A rating measure of ADHD-related neuropsychological impairment in children and adolescents: Data from theCognition and Motivation in Everyday Life (CAMEL) Scalefrom population and clinical samples

Abstract

A new parent-completed questionnaire, the Cognition and Motivation in Everyday Life (CAMEL) scale, was developed to provide a comprehensive assessment of neuropsychological impairment in children related to attention-deficit/hyperactivity disorder (ADHD) across diverse cognitive, motivational and energetic domains. Its psychometric properties were investigated. A total of 60 items were generated to cover a wide range of putative ADHD-related neuropsychological processes. A clinical (n = 142) and community (n = 810) sample of parents with children between 6 and 16 years of age completed the questionnaire. Data on ADHD symptoms were also collected with a commonly-used, validated parent rating scale to explore the associations between CAMEL scores and dimensional measures of child ADHD and conduct problems. Factor analysis identified six factors which we labeled (i) Cognition, (ii) Self-Direction and Organization, (iii) Effort Engagement, (iv) Arousal Regulation, (v) Motivational Responsiveness, and (vi) Cautiousness. Self-Direction and Organization and Arousal Regulation were the strongest predictors for ADHD symptomatology. Self-Direction and Organization was strongly associated with inattention and Arousal Regulation with hyperactivity-impulsivity symptoms. Parents distinguished between broad neuropsychological domains in reliable and plausible ways, making distinctions between key aspects of functioning. However, the boundaries between these domains did not map directly onto the distinctions drawn within traditional models of ADHD deficits. Further research is required to examine the predictive validity and cost-effectiveness of the CAMEL scale compared to direct objective testing using laboratory measures in predicting prognosis and treatment outcome.

Differences in Perceived Mental Effort Required and Discomfort during a Working Memory Task between Individuals At-risk And Not At-risk for ADHD

“…In particular, these distinctions will be useful to extend the ADHD literature, which has so far focused more on trait measures (Brown, 1996; Van Liefferinge et al, 2016) and on effort exerted in the moment (Sergeant, 2000, 2005). We hope that our study provides a reference point for the utility of these distinctions in the experience of effort.…”

“…Adolescents with ADHD have reported more difficulty sustaining effort as indicated by significant differences on the Effort Scale compared to an adolescent control group ( Rucklidge and Tannock, 2002 ). Similarly, the Cognitive and Motivation in Everyday Life (CAMEL) Scale ( Van Liefferinge et al, 2016 ), which assesses neuropsychological impairments in children and youth with ADHD, appears to tap into the ‘how hard I (typically) try’ aspect of mental effort. Sample items from the Effort Allocation Scale of the CAMEL are: “Takes time to warm-up – to get going on a task”; “Puts things off until the last minute,” and “Chooses the way with least effort.” Parents were asked to rate their children and youth based on the extent to which the items described their children’s behavior using a five-point Likert scale.…”

Measuring individual differences in task‐related motivation in children and adolescents: Development and validation of a new self‐report measure

“…This raises interesting questions that need to be assessed longitudinally and are outside of the scope of the current study. Parent‐reported motivational responsiveness towards elements such as compliments, rewards, positive feedback, and punishment (CAMEL; Van Liefferinge et al, ) aligns with the child's preference for similar task elements such as marked/graded, socially evaluated, and competitive. Thus, parent observations might be a good indicator for children's appraisal of task elements.…”

“…The “Cognition and Motivation in Everyday Life (CAMEL)” was completed by the parent to assess their perceptions of their child's neuropsychological functioning (Van Liefferinge et al, ). The scale consists of 73 items measuring cognition, self‐direction and organization, effort engagement, arousal regulation, cautiousness, and motivational responsiveness (Cronbach's alpha of scales >.65; Van Liefferinge et al, ). The current exploratory analysis only included the motivational responsiveness subscales as this relates most closely with motivation.…”

“…Other questionnaires focus on a specific motivational dimension (e.g., a motivation for learning or for school)-for example, the "Motivated Strategies for Learning Questionnaire" (Pintrich, Smith, Garcia, & McKeachie, 1993) and the "School Attitude Measure(s)" (Dolan, 1983). Yet others have focused on individuals' academic self-concept and motivation ("Self-concept and Motivation Inventory"; Drummond & McIntire, 1975), locus of causality of motivation ("Academic Motivation Scale" Vallerand et al, 1992), intrinsic motivation ("Children's Academic Intrinsic Motivation Inventory"; Gottfried, 1985), or motivational responsiveness towards external reinforcement ("Cognition and Motivation in Everyday Life";Van Liefferinge et al, 2017). However, the extent to which individuals engage in, and are stimulated to complete, a particular task is also determined by characteristics of that task-with the impact of such characteristics on motivation potentially varying between individual children (Lock, Shaw, Saari, & Latham, 1981;Morsink et al, 2017).…”