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Objective: To describe the developmental-behavioral pediatricians (DBPs), patients, and clinical practices used in the diagnostic assessments of attention-deficit/hyperactivity disorder (ADHD) within all 12 academic medical centers comprising Developmental-Behavioral Pediatrics Research Network (DBPNet)., Methods: Between December 2011 and June 2012, all DBPs who evaluated children with ADHD or autism spectrum disorders were asked to complete a diagnostic encounter survey form for up to 10 consecutive new cases that resulted in the diagnosis of ADHD or autism spectrum disorder. Fifty-two clinicians returned one or more forms for children diagnosed with ADHD (n = 211)., Results: DBPs were generally experienced full-time academics. Children were 76.3% male, 62.3% white, 24.5% African American, and 20.7% Hispanic. Mean child age was 8.0 + 3.1 years. DBPs reviewed parent ratings of behavior in 84.4% and teacher ratings in 69.2% of cases. They reviewed or completed at least one developmental assessment in 79.2% of cases: intelligence (60.2%), academic (57.8%), fine motor or visual motor (39.3%), speech/language (34.6%), or adaptive skills (28.9%). They made the diagnosis of coexisting conditions in 82.7% of cases, including learning disabilities (31.8%), speech/language disorders (31.8%), anxiety (14.2%), externalizing disorders (10.9%), and sleep disorders (9.5%). Among 146 children not medicated before the visit, stimulant medications were initiated in 15 children (10.2%)., Conclusions: Within DBPNet, DBPs were highly likely to complete comprehensive assessments of ADHD that went beyond the requirements of primary care practice guidelines. They typically identified coexisting developmental and learning conditions. They did not typically prescribe medication at the end of diagnostic encounters., (Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Background: The study examines the psychometric properties of the ADHD section of the semi-structured diagnostic interview ILF-EXTERNAL, which was conducted online via video chat. Methods: As part of the INTEGRATE-ADHD research project, 202 children and adolescents (age M = 12.87 years, SD = 3.04, 28.2 % female) with an administrative diagnosis of ADHD registered with their health insurance company were clinically assessed for the presence of ADHD according to the German ADHD S3 guideline. Using the ILF-EXTERNAL, one parent and, from the age of eight, also the children themselves were interviewed. A proxy rating by a parent was made using the German FBB-ADHS rating scale. In a subsample (n = 65), an independent blind interviewer rated the videorecordings of the ILF-EXTERNAL parent interview to determine the interrater reliability of the ILF-EXTERNAL. Results: All ADHD symptom scales of the ILF-EXTERNAL showed good to excellent internal consistency (α = 0.89 to 0.93). Interrater reliability was high for both categorical and dimensional analyses (κ = 0.78 and κ = 0.81; ICC(1,1) = 0.97 and 0.98). High correlations of the ILF-EXTERNAL parent interview with the FBB-ADHS (r = 0.79 to r = 0.85) and with the ILF-EXTERNAL child interview (r = 0.60 to r = 0.71) demonstrated convergent validity. Conclusions: Sound psychometric properties of the ILF-EXTERNAL were also confirmed for its use in an online setting. High interrater reliabilities demonstrate the quality of the ADHD diagnostics carried out in the consortium project INTEGRATE-ADHD.

Background: Sensory processing (SP) indicates the ability of the nervous system to receive, analyze, process, and respond to external sensory input and coordinates motor movements accordingly. Children with various neurodevelopmental disorders, like autism spectrum disorder, have SP issues. However, studies regarding SP issues in attention-deficit/hyperactivity disorder (ADHD) compared to typically developing children are relatively less. Aims and Objectives: To study the SP pattern of children with ADHD, to compare with the control group, and to study the correlation of symptom severity with SP deficit in children with ADHD. Materials and Methods: All children attending the child guidance clinic at R. G. Kar Medical College and Hospital were screened, and children with ADHD without any other comorbid disorder as diagnosed by Diagnostic and Statistical Manual 5 were selected. Their ADHD symptom severity was assessed using the ADHD test, and SP was assessed using the Short Sensory Profile (SSP). Results: The SSP mean score of the children with ADHD was significantly different than the mean score of the control group, and the percentage of children having a definite difference in SP was significantly different in the ADHD children group compared to the control group. The severity of the SP deficit also correlates with the severity of ADHD symptoms, as found by the correlation study. Conclusion: Children with ADHD have shown a definite difference in SP compared to controls, and the severity of the sensory problem is proportionate to the severity of the symptoms of ADHD.

