CONTACT: BECKY SOGLIN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-6660; fax (319) 335-8034
Release: Nov. 30, 1999
UI study: children with ADHD may need help with memory
IOWA CITY, Iowa -- Some children with Attention-Deficit
Hyperactivity Disorder (ADHD) also have memory problems that need separate
assessment and treatment, according to a University of Iowa study.
The memory deficits are caused by a learning disability
and affect short-term memory skills used for spelling, sounding out words
and other reading-related tasks, said Lynn C. Richman, Ph.D., UI professor
of pediatric psychology and the study's lead investigator. However, memory
lapses in children with ADHD are often attributed to the inattention associated
with the disorder rather than to a separate problem.
"In children with ADHD it can be difficult to determine
if certain learning difficulties are caused by inattention or by memory deficits
or both," Richman said. "Many physicians appropriately diagnose the Attention-Deficit
Hyperactivity Disorder but miss the memory problems."
"The bottom line is that you need to assess for learning
disabilities when you assess for ADHD, and vice versa," said Brian D. Johnson,
Ph.D., the paper's senior author. Johnson wrote about the study as part of
his UI doctoral dissertation in counseling psychology and published it as
an article in a recent issue of the journal Developmental Neuropsychology.
He is now an associate professor of professional psychology at the University
of Northern Colorado in Greeley.
Memory testing can help reveal whether a child has
trouble learning because of poor listening skills, usually caused by ADHD,
or because of difficulty remembering things, usually caused by a learning
Richman added that the study helps explain why children
with ADHD who receive medication for their condition may still show memory
"Medication can improve attention in children with
ADHD but not help solve the learning problems related to memory," Richman
said. "We need to find out if other medications can treat ADHD while also
addressing memory deficits, or help children get specialized memory training
and other educational interventions in addition to their ADHD treatment."
Johnson said the study was unique in how it examined
different types of ADHD and learning disabilities. The study examined 40 children
ages 7 to nearly 14 who had ADHD and 40 children in the same age group who
had Undifferentiated Attention Deficit Disorder (UADD), a subset of ADHD marked
only by inattention, not by hyperactivity or impulsivity. The researchers
controlled for IQ, gender and school grade and further subgrouped the children
based on whether tests showed they had reading disabilities. The children
were then given the Color Span Test, developed by Richman and other UI researchers
to assess visual and verbal memory.
The outcomes helped reveal that children with ADHD,
whether they had a learning disability or not, had significantly more memory
deficits than children with UADD.
The Color Span Test requires a person to retain color
names in increasingly lengthy sequences. The test includes four presentation-response
variations, such as the examiner pointing to colors in a particular sequence,
then asking the child to reproduce the sequence by pointing. The three other
tests include a pointing presentation requiring an oral response; an oral
presentation requiring a pointing response; and an oral presentation requiring
an oral response.
Whether they had UADD or ADHD, the children had the
most difficulty with the test variation that involved a pointing presentation
and pointing response. However, compared to children with UADD, the children
with ADHD had more difficulty when the presenter orally named the color sequence,
and they had to respond by pointing to the colors in order.
"This information can help teachers know which ways
are best for a child to learn or take a test," Richman said.
UI Health Care pediatric psychologists regularly use
an ADHD and learning disability diagnostic battery that includes the Color
Span Test to assess memory.
Richman says a next step would be to study how medication
affects the memory of children with ADHD. He will pursue more complex memory
analyses to learn how brain pathways may be affected. Johnson is studying
ADHD identification in college students. Elizabeth M. Altmaier, Ph.D., UI
professor of psychological and quantitative foundations, served as Johnson's
Approximately 6 percent of all people age 7 and older
have ADHD. Learning disabilities are even more common, affecting nearly 15
percent of the population. Most children with learning disabilities have some
type of memory deficit. Memory is not typically related to overall intelligence
in children with learning disabilities.
Learning disorders and ADHD can both result in inattention,
impulsivity and hyperactivity. However, children with learning disorders are
more likely to show symptoms at school but not at home; children with ADHD
will show problem behaviors in more than one setting.
University of Iowa Health Care describes the partnership
between the UI College of Medicine and the UI Hospitals and Clinics and the
patient care, medical education and research programs and services they provide.