Metacognitive interventions in text production and working memory in students with ADHD

Pisacco, Nelba Maria Teixeira; Sperafico, Yasmini Lais Spindler; Enricone, Jacqueline Raquel Bianchi; Guimarães, Luciano Santos Pinto; Rohde, Luis Augusto; Dorneles, Beatriz Vargas

doi:10.1186/s41155-017-0081-9

Nelba Maria Teixeira Pisacco ^** Correspondence: nmtpisacco@uepg.br; nelbapisacco@yahoo.com.br

Departamento de Educação, Universidade Estadual Ponta Grossa (UEPG), Praça Santos Andrade 01, Sala 113, CEP, Ponta Grossa, PR 84010-919, Brazil

Yasmini Lais Spindler Sperafico

Universidade Federal Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

Jacqueline Raquel Bianchi Enricone

Universidade Regional Integrada do Alto Uruguai e das Missoes (URI), Erechim, Brazil

Luciano Santos Pinto Guimarães

Grupo de Pesquisa e Pós-Graduação at Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil

Luis Augusto Rohde

Universidade Federal Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

Beatriz Vargas Dorneles

Universidade Federal Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

* Correspondence: nmtpisacco@uepg.br; nelbapisacco@yahoo.com.br

Authors’ contributions

NP conceived of the study, analyzed the data, and wrote parts of the manuscript. YS and JE collected data and wrote parts of the manuscript; LG analyzed the data and wrote parts of the manuscript. LR and BD supervised the study and wrote parts of the manuscript. All authors read and approved the final manuscript.

Authors’ information

Nelba M. T. Pisacco is a PhD in Education at the School of Education at Universidade Federal Rio Grande do Sul (UFRGS), graduated in Pedagogy, and is a professor at Universidade Estadual de Ponta Grossa (UEPG), Ponta Grossa, Brazil, and a researcher of the ADHD Outpatient Program at Hospital de Clínicas de Porto Alegre, Brazil.

Yasmini L. S. Sperafico is a PhD in Education at the School of Education at Universidade Federal Rio Grande do Sul (UFRGS), graduated in Mathematics, and is a member of the ADHD Outpatient Program at Hospital de Clínicas de Porto Alegre, Brazil.

Jacqueline Raquel Bianchi Enricone is a PhD in Education at the School of Education at Universidade Federal Rio Grande do Sul (UFRGS), graduated in Psychology, and is a professor at Universidade Integrada do Alto Uruguai e das Missões (URI), Erechim, Brazil, and a researcher of the ADHD Outpatient Program at Hospital de Clínicas de Porto Alegre, Brazil.

Luciano Santos Pinto Guimarães is a Master in Epidemiology at Universidade Federal do Rio Grande do Sul (UFRGS), graduated in Mathematics and in Statistics, and is a statistical analyst in the Group of Research and PostGraduation (GPPG) and a member of the Research Ethics Committee of the Hospital de Clínicas de Porto Alegre, Brazil.

Luís A. Rohde is a PhD in Psychiatry at Universidade Federal Rio Grande do Sul (UFRGS), graduated in Medicine, is a full professor of Psychiatry at Universidade Federal Rio Grande do Sul (UFRGS) and a director of the ADHD Outpatient Program at Hospital de Clínicas de Porto Alegre, Brazil.

Beatriz V. Dorneles has a pós-doctoral studies at Oxford University, is a full professor of Education in the Post-Graduate Programme of the School of Education, is a PhD in Education at Universidade Federal Rio Grande do Sul (UFRGS) and a member of the ADHD Outpatient Program at Hospital de Clínicas de Porto Alegre, Brazil.

Competing interests

The authors declare that they have no competing interests.

		IG-Combined		IG-WM
		Mean	SD	Mean	SD
Age		13.1	1.8	13.0	1.8
IQ		100	11.5	98.3	10.1
IQ		N	(%)	N	(%)
Sex	Male	18	75	16	69.6
Sex	Female	6	25	7	30.4
ADHD	ADHD-I	14	58.3	11	47.8
	ADHD-HI	2	8.3	1	4.3
	ADHD-C	8	33.3	11	47.8
Comorbidity	ODD	10	41.7	9	39.1
	CD	0	0.0	2	8.7
	SAD	1	4.2	1	4.3
	GAD	0	0.0	3	13.
	Phobias	2	8.4	4	17.3
	PTSD	1	4.2	0	0
	Epilepsy	1	4.2	0	0
	No comorbidity	11	45.8	9	39.1
Use of medication		4	16.7	4	17.4

