Evaluation of Adolescents with Restless Legs Syndrome: Relation to School Success

Restless Legs Syndrome (RLS), which may be a missed diagnosis in children, is seen at an important frequency. The aim of this study was to investigate the clinical characteristics of patients with RLS and to show the effect of RLS on school success. Forty-three patients with RLS and 43 healthy volunteers were included to the study. Blood samples were taken to measure ferritin. The averages of school exam scores were recorded. The patient group was classified as mild, moderate, severe, and very severe according to the RLS rating scale. The daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS). The"Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S)" was completed by parents, and patients' inattention, and hyperactivity-impulsivity scores were compared with the control group. According to the RLS rating scale scores 25.6% (n:11) were evaluated as mild, 60.5% (n:26) were moderate and 14% (n:6) were severe. The mean ferritin level was significantly lower in the patient group. The mean score of inattention and hyperactivity-impulsivity in the patient group to be significantly higher than the control. The mathematics and science course mean grades were significantly lower in the patient group than the controls (66.7±17.7 vs 74.2±11.7). ESS scores were found to be significantly higher in the patient group. In this study, RLS has been found associated with ADHD and iron deficiency, similar to previous studies. There are not many studies on the effects of RLS in children on daily life and this study has objectively shown that RLS reduces patients' school achievement

Hyperactivity and Inattention in Young Patients Born With an Atrial Septal or Ventricular Septal Defect

Background: Patients with congenital heart defects have a well-established risk of neuropsychiatric comorbidities. Inattention and hyperactivity are three to four times more frequent in children with complex congenital heart defects. We have previously shown a higher burden of overall attention deficit/hyperactivity disorder (ADHD) symptoms in adults with simple congenital heart defects as well. However, it is unknown whether the higher burden of ADHD symptoms is mainly driven by hyperactivity, inattention, or both.Methods: The participants [simple congenital heart defect = 80 (26.6 years old), controls = 36 (25.3 years old)] and a close relative for each (n = 107) responded to the long version of the Conners' Adults ADHD Rating Scales questionnaire. Our primary and secondary outcomes are mean T-scores in the ADHD scores and symptom sub-scores.Results: Patients with simple congenital heart defects reported a higher mean T-score at all three DSM-IV ADHD scores (ADHD—combined: 52.8 vs. 44.9, p = 0.007, ADHD—inattention: 55.5 vs. 46.4, p = 0.002, and ADHD—hyperactivity: 49.4 vs. 44.0, p = 0.03) and in all four ADHD symptom sub-scores (inattention/memory problems: 50.3 vs. 44.2, p = 0.001, hyperactivity/restlessness: 49.7 vs. 45.9, p = 0.03, impulsivity/emotional lability: 50.0 vs. 41.3, p = 0.001, and self-esteem problems: 53.8 vs. 46.3, p = 0.003). The results were maintained after the removal of outliers (incongruent responses), albeit the hyperactivity/restlessness ADHD symptom sub-score lost significance. Self- and informant ratings differed significantly on the ADHD—inattention score for the congenital heart defect group, where informants rated the ADHD—inattention scores better than the congenital heart defect patients rated themselves.Conclusions: Patients with a simple congenital heart defect have a higher symptom burden across all ADHD scores and all symptom sub-scores. The higher burden of ADHD is driven by both inattention and hyperactivity symptoms, though the inattention symptoms seem more prominent. Close relatives were less aware of the inattention symptoms than the congenital heart defect patients themselves. Routine screening for ADHD symptoms may be warranted to facilitate adequate help and guidance as these symptoms are easily overlooked.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03871881.

Inattention and hyperactivity symptoms in childhood predict physical activity in adolescence

Background Physical activity has been documented to influence several aspects of physical and mental health. Growing evidence shows that physical activity can improve attention. Less is known about how symptoms of inattention and hyperactivity / impulsivity in childhood are associated with physical activity in adolescence. We aimed to explore this relationship further. Methods We used a cohort of 3949 Swedish children (1884 boys and 2065 girls) with data collected at ages 9 (or 12) and 15. We investigated the influence of symptoms of inattention and hyperactivity / impulsivity in childhood – age 9/12 (inattention and hyperactivity/impulsivity separately) on self-rated physical activity at age 15, using multiple logistic regression models. We considered potential confounders such as sex, parental education level, physical activity in childhood and neurodevelopmental comorbidity. A cluster robust sandwich estimator was applied to adjust the standard errors for the nested twin data when computing the regression models. Results Symptoms of inattention in childhood (9/12) predicted less physical activity in adolescence (age 15) (OR = 0.83 CI = 0.78–0.89), whereas the opposite was true for hyperactivity/impulsivity (OR = 1.08 CI = 1.02–1.10). These associations still remained when taking possible confounders into account including neurodevelopmental and neurodevelopmental related comorbidity. Conclusions These findings support the importance of helping children and adolescents with inattention symptoms to engage in physical activity in suitable settings.

