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Controversy exists about the safety of soy formula, with the main concern relating to potential estrogenic effects of soy protein. Since estrogens influence early brain development, we compared behavioral development and cortical responses (event-related potentials; ERPs) to speech sounds in infants fed either breast milk or formula (milk- or soy-based). Across-groups ERP measures were generally similar and behavioral measures were within normal ranges, suggesting no important influences of soy formula on behavioral development and brain function during the study period. Analyses relating ERP and behavioral measures revealed diet- and gender-specific emphases that may reflect differences in developmental trajectories of brain-behavior relationships.

This investigation evaluated variations in resting heart rate (HR) measures during the first half year of life in healthy, full-term infants who were either breast-fed (BF), or fed formula with (milk-based: MF; soy-based: SF) or without (soy-based: SF(-)) commercially supplemented DHA (decosahexaenoic acid). In infants fed the DHA-deficient diet, higher HR and lower values for heart rate variability measures were observed, indicating decreased parasympathetic tone in this group. These effects, appearing at 4 months and continuing for the remainder of the study period, are consistent with suggestions that the 3-5-month postnatal interval may be an important period in the development of cardiovascular regulation. The absence of these effects in SF infants receiving the DHA-supplemented formula suggests that neither soy protein nor the associated phytochemicals in soy formula contribute to these effects to any appreciable extent. In general, the results do not indicate differences in any of the study variables attributable to soy formula per se.

The purpose of this investigation was to determine if processing of language stimuli during the first half year of life in breast-fed infants differs from that of formula-fed infants. This question was addressed by examining the brain event-related potentials of healthy infants receiving breast milk (n = 15) or milk-based formula (n = 18) recorded in response to consonant vowel syllables presented in an oddball paradigm. The same infants were studied when they were 3-months and 6-months-old. The two groups were comparable on several measures relating to biological and home environment variables previously reported to influence development, including gestation period, birth weight, mother's IQ, and family socioeconomic status, and did not differ in weight or mental or motor development at the times of the visits. In general, ERP response features previously documented in studies of syllable processing in 3-6-month-old infants were observed in this study, including positive components at asymptotically equal to 190 msec (P1), asymptotically equal to 370 msec (P2), and asymptotically equal to 600 msec (P600), and negative components at asymptotically equal to 250 msec (N250), asymptotically equal to 450 msec (N450), and a late, negative going slow wave between 655 and 995 msec (LSW). For both groups there were instances where specific components were either poorly defined, e.g., P1 and N250 to the infrequent syllable at 3 months, N450 and P600 to this syllable at both ages, or not present in many infants, e.g., the P600 to the frequent syllable at 6 months. These variations appeared to be related to individual differences in development or paradigm-related features, i.e., ISI and frequency of syllable occurrence.

To investigate whether growth status in infants and toddlers affects processes involved in speech perception and discrimination, cortical event-related potentials (ERPs) to consonant-vowel syllables were recorded from 48 healthy babies: 26 low in growth status (LGS, < 25 th percentile in growth measures) and from 22 normal in growth status (NGS, 25t--75 th percentile in growth measures). Food records indicated no significant differences in the amounts of various nutrients consumed in the two groups, but LGS babies consumed slightly more of most nutrients than NGS babies. In response to speech stimuli (either /pa/ or /ba/ presented with 20 and 80% randomized occurrence), brain ERPs showed two prominent post-stimulus components: a large positive wave peaking at about 484 msec and a negative but positive going slow wave (SW) between 867 and 1199 msec. Principal components analysis followed by promax rotation revealed four additional important components. Maximum peak and latency values-for these components showed that NGS and LGS babies differed from one another on all measures in either amplitude, latency, or both. Comparing the two groups of babies, only the LGS group demonstrated a deficit in the phonetic discrimination of speech sounds. The growth deficiencies of the LGS group could not be attributed to the lack of an adequate diet. These negative findings are present in babies generally considered to be healthy (lowest 10-25% in growth measures). This underscores the need for research examining in more detail the relationship between growth status and cognitive growth.

The cardiovascular response in children to morning nutrition has received little attention, and associated gender-related effects are virtually uninvestigated. This study evaluated resting heart-rate (HR) and heart-rate variability (HRV) in preadolescents after overnight fasting and again after eating a standardized breakfast or continuing to fast. HR increased slightly after eating and decreased significantly with continued fasting. These effects were present for both sexes. Relative to children who ate, those who continued fasting showed increases in HRV-particularly for inter-beat-interval and low frequency component (LF: 0.04-0.15 Hz) measures. Analyses revealed significant increases across variability measures for fasting children, but a selective LF decrease in those who were fed-an effect most prominent in females. Otherwise, males and females showed similar treatment-related changes in HRV. While within-gender comparisons showed similar results for HR, i.e., faster HR in fed compared with fasting males and females, respectively, fasting females-but not males-showed significantly greater increases in variability relative to their fed counterparts. Together, these findings suggest that extended overnight fasting initiates an increase in parasympathetic activity that attenuates the expected increase in cardiovascular output following a mid-morning meal. Observed gender differences were related to greater parasympathetic activity in males and to the apparent emphasis on parasympathetic regulation of LF variability. The implications of these findings for health concerns, the nature of responses to physiological and cognitive stressors, and how such differences may influence performance variables-particularly early in development when cardiovascular responses to these stressors may be more sensitive to nutritional factors-are discussed.

