Entrenamiento de la función ejecutiva en preescolares con trastorno por déficit de atención/hiperactividad combinado: Estudio prospectivo, controlado y aleatorizado

Introduction. 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. Aim. To determine EF training effect on ADHD-C and EF alterations in preschoolers. Subjects and methods. Inclusion criteria: 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 66.66y 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 stadistically 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.