hyperactivity disorder (ADHD), we designed a randomized, controlled functional near-infrared spectroscopy (fNIRS) NF intervention embedded in an immersive virtual reality classroom in which participants learned to control overhead lighting with their dorsolateral prefrontal brain activation. We tested the efficacy of the intervention on healthy adults displaying high impulsivity as a sub-clinical population sharing common features with ADHD. Twenty participants, 10 in an experimental and 10 in a shoulder muscle-based electromyography control group, underwent eight training sessions across 2 weeks. Training was bookended by a pre- and post-test including go/no-go, n-back, and stop-signal tasks (SST). Results indicated a significant reduction in commission errors on the no-go task with a simultaneous increase in prefrontal oxygenated hemoglobin concentration for the experimental group, but not for the control group. Furthermore, the ability of the subjects to gain control over the feedback parameter correlated strongly with the reduction in commission errors for the experimental, but not for the control group, indicating the potential importance of learning feedback control in moderating behavioral outcomes. In addition, participants of the fNIRS group showed a reduction in reaction time variability on the SST. Results indicate a clear effect of our NF intervention in reducing impulsive behavior possibly via a strengthening of frontal lobe functioning. Virtual reality additions to conventional NF may be one way to improve the ecological validity and symptom-relevance of the training situation, hence positively affecting transfer of acquired skills to real life.

NIRS-based neurofeedback training in a virtual reality classroom for children with attention-deficit/hyperactivity disorder: study protocol for a randomized controlled trial.

BACKGROUND: Children with attention-deficit/hyperactivity disorder (ADHD) suffer from attention deficits, motor hyperactivity, and impulsive behaviour. These impairments are experienced at home, at school, and with friends. Functional imaging studies show that ADHD behaviour and impairments in executive functions (EFs) are mirrored by aberrant neurophysiological functioning. Moreover, several studies show that ADHD behaviour, impairments in EFs, and a lack of self-control contribute to poor school performance. Non-pharmacological interventions such as neurofeedback training (NFT), for instance, aim at improving neurophysiological and neuropsychological functioning as well as behaviour. Consequently, NFT is expected to improve school performance, EFs, and self-control in children with ADHD. Generalization of acquired self-regulation skills from laboratory to real life is crucial for a transfer to everyday situations and is hypothesized to be facilitated via training using virtual reality (VR) environments. Consequently, experiencing NFT in VR is expected to yield greater effects than training in two dimensions (2D). METHODS/DESIGN: Ninety children with a clinical diagnosis of ADHD will be included in the study. Participants may be medicated or unmedicated. After random assignation to one of three conditions, all participants receive 15 training sessions of either near-infrared spectroscopy (NIRS)-based NFT in VR, NIRS-based NFT in 2D, or electromyogram-based biofeedback training in VR. ADHD symptoms, self-control, EF, health-related quality of life, school performance, and motor activity measured via parent, teacher, and child reports or objectively will be assessed before and after the intervention and at a 6 months follow-up. Furthermore, we are interested in parents' expectations about the training's effects. DISCUSSION: This is, to our knowledge, the first study investigating the efficacy of NFT for children with ADHD in a VR compared to a 2D environment. Furthermore, this study will contribute to the discussion about the efficacy and specific and unspecific effects of NFTs in children with ADHD. In addition to commonly assessed variables such as ADHD symptoms, NIRS and behavioural data obtained in EF measures, health-related quality of life, and parents' expectations about the intervention's effects, this study will investigate the effects on self-control, school performance, and motor activity. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02572180 . Registered on 19 November 2015.

Neurofeedback of slow cortical potentials as a treatment for adults with Attention Deficit-/Hyperactivity Disorder.

OBJECTIVE: Attention Deficit-/Hyperactivity Disorder (ADHD) has been treated successfully in children with neurofeedback (NF). In this study, for the first time NF is investigated in adults with ADHD. To answer the question of specificity the relationship between treatment outcome and self-regulation ability is assessed. METHODS: Twenty-four participants underwent 30 sessions of slow cortical potential NF. Measurements of ADHD and comorbid symptoms, as well as neurophysiological data (reaction time (RT) and RT variability (RTV) and contingent negative variation (CNV)) were performed before and after treatment, and again six months after sessions were completed. Participants were categorized into self-regulation learners and non-learners. RESULTS: Significant improvements on all symptom scales were observed with medium to large effect sizes after treatment and six months post treatment. RT and RTV decreased significantly and there was a trend for an increased CNV. Half of the participants successfully learned to regulate their brain activity. In the long-term, symptoms in the group of learners improved more than in non-learners with large effect sizes. CONCLUSION: NF is effective in treating adult ADHD long-term. The impact of self-regulation ability and possible unspecific effects still require further investigation. SIGNIFICANCE: This study is the first to investigate the effects of NF in adults with ADHD, relating clinical outcome to self-regulation performance.