Desempenho de crianças com e sem diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (TDAH) em uma bateria neuropsicológica computadorizada

Abstract

The Attention Deficit/Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder in childhood. It is estimated that 5.29% of children worldwide are diagnosed with ADHD. The main symptoms of ADHD include impaired focused attention, hyperactivity and impulsivity, and many children with the disorder have impairments in academic performance and relationships with peers, teachers and parents. To explain ADHD, the deficit model of executive functions (EF) have been proposed. Although not all children with ADHD have problems in EFs, tests that evaluate them are important to refine the diagnosis and in prognosis. Objectives: To compare the performance of children with and without ADHD on a computerized neuropsychological battery. Methods: We invited children aged 7-13 years old to participate in this research from schools in Belo Horizonte and Nova Lima, and patients from AMBDA HC-UFMG and private clinics. After the consent of the participant and their parents, the participants were subjected to computerized testing (Go-No-Go, Digit Span forward and backward, Donkey, Stroop Test, Tower of London, Card Sorting Test), the Raven (for pairing of subjects) and one questionnaire about use of computers and video games. In addition, parents completed the SNAP-IV (screening questionnaire of ADHD symptoms), SDQ (questionnaire screening behavioral disorders), brief questionnaire about use of computer and video games from their children and socioeconomic criteria. Results: 50 children, participated and 84% were performing at or above average on Raven and 54% have a diagnosis of ADHD. In the analysis performed using the SPSS (v. 20.0), children with ADHD showed poorer performance on tests that assess cognitive flexibility (Card Sorting Test (BCST)- no perseverative error: p=0,018), planning (Tower of London: p=0,047), inhibitory control (Card Sorting Test (BCST)- error: p=0,010) and attention Card Sorting Test (BCST)- correct answer: p=0,019). However there was no significant difference in working memory and decision making. Children with more symptoms of inattention showed worse performance in the Stroop (p=0,057, r=0,279) and Tower of London (score: p=0,038, r= -0,295; tries: p=0,051, r=0,277). Conclusion: Children with ADHD showed worse performance mainly on tests that assess planning and cognitive flexibility. The computerized neuropsychological assessment can be an important ally in the diagnosis of AHDH and provide relevant data for monitoring and treatment.