IntroductionThere is a high prevalence of sleep disturbances and disorders such as obstructive sleep apnea (OSA) in children with attention-deficit hyperactivity disorder (ADHD), though this relationship remains poorly characterized by objective measures. Polysomnographic studies (PSGs) on sleep disruptions in ADHD have yielded inconsistent results. Few have studied polysomnograms in stimulant-medicated vs. non-medicated children with ADHD+/-OSA. This study aimed to elucidate pathognomonic polysomnographic sleep disturbances in children diagnosed with ADHD+/-OSA.MethodsMedical charts and polysomnograms were retrospectively reviewed for children ages 4-18 who underwent overnight polysomnography at a tertiary care center from 2019 to 2022. ADHD diagnosis was determined by ICD code F90, and OSA was defined by apnea-hypopnea indices (AHI) ≥5 events/hour. Four groups were evaluated: children without OSA or ADHD, children with OSA alone, children with ADHD alone, and children with ADHD+OSA. Statistical analyses identified significant differences among variables of interest.Results4,013 children met the study criteria. 2,372 children were without OSA and without ADHD (59.1%), 1,197 with OSA alone (29.8%), 333 with ADHD alone (8.3%), and 111 with ADHD and OSA (2.8%). Insomnia (ICD code G47.00) was prevalent in children with ADHD alone. However, they exhibited significantly better sleep efficiency (SE), than children with OSA alone, and SE did not significantly differ from the other groups. No significant difference in periodic limb movements (PLMs) was found across all groups. The above results held true even after correcting for stimulant prescription.ConclusionThe increased frequency of clinical insomnia diagnoses in children with ADHD is not associated with any traditional parameters on polysomnogram. Innovative subclinical polysomnographic biomarkers are needed to identify sleep characteristics unique to ADHD. In children with both ADHD and OSA, PSG results do not reveal any distinctive sleep disturbances which cannot be better explained by OSA alone. These findings underscore the importance of screening for OSA in patients with ADHD and clinically assessing for other sleep concerns.

Abstract Background Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with overlapping behavioral features and genetic etiology. While brain cortical thickness (CTh) alterations have been reported in ASD and ADHD separately, the degree to which ASD and ADHD are associated with common and distinct patterns of CTh changes is unclear. Methods We searched PubMed, Web of Science, Embase, and Science Direct from inception to 8 December 2023 and included studies of cortical thickness comparing youth (age less than 18) with ASD or ADHD with typically developing controls (TDC). We conducted a comparative meta-analysis of vertex-based studies to identify common and distinct CTh alterations in ASD and ADHD. Results Twelve ASD datasets involving 458 individuals with ASD and 10 ADHD datasets involving 383 individuals with ADHD were included in the analysis. Compared to TDC, ASD showed increased CTh in bilateral superior frontal gyrus, left middle temporal gyrus, and right superior parietal lobule (SPL) and decreased CTh in right temporoparietal junction (TPJ). ADHD showed decreased CTh in bilateral precentral gyri, right postcentral gyrus, and right TPJ relative to TDC. Conjunction analysis showed both disorders shared reduced TPJ CTh located in default mode network (DMN). Comparative analyses indicated ASD had greater CTh in right SPL and TPJ located in dorsal attention network and thinner CTh in right TPJ located in ventral attention network than ADHD. Conclusions These results suggest shared thinner TPJ located in DMN is an overlapping neurobiological feature of ASD and ADHD. This alteration together with SPL alterations might be related to altered biological motion processing in ASD, while abnormalities in sensorimotor systems may contribute to behavioral control problems in ADHD. The disorder-specific thinner TPJ located in disparate attention networks provides novel insight into distinct symptoms of attentional deficits associated with the two neurodevelopmental disorders. Trial registration PROSPERO CRD42022370620. Registered on November 9, 2022.

Objective: The study investigated the potential mediating effects of emotion regulation and emotion lability/negativity in the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and functional impairment while also examining the associations between ADHD symptoms, emotion regulation, and impaired functioning in different life domains among children with ADHD. Materials and Methods: The clinical sample comprised 118 children diagnosed with ADHD aged 6–12 years. Primary caregivers completed parent reports on symptom severity using the Thai ADHD Screening Scale–Parent Version, assessed emotion regulation and lability/ negativity via the Emotion Regulation Checklist, and evaluated functional impairment using the Weiss Functional Impairment Rating Scale–Parent Version. Results: ADHD symptoms correlated negatively with overall emotion regulation (r = −0.515, p < 0.01) and positively with lability/negativity (r = 0.583, p < 0.01). Functional impairment exhibited a negative correlation with emotion regulation (r = −0.649, p < 0.01) and a positive correlation with lability/negativity (r = 0.701, p < 0.01). Elevated ADHD symptoms were linked with increased functional impairment (r = 0.639, p < 0.01). The parallel mediational model showed that emotion lability/negativity partially mediated the association between ADHD symptoms and functional impairment (β = 0.282, p < 0.001), suggesting that ADHD symptoms and emotion lability/negativity indirectly accentuate functional impairment. Thus, heightened ADHD symptoms may exacerbate emotion lability/negativity, contributing to increased functional impairments. Conclusion: Emotion regulation difficulties, particularly emotion lability/negativity, may serve as significant risk factors. Regular monitoring and targeting these challenges hold promise in alleviating adverse functional outcomes co-occurring with elevated ADHD symptoms.

