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School Neuropsychology October > Neuropsychology of Attention > Flashcards

Neuropsychology of Attention Flashcards

1
Q

DSM-5 Diagnostic Criteria for ADHD

A

Five or more symptoms of inattention and/or ≥5 symptoms of hyperactivity/impulsivity for ≥6 months to a degree that is inconsistent with the developmental level.
* Several symptoms were present before the age of 12 years.
* Several symptoms must be present in ≥2 settings (e.g., at home, school, or work; with friends or relatives; in other activities).
* Symptoms interfere with or reduce the quality of social, academic, or
occupational functioning.
* Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better
explained by another mental disorder

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2
Q

What is prevalence of ADHD per DSM 5

A

The DSM-5 indicates that about 5% of children have ADHD (APA,
2013).

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3
Q

Who is diagnosed more with ADHD (in children/adolescents), males or females?

A
  • In children and adolescents, ADHD is more commonly diagnosed in males than females, with the sex ratio ranging from 2:1 to 10:1.
    Interestingly, sex differences virtually disappear in adult populations
    the sex ratio ranging from 2:1 to 10:1.
    ADHD affects a greater proportion of female children and adolescents than is reflected in clinical practice.
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4
Q

ADHD impacts Social Functioning by

A

Children with ADHD tend to have fewer friends and less stable relationships than their same-age peers who do not have ADHD

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5
Q

Risk Factors for ADHD

A

Greatest risk factor is having a parent with ADHD
Low birth weight linked to development of ADHD symptoms
Low Apgar scores
lack of oxygen and neonatal
seizures are associated with later ADHD diagnoses
Exposure to Toxins

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6
Q

Brain anatomy difference with males and females in ADHD

A

Girls are more likely to present with predominantly inattentive
symptoms, which are believed to be housed greatly in the prefrontal
area, while boys more often present with combined inattentive and
hyperactive symptoms (i.e., ADHD—combined presentation) which is
reflected in the reduced surface area in both the prefrontal and the
premotor cortex.

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7
Q

Brain regions involved with attention

A

*Ventral anterior cingulate and dorsal anterior cingulate related to affective and cognitive executive control.

  • Nucleus Accumbens, Putamen, Caudate form the frontostriatal circuit linking amygdala and cerebellum to frontal lobes.
  • Imaging studies identify structural and functional abnormalities in all these areas of the ADHD brain.
  • Dorsolateral prefrontal cortex is associated with working memory
  • Ventromedial prefrontal cortex linked with complex decision making and planning
  • Parietal cortex related to orientation of attention

-thalamus

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8
Q

Neurotransmitter Circuits in ADHD

A

Dopamine system (red) involved in planning and initiation of motor responses, activation, switching, reaction to novelty, and processing of rewards.

  • Norepinephrine (blue) related to arousal modulation, signal-to noise ratios in cortical regions, cognitive preparation for urgent stimuli.
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9
Q

Thalamus and ADHD

A

Thalamus plays a key role in both the reward and alerting network.
* While the thalamus is a relay center for most of the sensory information, it also plays a role in alertness. Dysregulated thalamic circuitry could be related to the under arousal that is associated with
ADHD
* Connections between the thalamus and basal ganglia, particularly
between medial and anterior dorsal thalamus and the putamen, were
related to spatial working memory and also altered in ADHD

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10
Q

True or False: The Reward Network functions typically in the brain for those who have ADHD

A
  • False
    Functioning is abnormal when
    ADHD is present
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11
Q

True or False: The Alerting Network is weaker in those who have ADHD

A

True

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12
Q

What is the Default Mode Network?

A
  • DMN are regions with elevated metabolic activities when the brain was not engaged in a task, conversation, or other activity that required focus.
    In those with ADHD, the DMN doesn’t turn off when focus is required, resulting in competition for cognitive resources.
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13
Q

What are the factors in Mirsky’s Model of Attention?

A

In 1991, Mirsky and colleagues proposed a three-factor model of
attention: focus, sustain, and shift.
They expanded the model in 1996 to include encode, focus/execute, and stabilize.

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14
Q

Define encoding as related to attention

A

the ability to register information, as well as holding information briefly in mind while performing some action on it.
* Overlaps with the construct of Working Memory

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15
Q

Define sustain as related to attention

A

Maintaining attention on some specific stimulus for an extended interval of time.

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16
Q

Define stability as related to attention

A

A reflection of the variability of response reaction time. * Subsequent studies suggest that stability is associated with sustain

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17
Q

Define focus/execute as related to attention

A

Focusing attentional resources a specific task/stimuli while simultaneously screening out distracting stimuli.
* The variable of interest in this domain was speed of task completion; related to inhibition control and processing speed.

