scholarly journals Which Child Will Benefit From a Behavioral Intervention for ADHD? A Pilot Study to Predict Intervention Efficacy From Individual Reward Sensitivity

2020 ◽  
pp. 108705472092813
Author(s):  
Myrte J. M. van Langen ◽  
Branko M. van Hulst ◽  
Miriam Douma ◽  
Maarten Steffers ◽  
Nicolle M. H. van de Wiel ◽  
...  

Objective: This article aims to assess whether individual differences in reward sensitivity can be used to predict which children with attention-deficit/hyperactivity disorder (ADHD) will benefit most from behavioral interventions that include reinforcement. Methods: A 12-week behavioral intervention was offered to 21 children with ADHD and their parents. Reward sensitivity was assessed prior to the intervention using a combination of psychological and physiological measures. ADHD symptoms were assessed pre- and posttreatment using the Strengths and Weaknesses of ADHD and Normal behavior (SWAN) rating scale. Results: Lower scores on one of the questionnaire scales were associated with greater pre/posttreatment differences in ADHD symptoms. Conclusion: We found that pre/posttreatment change was associated with one measure of parent-rated reward sensitivity. Children with low impulsive negative behavior toward gaining reward improved most during treatment. This result suggests that aspects of reward-related behaviors in ADHD may be useful to predict the effectiveness of treatment.

2017 ◽  
Vol 68 (2) ◽  
pp. 279-283
Author(s):  
Mihail Silviu Tudosie ◽  
Elena Truta ◽  
Ana Maria Davitoiu ◽  
Luminita Stanciulescu ◽  
George Jinescu ◽  
...  

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.


2021 ◽  
pp. 155005942110334
Author(s):  
Parham Jalali ◽  
Nasrin Sho’ouri

Resent research has shown that electroencephalography (EEG) theta/beta ratio (TBR) in cases with attention deficit hyperactivity disorder (ADHD) has thus far been reported lower than that in healthy individuals. Accordingly, utilizing EEG-TBR as a biomarker to diagnose ADHD has been called into question. Besides, employing known protocol to reduce EEG-TBR in the vertex (Cz) channel to treat ADHD via neurofeedback (NFB) has been doubted. The present study was to propose a new NFB treatment protocol to manage ADHD using EEG signals from 30 healthy controls and 30 children with ADHD through an attention-based task and to calculate relative power in their different frequency bands. Then, the most significant distinguishing features of EEG signals from both groups were determined via a genetic algorithm (GA). The results revealed that EEG-TBR values in children with ADHD were lower compared with those in healthy peers; however, such a difference was not statistically significant. Likewise, inhibiting alpha band activity and enhancing delta one in F7 or T5 channels was proposed as a new NFB treatment protocol for ADHD. No significant increase in EEG-TBR in the Cz channel among children with ADHD casts doubt on the effectiveness of using EEG-TBR inhibitory protocols in the Cz channel. Consequently, it was proposed to apply the new protocol along with reinforced beta-band activity to treat or reduce ADHD symptoms.


2021 ◽  
pp. 108705472097855
Author(s):  
Upasana Bondopadhyay ◽  
Unai Diaz-Orueta ◽  
Andrew N. Coogan

Objective: Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. Methods: Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. Results: 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. Conclusion: Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.


PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 320-325 ◽  
Author(s):  
Jeffrey D. Kent ◽  
Joseph C. Blader ◽  
Harold S. Koplewicz ◽  
Howard Abikoff ◽  
Carmel A. Foley

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.


