Adhd neuropsychological test battery


Neuropsychological Testing for ADD/ADHD - Fifth Avenue Psychiatry

Fifth Avenue Psychiatry specializes in the accurate diagnosis of ADD/ADHD which often includes Neuropsychological Testing. Unfortunately, many adolescents, teenagers and adults go misdiagnosed. Psychological Testing can help distinguish an underlying anxiety disorder – or even normal energetic adolescents – from what is truly ADD or ADHD.

Depending on the presenting complaint, age and other factors a battery of psychological tests will be recommended. The specific group of tests can range from a small treatment focused battery to guide treatment to a thorough educational assessment that can uncover potential learning disabilities.

What tests are used to diagnose ADD/ADHD?

Neuropsychological testing involves a battery of objective and standardized tests. Usually, the doctor gets ADD/ADHD assessments from the parents, teacher or supervisor. Some common rating scales include:

  • The Vanderbilt Assessment Scale – reviews symptoms of ADHD according to the DSM-IV criteria. It also screens for co-existing conditions such as behavioral disorder, oppositional-defiant disorder, anxiety, and depression.
  • Behavior Assessment System for Adolescents – assesses hyperactivity, aggression and behavioral problems. It also addresses anxiety, depression, attention and learning problems and lack of certain essential skills.
  • Adolescent Behavior Checklist/Teacher Report Form – assesses physical complaints, aggressive or delinquent behavior and withdrawal.

Other important diagnostic tools include computer-based “continuous performance tests” where the adolescent or teen gives very simple responses (i.e., click a button) to a simple stimulus (numbers, letters, etc.) on a computer screen.

These tests are designed to be long and tedious so if an adolescent has ADD/ADHD they will be challenged. The attention they display in this test, and any subsequent mistakes or mistake patterns, are analyzed to help understand the individual weaknesses. Adolescents with ADD/ADHD will make specific errors on this test; some of which also measure hyperactivity.

These tests include Continuous Performance tests such as:

  • Individual Variables of Attention
  • Test of Variables of Attention
  • Connors Continuous Performance Test

Simpler Continuous Performance tests, which are shorter in duration and provide less sophisticated data, include:

  • Rapidly Recurring Target Figures Test
  • Digit Cancellation Tasks

Once there is an ADD/ADHD diagnosis, the doctor may request other tests in order to rule out other causes, such as:

  • Blood diseases, i.e., thyroid disease
  • Blood lead levels
  • CT scan or MRI for brain abnormalities
  • Encephalograph test brain waves to measure electrical activity in the brain
  • Hearing and vision

Neuropsychological assessment of adults with ADHD: A Delphi consensus study

. 2019 Jul-Aug;26(4):340-354.

doi: 10.1080/23279095.2018.1429441. Epub 2018 Feb 9.

Anselm B M Fuermaier  1 , Jan A Fricke  1 , Stefanie M de Vries  1 , Lara Tucha  1 , Oliver Tucha  1

Affiliations

Affiliation

  • 1 a Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences , University of Groningen , Groningen , The Netherlands.
  • PMID: 29424567
  • DOI: 10. 1080/23279095.2018.1429441

Anselm B M Fuermaier et al. Appl Neuropsychol Adult. 2019 Jul-Aug.

. 2019 Jul-Aug;26(4):340-354.

doi: 10.1080/23279095.2018.1429441. Epub 2018 Feb 9.

Authors

Anselm B M Fuermaier  1 , Jan A Fricke  1 , Stefanie M de Vries  1 , Lara Tucha  1 , Oliver Tucha  1

Affiliation

  • 1 a Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences , University of Groningen , Groningen , The Netherlands.
  • PMID: 29424567
  • DOI: 10.1080/23279095.2018.1429441

Abstract

Within the clinical evaluation of adults with attention deficit hyperactivity disorder (ADHD), cognitive functions are often assessed to characterize individual cognitive problems and guide treatment planning. However, the composition of an adequate neuropsychological assessment battery remains difficult given the large number of cognitive functions that can be distinguished, the variety of available tools to assess these functions, as well as the cognitive heterogeneity that has been observed between individuals with ADHD. Twenty-seven clinicians and researchers experienced in working with adults with ADHD took part in the present study. This study employed the Delphi methodology in order to compose an assessment battery for the measurement of the most important neuropsychological functions by employing the most suitable measures to assess these functions. Consensus between experts was achieved on a ranking of 16 neuropsychological functions that are important for the neuropsychological assessment of adults with ADHD. Furthermore, measures were suggested to assess each of the neuropsychological functions. The assessment battery as composed in the present study may support research and clinical practice in the selection of appropriate functions and measures for the determination of the individual level of cognitive functioning and treatment planning of adults with ADHD.