Abstract Background Leveraging a large nationwide study of Icelandic women, we aimed to narrow the evidence gap around female attention-deficit/hyperactivity disorder (ADHD) and cardiometabolic comorbidities by determining the prevalence of obesity, hypertension, type 2 diabetes, and cardiovascular diseases among women with ADHD and examine the association between cardiometabolic conditions and co-occurring ADHD with anxiety and mood disorders, alcoholism/substance use disorder (SUD), self-harm, and suicide attempts. Methods We conducted a cross-sectional analysis of the nationwide, all-female, population-based SAGA Cohort Study (n = 26,668). To ascertain diagnoses and symptoms, we used self-reported history of ADHD diagnoses, selected cardiometabolic conditions and psychiatric disorders, and measured current depressive, anxiety, and PTSD symptoms through appropriate questionnaires (PHQ-9, GAD-7, and PCL-5). We calculated age-adjusted prevalences of cardiometabolic conditions by women’s ADHD status and estimated adjusted prevalence ratios (PR) and 95% confidence intervals (CI), using modified Poisson regression models. Similarly, we assessed the association of cardiometabolic conditions and co-occurring ADHD with current psychiatric symptoms and psychiatric disorders, using adjusted PRs and 95% CIs. Results We identified 2299 (8.6%) women with a history of ADHD diagnosis. The age-adjusted prevalence of having at least one cardiometabolic condition was higher among women with ADHD (49.5%) than those without (41.7%), (PR = 1.19, 95% CI 1.14–1.25), with higher prevalence of all measured cardiometabolic conditions (myocardial infarctions (PR = 2.53, 95% CI 1.83-–3.49), type 2 diabetes (PR = 2.08, 95% CI 1.66–2.61), hypertension (PR = 1.23, 95% CI 1.12–1.34), and obesity (PR = 1.18, 95% CI 1.11–1.25)). Women with cardiometabolic conditions and co-occurring ADHD had, compared with those without ADHD, substantially increased prevalence of (a) all measured mood and anxiety disorders, e.g., depression (PR = 2.38, 95% CI 2.19–2.58), bipolar disorder (PR = 4.81, 95% CI 3.65–6.35), posttraumatic stress disorder (PR = 2.78, 95% CI 2.52–3.07), social phobia (PR = 2.96, 95% CI 2.64–3.32); (b) moderate/severe depressive, anxiety, and PTSD symptoms with PR = 1.76 (95% CI 1.67–1.85), PR = 1.97 (95% CI 1.82–2.12), and PR = 2.01 (95% CI 1.88–2.15), respectively; (c) alcoholism/SUD, PR = 4.79 (95% CI 3.90–5.89); and (d) self-harm, PR = 1.47 (95% CI 1.29–1.67) and suicide attempts, PR = 2.37 (95% CI 2.05–2.73). Conclusions ADHD is overrepresented among women with cardiometabolic conditions and contributes substantially to other psychiatric comorbidities among women with cardiometabolic conditions.

Abstract Background Gestational diabetes mellitus (GDM) is associated with both short- and long-term risks, although it is unknown if risks vary by severity, timing, and duration of gestational hyperglycemia. We aimed to identify trajectories of random capillary glucose (RCG) levels throughout pregnancy and assess their associations with both obstetric/neonatal outcomes and children’s risk of neurodevelopmental conditions (NDCs) (i.e., autism, intellectual disability, and attention-deficit/hyperactivity disorders [ADHD]). Methods A population-based cohort study was conducted involving 76,228 children born to 68,768 mothers without pregestational diabetes. Group-based trajectory modeling was utilized to identify distinct glucose trajectories across RCG values throughout the course of pregnancy. The associations between these trajectory groups and obstetric/neonatal outcomes as well as children’s NDCs were then assessed using generalized estimating equation models with a logit link. The Benjamini-Hochberg (BH) procedure was employed to adjust P-values for multiple comparisons, controlling the false discovery rate (FDR). Results Five distinct glucose trajectory groups were identified, each with varying percentages diagnosed with GDM. Their associations with obstetric/neonatal outcomes as well as children’s NDCs varied. For example, when compared to the “Persistently Low” group, other groups exhibited varying degrees of increased risk for large-for-gestational-age babies, with the exception of the “High in Early Pregnancy” group. Compared to the “Persistently Low” group, all other trajectory groups were associated with NDC outcomes, except the “High in Mid-Pregnancy” group. However, none of the associations with offspring NDCs remained significant after accounting for the FDR correction. Conclusions Persistent high glucose levels or moderately elevated glucose levels throughout pregnancy, as well as transient states of hyperglycemia in early or mid-pregnancy, were found to be associated with increased risks of specific obstetric and neonatal complications, and potentially offspring NDCs. These risks varied depending on the severity, timing, duration, and management of hyperglycemia. The findings underscore the need for continuous surveillance and individualized management strategies for women displaying different glucose trajectories during pregnancy. Limitations such as potential residual confounding, the role of mediators, and small sample size should be addressed in future studies.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) have higher risks of contracting COVID-19 and worse outcomes compared with adolescents without ADHD. The most effective method of preventing infection is vaccination. This follow-up study explored the prospective and cross-sectional factors influencing caregiver willingness to vaccinate children with ADHD against COVID-19. Baseline data on caregiver demographics, affiliate stigma, parenting stress, emotional difficulties, beliefs regarding the causes of ADHD, and ADHD symptoms were collected prior to the outbreak of the COVID-19 pandemic in Taiwan. At follow-up, the study assessed caregiver willingness to vaccinate children with ADHD, the challenges caregivers faced in parenting during the pandemic, and ADHD symptoms. The results revealed that caregiver age at baseline was positively associated with a willingness to vaccinate children against COVID-19 at follow-up. By contrast, the belief that ADHD resulted from failures in parental discipline at baseline was negatively associated with caregiver willingness to vaccinate. Parenting challenges were also negatively associated with caregiver willingness to vaccinate. Therefore, the age of caregivers, beliefs about the causes of ADHD, and parenting challenges during the pandemic should be considered when developing interventions to enhance caregiver willingness to vaccinate children with ADHD.

