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Sustained Attention Differences Between Children With ADHD and Normal Children Based On Auditory-Visual Stimulation

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26 views3 pages

Sustained Attention Differences Between Children With ADHD and Normal Children Based On Auditory-Visual Stimulation

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sumathimsh
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Sustained attention differences between children with

ADHD and normal children based on auditory-visual


stimulation
gao Yang1 jiahai Liu1 fangzhong Xu zhiping Liu1
ˎ

1:Zhejiang University City College, Hangzhou, China


2:Zhejiang Palit Hospital, Hangzhou,China

Abstract—To compare the difference of auditory and visual researches on ADHD cognitive mechanisms have
sustained attention between children with ADHD and normal unanimously recognized that children with ADHD show less
children over time, the study establishes time series dynamic short-term attention than control group which means children
model of the auditory-visual sustained attention of children with with ADHD have greater fluctuations.
ADHD and the relationship between children’s attention and
time. The goal of the study is to predict the behavior of ADHD Types of CPT include visual continuous performance test,
children. In this study, auditory-visual continuous performance auditory continuous performance test and audio-visual
test and multiple time series sampling are used to compare the integration of continuous operation test. Number of errors
difference of performance between 20 children with ADHD and reflects the subjects' attention deficit, number of miss reflects
20 normal children. The results show that there’s significant the impulse of subjects, so the objectivity of evaluation has
difference in attention deficit between them, and auditory-visual been improved greatly, which increase the accuracy rate of
sustained attention of ADHD children show a significant clinician's diagnostic.
downward trend over time.
In this study, we improve the domestic visual CPT, and
Keywords- ADHD; auditory stimulation; visual stimulation; use time series tests based on the auditory stimulation and
sustained attention visual stimulation, the duration of CPT is 40 minutes and
every minute is considered as a sequence to study the detail
I. Introduction change of ADHD children’s auditory and visual sustained
attention in every minute. Then we can image the change of
Attention deficit hyperactivity disorder (ADHD) is very ADHD children’s auditory and visual sustained attention over
common in clinical, it is one of the most widely studied time.
diseases in child psychiatry. In recent years, it ranks in the first
or second place in the child-patient cases, causing the whole Using the time series analysis methods makes the
society's attention on children with ADHD. Attention deficit is investigation of dynamic characteristics of ADHD children’s
considered the core symptoms of ADHD. ADHD often lead to sustained attention more objectively. It is both an attempt to
poor academic performance, social maladjustment, difficulties apply this method of analysis in ADHD research, but also
in finding jobs and even criminal, has attracted wide attention forms a new perspective of sustained attention variation and
[1] predicts the variation of visual sustained attention.
ADHD is a common childhood behavioral problems, with
high-incidence. Yet its etiology and pathology are unknown II. Methods
[2]. At present, continuous performance tests (CPT) are used
to evaluate attention disorder among children. A series of A. Subjects
numbers or characters are showed on a computer monitor as Experimental group: 20 children with ADHD are randomly
stimulants in a CPT, subjects are required to make response to selected from Tongde Provincial Hospital, Hangzhou, aged 7-
certain target, the reaction results are used to evaluate 14 years old, 16 of them are boys and 4 of them are girls.
attention deficit [3]. Andrew L. Cohen [4] (2007) considers Inclusion criteria: (1) Comply with the American Psychiatric
that CPT has moderate reliability and validity in the diagnosis Association "Diagnostic and Statistical Manual of Mental
of ADHD. Wang shu-yu[5], finds that in auditory continuity Disorders," Fourth Edition (DSM-IV) ADHD diagnostic
tests and audio-visual continuity test, the reaction time of criteria. (2) Exclude people with physical disease and
children with all ADHD subtypes are longer than those of extensive mental disorders, mental retardation, emotional
control group, and the number of misstatements and omissions disorders and other diseases. (3) All cases are not under
are significantly higher than those of control group. However, spiritual drug treatment. (4) All cases are right-handed.
there are the studies [6-7] find that the hit rate of ADHD Control group: Randomly select 20 normal children from
children is lower than that of control group in single goal primary school grades 1-6, Hangzhou, aged 7-14 years old.
visual CPT, while in the continuous goal CPT there is no Exclude people with physical disease and mental illness.
difference between them. The reason may be that the study Children are right-handed.
ignores the temporal characteristics of attention, which is not
to pay attention to that attention changes over time, the scores
are high in the beginning of the task, then decline. The

