VISUAL-SPATIAL-HOLIST1C AND AUDITOR

VISUAL-SPATIAL-HOLIST1C AND AUDITORY-VERBAL-CRYSTALLIZED FUNCTIONING
Associated with more posterior brain functions (Hale & Fiorello, 2004), visual-spatial-holistic and auditory-verbal-crystallized psychological pro-cesses are not as impaired as executive processes (e.g., working memory, processing speed) in children with ADHD (Mayes & Calhoun, 2006). However, since the frontally mediated executive functions govern all other aspects of cognition (Luria, 1973), the fact that children with ADHD also experience visual-spatial-holistic right hemisphere and auditory-verbal-crystallized left hemisphere dysfunction should not be surprising. In addi-tion, as noted earlier, frontal-striatal-thalamic circuit impairment likely affects sensory processing because of thalamus involvement. In addition, because of the superior and inferior longitudinal fasciculi (frontal-posterior white matter tracts that foster information processing), corpus callosum (left-right hemisphere communication) cingula to (regulation of decision making and anterior-posterior communication), and cerebellar (learning, memory, automaticity) involvement (e.g., Castellanos et al., 2002; Durston, 2003; Hale & Fiorello, 2004; Rubia et al., 1999; Valera et al., 2007; Vaidya et al., 1998), the executive regulation/output impairments common in ADHD .affect processing of information as well. Even though some children with attention problems could have visual or auditory processing problems that cause problems with attention, these children do not have "primary" or "true" ADHD (Hale et al., 2005). There is some debate in the literature regarding the extent to which visual-spatial-holistic deficits in children with ADHD are directly related to exec-utive dysfunction or whether these deficits are in fact due to comorbid processing problems. Visual-spatial-holistic processes are often associated with right hemisphere function (Hale & Fiorello, 2004). Not surprisingly, there appears to be a right hemisphere dominance for attention in general, with posterior regions necessary for attention orienting and the anterior regions responsible for sustained attention and inhibition (Arran, Roberts, & Pennington, 1998; Berger & Posner, 2000; Casey et al., 1997; Mirsky, 1996; Pliszka et al., 2000). Studies have suggested that right hemisphere dys-function, specifically right frontal lobe dysfunction (Aron, Robbins, & Pol-drack, 2004; Castellanos, 2001; Congdon & Canli, 2005; Durston, 2003; Rubia, 2002; Sandson, Bachna, & Morin, 2000; Vaidya et al., 2005), is clearly evident in ADHD. While right frontal impairment seems likely in ADHD, meta-analyses suggest that these children have few problems with visual orienting, which could suggest more right posterior attention problems (e.g., Huang-Pollock & Nigg, 2003). Visual-spatial-holisitic processes, especially visual working memory ones, appear to be more impaired than auditory-verbal-crystallized ones (Martinussen et al., 2005), and these visual deficits improve with medication treatment (Bedard et al., 2004). Visual sustained attention may be parti-cularly helpful in discriminating children with ADHD from children with psychosis who have difficulty with selective attention (Karatekin & Asar-now, 1999). Visual-spatial-holistic memory impairments in ADHD are also evident, but they are more related to executive processes involved in initial encoding and/or retrieval deficits reflecting more frontal-executive rather than in posterior dysfunction (e.g., Barnett, Maruff, & Vance, 2005). So while visual-spatial-holistic processing deficits are evident in ADHD, this may be due to the strong relationship between executive functions and visual-perceptual tasks (e.g., Denckla, 1996). However, given that attention orient-ing and attentional neglect can occur with right posterior dysfunction (Gross-Tsur, Shalev, Manor, & Arnir, 1995; Reddy & Hale, 2007; Posner & Petersen, 1990), it is important for differential diagnosis to determine if visual-spatial-holistic processes are primary, such would be the case in "nonverbal" learning disabilities (Hain, Hale, & Glass-Kendorski, 2008) or secondary to executive dysfunction and true "ADHD" because only the latter problem is likely to be ameliorated by stimulant medication (e.g., Hale, et al., 2005; 2006; 2007, February; in press; Reddy & Hale, 2007). Despite evidence that visual-spatial-holistic impairments are more likely than auditory-verbal-crystallized ones in ADHD (Martinussen et al., 2005; Sandson et al., 2000), attention deficits also overlap with auditory processing and language disorders (Moss & Sheiffele, 1994), which can interfere with the learning, behavioral, and social outcomes of affected children (Irwin, Carter, & Briggs-Gowan, 2002). In early research, 48 percent of children who had speech/language disorders met criteria for ADHD (Love & Thompson, 1988), and verbal working memory has been found to be more