Objective: This study examined the correlation between primary caregivers’ psychosocial factors and self-esteem in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A cross-sectional study involving primary caregivers and their children with ADHD, aged 8-15, was conducted from September 2022 to February 2023. The children’s self-esteem was assessed using the Five-Scale Test of Self-Esteem for Children. Primary caregivers’ psychosocial factors were assessed using the Attitude of Parenting Questionnaire, Parenting Style and Dimension Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder 7-item. Descriptive statistics and multivariable linear regression were used to determine the associations among variables. Results: The study included 66 pairs of children and adolescents with ADHD and their primary caregivers. The study found 53% of caregivers screened positive for depression, while 16.7% screened positive for anxiety. Almost all caregivers (90.9%) adopted an authoritative parenting. The mean self-esteem score in participants with ADHD was 39.23±8.99. Younger caregivers, those with an education level below a bachelor’s degree, higher monthly income, positive screening for depression, and lower attitudes toward parenting scores were significantly associated with low self-esteem scores in their children. Conclusion: Age, education level of caregivers, and monthly family income were significantly correlated with the self-esteem of children and adolescents with ADHD. The attitudes of caregivers towards parenting and depression in caregivers also impacted self-esteem of children with ADHD under their care. Thus, strategies aimed at promoting positive caregiving attitudes, regular screening of caregivers for depression, and providing appropriate treatment are recommended to enhance self-esteem in children and adolescents with ADHD.

Abstract Background The influence of maternal levothyroxine treatment during pregnancy remains unclear. This study aimed to evaluate the associations of maternal levothyroxine treatment during pregnancy with the birth and neurodevelopmental outcomes in offspring. Methods This population-based cohort study was conducted among pregnant women using the Hong Kong Clinical Data Analysis and Reporting System. Mother-child pairs in Hong Kong from 2001 to 2015 were included and children were followed up till 2020. We defined the exposure group as mothers who were exposed to levothyroxine during pregnancy. Preterm birth and small for gestational age (SGA) were included as birth outcomes. Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) were included as neurodevelopmental outcomes. Odds ratios (OR) or hazard ratios (HRs) with a 95% confidence interval (CI) were evaluated to assess the association of gestational levothyroxine use with offspring birth and neurodevelopmental outcomes respectively, using propensity score fine-stratification weighting and a Cox proportional hazards regression model. Results Among 422,156 mother-child pairs, 2125 children were born from mothers exposed to levothyroxine during pregnancy. A significantly increased risk of preterm birth was observed in children with maternal levothyroxine exposure during pregnancy, when compared to mothers who had no history of thyroid-related diagnoses or prescriptions (weighted OR [wOR]: 1.22, 95% CI: 1.07, 1.39). Similarly, an increased risk of preterm birth was found among children of gestational levothyroxine users, when compared to children of mothers who had used levothyroxine before but stopped during pregnancy (wOR: 2.16, 95% CI: 1.09, 4.25). Sensitivity analysis, by excluding mothers exposed to psychotropic or antiepileptic medications before or during pregnancy, also indicated a similar increased risk of preterm birth regarding the gestational use of levothyroxine (wOR: 1.26, 95% CI: 1.10, 1.45). No significant association was observed for the risk of SGA, ADHD, and ASD. Conclusions There is no evidence that gestational use of levothyroxine is associated with SGA, ADHD, or ASD in offspring. Gestational levothyroxine treatment is associated with a higher risk of preterm birth. Such risk might be confounded by the underlying maternal thyroid disease itself, however, we cannot completely exclude the possible effect of gestational L-T4 treatment on offspring preterm birth. Our findings provided support to the current guidelines on the cautious use of levothyroxine treatment during pregnancy.

Background: This study aimed to investigate the lived experiences of mothers with attention-deficit/ hyperactive children.Methods: The present qualitative descriptive study was conducted based on a phenomenological approach that investigated the experiences of primary caregivers of attention-deficit/ hyperactive children. The population of the study included mothers of attention-deficit/hyperactive primary school students in Tabriz. A total of 13 children were selected using purposive sampling. Data were collected through face-to-face, in-depth, and semi-structured interviews with participants. The interviews were conducted in schools and the Hasti Counseling Center. Moreover, Smith’s cognitive phenomenological method was used to analyze the data.Results: The analysis of the data revealed 4 main themes and 25 subthemes including emotional responses (depression, loneliness, anger and rage, embarrassment, desire to have a calm child, stress, confusion, remorse, regret, frustration, anxiety and dread), behavioral responses (self-blame, frequent crying, shouting, aggression, trying to control oneself), physical responses (palpitation, feeling hot water drops on one’s head), and cognitive responses (feeling inhuman, isolation, feeling guilty, embarrassed, and blameful, problems in pregnancy, insanity, feeling hyperactive due to inability to control oneself, feeling accused of lying).Conclusion: The results of this study will pave the way for further research in the field of mental health interventions for mothers of attention-deficit/hyperactive children. Accordingly, it is essential to design and evaluate the effectiveness of psychotherapy interventions that can cover various dimensions of the problems of this group of mothers.