Glucose is a major energy source for the brain, and along with several monosaccharide derivatives as components of brain gangliosides, they play important roles in neurologic function. However, there is little information available on the role of glucose and other monosaccharides on resting brain activity. This study was designed to evaluate the effects of a single dose of a carbohydrate supplement containing glucose and several of its derivatives on resting brain activity in 20 healthy male college students. The supplement provided an insignificant amount of carbohydrate (3.9 g), protein (0.28 g), fat (0 g), and calories (14 kcal). The amount of glucose in the supplement was 0.5 g (1% the amount of glucose used in adult studies of cognitive functioning and memory). We hypothesized that the glyconutrient supplement would enhance brain activity associated with alertness and attention. The study design was double blind, with subjects randomly assigned to one of two orders, either carbohydrate supplement week one followed by placebo a week later, or the opposite. Electrical brain activity was monitored by 15 electrodes positioned at nine standard international 10-20 system locations, including three bilateral pairs at frontal, parietal, and occipital sites. Thirty minutes following ingestion of a placebo or carbohydrate supplement drink, EEG activity was recorded for 10-mins while subjects focused on a stationary visual target. Spectral power of resting brain activity was computed and analyzed contrasting the placebo and supplement groups. Relative to placebo, the carbohydrate supplement significantly enhanced power in three brain wave frequencies (theta, alpha, and beta) that are known to be associated with attention and arousal. Since changes were observed in the supplement but not placebo group, our study suggests that additional sugars in the glyconutritional supplement facilitate enhancement of brain electrical activity. Whether the apparent enhancement of arousal in baseline recordings is associated with improved task performance remains to be determined.

To compare subjective parental perceptions of short-term diabetes control with objective glycated hemoglobin (HbA1c) measurements in a pediatric population.Parents of 159 children and adolescents with type 1 diabetes anonymously completed a questionnaire concerning demographics, parental perception of the child's recent glycemic control, concern about nocturnal blood glucose levels, and factors related to severity of the child's diabetes. Nonparametric correlations were performed among all variables and the child's current HbA1c measurement. Good short-term glycemic control was defined as an HbA1c value ofor = 8.5%.Five factors were found to correlate significantly with good glycemic control, and these variables were subjected to a logistic regression analysis. With use of a cutoff value of 0.58, results explained 26% of the variance and had an overall 71% correct classification rate. Children with good glycemic control were younger, had a shorter duration of diabetes, lived in families with higher socioeconomic status, were less likely to experience hospitalizations due to their diabetes, and had parents who "always worried" about nocturnal blood glucose variations. Parental perception and HbA1c values were not significantly related (P0.19); 60% of the parents correctly perceived the status of diabetes in their children, and 40% misperceived the level of glycemic control. Further analysis suggested that accuracy of parental perception was highly dependent on the child's level of glycemic control. Parents whose children had lower HbA1c values (or = 7.5%) correctly perceived the status of blood glucose control in their children, whereas parents whose children had poorer glycemic control (HbA1cor = 9.5%) had inaccurate perceptions.Subjective parental perceptions of diabetes control in their children may not correspond to objective assessments. Our findings suggest a need for more educational feedback concerning HbA1c levels and recommended goals for glycemic control.

The double-deficit theory of reading disability (Wolf & Bowers, 1999) was examined in a sample of 56 reading-disabled and 45 normal-reading elementary school children (aged 8 to 11). As hypothesized, the two groups differed markedly on all phonological analysis tasks and on rapid continuous naming of digits and letters (the double deficits), but they differed as well on orthographic tasks, attention ratings, arithmetic achievement, and all WISC-III factors except perceptual organization. Within the reading-disabled (RD) sample, children in the double-deficit subgroup were no more impaired in reading and spelling than those with a single deficit in phonological analysis, and those with a single deficit in rapid naming were no more impaired than those with neither deficit. Multiple regression analyses suggest that a multiple causality theory of RD is more plausible than a double-deficit theory.

Parental fears concerning seizure occurrence may be associated with behavioral changes within the home environment. One possible change involves sleeping arrangements. Questionnaires concerning demographics, medical history, and sleeping arrangements were completed by parents of 179 children with epilepsy and by parents of 155 children with diabetes for comparison purposes. Based on parental response, 40 (22%) children with epilepsy changed to less independent sleeping arrangements. Logistic regression suggested that parental concern over seizure occurrence was highly associated with this change (p=&lt0.001). In contrast, 13 (8%) of the children with diabetes changed to a less independent sleep pattern. Results suggest changes in sleeping arrangements may alert the pediatrician to possible parental anxiety that may need to be addressed.

Elementary and junior high school children (n = 13), who were diagnosed with nonorganic failure to thrive (FTT) as infants and toddlers, were compared with a normal control group (n = 14) on visual event-related potentials (ERPs) elicited during a primed lexical decision task. Positive stimuli were real words that were identical to the priming stimuli; negative stimuli were nonpronounceable letter strings. Although the groups did not differ in word-list reading level, the former FTT group had slower reaction (decision) times and did not show ERP evidence of priming in the N400 epoch. Anterior sites yielded better separation of the real words and letter strings than posterior sites. A late anterior component between 500 msec to 650 msec poststimulus onset showed the largest condition effect for both groups. The control group had a larger negative going late anterior component to words than the FTT group. The combined reaction time and ERP findings point to less automatized word recognition in the FTT group.

