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ADHD and TM Practice


Table 1. DMV-IV Diagnoses and Medication Use for the TM and Delayed Start Groups TM Group


ADHD Type ADHD Type Inattentive


Hyperactive Combined Totals


Procedure


Students were pretested, and then stratified by age and ADHD symptoms and randomly assigned to a group* immediate start TM or delayed-start*using blind drawing of names. Certified teachers of the TM technique went to the school to instruct the students in TM practice*four con- secutive days*and then for follow-up meetings once a month. The students were instructed in the standardized format to learn the TM technique, as described below. Four teachers at the school learned the TM technique and meditated with the children morning and afternoon.


Students were given paper-and-pencil tests in the school during class time, and made individual appointments for performance tests and EEG recordings. All students were posttested at 3 months and 6 months. The delayed-start students learned TM after the 3-month posttest.


Psychological Test Measures


Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency


The D-KEFS tests executive functions such as flexibility of thinking, inhibition, problem solving, planning, impulse control, concept formation, abstract thinking, and creativity in both verbal and spatial modalities.50 It has been standar- dized and used in both clinical groups and as a research tool for increasing knowledge of frontal-lobe functions.51 The Verbal Fluency subscale was considered appropriate because the school specializes in teaching students with language- based learning difficulties. The Verbal Fluency test provides information about the student’s word fluency and language- related concept fluency. It also assesses the ability to shift from one concept to another,52 a difficulty associated with ADHD. The measure also includes an Alternate Form, thus reducing practice effects at posttest.


The analysis of the Verbal Fluency test yields four measures:


Letter Fluency, Category Fluency, Category Switching, and Total Switching Accuracy. Letter Fluency is the total number of words the student can think of that start with a specified letter, in three 60-sec trials. Category Fluency is the number of words the student can say that belong to a designated semantic category (eg, animals, fruit) in two 60-sec trials. Category Switching evaluates the student’s ability to alternate between saying words from different semantic categories within a 60-sec trial. Total switching accuracy includes the


www.slm-psychiatry.com 75


3 2 4 9


Subjects on ADHD Medication


1 1


3 5


Comorbidity ADHD Type 1


1 1


2 4


2 6 9


Delayed Start Group


Subjects on ADHD Medication


0 1


4 5


Comorbidity 0


0 1 1


number of responses and number of correct responses in each trial.


Tower of London


The Tower of London measures higher order problem solving. Subjects are shown a configuration of colored balls stacked on pegs. The subject executes a sequence of moves that transforms his or her board to match the displayed configuration with the balls arranged on designated pegs. This analysis yields total correct score, total initiation time, total move score, total execution time, total time score, and total time violation. It has a reliability coefficient of .80 and loads on a principle component analysis with other tests of executive planning/inhibition.53


Self-Report Instruments Two self-report instruments were administered at the end of


the study*one to the children and one to their parents. The first one asked the children: ‘‘How much do you like your TM practice?’’ on a 7-point Likert Scale*1 (Not At All) to 7 (Very Much). The second scale asked parents how their children had changed on five ADHD-related symptoms. There were asked: ‘‘Compare your child before learning the Transcen- dental Meditation technique to now. Indicate the degree of change you have observed in the following areas: (a) ability to focus on schoolwork, (b) organizational abilities, (c) ability to work independently, (d) happiness, and (e) quality of sleep.’’ Responses were along a 11-point Likert Scale from 5 (Strong Negative Changes) to 5 (Strong Positive Changes).


Other Psychological Tests Four other tests were administered. However, because there


were incomplete data for these four measures, these data are not interpretable. Thus, they will not be reported. The test and the corresponding number of completed forms were: Spielberger’s State and Trait Anxiety scale (TM4, Delayed6), SNAP IV (TM5, Delayed5), the Teacher BRIEF (TM3, Delayed5), and the Youth Self-Report (TM7, Delayed5).


EEG Recording Protocol The EEG was recorded during a computer-administered


paired choice reaction-time task to calculate theta/beta ratios (Cz) and patterns of EEG coherence. The task began with a one- or two-digit number (300 ms duration), a 1200 ms blank screen, and another one- or two-digit number (300 ms


M&B 2011; 2:(1). July 2011


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