Article

Inattention/Overactivity Following Early Severe Institutional Deprivation: Presentation and Associations in Early Adolescence

Developmental Brain-Behaviour Unit, School of Psychology, University of Southampton, Southampton, UK.
Journal of Abnormal Child Psychology (Impact Factor: 3.48). 05/2008; 36(3):385-98. DOI: 10.1007/s10802-007-9185-5
Source: PubMed

ABSTRACT

The current study examined the persistence and phenotypic presentation of inattention/overactivity (I/O) into early adolescence, in a sample of institution reared (IR) children adopted from Romania before the age of 43 months. Total sample comprised 144 IR and 21 non-IR Romanian adoptees, and a comparison group of 52 within-UK adoptees, assessed at ages 6 and 11 years. I/O was rated using Rutter Scales completed by parents and teachers. I/O continued to be strongly associated with institutional deprivation, with continuities between ages 6 and 11 outcomes. There were higher rates of deprivation-related I/O in boys than girls, and I/O was strongly associated with conduct problems, disinhibited attachment and executive function but not IQ more generally, independently of gender. Deprivation-related I/O shares many common features with ADHD, despite its different etiology and putative developmental mechanisms. I/O is a persistent domain of impairment following early institutional deprivation of 6 months or more, suggesting there may be a possible pathway to impairment through some form of neuro-developmental programming during critical periods of early development.

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Available from: Emma Colvert, Mar 18, 2015
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    • "We explore this hypothesis in the current report. The possibility of an early neurodevelopmental mechanism linking environmental experience to ADHD (Taylor & Rogers, 2005; Stevens et al. 2008) is suggested by studies linking other types of early adverse environments other than institutionalization to ADHD (Biederman et al. 1995; McLaughlin et al. 2010b). Deficits in EF have also been observed in children exposed to various adverse conditions, such as maltreatment (Pears et al. 2010) and witnessing domestic violence (DePrince et al. 2009). "
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    ABSTRACT: Background: Young children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD. Method: A sample of 136 children (aged 6-30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners' offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity. Results: Children with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years. Conclusions: Institutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.
    Full-text · Article · Oct 2015 · Psychological Medicine
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    • "Moreover, EF deficits have been regularly reported in children with cerebral damage consecutive to medical conditions such as phenylketonuria and sickle cell disease (Azadi, Seddigh, Tehrani-Doost, Alaghband-Rad, & Ashrafi, 2009; Kral, Brown, & Hynd, 2001), traumatic brain injury (Levin & Hanten, 2005), and prenatal exposure to teratogenic agents (Rasmussen, 2005). EF weaknesses have also been reported in children subjected to severe adverse environmental conditions such as early care deprivation (Stevens et al., 2008). "
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    ABSTRACT: Whereas studies of the past 10years have shown the executive functions (EFs) in adults to be differentiated into at least three principal components (working memory, inhibition, and flexibility), EF structure in children is far less well understood despite a large body of research on the subject. A study was undertaken to test different structural models of EFs through confirmatory factor analysis (CFA) on a large sample of typically developing kindergarteners (N=272). The method employed sought to remedy the shortcomings of past research in this field such as absence of CFA, insufficient number of EF components tested, insufficient number of indicators per latent variable, and absence of control on processing speed. Children were assessed using a battery of EF tasks developed by the researchers to measure working memory (WM), flexibility, and inhibition (backward word span, backward block span, fruit Stroop, day-night test, hand Stroop, Trails-P, card sort, face sort, and verbal fluency shift). CFA results show the best-fitting model to comprise two factors, namely, an inhibition factor and a WM-flexibility factor. Invariance analyses suggest that this structure is the same for girls and boys and that latent variable means do not differ by sex. These results support the hypothesis of EF differentiation during development. The researchers formulate other hypotheses regarding neurophysiological development. Copyright © 2015 Elsevier Inc. All rights reserved.
    Full-text · Article · Aug 2015 · Journal of Experimental Child Psychology
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    • "EF deficits have been regularly reported in children with cerebral damage consecutive to medical conditions such as phenylketonuria and sickle cell disease (Azadi, Seddigh, Tehrani-Doost, Alaghband-Rad, & Ashrafi, 2009; Kral, Brown, & Hynd, 2001), traumatic brain injury (Levin & Hanten, 2005), or prenatal exposure to teratogenic agents (Rasmussen, 2005). EF weaknesses have also been reported in children who suffered from severe adverse environmental conditions such as early care deprivation (Stevens et al., 2008). EF deficits have been documented in some neurodevelopmental disorders (Kenworthy, Yerys, Anthony, & Wallace, 2008; Pennington & Ozonoff, 1996), including autism spectrum disorders, Tourette syndrome, and attention-deficit/hyperactivity disorder (ADHD). "
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    ABSTRACT: Executive function (EF) deficits have yet to be demonstrated convincingly in children with disruptive behaviour disorders (DBD), as only a few studies have reported these. The presence of EF weaknesses in children with DBD has often been contested on account of the high comorbidity between DBD and attention-deficit/hyperactivity disorder (ADHD) and of methodological shortcomings regarding EF measures. Against this background, the link between EF and disruptive behaviours in kindergarteners was investigated using a carefully selected battery of EF measures. Three groups of kindergarteners were compared: (1) a group combining high levels of disruptive behaviours and ADHD symptoms (COMB); (2) a group presenting high levels of disruptive/aggressive behaviours and low levels of ADHD symptoms (AGG); and (3) a normative group (NOR). Children in the COMB and AGG groups presented weaker inhibition capacities compared with normative peers. Also, only the COMB group showed weaker working memory capacities compared with the NOR group. Results support the idea that preschool children with DBD have weaker inhibition capacities and that this weakness could be common to both ADHD and DBD. © 2015 The British Psychological Society.
    Full-text · Article · Jul 2015 · British Journal of Developmental Psychology
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