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In addition to higher-order executive functions, underlying sensory processing ability is also thought to play an important role in Attention-Deficit/Hyperactivity Disorder (AD/HD). An event-related potential feature, the mismatch negativity, reflects the ability of automatic sensory change processing and may be correlated with AD/HD symptoms and executive functions. This study aims to investigate the characteristics of visual mismatch negativity (vMMN) in adults with AD/HD. Twenty eight adults with AD/HD and 31 healthy controls were included in this study. These two groups were matched in age, IQ and sex. In addition, both groups completed psychiatric evaluations, a visual ERP task used to elicit vMMN, and psychological measures about AD/HD symptoms and day-to-day executive functions. Compared to trols, the late vMMN (230–330 ms) was significantly reduced in the AD/HD group. Correlation analyses showed that late vMMN was correlated with executive functions but not AD/HD symptoms. However, further mediation analyses showed that different executive functions had mediated the relationships between late vMMN and AD/HD symptoms. Our findings indicate that the late vMMN, reflecting automatic sensory change processing ability, was impaired in adults with AD/HD. This impairment could have negative impact on AD/HD symptoms via affecting day-to-day executive functions. [ABSTRACT FROM AUTHOR]

There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training. [ABSTRACT FROM AUTHOR]

The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced 'dose' of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD. [ABSTRACT FROM AUTHOR]

The Attention Deficit Hyperactivity Disorder (AD/HD) is the most common neurodevelopmental disorder of childhood and one of the more widespread chronic diseases that affect children school age, based on the DSM-IV. This study focuses on the influence of stress to the kids suffering from ADHD and the importance of other elements on it. This particular study was based on articles in scientific journals, with the purpose to investigate some of the factors that affect positively or negatively in the exacerbation of anxiety on children suffering from ADHD and how the prenatal and parental stress affects this condition. The results have shown that the environmental factors, nutrition, hormones, neurotransmitters and alternative techniques are directly related with the characteristics of the disorder and the ways of how to improve it. In the light of these findings, we came to the conclusion that we can intervene to the deficits of mainly socio-emotional functions through the above factors. [ABSTRACT FROM AUTHOR]

The Attention Deficit Hyperactivity Disorder (AD/HD) is the most common neurodevelopmental disorder of childhood and one of the more widespread chronic diseases that affect children school age, based on the DSM-IV. This study focuses on the influence of stress to the kids suffering from ADHD and the importance of other elements on it. This particular study was based on articles in scientific journals, with the purpose to investigate some of the factors that affect positively or negatively in the exacerbation of anxiety on children suffering from ADHD and how the prenatal and parental stress affects this condition. [ABSTRACT FROM AUTHOR]

This study investigated age-related changes in the EEG of subtypes of Attention-Deficit/Hyperactivity Disorder (AD/HD) compared with neurotypical controls, using an eyes-open resting condition. Two hundred and twenty five children between the ages of 5 and 16 years participated in this study. Groups consisted of AD/HD of the combined (AD/HDcom) and inattentive (AD/HDin) types, which were compared with controls for each of three age ranges: Young (5–8 years), Middle (9–12 years), and Old (13–16 years). The EEG was recorded and analyzed using AMLAB hardware and software, and Fourier transformed to provide estimates for total power, and absolute and relative power in the delta, theta, alpha and beta bands. Compared to controls, the AD/HD groups had globally increased relative theta. Regional differences were found for absolute and relative alpha and beta. Compared to AD/HDcom, AD/HDin had globally reduced total power, absolute and relative theta, and absolute alpha. Regional differences only were found for absolute and relative delta, absolute beta, and relative alpha. No simple interactions were found for diagnostic factors with age. These results indicate that maturational effects can be observed between subtypes of AD/HD and controls in the eyes-open condition with similarities to those reported in eyes-closed conditions, although substantial differences are apparent in the maturation of fast wave activity, primarily alpha. These results provide evidence of maturational differences between subtypes of AD/HD in eyes-open conditions, and provide additional support for the suggestion that subtypes of AD/HD differ in severity rather than the nature of underlying neurological impairment. • Maturational differences can be observed between AD/HD and Control subjects using an eyes-open condition. • Maturational differences occur between the combined and Inattentive types of AD/HD. • EEG differences between the Combined and Inattentive types of AD/HD are associated with degree of severity of the symptoms. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

• EEG studies from 2002 to 2019 are reviewed with implications for basic science and clinical practice. • Advances have been made in knowledge of the effects of age, sex, type and medication on the EEG. • Few replication studies have been done and there is a need for consolidation of this literature. This article reviews the eyes-open and eyes-closed resting electroencephalogram (EEG) literature for Attention-Deficit/Hyperactivity Disorder (AD/HD) from 2002 to 2019. This time has seen substantial increase in interest in resting state EEG, with investigations moving from a comparison of an AD/HD sample to a control group, to research investigating a wide range of theoretical and clinical aspects of the disorder. This has included investigations of subgroups based on their EEG profile, sex differences in the EEG, increasing interest in the EEG of adults, and the effects of comorbid disorders on the EEG of people with AD/HD. Research has further investigated the hyper- and hypo- arousal models of AD/HD, as well as the developmental deviation model. From a clinical perspective, a growing body of literature is emerging trying to ascertain if the EEG can be used as a diagnostic test, particularly the theta/beta ratio. While these advances have been made, there is widespread use of both the eyes-open and eyes-closed resting paradigms as being interchangeable, despite the two paradigms differ on a number of important factors. There is also lack of independent replication within the literature, which is needed to consolidate many of the findings that have been published. [ABSTRACT FROM AUTHOR]