he effects of neurofeedback on attention and sleep in individuals with and without ADHD or insomnia: a literature review

Electroencephalography-Neurofeedbacktraining (E-NFT) is a method to support subjects in learning to self-regulate their own brain activity. Besides that E-NFT may improve cognitive functions in healthy people, it may improve symptoms in different disorders, such as Attention Deficit and Hyperactivity Disorder (ADHD) and insomnia. The evidence of E-NFT for the treatment of attention problems in ADHD is still under debate just as the suggested efficacy of E-NFT for reducing sleep problems in individuals suffering from insomnia and for improving attention and sleep in the general population. Therefore, this review examines the efficacy of E-NFT on attention and sleep in patients and healthy individuals. The reviewed literature provides evidence that standard E-NFT protocols may have a positive long-lasting effect on the inattention and hyperactivity/impulsivity symptoms in children with ADHD. In healthy children and young adults, E-NFT has been found to improve different aspects of attention and to reduce impulsivity. In addition, positive effects of E-NFT have been documented on sleep onset latency and on tiredness in healthy individuals. Sleep improvements have also been found in insomnia patients after standard E-NFT, although these subjective sleep improvements may likely depend on unspecific E-NFT training effects.

How interactions between ADHD and schools affect educational achievement: a family-based genetically sensitive study

Background: Children with ADHD tend to achieve less than their peers in school. It is unknown whether schools moderate this ADHD deficit. Selection into schools poses a methodological problem.Methods: We linked data on ADHD symptoms of inattention and hyperactivity and parent-child ADHD polygenic scores (PGS) from the Norwegian Mother, Father, and Child Cohort Study (MoBa) to standardised test results and school identifiers. Using multilevel models, we estimated interactions of school effects with individual differences between students in inattention, hyperactivity, and ADHD-PGS. In our PGS analyses, we ruled out selection by adjusting for parental ADHD-PGS (a within-family PGS design). We then tested whether five measures of the social backgrounds of students at the schools explained any interactions. Results: Analysis of up to 23,598 students attending 2,579 schools revealed interactions between school and ADHD effects on standardised test results. The variability between schools in the effects of inattention, hyperactivity, and within-family ADHD-PGS on achievement was 0.08, 0.07, and 0.05 SDs, respectively. For example, a one SD increase in inattention changed achievement by -0.23 SDs (SE=0.009) on average, but in 2.5% of schools with the weakest effects, the value was -0.07 or less. Schools contributed more to achievement differences for students with higher levels of ADHD, explaining more than four times as much variance in achievement for children with high versus average inattention symptoms. School sociodemographic measures could not explain the ADHD-by-school interactions.Conclusion: Associations between ADHD and achievement are context dependent. Children with elevated ADHD symptoms and genetic risk perform better in some schools than others. Future research should identify specific school factors that support these students, potentially using the within-family gene-environment interaction approach introduced here.

Frequency of Attention Deficit Hyperactivity Disorder (ADHD) in children aged 6-11 years old in the city of Piranshahr

Background. One of the most common childhood disorders is attention-deficit/hyperactivity disorder (ADHD). This study aimed to determine the prevalence of ADHD in children aged 6-11 years in Piranshahr city (Iran). Methods. This descriptive-analytical study involved six hundred primary school students (300 girls and 300 boys) in Piranshahr city who were enrolled in the study using stratified random sampling. The frequency of ADHD was assessed using the short form of the Conners Teacher and Parent Rating Scale. Results. The frequency of inattention and hyperactivity indices in girls were respectively 13% and 15%, per Conners Parents Rating Scale, and 14.6% and 16.6% per Conners Teacher Rating Scale, while the frequency of ADHD index was 6.33% and 8.66%, respectively. The frequency of inattention and hyperactivity indexes in boys were respectively 11% and 17% per Conners Teacher Rating Scale, and 20.6% and 24.6%, respectively, per Conners Parents Rating scale, whereas the frequency of ADHD index was based on parents and teacher was 5.6% and 18.3%, respectively. Conclusion. This study showed that the prevalence of children prone to ADHD in the Piranshahr region is relatively high in comparison with other regions of the country. Therefore, it is necessary to study this disorder in the identity card of children at the entrance to kindergartens and schools to identify the patients, so through timely and appropriate intervention, its important complications in adolescence and adulthood can be prevented.

