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Children with neurofibromatosis type 1 (NF1) often experience executive dysfunction, attention deficit/hyperactivity disorder (ADHD) symptoms and poor social skills, however, the nature of the relationships between these domains in children with NF1 is unclear. This study investigated these relationships using primary caregiver ratings of executive functions, ADHD symptoms and social skills in children with NF1. Participants were 136 children with NF1 and 93 typically developing (TD) controls aged 3-15 years recruited from 3 multidisciplinary neurofibromatosis clinics in Melbourne and Sydney, Australia, and Washington DC, USA. Mediation analysis was performed on primary outcome variables: parent ratings of executive functions (Behavior Rating Inventory of Executive Function, Metacognition Index), ADHD symptoms (Conners-3/Conners ADHD Diagnostic and Statistical Manual for Mental Disorders Scales) and social skills (Social Skills Improvement System-Rating Scale), adjusting for potential confounders (full scale IQ, sex, and social risk). Results revealed significantly poorer executive functions, elevated ADHD symptoms and reduced social skills in children with NF1 compared to controls. Poorer executive functions significantly predicted elevated ADHD symptoms and poorer social skills. Elevated ADHD symptoms significantly mediated the relationship between executive functions and social skills problems although did not fully account for social dysfunction. This study provides evidence for the importance of targeting ADHD symptoms as part of future interventions aimed at promoting prosocial behaviors in children with NF1.

The study investigated set-shifting impairment differences in children by Attention Deficit Hyperactive Disorder (ADHD) subtype compared to neurotypical peers. The sample consisted of 156 primary s...

Emerging evidence highlights intraindividual variability (IIV) during executive function (EF) tasks as a reliable endophenotype of Attention Deficit/Hyperactivity Disorder (ADHD) and as contributing to motor dysregulation and hyperactive-impulsive behaviors. This study examined the relationship between EF and motor control in children with and without ADHD.Ninety-seven children (6-13 years) completed standardized and experimental tasks of executive and motor control. Primary caregivers completed a semi-structured interview, and behavioral rating forms for ADHD symptoms and EF.Children with ADHD demonstrated lower performance on motor dexterity and sequencing tasks, and greater IIV during EF tasks with lower cognitive demand. IIV accounted for ADHD symptoms of hyperactivity, beyond age and motor dexterity. IIV from EF measures with lower cognitive demand was also sensitive to ADHD symptoms.IIV metrics may tap into the motor regulation challenges associated with ADHD, as well as attentional lapsing at lower levels of cognitive demand.

This article reports on the perceptions of single parents on their parenting styles in raising their children living with attention-deficit/hyperactive disorder (ADHD). Purposive sampling was used ...

Adult Attention Deficit/Hyperactivity Disorder (ADHD) is prone to misdiagnosis because its symptoms are subjective, share features with a broad range of mental, behavioral and physical disorders, and express themselves heterogeneously. Furthermore, Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for adult ADHD diagnosis remain underdeveloped, prompting a need for systematic and empirically-informed guidelines.This article presents a brief history of research on adult ADHD and reviews common sources of false positive and false negative diagnoses. A systematic, stepped diagnostic procedure is described that adheres to DSM guidelines and integrates the latest science on adult ADHD assessment and diagnosis.Seven steps are recommended: a structured diagnostic interview with the patient, collection of informant ratings, casting a wide net on symptoms using "or rule" to integrate informant reports, providing checks and balances on the "or rule" by enforcing the impairment criterion, chronicling a symptom timeline, ruling out alternative explanations for symptoms, and finalizing the diagnosis.Based on the extant research, it is expected that the stepped diagnostic procedure will increase detection of malingering, improve diagnostic accuracy, and detect non-ADHD cases with subclinical difficulties or non-ADHD pathologies.

Given the functional impairments associated with Attention Deficit/Hyperactivity Disorder (AD/HD), a valid diagnosis is important. However, particularly when carried out in adulthood, the diagnostic process can be challenging and is complicated by conclusive evidence that a proportion of individuals referred for evaluation of AD/HD exaggerate or feign their symptoms. Relatively few methods, however, exist to identify such feigning. While continuous performance tests (CPTs) may provide useful information regarding performance validity, the question remains as to whether there are consistent patterns of exaggeration demonstrated by those feigning AD/HD. Thus, this study used cluster analysis to determine whether valid and reliable performance clusters would emerge based on CPT performance. Using archival data from a university-based AD/HD screening clinic, we investigated the performance of 305 adults on the Test of Variables of Attention (TOVA). Three profiles emerged, including one cluster who demonstrated exceptionally low performance on the TOVA, exceptionally high reports of AD/HD symptomology, and higher rates of failure on symptom and performance validity tests. The implication from our analysis is that this group most likely represents individuals who were exaggerating or magnifying their difficulties. The results reaffirm previous research showing that performance profiles on a continuous performance test can be used as an indicator of credible performance.