Martina Barnevik Olsson,1,2 Anette Holm,3 Joakim Westerlund,1,4 Åsa Lundholm Hedvall,1,3 Christopher Gillberg,1 Elisabeth Fernell1 1Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, 2PRIMA Child and Adult Psychiatry, 3Department of Psychology, Astrid Lindgren Children’s Hospital, 4Department of Psychology, Stockholm University, Stockholm, Sweden Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as “high-functioning”, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70–84) is limited.Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5–6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36).Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84.Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support. Keywords: AD/HD, A-TAC, autism spectrum disorder, borderline intellectual functioning, developmental disorders, Vineland

Magnus Landgren,1,2 Salmir Nasic,3 Mats Johnson,1,2 Trygve Lövoll,1 Daniel Holmgren,4,5 Elisabeth Fernell2 1Department of Pediatrics, Unit of Developmental Disorders, Skaraborg’s Hospital, Mariestad, 2Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, 3Research and Development Centre, 4Department of Pediatrics, Skaraborg’s Hospital, Skövde, 5University of Gothenburg, Gothenburg, Sweden Background: Knowledge about the long-term effects on blood pressure (BP) and body mass index (BMI) when treating young patients for attention-deficit/hyperactivity disorder (AD/HD) with stimulants is limited. Most of the studies have reported mean and not individual values for anthropometrics and BP in treatment with stimulants. This seems to be the first study of changes based on the analyses of individual data measured over time. Patients and methods: Seventy young patients (aged 8–18 years) diagnosed with AD/HD and responding well to treatment with stimulants were followed for a mean period of 3 years and 3 months. BP, heart rate, height, weight, and BMI were transformed to standard deviations or z-scores from before treatment to the last registered visit. Results: The mean dose of methylphenidate was 0.95 mg/kg. The mean increase of systolic and diastolic BP was 0.4 z-score and 0.1 z-score, respectively. The systolic BP was associated with BMI; a higher BMI at baseline increased the risk for an increase in systolic BP. Ten percent of the total group had a weight at follow-up of +1.5 SD at baseline, 50% had a significantly reduced BMI. Conclusion: Consequences of stimulant treatment must be evaluated individually. Besides significant effects on core AD/HD symptoms, some patients have lower BMI and BP and some increase/maintain their BMI and/or increase their systolic BP. The risk of reduced height trajectory needs further research. Keywords: AD/HD, treatment, heart rate, long-term follow-up, methylphenidate, improvement, cardiovascular, overweight, height, BMI, health

Child mental illness impacts the entire family, and previous research has consistently found that parenting children with mental health disorders is psychologically distressing. The study’s purpose was to delineate the stressors for which parents request advice and the online interactions in which often isolated parents engage. We coded the content of 146 posts written by parents of 77 daughters and 69 sons ages 5 to 18 years with AD/HD, bipolar disorder, and depressive and anxiety disorders (M age = 10) on four publicly accessible internet forums. Most posters were mothers, most wrote to seek information or advice, and most received advice from other women. Parents posted on a wide range of parental concerns, most frequently the effects of children’s illness on themselves, specifically feelings of helplessness, their need for advice on their own coping, and the stress of child discipline. Parents frequently also expressed concern about child symptoms, especially poor academic performance, and had questions about efficacy, side effects of, and noncompliance with medication. Parents’ concerns did not differ by child diagnosis, gender, or age. However, parents of children with AD/HD only were significantly less likely to describe parent-child verbal or physical conflict than other forum parents. Future research should create empirically based recommendations for effective discipline and medication management that reflects parents’ concerns. [ABSTRACT FROM AUTHOR]

Objective Several studies have suggested that objective deficits in the processing of abstract information in conjunction with an enhanced ability to process concrete information is a definitive characteristic of autism spectrum disorder (ASD). However, this cognitive imbalance is not necessarily clear in high-functioning autistic individuals who do not display absolute differences relative to typically developing (TD) populations. Thus, the purpose of this study was to identify this cognitive tendency in high-functioning autistic individuals using intra-individual cognitive comparisons. Methods The reaction times (RTs) of TD children, children with ASD, and children with attention deficit hyperactivity disorder (AD/HD) (n = 17 in each group, mean age = 11.9 years, age range = 9.8–15.8 years) were compared using the Which/How-to-Apply Tools (W/HAT) test, which consists of tasks requiring the adaptive use of novel tools and familiar tools in atypical and typical situations. Differences in RTs between the atypical and typical trials ([A–T]) were used to assess intra-individual cognitive imbalances. Results As predicted, the [A–T] scores of the ASD group were significantly higher than those of the TD group even though the RTs in the atypical and typical trials did not differ. Additionally, the [A–T] values were significantly higher in the ASD group than in the AD/HD group, which indicates that the cognitive imbalance was specific to ASD individuals. No significant interaction was detected between the trial and subject group. Conclusions The findings of this study demonstrate that a cognitive imbalance in ASD individuals may enhance the current understanding of the pathophysiology of this disorder, which is found in a range of individuals, including those with obvious cortical dysfunction to those with only intra-individual imbalances. [ABSTRACT FROM AUTHOR]

Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as "high-functioning", that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70-84) is limited. Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5-6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support. [ABSTRACT FROM AUTHOR]

The theta/beta ratio (TBR) is a major area of interest within electroencephalogram (EEG) research in AD/HD. While researchers suggest a prognostic role for TBR in AD/HD, its relationship to behavior remains uncertain. Recent evidence suggests that elevated TBR in AD/HD may be related to atypical inhibition, particularly at an attentional level. This study aimed to examine the performance on three inhibitory tasks of children with AD/HD. Fifty-eight children with AD/HD participated, divided into an elevated TBR (ET) group and a control group (CT). A behavioral disassociation was found − compared to CT, ET showed more difficulty in inhibiting surrounding stimuli but had less day-to-day inhibitory issues measured by BRIEF. There was no significant group difference on response inhibition. The results support the prognostic value of TBR in AD/HD. Elevated TBR may be an inhibitory biomarker; further studies are needed to explore the behavioral implications in patients without elevated TBR. [ABSTRACT FROM AUTHOR]

BACKGROUND: Relationships among consumer demographic variables, services, and employment outcomes for 7,776 16 to 19 year old and 2,183 20 to 24 year old consumers with ADHD were examined. OBJECTIVE: To examine employment outcomes, relationships among demographic and case service variables, and weekly earnings for African American, White, and Hispanic consumers with ADHD ages 16-19 and 20-24. METHODS: For research question one the criterion variable was successful employment or not employed. The predictor variables included consumer demographic and vocational rehabilitation service variables. Participants in both the 16-19 and 20-24 age groups were randomly split for cross validation. RESULTS: Demographic variables of Hispanic and African American, high school graduation and postsecondary education, public support at application, and case service variables of college training, on the job training, job search assistance, and job placement were related to successful employment. White consumers earned significantly more than African American and Hispanic consumers in the 16-19 group, and significantly more than African American consumers in the 20-24 group. CONCLUSIONS: Implications for practice include: characteristics identified by ethnically diverse parents of professionals who made a positive difference in the life of their child and guidelines for collaboration identified by ethnically diverse parents. [ABSTRACT FROM AUTHOR]

Previous studies report reductions in symptom severity after combined working memory (WM) and inhibitory control (IC) training in children with AD/HD. Based on theoretical accounts of the role of arousal/attention modulation problems in AD/HD, the current study examined the efficacy of combined WM, IC, and neurofeedback training in children with AD/HD and subclinical AD/HD. Using a randomized waitlist control design, 85 children were randomly allocated to a training or waitlist condition and completed pre- and post-training assessments of overt behavior, trained and untrained cognitive task performance, and resting and task-related EEG activity. The training group completed twenty-five sessions of training using Focus Pocus software at home over a 7 to 8-week period. Trainees improved at the trained tasks, while enjoyment and engagement declined across sessions. After training, AD/HD symptom severity was reduced in the AD/HD and subclinical groups according to parents, and in the former group only according to blinded teachers and significant-others. There were minor improvements in two of six near-transfer tasks, and evidence of far-transfer of training effects in four of five far-transfer tasks. Frontal region changes indicated normalization of atypical EEG features with reduced delta and increased alpha activity. It is concluded that technology developments provide an interesting a vehicle for delivering interventions and that, while further research is needed, combined WM, IC, and neurofeedback training can reduce AD/HD symptom severity in children with AD/HD and may also be beneficial to children with subclinical AD/HD. [ABSTRACT FROM AUTHOR]

Objectives Right hemisphere, which is attributed to the sound intensity discrimination, has abnormality in people with attention deficit/hyperactivity disorder (AD/HD). However, it is not studied whether the defect in the right hemisphere has influenced on the intensity sensation of AD/HD subjects or not. In this study, the sensitivity of normal and AD/HD children to the sound intensity was investigated. Methods Nineteen normal and fourteen AD/HD children participated in the study and performed a simple auditory reaction time task. Using the regression analysis, the sensitivity of right and left ears to various sound intensity levels was examined. Results The statistical results showed that the sensitivity of AD/HD subjects to the intensity was lower than the normal group ( p < 0.0001). Left and right pathways of the auditory system had the same pattern of response in AD/HD subjects ( p > 0.05). However, in control group the left pathway was more sensitive to the sound intensity level than the right one ( p = 0.0156). Conclusions It can be probable that the deficit of the right hemisphere has influenced on the auditory sensitivity of AD/HD children. The possible existent deficits of other auditory system components such as middle ear, inner ear, or involved brain stem nucleuses may also lead to the observed results. The development of new biomarkers based on the sensitivity of the brain hemispheres to the sound intensity has been suggested to estimate the risk of AD/HD. Designing new technique to correct the auditory feedback has been also proposed in behavioral treatment sessions. [ABSTRACT FROM AUTHOR]

