Childhood Attention-Deficit/Hyperactivity Disorder: Nonpharmacological Treatments and Their Combination With Medication

2007 ◽  
pp. 3-28 ◽  
Author(s):  
Stephen P. Hinshaw ◽  
Rachel G. Klein ◽  
Howard B. Abikoff
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Behavior Therapy ◽  
Attention Deficit ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Childhood And Adolescence ◽  
Clinical Value ◽  
Clinical Behavior ◽  
Children With Adhd ◽  
Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a persistent disorder of childhood and adolescence that mandates early and effective intervention. Among psychosocial interventions, direct contingency management applies systematic manipulation of rewards and punishments in specialized settings. It typically yields large effects on behavior and academic performance, but (a) outcomes are often appraised through single-case experimental designs, outside the typology of clinical trials used in this volume, and (b) their effects tend not to generalize or maintain beyond the settings in which they are applied. Clinical behavior therapy involves consultation with parents and teachers regarding optimal home and school management practices. A number of Type 2 trials demonstrate the clinical value of such procedures for the behavior problems of children with ADHD as rated by parents and teachers but typically not by independent observations. Several Type 1 investigations of systematic combinations of direct contingency management plus clinical behavior therapy have yielded findings indicating significant improvements, but effects on symptoms are smaller than those found with medication. Multimodal treatment—combining intensive behavioral intervention with well-delivered pharmacological agents—does not always reveal significantly superior outcomes to medication alone, but it more consistently yields normalization of behavior patterns among children with ADHD. Further work on tailoring psychosocial interventions to ADHD-related deficits and impairments and on promoting generalized change beyond specifically targeted behaviors is urgently needed.

Psychopathology and Symptom Remission at Adolescence Among Children with Attention-Deficit–Hyperactivity Disorder

2010 ◽  
Vol 44 (4) ◽  
pp. 323-332 ◽  
Author(s):  
Susan Shur-Fen Gau ◽  
Yu-Ju Lin ◽  
Andrew Tai-Ann Cheng ◽  
Yen-Nan Chiu ◽  
Wen-Che Tsai ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Parental Education ◽  
Childhood And Adolescence ◽  
Adhd Group ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant ◽  
Core Symptoms

Objective: The aim of the present study was to examine changes of attention-deficit–hyperactivity disorder (ADHD) symptoms and psychiatric comorbidities at adolescence, and mother-child agreement on reports of ADHD symptoms among children with ADHD as compared to unaffected controls. Methods: The participants included 93 patients (male, 82.8%) aged 11–16, who were clinically diagnosed with ADHD at the mean age of 7.3 ± 2.8 years, and 93 age-, sex-, and parental education-matched school controls. The participants and their mothers were frist interviewed separately for baseline psychopathology at childhood, followed by current psychopathology using the Chinese Kiddie Epidemiologic version of the Schedule for Affective Disorders and Schizophrenia. Results: At adolescence, 46 patients (49.5%) met full DSM-IV ADHD criteria, 31 (33.3%) had subthreshold ADHD, and 16 (17.2%) had recovered from ADHD. We found a significant progressive decline in the three ADHD core symptoms for the ADHD group: hyperactivity had the greatest effect size, followed by inattention, and then impulsivity. Children with ADHD tended to report less severe ADHD symptoms at childhood and adolescence than their mothers. They were more likely than the controls to have oppositional defiant disorder (odds ratio (OR)=18.0; 95% confidence interval (CI)=8.3–38.9), conduct disorder (OR=23.1, 95%CI =5.3–100.2), mood disorders (OR=3.8, 95%CI = 1.5–9.4), bipolar disorders (Fisher's exact p < 0.001), and sleep disorders (OR=3.1, 95%CI = 1.6–6.0) at adolescence. Conclusions: The present findings are similar to those of Western studies, regarding the patterns of comorbidity, stability of core symptoms, and mother–child differences on symptom reports.

