Working Memory and Skill Acquisition in Childhood ADHD

描述（由申请人提供）：儿童注意力缺陷多动障碍（ADHD）是转诊到医疗，心理和学校服务的最常见原因之一。即使没有共病的学习障碍，ADHD儿童也有很高的学习成绩不佳的风险。青少年和成人结果研究表明，有注意力问题的儿童不仅更有可能获得特殊教育服务和辅导，而且高中辍学率更高，职业地位更低。因此，确定ADHD儿童的学习过程如何进行，以及哪些神经心理因素可能影响技能获得，对理论发展和临床应用至关重要。这项拟议的研究将探讨工作记忆在儿童复杂的认知和感觉运动技能的发展中发挥的作用，合并（ADHD-C）和主要注意力不集中（ADHD-I）亚型的ADHD。当地社区的儿童将从学校、报纸广告和散发的传单中招募。为了获得尽可能广泛的代表性样本，他们还将从当地的儿科，心理和精神病诊所招募。ADHD和合并症的诊断将根据DSM-IV标准进行，并将基于家长/教师问卷以及对家长进行的结构化访谈。孩子们将完成计算机生成的任务，这些任务旨在测量技能获得的过程，沿着标准的神经心理学测量工作记忆、学业成绩和认知功能。提出的认知神经科学方法来理解ADHD有可能更好地告知ADHD亚型的机制模型。具体来说，这种方法将有助于确定是否以及如何建立神经心理缺陷（即工作记忆缺陷）可能会直接影响学习过程，从而导致学业成绩不佳。如果这一过程能够被阐明，这些发现最终可能会导致更好的学术补救计划和治疗的发展。

DESCRIPTION (provided by applicant): Childhood Attention Deficit Hyperactivity Disorder (ADHD) is among the most common reasons for referral to medical, psychological, and school services. Even in the absence of co-morbid learning disabilities, children with ADHD are at high risk for academic underachievement. Adolescent and adult outcome studies indicate that children with attention problems are not only more likely to access special education services and tutoring, but also have a higher high school drop-out rate and lower occupational status. Therefore, determining how the learning process proceeds in children with ADHD, and what neuropsychological factors may impact skill acquisition, is crucial to both theory development and clinical application. The proposed study will examine the role working memory plays in the development of complex cognitive and sensorimotor skills in children with the combined (ADHD-C) and primarily inattentive (ADHD-I) subtypes of ADHD. Children from the local community will be recruited from schools, newspaper ads, and distributed flyers. To obtain as broadly a representative sample as possible, they will also be recruited from local pediatric, psychological, and psychiatric clinics. ADHD and co-morbid diagnoses will be made according to DSM-IV criteria and will be based on parent/teacher questionnaires as well as a structured interview administered to parents. Children will complete computer-generated tasks designed to measure the process of skill acquisition, along with standard neuropsychological measures of working memory, academic achievement, and cognitive functioning. The proposed cognitive neuroscience approach to understanding ADHD has the potential to better inform a mechanistic model of ADHD subtypes. Specifically, this approach will help identify whether and how established neuropsychological deficits (namely, deficits in working memory) may directly impact the process of learning, and thus lead to academic underachievement. If this process can be illuminated, such findings may eventually lead to the development of better academic remedial programs and treatments.