Sarver Dustin E, Rapport Mark D, Kofler Michael J, Raiker Joseph S, Friedman Lauren M
Center for Advancement of Youth, Department of Pediatrics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA,
J Abnorm Child Psychol. 2015 Oct;43(7):1219-32. doi: 10.1007/s10802-015-0011-1.
Excess gross motor activity (hyperactivity) is considered a core diagnostic feature of childhood ADHD that impedes learning. This view has been challenged, however, by recent models that conceptualize excess motor activity as a compensatory mechanism that facilitates neurocognitive functioning in children with ADHD. The current study investigated competing model predictions regarding activity level's relation with working memory (WM) performance and attention in boys aged 8-12 years (M = 9.64, SD = 1.26) with ADHD (n = 29) and typically developing children (TD; n = 23). Children's phonological WM and attentive behavior were objectively assessed during four counterbalanced WM tasks administered across four separate sessions. These data were then sequenced hierarchically based on behavioral observations of each child's gross motor activity during each task. Analysis of the relations among intra-individual changes in observed activity level, attention, and performance revealed that higher rates of activity level predicted significantly better, but not normalized WM performance for children with ADHD. Conversely, higher rates of activity level predicted somewhat lower WM performance for TD children. Variations in movement did not predict changes in attention for either group. At the individual level, children with ADHD and TD children were more likely to be classified as reliably Improved and Deteriorated, respectively, when comparing their WM performance at their highest versus lowest observed activity level. These findings appear most consistent with models ascribing a functional role to hyperactivity in ADHD, with implications for selecting behavioral treatment targets to avoid overcorrecting gross motor activity during academic tasks that rely on phonological WM.
过度的大肌肉活动（多动）被认为是儿童注意力缺陷多动障碍（ADHD）的一个核心诊断特征，它会妨碍学习。然而，最近的模型对这一观点提出了挑战，这些模型将过度的运动活动概念化为一种补偿机制，有助于ADHD儿童的神经认知功能。本研究调查了关于8至12岁男孩（M = 9.64，SD = 1.26）的活动水平与工作记忆（WM）表现及注意力之间关系的相互竞争的模型预测，这些男孩患有ADHD（n = 29）以及发育正常的儿童（TD；n = 23）。在四个单独的会话中进行的四个平衡的WM任务期间，客观评估了儿童的语音WM和注意力行为。然后根据每个孩子在每个任务期间的大肌肉活动的行为观察，对这些数据进行分层排序。对观察到的活动水平、注意力和表现的个体内部变化之间的关系分析表明，活动水平较高预示着ADHD儿童的WM表现显著更好，但未达到正常水平。相反，活动水平较高预示着TD儿童的WM表现略低。两组儿童的运动变化均未预测注意力的变化。在个体水平上，将ADHD儿童和TD儿童在观察到的最高与最低活动水平下的WM表现进行比较时，ADHD儿童和TD儿童分别更有可能被可靠地分类为改善和恶化。这些发现似乎最符合将多动在ADHD中归因于功能作用的模型，这对于选择行为治疗目标具有启示意义，以避免在依赖语音WM的学术任务中过度纠正大肌肉活动。