Physical Fitness and Resting EEG in Children With Attention Deficit Hyperactivity Disorder

2015 ◽  
Vol 29 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Ching-Wen Huang ◽  
Chung-Ju Huang ◽  
Chiao-Ling Hung ◽  
Chia-Hao Shih ◽  
Tsung-Min Hung
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Physical Fitness ◽  
Attention Deficit ◽  
Resting State ◽  
Self Control ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Higher Power ◽  
Eyes Open ◽  
The Relationship

Children with attention deficit hyperactivity disorder (ADHD) are characterized by a deviant pattern of brain oscillations during resting state, particularly elevated theta power and increased theta/alpha and theta/beta ratios that are related to cognitive functioning. Physical fitness has been found beneficial to cognitive performance in a wide age population. The purpose of the present study was to investigate the relationship between physical fitness and resting-state electroencephalographic (EEG) oscillations in children with ADHD. EEG was recorded during eyes-open resting for 28 children (23 boys and 5 girls, 8.66 ± 1.10 years) with ADHD, and a battery of physical fitness assessments including flexibility, muscular endurance, power, and agility tests were administered. The results indicated that ADHD children with higher power fitness exhibited a smaller theta/alpha ratio than those with lower power fitness. These findings suggest that power fitness may be associated with improved attentional self-control in children with ADHD.

The Impact of Copper in Children with Attention Deficit Hyperactivity Disorder

2017 ◽  
Vol 68 (2) ◽  
pp. 279-283
Author(s):  
Mihail Silviu Tudosie ◽  
Elena Truta ◽  
Ana Maria Davitoiu ◽  
Luminita Stanciulescu ◽  
George Jinescu ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Copper Concentration ◽  
Graphite Furnace ◽  
Urine Samples ◽  
Health State ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
The Impact

During one year (september 2013 � september 2014), 50 children from the residential institution for children SOS Satele Copiilor Bucharest, where included in our research. The children were distributed in two groups: Group A which consisted of 25 children (12 girls, 13 boys) who were not diagnosed with attention deficit hyperactivity disorder (ADHD) and Group B which consisted of 25 children (14 boys, 11 girls) who were diagnosed with ADHD. Initially, the two groups were subjected at a psycho-diagnostic battery of tests, one of them being the Evaluating the Health State of children with ADHD questionnaire elaborated by us, particularly for this research, with the purpose of highlighting the direct link between the children health state and their ADHD symptoms. This study sought to determine the concentration of copper in urine samples from a group of children with ADHD and a group of normal children, to highlight the role of copper in the development of ADHD symptoms. Levels of copper concentration in urine samples from the two groups were processed by Student�s t-Test. Statistical analysis showed that the arithmetic averages of copper concentration in urine samples, of the two groups do not differ significantly, so copper may be causing ADHD symptoms occur. The copper content in urine samples has been determined using atomic absorption spectrometry with graphite furnace.

scholarly journals A Cross-Sectional Study of 0.6 Million Children with Attention-Deficit/Hyperactivity Disorder in the United States

2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Family Income ◽  
Neurodevelopmental Disorder ◽  
Multiple Logistic Regression Analysis ◽  
The United States ◽  
Cross Sectional ◽  
Children With Adhd ◽  
Hyperactivity Disorder

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.

Good Holders, Bad Shufflers: An Examination of Working Memory Processes and Modalities in Children with and without Attention-Deficit/Hyperactivity Disorder

2015 ◽  
Vol 22 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Ashley N. Simone ◽  
Anne-Claude V. Bédard ◽  
David J. Marks ◽  
Jeffrey M. Halperin
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Attention Deficit ◽  
Digit Span ◽  
Specific Pattern ◽  
Significant Group ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Group Condition ◽  
Visual Spatial

AbstractThe aim of this study was to examine working memory (WM) modalities (visual-spatial and auditory-verbal) and processes (maintenance and manipulation) in children with and without attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 63 8-year-old children with ADHD and an age- and sex-matched non-ADHD comparison group (N=51). Auditory-verbal and visual-spatial WM were assessed using the Digit Span and Spatial Span subtests from the Wechsler Intelligence Scale for Children Integrated - Fourth Edition. WM maintenance and manipulation were assessed via forward and backward span indices, respectively. Data were analyzed using a 3-way Group (ADHD vs. non-ADHD)×Modality (Auditory-Verbal vs. Visual-Spatial)×Condition (Forward vs. Backward) Analysis of Variance (ANOVA). Secondary analyses examined differences between Combined and Predominantly Inattentive ADHD presentations. Significant Group×Condition (p=.02) and Group×Modality (p=.03) interactions indicated differentially poorer performance by those with ADHD on backward relative to forward and visual-spatial relative to auditory-verbal tasks, respectively. The 3-way interaction was not significant. Analyses targeting ADHD presentations yielded a significant Group×Condition interaction (p=.009) such that children with ADHD-Predominantly Inattentive Presentation performed differentially poorer on backward relative to forward tasks compared to the children with ADHD-Combined Presentation. Findings indicate a specific pattern of WM weaknesses (i.e., WM manipulation and visual-spatial tasks) for children with ADHD. Furthermore, differential patterns of WM performance were found for children with ADHD-Predominantly Inattentive versus Combined Presentations. (JINS, 2016, 22, 1–11)