Objective Attention-deficit/hyperactivity disorder (AD/HD) is a common developmental disorder. Many reports have suggested that symptoms of AD/HD are related to frontal lobe dysfunctions, particularly disinhibition. However, measuring neurological findings with biomarkers during frontal functional tasks has sometimes been difficult in children with AD/HD. This study aimed to investigate frontal inhibitory function objectively in children with AD/HD during "rock, paper, scissors" (RPS) tasks, as a familiar game for Japanese children, using near-infrared spectroscopy (NIRS). Subjects and methods Eighteen children with AD/HD were compared with 27 typically developing children (TDC). Children from each group were divided into two age groups: younger, 6-10 years; and older, 11-16 years. Changes in oxygenated hemoglobin [oxy-Hb] were measured in the prefrontal region using NIRS during a 'to lose' RPS task, in which subjects were asked to present the RPS signal that would lose in response to one of the three signals displayed randomly on a computer screen every 2.0 s. Results The rate of correct performance with both TDC and AD/HD increased with age. Only in the older group, the rate of correct performance was significantly higher with TDC than with AD/HD. However, children with AD/HD in both age groups showed significantly lower [oxy-Hb] activity in the prefrontal region during the 'to lose' RPS task, particularly in the dorsolateral area. Conclusions Our results suggest that prefrontal region activation during the 'to lose' RPS task could offer a biomarker for diagnosing AD/HD, and may help in the early treatment of AD/HD. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to show that a more exact diagnosis and dietary intervention in AD/HD (Attention Deficit/Hyperactivity Di­sor­der) is possible and probable. The clinical symptom based diagnosis we suggest may be supplemented with physiological tests. A ge­netic and environmental inter-action is clearly involved and explainable using phenyl­ke­tonuria as a model.Method: Examining peer reviewed published papers on gut to blood, blood to brain inter­action and effect of interventions in AD/HD and our own studies in the field. The various treatment options are discussed.Results: It can be shown that a gut to brain activity is possible and probable, and dietary intervention is useful and probably safer than drugs. Preliminary data on a small five year follow up of dietary intervention is shown.

The Child Behavior Checklist–Dysregulation Profile (CBCL-DP) refers to a pattern of elevated scores on the Attention Problems, Aggression, and Anxiety/Depression subscales of the Child Behavior Checklist. The aim of the present study was to investigate the potential role of GABA inhibitory neurons in children with attention deficit/hyperactivity disorder (AD/HD) and dysregulation assessed with a dimensional measure. Brain single photon emission computed tomography (SPECT) was performed in 35 children with AD/HD using 123I-iomazenil, which binds with high affinity to benzodiazepine receptors. Iomazenil binding activities were assessed with respect to the presence or absence of a threshold CBCL-DP (a score ≥210 for the sum of the three subscales Attention Problems, Aggression, and Anxiety/Depression). We then attempted to identify which CBCL-DP subscale explained the most variance with respect to SPECT data, using age, sex, and history of maltreatment as covariates. Significantly higher iomazenil binding activity was seen in the posterior cingulate cortex (PCC) of AD/HD children with a significant CBCL-DP. The Anxiety/Depression subscale on the CBCL had significant effects on higher iomazenil binding activity in the left superior frontal, middle frontal, and temporal regions, as well as in the PCC. The present brain SPECT findings suggest that GABAergic inhibitory neurons may play an important role in the neurobiology of the CBCL-DP, in children with ADHD.

The current gold standard for the diagnosis of AD/HD is based on subjective reports from teachers, parents, and clinicians. These measures can be problematic as they are open to rater biases and also fail to account for the developmental nature of symptoms. The current study examined the diagnostic accuracy of two objective measures, a computer-based Continuous Performance Task and actigraphy (e.g. motion tracking device) in differentiating children with AD/HD (N=70) from healthy controls (N=70). It was predicted that task-unrelated movement (measured via actigraphy) during a CPT and CPT performance would have high classification accuracy in differentiating children with AD/HD from healthy controls, and that the inclusion of age would increase this accuracy. Results indicated that total energy expenditure from the task-unrelated wrist and ankle movement during the CPT was higher in children with AD/HD than controls, and that CPT performance was poorer in AD/HD than controls. Discriminant function analyses revealed that the CPT Full-Scale Response Control Quotient and wrist and ankle energy expenditure provided optimal classification accuracy - correctly classifying 86% of cases, with sensitivity of 81.4% and specificity of 91.4%. The prediction that classification accuracy would increase with the inclusion of age was not supported by the data. When taken in conjunction with other clinical assessments, these findings suggest that actigraphy during a CPT and CPT performance may increase the probability of a correct AD/HD diagnosis. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (AD/HD) is one of the most frequently occurring disorders in school children, and information and communication technology (ICT) in education is one of the tools that is lately considered as helpful for the education of some children with disorders. This research is a case study – using mixed-methods – of the contribution of an ICT-based biology course for the improvement of school achievement of an AD/HD student. Interviews and observations using two independent observers were the research tools for the collection of data, whose analysis revealed that the AD/HD student preferred the ICT lesson, during which all three characteristics of the syndrome became less intense and he was more focused on the educational procedure in comparison with other times. The AD/HD student became more positive toward the biology course and he better understood the biology concepts. [ABSTRACT FROM AUTHOR]

The study presents neuropsychiatric profiles of children aged 11 with autism spectrum disorder, assessed before 4.5 years, and after interventions. The original group comprised a community sample of 208 children with ASD. Parents of 128 participated-34 with average intellectual function, 36 with borderline intellectual function and 58 with intellectual disability. They were interviewed using the Autism-Tics, AD/HD and other Comorbidities interview. Criteria for a clinical/subclinical proxy of ASD were met by 71, 89 and 95 %, respectively. Criteria for at least one of ASD, AD/HD, Learning disorder or Developmental Coordination Disorder were met by 82, 94 and 97 %. More than 90 % of children with a preschool diagnosis of ASD have remaining neuropsychiatric problems at 11, despite early intervention. [ABSTRACT FROM AUTHOR]

