Metacognitive executive function training for young children with ADHD: a proof-of-concept study

AbstractAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. The treatment of ADHD could potentially be improved with the development of combination therapies targeting multiple systems. Both the number of children diagnosed with ADHD and the use of stimulant medications for its treatment have been rising in recent years, and concern about side-effects and future problems that medication may cause have been increasing. An alternative treatment strategy for ADHD attracting wide interest is the targeting of neuropsychological functioning, such as executive function impairments. Computerized training programs (including video games) have drawn interest as a tool to train improvements in executive function deficits in children with ADHD. Our lab is currently conducting a pilot study to assess the effects of the online game Minecraft as a therapeutic video game (TVG) to train executive function deficits in children with ADHD. The effect of the TVG intervention in combination with stimulants is being investigated to develop a drug-device combination therapy that can address both the dopaminergic dysfunction and executive function deficits present in ADHD. Although the results of this study will be used to guide the clinical development process, additional guidance for the optimization of the executive function training activities will be provided by a computational model of executive functions built with artificial neural networks (ANNs). This model uses ANNs to complete virtual tasks resembling the executive function training activities that the study subjects practice in the Minecraft world, and the schedule of virtual tasks that result in maximum improvements in ANN performance on these tasks will be investigated as a method to inform the selection of training regimens in future clinical studies.

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Executive Function Training for Preschool Children With ADHD: A Randomized Controlled Trial

Journal of Attention Disorders ◽

10.1177/1087054720956723 ◽

2020 ◽

pp. 108705472095672

Author(s):

Lan Shuai ◽

Yuanyuan Wang ◽

Wei Li ◽

Amanda Wilson ◽

Shanshan Wang ◽

...

Keyword(s):

Executive Function ◽

Preschool Children ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Controlled Study ◽

Children With Adhd ◽

Randomized Controlled ◽

Oppositional Defiant ◽

Executive Function Training

Objective: This randomized controlled study explored the efficacy, feasibility, and acceptability of executive function training (EFT) for preschool children with ADHD. Method: The current study design was an 8 week randomized parallel groups, single-blinded trial, using EFT-P. A total of 96 children with an ADHD diagnosis at age 4 to 5 years old were randomized into the intervention group and waitlist group. In the intervention group, 46 out of 50 participants completed the 8-week program, compared with 39 out of 46 in the waiting group. The level of ADHD symptoms and the executive function (EF) were evaluated by both neuropsychological tests from NEPSY Second Edition (NEPSY-II) and Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P). Results: The EFT is feasible to administer and is acceptable for preschool children, with a 93% retention rate. Results showed that following the intervention, the visual-motor precision ( p = .024), ADHD diagnostic state ( p = .01), and oppositional defiant symptoms ( p = .023) improved significantly in preschool children. However, the symptoms of ADHD and other EF evaluations were found to be insignificant. Conclusion: The EFT is feasible, acceptable, and potentially effective to reduce symptoms and improve EF for preschool children with ADHD. The next step is to extend the program time and provide more frequent practice of activities between the children and the therapist and/or parent, to improve the effectiveness.

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Childhood Executive Function Inventory (CHEXI): A promising measure for identifying young children with ADHD?

Journal of Clinical and Experimental Neuropsychology ◽

10.1080/13803390902806527 ◽

2010 ◽

Vol 32 (1) ◽

pp. 38-43 ◽

Cited By ~ 21

Author(s):

Lisa B. Thorell ◽

Lilianne Eninger ◽

Karin C. Brocki ◽

Gunilla Bohlin

Keyword(s):

Executive Function ◽

Young Children ◽

Children With Adhd

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Connectivity of the Superior Longitudinal Fasciculus II and Executive Function in Children with ADHD

Journal of Student Research ◽

10.47611/jsrhs.v10i3.1792 ◽

2021 ◽

Vol 10 (3) ◽

Author(s):

Larissa Ma ◽

Leya Joykutty ◽

Anthony Dick

Keyword(s):

Executive Function ◽

White Matter ◽

Young Children ◽

Neurodevelopmental Disorder ◽

Strong Association ◽

Superior Longitudinal Fasciculus ◽

Card Sort ◽

Children With Adhd ◽

And Performance ◽

Brain Behavior

Attention-deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder marked by inattention, hyperactivity, and impulsiveness. The importance of the Superior Longitudinal Fasciculus II (SLFII), a white matter tract connecting the frontal and parietal regions, to developing executive function has not been established in children who typically have executive function deficits. The present study explored the association between diffusion properties of the SLFII and developing executive function in young children diagnosed with ADHD. A dataset with the performance on the NIH Toolbox Card Sort and the NIH Toolbox Flanker, two executive function tasks, in 59 4-7-year-old children was used, and diffusion-weighted magnetic resonance imaging scans were used to quantify the white matter properties of the bilateral SLFII. The results showed that there was an association between age and performance on the Flanker and Card Sort tasks. As age increased, performance also improved. There was no significant association between white matter properties of the SLFII, birth sex, and the Card Sort and Flanker tasks. As the first study to explore this association in children of this age with ADHD, this result was unexpected suggesting that it may be the case that it is too early in development to detect a strong association. The findings inform contemporary and future investigations into the brain-behavior relations between SLFII and executive function in children with ADHD. With further research, neuroimaging could become a potential diagnostic biomarker for predicting executive function impairments and ADHD symptoms in young children, potentially altering treatment outcomes.

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Feasibility of an Activity Protocol for Young Children in a Whole Room Indirect Calorimeter: A Proof-of-Concept Study

Journal of Physical Activity and Health ◽

10.1123/jpah.6.5.633 ◽

2009 ◽

Vol 6 (5) ◽

pp. 633-637 ◽

Cited By ~ 2

Author(s):

Anouk WMC Oortwijn ◽

Guy Plasqui ◽

John J. Reilly ◽

Anthony D. Okely

Keyword(s):

Pilot Study ◽

Energy Expenditure ◽

Young Children ◽

Healthy Children ◽

Proof Of Concept ◽

Future Studies ◽

Concept Study ◽

Actigraph Accelerometer ◽

Vigorous Intensity ◽

The Right

Background:The purpose of this pilot study was to assess the feasibility of a structured activity protocol in a room calorimeter among young children.Methods:Five healthy children (age 5.2 ± 0.4 y) performed an activity protocol in a room calorimeter, ranging from sedentary to vigorous-intensity activities. Energy expenditure (EE) was calculated from continuous measurements of O2-consumption and CO2-production using Weir’s formula. Resting EE was defined as EE during the first 30 min of the study where participants were seated while watching television. The children wore an ActiGraph accelerometer on the right and left hip.Results:The protocol was well tolerated by all children, and lasted 150 to 175 min. Further, differences were seen in both EE and accelerometer counts across 3 of the 4 activity intensities.Conclusions:It is feasible for young children to perform a structured activity protocol in a room calorimeter enhancing the possibility of conducting future studies to cross-validate existing accelerometer prediction equations.

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