[Training of executive function in preschool children with combined attention deficit hyperactivity disorder: a prospective, controlled and randomized trial].
BACKGROUND
School-age children with attention deficit hyperactivity disorder, combined type (ADHD-C) have executive function (EF) alterations. ADHD-C and EF alterations improve with methylphenidate or after training of working memory.


OBJECTIVE
To determine EF training effect on ADHD-C and EF alterations in preschoolers.


METHODS



METHODS
randomly assigned, 2-4 years old with ADHD-C, from 7-1-2004 to 6-30-2005, normal neurological examination, no evidences of underlying chronic disorders, no taking long term medications and parents agree to train or no EF daily. Parents filled out DSM-IV diagnostic criteria form for ADHD-C and children were tested with the Standard Dimensional Change Card Sort Task at the first visit and once a year from 1 to 3 years. Inattention, hyperactivity/impulsivity and EF average scores were statistically analyzed by the t Student for significance.


RESULTS
Of 25, 13 were trained. ADHD-C incidence went down to 16 (64%), 6 (24%) and 10 (40%) trained and untrained. Incidence was 50, 40 and 25% 100, and 66.66 y 100 after 1, 2 and 3 years with and without training. Inattention average score was 8.25, 8.4 and 7 before and 6, 5.8, and 5.5 before and after 1, 2 and 3 years of training. Hyperactivity/impulsivity average score was 8.5, 8.4 and 7.75 before and 5.75, 5.6, and 5.25 after 1, 2 and 3 years of training. EF average score was 5.2, 4.8, and 5.5 before and 8.5, 10 and 9.5 after 1, 2 and 3 years of training. Degree of improving of inattention, hyperactivity/impulsivity and EF were statistically significant for training of EF for 1, 2 and 3 years (p = 0.013, 0.002, 0.0249).


CONCLUSIONS
Children with preschool ADHD-C and EF disorders should receive training of EF for at least 3 years from age of diagnoses to improve their condition.
Papazian
O
O
Neurology Department, Miami Children's Hospital, Miami, Florida, 33155 USA. oscar.papazian@mch.com
Alfonso
I
I
Luzondo
R J
RJ
Araguez
N
N
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001521:Behavior Therapy; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D018479:Early Intervention, Educational; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011340:Problem Solving; D011446:Prospective Studies