Although it is widely known that high intra-individual variability (IIV) is a key characteristic of attention deficit/hyperactivity disorder (ADHD), a detailed exploration of the IIV pattern during the time course of a cognitive task has never been carried out. In this study, 30 children with ADHD and 30 controls, were administered the Conners’ Continuous Performance Task (CPT-II). The across-block individual performance of the groups was analyzed using an ex-Gaussian approach, which enabled a clearer understanding of how individual response times (RTs) fluctuate during a task in comparison with conventional measures of central tendency. While the conventional measures showed a significant group effect on mean RTs but similar RT trends across blocks between the two groups, the ex-Gaussian results revealed no actual differences between the two groups in the normally distributed component of mean RTs (mu). In contrast to the control group, the children with ADHD showed a steep increase in the exponentially distributed component of RTs (tau) across blocks, thereby indicating that extremely long RTs progressively increased soon after the beginning of the task. Taken together, the results demonstrated that sustained attention deficit in ADHD can be detected by analyzing the IIV in the first few task blocks. (JINS, 2013, 19, 1–9)

Recent studies suggest that children with different etiologies of attention disorder also differ as to the types of errors they make on attention tasks. Because these errors are reflective of the core deficits underlying their attention problems, we sought to compare error patterns in children with different attention disorders. Studied were 144 children aged 7–12 years, 43 with attention deficit hyperactivity disorder (ADHD), 35 with congenital hypothyroidism (CH), and 68 controls. Two variations of the continuous performance task (CPT) that differed in demands on inhibitory control and memory were used. One variation, the CPT:A-not-X task, required subjects to observe a continuous stream of letters shown at different rates on the computer screen and respond to all stimuli except “X”. The other variation, the CPT:AX task, required them to respond whenever a specified combination of letter such as “A” followed by “X” appeared on the screen. On the CPT:A-not-X task, children with ADHD differed from controls in commission errors, signifying difficulty with inhibitory control, whereas children with CH differed in perceptual sensitivity or signal detection. Although the CH and ADHD groups both performed more poorly than controls on the CPT:AX task, children with CH made more errors to the first stimulus item, suggesting a problem holding information in memory, whereas children with ADHD made more errors to the second item, suggesting impulsivity. These results therefore signify the utility of these tasks in identifying the different mechanisms underlying the specific attention deficits of different groups of children.

Little is known about the effects of environmental enrichment on psychophysiological measures of arousal and orienting in humans. This study tests the hypothesis that early educational and health enrichment is associated with long-term increases in psychophysiological orienting and arousal. One hundred children were experimentally assigned to a two-year enriched nursery school intervention at ages 3–5 years and matched at age 3 years on psychophysiological measures, gender, and ethnicity to 100 comparisons who received the normal educational experience. Children were retested 6–8 years later at age 11 years on skin conductance (SC) and electroencephalogram (EEG) measures of arousal and attention during pre- and postexperimental rest periods and during the continuous performance task. Nursery enrichment was associated with increased SC amplitudes, faster SC rise times, faster SC recovery times, and less slow-wave EEG during both rest and CPT conditions. This is believed to be the first study to show that early environmental enrichment is associated with long-term increases in psychophysiological orienting and arousal in humans. Results draw attention to the important influence of the early environment in shaping later psychophysiological functioning.

Nine children meeting DSM-III-R criteria for Attention Deficit Hyperactivity Disorder (ADHD) and eighteen normal children participated in this study. A screening assessment revealed significantly more behavioural and academic problems in the ADHD group. Subjects performed a low demand visual vigilance task (the reference task) and the AX version of the continuous perfonnance task (CPT), while the steady-state visually evoked potential (SSVEP) was continuously recorded from 64 scalp electrode sites. The topography of the SSVEP amplitude difference between the reference and AX tasks was examined. In the 3.5 second interval between the appearances of the “A” and the “X” normal children showed transient reductions in right prefrontal SSVEP amplitude and a sustained reduction in right parieto-occipital SSVEP amplitude. These reductions in SSVEP amplitude were not seen in ADHD subjects. These results suggest that the presentation of a priming stimulus is associated with increased activation of right prefrontal and parieto-occipital regions in normal children, whereas the absence of this pattern of activation suggests a deficit in these processes in ADHD.