Objective This study investigated differences in EEG coherence measures between two groups of children with Attention-Deficit/Hyperactivity Disorder (AD/HD) – one with the more common EEG profile (increased theta), and a group with excess alpha activity as the dominant EEG abnormality. Methods 26 children (aged 9–13 years) with AD/HD were included in each of the excess-theta and excess-alpha groups, and were age- and sex-matched with 26 control subjects. EEG was recorded from 19 electrode sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta bands. Results In comparison with the controls, the excess-theta AD/HD group had increased theta intrahemispheric coherences at short-medium inter-electrode distances. Frontally, the excess-theta AD/HD group had increased interhemispheric theta and reduced beta coherences. The excess-alpha group primarily showed increased slow wave (delta and theta) intrahemispheric coherence at short-medium inter-electrode distances, and reduced alpha coherence at longer inter-electrode distances, compared with controls. An increase in frontal interhemispheric theta coherence was also found. Conclusions These results suggest that AD/HD children with excess alpha power have an underlying connectivity dysfunction in the frontal lobes, which is found in common with other subjects with the excess-theta EEG profile. However, a number of qualitative differences exist that could be associated with other aspects of the AD/HD diagnosis. The excess-alpha group appeared to have fewer frontal-lobe abnormalities than the excess-theta AD/HD group. Significance This is the first study to investigate coherence in AD/HD children who have the atypical profile of increased alpha power in their EEG. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to follow up the 17 children, from a total group of 208 children with autism spectrum disorder (ASD), who "recovered from autism". They had been clinically diagnosed with ASD at or under the age of 4 years. For 2 years thereafter they received intervention based on applied behavior analysis. These 17 children were all of average or borderline intellectual functioning. On the 2-year follow-up assessment, they no longer met criteria for ASD. Methods: At about 10 years of age they were targeted for a new follow-up. Parents were given a semi structured interview regarding the child's daily functioning, school situation, and need of support, and were interviewed using the Vineland Adaptive Behavior Scales (VABS) and the Autism - Tics, Attention-deficit/hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) telephone interview. Results: The vast majority of the children had moderate-to-severe problems with attention/ activity regulation, speech and language, behavior, and/or social interaction. A majority of the children had declined in their VABS scores. Most of the 14 children whose parents were A-TAC-interviewed had problems within many behavioral A-TAC domains, and four (29%) had symptom levels corresponding to a clinical diagnosis of ASD, AD/HD, or both. Another seven children (50%) had pronounced subthreshold indicators of ASD, AD/HD, or both. Conclusion: Children diagnosed at 2-4 years of age as suffering from ASD and who, after appropriate intervention for 2 years, no longer met diagnostic criteria for the disorder, clearly needed to be followed up longer. About 3-4 years later, they still had major problems diagnosable under the umbrella term of ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). They continued to be in need of support, educationally, from a neurodevelopmental and a medical point of view. According to parent interview data, a substantial minority of these children again met diagnostic criteria for ASD. [ABSTRACT FROM AUTHOR]

This qualitative research explored parents’ perspectives of parenting a child with AD/HD-Combined subtype (CT) who was unmedicated. Sixteen parents were interviewed twice and two parents were interviewed once. Data were analysed using grounded theory methods. Findings indicated that parents’ perspectives were primarily concerned with trying to control their child’s difficult behaviours. The substantive theory of Gaining Control that emerged explains the processes that parents used to try to control these behaviours. Two parental controlling/coping pathways were identified. An emotional pathway was associated with negative parental behaviours, poor outcomes, and high distress. The cognitive pathway was associated with surprisingly positive outcomes and low levels of distress. Important outcomes identified included achieving a positive cooperative relationship and highly elevated volitional performance. Processes and subprocesses are described and explained in detail. These findings may have significant clinical and educational implications for enhancing outcomes for the parents and their child. [ABSTRACT FROM AUTHOR]

Highlights: [•] This is the first study to support hypoarousal in girls with AD/HD. [•] A positive correlation found between SCL and alpha in AD/HD girls implies an anomalous arousal mechanism. [•] This study also explores intriguing relationships between physiology and symptom behaviours. [ABSTRACT FROM AUTHOR]

