Restricted accessResearch articleFirst published online 2018-12
Attention-Deficit/Hyperactivity Disorder-Related Deficits and Psychostimulant Medication Effects on Comprehension of Audiovisually Presented Educational Material in Children
We aimed to (1) examine differences in observed visual attention and motor activity, as well as comprehension of a science video between children with and without attention-deficit/hyperactivity disorder (ADHD) and (2) explore if psychostimulant medication improves ADHD behaviors and comprehension of a science video in children with ADHD.
Method:
Children aged 7–11 with (n = 91) and without (n = 45) ADHD watched a science video and then completed a comprehension test. Then, children with ADHD began a 4-week within-subject, randomized, double-blind crossover trial of methylphenidate (MPH). At post-testing, children were randomized to receive placebo or their optimal dosage, watched another science film, and completed a comprehension test.
Results:
Children with ADHD exhibited higher rates of motor activity during, and worse comprehension of material discussed within, the science video. Mediation models revealed that increased motor activity suppressed between-group differences in comprehension. MPH improved comprehension and visual attention, but not motor activity during the science video.
Conclusion:
Children with ADHD may benefit from MPH to improve comprehension of and sustained attention during audiovisually presented learning material.
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References
1.
AbikoffHB, JensenPS, ArnoldLE, HozaB, HechtmanL, PollackS, MartinD, AlvirJ, MarchJS, HinshawS, VitielloB, NewcornJ, GreinerA, CantwellDP, ConnersCK, ElliottG, GreenhillLL, KraemerH, PelhamWEJr, SevereJB, SwansonJM, WellsK, WigalT: Observed classroom behavior of children with ADHD: Relationship to gender and comorbidity. J Abnorm Child Psychol, 30:349–359, 2002.
2.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-5, 5th ed. Arlington: American Psychiatric Publishing; 2013.
3.
BarkleyRA (ed): Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 5th ed. New York, Guilford Publications, 2014.
4.
BashirAS, ScavuzzoA: Children with language disorders: Natural history and academic success. J Learn Disabil, 25:53–65, 1992.
5.
BaileyUL, DerefinkoKJ, MilichR, LorchEP, MetzeA: The effects of stimulant medication on free recall of story events among children with ADHD. J Psychopathol Behav Assess, 33:409–419, 2011.
6.
BaileyUL, LorchEP, MilichR, CharnigoR: Developmental changes in attention and comprehension among children with attention deficit hyperactivity disorder. Child Dev, 80:1842–1855, 2009.
7.
BellaniM, MorettiA, PerliniC, BrambillaP: Language disturbances in ADHD. Epidemiol Psychiatr Sci, 20:311–315, 2011.
8.
CainK, BignellS: Reading and listening comprehension and their relation to inattention and hyperactivity. Br J Educ Psychol, 84:108–124, 2014.
9.
CurrieJ, StabileM, JonesL: Do stimulant medications improve educational and behavioral outcomes for children with ADHD?. J Health Econ, 37:58–69, 2014.
10.
DennisM, FrancisDJ, CirinoPT, SchacharR, BarnesMA, FletcherJM: Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. J Int Neuropsychol Soc, 15:331–343, 2009.
11.
DuPaulGJ, RapportMD: Does methylphenidate normalize the classroom performance of children with attention deficit disorder?. J Am Acad Child Adolesc Psychiatry, 32:190–198, 1993.
12.
EpsteinJN, BrinkmanWB, FroehlichT, LangbergJM, NaradME, AntoniniTN, SheilsK, SimonJO, AltayeM: Effects of stimulant medication, incentives, and event rate on reaction time variability in children with ADHD. Neuropsychopharmacology, 36:1060–1072, 2011.
13.
EvansSW, PelhamWE, SmithBH, BuksteinO, GnagyEM, GreinerAR, AltenderferL, Baron-MyakC: Dose–response effects of methylphenidate on ecologically valid measures of academic performance and classroom behavior in adolescents with ADHD. Exp Clin Psychopharmacol, 9:163–175, 2001.
14.
FrazierTW, YoungstromEA, GluttingJJ, WatkinsMW: ADHD and achievement: Meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. J Learn Disabil, 40:49–65, 2007.