Aim:Oral diseases can affect various aspects of life in children with attention deficit hyperactivity disorder (ADHD). The aim of this study was to evaluate the oral health conditions, oral health behaviors, and the oral health-related quality of life (OHRQoL) of children with ADHD.Materials and Methods:A sample of 76 children with ADHD who were treatment naive was compared to 71 healthy children, with ages ranging from 6 to 13 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT, dmft index), the plaque index, the gingival index, occlusion status, overjet, overbite and parafunctional oral habits were determined. The children’s parents completed the Turkish version of early childhood oral health impact scale (T-ECOHIS) and questionnaires regarding oral health behaviors and dental care.Results:The child impact score (CIS) of the T-ECOHIS were significantly higher among those children with ADHD compared to the control group patients (16 versus 12), consistent with poorer OHRQoL. The children with ADHD also had more dental trauma in both dentitions and more frequent nail-biting habits compared to the participants in the control group.Conclusion:In our study, T ECOHIS-CIS scores showed that those children with ADHD were affected more when compared to those children without ADHD in terms of oral health problems.

Abstract Background Previous studies have reported associations between attention-deficit/hyperactivity disorder (ADHD) and lower socioeconomic status and intelligence. We aimed to evaluate the causal directions and strengths for these associations by use of a bi-directional two-sample Mendelian randomization (MR) design. Methods We used summary-level data from the largest available genome-wide association studies (GWAS) to identify genetic instruments for ADHD, intelligence, and markers of socioeconomic status including the Townsend deprivation index, household income, and educational attainment. Effect estimates from individual genetic variants were combined using inverse-variance weighted regression. Results A genetically predicted one standard deviation (SD) increment in the Townsend deprivation index conferred an odds ratio (OR) of 5.29 (95% confidence interval (CI) 1.89–14.76) for an ADHD diagnosis (p

Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder among neurodevelopmental disorders. Children with ADHD have serious difficulties in their playing patterns. This review aims at seeing occupational therapy interventions using to improve play among children with ADHD. Methods: Four databases (PubMed, Web of Science, Scopus, and Elsevier) were searched. Rayyan QCRI online application was used for managing and screening the obtained data. The included articles were reviewed for their quality based on the Centre of Evidence-Based Medicine, research pyramid, CONSORT (CONsolidated Standards Of Reporting Trials), and STARD (Standards for Reporting Diagnostic Accuracy) statement. Results: A total of 104 articles were found after the search. After the screening and review process, six articles were included for the main review. Data extraction was done for these six articles (two randomized trial control and four non-randomized trial control studies). Discussion: Play-based interventions could be effective for improving social play in ADHD when delivered by a therapist. For parent-delivered interventions, more studies with larger sample sizes are required.

Abstract John Fitzgerald Kennedy (JFK), the 35th President of the USA, had chronic low back pain deemed to be centralized pain. Reportedly, attention‐deficit/hyperactivity disorder (ADHD) could associate with centralized pain. Based on his biographies, JFK could have had ADHD, a plausible cause of pain that afflicted him.

Background and Aims Today, young children with attention-deficit/hyperactivity disorder (ADHD) have a variety of developmental disorders and problems, including developmental coordination disorder, anxiety, and sleep disorders. The aim of this study was to evaluate the effectiveness of neurofeedback combined with a selected exercise program on motor function, anxiety, and sleep in children with ADHD. Methods In the current study, 20 children aged 7 to 9 years with ADHD who had normal intelligence were randomly divided into experimental and control groups. The experimental group underwent neurofeedback and physical activity training for 24 sessions of 45 minutes for one session. The experimental group was randomly divided into two groups, of whom five cases started their training sessions with neurofeedback and five cases started with physical activity. The control group performed their normal daily activities during this period. In the pre-test and post-test, the Bruininks-Oseretsky motor proficiency test was used to measure motor performance, the Child Behavior Checklist was used to measure anxiety, and the Child Sleep Habit Questionnaire was used to measure sleep habits. Data obtained from the present study were analyzed using analysis of covariance and SPSS v. 25 statistical software. Results The results showed that there was a significant difference between the experimental and control groups in the scores of motor function, anxiety, and sleep habits (P=0.001). Conclusion Combined exercises can be useful in improving motor function, anxiety, and sleep habits in children with ADHD.

Objective: To systematically evaluate the effectiveness of mindfulness-based parenting programs in reducing parenting stress in parents of children and adolescents with ADHD. Materials and Methods: Studies published in English or Thai before February 2020 were identified through the PubMed, Embase, and Thai-Journal Citation Index databases. Studies were included if they used mindfulness-based parenting interventions for parents of children and adolescents with ADHD, and parenting stress was measured. The risk of bias was evaluated with the Cochrane risk-of-bias assessment tool for randomized trials, and with the ROBIN-I tool for non-randomized studies. Results: Six studies were included. The 2 randomized controlled trials reported significant reductions in parenting stress in the intervention groups compared with the control groups at post-test, and this effect was maintained at the 8-week follow-up of one of the studies. However, the 4 pre-experimental studies reported conflicting results. Two reported significant reductions in parenting stress from pre- to post-intervention, with one of those studies reporting a further reduction in parental stress at the 6-week follow-up. In contrast, another study reported a significant reduction in parental stress from pre- to post-intervention for fathers but not mothers; this effect was maintained at the 8-week follow-up. The fourth study reported no significant changes in parental stress from preto post-intervention. A meta-analysis of 3 studies demonstrated no significant changes in parenting stress from pre- to post-intervention. Conclusion: The effectiveness of mindfulness-based parenting programs in reducing parenting stress in parents of children and adolescents with ADHD is still inconclusive, although promising. Further studies are needed.