Background: Identifying children with childhood-onset neurodevelopmental problems (NDPs, defined here as autism spectrum disorders [ASDs], attention-deficit/hyperactivity disorder [AD/HD], tic disorders [TDs], learning disorders [LDs] and development coordination disorder), using easily administered screening instruments, is a prerequisite for epidemiological research. Such instruments are also clinically useful to prioritize children for comprehensive assessments, to screen risk groups, and to follow controls. Autism-Tics, ADHD, and other Co-morbidities inventory (A-TAC) was developed to meet these requirements; here the A-TAC's prospective and psychometric properties are examined, when used in a population-based, epidemiological setting. Methods: Since 2004, parents of all Swedish twins have been asked to take part in an ongoing, nation-wide twin study (The Child and Adolescent Twin Study in Sweden). The study includes the A-TAC, carried out as a telephone interview with parents of twins aged 9 or 12. In the present study, screen-positive twins from three birth year cohorts (1993-1995) were invited to a comprehensive clinical follow-up (blinded for previous screening results) together with their co-twins and randomly selected, healthy controls at age 15 (Total N = 452). Results: Sensitivity and specificity of A-TAC scores for predicting later clinical diagnoses were good to excellent overall, with values of the area under the receiver operating characteristics curves ranging from 0.77 (AD/HD) to 0.91 (ASDs). Among children who were screen-positive for an ASD, 48% received a clinical diagnosis of ASDs. For AD/HD, the corresponding figure was also 48%, for LDs 16%, and for TDs 60%. Between 4% and 35% of screen-positive children did not receive any diagnosis at the clinical follow-up three years later. Among screen-negative controls, prevalence of ASDs, AD/HD, LDs, and TDs was 0%, 7%, 4%, and 2%, respectively. Conclusions: The A-TAC appeared to be a valid instrument to assess NDPs in this population-based, longitudinal study. It has good-to-excellent psychometric properties, with an excellent ability to distinguish NDPs (mainly ASDs) from non-NDPs at least three years after the screening evaluations, although specific diagnoses did not correspond closely to actual clinical diagnoses. [ABSTRACT FROM AUTHOR]

Abstract: This study investigated sex differences between the EEGs of Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD) within boys and girls aged 8–12years. Subject groups included 80AD/HD Combined type (40 boys and 40 girls), 80AD/HD Inattentive type (40 boys and 40 girls) and 80 controls (40 boys and 40 girls). An eyes-closed resting EEG was recorded and Fourier transformed to provide estimates for absolute and relative power in the delta, theta, alpha and beta frequency bands, as well as total power and the theta/beta ratio. The boy AD/HD groups, compared with boy controls, had greater absolute and relative theta, greater theta/beta ratio, reduced absolute and relative alpha, and reduced absolute and relative beta. The girl AD/HD groups, compared with girl controls, had greater absolute delta, greater absolute and relative theta, greater theta/beta ratio, greater total power, and reduced relative delta and relative beta. Between AD/HD types, Combined type boys had globally greater absolute and relative theta, greater theta/beta ratio, and less relative alpha than Inattentive type boys. While topographical differences emerged, there were no significant global differences between AD/HD types in girls. That is, EEG differences between AD/HD types are dissimilar in boys and girls. Different EEG maturational patterns between boys and girls also obscure AD/HD-related EEG abnormalities. These results have important implications for our understanding of AD/HD in girls. Ignoring such sex differences may have compromised the value of previous AD/HD investigations, and these sex differences should be recognised in future research. [Copyright &y& Elsevier]

Highlights: [•] Research indicates that multiple disorders co-occur with autism. [•] Attention-deficit/hyperactivity disorder (AD/HD) is one of the most common comorbid conditions with autism. [•] Common biological and environmental factors between the disorders are being explored. [•] There is a need for test batteries that assess both conditions in those with autism. [ABSTRACT FROM AUTHOR]

Abstract: Demanding tasks require a greater amount of effort, in which case individuals are required to alter their energetic-state to a level appropriate to perform the task. According to the Cognitive-Energetic Model (CEM), children with AD/HD are unable to effectively modulate their energetic state, leading to task underperformance. Using an Eriksen flanker task with varying event-rates, the current study compared the ability of typically-developing children and children with AD/HD to modulate their energetic state. In line with the CEM, it was predicted that children with AD/HD would underperform in the fast and slow event-rates. Results indicated that the groups did not differ in commission errors (i.e., incorrect responses). However, children with AD/HD made more omission errors to incongruent stimuli at the fast and slow event-rates, compared to controls. N2 amplitude was significantly larger for the AD/HD than control group in the slow event-rate. It is concluded that the energetic state modulation dysfunction in children with AD/HD results in an inability to attend to the task, as opposed to an inability to perform the task itself. Furthermore, these task performance differences did not manifest in either the N2 or P3 ERP components. Therefore, inattention in children with AD/HD may have its locus in response preparation, as opposed to stimulus processing, but more research is required to validate these conjectures. [Copyright &y& Elsevier]

There is accumulating evidence that computerised cognitive training of inhibitory control and/or working memory can lead to behavioural improvement in children with AD/HD. Using a randomised waitlist control design, the present study examined the effects of combined working memory and inhibitory control training, with and without passive attention monitoring via EEG, for children with and without AD/HD. One hundred and twenty-eight children (60 children with AD/HD, 68 without AD/HD) were randomly allocated to one of three training conditions (waitlist; working memory and inhibitory control with attention monitoring; working memory and inhibitory control without attention monitoring) and completed with pre- and post-training assessments of overt behaviour (from 2 sources), trained and untrained cognitive task performance, and resting EEG activity. The two active training conditions completed 25 sessions of training at home over a 4- 5-week period. Results showed significant improvements in overt behaviour for children with AD/HD in both training conditions compared to the waitlist condition as rated by a parent and other adult. Post-training improvements in the areas of spatial working memory, ignoring distracting stimuli, and sustained attention were reported for children with AD/HD. Children without AD/HD showed behavioural improvements after training. The improvements for both groups were maintained over the 6-week period following training. The passive attention monitoring via EEG had a minor effect on training outcomes. Overall, the results suggest that combined WM/IC training can result in improved behavioural control for children with and without AD/HD. [ABSTRACT FROM AUTHOR]