A sustained heart rate (HR) deceleration, elicited by low-intensity stimulation, is considered part of Sokolov’s generalized orienting reflex and is a useful measure of information processing in nonverbal subjects. This study was undertaken to investigate developmental changes in the perinatal period in information processing during quiet sleep (QS). Twenty-six infants were tested as fetuses at 36–40 weeks and again as neonates at a postnatal age of 2 weeks. Quiet sleep was defined in the same way for fetuses and neonates, and the same airborne sound was used for fetal and neonatal testing. We found that stimulation elicited a sustained, monophasic HR deceleration in the majority of fetuses. However, the response was more heterogenous when these infants were tested after birth, with approximately half the 2-week-old infants exhibiting a prolonged HR deceleration and half exhibiting a HR acceleration. These data provide evidence that a developmental change may occur, between the prenatal and postnatal periods, in information processing during QS.

Results from comprehensive neuropsychological assessments of children diagnosed with epilepsy have rarely been reported. Previous research has generally focused on the measurement of overall intellectual ability and achievement skills. In the present study, neuropsychological evaluations including memory, attention, language, achievement, fine motor, executive function, visual motor integration, and behavior were completed on children ( n = 79 ) diagnosed with epilepsy. Neurocognitive skills were within expectations for measured intelligence with the exception of verbal and visual attention skills, which were significantly below expectations based on measured ability. Behaviorally, children were rated by their parents as demonstrating clinically elevated attentional problems. Differences in cognitive and behavioral function were not found according to seizure type. Findings suggested a more diffuse effect of childhood epilepsy reflected in a pattern of decreased attention skills.

Visual and auditory rhyme judgment tasks were administered to adolescent dyslexics and normal readers while event-related brain potentials were recorded. Reading disabled subjects were split into two groups based on a median split of scores on a visual non-word decoding test. The better decoders were called Phonetics and the poorer decoders were referred to as Dysphonetics. Single syllable, real word stimuli were used, and both rhyming and non-rhyming targets had a 50% chance for matching orthography. In the visual paradigm the normal readers exhibited a left frontal CNV before targets, a large reduction in frontal N400 for matching orthography (orthographic priming), and a large reduction in parietal N400 for rhyming targets (phonological priming). Dysphonetics had an intact CNV and orthographic priming, but the group's phonological priming was very reduced. Phonetics showed both orthographic and phonological priming but had a marked reduction in their CNV. In the auditory task, controls showed a left parietal N400 priming effect for rhyming targets. Dysphonetics showed a similar bilateral effect. The Phonetics did not show a normal priming effect, but produced evidence for priming at a longer latency. Additionally, the Phonetic group responded more slowly than either of the other two groups, who responded with similar latencies. These results support the separation of the reading disabled into a group that has difficulty translating orthography into phonology, and a group that is slower functioning and has reduced capacity in preparing for a response.

Abuse characteristics and severity, although critical constructs in child maltreatment research, have been found to be among the constructs least well measured by existing instruments. Three studies are presented describing the development and testing of an instrument, the Abuse Dimensions Inventory (ADI), designed to address these needs. The first study surveys a national sample of professionals to determine rankings and agreement on rankings for abuse severity across a number of dimensions. Scales on the ADI were constructed based on the results. The second study examines interrater reliability of the instrument based on semistructured interview data. The third study examines the instrument's construct validity by factor analysis. The findings suggest that considerable agreement exists on how professionals rank abuse features in terms of severity and that ADI scales based on these rankings can be reliably coded from interview data. Additionally, the instrument was found to possess a factor structure consistent with expectations.

Auditory and visual rhyme judgement tasks were administered to 16 adolescent dyslexics (age range 13–18 years, mean age 15½) and 16 age-matched normal readers. Dyslexics and controls demonstrated orthographic facilitation in both tasks, i.e. rhymes with matching orthography, e.g. king, sing, were responded to faster than rhymes with dissimilar orthography, e.g. chair, dare, thus indicating short term memory storage of orthographic information during visual presentations, as well as activation of orthographic information during auditory presentations. Despite this facilitation dyslexics made significantly more errors and responded significantly slower than controls in both tasks. Dyslexics had extremely high error rates for visual rhyme judgement trials in which phonological and orthographic information were inconsistent, i.e. rhymes that had different orthographic endings, e.g. chair, dare, and non-rhymes that had similar orthographic patterns, e.g. food, blood. The dyslexics' high error rates and slow reaction times are discussed in terms of poor phonological processing, lack or orthographic flexibility and slow processing speeds. © 1997 John Wiley & Sons, Ltd.

The purpose of this study was to determine the effect of stimulus intensity on heart rate response in 18 low-risk human fetuses between 37 and 40 weeks gestation. Each fetus was stimulated in quiet sleep with a 30-s voice sound at intensities of 80 dB and 90 dB. The fetal cardiac electrical signal was captured transabdominally at a rate of 1024 Hz and fetal R-waves were extracted using adaptive signal-processing techniques. We found that fetuses generally exhibited a 5- to 10-s decrease in heart rate following stimulus onset at an intensity of 80 dB. The response pattern changed from deceleratory to acceleratory when stimulus intensity was increased to 90 dB. Our findings suggest that a heart rate deceleration at low-stimulus intensity may be a component of the orienting reflex in the human fetus.

