Group cognitive behavioral therapy for children and adolescents with ADHD.

The present study analyzed the use of group CBT protocol to treat ADHD by comparing two types of treatment, unimodal (medication only) and multimodal (medication combined with CBT), in terms of their effects on cognitive and behavioral domains, social skills, and type of treatment effect by ADHD subtype. Participants were 60 children with ADHD, subtypes inattentive and combined, aged 7 to 14, 48 boys. Combined treatment included 20 CBT sessions while all children were given Ritalin LA® 20 mg. Cognitive and behavioral outcome measures showed no differences between treatment groups. On social skills, multimodal showed more improvement in frequency indicators on empathy, assertiveness, and self-control subscales and in the difficulty on assertiveness and self-control subscales. Using a group CBT protocol for multimodal ADHD treatment may improve patient adherence and ADHD peripheral symptoms.

Group cognitive behavioral therapy for children and adolescents with ADHD

The present study analyzed the use of group CBT protocol to treat ADHD by comparing two types of treatment, unimodal (medication only) and multimodal (medication combined with CBT), in terms of their effects on cognitive and behavioral domains, social skills, and type of treatment effect by ADHD subtype. Participants were 60 children with ADHD, subtypes inattentive and combined, aged 7 to 14, 48 boys. Combined treatment included 20 CBT sessions while all children were given Ritalin LA® 20 mg. Cognitive and behavioral outcome measures showed no differences between treatment groups. On social skills, multimodal showed more improvement in frequency indicators on empathy, assertiveness, and self-control subscales and in the difficulty on assertiveness and self-control subscales. Using a group CBT protocol for multimodal ADHD treatment may improve patient adherence and ADHD peripheral symptoms. (AU)

Use of Cognitive Behavioral Therapy and Token Economy to Alleviate Dysfunctional Behavior in Children with Attention-Deficit Hyperactivity Disorder.

Medication has proved highly efficacious as a means of alleviating general symptoms of attention-deficit hyperactivity disorder (ADHD). However, many patients remain functionally impaired by inappropriate behavior. The present study analyzed the use of cognitive behavioral therapy (CBT) with the Token-Economy (TE) technique to alleviate problem behavior for 25 participants with ADHD, all children (19 boys, mean age 10.11) on long-term methylphenidate medication, who were given 20 CBT sessions with 10 weeks of TE introduced as of session 5. Their ten most acute problem behaviors were selected and written records kept. On weekdays, parents recorded each inappropriate behavior and provided a suitable model for their actions. At weekly sessions, problem behaviors were counted and incident-free participants rewarded with a token. To analyze improvement (less frequent problem behavior), a list of 11 behavioral categories was rated: inattention, impulsivity, hyperactivity, disorganization, disobeying rules and routines, poor self-care, verbal/physical aggression, low frustration tolerance, compulsive behavior, antisocial behavior, lacking in initiative and distraction. Two CBT specialists categorized behaviors and an ADHD specialist ruled on discrepancies. Statistical analyses used were Generalized Estimating Equations with Poisson distribution and autoregressive order correlation structure. In the course of the sessions, problematic behaviors decreased significantly in seven categories: impulsiveness, hyperactivity, disorganization, disobeying rules and routine, poor self-care, low frustration tolerance, compulsive behaviors, and antisocial behaviors. Caregiver attitudes to children's inappropriate behavior were discussed and reshaped. As functional improvement was observed on applying TE for 10 weeks, this type of intervention may be useful as an auxiliary strategy combined with medication.

