M-MAT(TM) McLean-Motion Analysis Test
M-MAT(TM) Tracks changes in attention that can indicate Attention Deficit/Hyperactivity Disorder (ADHD) in children
NEW ORLEANS, May 10, 2001 /PRNewswire/ -- A new device that measures shifts in attention states may provide new insight into the nature of a child's attention problems -- as well as the effects of medications used to treat attention deficit/hyperactivity disorder (ADHD), according to a study presented at the 2001 annual meeting of the American Psychiatric Association.
The study used Harvard's McLean Hospital new test M-MAT(TM) to compare changes in attention states in children with and without ADHD. M-MAT (formerly Optax Systems) couples a specialized computer test with a sensitive motion-analysis camera to measure the three key symptoms of ADHD: inattention, impulsivity, and hyperactivity.(1)
Unlike older tests that summarize inattention with an overall measurement, M-MAT analyzes a child's attention state every 30 seconds. During each half-minute segment, the test identifies whether the child is demonstrating the highest level of attention ("on-task"), slightly less attention ("distracted"), impulsive responses on the test ("impulsivity"), or whether the child is scoring no better than chance on the test ("randomly responding").(2)
"Children with ADHD can have brief moments when they focus well. Therefore, detecting slight changes in attention is more accurate than summarizing inattention with one overall measurement," said lead investigator and M-MAT developer Martin H. Teicher, M.D., Ph.D., Associate Professor of Psychiatry at Harvard Medical School. "Many people believe ADHD is overdiagnosed, but much of the controversy might be avoided if physicians could objectively -- and precisely -- assess all its symptoms and observe how they change over time."
The M-MAT test was developed at McLean Hospital, a major teaching institution of Harvard Medical School. Just launched nationwide by M-MAT Systems, Inc., the M-MAT test can be added to traditional assessment methods to help psychiatrists, pediatricians, and other ADHD specialists quickly and objectively assess a child's symptoms, measure the child's response to medication, and follow the child's progress over time.
"While rating scales that ask parents and teachers for their opinions about a child's behavior are useful, M-MAT provides one of the missing pieces of the puzzle -- a piece that does not depend on the subjective observations of others, and one that provides a common benchmark for physicians around the country," Dr. Teicher said.
ADHD affects 3 percent to 5 percent of all school-age children, or about two million children in the United States alone.(3) Without proper diagnosis and treatment, ADHD can lead to low self-esteem, social and academic failure, and an increased risk of later antisocial and criminal behavior, including substance abuse.(4)
Key findings
The new study evaluated 60 children diagnosed with ADHD using DSM-IV criteria (the standard psychiatric diagnostic manual). The children were given the M-MAT test before taking any medication, and re-tested two hours after taking a dose of Ritalin(R), a commonly prescribed medication for treating ADHD. For comparison purposes, eight children who did not have ADHD also were tested. The study showed that:
* Unmedicated children with ADHD shifted their attention state
2.4 times more often than children who did not have ADHD
(p < 0.0001; a p value of less than 0.05 is statistically
significant).
* Children with ADHD were "on-task" during only 42.6% of the 30-second
segments, while children without ADHD were on-task during 82.4% of
the 30-second segments (p < 0.001).
* Treatment with Ritalin reduced the number of attention shifts in children with ADHD by 45%, to a rate not significantly different from normal (p < 0.0001).
* Medication also significantly increased the "on-task" rate of children with ADHD, from 42.6% to 75.4% of the time (p < 0.00001).(5)
The M-MAT test
M-MAT is a 15-minute test designed for children ages 6 to 12. It is the only scientific, objective method for simultaneously measuring inattention, impulsivity, and hyperactivity.
"For the first time, physicians have a clear picture of a child's exact movements, revealing precisely and objectively the child's capacity to remain focused and motionless while challenged by a monotonous task," Dr. Teicher said.
A child who fidgets throughout the test and whose movements cover a wide area may be showing signs of hyperactivity, Dr. Teicher explained. In addition, a child who makes certain types of mistakes during the computer test may be showing signs of impulsivity and/or inattentiveness that might indicate ADHD.(6)
Once a child completes the test, the physician transmits the test data over the Internet for analysis by the M-MAT Systems computers. Within minutes, a detailed report is returned to the physician that numerically and graphically displays 12 specific measurements of the child's attention and levels of impulsivity and activity. For comparison, normal reference ranges for children of the same age and gender are provided for each of the measurements. These norms are based on the testing of thousands of children without ADHD at the Developmental Biopsychiatry Research Laboratory at McLean Hospital.