Keywords: Adult ADHD; Delphi; cognition; neuropsychological assessment.

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MeSH terms

Possibilities of neuropsychological correction in overcoming educational difficulties in a younger adolescent with attention deficit hyperactivity disorder



The article describes the main learning difficulties in a younger adolescent with ADHD, with a special emphasis on the neuropsychological causes of such manifestations. The results before and after neuropsychological correction are presented.

Keywords: nine0012 attention deficit hyperactivity disorder, ADHD, learning difficulties, learning difficulties, younger teenager, neuropsychology, neuropsychological correction.

At present, the search for and elimination of the causes of difficulties that some children have in mastering the school curriculum is one of the main problems. This study focuses on the possibility of correcting learning difficulties in younger adolescents with attention deficit hyperactivity disorder (ADHD), which has recently become more common. To overcome emerging learning difficulties, each child needs an individual approach that takes into account precisely his strengths and weaknesses, this was pointed out, among others, by N. M. Pylaeva and T. V. Akhutina [1;3]. This approach is most developed in neuropsychology, including domestic neuropsychology, based on the ideas of L. S. Vygotsky and built A. R. Luria. Thus, the purpose of this work is to describe the possibilities of neuropsychological correction in overcoming the learning difficulties of a younger adolescent with ADHD. nine0003

Overcoming learning difficulties younger teenager with attention deficit disorder and hyperactivity

The main learning skills that younger teenagers should have at a high level are writing, reading and counting. At the same time, the ability to apply effective mnemonic strategies, the ability to give abstract definitions of words, analyze language metaphors should be formed, and in oral, written stories and retellings of children, much more attention is paid to describing the thoughts and feelings of the characters. It is also necessary to be able to solve mathematical problems in several steps, use different units of measurement and translate them, while younger teenagers must make the transition from arithmetic calculations to simple algebraic ones: solve simple equations, problems with formulas, etc. The development of conceptual thinking contributes to the emergence by the end of primary school age, reflection, which, being a neoplasm of adolescence, transforms not only the cognitive activity of students, but also the nature of their relationship to other people and to themselves. nine0003

Attention deficit hyperactivity disorder (ADHD) occurs in approximately 1 in 20 children and adolescents today [2]. ADHD in children mainly manifests itself in the form of attention disorders, hyperactivity and impulsivity, which are permanent, non-situational and age-inappropriate. The impulsiveness of a teenager with ADHD is manifested in inaccurate performance of tasks with numerous errors, despite high motivation when performing a task, in restraint in words, deeds and actions [6]. The hyperactivity of such children is manifested in the following features: a reduced level of a sense of security, a tendency to aggressive behavior, increased anxiety, instability to stress, the desire to satisfy their emotions in a fantasy world. In general, they are characterized by a lower level of social maturity than happens at their age [7]. nine0003

In the younger adolescence, cognitive impairments come to the fore: lack of formation of control functions, disorders of attention and working memory. As a result, children with ADHD experience clear learning difficulties.

Domestic neuropsychology of childhood understands learning difficulties as a partial lag in the development of higher mental functions in children who are both students in a correctional class or an adapted educational program in a regular class, and children without a clinical diagnosis, but who experience persistent difficulties in one or more subjects. [eight]. nine0003

A teenager with ADHD can concentrate his attention for up to 10-15 minutes, then the child loses his ability to work and, in general, the ability to calmly wait for the end of a standardized lesson. With a low ability to concentrate their attention for a long time, the adolescent also has low scores on such attentional characteristics as switchability, distribution and stability. At the same time, attention is associated with cognitive and sensory processes, as well as the ability to qualitatively organize one's activities. In this regard, such a teenager shows a deficit of attention in the following types: sensory, intellectual, motor, voluntary and involuntary attention. These manifestations are a catalyst for learning difficulties. nine0003

Due to dysfunction of the frontal lobes, it is difficult for a teenager with ADHD to follow the rules or instructions established in the group, while such a student is unable to rationally organize his activities and, as a result, is unable to work efficiently without outside help. It is generally difficult for a teenager with ADHD to engage in types of work that require prolonged mental stress or perseverance [4]. Against the background of these problems, low self-esteem is formed.

