Abstract
We administered the Tower of Hanoi to demographically comparable samples of control participants (n = 34) and children with the Combined (n = 22) and Inattentive subtypes (n = 19) of Attention-Deficit/Hyperactivity Disorder (ADHD). Controls excelled over children with the Inattentive subtype, who outperformed patients with the Combined subtype. These results replicated findings of greater executive deficits in the Combined than in the Inattentive type of ADHD. Double-blind administration of methylphenidate improved task performance only for patients with the Inattentive subtype. In a drug-free Baseline session, children with both subtypes of ADHD made more private verbalizations than controls, particularly when failing puzzles. In later sessions, regardless of drug condition, the inattentive sample exhibited a smaller increase in self-regulatory utterances under failure. In contrast, the combined sample decreased self-regulatory verbalizations under failure only under methylphenidate. The results support some differences between the two subtypes of ADHD in executive functioning and in their response to stimulant therapy.
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Ackerman, R. T., Anhalt, J. M., Dykman, R. A., & Holcomb, P. J. (1986). Effortful processing deficits in children with reading and/or attention disorders. Brain and Cognition, 5, 22–40.
Aman, C. J., Roberts, R. J., Jr., & Pennington, B. F. (1998). A neuropsychological examination of the underlying deficit in attention deficit hyperactivity disorder: Frontal lobe versus right parietal lobe theories. Developmental Psychology, 34, 956–969.
Barkley, R. A. (1997). ADHD and the nature of self-control. New York: Guilford.
Barkley, R. A., DuPaul, G. J., & McMurray, B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology, 58, 775–789.
Barkley, R. A., DuPaul, G. J., & McMurray, B. (1991). Attention Deficit Disorder with and without hyperactivity: Clinical response to three dose levels of methylphenidate. Pediatrics, 87, 519–531.
Barkley, R. A., Grodzinsky, G., & DuPaul, G. J. (1992). Frontal lobe functions in Attention Deficit Disorder with and without hyperactivity: A review and research report. Journal of Abnormal Child Psychology, 20, 163–188.
Beaudichon, J. (1973). Nature and instrumental function of private speech in problem solving situations. Merrill-Palmer Quarterly, 19, 117–135.
Berk, L. E. (1986). Relationship of elementary school children's private speech to behavioral accompaniment to task, attention, and task performance. Developmental Psychology, 22, 671–680.
Berk, L. E., & Garvin, R. A. (1984). Development of private speech among low-income Appalachian children. Developmental Psychology, 20, 271–286.
Berk, L. E., & Landau, S. (1993). Private speech of learning disabled and normally achieving children in classroom academic and laboratory contexts. Child Development, 64, 556–571.
Berk, L. E., & Potts, M. (1991). Development and functional significance of private speech among attention-deficit hyperactivity disordered and normal boys. Journal of Abnormal Child Psychology, 19, 357–377.
Bishop, D. V. M., Aamodt-Leeper, G., Creswell, C., McGurk, R., & Skuse, D. H. (2001). Individual differences in cognitive planning on the Tower of Hanoi task: Neuropsychological maturity or measurement error? Journal of Child Psychology and Psychiatry, 42, 551–556.
Bivens, J. A., & Berk, L. E. (1990). A longitudinal study of the development of elementary school children's private speech. Merrill-Palmer Quarterly, 36, 443–463.
Borys, S. V., Spitz, H. H., & Dorans, B. A. (1982). Tower of Hanoi performance of retarded young adults and nonretarded children as a function of solution length and goal state. Journal of Experimental Child Psychology, 33, 87–110.
Campbell, S. B. (1973). Cognitive styles in reflective, impulsive, and hyperactive boys and their mothers. Perceptual and Motor Skills, 36, 747–752.
Carlson, C. L., & Mann, M. (2000). Attention-Deficit/Hyperactivity Disorder, predominantly inattentive subtype. Child and Adolescent Psychiatric Clinics of North America, 9, 499–510.
Chhabildas, N. Pennington, B. F., & Willcutt, E. G. (2001). A comparison of the neuropsychological profiles of the DSM-IV subtypes of ADHD. Journal of Abnormal Child Psychology, 29, 529–540.