Strategies used by 84 sexually abused children, ages 7 to 12, to cope with their abuse were evaluated, along with child abuse-related symptoms, parent-reported behavioral symptoms, and teacher-reported behavioral symptoms. Principal components analysis of coping yielded four strategies that were labeled avoidant coping, internalized coping, angry coping, and active/social coping. Each coping strategy was found to be associated with a unique set of abuse characteristics, abuse-related social environment, and symptoms. In contrast to findings with adult survivors and adolescents, use of avoidant coping strategies among school-age children was found to be related to fewer behavioral problems, although it was also associated with greater sexual anxieties. Internalized coping was found to be associated with increased guilt and PTSD hyperarousal symptoms. Active/social coping was the only strategy found to be unrelated to symptoms, but neither was it associated with measured benefits. In contrast to some clinical opinion that externalizing blame and venting anger is a helpful strategy, angry coping was found to be associated with a wide range of behavioral and emotional problems as rated by the child's home-room school teacher. Results are discussed in terms of a proposed mediational model.

This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children's Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.

This article discusses past research bearing on the question of the etiology of Posttraumatic Stress Disorder (PTSD). It argues that PTSD can be adequately accounted for by a process of emotional sensitization and that this is a more parsimonious explanation than the two-factor learning theory of Mowrer, now postulated by several writers. In brief, the etiology and subsequent development of PTSD is viewed as the result of the sensitization of fear/anxiety which is linked to a variety of to be conditional stimuli by both backward and forward association: these become conditional stimuli (CSi) once paired with the instigating circumstances. It is furthermore assumed that PTSD will not occur in the absence of a genetic susceptibility that may vary from zero to absolute certainty. Thus far, our evidence is limited to a sensitivity to loud sounds, but it is highly probable that touch and other sensory systems are involved (not necessarily in parallel). The fact that abuse often leads to behavioral disorders, including sexually seductive behaviors in children sexually abused, requires a recognition that emotional reactions other than fear may be sensitized. Fear in combination with pleasure or pleasure alone coupled with a loss of self-esteem may explain these acting-out behaviors.

Speed of responding in different domains (handwriting, coding, naming, and simple text reading) was compared in two samples of adolescents with learning disabilities. In both samples, speed measures were significantly interrelated. Slowness was more characteristic of students with generalized basic skill deficits (reading, spelling, and arithmetic) than of those with single achievement deficits. Phonological decoding skill and naming speed (sample 2 only) were not correlated. Poor decoders were poor word list readers, whether or not slow namers, whereas slow namers were poor in arithmetic and were slow readers, whether or not poor decoders. The relation between slow naming/reading and weakness in arithmetical calculation merits further study in learning-disabled students. It is suggested that slowness impedes automatization in reading, spelling, and arithmetic.

Two subtypes of poor readers, dysphonetic and phonetic, were compared on EEG spectral values obtained as they viewed strings of letters and short words. Dysphonetic poor readers had significantly higher values than phonetics in the theta and delta bands. Both phonetic and dysphonetic poor readers had lower beta values than adequate reading children with Attention Deficit Disorder. This evidence indicates that poor readers, especially dysphonetics, were less actively engaged in the task.

Two subgroups of learning disabled students, reading disabled only (RD) and reading/arithmetic disabled (RAD), were contrasted at two age levels, 8 to 12 years old and 12 to 17 years old. At both age levels, RAD students were significantly poorer spellers and weaker on the Arithmetic and Coding subtests of the Wechsler Intelligence Scale for Children (WISC) than RD‐only students. The younger subgroups were also differentiated by four other WISC‐R sub‐tests: Information, Similarities, Comprehension, and Block Design. The adolescent subgroups differed on the new Symbol Search subtest of the WISC‐III. The subgroups did not differ at either age level on phonological skills, memory tasks, naming speed, and picture vocabulary. Nor did they differ on parent ratings of externalizing and internalizing behavior problems. Evidence is presented that arithmetic disabled children fall relatively further behind with increasing age. A core weakness in reading and arithmetic disability is processing speed, and students wi...

Objective This study assessed the influence of gender on the comparability of self and observer ratings of anxiety and depression in adolescents. Method Subjects were 75 inpatient adolescents who were administered structured interviews of the revised Hamilton Rating Scales for Depression (HRSD-R) and Anxiety (HARS-R) and read the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results All measures demonstrated adequate internal consistency and validity. The correlation between the BDI and HRSD-R was significantly higher for females than males; of 11 symptoms that overlap on the BDI and HRSD-R, observers significantly agreed with males and females in their perceptions of 5 and 11 depressive symptoms, respectively. The correlation between the BAI and HARS-R did not differ significantly for males and females. Conclusions Results suggest that self-reports of anxiety symptoms are a valid, cost-effective alternative to anxiety observer ratings for boys and girls, while only girls' self-reports of depression are comparable to depression ratings by observers. There is the need to collect self-report information from adolescent boys because they may not communicate subjective symptoms of depression, e.g., guilt, to observers.

In a visual event-related potential (ERP) study, children diagnosed as dyslexic in terms of both age and IQ discrepancy criteria were compared with two contrast groups: poor for age (SLOW) readers and normal reading children with Attention Deficit Disorder (ADD). The children viewed 200 stimulus pairs and judged whether the second stimulus of each pair rhymed with the first. The first stimulus was always a three-letter word, while half of the second stimuli were pronounceable nonsense words and half were real words. Rhyme probability was 50%. The ERP waveforms of the dyslexics were significantly different from those of the ADD group in showing less late negativity. The SLOW group's waveforms more closely paralleled those of the ADD group. The major anomalous feature of the dyslexics' waveform was a pronounced late positive peak (P500), which followed an attenuated N450 peak. Over all groups, the N450 peak was sensitive to the rhyme manipulation, as has been found in adults (Rugg, 1984a, 1984b). Real words and nonsense words produced similar waveforms. Hemispheric effects were found but did not interact with group. Results suggest non-automatic visual cognitive processing of rhyme in dyslexics.