Summary: Background: Attention-deficit/hyperactivity disorder (ADHD) has been reported to be associated with longer screen time utilization (STU) at the behavioral level. However, whether there are shared neural links between ADHD symptoms and prolonged STU is not clear and has not been explored in a single large-scale dataset. Methods: Leveraging the genetics, neuroimaging and behavioral data of 11,000+ children aged 9–11 from the Adolescent Brain Cognitive Development cohort, this study investigates the associations between the polygenic risk and trait for ADHD, STU, and white matter microstructure through cross-sectionally and longitudinal analyses. Findings: Children with higher polygenic risk scores for ADHD tend to have longer STU and more severe ADHD symptoms. Fractional anisotropy (FA) values in several white matter tracts are negatively correlated with both the ADHD polygenic risk score and STU, including the inferior frontal-striatal tract, inferior frontal-occipital fasciculus, superior longitudinal fasciculus and corpus callosum. Most of these tracts are linked to visual-related functions. Longitudinal analyses indicate a directional effect of white matter microstructure on the ADHD scale, and a bi-directional effect between the ADHD scale and STU. Furthermore, reduction of FA in several white matter tracts mediates the association between the ADHD polygenic risk score and STU. Interpretation: These findings shed new light on the shared neural overlaps between ADHD symptoms and prolonged STU, and provide evidence that the polygenic risk for ADHD is related, via white matter microstructure and the ADHD trait, to STU. Funding: This study was mainly supported by NSFC and National Key R&D Program of China.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is an important research topic and a common disorder among children in schools, accompanied by the symptoms of aggression, hyperactivity, anxiety, and attention deficit. Considering the side-effects of medications used to treat this disorder, this study endeavored to investigate the effect of perceptual-motor parent-child exercises on executive functions in children with ADHD.Materials and Methods: Participants were 36 children with ADHD with age range of 7-10 years with their mothers, randomly divided into two 18-person groups of mother-and-child-together exercises and mother-child-separately exercises. Regarding the above-mentioned groups, the participants practiced perceptual-motor exercises for 8 weeks, three 45-minute sessions per week. Before and after the intervention, data were collected by the Stroop Word Test (computerized version). Data analysis was done through the covariance test at significance level of 0.05.Results: Higher mean post-test scores in both groups showed that perceptual-motor exercises were effective on executive functions. However, the number of congruent errors (P = 0.006), incongruent errors, congruent correct responses, incongruent correct responses (P = 0.001), congruent reaction time (P = 0.028), incongruent reaction time (P = 0.007), and interference scores were significantly different between the two groups. The mother-and-child-together exercise group performed better than the mother-child-separately exercise group.Conclusion: Findings reveal that perceptual-motor exercises can improve executive functions of children with ADHD, and mother-and-child-together exercises can be an appropriate method for improving executive functions of children with ADHD.

Child morbidity and disability is a national problem in any country, and measures to reduce it are the priority for every society. Recent years, children’s diseases such as neuropsychiatric diseases, (24,3%), nervous system diseases (22.9%); congenital anomalies (malformations), deformations and chromosomal disorders (16.2%). The absolute value of disabled children with nervous system diseases as of January 1, 2020 was 157,727.At all stages of the nervous system formation, the process of cell membranes formation, covering both glial cells and neurons themselves (and their branches - dendrites and axons), progresses actively. Cell membranes consist mainly of phospholipids, which are synthesized from long chain polyunsaturated fatty acids coming from food. In an attempt to determine the reasons for the growing disability of the child population, the researchers drew attention to the changed nature of the nutrition of society in general and the child population in particular over the past century. One of the significant components of the diet that affects the formation and development of the nervous system and the mental sphere were polyunsaturated fatty acids, some of which, with an unbalanced diet, can’t be obtained by the body from sources alternative to food. In this review, we observe the experience of correcting the nutritional status of young children and pregnant and lactating women with omega-3 polyunsaturated fatty acids. Numerous studies have confirmed the fact that there is a relationship between omega-3 polyunsaturated fatty acids deficiency, neurological deficiency and reduced intellectual abilities of a child.