This study investigated the relationship between symptom validity scales on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in the context of Attention-Deficit/Hyperactivity Disorder (ADHD) evaluation. The sample comprised 140 consecutive patients referred for a neuropsychological evaluation of ADHD and were administered the CAT-A and the MMPI-2-RF and a battery of performance-based neurocognitive tests. Results indicated CAT-A/MMPI-2-RF symptom validity concordance of 51% between measures, with 38% concordant valid and 13% concordant invalid responses. Among those with discordance symptom validity results, rates of valid CAT-A/invalid MMPI-2-RF responding (41%) were more common than invalid CAT-A/valid MMPI-2-RF responding (8%). Results also indicated higher levels of ADHD symptoms among invalid responding within the CAT-A, whereas the MMPI-2-RF Cognitive Complaints scale did not differ by CAT-A validity status. Finally, symptom validity scales on both the CAT-A and MMPI-2-RF were largely discordant from neuropsychological test validity status per performance validity tests. Findings highlight the need for symptom validity testing when assessing ADHD and indicate that validity indices on broad personality assessments may assess different constructs than embedded validity indices in ADHD-specific measures.

Attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents. We aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD + BPD in an inpatient sample to determine the effect of co-morbidity on mentalization abilities.We have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD + BPD groups in terms of their mentalization abilities.Correct MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups.We included only inpatient sample without considering their medication condition, we did not compare the mentalization scores of the patient groups with healthy controls and we used self-report measures for several assessments.Mentalization patterns in ADHD and BPD are distinct. ADHD may be related to hypomentalization, instead, BPD may be related to hypermentalization.

The relation between sustained attention in the laboratory and behaviors exhibited in naturalistic settings among children with Attention Deficit/Hyperactivity Disorder (ADHD) remains unclear. Additionally, research on stimulant medication effects in these areas and their association with one another remains scarce. Twenty-one children with ADHD and 21 children without ADHD completed a novel continuous performance test (CPT) involving high cognitive demands (e.g., visual search). Participants with ADHD also attended a Summer Treatment Program and received three doses of stimulant medication (placebo, low, and high). Their behavior in classroom and peer settings was observed and recorded, and they completed the CPT in each medication condition. The CPT measures of bias and sensitivity were used in analyses. Results indicated that children with ADHD had impaired overall performance and worse bias during the second half of the task compared to controls. Methylphenidate improved both naturalistic behavior and overall CPT performance but did not specifically improve the sustained attention deficit. Despite improvements in overall CPT performance, medication-related improvement in CPT performance did not mediate medication-related improvement in observed behavior in classroom or recreational settings. As such, our findings suggest that although children with ADHD do demonstrate a sustained attention deficit, salutary psychostimulant effects on CPT performance are not indicative of, or causally linked to, psychostimulant effects on presenting problems in naturalistic settings.

Attention Deficit/Hyperactivity Disorder (ADHD) is associated with difficulty initiating and following-through with tasks. When coaching clients with ADHD (a type of coaching called ‘ADHD coaching’...

This study examined the predictive role of attention deficit disorders (ADHD) on the experience of loneliness among college students during the move to distance learning and social distancing polic...

Previous studies have indicated that stuttering is often accompanied by co-occurring disorders, including social anxiety disorder, attention deficit/hyperactivity disorder (ADHD), and autism spectr...

The number of referrals for diagnostic assessments of Attention Deficit/Hyperactivity Disorder (ADHD) has increased in the last decade. There is a lack of studies examining the diagnostic process and the treatment provided, particularly from a gender perspective.From a consecutive cohort of Child and Adolescent Psychiatric (CAP) outpatients, the medical records of 50 boys and 50 girls (under 18 years of age) with a diagnosis of ADHD were selected by an Excel random numbers generator. Data about referral reason, diagnostic process and treatment were analysed.Emotional symptoms were more common as a reason for referral to CAP among girls, whereas neurodevelopmental disorders were more common among boys. Compared to the boys, the girls were older at first visit to CAP and at the ADHD diagnosis. The girls had had more visits to the clinic prior to the ADHD diagnostic decision and had more often been prescribed non-ADHD medication both before and after the ADHD diagnosis. The rate of ADHD medication was similar in boys and girls. Girls had more often been admitted to a CAP inpatient care unit prior to the ADHD diagnosis due to acute psychiatric symptoms, and had received more individual psychotherapeutic counselling.The results highlight the need for broader psychiatric investigations including neuropsychiatric symptoms in girls referred for 'emotional problems'.