Imaging Normal and Abnormal Brain Development: New Perspectives for Child Psychiatry

2001 ◽  
Vol 35 (3) ◽  
pp. 272-281 ◽  
Author(s):  
Judith L. Rapoport ◽  
Xavier F. Castellanos ◽  
Nitin Gogate ◽  
Kristin Janson ◽  
Shawn Kohler ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Brain Development ◽  
Attention Deficit ◽  
Grey Matter ◽  
Brain Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Childhood And Adolescence ◽  
Hyperactivity Disorder ◽  
Developmental Neuroscience ◽  
Abnormal Brain

Objective: The availability of non-invasive brain imaging permits the study of normal and abnormal brain development in childhood and adolescence. This paper summarizes current knowledge of brain abnormalities of two conditions, attention deficit hyperactivity disorder (ADHD) and childhood onset schizophrenia (COS), and illustrates how such findings are bringing clinical and preclinical perspectives closer together. Method: A selected review is presented of the pattern and temporal characteristics of anatomic brain magnetic resonance imaging (MRI) studies in ADHD and COS. These results are discussed in terms of candidate mechanisms suggested by studies in developmental neuroscience. Results: There are consistent, diagnostically specific patterns of brain abnormality for ADHD and COS. Attention deficit hyperactivity disorder is characterized by a slightly smaller (4%) total brain volume (both white and grey matter), less-consistent abnormalities of the basal ganglia and a striking (15%) decrease in posterior inferior cerebellar vermal volume. These changes do not progress with age. In contrast, patients with COS have smaller brain volume due to a 10% decrease in cortical grey volume. Moreover, in COS there is a progressive loss of regional grey volume particularly in frontal and temporal regions during adolescence. Conclusions: In ADHD, the developmental pattern suggests an early non-progressive ‘lesion’ involving neurotrophic factors controlling overall brain growth and selected dopamine circuits. In contrast, in COS, which shows progressive grey matter loss, various candidate processes influencing later synaptic and dendritic pruning are suggested by human post-mortem and developmental animal studies.

Effects of Late-Afternoon Methylphenidate Administration on Behavior and Sleep in Attention-Deficit Hyperactivity Disorder

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 320-325 ◽  
Author(s):  
Jeffrey D. Kent ◽  
Joseph C. Blader ◽  
Harold S. Koplewicz ◽  
Howard Abikoff ◽  
Carmel A. Foley
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Weight Loss ◽  
Attention Deficit ◽  
Sleep Latency ◽  
Inpatient Service ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Late Afternoon ◽  
Hyperactivity Disorder ◽  
Child Psychiatric

Objective. This study evaluated the effects on behavior and sleep of methylphenidate (MPH) administered at 4 PM to children with attention-deficit hyperactivity disorder (ADHD). Methodology. Twelve children admitted to a child psychiatric inpatient service with ADHD participated in a double-blind, crossover study in which they received a 4 PM dose of either 15 mg of MPH, 10 mg of MPH, or a placebo in random order for 12 consecutive days. Ratings of behavior, including ADHD symptoms, pertaining to the period from dose administration until sleep onset, were supplied nightly by hospital staff. Sleep latency and sleep adequacy were also assessed for each night. Results. MPH resulted in markedly improved behavioral control compared with placebo; there was no difference between 15-mg and 10-mg MPH doses. MPH did not alter sleep latencies observed with the placebo. Children were more often rated as less tired on awakening after nights that they received 10 mg of MPH compared with 15 mg of MPH and the placebo. Weight loss was apparent among 83% of the patients, but dinner intake did not vary with third-dose condition. Conclusions. Morning and noon administration of stimulants to children with ADHD is a near-universal practice, but many clinicians avoid a third, late-afternoon administration for fear of inducing insomnia. This study's findings show that children with ADHD derive substantial symptom reduction from MPH administered in late afternoon, with no untoward effects on sleep. Therefore, three-times-a-day dosing should be considered for those children exhibiting ADHD symptoms in the evening. Adverse effects on sleep latency were not apparent in the sample overall. Nonetheless, monitoring for possible aggravation of sleep problems and weight loss remains sound treatment practice.

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