The generally accepted model of sensory processing of visual and auditory stimuli assumes two major parallel processing streams, ventral and dorsal, which comprise functionally and anatomically distinct but interacting processes in which the ventral stream supports stimulus identification, and the dorsal stream is involved in recognizing the stimulus spatial location and sensori-motor integration functions. However, recent studies suggest the existence of a third, very fast sensory processing pathway, a gating stream that directly links the primary auditory cortices to the executive prefrontal cortex within the first 50 milliseconds after presentation of a stimulus, bypassing hierarchical structure of the ventral and dorsal pathways. Gating stream propagates the sensory gating phenomenon, which serves as a basic protective mechanism preventing irrelevant, repeated information from recurrent sensory processing. The goal of the present paper is to introduce the novel ‘three-stream’ model of auditory processing, including the new fast sensory processing stream, i.e. gating stream, alongside the well-affirmed dorsal and ventral sensory processing pathways. The impairments in sensory processing along the gating stream have been found to be strongly involved in the pathophysiological sensory processing in Alzheimer’s disease and could be the underlying issue in numerous neuropsychiatric disorders and diseases that are linked to the pathological sensory gating inhibition, such as schizophrenia, post-traumatic stress disorder, bipolar disorder or attention deficit hyperactivity disorder.

Objectives Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age. Methods As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age. Results Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model. Conclusions Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Objectives: This study aimed to determine the incidence of Attention-Deficit/Hyperactivity Disorder (ADHD) among primary school children in Ulaanbaatar and identify some of the influencing factors and specific clinical features. Methods: A total of 973 primary school children between 6 – 13 years of age in grades 2-5, along with 973 parents/caretakers, and 91 class teachers were recruited from secondary schools of Ulaanbaatar, Mongolia. Results: ADHD prevalence for the 973 participants was 16.6% based on teacher’s reports and 9.7% based on parent’s reports. Using the criteria that both the teacher and parent/caretaker both reported ADHD for a child, 50 children were diagnosed with ADHD, and the estimated prevalence was 5.8% in Ulaanbaatar. Among the 50 children with ADHD, 78% were boys, 22% were girls, with ADHD being four times more common in boys than girls (p =.0001). The constituent ratios of ADHD-Inattentive, ADHD-Hyperactive/impulsive, and ADHD-Combined subtypes were 4.07%, 3.3%, and 1.5%, respectively. The risks were 7.5 times higher when the mother smoked during pregnancy and 2.9 times higher when the child lived with a grandparent than with both parents (p

Abstract Background There are no guidelines concerning the best approach to improving sleep, but it has been shown that it can benefit the affected children and their entire families. The aim of this review is to analyse the efficacy and safety of melatonin in treating pediatric insomnia and sleep disturbances. Main body Sleep disturbances are highly prevalent in children and, without appropriate treatment, can become chronic and last for many years; however, distinguishing sleep disturbances from normal age-related changes can be a challenge for physicians and may delay treatment. Some published studies have shown that melatonin can be safe and effective not only in the case of primary sleep disorders, but also for sleep disorders associated with various neurological conditions. However, there is still uncertainty concerning dosing regimens and a lack of other data. The dose of melatonin should therefore be individualised on the basis of multiple factors, including the severity and type of sleep problem and the associated neurological pathology. Conclusions Melatonin can be safe and effective in treating both primary sleep disorders and the sleep disorders associated with various neurological conditions. However, there is a need for further studies aimed at identifying the sleep disordered infants and children who will benefit most from melatonin treatment, and determining appropriate doses based on the severity and type of disorder.

Schizophrenia remains one of the most debilitating human neurodevelopmental disorders, with few effective treatments and striking consequences felt by individuals, communities and society as a whole. As such, there remains a critical need for further investigation into the mechanistic underpinnings of schizophrenia so that novel therapeutic targets can be identified. Because schizophrenia is a highly heritable disorder, genetic risk factors remain an attractive avenue for this research. Given their clear molecular genetic consequences, recurrent microdeletions and duplications, or copy number variants (CNVs), represent one of the most tractable genetic entry points to elucidating these mechanisms. To date, eight CNVs have been shown to significantly increase the risk of schizophrenia. Although rodent models of these CNVs that exhibit behavioral phenotypes have been generated, the underlying molecular mechanisms remain largely elusive. Over the past decades, the zebrafish has emerged as a powerful vertebrate model that has led to fundamental discoveries in developmental neurobiology and behavioral genetics. Here, we review the attributes that make zebrafish exceptionally well suited to investigating individual and combinatorial gene contributions to CNV-mediated brain dysfunction in schizophrenia. With highly conserved genetics and neural substrates, an ever-expanding molecular genetic and imaging toolkit, and ability to perform high-throughput and high-content genetic and pharmacologic screens, zebrafish is poised to generate deep insights into the molecular genetic mechanisms of schizophrenia-associated neurodevelopmental and behavioral deficits, and to facilitate the identification of therapeutic targets.

Background: Attention-deficit/hyperactivity disorder (ADHD) is a disabling disorder. High rates of ADHD have been consistently reported among prisoners. The main objectives were (1) to estimate the prevalence of ADHD symptoms in a sample of male inmates and (2) to investigate the relationship between ADHD symptoms and socio-demographic/clinical features. According to the high prevalence of childhood trauma among inmates, we assessed whether exposition to childhood trauma can be related to the presence of ADHD symptoms. Methods: A total of 159 male prisoners admitted to Monza prison between January 2020 and June 2021 were included. Both Wender Utah ADHD rating scale and adult ADHD self-report scale were administered to assess ADHD symptoms. Moreover, inmates completed the childhood trauma questionnaire. Results: Data were available for 108 inmates. Thirty-five prisoners (32.4%) were found on screening to meet the criteria for symptoms of ADHD. Cocaine use disorder, prescription of mood stabilizers and a history of emotional abuse significantly increased the likelihood of having clinically significant ADHD symptoms. Furthermore, patients who experienced physical neglect resulted in meeting the criteria for ADHD symptoms. Conclusions: ADHD symptoms are widespread among inmates and are associated with specific risk factors. Screening for ADHD should be done to provide appropriate intervention strategies.