This investigation contrasted the cognitive content or cognitions of 162 inpatient adolescents (M=14.6,SD=1.6) in an effort to differentiate noncognitive anxiety and depressive symptoms. A principal-factors analysis with promax rotation of the Cognition Checklist (Beck, Brown, Steer, Eidelson, & Riskind, 1987) revealed that anxiety and depressive cognitions consisted of three factors, consistent with the tripartite theory of internalizing affect (Clark & Watson, 1991): specific anxiety cognitions, specific depressive cognitions, and general cognitions (overlapping depressive and anxious cognitions). Self-reported noncognitive depressive symptoms were significantly predicted by specific depressive cognitions and general cognitions; specific anxiety cognitions did not significantly predict depressive symptoms. Self-reported noncognitive anxiety symptoms were significantly predicted by specific anxiety cognitions and general cognitions, but were not predicted by specific depressive cognitions. Results were interpreted in light of the cognitive content-specificity hypothesis (Beck, 1976) and the tripartite model of internalizing symptoms.

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640-900 msec slow wave) and (2) greater right parietal than left parietal negativity (430-750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700-900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.

This article reviews research on three behavioral subtypes of attention deficit disorder (ADD): without hyperactivity (ADD/WO), with hyperactivity (ADDH), and with hyperactivity and aggression (ADDHA). Children with ADDHA appear to be at increased risk to have oppositional and conduct disorders, whereas children with ADD/WO tend to show symptoms such as anxiety and depressed mood. Children in the three subtypes have similar rates of learning disabilities, but all have higher rates than found in control groups. Teacher and parent ratings are more sensitive than laboratory measures in differentiating the subtypes. Follow-up studies strongly suggest more adverse outcomes for ADDHA children.

Beat-to-beat heart rate (HR) was analyzed for 9 contiguous seconds in a warned reaction time (RT) paradigm. Imperative stimuli were tones of three intensity levels (55, 78, and 100 db); a visual warning signal occurred 5 sec before tone onset. Baseline and reward conditions were run. Normal controls were contrasted with three Attention Deficit Disorder (ADD) subgroups: ADD-only, ADD with hyperactivity (ADDH), ADD with hyperactivity and aggression (ADDHA). The ADD subgroups were predicted to show less deceleration in HR because of their problem sustaining readiness to respond. Significant sex x group differences in HR levels and change scores were found. Overall, girls had higher HR levels than boys and the ADD-only group (boys and girls) had lower HRs than the other ADD groups. But, the ADD-only boys had more marked deceleration to the warning signal and acceleration to the tones than the other ADD boys, whereas the ADD-only girls were no more reactive than the ADDH and ADDHA girls. Control girls had the highest HR levels and were the most reactive to stimuli. Control boys and ADD-only boys had similar HR levels and reaction patterns. ADD-only girls appear to be underaroused, whereas ADD-only boys do not. Results suggest that cardiac measures can provide external validation of disruptive and nondisruptive ADD subtypes.

In a large, heterogeneous sample (N = 182) of children with attention deficit disorder (ADD), the prevalences of additional DSM-III diagnoses were determined using the Diagnostic Interview for Children and Adolescents (DICA). More than half the children had additional DSM-III psychiatric diagnoses. Oppositional disorder and anxiety/mood disorders were the most frequent diagnoses. White male children with ADD were selected into four contrast groups based on comorbidity: ADD children with no additional diagnosis (neither), with anxiety or depression (ANX/DEP), with oppositional or conduct disorder (OPP/CON), and with both ANX/DEP and OPP/CON diagnoses (both). ADD children who had both ANX/DEP and OPP/CON were significantly more improved on a high dose (0.6 mg/kg bid) than a low dose (0.3 mg/kg bid), but ADD boys in the other diagnostic groups responded as well to both doses. There was no evidence that ADD children with comorbid emotional or disruptive behavior disorders respond any less well to psychostimulants than other ADD children. However, there is a concern for those children who have the comorbid combination of (1) ADD, (2) an additional externalizing disorder (disruptive behavior disorder), and (3) an internalizing disorder (a mood or anxiety disorder). These children may not respond to low clinical doses of psychostimulants, but may respond well at higher doses. Children's self-ratings on the DICA may provide important clinical data concerning stimulant dosing which are not provided by teacher or parent ratings. We found no evidence that ADD children with comorbid emotional disorders respond any less well to a psychostimulant than ADD children without emotional comorbidity.

Using an auditory stimulus intensity paradigm, we obtained both event related potentials (ERPs) and press and release reaction times (RT) from a large sample of children with Attention Deficit Disorder (ADD). The ERP gradients to three tone intensities were used to classify the children as augmenters (steep gradients), moderates, or reducers (shallow or negative gradients). The RT data were used to classify the children as strong or sensitive, following neo-Pavlovian guidelines. The children were then cross-classified on these two dimensions and compared on cognitive, behavioral, and performance measures. The groups were also compared in response to two dosage levels of methylphenidate. Based on prior studies, we hypothesized that: 1. ERP augmenters would respond as well to the low as high dose but that reducers would respond better to high than low dose; and II. sensitive types (RT measure) would do better on the higher dose and strong types on the low dose. The first hypothesis was confirmed on a performance task but not on behavioral ratings. At the lower dose, augmenters improved most and reducers least on a 10-minute coding task presumed to require sustained attention. There was no support for the second hypothesis either in ratings or performance. The ERP augmentation measure was significantly related to teacher rated attentiveness; i.e., reducers and moderates were rated more adversely. The RT sensitivity measure tended to be related to achievement; i.e., strong types had lower reading and spelling scores. The ERP and RT sensitivity measures were not significantly correlated.