Introduction Behavioural problems in pre-school children are closely related to their mental health. Such problems include attention deficit, personality disorder, overdependency, poor adaptability and conduct problems. Methods From December 2018 to January 2019, we conducted a cross-sectional survey of parents of pre-schoolers. The survey covered sixteen kindergartens in six districts of Chongqing, China. A total of 2200 participants participated in the survey, and 1895 questionnaires were returned. After screening, 1496 valid questionnaires were compiled in the data analysis (n=1496). Results Analysis of the maximum likelihood estimation revealed that age, preterm birth, household income, amount of daily interaction with parents, and scolding frequency affected behavioural problems in the pre-schoolers. Behavioural problems tend to be attenuated as children grow. Preterm children had a higher probability of developing behavioural problems than did non-preterm children. Children from families with monthly household incomes between $1130-$1695 USD and $1696-$2260 USD were more prone to developing behavioural problems. Children whose parents spent less time interacting with them (39.26% of parents interacted with children less than 1 hour per day) and children who were scolded more often had greater behavioural problems (13.44% of parents often scolded their children). Discussion This study was conducted to evaluate the influence of parenting methods on pre-school children and the education provided by parents on their pre-school children's behavioural problems to provide insights for Chinese parents and mental health professionals to improve treatment of behavioural problems.

Viloxazine is currently being developed as a treatment for attention deficit/hyperactivity disorder (ADHD). The aim of these studies is to update the understanding of the rat and human metabolism a...

Background: Thought content and its impact on sustained attention in individuals with attention deficit hyperactivity disorder (ADHD) are topics of growing interest in literature.Objective: We hypo...

Epilepsy is one of the most common neurologic disorders in pediatric age, with a prevalence ranging from 3.2 to 5.5/1000, and an incidence from 40 to 180 per 100.000 [1]. Attention deficit hyperact...

This study investigated the communication skills of children with autism spectrum disorders (H. M. Geurts & M. Embrechts), Attention Deficit/Hyperactivity Disorder (Hilde M Geurts & Mariette Embrec...

OBJECTIVE: To investigate the symptom dimensions of Oppositional Defiant Disorder (ODD; irritability, defiance) and Attention-Deficit/Hyperactivity Disorder (ADHD; inattention, hyperactivity-impulsivity) as predictors of academic performance, depressive symptoms, and peer functioning in middle childhood. METHOD: Children (N=346; 51% female) were assessed via teacher-report on measures of ODD/ADHD symptoms at baseline (grades K-2) and academic performance, depressive symptoms, peer rejection, and victimization on 7 occasions over 4 school-years (from K-2 through 3-5). Self-report and GPA data collected in grades 3-5 served as converging outcome measures. Latent growth curve and multiple regression models were estimated using a hierarchical/sensitivity approach to assess robustness and specificity of effects. RESULTS: Irritability predicted higher baseline depressive symptoms, peer rejection, and victimization, whereas defiance predicted higher baseline peer rejection; however, none of these ODD-related effects persisted 3 years later to grades 3-5. In contrast, inattention predicted persistently poorer academic performance, persistently higher depressive symptoms, and higher baseline victimization; hyperactivity-impulsivity predicted subsequent peer rejection and victimization in grades 3-5. In converging models, only inattention emerged as a robust predictor of 3-year outcomes (namely, GPA, depressive symptoms, peer rejection, and relational victimization). CONCLUSIONS: Broadly, ODD dimensions—particularly irritability—may be linked to acute disturbances in social-emotional functioning in school-age children, whereas ADHD dimensions may predict more persistent patterns of peer, affective, and academic problems. By examining all four ODD/ADHD symptom dimensions simultaneously, the present analyses offer clarity and specificity regarding which dimensions affect what outcomes, and when. Findings underscore the importance of multi-dimensional approaches to research, assessment, and intervention.