18
Q

Define shift as related to attention

A

The ability to move from one salient stimulus to another. * Mirsky (1996) recognized that shift is also an “executive function” which blurs boundaries between attention and EF.

19
Q

Define attentional capacity

A

the amount of information that can be temporarily held
in memory.
* AKA: short-term memory, primary memory, registration of information.
* Distinguished from working memory by not involving any manipulation of
the information.
* Everyday tasks that require primary memory include recall of names, dates,
and addresses. Likewise, remembering a list of items on a shopping list
would short-term memory.
* Every academic task that students are asked to do includes some
attentional capacity.

20
Q

How do we assess attentional capacity?

A

*digits forward task.
*word recall and sentence repetition tasks
*Story recall tasks give insight into attentional capacity for highly meaningful
contextual tasks and arguably are a better reflection of attentional capacity in a
classroom setting.
*Visual attentional capacity makes an independent contribution to reading comprehension separate from phonological processing and auditory working memory (Finger windows test from the WRAML3.)

21
Q

What is the definition of working memory

A

Working memory is the ability to not just hold information in mind
but also manipulate information in some way.
* Working memory is embedded in virtually everything we ask students to do during assessments.

22
Q

What academic task is auditory working memory involved in?

What academic task is visual working memory involved in?

A

*Auditory working memory is implicated in reading abilities (Peng et al., 2018).

  • Visual working memory is associated with mathematics (Toll et al., 2016).
23
Q

How do we assess verbal working memory?

A

Digits backward tasks measure verbal working memory.
Sequencing tasks, Sentence Recall, Verbal Working Memory from the WRAML3.

24
Q

How do we assess visual working memory?

A

Visual working memory on The WRAML3.
WISC-V includes Picture Span.

25
Q

What is the difference between sustained attention and selective attention?

A

Sustained attention is the ability to remain focused or vigilant for a prolonged period.

Selective attention is staying focused in the face of environmental distractions.

To test attention, the focus will be on three approaches:
* Computerized continuous performance tests.
* Test of Everyday Attention for Children (TEA-Ch2).
* NEPSY-II.

26
Q

What is cognitive flexibility?

A

(AKA: set shifting; switching) measures the ability to shift and refocus
quickly from one salient stimulus to another.
* Children with ADHD have trouble holding competing rule sets in mind during switching tasks and/or inhibiting those rule sets once shifting is required.

27
Q

True or False: Children and adolescents with ADHD often have corresponding
problems with processing speed.

A

True
Note*Processing speed deficits can be a mediating factor in difficulty with social
functioning among children with ADHD

28
Q

What is processing speed comprised of?

A

perceptual speed, ( Perceptual speed is how long it takes to complete a simple task)
cognitive processing speed, (comprised of more cognitively demanding tasks)
and output speed (ability to quickly generate a response with limited cognitive demands.)

29
Q

True or False: Those with ADHD often demonstrate difficulties with learning and
memory, which should be distinguished from learning disorders.

A

True

30
Q

True or False: there is no comorbidity between ADHD and learning disorders

A

False
The comorbidity between learning disorders and ADHD diagnoses is
quite high: as many as 50% of adolescents with ADHD also meet
criteria for a learning disorder

31
Q

ADHD Interventions

A

Medication
School Supports
Daily Behavior Report Cards
Organizational Assistance
Notetaking Help
Low Distraction Testing
Extended Testing Time (Mixed results)
Social skills training
* Cognitive behavioral therapy
* Parent training.
Dietary interventions
* Neurofeedback
* Physical exercise
* Sleep interventions

32
Q

Which physical health concern(s) can masquerade as ADHD?

A

Obstructive Sleep Apnea
Traumatic Brain Injury
Hypothyroidism

33
Q

What region of the brain has less surface area in girls with ADHD

A

Frontal Lobe

34
Q

What is the greatest risk factor for developing ADHD?

A

Parent diagnosed with ADHD

35
Q

According to studies cited in the presentation, what percentage of 9th graders with ADHD are likely to have a comorbid learning disorder?

A

50%

36
Q

Which cognitive networks are associated with ADHD?

A

Reward Network
Alerting Network
Default Mode Network

37
Q

What is not a component of Mirsky’s attention model

A

Retrieve

38
Q

What does the American Academy of Pediatrics recommend as a first line treatment for adolescents with ADHD?

A

Medication

39
Q

Omission errors are signs of:

A

Poor sustained attention

40
Q

Which of the following is an intervention?

A

Teaching note taking skills

41
Q

Which lifestyle intervention has the most consistent and compelling research support?

A

Physical exercise

School Neuropsychology October (4 decks)

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