indicative of language impairment than ADHD (Cohen et al., 2000). In addition, children with central auditory pi ocessing disorder often meet criteria for ADHD (Riccio et al., 1994), with the CAPD deficits suggested as possible causes for, or intensifying of, the behavioral issues experienced by children with ADHD (Sundheim & Voeller, 2004). In fact, Barkley (1997) argues that poor internalization of language in ADHD is in part responsible for poor behavior regulation and impulse control, consistent with findings that ventrolateral frontal regions are responsible for response inhibition tasks (Liddle, Kiehl, & Smith, 2001). Early reports of auditory and language deficits in ADHD have not been substantiated, leading some to question the language-ADHD relationship (Ors et al., 2005; Williams, Stott, Goodyer, & Sahakian, 2000). Clearly, children who do not process language efficiently will appear inattentive in the class-room (Buttross, 2000), and could meet "comorbid" ADHD when asked the DSM-IV-IR criteria, butt is this redly ADHD? Early research in this area often did not screen for comorbid SLD and, when directly tested, auditory processing and language deficits were more often associated with SLD than ADHD (Gomez & Condon, 1999; Pisecco, Baker, Silva, & Brooke, 2001; Purvis & Tannock, 2000). ADHD executive deficits appear to be independent of SLD (Klorman et al., 1999; McInnes, Humphries, Hogg-Johnson, & Tannock, 2003), suggesting these are related but distinct disorders (Chermak, Hall, & Musiek, 1999). Perhaps the language deficits in ADHD are more related to the executive/expressive aspects of language (Goodyer, 2000), such as working memory required during verbal retrieval, language organization/formulation, and pragmatic language, which are known to be impaired in ADHD and affected by frontal-executive dysfunction (e.g., Hale et al., 2005; Hurks et al., 2004; Kim & Kaiser, 2000; Kourakis et al., 2004; Purvis & Tannock, 1997; Tannock & Schachar, 1996; Thorell, 2007; Westby & Cutler, 1994). These findings suggest that right hemisphere implicit or indirect language processes (e.g., metaphors, humor, idioms, pragmatics) may be more impaired (e.g., Bryan & Hale, 2001) and consistent with earlier arguments regarding right hemisphere impairment in ADHD. In fact, while the inferior frontal cortex may be responsible for response inhibition as suggested by Barkley's (1997) arguments, it appears to be a right notleft—sided predominance for this function.

Hasil (Bahasa Indonesia) 1:

VISUAL-SPASIAL-HOLIST1C DAN PENDENGARAN-VERBAL MENGKRISTAL BERFUNGSI Associated with more posterior brain functions (Hale & Fiorello, 2004), visual-spatial-holistic and auditory-verbal-crystallized psychological pro-cesses are not as impaired as executive processes (e.g., working memory, processing speed) in children with ADHD (Mayes & Calhoun, 2006). However, since the frontally mediated executive functions govern all other aspects of cognition (Luria, 1973), the fact that children with ADHD also experience visual-spatial-holistic right hemisphere and auditory-verbal-crystallized left hemisphere dysfunction should not be surprising. In addi-tion, as noted earlier, frontal-striatal-thalamic circuit impairment likely affects sensory processing because of thalamus involvement. In addition, because of the superior and inferior longitudinal fasciculi (frontal-posterior white matter tracts that foster information processing), corpus callosum (left-right hemisphere communication) cingula to (regulation of decision making and anterior-posterior communication), and cerebellar (learning, memory, automaticity) involvement (e.g., Castellanos et al., 2002; Durston, 2003; Hale & Fiorello, 2004; Rubia et al., 1999; Valera et al., 2007; Vaidya et al., 1998), the executive regulation/output impairments common in ADHD .affect processing of information as well. Even though some children with attention problems could have visual or auditory processing problems that cause problems with attention, these children do not have "primary" or "true" ADHD (Hale et al., 2005). There is some debate in the literature regarding the extent to which visual-spatial-holistic deficits in children with ADHD are directly related to exec-utive dysfunction or whether these deficits are in fact due to comorbid processing problems. Visual-spatial-holistic processes are often associated with right hemisphere function (Hale & Fiorello, 2004). Not surprisingly, there appears to be a right hemisphere dominance for attention in general, with posterior regions necessary for attention orienting and the anterior regions responsible for sustained attention and inhibition (Arran, Roberts, & Pennington, 1998; Berger & Posner, 2000; Casey et al., 1997; Mirsky, 1996; Pliszka et al., 2000). Studies have suggested that right hemisphere dys-function, specifically right frontal lobe dysfunction (Aron, Robbins, & Pol-drack, 2004; Castellanos, 2001; Congdon & Canli, 