OBJECTIVE: Attention-Deficit/Hyperactivity Disorder-Predominantly Inattentive Presentation (ADHD-I) and Specific Learning Disorder (SLD) are commonly co-occurring conditions. Despite the considerable diagnostic overlap, the effect of SLD comorbidity on outcomes of behavioral interventions for ADHD-I remains critically understudied. METHOD: The current study examines the effect of reading or math SLD comorbidity in 35 children with comorbid ADHD-I+SLD and 39 children with ADHD-I only following a behavioral treatment integrated across home and school (Child Life and Attention Skills [CLAS]). Pre- and post- treatment outcome measures included teacher-rated inattention, organizational deficits, and study skills; and parent-rated inattention, organizational deficits, and homework problems. RESULTS: A similar pattern emerged across all teacher-rated measures: children with ADHD-I and comorbid ADHD-I+SLD did not differ significantly at baseline, but between-group differences were evident following the CLAS intervention. Specifically, children with ADHD-I and comorbid ADHD-I+SLD improved on teacher-rated measures following the CLAS intervention, but children with ADHD-I only experienced greater improvement relative to those with a comorbid SLD. No significant interactions were observed on parent-rated measures—all children improved following the CLAS intervention on parent-rated measures, regardless of SLD Status. CONCLUSIONS: The current results reveal that children with ADHD-I+SLD comorbidity benefit significantly from multimodal behavioral interventions, although improvements in the school setting are attenuated significantly. A treatment-resistant fraction of inattention was identified only in the SLD group, implying that this fraction is related to SLD and becomes apparent only when behavioral intervention for ADHD is administered.

Introduction: It has been demonstrated that children with attention deficit and hyperactivity disorder (ADHD) have impairments in working memory (WM), and particularly its visuospatial component, responsible for academic underachievement. Furthermore, children with ADHD have difficulty in metacognition, and consequently use inappropriate strategies to control attention and impulsive behavior. The aim of the present study was to devise a training that combined individual exercises on visuospatial WM and group metacognitive activities capable of helping children with ADHD to ameliorate their performance in executive functioning tasks, and to contain their inattentive and hyperactive/impulsive behavior. Method: A combined training that focused on visuospatial WM and metacognition was administered to 12 children with a diagnosis of ADHD and 15 typically-developing children. Tasks on executive functions and questionnaires for parents and teachers were administered before and at the end of the training, and one month after the post-test. Specific short- and long-term training gains and transfer effects were examined. Effects of the training on parents' and teachers' ratings were also considered. Results: Specific gains and transfer effects were found at the post-test and long-term assessments in both typically-developing children and those with ADHD. Parents' and teachers' ratings also indicated an improvement in the symptomatic behavior of children with ADHD. Conclusion: The results of this study have clinical and educational implications. A training that combines individual computerized visuospatial WM activities with metacognitive group reflection about useful strategies seems to produce promising results, helping children with ADHD to improve their executive functioning and behavioral problems.

Objective: Attention and executive function (EF) deficits are ubiquitous in neurodevelopmental disorders including Attention Deficit/Hyperactivity Disorder (ADHD), as are high levels of intraindividual variability (IIV). Attention and EF are typically assessed using informant ratings and objective measures; however, discrepancies between different metrics often make it difficult to fully characterize a child's attention capabilities, and IIV has been proposed as a potentially useful discriminator. Our objective was to explore the relationship between IIV, using the residualized intraindividual standard deviation (rISD) method, and informant ratings of attention and EF in a mixed pediatric sample, to determine the potential utility of IIV for aiding attention diagnostics. Another commonly used, though controversial, IIV indicator, the coefficient of variation (ICV), was calculated for comparison purposes. Method: We assessed 51 children with varying degrees of attention and EF deficits. Measures included parent and teacher responses on the Comprehensive Executive Function Inventory (CEFI) and response times (RT) on a go/no-go task, which were used to estimate IIV. Results: Mean RT, rISD, and ICV were significantly related to parent and teacher ratings of attention, though ICV showed a relatively weaker association. rISD also showed associations with parent ratings of working memory and self-monitoring, as well as teacher ratings of working memory. Conclusion: The significant, and relatively stronger, relationship between rISD and parent and teacher ratings of attention supports the use of this metric, compared to mean RT and ICV. The rISD indicator of IIV thus shows potential utility as a unique and objective measure of attention in children across various neurodevelopmental disorders and, with additional research, may prove useful for diagnosis of attention problems.