2017 ◽  
Vol 24 (4) ◽  
pp. 499-508 ◽  
Author(s):  
Stephanie G. Craig ◽  
Margaret D. Weiss ◽  
Kristen L. Hudec ◽  
Christopher Gibbins

Objective: Children with ADHD display higher rates of sleep problems, and both sleep disorders and ADHD have been shown to affect functioning in childhood. The current study examines the frequency and relationship between sleep problems and ADHD, and their impact on quality of life (QoL) and functional impairment. Method: Parents of 192 children with ADHD ( M = 10.23 years) completed measures regarding their child’s ADHD symptoms (Swanson, Nolan and Pelham [SNAP]), sleep disorders (Pediatric Sleep Questionnaire [PSQ]), QoL (Child Health Illness Profile [CHIP-PE]), and functioning (Weiss Functional Impairment Rating Scale–Parent Report [WFIRS-P]). Results: Common sleep complaints in participants were insomnia, excessive daytime sleepiness (EDS), and variability in sleep schedule. Regression analysis indicated that sleep problems and ADHD symptoms independently predicted lower levels of QoL (Δ R2 = .12, p < .001) and social functioning (Δ R2 = .12, p < .001). Conclusion: The results suggest that ADHD may coexist with somnolence and that both conditions have a significant impact on a child’s functioning and QoL.


2014 ◽  
Vol 45 (8) ◽  
pp. 1601-1612 ◽  
Author(s):  
S. Park ◽  
J.-M. Lee ◽  
J.-W. Kim ◽  
J. H. Cheong ◽  
H. J. Yun ◽  
...  

Background.Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children.Method.A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated.Results.Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri.Conclusions.The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD.


2018 ◽  
Vol 103 (9) ◽  
pp. 841-846 ◽  
Author(s):  
Daryl Efron ◽  
Kirsten Furley ◽  
Alisha Gulenc ◽  
Emma Sciberras

ObjectiveThis study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD.Design and settingIn this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure.Patients117 children with ADHD and 149 control children were included in the analyses.Main outcome measuresMaternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years.ResultsMothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01).ConclusionsMaternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A245-A245
Author(s):  
Xiao Li ◽  
Ka Sin Caroline Shea ◽  
Lok Fan Lau ◽  
Ching Kwong Dino Wong ◽  
Waiyan Vivian Chiu ◽  
...  

Abstract Introduction Circadian rhythm disturbances, including delayed circadian rhythm and increased motor activity, are commonly seen in attention-deficit hyperactivity disorder (ADHD). Previous research suggested a link between circadian rhythm disturbances and poor psychosocial functioning in children, but such a relationship has not been examined in children with ADHD. This study aimed at examining the association between circadian-related parameters and psychosocial functioning in children with ADHD. Methods Seventy-nine children with ADHD were recruited into this study (age range: 6–12 years, 75.9% male). They were assessed by parent-report questionnaires on sleep problems (Children’s Sleep Habits Questionnaire, CSHQ), ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale, SWAN), and psychosocial functioning (Strengths and Difficulties Questionnaire, SDQ). Actigraphic data collected for seven consecutive days were analyzed using parametric and nonparametric methods. The relationship between circadian parameters and psychosocial functioning was analyzed using multiple regression while controlling for age, sex, ADHD medication, total sleep time, and CSHQ total score. Results Later acrophase was significantly associated with higher scores on SDQ emotional problems (St. β = 0.30, p = 0.03) and SWAN inattention subscale (St. β = 0.27, p = 0.043). Lower relative amplitude was associated with higher scores on SDQ hyperactivity symptoms (St. β = -0.29, p = 0.045) and SDQ total difficulties (St. β = -0.31, p = 0.036). Higher levels of mean activity level during the least active 5-h period (L5) were related to higher scores on SDQ peer problems (St. β = 0.38, p = 0.021), SDQ internalizing problems (St. β = 0.38, p = 0.020) and SDQ total difficulties (St. β = 0.33, p = 0.036). Later onset of L5 was associated with increased SDQ emotional problems (St. β = 0.26, p = 0.046). Conclusion Circadian rest-activity rhythm disturbances (delayed phase, blunted rest-activity rhythms, higher level of nocturnal activity, and later onset of nocturnal rest) were associated with poor psychosocial functioning in children with ADHD. Further longitudinal studies are needed to examine the effects of circadian disruption on psychosocial functioning in children with ADHD. Support (if any) This work was supported by the Health and Medical Research Fund (Project No.: 30160604).