Performance of a Brazilian sample on the computerized Wisconsin Card Sorting Test

The computerized version of the Wisconsin Card Sorting Test (WCST) is based on the same normative data developed previously for the manual version. However, equivalence of the measures of both versions is controversial. This study investigated the performance of a Brazilian student sample with subjects aged 6-15 years in the computerized version of the WCST. As a result of the analyses, the study pointed out that type of school (public or private) was significant in almost all measures and also that age and gender effects were similar to those previously described in the manual version. These results showed that the computerized WCST may not be free of cultural and socioeconomic influences and that the validation and standardization of this version is warranted.(AU)

Performance of a Brazilian sample on the computerized Wisconsin Card Sorting Test

The computerized version of the Wisconsin Card Sorting Test (WCST) is based on the same normative data developed previously for the manual version. However, equivalence of the measures of both versions is controversial. This study investigated the performance of a Brazilian student sample with subjects aged 6-15 years in the computerized version of the WCST. As a result of the analyses, the study pointed out that type of school (public or private) was significant in almost all measures and also that age and gender effects were similar to those previously described in the manual version. These results showed that the computerized WCST may not be free of cultural and socioeconomic influences and that the validation and standardization of this version is warranted.

Performance patterns in Conners' CPT among children with attention deficit hyperactivity disorder and dyslexia.

This study investigated the performance of children with attention deficit hyperactivity disorder (ADHD) and dyslexia using Conners' Continuous Performance Test (CCPT). The clinical groups were composed of 52 children with ADHD and 32 children with dyslexia. Performance in the CCPT was evaluated using ANCOVA to compare the clinical groups with the normative Brazilian sample. The ADHD group performed worse than the normative sample in almost all of the measurements, except for reaction time and response style. The dyslexia group scored higher on commissions, variability, perseverations and inconsistency in the reaction time over the six time blocks (Hit SE Block Change) than the children in the normative Brazilian sample. The ADHD and dyslexia groups differed in omission measurements, Hit RT SE, variability, perseverations, Hit RT Interstimulus Intervals (ISI) Change and Hit SE ISI Change. We thus found that the dyslexia group had specific deficit patterns, with greater response to non-target stimuli, greater perseveration and response variability, and difficulties in hit reaction time as the test progressed.

Performance patterns in Conners' CPT among children with attention deficit hyperactivity disorder and dyslexia / Padrão de desempenho no Conners' CPT em crianças com transtorno do déficit de atenção e hiperatividade e dislexia

This study investigated the performance of children with attention deficit hyperactivity disorder (ADHD) and dyslexia using Conners' Continuous Performance Test (CCPT). The clinical groups were composed of 52 children with ADHD and 32 children with dyslexia. Performance in the CCPT was evaluated using ANCOVA to compare the clinical groups with the normative Brazilian sample. The ADHD group performed worse than the normative sample in almost all of the measurements, except for reaction time and response style. The dyslexia group scored higher on commissions, variability, perseverations and inconsistency in the reaction time over the six time blocks (Hit SE Block Change) than the children in the normative Brazilian sample. The ADHD and dyslexia groups differed in omission measurements, Hit RT SE, variability, perseverations, Hit RT Interstimulus Intervals (ISI) Change and Hit SE ISI Change. We thus found that the dyslexia group had specific deficit patterns, with greater response to non-target stimuli, greater perseveration and response variability, and difficulties in hit reaction time as the test progressed.

O presente estudo investigou o desempenho de crianças com transtorno do déficit de atenção e hiperatividade (TDAH) e dislexia no Teste de Desempenho Contínuo de Conner (do inglês Conners' Continnuous Performance Test). Foram considerados dois grupos clínicos: 52 crianças com TDAH e 32 com dislexia. O desempenho no CCPT foi analisado por meio do teste ANCOVA, comparando os grupos clínicos com a amostra de normatização brasileira. O grupo TDAH teve pior desempenho que os controles em quase todas as medidas, exceto em medidas de tempo de reação e estilo de resposta. Já o grupo dislexia teve maiores escores em comissões, variabilidade, perseverações e inconsistência nas mudanças de tempo de reação no decorrer dos seis blocos de tempo (Hit SE Block Change). Os grupos TDAH e disléxicos diferiram entre si nas medidas de omissões, variabilidade do tempo de reação, perseverações, mudança de tempo de reação por intervalos interstimulus. Verificou-se assim que as crianças com dislexia apresentam padrões específicos de déficits, com maior resposta aos estímulos não alvos, maior perseveração e variabilidade de respostas, assim como dificuldades no tempo de reação conforme o desenvolvimento do teste.