College students with attention deficit/hyperactivity disorder are likely to engage in alcohol use and experience alcohol-related problems. Use of protective behavioral strategies is related to fewer alcohol-related consequences. However, this association has not been sufficiently examined in relation to attention deficit/hyperactivity disorder symptoms, which could alter the likelihood of utilizing protective behavioral strategies. This study examined whether attention deficit/hyperactivity disorder symptoms moderate the relationship between protective behavioral strategies and alcohol use, and whether this differs by sex. Participants were 125 treatment-mandated college students (58.6% male; Mage = 19.50 years) who completed measures of attention deficit/hyperactivity disorder symptoms, protective behavioral strategies, and past-2-week drinking. There was a significant 3-way interaction such that drinking was highest when protective behavioral strategy use was low and hyperactivity/impulsivity symptoms were high, but only for women. There was also a significant protective behavioral strategy by inattention interaction, as students with high inattention and low protective behavioral strategy use consumed the most drinks. Interventions to enhance use of protective behavioral strategies may effectively decrease alcohol use for college students with attention deficit/hyperactivity disorder symptoms, particularly women.

Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings ar...

OBJECTIVE: The objective was to determine the proportion of trait (consistency across occasions) and occasion-specific variance in sluggish cognitive tempo (SCT), attention-deficit/hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) symptom ratings. METHODS: A single trait factor-multiple state factors model was applied to parent ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms for 978 children (50% female) across prekindergarten (M= 4.90 years), kindergarten (M = 6.27 years), first (M = 7.42 years), second (M = 8.45 years), and fourth grade (M = 10.45 years) assessments. RESULTS: For the prekindergarten assessment, SCT, ADHD-IN, ADHD-HI, and ODD contained more occasion-specific than trait variance (54%, 64%, 56%, and 55% occasion-specific variance, respectively). In contrast, SCT, ADHD-IN, ADHD-HI, and ODD contained more trait than occasion-specific variance for the kindergarten through fourth grade assessments (62% to 72%, 65% to 68%, 71% to 75%, and 60% to 69% trait variance, respectively). CONCLUSIONS: SCT, ADHD-IN, ADHD-HI, and ODD are slightly to moderately more state-like than trait-like during the prekindergarten developmental period but are more stable traits than fluctuating states from kindergarten to fourth grade. Findings indicate that, particularly after children start formal schooling, these psychopathology dimensions are primarily stable traits; implications for assessment are discussed.

We aimed to identify adolescent mediators of the significant and sizable link between childhood attention deficit/hyperactivity disorder (ADHD) and later unplanned pregnancy in our prospectively followed, all-female sample. Participants included an ethnically diverse (47% non-White) sample of women with (n =140) and without (n =88) childhood ADHD who were assessed 4 times across childhood, adolescence, and adulthood. Potential mediators were measured via self, parent, and teacher report on questionnaires and interviews and by objective testing. We tested 5 early adolescent variables in three domains (personality, behavioral, and academic) as components of serial mediation pathways from (a) childhood ADHD status to (b) the early adolescent putative mediator to (c) risky sexual behavior in late adolescence and finally to (d) unplanned pregnancy by early adulthood. Of these, academic achievement (indirect effect=.1339, SE =.0721), 95% confidence interval (CI) [.0350, .3225] and substance use frequency (indirect effect=.0211, SE =.0167), 95% CI [.0013, .0711] operated through late-adolescent risky sexual behavior to explain rates of unplanned pregnancy, even adjusting for the effects of age, IQ, and family socioeconomic status (SES). When these 2 indirect effects were entered simultaneously, only the pathway from childhood ADHD to low academic achievement to higher rates of risky sexual behavior to unplanned pregnancy was significant (indirect effect=.0295, SE =.0145), 95% CI [.0056, .0620]. We discuss the significance of these early adolescent mediators, particularly academic engagement, as potential intervention targets intended to reduce rates of later unplanned pregnancies among female individuals with ADHD.

The case of Mark presents the confluence of issues that are controversial in contemporary psychoanalysis: namely, how to understand and treat a “neurodevelopmental disorder” like attention deficit ...

Purpose: The Conners Rating Scales are widely used in research and clinical practice for measuring attention deficit/hyperactivity disorder (ADHD) and associated problem behaviors, but country-spec...

Background: Parenting of children with Developmental Disabilities is considered to be a challenging task. This group of parents are at risk for lower levels of being satisfied with caregiving to th...

Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders that often persist into adulthood. ADHD is associated with a high percentage of comorbid psychiatr...