Children with attention deficit disorder (ADD) and dyslexia (n = 82) made significantly more errors than normally reading children with ADD (n = 83) on a simple auditory test of phonological sensitivity to rhyme and alliteration (Bradley, 1984). A subgroup of children with dyslexia who were sensitive to rhyme and alliteration had higher scores on the Wechsler Intelligence Scale for Children-Revised (WISC-R) Spatial factor than a dyslexic subgroup who were phonologically insensitive. In multiple regression analyses, age-corrected phonological sensitivity scores contributed significantly to the prediction of both reading and spelling Wide Range Achievement Test (WRAT) scores, this beyond the contribution of WISC-R variables. Of interest for dyslexia subtyping theories, Spatial factor scores had a subtractive effect in these regression analyses.

The activity of a putative marker of central dopamine function, spontaneous eye blink rate is examined in patients with schizophrenia. Chronic schizophrenic patients withdrawn from medication have elevated blink rates which are reduced by neuroleptic medication. Furthermore, neuroleptics reduce the so called “positive” symptoms of schizophrenia and blink rates in a positively correlated fashion. The above findings apply to patients who have normal cerebral ventricles and not those with large ventricles. Taken together, this evidence suggests that spontaneous eye blink rate is a marker of central dopamine activity and that increased dopaminergic activity is a relevant factor in chronic schizophrenic patients who have normal cerebral ventricles.

Effects of breast milk and milk formula supplemented with docosahexaenoic acid and arachidonic acid on speech processing were investigated by recording event-related potentials (ERPs) to synthesized /pa/ and /ba/ (oddball paradigm, 80%:20%) at 3 and 6 months of age. Behavioral assessment was also obtained. A major positive component (P200) was elicited by both types of sounds. It had a maximal scalp distribution in the fronto-central areas in both groups of infants. The mean latencies did not differ between the groups or between the stimulus types. However, the latencies decreased across age in both groups. The mean P200 amplitude in the formula-fed infants was lower than that in the breast-fed infants, but the difference was not significant. The between-stimulus differences in frontal P200 amplitudes were positively correlated with the behavioral scores of Bayley Index of Infant Development. These data suggest that the processing of the present speech stimuli is not affected by the investigated diets in the early infancy.

Objective Event-related desynchronization and synchronization (ERD/ERS) methodology was used to study interactions between nutrition, brain function, cognition and behavior in children who ate or skipped breakfast after overnight fasting. Methods Healthy preadolescents performed a cued visual Go/No-Go RT task after overnight fasting (Phase 1) and again (Phase 2) after eating breakfast ( n =30) or continuing to fast ( n =30). ERS and ERD determinations (8–10, 10–12Hz; frontal, central, parietal, occipital sites) and measures of sleep (overnight actigraphy) and blood glucose (finger sticks) were obtained. Results Feeding increased blood glucose, but the groups were similar in sleep amount and response accuracy. Between-phase comparisons showed slower RT and increased alpha synchronization in fasting subjects, but little change in those who ate breakfast. Phase 2 group differences emphasized greater frontal early ERS and late frontal–central ERD in Fed subjects. Conclusions In preadolescents a brief extension of overnight fasting resulted in significant changes in brain activity and behavior that were effectively countered by eating breakfast. Delaying breakfast until mid-morning appeared to have introduced fasting effects that attenuated responses in Fed subjects. Significance These findings show the sensitivity of brain function and behavior to subtle variations in nutritional status and argue for greater consideration of nutritional variables in neurobehavioral studies.

Recent studies have demonstrated that comparisons of scalp topographical distributions of event-related potentials (ERPs) between experiment conditions may not correctly indicate underlying changes in neural sources if the signals are not scaled prior to the comparisons. This important issue was re-evaluated in this paper using both simulated and experimental data. Simulated data were generated according to 16 different brain models containing 2-4 dipole sources varying in strength, orientation, origin and number. The changes made in the strength, orientation and origin included relative changes between the sources or symmetrical changes in the sources. Experimental data were ERPs collected from 45 infants at 3 months of age. Influences of linked-ear and average references were examined. A scaling method based on relations of signal amplitudes between conditions was devised and compared with the vector method (McCarthy and Wood, 1985). While real topographic differences generated by complex changes in underlying sources were preserved, interactions between condition and electrode site due to mere strength changes were successfully identified by the new method, irrespective of reference method used. However, the vector method was not always reliable because failure to differentiate or mistakenly indicate changes in sources may occur when a linked-mastoid reference was used. The method presented in this paper is reliable and recommended prior to topographic comparisons to distinguish different types of changes in underlying neural sources.

It would be impossible to cover in this book the thousands of articles that have been written on the subject of hyperactivity and related disorders over the last 50 to 60 yr. This chapter focuses on the early history, giving enough recent history to track major ideas and relations as the author sees them. But even here, there are problems. If one looks at the reference lists in books on this subject, it becomes immediately obvious that the lists are quite different, with each writer paying attention to his or her particular interests. Current research reports and hundreds of reviews of attention deficit hyperactivity disorder (ADHD) suffer from an immense historical amnesia. Concepts change, and many of the historical ideas are revisited and passed on cloaked in new terminology. The criteria now used to identify these children compared with those used some 50 yr ago, although more refined and less inclusive, are not all that different. You see a child in the cafeteria who is overly active, impulsive, and inattentive (three items); he will likely satisfy the current ADHD criteria. However, what was once largely speculation regarding a neurological basis and related genetic basis for ADHD is now supported by a large number of very good studies, which will be discussed in the subsequent chapters of this book. Much has happened in the last 10 yr. And yet, there remains much to do for those of us who love unresolved issues.