An analysis of neuropsychological studies [5;7] indicates a tendency towards increased fatigue and exhaustion of nervous processes, and insufficient control in younger adolescents with ADHD. nine0003

General awareness and the amount of simple knowledge in such adolescents do not differ from healthy peers, in contrast to the ability to build inferences. There are also difficulties in spatial and quasi-spatial (understanding logical-grammatical structures) perception. There are low rates in visual-objective and long-term auditory-speech memory. In the field of visual-figurative thinking in children with ADHD, difficulties are noticeable in identifying the essential features of an object, in distinguishing objects within a group of the same semantic field, in updating the image by word-name and in the nominative function of speech. In voluntary movements in adolescents with ADHD, there are often violations of fine motor skills, perseveration [8]. nine0003

Among children with ADHD, there are often cases of mental retardation, which in most cases are the result of problems with attention, as well as features characteristic of ADHD: restlessness, lack of focus and impulsiveness of actions, increased excitability. As a result, ADHD is often accompanied by negative manifestations in such basic learning skills as reading, counting, writing. Thus, in younger adolescents with ADHD, there is a persistent maladaptation in schooling. nine0003

An example of the application of the technique of neuropsychological correction of a younger adolescent with attention deficit disorder and hyperactivity

Anamnestic information: Alice M., age 11 years. The family is complete, guardian. There are two brothers: older and younger. At the time of the study, 4 people live in the family: mom, dad, younger brother (7 years old) and the girl herself. The older brother is in another city, periodically visits his family. The girl was taken under guardianship at the age of 4 years, then ADHD was diagnosed. Living conditions are good, the family has its own house. The child has a private space for sleep, play activities and activities. The level of material security of the family is above average. The psychological climate in the family is favorable. nine0003

Complaints from the mother: high distractibility in the classroom, low concentration of attention, difficulties in understanding tasks in mathematics (tasks can be performed by analogy). With parental control, it makes fewer mistakes. When reading the text, he does not understand the meaning of what he read, he cannot highlight the main idea. There is a decreased sense of fear. The girl is impulsive, emotionally excitable, there are difficulties with self-control.

The study was conducted on the basis of the Psychological Center of the Pedagogical Institute of the Federal State Budgetary Educational Institution of Higher Education "Pacific State University" in Khabarovsk in three stages: nine0003

  1. History taking and primary neuropsychological diagnostics;
  2. Drawing up and carrying out corrective work based on the neuropsychological approach;
  3. Repeated neuropsychological diagnosis and analysis of results.

The choice of diagnostic methods was made on the basis of a battery of neuropsychological tests by A.R. Luria, which determines the accuracy of the neuropsychological study. Methods were selected taking into account age. nine0003

In the course of diagnostics, the girl showed difficulties in independently solving problems with several actions, and in general, difficulties were manifested in retaining instructions. Difficulties were also observed in understanding the hidden and figurative meaning. Were noted: emotional lability, impulsiveness in statements and actions.

The result of the primary diagnostic examination revealed moderate regulatory difficulties: serial organization, programming and control. Also, the lack of energy support for activities against the background of weakness in the processing of visual-spatial information and unexpressed manifestations of the type of verbal paraphasia. This picture was interpreted in favor of functional weakness of the reticulofrontal complex and insufficient formation of the frontal lobes, insufficient formation of the upper parietal-occipital areas of the brain, as well as functional immaturity of the right hemisphere and interhemispheric interaction. At the same time, the study showed a high level of mechanical memory, including auditory-speech and long-term, which is usually not typical for children with ADHD and, as a result, was used as a support during corrective work. nine0003

Based on the diagnostics, an individual neuropsychological correctional program was compiled based on the method of "Replacing ontogenesis" by A. V. Semenovich, as well as the methods of T. V. Akhutina, N. M. Pylaeva, aimed at the development and correction of cognitive functions, as well as those included in them components. Corrective work was carried out for 10 months 4 times a week. The duration of the lessons is 35-40 minutes. It included: motor correction; cognitive and educational. nine0003

Results

Comparison of the results of the primary and final diagnostics showed: an increase in the level of self-control; increase in volume, increase in concentration, stability, level of distribution of voluntary attention; removal of manifestations of impulsivity; development of interhemispheric interaction; development of intellectual abilities; the formation of abstract thinking, the ability to generalize and categorize.

In educational activities, the girl began to show perseverance, independence. Multi-action tasks are no longer difficult. The number of such errors in works on the Russian language has significantly decreased: repetitions and omissions of words and letters, omissions of punctuation marks, writing the beginning of a sentence with a small letter. Improved ability to understand hidden and figurative meaning. nine0003

Conclusion

As the results of the study show, the analysis of the strengths and weaknesses of the mental functions of the child allows you to create the most effective program for correcting the learning difficulties of a younger teenager with attention deficit hyperactivity disorder. This study will be of interest to defectologists, psychologists, neuropsychologists, as well as parents of children with ADHD.