The aim of this study was to develop a screening questionnaire for auditory processing disorder (APD).Fifty-two questions were created to enable parent/teacher proxies to rate students listening skills in terms of auditory processing, attention and language factors.Parents rated their child's frequency of competent performance (regularly, often, sometimes or rarely) on 52 questions. Scores were calculated for three scales: auditory processing, attention and language. Data was collected from 198 normal controls, 20 students with auditory processing disorder, 40 students with attention deficit hyperactivity disorder and 10 students with a learning disability. Subjects were split into a younger group (7-10 y) and an older group (11-17 y).Factor analysis revealed substantial internal validity. Analysis of external validity using a regression model revealed significant differences between normal and clinical groups for all scales (p 0.001) and also significantly separated the three clinical groups. A group differential analysis of scale score results clearly demonstrated inter-group differences at 89% (on average) sensitivity and specificity levels.The auditory processing domains questionnaire appears to be an effective screening questionnaire for APD with scale score patterns likely to be helpful in making appropriate clinical referrals.

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are prevalent childhood disorders characterized by disruptive behavior. Parent-Child Interaction Therapy (PCIT) is...

Richard Gallagher, Associate Professor of Child and Adolescent Psychiatry and of Psychiatry at New York University, is Director of Special Projects at the Institute for Attention Deficit Hyperactiv...

Students with ADHD are less likely to graduate from college than their peers; this study examines the currency and readability of ADHD documentation guidelines of 335 randomly selected, four-year, public and non-profit private institutions in the United States. Findings reveal that ADHD documentation is current, yet composed at nearly a 17th-grade level, rendering it difficult for students to apply for the learning accommodations they need. Implications for practitioners and future research are addressed.

Increased intrasubject variability in reaction times (RT-ISV) is frequently found in individuals with autism spectrum disorder (ASD). However, how dimensional attention deficit/hyperactivity disorder (ADHD) symptoms impact RT-ISV in individuals with ASD remains elusive. We assessed 97 high-functioning youths with co-occurring ASD and ADHD (ASD+ADHD), 124 high-functioning youths with ASD only, 98 youths with ADHD only, and 249 typically developing youths, 8-18 years of age, using the Conners Continuous Performance Test (CCPT). We compared the conventional CCPT parameters (omission errors, commission errors, mean RT and RT standard error (RTSE) as well as the ex-Gaussian parameters of RT (mu, sigma, and tau) across the four groups. We also conducted regression analyses to assess the relationships between RT indices and symptoms of ADHD and ASD in the ASD group (i.e., the ASD+ADHD and ASD-only groups). The ASD+ADHD and ADHD-only groups had higher RT-ISV than the other two groups. RT-ISV, specifically RTSE and tau, was significantly associated with ADHD symptoms rather than autistic traits in the ASD group. Regression models also revealed that sex partly accounted for RT-ISV variance in the ASD group. A post hoc analysis showed girls with ASD had higher tau and RTSE values than their male counterparts. Our results suggest that RT-ISV is primarily associated with co-occurring ADHD symptoms/diagnosis in children and adolescents with ASD. These results do not support the hypothesis of response variability as a transdiagnostic phenotype for ASD and ADHD and warrant further validation at a neural level.

Attention deficit/hyperactivity disorder (ADHD) is now conceptualized as a life-course persistent disorder, including impairments in the occupational functional domains. Occupational impairment is ...

OBJECTIVE: Resilience models suggest that there are likely to be multiple trajectories of self-worth, and that despite experiencing impairment, some youth with attention-deficit/hyperactivity disorder (ADHD) may maintain a positive self-worth, which could buffer them against negative outcomes. The present study used a cohort-sequential longitudinal design to evaluate developmental trajectories of global self-worth in a sample of 324 middle school-aged adolescents (71% male) diagnosed with ADHD between ages 11 and 14 in predicting outcomes at age 15. METHOD: Sex, medication status, and ADHD/oppositional defiant disorder symptom severity were included as covariates in the models. RESULTS: Using Growth Mixture Modeling (GMM), three distinct self-worth trajectory groups were identified: (1) high and increasing (44.4% of participants); (2) moderate and decreasing (48.8%); and (3) low and decreasing (6.8%). Participants with high and increasing global self-worth were less likely to exhibit co-occurring depressive symptoms and had better social functioning and higher grades at age 15 relative to those in either decreasing trajectory. CONCLUSIONS: Implications of these findings for monitoring and supporting positive global self-worth for adolescents with ADHD are discussed.

The term ‘transition’ is used to refer to the process of moving from child to adult services. Among child and adolescent mental health services attenders, young people with Attention Deficit Hypera...