Chang, H. T. (2000). Effects of methylphenidate on performance and private speech of children with Attention-Deficit/Hyperactivity Disorder during the Tower of Hanoi Task. Unpublished doctoral dissertation, University of Rochester, Rochester, NY.
Copeland, A. P. (1979). Types of private speech produced by hyperactive and nonhyperactive boys. Journal of Abnormal Child Psychology, 7, 169–177.
Culbertson, W. C., & Zillmer, E. A. (2001). Tower of London. North Tonawanda, NY: Multi-Health Systems.
Douglas, V. I. (1999). Cognitive control processes in Attention-Deficit/Hyperactivity Disorder. In H. C. Quay & A. E. Hogan (Eds.), Handbook of disruptive behavior disorders (pp. 105–138). New York: Kluwer Academic/Plenum.
DuPaul, G. J. (1991). Parent and teacher ratings of ADHD symptoms: Psychometric properties in a community-based sample. Journal of Clinical Child Psychology, 20, 242–253.
Faraone, S. V., Biederman, J., Weber, W., & Russell, R. L. (1998). Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of Attention-Deficit/Hyperactivity Disorder: Results from a clinically referred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 185–193.
Frauenglass, M., & Diaz, R. (1985). Self-regulatory functions of children's private speech: A critical analysis of recent challenges to Vygotsky's theory. Developmental Psychology, 21, 357–364.
Goel, V., & Grafman, J. (1995). Are the frontal lobes implicated in planning functions? Interpreting data from the Tower of Hanoi. Neuropsychologia, 5, 623–642.
Goodman, S. H. (1981). The integration of verbal and motor behavior in preschool children. Child Development, 52, 280–289.
Hinshaw, S. P. (2001). Is the inattentive type of ADHD a separate disorder? Clinical Psychology: Science and Practice, 8, 498–501.
Houghton, S., Douglas, G., West, J., Whiting, K., Wall, M., Langsford, S., Powell, L., & Carroll, A. (1999). Differential patterns of executive function in children with Attention-Deficit Hyperactivity Disorder according to gender and subtype. Journal of Child Neurology, 14, 801–805.
Kaufman, A. S., & Kaufman, N. C. (1985). Kaufman tests of academic achievement. Circle Pines, MN: American Guidance Service.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1998). Schedule for affective disorders and schizophrenia for school-age children—Present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of American Academy of Child & Adolescent Psychiatry, 36, 980–988.
Klein, W. L. (1964). An investigation of the spontaneous speech of children during problem solving. Dissertation Abstracts International, 25, 2031. (University Microfilms No. 64–09, 240).
Klorman, R., Hazel-Fernandez, L. A., Shaywitz, S. L., Fletcher, J. M., Marchione, K. E., Holahan, J. M., Stuebing, K. K., Brumaghim, J. T., & Shaywitz, B. A. (1999). Executive functioning deficits in attention deficit/hyperactivity disorder are independent of oppositional defiant or reading disorder. Journal of American Academy of Child and Adolescent Psychiatry, 38, 1148–1155.
Kohlberg, L. Yaeger, J., & Hjertholm, E. (1968). Private speech: Four studies and a review of theories. Child Development, 39, 691–736.
Lahey, B., & Carlson, C. (1991). Validity of diagnostic category of attention deficit disorder without hyperactivity: A review of the literature. Journal of Learning Disabilities, 24, 110–120.
McBurnett, K. (2000). Methylphenidate treatment of DSM-IV types of Attention Deficit Hyperactivity Disorder. In L. Greenhill, and B. Osman (Eds.), Ritalin Theory and practice (2nd ed., pp. 253–263). Larchmont, NY: M. A. Liebert.
Meichenbaum, D., & Biemiller, A. (1990, May). In search of student expertise in the classroom: A metacognitive analysis. Paper presented at the conference on Cognitive Research for Instructional Innovation, University of Maryland, College Park, Maryland.
Meichenbaum, D., & Goodman, S. (1979). Clinical use of private speech and critical questions about its study in natural settings. In G. Zivin (Ed.), The development of self-regulation through private speech (pp. 325–360). New York: Wiley.
Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463–488.
MTA Cooperative Group (1999). A 14-month randomized clinical trial of treatment strategies for Attention-Deficit/Hyperactivity Disorder. Archives of General Psychiatry, 56, 1073–1086.