Literature:

  1. Akhutina T. V. Neuropsychologist at school: a guide for teachers, school psychologists and parents / T. V. Akhutina, I. O. Kamardina, N. M. Pylaeva; T. V. Akhutina, I. O. Kamardina, N. M. Pylaeva. - Moscow: Sekachev V. Yu., 2012. - 46 p. nine0062
  2. Zavadenko N. N. Attention deficit hyperactivity disorder: modern principles of diagnosis and treatment / N. N. Zavadenko // Problems of modern pediatrics. - 2014. - No. 4. - S. 48–53.
  3. Pylaeva N. M. Neuropsychology and school / N. M. Pylaeva, T. V. Akhutina // Moscow University Bulletin. Series 14: Psychology. - 2012. - No. 2. - S. 116–122.
  4. Semina M. V. Problems of school education for children with attention deficit hyperactivity disorder. / M. V. Semina, A. I. Chinchikova // International scientific journal "Symbol of Science". - 2015. - No. 11. S. - 224–226. nine0062
  5. Tereshchenko EE Principles of correction of the cognitive sphere of younger adolescents with learning difficulties. / E. E. Tereshchenko // Psychology and pedagogy: methodology and problems of practical application. - 2012. - No. 7. S. - 86–89.
  6. Fotekova T. A. Dynamics of higher mental functions in younger adolescence. / T. A. Fotekova, K. A. Bogomolova // Eurasian Union of Scientists. - 2020. - No. 5. P. 10–12.
  7. Tsvetkov AV Methods of neuropsychological correction of attention deficit hyperactivity disorder. / A. V. Tsvetkov // Moscow Psychological and Social Institute. - 2010. - No. 4. S. 33-40. nine0062
  8. Shumakova N. B. Peculiarities of creativity in younger adolescence. / N. B. Shumakova // Electronic journal "Psychological and pedagogical research". - 2017. - No. 4. S. 108-117.

Basic terms (automatically generated) : younger teenager, attention deficit disorder, difficulty, neuropsychological correction, teenager, child, correctional work, high level, domestic neuropsychology, figurative meaning.

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178. Medical Academy. I. M. Sechenova QUESTIONNAIRE FOR PARENTS

179. Name of the child age school (daycare center)

180. Think about your child before he or she came to school. What he was like at the age of 6-7 years, and what he has become over the past six months. Did

181. Have any of the following features observed in your child?

182. When answering the questions, please circle the appropriate number).

183. Behavioral features of a child under 7 years of age for the last six months

184. Fussy movements of arms and legs, or squirming while sitting on a chair (adolescents may have a subjective feeling of impatience). 1-yes, 0-no 1-yes, 0-no

185. Remains in a chair with difficulty when performing any tasks. 1-yes 0 no 1-yes, 0-no

186. Z. Easily distracted by extraneous stimuli. 1-yes, 0-no 1-yes, 0-no

187. Has difficulty waiting in line to join the game. 1-yes, 0-no 1-yes, 0-no

188. Answers questions without thinking and before the question is finished. 1-yes, 0-no 1-yes, 0-no

189. Has difficulty following instructions from others. 1-yes, 0-no 1-yes, 0-no

190. With difficulty keeps attention when performing tasks or in game situations. 1-yes, 0-no 1-yes, 0-no

191. Often switches from one unfinished business to another. 1-yes, 0-no 1-yes, 0-no

192. Restless during play. 1-yes, 0-no 1-yes, 0-no

193. Y. Often overly talkative. 1-yes, 0-no 1-yes, 0-no11. In a conversation, he often interrupts, imposes his opinion, in games he is often a "target". 1-yes, 0-no 1-yes, 0-no

194. Often the chr does not seem to hear what is said to HIM or HER. 1-yes, 0-no 1-yes, 0-no

195. Often loses items and things necessary for work at home or in the classroom (toys, pencils, books, etc.) 1-yes, 0-no 1- yes, 0-no

196. Ignores physical danger and possible consequences (eg, running down the street without looking back). 1-yes, 0-no 1-yes, 0-no

197. Information will not be disclosed.

198. Medical Academy. IM Sechenova QUESTIONNAIRE for the teacher's assessment of the characteristics of the child's behavior at school school class

199.


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