Positive father involvement is an express goal of early childhood programs, including Head Start, because fathers can develop positive parenting strategies that may help improve child and family functioning. The goal for this study was to adapt a clinic-based, behavioral parent training program previously used for fathers of children with attention deficit/hyperactivity disorder to be used in an after-school format for young children at risk for academic or behavioral challenges. In a pilot study, 67 fathers were randomly assigned to the behavioral parent training program, or a waitlist, and at the end of the initial 6 weeks of the program all fathers participated in a parent–child interaction to evaluate parenting behavior. Results indicated that fathers who received the behavioral parenting program were less negative in their interactions with their child, in spite of inconsistent attendance at the program overall. Fathers did not evidence improved rates of praise or modify their rates of using ...

The writing abilities of children with ADHD symptoms were examined in a simple dictation task, and then in two conditions with concurrent verbal or visuospatial working memory (WM) loads. The children with ADHD symptoms generally made more spelling mistakes than controls, and the concurrent loads impaired their performance, but with partly different effects. The concurrent verbal WM task prompted an increase in the phonological errors, while the concurrent visuospatial WM task prompted more non-phonological errors, matching the Italian phonology, but not the Italian orthography. In the ADHD group, the children proving better able to cope with a concurrent verbal WM load had a better spelling performance too. The ADHD and control groups had a similar handwriting speed, but the former group's writing quality was poorer. Our results suggest that WM supports writing skills, and that children with ADHD symptoms have general writing difficulties, but strength in coping with concurrent verbal information may support their spelling performance.

The study investigated comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and depression in a sample of rural primary school children in Limpopo Province, South Africa. A total of 320 learner...

Autism spectrum disorder (ASD) and attention deficit (hyperactivity) disorder (ADD/ADHD) are key focuses of current health research due to their increasing prevalence. The objective of this systematic literature search and critical review was to evaluate whether the human epidemiologic data indicate a pattern of association between ASD or ADD/ADHD and developmental exposure to particulate matter (PM), with a focus on exposures encountered before the age of three. A MEDLINE and EMBASE search was conducted; following preliminary and full-text screening, 14 relevant articles were identified for review. Three of the 14 studies were prospective cohort studies evaluating exposure to PM10; 11 studies had a case-control design. There was no consistent association between developmental PM exposure and ASD across the three of the cohort studies. Seven of the case-control studies examined the relationship between PM2.5 and/or PM10 and ASD; four examined the relationship between developmental diesel PM exposure and ASD. Overall, there was low external consistency in results among studies of PM2.5/PM10 and ASD, with some reporting high internal consistency without significant associations, others showing associations with high internal consistency for specific exposure windows only (e.g., third trimester), and still others showing high consistency for moderate to strong associations between PM and ASD. The majority of studies reporting significant results had low effect sizes in conjunction with small sample sizes. The four studies of diesel PM and ASD also had low external consistency of results. Only one study evaluated associations with ADD/ADHD, and it found no significant associations with PM10. The inconsistent findings across studies of developmental exposure to PM and ASD may be attributed to differences in the study populations, exposure assessments, outcome assessments, or chance. Further research is needed to understand the underlying biological mechanisms that lead to ASD and ADD/ADHD and how PM might be involved in those mechanisms, if at all. High-quality epidemiologic studies are also needed to conclusively determine whether developmental PM exposure is a causal factor for ASD or ADD/ADHD, with focus on a well-developed exposure assessment.

Objective. The goal of the current study was to examine the impact of maternal attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms on several dimensions of parenting...

Intra-individual variability (IIV) is defined as systematic within-person variation in performance either across test sessions (e.g., test/retest performance on the same task) or in one session (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV have been noted as a characteristic of neurodevelopmental disorders such as attention deficit/hyperactivity disorder​ (ADHD), but IIV is yet to be investigated in fetal alcohol spectrum disorder (FASD). FASD is a term used to describe a range of conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome/partial fetal alcohol syndrome; 2. static encephalopathy/alcohol exposed; 3. neurobehavioral disorder/alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; 4. typically-developing (TD) age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. The results indicate increased levels of IIV in those with FASD compared to the TD controls. It was found that IIV uniquely contributes to predicting adaptive behavior above and beyond attention, while attention partially mediates the relationship between IIV and adaptive behavior. This is the first study to the authors' knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.