The Barkley Current Symptoms Scale (BCSS)-Self-Report Form was designed to assess attentiondeficit/ hyperactivity disorder. The purpose of the current study was to add to BCSS psychometric literature in a sample of university students. Comparisons with normative data are provided, and implications for these findings are offered. [ABSTRACT FROM AUTHOR]

Abstract: Event-related potentials (ERPs) such as Nd, N2b, and P300 in an attentional task and an auditory oddball task were compared among 54 adult AD/HD patients, 43 schizophrenic patients (SZ), and 40 healthy age-matched volunteers (HC). It is known that Nd, N2b, and P300 reflect selective attention, voluntary attention, and cognitive context updating respectively. The peak amplitude of P300 was significantly lower in the adult AD/HD and SZ groups than in the HC group. The peak latencies of late Nd, N2b, and P300 were significantly longer in the SZ group than in the HC and adult AD/HD groups. Thus, attenuated amplitude and prolonged latency of various ERP components in the SZ group suggest the possibility of impairment of basic mechanisms underlying cognitive processing. Unlike the SZ group, the adult AD/HD group exhibited reduced amplitude of P300 but not prolonged latency. These findings suggest the existence of a different type of cognitive dysfunction in the adult AD/HD group, which might be closely related to attentional function. [Copyright &y& Elsevier]

Abstract: Objective: We compared EEG coherence in children with and without AD/HD, and sought to relate observed anomalies to AD/HD symptoms. Methods: Forty children with AD/HD and 40 age- and sex-matched controls had eyes-closed resting EEG coherence calculated for eight interhemispheric electrode pairs and eight intrahemispheric pairs (four within each hemisphere) in the delta, theta, alpha, beta and “40Hz” gamma bands. Results: At short-medium inter-electrode distances, the AD/HD group had increased intrahemispheric coherence in delta and theta, and reduced (L>R) laterality in delta, alpha, beta and gamma. Over longer inter-electrode distances, the AD/HD group had reduced intrahemispheric coherence in alpha. In interhemispheric comparisons, the AD/HD group had reduced frontal coherence in delta, alpha and gamma, increased temporal theta and reduced temporal alpha coherences, and increased central/parietal/occipital coherence in theta. Smaller left-lateralized coherences in AD/HD correlated negatively with DSM Inattentive and DSM Total scores, and smaller frontal interhemispheric coherence in alpha correlated negatively with DSM Hyperactive/Impulsive score. Conclusions: The negative correlations between AD/HD coherence anomalies and symptoms suggest that several anomalies reflect compensatory brain function. Significance: Coherence differences in AD/HD may reflect anomalous frontal right-hemisphere linkages that help compensate functional brain anomalies in the left frontal regions in this disorder. [Copyright &y& Elsevier]

A new parent report measure entitled the Salience. Organization and Management of Time Scale (SOMTS) that assessed the temporal regulation of children with and without Attention Deficit Hyperactivity Disorder (AD/HD) in everyday contexts was developed over three phases (item generation, preliminary validation, and factorial structure). Items were compiled from related earlier instruments plus parental interviews, with final selection determined on the basis of item affectivity indices. The final study was, in part, an online study. Principal components analysis and confirmatory factor analyses from a sample of parents of children with (n = 194) and without (n = 142) AD/HD indicated a three factor structure of the new instrument (Verbalizing temporal structures, Temporal self-regulation, and Conceptualizing and sequencing time). Significant between-group differences revealed children with AD/HD performed worse on all three factors compared to children without AD/HD. The factors exhibited moderate discriminant validity when used individually and excellent discriminant validity when used in combination. The three distinct and reliable factors identified by the new instrument map well onto themes emphasized in a comprehensive theory of AD/HD and the between-group differences are consistent with the theory's characterization of a developmental delay in sense of time in young people with the disorder. [ABSTRACT FROM AUTHOR]

Abstract: The prevention of aggressive behaviours is a core priority for psychiatric clinical work, but the association between the diagnostic concepts used in psychiatry and aggression remains largely unknown. Outpatients referred for psychiatric evaluations of childhood-onset neuropsychiatric disorders (n =178) and perpetrators of violent crimes referred to pre-trial forensic psychiatric investigations (n =92) had comprehensive, instrument-based, psychiatric assessments, including the Life History of Aggression (LHA) scales. Total and subscale LHA scores were compared to the categorical and dimensional diagnoses of childhood and adult DSM-IV axis I and II mental disorders, general intelligence (IQ), Global Assessment of Functioning (GAF), and personality traits according to the Temperament and Character Inventory (TCI). Overall, the two groups had similar LHA scores, but the offender group scored higher on the Antisocial subscale. Higher total LHA scores were independently associated with the hyperactivity facet of attention-deficit/hyperactivity disorder (AD/HD), childhood conduct disorder, substance-related disorders, and low scores on the Cooperativeness character dimension according to the TCI. IQ and GAF-scores were negatively correlated with the LHA subscale Self-directed aggression. Autistic traits were inversely correlated with aggression among outpatients, while the opposite pattern was noted in the forensic group. The findings call for assessments of aggression-related behaviours in all psychiatric settings. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this study was to determine whether EEG differences exist between children with attention-deficit/hyperactivity disorder (AD/HD) who later outgrow the disorder and those who continue to be symptomatic as adults. Methods: Thirty-eight boys, diagnosed with AD/HD as children, were reassessed 11years later to determine who met criteria for adult AD/HD. At the childhood assessment, an EEG was recorded from the AD/HD group and a control group, during an eyes-closed resting condition. This was analysed for absolute and relative power in the delta, theta, alpha and beta bands, and the theta/beta ratio. Results: At the childhood assessment, the AD/HD group had an EEG profile typical of the disorder, with increased absolute and relative theta, reduced relative alpha, and increased theta/beta ratio. EEG differences were found between those who outgrew the disorder and those who did not – the adult AD/HD group had greater childhood global relative beta, reduced frontal relative theta, and increased frontal absolute and relative beta. Conclusions: These results suggest the existence of specific CNS differences in childhood AD/HD that may be used to predict the developmental course of the disorder. Significance: This is the first study to investigate childhood EEG markers of adult AD/HD. [Copyright &y& Elsevier]

