Cognitive Testing to Identify Children With ADHD Who Do and Do Not Respond to Methylphenidate

The historic development of the attention deficit hyperactivity disorder (ADHD) construct is, in many cases, paralleled by research questions addressed with the continuous performance test (CPT). This task, the use of which dates back to the 1950s for the diagnosis of brain damage, requires responding to rare targets in a sequence of stimuli during prolonged assessment. In our review, we illustrate how the CPT was and still is used for the assessment of sustained attention and impulsivity as core features of ADHD. In addition to impaired performance at the neuropsychological level, the CPT also taps underlying brain activity that can be registered by neuroimaging techniques such as fMRI and EEG. The latter allows more detailed operationalization of ADHD theories, and reveals impairments at different stages of information processing. The CPT has also been applied for treatment evaluation. Recently, distinct genetic effects on preparation and response control or impulsivity were detected using the CPT. As such, the task remains a valuable tool for further investigations of genetic and environmental factors of ADHD.

The underlying cause(s) of abnormalities expressed by patients with attention deficit hyperactivity disorder (ADHD) have yet to be delineated. One factor that has been associated with increased vulnerability to ADHD is polymorphism(s) of TACR1, which is the human equivalent of the rodent NK1 (substance P-preferring) receptor gene (Nk1r). We have reported previously that genetically altered mice, lacking functional NK1R (NK1R–/–), express locomotor hyperactivity, which was blunted by the first-line treatment for ADHD, methylphenidate. Here, we compared the effects of this psychostimulant (3, 10 and 30 mg/kg, intraperitoneally) on the behaviour of NK1R-/- mice and their wild types in the 5-Choice Continuous Performance Test, which emulates procedures used to study attention and response control in ADHD patients. Methylphenidate increased total trials (a measure of ‘productivity’) completed by wild types, but not by NK1R-/- mice. Conversely, this drug reduced perseveration by NK1R-/- mice, but not by wild types. Other drug-induced changes in key behaviours were not genotype dependent, especially at the highest dose: for example, % omissions (an index of inattentiveness) was increased, whereas % false alarms and % premature responses (measures of impulsivity) declined in both genotypes, indicating reduced overall response. These findings are discussed in the context of the efficacy of methylphenidate in the treatment of ADHD. Moreover, they lead to several testable proposals. First, methylphenidate does not improve attention in a subgroup of ADHD patients with a functional deficit of TACR1. Second, these patients do not express excessive false alarms when compared with other groups of subjects, but they do express excessive perseveration, which would be ameliorated by methylphenidate.

Abstract-Attention Deficit Hyperactive Disorder (ADHD) is a new issue in neuropsychiatric syndrome experienced on Childhood Student. These symptoms interfere in the development of cognitive, social, and early-childhood communication. The background to this idea is in communicating a child with ADHD tends to difficulty in talking, like cutting and interfering with other people's conversation, difficulty stringing words, talking too loudly, speaking inefficiently, and often misstep's cause commotion with other on kindergarten/playgroup student. Difficulty communicating children ADHD this can be handled through the treatment by speech therapy. Speech therapy is used for the provision of treatments that deal with language, speech and sound disorders that serve as the foundation for making diagnosis and treatment. The manuscript objective is to describe ADHD and how to treatment it with speech therapy is oriented to train and sharpen phonological awareness of early childhood in recognizing alphabet and words, especially in its use to communicate.