Variables	Time	Mean score								ES	p value
		IG-Combined			IG-WM			General			Group	Time	Interaction
		Mean		SE	Mean		SE	Mean	SE		Group	Time	Interaction
Textual articulation^a a Poisson distribution	1	1.7	aA	0.1	1.8	aA	0.2	1.8	0.11	0.09	0.009	< 0.001	0.002
	2	3.1	bA	0.2	2.3	bB	0.2	2.7	0.12	1.0
	3	2.7	cA	0.2	2.0	abB	0.2	2.3	0.12	0.8
	General	2.5		0.12	2.0		0.14
Elements of the narrative^a a Poisson distribution	1	4.6		0.3	4.3		0.2	4.5a	0.2	0.22	0.018	< 0.001	0.448
	2	6.0		0.2	5.2		0.3	5.6b	0.2	0.83
	3	5.7		0.2	4.9		0.2	5.3b	0.2	0.69
	General	5.4	A	0.2	4.8	B	0.2
Denouement^b b Binary logit distribution	1	0.8	aA	0.09	0.61	aA	0.1	0.68	0.07	0.3	< 0.001	< 0.001	< 0.001
	2	1	bA	0	0.87	aA	0.07	1	0	0.5
	3	1	bA	0	0.85	aB	0.08	0	0	3.4
	Geral	0.9		0	0.8		0.04
Planning errors^a a Poisson distribution	1	3.0		0.7	2.7		0.6	2.8	0.4	0.1	0.646	< 0.001	0.112
	2	2.0		0.4	2.9		0.5	2.4	0.3	0.4
	3	1.2		0.3	1.3		0.3	1.2	0.2	0.03
	General	1.9		0.3	2.1		0.4
Text extension^a a Poisson distribution	1	63.1		12.5	62.4		9.7	62.7	7.9	0.01	0.685	< 0.001	0.822
	2	89.3		7.7	86.6		9.2	87.9	6.0	0.06
	3	65.5		8.3	56.9		7.7	61.1	5.7	0.2
	General	71.7		8.6	67.5		6.1
Morphosyn-tactic errors^a a Poisson distribution	1	3.5		0.5	4.7		0.6	4.1	0.4	0.4	0.243	0.024	0.699
	2	5.1		0.7	5.8		0.8	5.4	0.5	0.2
	3	3.8		0.5	4.2		0.6	4.0	0.4	0.2
	General	4.1		0.4	4.8		0.5
Presentation errors^a a Poisson distribution	1	7.7		1.0	9.4		1.2	8.5	0.8	0.3	0.137	0.001	0.317
	2	11.2		1.5	18.0		4.9	14.2	2.1	0.4
	3	8.0		1.1	7.9		1.3	7.9	0.9	0.01
	General	8.8		0.8	11.0		1.3
Words/Clauses^c c Normal distribution	1	5.5	aA	0.2	6.0	aB	0.2	5.7	0.2	0.6	0.580	0.265	0.030
	2	5.6	aA	0.2	5.3	bA	0.1	5.5	0.1	0.5
	3	5.6	aA	0.3	5.7	abA	0.3	5.6	0.2	0.09
	General	5.6		0.1	5.7		0.2
Paragraph^c c Normal distribution	1	1.8	aA	0.1	1.4	aB	0.1	1.6	0.1	0.6	< 0.001	0.002	0.031
	2	2.5	bA	0.2	1.5	aB	0.1	2.0	0.1	1.3
	3	2.1	abA	0.2	1.5	aB	0.1	1.8	0.1	0.8
	General	2.1		0.1	1.5		0.1
Punctuation^c c Normal distribution	1	1.8		0.1	1.6		0.2	1.7	0.1	0.3	0.002	0.681	0.401
	2	2.0		0.1	1.5		0.1	1.8	0.1	0.8
	3	2.0		0.1	1.5		0.1	1.7	0.1	0.9
	General	1.9	A	0.1	1.5	B	0.1
Revision^c c Normal distribution	1	11.8		2.6	8.37		1.3	10.1	1.5	0.3	0.004	< 0.001	0.198
	2	23.8		3.6	13.1		2.4	18.5	2.1	0.7
	3	23.2		4.2	11.9		2.2	17.6	2.3	0.7
	General	19.6	A	2.5	11.1	B	1.5