Zhejiang Provincial Natural Science Foundation (Y2080622)

978-1-4577-1415-3/12/$26.00 ©2012 IEEE


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B. Laboratory instruments and materials and Winter model [8-9]. The choice of time series analysis
The experiment is controlled by a personal computer, the methods and models is based on data characteristics and
screen resolution was 1024 × 768. In the auditory CPT, PC regularity of the decision. Therefore, before the selection of
speakers randomly generate the sound of numbers from 0 to 9, specific analytical model, we drew ordinary sequence diagram
each sound is played for 100ms and the duration of two of correct numbers of both ADHD group and control group.
sounds is 1900ms. In the visual CPT, stimulus materials are
the Arabic numerals 0-9, the size is 3cm × 3cm, the color is
red. Stimuli are presented in the center of 14-inch color
display, the distance from the subjects and screen is 60cm.

C. Experiment design
Auditory CPT: This study takes place in the psychological
tests room from Tongde hospital in Zhejiang Province, it’s a
quiet test environment without any interference. Basic
information is saved in computer before the experiment,
including name, age and gender. Then experimental objects
are informed to the subjects. Before the experiment,
participants take enough practices. During the test, examiner
stands in the rear to ensure that the experiment can be carried
out smoothly, and to record the behavior of the subjects. When
the formal experiment begins, subjects first hear the target
sound of number which needs to respond to. Then they will
hear the randomly generated sound of number from 0 to 9.
Each sound lasts for 100ms, the duration of two sounds is
1900ms. When subjects hear the same sound as the target Figure 1. Sequence diagram of correct rate of both ADHD group and
sound, they are asked to press the corresponding number key. control group in auditory CPT
The total test lasts for 40 minutes, and every minute is a
sequence which forms a total of 40 sequences. The computer First we can see from the general sequence diagram is that
automatically records correct number, miss number of, error average accuracy rate of each sequence of both ADHD group
number and average reaction time. and control group does not exist cyclical changes. The correct
numbers of ADHD group between the first sequence and
Visual CPT: This study takes place in the psychological
sequence 38 although have fluctuations, but show obviously
tests room from Tongde hospital in Zhejiang Province, it’s a
downward trend. We can judge from this that the
quiet test environment without any interference. Basic concentration level of ADHD children decreases in the 1-
information is saved in computer before the experiment, 38Min. However, average accuracy of control group fluctuates
including name, age and gender. Then experimental objects around a certain level. From this figure we can know that
are informed to the subjects. Before the experiment, there’s difference in trend of correct number over time
participants take enough practices. During the test, random between two groups.
number from 0 to 9 are displayed in the middle of the screen,
each number lasts for 100ms and the duration of two numbers We can see from the figure that the average correct rate of
is 1900ms. After subjects see the number, they are asked to both groups rise in the last two minutes. In this experiment,
the experimental procedure is not set to run full-screen and
press the same number on the keyboard. The whole test lasts
subjects can see the time in the bottom of the screen. So we
for 40 minutes, and every minute is a sequence, every number
consider the reason is that subjects are aware of the
will be displayed once in a sequence. The computer experiment is about to end and thus cause interference.
automatically records correct number, miss number of, error Therefore, we judge that the correct rate of both groups
number and average reaction time. increase because subjects can determine the end of the
D. Statistical analysis experiment.
The correct numbers of every sequence are analyzed. The T-test analysis finds that the correct rate of ADHD
Independent samples T-test is used to assess the difference group is significantly lower than that of control group (See
between two groups. Then we use time series analysis to set Table 1).
up the time series model of children with ADHD. The above
statistics are completed with SPSS 17.0.
TABLE I. DIFFERENCE OF AVERAGE CORRECT RATE BETWEEN
TWO GROUPS IN AUDITORY CPT
III. results
Average correct rate t p
Time series analysis methods include exponential ADHD group Control group
smoothing analysis, ARIMA models and exponential 0.62±0.74 0.87±0.06 16.95 .000
smoothing method which include simple model, Holt model