Sixty-five subjects, ages 8 to 12, participated in a visual electrophysiological study. Twenty-two of the subjects had received a diagnosis of nonorganic failure-to-thrive (FTT) before the age of three. The remaining 43 subjects had no history of FTT and served as Controls. IQs were obtained with the abbreviated WISC-III, and the Controls were split into two groups, LO IQ and HI IQ, to provide a LO IQ Control group with an average IQ equivalent to the FTT group. Event-related brain potentials (ERPs) were recorded from five scalp locations during a cued continuous performance task (CPT). Subjects had to press a button every time they saw the letter "X" following the letter "A" (50 targets out of 400 stimuli). During the CPT, the FTT subjects made marginally more errors of omission to targets than the LO IQ Control group and significantly more errors of omission than the HI IQ Control subjects. The groups did not differ significantly on errors of commission (false alarms) or reaction times to targets. ERP averages revealed a group difference in amplitude in a late slow wave for the 50 non-X stimuli (false targets) that followed the letter A. This difference was greatest over frontal sites, where the FTT group had a more negative going slow wave than each control group. Late frontal negativity to No Go stimuli has been linked with post-decisional processing, notably in young children. Thus, the FTT subjects may have less efficient inhibitory processes, reflected by additional late frontal activation.

The purpose of this study was to determine whether temporal pattern and/or spectral complexity were important stimulus parameters for eliciting a cardiac orienting reflex (OR) in low-risk human fetuses. Each of 28 term fetuses was exposed to four sounds formed from the four different combinations of temporal pattern (pulsed, continuous) and spectral complexity (sine wave, IsJ). The fetal cardiac electrical signal was captured transabdominally at a rate of 1024 Hz, and fetal R-waves were extracted by using adaptive signal-processing techniques. We found that pulsed sounds elicited a significantly greater decrease in heart rate (HR) than did continuous sounds. However, the HR response was relatively unaffected by spectral complexity. For the pure tone and the phoneme used in this study, our results indicate that temporal characteristics were more effective at eliciting a cardiac OR in human fetuses than was spectral complexity.

The cardiac orienting reflex is elicited by a low-intensity sound, it consists of a sustained heart rate (HR) deceleration, and it is a specific physiological correlate of cognitive processing. In this study we examined the relationship between behavioral state and the cardiac orienting reflex in 75 human fetuses between 36 and 40 weeks gestation. Each fetus was stimulated with a 30-s speech sound at an average intensity of 83 dB SPL in quiet sleep (QS) and active sleep (AS). The fetal cardiac electrical signal was captured transabdominally at a rate of 1024 Hz and fetal R-waves were extracted using adaptive signal processing. Fetal behavioral states were assigned based on HR pattern and the presence or absence of eye and general body movements. We found that a significant HR deceleration occurred, in both QS and AS, following stimulus onset. However, HR decelerations occurred more often in QS than AS; and for fetuses exhibiting a HR deceleration, the magnitude of the deceleration was greater in AS compared to QS. In addition, in AS female fetuses exhibited a larger, more sustained HR deceleratory response than male fetuses, but the seconds x gender interaction in QS was not significant. Based on these results, we concluded that behavioral state is an important determinant of the HR deceleratory response in human fetuses.

Summary: Purpose: To determine possible cognitive and behavioral effects of antiepileptic drug (AED) therapy by assessing children with newly diagnosed epilepsy before and after initiation of treatment. A comparison group of children with diabetes mellitus (DM) was included to control for the effects of practice, maturation, and chronic illness. Methods: Baseline neuropsychological assessments were completed for children with epilepsy (n = 37) and children with DM (n = 26) recruited through outpatient clinics at a regional children's hospital. Children were reevaluated 6 months from baseline testing. At follow-up, children with epilepsy had therapeutic AED levels and controlled seizures. Statistical analysis included a between-group repeated measures ANCOVA with pretest scores serving as the covariate. Results: Significant differences between groups were not found for any cognitive or behavioral factors, including attention (p < 0.24), immediate memory (p < 0.24), delayed memory (p < 0.10), complex motor speed (p < 0.19), or behavior problems (p < 0.89). Conclusions: Changes in performance on cognitive and behavioral measures were not different for children treated with AEDs and controls. Although adverse effects may be associated with prolonged treatment, results would not suggest adverse effects from AED monotherapy during the first 6 months of therapy.

Objective: The purpose of this study was to compare the prevalence of Post Traumatic Stress Disorder and other diagnoses in three groups of abused children, sexual only (N = 127), physical only (N = 43), and BOTH (N = 34). Method: The children, aged 7 to 13 years, were referred to the project from several sources at Arkansas Children’s Hospital and from associated local agencies. The victims and caregivers were separately administered the Diagnostic Interview for Children and Adolescents, Revised Version (DICA). Additionally, caregivers and classroom teachers completed the Child Behavior Checklist (CBCL). Characteristics of the abuse were obtained from an investigative questionnaire. Results: Both victims and caregivers endorsed high rates of disorders, with caregivers generally giving higher rates than children and boys having more externalizing diagnoses than girls. Children in the BOTH group had more diagnoses overall. Concordance between victims and caregivers was modest. PTSD was significantly comorbid with most affective disorders. On the CBCL, caregivers rated girls less disturbed than boys and the sexually abused only group less disturbed than the other groups. Teachers rated the boys more adversely than girls but did not see differences by abuse group. A younger age of onset of sexual abuse and coercion to maintain secrecy predicted a higher number of total diagnoses. Also, children who were physically abused by males had more diagnoses than those physically abused by females. Conclusions: Children who have been both physically/sexually abused appear to be at highest risk of psychiatric disturbance. PTSD, though common (circa one-third of victims), is generally comorbid with other affective disorders.