15.
HartantoTA, KrafftCE, IosifAM, SchweitzerJB: A trial-by-trial analysis reveals more intense physical activity is associated with better cognitive control performance in attention-deficit/hyperactivity disorder. Child Neuropsychol, 22:618–626, 2016.
16.
HawkLWJr, FoscoWD, ColderCR, WaxmonskyJG, PelhamWEJr, RoschKS: How do stimulant treatments for ADHD work? Evidence for mediation by improved cognition. J Child Psychol Psychiatr, 2018. [Epub ahead of print]. DOI: 10.1111/jcpp.12917.
17.
IBM Corporation: IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corporation; 2016.
18.
ImerajL, AntropI, Sonuga-BarkeE, DeboutteD, DeschepperE, BalS, RoeyersH: The impact of instructional context on classroom on-task behavior: A matched comparison of children with ADHD and non-ADHD classmates. J Sch Psychol, 51:487–498, 2013.
19.
JalongoMR: Listening in early childhood: An interdisciplinary review of the literature. Int J Listening, 24:1–18, 2010.
20.
KercoodS, BandaDR: The effects of added physical activity on performance during a listening comprehension task for students with and without attention problems. Int J App Educ Stud, 13:19–32, 2012.
21.
KimYSG: Language and cognitive predictors of text comprehension: Evidence from multivariate analysis. Child Dev, 86:128–144, 2015.
22.
KimYSG: Direct and mediated effects of language and cognitive skills on comprehension of oral narrative texts (listening comprehension) for children. J Exp Child Psychol, 141:101–120, 2016.
23.
KoflerMJ, RaikerJS, SarverDE, WellsEL, SotoEF: Is hyperactivity ubiquitous in ADHD or dependent on environmental demands? Evidence from meta-analysis. Clin Psychol Rev, 46:12–24, 2016.
24.
KoflerMJ, RapportMD, AldersonRM: Quantifying ADHD classroom inattentiveness, its moderators, and variability: A meta-analytic review. J Child Psychol Psychiatry, 49:59–69, 2008.
25.
LandauS, LorchEP, MilichR: Visual attention to and comprehension of television in attention‐deficit hyperactivity disordered and normal boys. Child Dev, 63:928–937, 1992.
26.
LangbergJM, BeckerSP: Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder?. Clin Child Fam Psychol Rev, 15:215–233, 2012.
27.
LauthGW, HeubeckBG, MackowiakK: Observation of children with attention-deficit hyperactivity (ADHD) problems in three natural classroom contexts. Br J Educ Psychol, 76:385–404, 2006.
28.
LorchEP, MilichR, SanchezRP, van den BroekP, BaerS, HooksK, HartungC, WelshR: Comprehension of televised stories in boys with attention deficit/hyperactivity disorder and nonreferred boys. J Abnorm Psychol, 109:321–330, 2000.
29.
LorchEP, O'NeilK, BerthiaumeKS, MilichR, EasthamD, BrooksT: Story comprehension and the impact of studying on recall in children with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol, 33:506–515, 2004.
30.
McInnesA, BedardAC, Hogg-JohnsonS, TannockR: Preliminary evidence of beneficial effects of methylphenidate on listening comprehension in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol, 17:35–49, 2007.
31.
McInnesA, HumphriesT, Hogg-JohnsonS, TannockR: Listening comprehension and working memory are impaired in attention-deficit hyperactivity disorder irrespective of language impairment. J Abnorm Child Psychol, 31:427–443, 2003.
MolinaBS, HinshawSP, SwansonJM, ArnoldLE, VitielloB, JensenPS, EpsteinJN, HozaB, HechtmanL, AbikoffHB, ElliottGR, GreenhillLL, NewcornJH, WellsKC, WigalT, GibbonsRD, HurK, HouckPR, MTA Cooperative Group: The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry, 48:484–500, 2009.
34.
MTA Cooperative Group: Multimodal Treatment Study of Children with ADHD. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry, 56:1073–1086, 1999.
35.
MuthénLK, MuthénBO: Mplus Version 7. Los Angeles, CA: Muthén & Muthén, 1998.
36.