2005; Durston, 2003; Rubia, 2002; Sandson, Bachna, & Morin, 2000; Vaidya et al., 2005), is clearly evident in ADHD. While right frontal impairment seems likely in ADHD, meta-analyses suggest that these children have few problems with visual orienting, which could suggest more right posterior attention problems (e.g., Huang-Pollock & Nigg, 2003). Visual-spatial-holisitic processes, especially visual working memory ones, appear to be more impaired than auditory-verbal-crystallized ones (Martinussen et al., 2005), and these visual deficits improve with medication treatment (Bedard et al., 2004). Visual sustained attention may be parti-cularly helpful in discriminating children with ADHD from children with psychosis who have difficulty with selective attention (Karatekin & Asar-now, 1999). Visual-spatial-holistic memory impairments in ADHD are also evident, but they are more related to executive processes involved in initial encoding and/or retrieval deficits reflecting more frontal-executive rather than in posterior dysfunction (e.g., Barnett, Maruff, & Vance, 2005). So while visual-spatial-holistic processing deficits are evident in ADHD, this may be due to the strong relationship between executive functions and visual-perceptual tasks (e.g., Denckla, 1996). However, given that attention orient-ing and attentional neglect can occur with right posterior dysfunction (Gross-Tsur, Shalev, Manor, & Arnir, 1995; Reddy & Hale, 2007; Posner & Petersen, 1990), it is important for differential diagnosis to determine if visual-spatial-holistic processes are primary, such would be the case in "nonverbal" learning disabilities (Hain, Hale, & Glass-Kendorski, 2008) or secondary to executive dysfunction and true "ADHD" because only the latter problem is likely to be ameliorated by stimulant medication (e.g., Hale, et al., 2005; 2006; 2007, February; in press; Reddy & Hale, 2007). Despite evidence that visual-spatial-holistic impairments are more likely than auditory-verbal-crystallized ones in ADHD (Martinussen et al., 2005; Sandson et al., 2000), attention deficits also overlap with auditory processing and language disorders (Moss & Sheiffele, 1994), which can interfere with the learning, behavioral, and social outcomes of affected children (Irwin, Carter, & Briggs-Gowan, 2002). In early research, 48 percent of children who had speech/language disorders met criteria for ADHD (Love & Thompson, 1988), and verbal working memory has been found to be more indicative of language impairment than ADHD (Cohen et al., 2000). In addition, children with central auditory pi ocessing disorder often meet criteria for ADHD (Riccio et al., 1994), with the CAPD deficits suggested as possible causes for, or intensifying of, the behavioral issues experienced by children with ADHD (Sundheim & Voeller, 2004). In fact, Barkley (1997) argues that poor internalization of language in ADHD is in part responsible for poor behavior regulation and impulse control, consistent with findings that ventrolateral frontal regions are responsible for response inhibition tasks (Liddle, Kiehl, & Smith, 2001). Early reports of auditory and language deficits in ADHD have not been substantiated, leading some to question the language-ADHD relationship (Ors et al., 2005; Williams, Stott, Goodyer, & Sahakian, 2000). Clearly, children who do not process language efficiently will appear inattentive in the class-room (Buttross, 2000), and could meet "comorbid" ADHD when asked the DSM-IV-IR criteria, butt is this redly ADHD? Early research in this area often did not screen for comorbid SLD and, when directly tested, auditory processing and language deficits were more often associated with SLD than ADHD (Gomez & Condon, 1999; Pisecco, Baker, Silva, & Brooke, 2001; Purvis & Tannock, 2000). ADHD executive deficits appear to be independent of SLD (Klorman et al., 1999; McInnes, Humphries, Hogg-Johnson, & Tannock, 2003), suggesting these are related but distinct disorders (Chermak, Hall, & Musiek, 1999). Perhaps the language deficits in ADHD are more related to the executive/expressive aspects of language (Goodyer, 2000), such as working memory required during verbal retrieval, language organization/formulation, and pragmatic language, which are known to be impaired in ADHD and affected by frontal-executive dysfunction (e.g., Hale et al., 2005; Hurks et al., 2004; Kim & Kaiser, 2000; Kourakis et al., 2004; Purvis & Tannock, 1997; Tannock & Schachar, 1996; Thorell, 2007; Westby & Cutler, 1994). These findings suggest that right hemisphere implicit or indirect language processes (e.g., metaphors, humor, idioms, pragmatics) may be more impaired (e.g., Bryan & Hale, 2001) and consistent with earlier arguments regarding right hemisphere impairment in ADHD. In fact, while the inferior frontal cortex may be responsible for response inhibition as suggested by Barkley's (1997) arguments, it appears to be a right notleft—sided predominance for this function.