Murray, J. D. (1979). Spontaneous private speech and performance on a delayed match-to-sample task. Journal of Experimental Child Psychology, 27, 286–302.
Nigg, J. T., Blaskey, L. G., Huang-Pollock, C., & Rappley, M. D. (2002). Neuropsychological executive functions and DSM-IV ADHD subtypes. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 59–66.
Owen, A. M., Downes, J. J., Sahakian, B. J., Polkey, C. E., & Robbins, T. W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28, 1021–1034.
Ozonoff, S., & Jensen, J. (1999). Specific executive function profiles in three neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 29, 171–177.
Paternite, C. E., Loney, J., & Roberts, M. A. (1996). A preliminary validation of subtypes of DSM-IV Attention-Deficit/Hyperactivity Disorder. Journal of Attention Disorders, 1, 70–86.
Pennington, B. F., Groisser, D., & Welsh, M. C. (1993). Contrasting cognitive deficits in attention deficit hyperactivity disorder versus reading disability. Developmental Psychology, 29, 511–523.
Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51–87.
Schachar, R., Ickowicz, A., & Wachsmuth, R. (1995). Parent Interview for Child Symptoms (P.I.C.S.—4). Unpublished document, The Hospital for Sick Children, Toronto, ON Canada.
Sergeant, J. A., Geurts, H., & Oosterlaan, J. (2002). How specific is a deficit of executive functioning for Attention-Deficit/Hyperactivity Disorder? Behavioural Brain Research, 130, 3–28.
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London, 298, 199–209.
Simon, H. (1975). The functional equivalence of problem solving skills. Cognitive Psychology, 7, 268–288.
Spitz, H. H., Minsky, S. K., & Bessellieu, C. L. (1984). Subgoal length versus full solution length in predicting Tower of Hanoi problem-solving performance. Bulletin of Psychonomic Society, 22, 301–304.
Spitz, H. H., Minsky, S. K., & Bessellieu, C. L. (1985). Influence of planning time and first-move strategy on Tower of Hanoi problem-solving performance of mentally retarded young adults and nonretarded children. American Journal of Mental Deficiency, 90, 49–56.
Spitz, H. H., Webster, N. A., & Borys, S. V. (1982). Further studies of the Tower of Hanoi problem-solving performance of retarded young adults and nonretarded children. Developmental Psychology, 18, 922–930.
Vygotsky, L. (1934/1962). Thought and language. Cambridge, MA: MIT Press.
Wechsler, D. (1991). Manual for the Wechsler Intelligence Scale for Children—Third edition. San Antonio, TX: The Psychological Corporation.
Weyandt, L. L. & Willis, W. G. (1994). Executive functions in school-aged children: Potential efficacy of tasks in discriminating clinical groups. Developmental Neuropsychology, 10, 27–38.
Winsler, A. (1998). Parent-child interactions and private speech in boys with ADHD. Applied Developmental Science, 2, 17–39.
Woodcock, R. W., & Johnson, M. B. (1989). Woodcock-Johnson Psychoeducational Battery—Revised. Allen, TX: DLM Teaching Resources.
Zentall, S. S., Gohs, D. E., & Culatta, B. (1983). Language and activity of hyperactive and comparison children during listening tasks. Exceptional Children, 50, 255–266.
Zivin, G. (1972). Functions of private speech during problem-solving in preschool children. Dissertation Abstracts International, 33(2-B), 1834. (University Microfilms No. 72–26, 224).
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Portions of these results were submitted as part of H. Theresa Chang's PhD dissertation (Chang, 2000) and Helena Kopecky's unpublished master's research, both conducted at the University of Rochester and supervised by Rafael Klorman.
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Kopecky, H., Chang, H.T., Klorman, R. et al. Performance and Private Speech of Children with Attention-Deficit/Hyperactivity Disorder While Taking the Tower of Hanoi Test: Effects of Depth of Search, Diagnostic Subtype, and Methylphenidate. J Abnorm Child Psychol 33, 625–638 (2005). https://doi.org/10.1007/s10802-005-6742-7
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DOI: https://doi.org/10.1007/s10802-005-6742-7