Noldus Information Technology: The Observer XT. Wageningen, The Netherlands: Noldus Information Technology b. v., 2008.
37.
NormandS, SchneiderBH, LeeMD, MaisonneuveMF, Chupetlovska-AnastasovaA, KuehnSM, RobaeyP: Continuities and changes in the friendships of children with and without ADHD: A longitudinal, observational study. J Abnorm Child Psychol, 41:1161–1175, 2013.
38.
OrbanSA, RapportMD, FriedmanLM, EckrichSJ, KoflerMJ: Inattentive behavior in boys with ADHD during classroom instruction: The mediating role of working memory processes. J Abnorm Child Psychol, 46:713–727, 2017.
39.
PapaeliouCF, ManiadakiK, KakourosE: Association between story recall and other language abilities in schoolchildren with ADHD. J Atten Disord, 19:53–62, 2015.
40.
PelhamWE, CarlsonC, SamsSE, VallanoG, DixonMJ, HozaB: Separate and combined effects of methylphenidate and behavior modification on boys with attention deficit-hyperactivity disorder in the classroom. J Consult Clin Psychol, 61:506–515, 1993.
41.
PelhamWEJr, FabianoGA, MassettiGM: Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. J Clin Child Adolesc Psychol, 34:449–476, 2005.
42.
PelhamWE, HozaB, PillowDR, GnagyEM, KippHL, GreinerAR, WaschbuschDA, TraneST, GreenhouseJ, WolfsonL, FitzpatrickE: Effects of methylphenidate and expectancy on children with ADHD: Behavior, academic performance, and attributions in a summer treatment program and regular classroom settings. J Consult Clin Psychol, 70:320–335, 2002.
43.
PorrinoLJ, RapoportJL, BeharD, SceeryW, IsmondDR, BunneyWE: A naturalistic assessment of the motor activity of hyperactive boys: I. Comparison with normal controls. Arch Gen Psychiatry, 40:681–687, 1983.
44.
PrasadV, BroganE, MulvaneyC, GraingeM, StantonW, SayalK: How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis. Eur Child Adolesc Psychiatry, 22:203–216, 2013.
45.
Rainbow Educational Media (Producer): Plants: A First Look [Motion picture]. Evanston, IL, United Learning, 2001a.
46.
Rainbow Educational Media (Producer): Solids Liquids, Gases: A First Look [Motion picture]. Evanston, IL, United Learning, 2001b.
47.
RapportMD, BoldenJ, KoflerMJ, SarverDE, RaikerJS, AldersonRM: Hyperactivity in boys with attention-deficit/hyperactivity disorder (ADHD): A ubiquitous core symptom or manifestation of working memory deficits?. J Abnorm Child Psychol, 37:521–534, 2009.
48.
RapportMD, DenneyC, DuPaulGJ, GardnerMJ: Attention deficit disorder and methylphenidate: Normalization rates, clinical effectiveness, and response prediction in 76 children. J Am Acad Child Adolesc Psychiatry, 33:882–893, 1994.
ShafferD, FisherP, LucasCP, DulcanMK, Schwab-StoneME: NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry, 39:28–38, 2000.
51.
TannockR, IckowiczA, SchacharR: Differential effects of methylphenidate on working memory in ADHD children with and without comorbid anxiety. J Am Acad Child Adolesc Psychiatry, 34:886–896, 1995.
52.
TannockR, PurvisKL, SchacharRJ: Narrative abilities in children with attention deficit hyperactivity disorder and normal peers. J Abnorm Child Psychol, 21:103–117, 1993.
53.
Vile JunodRE, DuPaulGJ, JitendraAK, VolpeRJ, ClearyKS: Classroom observations of students with and without ADHD: Differences across types of engagement. J Sch Psychol, 44:87–104, 2006.
54.
WehmeierPM, SchachtA, BarkleyRA: Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health, 46:209–217, 2010.
55.
WigalSB, WigalT, SchuckS, BramsM, WilliamsonD, ArmstrongRB, StarrHL: Academic, behavioral, and cognitive effects of OROS® methylphenidate on older children with ADHD. J Child Adolesc Psychopharmacol, 21:121–131, 2011.
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