Hood, J.; (2008) An exploratory study of developmental confabulation in children. Doctoral thesis , University of London.

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Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder estimated to affect approximately 5 percent of the population, although prevalence studies can vary between 3 to 12 percent of the paediatric population. There is a significant literature reporting that ADHD has significant implications for children, their families, and health and education systems. Difficulties with challenging behaviour, learning, academic achievement and psychosocial functioning are commonly reported in children who have a diagnosis of ADHD and stimulant medication is the routinely recommended treatment. However, despite the documented behavioural and learning difficulties reported in this population, there has been little attempt to examine these children from a neuropsychological perspective in which detailed objective cognitive assessments are performed and with confounding variables controlled for by assessing children from similar social backgrounds, with comparable levels of intellectual functioning, comparable ages and gender, but without ADHD diagnoses. Such a perspective would significantly inform our understanding of the underlying cognitive attention deficits associated with children who have ADHD and provide a means of reliably measuring the effectiveness of stimulant medication. This assignment describes ADHD in terms of the criteria and process by which the diagnosis is made. The behavioural and educational challenges that children with ADHD commonly present to educational and health professionals are discussed. Psychological models of cognitive attention are outlined in order to consider specific attention deficits that might underlie the behavioural and attentional problems shown in children who have a diagnosis of ADHD. Neuropsychological methods of assessing cognitive attention are illustrated with particular reference to the Test of Everyday Attention for Children (TEA-Ch - Manly et al., 2001) and the application of such measures with this group of children are discussed. The use of stimulant medication for the treatment of ADHD is discussed in terms of its effectiveness in the management of behavioural difficulties. A controlled trial is described to evaluate the effectiveness of stimulant medication on cognitive attention in which 15 children with a diagnosis of ADHD performed a neuropsychological assessment before and after they were administered stimulant medication. To control for possible confounding variables, 16 children without diagnoses of ADHD were matched on age, gender, social background and intellectual functioning and were administered the neuropsychological assessments at similar time points to the ADHD group to control for possible practice effects of same day testing. This investigation reports significant improvement in many aspects of cognitive attention for children with ADHD compared to controls when stimulant medication was administered. The implications for diagnosis, management and educational support of children who may have ADHD are discussed, particularly in terms of the possible role for educational psychologists when working with this significant percentage of the paediatric population.

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