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In the visual stimulation experiments, the correct rate over show that there’s significant difference in attention deficit
time of both groups shown in Figure 2. There is significant between them, and auditory-visual sustained attention of
difference in average correct rate between ADHD group (51%) ADHD children show a significant downward trend over time.
and control group (88%) (See Table 2). The results are similar
to the auditory CPT experiment. The correct rate of ADHD Compared with traditional CPT experiment, this study
group gradually decrease in the course of 1-40min, and control make improvements in length of time and task difficulty. We
group Experiments and experimental results are similar to extend the time of experiment to 40 minutes which is as same
ADHD children in the course of 1-40min correct rate as the time of a lesson. What’s more, we increase the difficulty
gradually decreased, and correct rate of normal group of the task which makes subjects devote more attention
fluctuates around a certain level. Relative to the auditory resources to the experiment, and leads us to observe the
experiment is that correct rates don’t show sudden rise in the significant difference between two groups. Compared to
last two minutes, possibly because subjects must constantly traditional CPT experiment, this research method have more
pay attention to the middle of the screen, and have no time to practical significance as the subjects in classroom require
pay attention to the time display in bottom of the screen. more attentional resources.

References
[1] LIANG Shao-xia, MAI Zhi-guang. A Study on the Diagnosis of
Attention Deficit Hyperactivity Disorder in Children by Continuous
Attention Task and Conners Parent Symptom Questionnaire.Chines
Journal of Child Health Care.2002,10:99-100
[2] Epstein J N, Erkanli A, Conners C K , Klaric J, et al. Relations Between
Continuous Performance Test Performance Measures and ADHD
Behaviors. Journal of Abnormal Child Psychology, 2003, 31(5):543-555.
[3] Jeffery N. Epstein, Alaatin Erkanli, C. Keith Conners, John Klaric, Jane
E. Costello, Adrian Angold1. Relations Between Continuous
Performance Test Performance Measures and ADHD Behaviors. Journal
of Abnormal Child Psychology.2003㧦543–554.
[4] Andrew L.Cohen 㧘 Steven K.Shapiro.Exploring the Performance
Differences on the Flicker Task and the Conners ̉ Continuous
Performance Test in Adults With ADHD.Journal of Attention
Disorders.2007,1:49-63
[5] WANG Shu-yu, ZHAO Li, ZHANG Qiu-he, et al. The Application of
Sustained Attention Test to Attention Deficit Hyperactivity Disabilities .
Chinese Journal of Behavioral Medical Science.2005,14(8):718
[6] LIU Si-yan, FANG Yi-mai, LIU Jia-hai. The research of audio sustained
attention in ADHD on time seriesmodel.Journal of Zhejing
University(Science Edition),2011,38(6):0-0㧚
Figure 2. Sequence diagram of correct rate of both ADHD group and [7] Gayle P. Dolan 㧘 David H. Stone, Andrew H. Briggs. A Systematic
control group in visual CPT Review of Continuous Performance Task Research in Children
Prenatally Exposed to Alcohol. Alcohol & Alcoholism.2009,1.:30–38
[8] LIU Luo-man. The Application of Exponential Smoothing in Time
TABLE II. DIFFERENCE OF AVERAGE CORRECT RATE BETWEEN Series Analysis. Journal of Shenyang Normal University (Natural
Science).2009,27(4):416-418
TWO GROUPS IN VISUAL CPT
[9] YAO Yi, LI Xiao-pin. The Application of Time Series Analysis Method
Average correct rate t p in Psychology Research. Journal of Xuzhou Normal
ADHD group Control group University(Philosophy and Social Sciences Edition).2007,33(5):111-114
0.51±0.09 0.88±0.05 22.56 .000

IV. Conclusion
CPT laboratory studies often use the number of miss, the
number of false, the average reaction time and reaction time
changes as indicators. The number of miss is used to reflect
the subjects' attention deficit, and the number of false is used
to reflect the characteristics of the impulsivity, the reaction
time is used to reflect speed of response, reaction time changes
can reflect stability of attention [7]. However, note that the
cognitive is dynamic, static indicators cannot accurately
reflect the dynamic characteristics of attention. So we use time
series models in the study to compare the difference of
auditory and visual sustained attention between children with
ADHD and normal children over time. Time series dynamic
models of the auditory-visual sustained attention of children
with ADHD and the relationship between children’s attention
and time are established. The results

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