The physician then uses this report, along with other professional assessment tools, to complete a comprehensive evaluation of the child, and to help determine the best course of treatment. In some cases, the results of the report may suggest to the physician the need to investigate other conditions with symptoms that may masquerade as ADHD, such as anxiety disorders, mood disorders, sleep problems, stress, and some types of learning disorders.(7)
If the physician decides to treat the child for ADHD, follow-up M-MAT testing can quickly measure the effects of medication on the child's ability to sit still and pay attention, streamlining the often time-consuming process of trial and error currently used to determine the right medication and dose for each child.
"Each child's response to a particular medication is unique, and it can be a painstaking process for physicians, patients, and parents to determine the best course of therapy," said Andrew Adesman, M.D., Director of Developmental & Behavioral Pediatrics at Schneider Children's Hospital of the North Shore-Long Island Jewish Health System in New York, and one of the first ADHD experts to introduce M-MAT into his practice. "The more quickly we can tailor the medication -- and the dose of that medication -- to a child's needs, the sooner the child can benefit from treatment."
The scientific basis of M-MAT
M-MAT test results have been shown to correlate strongly with brain activity patterns that researchers associate with ADHD. In particular:
* Children who tested positive on M-MAT had lower blood flow in the putamen, a part of the brain known to regulate attention and body movements.
* Children with ADHD who tested positive on M-MAT had a positive response to Ritalin. This response was demonstrated by the increase in blood flow in their putamen areas and the improvements in their M-MAT scores after taking the medication.
• Children with ADHD who did not test positive on M-MAT did not respond well to Ritalin. In these children, blood flow in the putamen actually decreased after taking Ritalin, rather than increasing. Additionally, their M-MAT scores showed little or no improvement, suggesting that these children should be considered for treatments other than Ritalin.(8)
M-MAT is supported by more than five years of clinical research and rigorous scientific testing. Several published studies have demonstrated the test's accuracy and shown that it provides clear, reproducible data.
About ADHD
ADHD may cause some people to have difficulty focusing on specific tasks, have trouble sitting still, or to speak or act inappropriately. It is considered one of the most commonly diagnosed disorders in children.(9) While many people believe ADHD is a childhood problem, up to 70 percent of children still exhibit symptoms into adulthood.(10) Although there is no cure for ADHD, early diagnosis and appropriate treatment can enable people with ADHD to successfully cope with the disorder.(11)
REFERENCES
(1) National Institute of Mental Health. Attention Deficit Hyperactivity Disorder. http://www.nimh.nih.gov/publicat/adhd/cfm.
(2) Teicher MH. Effect of Methylphenidate on Attention Shifts in
Children with ADHD. Presented at American Psychiatric Association
Annual Meeting, May 10, 2001.
(3) National Institute of Mental Health. Attention Deficit Hyperactivity
Disorder. http://www.nimh.nih.gov/publicat/adhd/cfm.
(4) Children & Adults with Attention-Deficit Hyperactivity Disorder. The
Disability Named AD/HD. CHADDFacts #1; 2000.
(6) Teicher MH, Ito Y, Glod CA, Barber NI. Objective Measurement of Hyperactivity and Attentional Problems in ADHD. J Am Acad Child Adolesc Psychiatry 1996; 35:334-342.
(7) Children & Adults with Attention-Deficit Hyperactivity Disorder. The
Disability Named AD/HD. CHADDFacts #1; 2000.
(8) Teicher MH, Anderson CM, Polcari A et al. Functional deficits in basal ganglia of children with attention-deficit/hyperactivity
disorder shown with functional magnetic resonance imaging
relaxometry. Nature Medicine. 2000; 6:470-473.
(9) National Institutes of Mental Health. Attention Deficit
Hyperactivity Disorder. http://www.nimh.nih.gov/publicat/adhd/cfm.
(10) Children & Adults with Attention-Deficit Hyperactivity Disorder.
Attention-Deficit/Hyperactivity Disorder in Adults. CHADDFacts #7;
2000.
(11) National Institute of Mental Health. Attention Deficit Hyperactivity
Disorder. http://www.nimh.nih.gov/publicat/adhd/cfm.
SOURCE M-MAT Systems, Inc.