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Katja Becker ◽  
Tobias Banaschewski ◽  
Daniel Brandeis ◽  
Christina Dose ◽  
Christopher Hautmann ◽  
...  

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a psychosocially impairing and cost-intensive mental disorder, with first symptoms occurring in early childhood. It can usually be diagnosed reliably at preschool age. Early detection of children with ADHD symptoms and an early, age-appropriate treatment are needed in order to reduce symptoms, prevent secondary problems and enable a better school start. Despite existing ADHD treatment research and guideline recommendations for the treatment of ADHD in preschool children, there is still a need to optimise individualised treatment strategies in order to improve outcomes. Therefore, the ESCApreschool study (Evidence-Based, Stepped Care of ADHD in Preschool Children aged 3 years and 0 months to 6 years and 11 months of age (3;0 to 6;11 years) addresses the treatment of 3–6-year-old preschool children with elevated ADHD symptoms within a large multicentre trial. The study aims to investigate the efficacy of an individualised stepwise-intensifying treatment programme. Methods The target sample size of ESCApreschool is 200 children (boys and girls) aged 3;0 to 6;11 years with an ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or a diagnosis of oppositional defiant disorder (ODD) plus additional substantial ADHD symptoms. The first step of the adaptive, stepped care design used in ESCApreschool consists of a telephone-assisted self-help (TASH) intervention for parents. Participants are randomised to either the TASH group or a waiting control group. The treatment in step 2 depends on the outcome of step 1: TASH responders without significant residual ADHD/ODD symptoms receive booster sessions of TASH. Partial or non-responders of step 1 are randomised again to either parent management and preschool teacher training or treatment as usual. Discussion The ESCApreschool trial aims to improve knowledge about individualised treatment strategies for preschool children with ADHD following an adaptive stepped care approach, and to provide a scientific basis for individualised medicine for preschool children with ADHD in routine clinical care. Trial registration The trial was registered at the German Clinical Trials Register (DRKS) as a Current Controlled Trial under DRKS00008971 on 1 October 2015. This manuscript is based on protocol version 3 (14 October 2016).


2019 ◽  
Vol 18 (6) ◽  
pp. 1467-1481 ◽  
Author(s):  
Rapson Gomez ◽  
Vasileios Stavropoulos ◽  
Alasdair Vance ◽  
Mark D. Griffiths

AbstractThe present study focused on inattention and hyperactivity/impulsivity differences of gifted children with and without attention deficit-hyperactivity disorder (ADHD). Based on clinical assessment utilizing the Anxiety Disorders Interview Schedule for Children (ADISC-IV) and the Wechsler Intelligence Scale for Children—Fourth Edition, attendees of a public outpatient child service (boys = 359, girls = 148), with mean age 10.60 years (SD = 3.08 years), were allocated into four groups: ADHD (N = 350), gifted (N = 15), gifted/ADHD (N = 18), and clinical controls (N = 124). The Strengths and Weaknesses of ADHD-Symptoms and Normal Behavior Scale dimensionally assessed inattention and hyperactivity/impulsivity variations. Compared to the gifted/ADHD group, the ADHD group had higher scores for inattention and comparable scores for hyperactivity/impulsivity. For most symptoms, the ADHD groups (gifted or not) rated higher than the non-ADHD groups (control and gifted without ADHD). Findings appeared to indicate that (i) ADHD is a valid diagnosis among children who are gifted, (ii) gifted children might tend to be less inattentive than non-gifted ADHD children, and (iii) ADHD-gifted children appear to differ from the non-ADHD-gifted children with regard to specific hyperactive and impulsive behaviors. The practical implication of these findings is that clinicians may wish to focus on these symptoms when diagnosing ADHD among children with high intelligence.


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