Sensory noise as a possible non-pharmacological intervention for children with attention-deficit/hyperactivity disorder

Research output: ThesisDoctoral Thesis (compilation)

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Abstract

Background
Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) commonly
exhibit academic underachievement. The condition is thought to be linked to a
dysregulation of the dopamine (DA) and norepinephrine (NE) systems, which are
normalized with pharmacological medication. While pharmacological and non-
pharmacological interventions are available, more than 50% abort treatment after one year, and children with ADHD continue to struggle to achieve academic performance levels comparable to their typically developing peers.

Previous research suggests that white noise stimulation may enhance cognitive
performance in children with ADHD. While many of the existing studies have used
auditory white noise, the theoretical framework of this thesis suggests that noise
stimulation in any sensory modality could yield similar benefits as from auditory noise. This thesis also investigates potential regulatory effects from white noise stimulation on DA and NE through the measurement of blink rate and pupil diameter, which serve as proxies for these neurotransmitter systems.

Methods
Three distinct noise modalities – auditory, visual, and vestibular – were examined
regarding their ability to affect cognitive performance, pupil diameter and blink rate in children with ADHD and typically developing children (TDC). Each noise modality
was compared against a no-noise condition, during tasks previously validated for their sensitivity in discerning differences between children with ADHD and TDC.
Performance on the tasks was evaluated in relation to the different groups (ADHD and
TDC), while blink rate and pupil diameter were assessed regarding their relationship
to ADHD symptom severity in the entire sample.

Results
No beneficial effects on cognitive performance attributable to noise stimulation were
observed, irrespective of noise modality. Furthermore, no relationship between blink
rate or pupil diameter and ADHD symptom severity was found. The level of symptoms
experienced did not predict pupil diameter or blink rate without noise. Neither did it
interact with the noise stimulation in any way. However, boys had significantly larger
pupil diameters compared to girls during both the no-noise condition and during
auditory white noise stimulation. The boys were significantly affected by the noise
stimulation.

Conclusions
White noise stimulation seems to be ineffective in improving cognitive performance for children with ADHD in several tasks related to working memory and executive
function. Additionally, blink rate and pupil diameter do not seem to be reliably
associated with ADHD symptom severity, nor modulated by auditory white noise
stimulation. However, the pupil diameter in boys was consistently larger throughout
the entire task as a result of the noise stimulation. The fact that only boys, and not girls, were significantly affected by the auditory white noise stimulation suggests that
individual differences may influence responsiveness, warranting further investigation
into potential influencing factors.
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Department of Clinical Sciences, Lund
Supervisors/Advisors
  • Claesdotter-Knutsson, Emma, Supervisor
  • Nyström, Marcus, Assistant supervisor
  • Tallberg, Pia, Assistant supervisor
  • Söderlund, Göran, Assistant supervisor, External person
  • Gustafsson, Peik, Assistant supervisor
Award date2025 Feb 7
Place of PublicationLund
Publisher
ISBN (Print)978-91-8021-660-9
Publication statusPublished - 2025

Bibliographical note

Defence details
Date: 2025-02-07
Time: 09:00
Place: Konferensrum 12, Psykiatrihuset, Baravägen 1 i Lund
External reviewer(s)
Name: Warkentin, Siegbert
Title: Professor
Affiliation: Linnaeus University

Subject classification (UKÄ)

  • Psychiatry

Free keywords

  • Sensory noise
  • ADHD
  • White noise
  • Eye tracking
  • Blink rate
  • Pupi diameter
  • Cognitive performance

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