Social and Academic Problems in ADHD: The Role of Implicit and Explicit Learning

ADHD 中的社会和学术问题：内隐和外显学习的作用

基本信息

批准号：
8247134
负责人：
CYNTHIA L HUANG-POLLOCK
金额：
$ 35.86万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2015-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8247134
关键词：
Academic achievement Accounting Address Adopted Attention deficit hyperactivity disorder Basal Ganglia Belief Child Childhood Chronic Cognitive Cognitive remediation Complex Corpus striatum structure DSM-IV Development Educational Intervention Exclusion Face Goals Group Processes Impairment Individual Individual Differences Intervention Joints Learning Mediating Modeling Neurosciences Occupational Status Outcome Performance Process Program Development Psychosocial Assessment and Care Research Risk Factors Role Self-control as a personality trait Services Shapes Short-Term Memory Social Adjustment Social Behavior Social Problems Socioeconomic Status Specific qualifier value Speed Structure Substance abuse problem System Testing Training Underachievement Ursidae Family Work aged cognitive neuroscience design disorder control executive function improved innovation intervention program meetings peer prefrontal lobe processing speed programs psychoeducational psychosocial public health relevance remediation skill acquisition skills social social skills theories

项目摘要

DESCRIPTION (provided by applicant): The planned study is to improve the field's understanding of the cognitive and learning processes that shape two of the most chronic real world impairments seen in children with ADHD: social performance deficits and academic underachievement. Prior work has established that ADHD-related weaknesses in working memory (WM) directly impacts the ability of children with ADHD to explicitly acquire a cognitive skill, of which academic achievement would be but one example. Such work is relevant to a promising new direction in ADHD intervention which adopts a cognitive remediation approach to treatment. Initial findings from these cutting edge programs are encouraging; however, most target "executive functions" (EF) which are both poorly specified and non-unitary as individual constructs and as a collective group of processes. Results from the current application have the potential to answer the growing call to integrate neuroscience into educational and intervention programs by guiding the development of these programs through the identification of more specific/efficient cognitive target(s) for remediation. The first aim of the present study therefore asks whether slow speed of processing accounts for ADHD-related deficits in WM as well as the poor acquisition of explicit cognitive skills, which in turn would predict chronic academic underachievement. If this proves to be the case, then psychotherapeutic and pharmacologic interventions should target processing speed (as opposed to the more molar EF process), which would have positive downstream implications for a number of higher order executive processes, including but not limited to WM. Another potential rate limiting step to the development of innovative treatments, is that the examination of EFs has largely dominated research in the cognitive neuroscience of childhood ADHD, to the exclusion of other promising cognitive mechanisms. The second and third aims thus examine whether the implicit learning system, a learning system largely independent of EF, but dependent upon neuroanatomical structures implicated in ADHD (i.e. basal ganglia and striatum) and responsible for learning complex nonverbal rules used in directing social behavior, is (a) intact in children with ADHD, and (b) can predict social performance deficits in ADHD. Despite the availability of a number of empirically supported psychosocial treatments for ADHD, none have demonstrated long term benefits in the normalization of peer status or academic achievement. To meet these goals, we have adopted an SEM approach to systematically examine the potential conjoint contributions of EFs, speeded performance, and explicit/implicit learning processes on social and academic performance in children aged 8-12 with and without DSM-IV ADHD.The void in our basic understanding of skill acquisition processes in ADHD, combined with a need to improve our existing psychosocial and academic remediation programs, argues for a comprehensive study of explicit and implicit learning in ADHD, and of the cognitive processes that contribute to the acquisition of skill. PUBLIC HEALTH RELEVANCE: The goal of this study is to better understand the cognitive and learning processes that contribute to two of the most common, co-occurring, and chronic impairments seen in children with ADHD: social maladjustment and academic underachievement. Both are significant risk factors for a host of negative outcomes including delinquency, substance abuse, as well as lower occupational and socioeconomic status. The void in our basic understanding of skill acquisition processes in ADHD, combined with a need to improve our existing psychosocial and academic remediation programs, argues for a comprehensive study of learning in ADHD, and of the cognitive processes that contribute to the acquisition of skill.

描述（由申请人提供）：计划中的研究旨在提高该领域对认知和学习过程的理解，这些过程形成了 ADHD 儿童在现实世界中最常见的两种障碍：社交表现缺陷和学业成绩不佳。先前的研究已经证实，与 ADHD 相关的工作记忆 (WM) 缺陷会直接影响 ADHD 儿童明确获得认知技能的能力，其中学业成绩只是一个例子。此类工作与 ADHD 干预的一个有希望的新方向相关，即采用认知补救方法进行治疗。这些前沿项目的初步结果令人鼓舞；然而，大多数目标都是“执行职能”（EF），这些职能既不明确，又不统一，无论是作为单独的构造还是作为过程的集体组。当前应用的结果有可能满足日益增长的将神经科学融入教育和干预项目的呼声，通过识别更具体/更有效的认知目标来指导这些项目的开发以进行补救。因此，本研究的第一个目标是询问处理速度慢是否会导致 WM 中与 ADHD 相关的缺陷以及外显认知技能的获取不良，而这反过来又会导致长期学业成绩不佳。如果事实证明是这样，那么心理治疗和药物干预应该以处理速度为目标（而不是更多摩尔的 EF 过程），这将对许多更高阶执行过程（包括但不限于 WM）产生积极的下游影响。创新疗法开发的另一个潜在限制步骤是，对 EF 的检查在很大程度上主导了儿童多动症认知神经科学研究，而排除了其他有希望的认知机制。因此，第二个和第三个目标检查内隐学习系统是否是一个很大程度上独立于 EF 的学习系统，但依赖于 ADHD 涉及的神经解剖结构（即基底神经节和纹状体）并负责学习用于指导社会行为的复杂非语言规则。 (a) 患有多动症的儿童完好无损，(b) 可以预测多动症儿童的社交表现缺陷。尽管有许多经经验支持的多动症心理社会治疗方法，但没有一种方法能够显示出对同伴地位或学业成绩正常化的长期益处。为了实现这些目标，我们采用了 SEM 方法来系统地研究 EF、加速表现以及显性/隐性学习过程对患有和不患有 DSM-IV ADHD 的 8-12 岁儿童的社会和学业表现的潜在联合贡献。我们对 ADHD 技能获取过程的基本理解存在空白，再加上改进我们现有的社会心理和学术补救计划的需要，主张对 ADHD 的外显和内隐学习以及有助于形成多动症的认知过程进行全面研究。技能的获得。公共健康相关性：本研究的目的是更好地了解认知和学习过程，这些过程导致多动症儿童中最常见、同时发生和慢性的损害：社会适应不良和学业成绩不佳。两者都是导致一系列负面结果的重要风险因素，包括犯罪、药物滥用以及较低的职业和社会经济地位。我们对多动症技能习得过程的基本理解存在空白，再加上改进我们现有的社会心理和学术补救计划的需要，因此需要对多动症的学习以及有助于习得技能的认知过程进行全面研究。