Social isolation (SI) mice exhibit behavioral abnormalities such as impairments of sociability- and attention-like behaviors, offering an animal model of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD). This study aimed to identify the effects of Sansoninto (SST; 酸棗仁湯 suān zǎo rén tāng) on the psychiatric symptoms related to ADHD using SI mice. Four-week-old mice were socially isolated during the experimental period, and SST administration (800 or 2400 mg/kg, p.o.) was started at 2 weeks after starting SI. SST ameliorated SI-induced impairments of sociability- and attention-like behaviors in a dose-dependent manner, and tended to ameliorate contextual- and auditory-dependent fear memory deficit. Moreover, the expression level of Egr-1 was down-regulated by SI stress, and was restored by a high dose of SST. These findings suggest that SST is useful for improvement of psychiatric disorders such as ADHD.

Background: Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder (ADHD) showed difficulties in neuropsychological function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsychological weakness differed among ADHD presentations in preschool children. Methods: The 226 preschoolers (163 with ADHD and 63 controls) with the age of 4–5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version (BRIEF-P) and a series of tests to investigate neuropsychological function. Results: Preschoolers with ADHD showed higher scores in all domains of the BRIEF-P (inhibition: 30.64 ± 5.78 vs.20.69 ± 3.86, P < 0.001; shift: 13.40 ± 3.03 vs.12.41 ± 2.79, P = 0.039; emotional control:15.10 ± 3.53 vs.12.20 ± 2.46, P < 0.001; working memory: 28.41 ± 4.99 vs.20.95 ± 4.60, P < 0.001; plan/organize: 17.04 ± 3.30 vs.13.29 ± 2.40, P < 0.001) and lower scores of Statue (23.18 ± 7.84 vs.28.27 ± 3.18, P = 0.001), Word Generation (15.22 ± 6.52 vs.19.53 ± 7.69, P = 0.025), Comprehension of Instructions (14.00 ± 4.44 vs.17.02 ± 3.39, P = 0.016), Visuomotor Precision (P < 0.050), Toy delay (P = 0.048), and Matrices tasks (P = 0.011), compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P (P < 0.001), and the ADHD-combined symptoms (ADHD-C) group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer performances than the ADHD-predominantly inattentive symptoms (ADHD-I) group on Statue tasks (F = 7.34, η2 = 0.12, P < 0.001). Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer performances compared to the ADHD-C group in the Block Construction task (F = 4.89, η2 = 0.067, P = 0.003). However, no significant group differences were found between the ADHD-I group and normal control. Conclusion: Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects.

The aims of this study were to examine the proportion of caregivers who were hesitant to vaccinate their children with attention-deficit/hyperactivity disorder (ADHD) against coronavirus disease 2019 (COVID-19) and the factors related to caregiver intentions to vaccinate their children against COVID-19. In total, 161 caregivers of children with ADHD were recruited in this study. The caregivers completed an online questionnaire to provide data regarding their intention to vaccinate their children against COVID-19, concerns about the effectiveness and safety of vaccines, unfavorable family attitudes toward vaccines, and children’s medication use for ADHD and comorbid psychopathology. The factors related to caregiver intentions to vaccinate their child were examined using linear regression analysis. The results indicated that 25.5% of caregivers were hesitant to vaccinate their children with ADHD, and 11.8% refused to vaccinate their children against COVID-19. The caregivers’ concerns about the safety of vaccines and children’s regular use of medication for ADHD were negatively associated with caregiver intentions to vaccinate, whereas the children’s comorbid conduct or oppositional defiant problems were positively associated with the caregiver intentions to vaccinate. An intervention that enhances caregiver intentions to vaccinate their children with ADHD against COVID-19 by addressing the related factors found in this study is warranted.

In this paper, a random-forest-based method was proposed for the classification and localization of Attention-Deficit/Hyperactivity Disorder (ADHD), a common neurodevelopmental disorder among children. Experimental data were magnetic resonance imaging (MRI) from the public case-control dataset of 3D images for ADHD-200. Each MRI image was a 3D-tensor of 121×145×121 size. All 3D matrices (MRI) were segmented into the slices from each of three orthogonal directions. Each slice from the same position of the same direction in the training set was converted into a vector, and all these vectors were composed into a designed matrix to train the random forest classification algorithm; then, the well-trained RF classifier was exploited to give a prediction label in correspondence direction and position. Diagnosis and location results can be obtained upon the intersection of these three prediction matrices. The performance of our proposed method was illustrated on the dataset from New York University (NYU), Kennedy Krieger Institute (KKI) and full datasets; the results show that the proposed methods can archive more accuracy identification in discrimination of ADHD, and can be extended to the other practices of diagnosis. Moreover, another suspected region was found at the first time.