Variables	Time	Mean score									ES	p value
		Combined			WM			General				Group	Time	Interaction
		Mean		SE	Mean		SE	Mean		SE		Group	Time	Interaction
RAVLT A7^a a Poisson distribution	1	9.3		0.7	8.7		0.6	9.0	A	0.5	0.19	0.552	< 0.001	0.327
	2	10.7		0.7	10.7		0.5	10.7	B	0.4	0.01
	3	11.0		0.5	10.3		0.7	10.6	B	0.4	0.27
	General	10.3		0.5	9.9		0.5
DI-backward^a a Poisson distribution	1	8.8		0.5	9.3		0.4	9.0	A	0.3	0.27	0.209	0.049	0.753
	2	8.2		0.4	8.9		0.5	8.6	B	0.3	0.34
	3	8.5		0.6	9.5		0.5	9.0	ab	0.4	0.38
	General	8.5		0.4	9.3		0.4
SS-backward^c c Normal distribution	1	4.7	aA	0.2	5.3	aB	0.2	5.0		0.1	0.59	0.794	0.759	0.014
	2	5.2	aA	0.2	5.0	aA	0.2	5.1		0.1	0.23
	3	5.0	aA	0.2	4.9	aA	0.2	4.9		0.2	0.20
	General	5.0		0.2	5.0		0.2
Inattention^c c Normal distribution	1	1.9		0.11	1.9		0.1	1.9	A	0.09	0.00	0.928	< 0.001	0.896
	2	1.4		0.12	1.4		0.2	1.4	B	0.1	0.04
	General	1.7		0.10	1.7		0.1
Hyperactivity/impulsivity^c c Normal distribution	1	1.2	aA	0.2	1.0	Ba	0.2	1.1		0.1	0.33	0.692	0.003	0.035
	2	0.8	bA	0.2	0.9	Aa	0.2	0.8		0.1	0.14
	General	1.0		0.2	0.9		0.2
Total symptoms^c c Normal distribution	1	1.6		0.1	1.4		0.1	1.5	A	0.08	0.24	0.816	< 0.001	0.194
	2	1.1		0.1	1.2		0.2	1.1	B	0.09	0.11
	General	1.3		0.1	1.3		0.1

NTPT correction criteria
Indicators by process		Score
Planning	Narrative elements**	1 point per element present in the text: introduction of subject matter, characters, ambiance, problem or purpose, action, denouement and emotions; (range=0–7).
	Temporal sequence error*	1 point per each alteration in the chronological order of events.
	Content errors/digressions*	1 point per one of off-topic statements.
	Cohesion errors*	1 point per each incomplete and/or ambiguous reference by inadequate use or absence of connectives.
	Planning errors	Sum of sequence, content, and cohesion errors.
Translation	Number of words*	1 point for words of the text.
	Number of clauses*	1 point per clauses (1 point per unit composed by subject and predicate that included a personal form of a verb).
	Words per clause*	Division of number of words by number of clauses.
	Number of sentences	1 point per sentence.
	Number of compound sentences	1 point per compound sentence (more than one clause).
	Syntactic complexity*	Division between compound sentences and number of sentences.
	Morphosyntactic errors*	1 point per error (agreement of gender, number, or between subject and verb; in the order of words in sentences; omissions, substitutions or additions of functional words [such as articles, prepositions, adverbs]).
	Spelling errors*	1 point per spelling error (there can be more than one error in a word).
	Correct words	1 point per word with no spelling errors.
	Absolute spelling accuracy	Percentage of number of correct words in relation to number of words.
	Relative spelling accuracy	Percentage of number of words spelled correctly and number of words that are not monosyllables.
	Presentation errors*	1 point per error (erasures, illegible words, inadequacy as to capitalization, spacing and separation of words, etc.).
	Paragraphing (organization of text content into paragraphs)	Considering the text in its entirety, assign: 1 for no division of paragraphs; 2 for inadequate paragraphing; 3, partially adequate paragraphing; and 4 for adequate punctuation (range=1–4)
	Score	Considering the text in its entirety, assign: 1 for no punctuation; 2 for inadequate punctuation; 3 for partially adequate punctuation; and 4 for adequate punctuation (range=1–4).
Revision	Formal revisions*	1 point per each rewriting of illegible words, correction of punctuation, and correction of spelling.
	Content revisions*	1 point per each addition, exclusion, shift, and transformation of word, sentence, or clause in attempting to improve the content.
	Formal revision	Percentage of formal revisions in relation to total formal errors
	Content revision	Percentage of content revisions in relation to total content errors
	Revision*	Percentage of formal revisions and content revisions in relation to total revisions.

[TFN1] ADHD-I predominantly of the inattentive type, ADHD-HI predominantly of the hyperactive/impulsive type, ADHD-C combined type, ODD opposition defiant disorder, CD conduct disorders, GAD generalized anxiety disorder, SAD separation anxiety disorder; PTSD post-traumatic stress disorder

Metacognitive interventions in text production and working memory in students with ADHD

Abstract