Abstract: This retrospective study investigated differences in regional derivations of EEG coherence between good and poor responders to methylphenidate (MPH) in children (aged 8–12years) with the combined type of attention-deficit/hyperactivity disorder (AD/HD). Participants included groups of good and poor male MPH responders and an aged-matched group of male controls. An eyes-closed, resting electroencephalogram (EEG) was recorded from 21 electrode sites. Coherence was calculated from eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta frequency bands. Compared with controls, the AD/HD participants had enhanced laterality over short-medium inter-electrode distances, and elevated frontal interhemispheric coherences, in the theta band. Good MPH responders had higher intrahemispheric coherences than poor MPH responders over short-medium and long inter-electrode distances in the beta band. Enhanced laterality at short-medium inter-electrode distances suggests that the AD/HD children may have a developmental lag in short-axonal connections in the left hemisphere. Elevated frontal interhemispheric theta coherence consistently indicates some frontal dysfunction in AD/HD. The beta coherence differences found between good and poor MPH responders could indicate that good MPH responders have some type of structural dysfunction associated with cortical connections involved in attention/arousal. [ABSTRACT FROM AUTHOR]

Abstract: Eighty-three inmates of a correctional facility, who committed serious offences, participated in this study. They were all male and aged 14–17 years, with a mean age of 15.5 (SD=1.21) years. Eighty-six age- and sex-matched controls were enrolled. Some psychological questionnaires such as on self-esteem and aggression were conducted in both groups. The aims of the present study were as follows: first, to clarify the characteristics of the subjects, such as IQ, psychological traits, and AD/HD symptoms; second, to examine how the subjects’ self-esteem and aggression changed and/or improved on admission and at the time of parole (during the correctional educational period). For the results of paired t-tests, the self-esteem of subjects changed little. Therefore, our findings suggest that the improvement of antisocial behavior and transition of self-esteem are not directly linked with each other. Most inmates of the correctional facility showed a borderline IQ, markedly low self-esteem, unstable aggression, and serious AD/HD symptoms. In addition, the low self-esteem of subjects was not consistently elevated during the correctional education period. Moreover, their aggression was strongly correlated with AD/HD symptoms, both on admission and at the time of parole. [ABSTRACT FROM AUTHOR]

There has been limited South African research to date on family resilience as well as on the resiliency of families living with children diagnosed with AD/HD. We aimed to explore and describe the factors that facilitate adjustment and adaptation in families after a child has been clinically diagnosed with AD/HD. The Resiliency Model of Family Stress, Adjustment and Adaptation served as a framework to conceptualize the families' adjustment and adaptation processes. The study was triangular in nature, with an exploratory, descriptive approach. Non-probability purposive sampling was used to gain participants for the study. A biographical questionnaire and seven structured questionnaires were used to gather data. The biographical data were analysed using descriptive statistics. Quantitative data were analysed by means of correlation analysis, and content analysis was used to analyse the qualitative data obtained from the open-ended question on the biographical questionnaire. While the results of the quantitative analysis and qualitative analysis yielded various results, some commonalities can be highlighted; social support, family time and routines, and incendiary (affirmative) communication. The study sample also demonstrated their ability to bounce back from the adversities that previous research consistently highlighted as difficulties in their context. The findings of the research can be incorporated into individual and family level interventions for families living with a child diagnosed with AD/HD. [ABSTRACT FROM AUTHOR]

Objective: To compare telephone interview screening for child psychiatric/neuropsychiatric disorders using the inventory of Autism—Tics, Attention deficit/hyperactivity disorder (AD/HD) and other Comorbidities (A-TAC) with results from the Child Behavior Checklist (CBCL). Background: The A-TAC is a parent telephone interview focusing on autism spectrum disorders (ASDs) and co-existing problems, developed for lay interviewers. Subjects and methods: A-TAC telephone interviews and CBCL questionnaires were obtained from parents of 106 Swedish twin pairs aged 9 and 12 years. Results: Correlations between A-TAC modules and CBCL scales aimed at measuring similar concepts were generally significant albeit modest, with correlation coefficients ranging from 0.30 through 0.55. Conclusion: The A-TAC has convergent validity with the CBCL in several problem areas, but the A-TAC also provides more detailed and specific assessments of ASD symptoms and related neuropsychiatric problems. [ABSTRACT FROM AUTHOR]