This article reports the results of a within-subject design. Fifty subjects with a physician diagnosis of fibromyalgia (FM) and/or chronic fatigue syndrome (CFS) were interviewed using a structured interview form. Each subject was interviewed initially, and again nine months later (follow-up). Subjects had, on their own, consumed nutritional supplements including freeze-dried aloe vera gel extract; a combination of freeze-dried aloe vera gel extract and additional plant-derived saccharides; freeze-dried fruits and vegetables in combination with the saccharides; and a formulation of dioscorea complex containing the saccharides and a vitamin/mineral complex. With medical treatments, approximately 25 percent of FM patients improved, but the beneficial effects of medical treatment rarely persist more than a few months. All subjects in this study had received some form of medical treatment prior to taking the nutritional supplements, but none with enduring success. Nutritional supplements resulted in a remarkable reduction in initial symptom severity, with continued improvement in the period between initial assessment and the follow-up. Further research is needed to verify these results, specifically crossover designs in well-defined populations.

This study reports the effects of two nutritional products upon the severity of symptoms in children with confirmed diagnoses of Attention-Deficit Hyperactivity Disorder (ADHD): a glyconutritional product containing saccharides known to be important in healthy functioning and a phytonutritional product containing flash-dried fruits and vegetables. Seventeen ADHD children were recruited from a local parent support group. Parents of five of the subjects did not have their children on methylphenidate. Of the remaining twelve, all on methylphenidate, six were left on prescribed doses (random assignment). The other six had their doses reduced by half after two weeks (study duration was six weeks). The subjects were assessed initially and three subsequent times over a period of six weeks (longitudinal nonrandomized design). The behavior disorder items for ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) as listed in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV) (American Psychiatric Association, 1994) were rated by teachers and parents on a 3-point scale. Also included was a Side Effects Scale described by Barkley (1990). The children received the glyconutritional supplement for the entire six weeks. After three weeks, the phytonutritional supplement was added to the diet to increase the probability of positive results. The glyconutritional supplement decreased the number and severity of ADHD, associated ODD and CD symptoms, and side effects in all groups during the first two weeks of the study. There was little further reduction with the addition of the phytonutritional supplement. The three study groups did not differ statistically in degree of reduction over observations. Present results suggest that symptoms of ADHD may be reduced by the addition to the diet of saccharides used by the body in glycoconjugate synthesis.

EEG power spectra were studied in two poor-reading adolescent groups (dysphonetic and phonetic) as the students viewed strings of letters and easy words (seven categories). The students ranged in age from 12 to 16 years; 29 were male, 9 were female. Bilateral results are reported from frontal, parietal, and occipital regions. Significant Group × Hemisphere effects were found in the alpha and beta bands, with the phonetic group showing right greater than left asymmetry. This finding was interpreted to reflect more circumscribed and mature processing in the phonetically abler poor readers, given that normally reading adults typically show right greater than left asymmetry in word tasks. Overall, the dysphonetic group had higher beta power than the phonetic group, which may reflect greater effort.

We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avoidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup. Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4 +/- 1 sec) between tones and the other with longer intervals (17 +/- 2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.

Event-related brain potentials were recorded while disabled adolescent subjects read and judged whether two sequentially presented pictures had names that rhymed. Subjects with relatively good phonetic skills displayed an N400 priming effect, i.e., a significant reduction in the amplitude of the negative peak, occurring approximately 400 msec post-stimulus, for pictures with names that rhymed with preceding pictures as compared with pictures that had names that did not rhyme with the prime. No such effect was evident for subjects with relatively poor phonetic skills. This lack of an N400 priming effect provides evidence for a reduction in neural capacity and/or activation during phonological processing in the subjects with poor phonological skills. Demonstrating the N400 priming effect to be stronger in one group of reading disabled subjects, compared to another, supports the position that specific subtypes of reading disability exist. In addition to the stronger N400 priming effect, the phonetically stronger group also exhibited an enhanced negativity, from 700 to 1,000 msec after target stimulus onset, compared to phonetically inferior subjects. This finding replicates earlier work and possibly reflects a higher level of confidence in the group with better phonetic skills.

EEG power spectra were studied in two poor reader groups (with dyslexia and slow learning) and a normally reading clinic control group (with attention deficit disorder) as the children viewed strings of words and letters (seven categories). The children ranged in age from 7.5 to 12 years; 33 were girls, 86 were boys. Bilateral temporal and parietal sites and four midline sites were used. The major difference between groups was in the low beta band, where the ADD group had greater power at the parietal and midline sites. Also, the slow learner group had marginally greater low betn at the left than right temporal site, with the opposite trend found for the dyslexic and ADD groups. Across groups, power was greater at the right than at the left parietal site in the delta and alpha bands and at the right than at the left temporal site in the low beta band. Stimulus category effects were modest, with some alpha suppression to word strings, relative to letter strings, found in the poor readers. In correlational analyses, the Combination of greater low beta and less theta power significantly predicted better reading and spelling, Results indicate that the adequate readers more actively processed the stimuli than did the poor readers.