A growing literature indicates that attention deficit/hyperactivity disorder (ADHD) involves difficulty processing threat-related emotion faces. This deficit is especially important to understand in young children, as threat emotion processing is related to the development of social skills and related behavioral regulation. Therefore, the current study aimed to better understand the neural basis of this processing in young children with ADHD symptoms. Forty-seven children between 4 and 7 years of age were included in the analysis, 28 typical developing and 19 with clinically significant levels of ADHD hyperactive/impulsive symptoms. Participants completed a passive affective face-viewing task. Event-related potentials were assessed for each emotion, and parental report of child behavior and emotion regulation abilities was assessed. Children with ADHD symptoms showed altered N170 modulation in response to specific emotion faces, such that the N170 was less negative in response to fearful compared to neutral faces, whereas typically developing children showed the opposite pattern. Groups did not differ in reactivity to anger or non-threat-related emotion faces. The N170 difference in fearful compared to neutral faces correlated with reported behavior, such that less fear reactivity predicted fewer prosocial behaviors. Abnormalities in the underlying neural systems for fear processing in young children with ADHD symptoms may play an important role in social and behavioral deficits within this population.

Converging evidence suggests shared genetic underpinnings of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Studies of infants at risk for ASD have proliferated over the past decade; the few studies that have followed these infants beyond age 3 report a range of difficulties facing a subset of these infants as they reach school age, including elevated levels of attention problems and externalizing behavior. Given this, we aimed to identify early predictors of school-age ADHD outcomes in a sample of infant siblings at risk for ASD. This study reports on a sample of 59 infants at high and low risk for ASD who had been followed for more than a decade, collecting data at regular intervals from 3 to 36months and then determining diagnostic outcome at 8-10years of age. Seventeen participants were diagnosed with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) ADHD at school age (n=14 high risk, 3 low risk). As infants, the ADHD outcome group demonstrated atypical longitudinal patterns of sustained visual attention. A significantly larger proportion of their parents reported behavior/temperament problems at 36months of age, and examiners noted the presence of inattentive, hyperactive, and/or impulsive behaviors in this group by 18months of age. These data suggest that behavioral indicators of risk for later ADHD may be present early in development, which may improve earlier detection and treatment of the disorder.

Barkley has been a notable, remarkable contributor to the field of Attention Deficit Hyperactive Disorder (ADHD) for over 40 years. His first edition of this text appeared in 1981, titled Hyperacti...

Hsiang-Lin Chan,1,2,* Wen-Sheng Liu,3–6,* Yi-Hsuan Hsieh,1,2 Chiao-Fan Lin,1,2 Tiing-Soon Ling,2,7 Yu-Shu Huang1,2 1Department of Child Psychiatry, Chang Gung Memorial Hospital, 2College of Medicine, Chang Gung University, Taoyuan, 3Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei, Taiwan; 4School of Medicine, National Yang-Ming University, Taipei, Taiwan; 5Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 6College of Science and Engineering, Fu Jen Catholic University, New Taipei City, Taiwan; 7Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China *These authors contributed equally to this work Objectives: This study aimed to estimate the percentages of attention deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in Taiwanese aboriginal preschool children. Child development level was compared between the two groups. Methods: Teachers completed screening questionnaires for ADHD, ASD, and development level for 36- to 72-month-old children in kindergartens in Taiwan. The questionnaire results were compared between the aboriginal and nonaboriginal children. One child psychiatrist then interviewed the aboriginal preschool children to determine if they had ADHD and/or ASD. Results: We collected 93 questionnaires from the aboriginal group and 60 from the nonaboriginal group. In the aboriginal group, 5.37% of the children were identified to have ADHD, while 1.08% were identified to have ASD. Significantly fewer aboriginal children had developmental delays for situation comprehension and personal–social development (P=0.012 and 0.002, respectively) than nonaboriginal children. Conclusion: Aboriginal children in Taiwan had typical percentages of ADHD and ASD compared to those published in the literature. Aboriginal children showed relative strengths in situation comprehension and personal–social skills. Further studies are required to understand the learning styles of the aboriginal children and to develop effective screening and intervention strategies for ADHD and ASD. Keywords: attention deficit and hyperactivity disorder, autism spectrum disorder, aboriginal children, child development, developmental delay

Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) commonly co-occur. With the DSM-5, clinicians are permitted to make an ASD diagnosis in the context of ADHD. In earlier versions of the DSM, this was not acceptable. Both ASD and ADHD are reported to have had substantial increases in prevalence within the past 10 years. As a function of both the increased prevalence of both disorders as well as the ability to make an ASD diagnosis in ADHD, there has been a significant amount of research focusing on the comorbidity between ADHD and ASD in the past few years. Here, we provide an update on the biological, cognitive and behavioral overlap/distinctiveness between the two neurodevelopmental disorders with a focus on data published in the last four years. Treatment strategies for the comorbid condition as well as future areas of research and clinical need are discussed.