“Late-onset” ADHD symptoms in young adulthood: Is this ADHD?

Objective: We investigated whether “late-onset” ADHD that emerges in adolescence/adulthood is similar in risk factor profile to: (1) child-onset ADHD, but emerges later because of scaffolding/compensation from childhood resources; and (2) depression, because it typically onsets in adolescence/adulthood and shows symptom and genetic overlaps with ADHD. Methods: We examined associations between late-onset ADHD and ADHD risk factors, cognitive tasks, childhood resources and depression risk factors in a population-based cohort followed-up to age 25 years ( N=4224–9764). Results: Parent-rated late-onset ADHD was like child-onset persistent ADHD in associations with ADHD polygenic risk scores and cognitive task performance, although self-rated late-onset ADHD was not. Late-onset ADHD was associated with higher levels of childhood resources than child-onset ADHD and did not show strong evidence of association with depression risk factors. Conclusions: Late-onset ADHD shares characteristics with child-onset ADHD when parent-rated, but differences for self-reports require investigation. Childhood resources may delay the onset of ADHD.

Immediate and Sustained Effects of Neurofeedback and Working Memory Training on Cognitive Functions in Children and Adolescents with ADHD: A Multi-Arm Pragmatic Randomized Controlled Trial

Objective: To evaluate the effects of neurocognitive training methods on targeted cognitive functions in children and adolescent with ADHD. Method: A pragmatic four-arm randomized controlled trial compared two types of neurofeedback (Slow Cortical Potential and Live Z-score) and Working-memory training (WMT) with treatment as usual. N = 202 participants with ADHD aged 9 to 17 years were included. A battery of cognitive function tests was completed pretreatment, posttreatment, and after 6-months. Results: The effects of WMT on spatial and verbal working-memory were superior to neurofeedback and treatment as usual at posttreatment, but only partially sustained at follow-up. No other consistent effects were observed. We found no clear indications that effects were moderated by ADHD presentation, ongoing medication, age, or sex. Conclusion: The sustained effects of neurocognitive training on cognitive functioning in children and adolescents with ADHD may be limited. Future research should focus on more personalized forms of neurocognitive training.

Early Development of ADHD and ODD Symptoms from the Toddler to Preschool Years

Objective: ADHD and ODD are commonly co-occurring, but often studied individually. This study evaluated common trajectories of these disorders and explored how they co-develop in early childhood. Method: Community parents ( N = 273) completed online surveys about their 2-year-old. Children’s inattention, hyperactivity/impulsivity, and oppositional defiant disorder symptoms over 2 years were examined using latent class, dual trajectory, and cross-lagged analyses. Results: Most children followed low symptom trajectories. A small portion showed high, moderate, or increasing trajectories. The hyperactive/impulsive domain of ADHD showed a declining symptoms group. Children in high ODD groups were likely to be in high ADHD symptom groups; the converse was true but probabilities were lower. Hyperactive/impulsive symptoms predicted ODD symptoms across time, more than vice versa. Conclusion: The study extends the small body of literature assessing early development of ADHD and ODD. Findings suggest that earlier intervention for symptoms of ADHD may mitigate risk of developing ODD.

Depressive Symptoms Account for Loss of Positive Attention Bias in ADHD Patients: An Eye-Tracking Study

Objectives: Depression and ADHD often co-occur and are both characterized by altered attentional processing. Differences and overlap in the profile of attention to emotional information may help explain the co-occurence. We examined negative attention bias in ADHD as neurocognitive marker for comorbid depression. Methods: Patients with depression ( n = 63), ADHD ( n = 43), ADHD and depression ( n = 25), and non-psychiatric controls ( n = 68) were compared on attention allocation toward emotional faces. The following eye-tracking indices were used: gaze duration, number of revisits, and location and duration of first fixation. Results: Controls revisited the happy faces more than the other facial expressions. Both the depression and the comorbid group showed significantly less revisits of the happy faces compared to the ADHD and the control group. Interestingly, after controlling for depressive symptoms, the groups no longer differed on the number of revisits. Conclusion: ADHD patients show a relative positive attention bias, while negative attention bias in ADHD likely indicates (sub)clinical comorbid depression.

The Task Matters: A Scoping Review on Reading Comprehension Abilities in ADHD

Objective: A broad range of tasks have been used to classify individuals with ADHD with reading comprehension difficulties. However, the inconsistency in the literature warrants a scoping review of current knowledge about the relationship between ADHD diagnosis and reading comprehension ability. Method: A comprehensive search strategy was performed to identify relevant articles on the topic. Thirty-four articles met inclusion criteria for the current review. Results: The evidence as a whole suggests reading comprehension is impaired in ADHD. The most prominent effect was found in studies where participants retell or pick out central ideas in stories. On these tasks, participants with ADHD performed consistently worse than typically developing controls. However, some studies found that performance in ADHD improved when reading comprehension task demands were low. Conclusion: Results suggest that performance in ADHD depends on the way reading comprehension is measured and further guide future work clarifying why there are such discrepant findings across studies.