ADHD and ODD Dimensions: Time Varying Prediction of Internalizing Problems from Childhood to Adolescence

Objective Although childhood ADHD is a risk factor for internalizing problems, it consists of separable inattention and hyperactivity dimensions that differentially predict outcomes. Oppositional defiant disorder also consists of separable dimensions (i.e., irritable, oppositional), co-occurs with ADHD, and predicts internalizing outcomes. To discern independent associations with internalizing problems, dimensions must be considered simultaneously. Methods Controlling for age, sex, and race, we tested inattention, hyperactivity, irritability, and oppositionality as time-varying predictors of 6 to 7-year prospective change in parent- and teacher-rated internalizing problems in 230 ethnically- diverse (50% Caucasian) 5 to 10 year old youth ( M = 7.4 years, 68% male) with ( n = 120) and without ADHD ( n = 110). Results Escalating inattention and irritability, but not hyperactivity and oppositionality, uniquely predicted internalizing problems. Conclusion These findings suggest that inattention and irritability are unique risk factors for later internalizing problems. These dimensions may catalyze internalizing problems across development and constitute important intervention targets.

Elevated risk of attention deficit hyperactivity disorder (ADHD) in Japanese children with higher genetic susceptibility to ADHD with a birth weight under 2000 g

Background Both genetic and pre- and perinatal factors, including birth weight, have been implicated in the onset of attention deficit hyperactivity disorder (ADHD) traits among children. This study aimed to elucidate to what extent the genetic risk of ADHD moderates the association between birth weight and ADHD traits among Japanese children. Methods We conducted a longitudinal birth cohort study (Hamamatsu Birth Cohort for Mother and Children Study) to investigate the association of genetic risk for ADHD and low birth weight with ADHD traits among Japanese children. Out of 1258 children, we included 796 who completed follow-ups at 8 to 9 years of age. Birth weight was categorized as <2000 g, 2000–2499 g, and ≥2500 g. Polygenic risk score for ADHD was generated using the summary data of a large-scale genome-wide association study. The Rating Scale IV (ADHD-RS) assessed ADHD traits (inattention and hyperactivity/impulsivity) based on parental reports. Following previous studies, sex, birth order of the child, gestational age at birth, mother’s age at delivery, educational attainment, pre-pregnancy body mass index, pre-pregnancy or during pregnancy smoking status, alcohol consumption during pregnancy, father’s age, education, and annual family income were considered as covariates. Multivariable negative binomial regression was applied to evaluate the association between birth weight and ADHD traits, while adjusting for potential covariates. The interaction term between birth weight categories and binary polygenic risk was added to the model. Results Birth weight of 2000–2499 g was not associated with ADHD traits. Birth weight under 2000 g was significantly associated with both inattention and hyperactivity. When accounting for higher and lower genetic risk for ADHD, only those with higher genetic risk and birth weight < 2000 g were associated with inattention (rate ratio [RR] 1.56, 95% CI 1.07–2.27) and hyperactivity (RR 1.87, 95% CI 1.14–3.06). Conclusions Birth weight under 2000 g, together with the genetic risk of ADHD, contributes to higher levels of ADHD traits among Japanese children aged 8 to 9 years. The suggested association between low birth weight and ADHD is confined to children with a genetic susceptibility to ADHD, indicating the relevance of genetic-environmental interactions in the etiology.

Effect of a Plyometric Training Program on the Physical Parameters of ADHD Children: Behavioral and Cognitive Consequences

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopment disorder with inappropriate levels of inattention and hyperactivity/impulsivity that emerge during preschool-age causing several impairement that should be supported. Objectives: The purpose of this research was to explore the repercussion of plyometric training protocol (PT) on disruptive behavior and executive control among children with ADHD. Methods: Executive functions and ADHD related behaviors are assessed by graded tests before and after a 12-week PT (plyometric training) or NPT (did not perform PT training). Results: Findings show that participation in PT enhances behavior reports by parents and teachers (P < 0.001) and level of executive function (P < 0.001). Conclusions: These findings suggest that PT may improve positively ADHD symptomatology.