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Evidence of utilization behavior in children with ADHD

The purpose of this study was to investigate whether inappropriate/excessive motor activity seen in children with Attention Deficit Hyperactivity Disorder (ADHD) could be characterized as Utilization Behavior (UB). Given evidence that the neuropathology of ADHD may involve frontal-striatal systems, we investigated the possibility that children with ADHD may demonstrate “utilization behavior.” Utilization Behavior (UB) is a neurobehavioral syndrome documented in individuals with damage or dysfunction in the frontal areas of the brain; patients exhibiting UB are often described as reaching out and utilizing objects in the environment in an automatic and inappropriate manner. The sample consisted of two group of children; children with ADHD (n = 32) and control children (n = 31). Children were assessed individually in a testing room where various objects, selected to elicit UB, were present. They completed cognitive tests and also were allowed to engage in an unsupervised activity. Testing sessions were videotaped and instances of physical activity (i.e., upper limb motor activity and utilization of objects) were counted by two raters. Results indicated high levels of object utilization in approximately one-half of the children with ADHD, whereas almost no such behavior was observed in controls. This behavior did not appear to be a result of generally heightened activity levels or due to instruction set, but differed according to object familiarity and object visibility. Levels of UB were statistically associated with the severity of hyperactivity, as reported by parents, of children with ADHD. This study suggests that inappropriate/excessive motor activity may, at least in part, be characterized as UB in some children with ADHD. (JINS, 2005, 11, 367–375.)