The Processes Underlying Positive Illusory Bias in ADHD: The Role of Executive Functions and Pragmatic Language Skills

Objective: Children with ADHD often show a positive illusory bias (PIB), reporting an extremely positive idea of their own competence, despite their difficulties. The mechanisms underlying this phenomenon are still poorly understood. In the present study, we examined social PIB and investigated the role of executive functions (EFs) and pragmatic language (PL). Method: Forty-one children with ADHD and 42 typically-developing children matched on age, IQ, and receptive language were administered measures of social competence, EFs and PL. The parents were also asked to estimate their child’s social competence. Results: There was evidence of social difficulties and PIB in children with ADHD. Only PL, not EFs, seemed to mediate the association between ADHD and PIB. Conclusion: Our findings suggest that PL abilities should be considered in efforts to improve self-perception in children with ADHD.

Parent ADHD Is Associated With Greater Parenting Distress in the First Year Postpartum

Objective: Little is known about the experience of parenting infants when a mother or father has ADHD. This study examined cross-sectional predictors of parenting distress experienced by parents with and without ADHD who also have infants. Methods: Participants were 73 mother-father pairs ( N = 146) of infants 6 to 10 months old. Half of the families included a parent with ADHD. Psychosocial predictors were tested using multilevel modeling. Results: Parent or partner ADHD, lower parent sleep quality, fewer social supports, and less infant surgency and effortful control were associated with greater parental distress. Infant negative affect and sleep were not associated. Conclusions: Parents with ADHD and their partners experience greater parenting distress in the first year of their child’s life than parents without ADHD. Addressing parent ADHD symptoms and co-occurring difficulties, including sleep disturbances, are potential targets for early interventions to maximize both parent and infant mental health outcomes.

A Systematic Review of Longitudinal Studies Investigating the Association Between Early Life Maternal Depression and Offspring ADHD

Objective: The systematic review sought to understand the relationship between maternal depression and later ADHD in children. Method: Three databases were used to identify the studies (Medline, Web of Science and PsychInfo) resulting in 1,223 studies being screened and 14 articles being included in the review. Results: The majority of studies ( N = 11) reported a significant relationship between maternal depression (across both prenatal and postnatal periods) and ADHD symptoms in children. This relationship remained significant when temperament, or past ADHD symptoms were controlled for. Several methodological issues were identified including; overreliance on maternal report and parental ADHD not being accounted for in most studies. Conclusion: The review adds to the literature regarding the temporal relationship between maternal depression and the development of ADHD in children, and thus supports the case for improving access to mental health services for mothers as a preventative strategy in the development of child psychopathology.

Hospital-Based Modified Cogmed Working Memory Training for Youth With ADHD

Objective: This study evaluated a modified working memory training program, Cogmed, for ADHD youth. Method: Forty youth were randomized to modified Cogmed training (MCT) or treatment as usual (CON). MCT was delivered in an outpatient mental health clinic in 3 weekly 35-minute sessions with a dedicated coach for 10 weeks. Participants completed assessments at baseline, after the intervention, and again 3 months later. Results: After controlling for baseline, groups were comparable on working memory, academics, and ADHD symptoms. The MCT group was rated by parents and teachers as having fewer executive function challenges and youth endorsed better self-concept compared with the CON group. Conclusions: MCT was associated with some improvement, which could not be attributed to increased working memory capacity and may reflect other facets of the program. Results question the usefulness of Cogmed but highlight considerations for optimizing adherence, engagement, and the therapeutic alliance in interventions for ADHD youth.

Incremental Validity of Multi-Method and Multi-Informant Evaluations in the Clinical Diagnosis of Preschool ADHD

Objectives: This study investigated the discriminative validity of various single or combined measurements of electroencephalogram (EEG) data, Conners’ Kiddie Continuous Performance Test (K-CPT), and Disruptive Behavior Disorder Rating Scale (DBDRS) to differentiate preschool children with ADHD from those with typical development (TD). Method: We recruited 70 preschoolers, of whom 38 were diagnosed with ADHD and 32 exhibited TD; all participants underwent the K-CPT and wireless EEG recording in different conditions (rest, slow-rate, and fast-rate task). Results: Slow-rate task-related central parietal delta (1–4 Hz) and central alpha (8–13 Hz) and beta (13–30 Hz) powers between groups with ADHD and TD were significantly distinct ( p < .05). A combination of DBDRS, K-CPT, and specific EEG data provided the best probability scores (area under curve = 0.926, p < .001) and discriminative validity to identify preschool children with ADHD (overall correct classification rate = 85.71%). Conclusions: Multi-method and multi-informant evaluations should be emphasized in clinical diagnosis of preschool ADHD.