Reading abilities and cognitive processing in grade 3 children with ADHD comorbid with developmental dyslexia.

ObjectiveTo explore and compare the cognitive processing weakness of children with Attention deficit hyperactivity disorder (ADHD) and comorbid reading disabilities (RD) (ADHD+RD) and children with ADHD only using the Das-Naglieri Cognitive Assessment System (DN:CAS).MethodsEighty-eight children with ADHD who visited the hospital for the first time from September 2021 to November 2021 and had a Full scale intelligence quotient (IQ) of ≥85 on the Wechsler Intelligence Scale for Children revised in China (C-WISC) were selected (Age: 6–12 years; Grade: 2–6). Based on comorbidity with RD and the subtypes of ADHD (e.g., Inattention dominant type, ADHD-I, Hyperactivity/Impulse dominant type, ADHD-H and Combined type, ADHD-C), these children were divided into the ADHD+RD group (n = 30) and ADHD group (n = 58) as well as the corresponding subgroups. Clinical data on gender, age, grade, IQ scores, and DN:CAS processing scores were compared between both groups/subgroups. Spearman's correlation test was used for correlation analysis of results of interest.ResultsNo differences in age, grade, male-to-female ratio, verbal IQ, performance IQ, and full scale IQ were observed between the ADHD+RD group and ADHD group as well as the corresponding subgroups (P > 0.05). Children in the ADHD-C+RD subgroup had lower scores in Planning processing of DN:CAS than those in the ADHD-C subgroup (P = 0.040). However, there were no significant difference between the ADHD-I+RD subgroup and ADHD-I subgroup in Planning scores of DN:CAS assessment; The grade of ADHD-C+RD and ADHD-I+RD subgroups were positively correlated with the Planning scores of DN: CAS (r = 0.599, P = 0.030 and r = 0.508, P = 0.044, respectively). The grade of ADHD-C subgroup was positively correlated with the Planning and Simultaneous processing scores of DN: CAS (r = 0.409, P = 0.042 and r = 0.406, P = 0.044, respectively).ConclusionOur study confirmed that children of ADHD-C with comorbid RD have a more severe Planning processing weakness compared to children with ADHD-C only. Among the children of ADHD-C+RD, ADHD-I+RD and ADHD-C, such a Planning processing impairment may improve with increasing educational skills.

Developmental dyslexia (DD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common neurodevelopmental disorders among school-age children. These disorders frequently co-occur, with up to 40–50% of children with one diagnosis meeting criteria for the other, and similar percentages of children with either DD or ADHD exhibiting impaired executive functions (EF). Although both ADHD and EF deficits are common in dyslexia, there is little evidence about how ADHD and EF deficits specifically influence the brain basis of reading difficulty in dyslexia, and whether the influences of ADHD and EF on dyslexia can be disentangled. The goal of the current study was to investigate, at both behavioral and brain levels, whether reading performance in individuals with dyslexia is more strongly associated with EF or with diagnostic status of comorbid ADHD. We examined reading abilities and EF in children (8-13 years old) with typical reading ability, DD only, or both DD + ADHD. Across both groups with dyslexia, impaired EF was associated with greater impairment on measures loading onto a reading fluency, but not a reading accuracy, factor. There were no significant differences between the DD and DD + ADHD groups on measures of reading fluency or reading accuracy. During functional magnetic resonance imaging (fMRI) while performing a rhyme-matching reading task requiring phonological awareness, typically developing readers showed greater left-hemisphere reading network activation than children with DD or DD + ADHD. Children with DD and DD + ADHD did not show differential activation, but DD children with unimpaired EF showed greater activation than those with impaired EF in reading-related areas. Thus, ADHD status alone had no measurable influence on reading performance or brain activation. Impaired EF in dyslexia, independent of ADHD status, was associated with greater deficits in reading fluency and greater reductions of activation in response to print in the typical left-hemisphere reading network.

Objective To explore the relationship between the Chinese Version Wechsler intelligence scale for children(C-WISC) and the Das-Naglieri cognitive assessment system(DN: CAS) in children with attention deficit hyperactivity disorder (ADHD). Methods Thirty-two children with ADHD were evaluated with C-WISC and the digital remote assessment system——DN: CAS, and both results were administered for correlation analysis. Results The results showed that there was a strong correlation between the full intelligence quotient (FIQ) of C-WISC and the full score of DN: CAS, also the scores in Plan, Simultaneous, and Successive of DN-CAS, and the correlation coefficient was between 0.6 to 0.8. There was a strong correlation between the full score of DN: CAS and the verbal comprehension IQ(VCIQ), perceptual organization IQ(POIQ), memory/concentration IQ(M/CIQ), verbal IQ(VIQ), and performance IQ(PIQ) of C-WISC, as the correlation coefficient ranges from 0.6 to 0.8. There was also a strong correlation between the score in Planning and VCIQ, POIQ, M/CIQ, VIQ of C-WISC. As to the score in Simultaneous of DN: CAS and POIQ, VIQ, PIQ of C-WISC, the correlation was also strong with the correlation coefficient ranging from 0.6 to 0.8. For the rest of the sub-tests of C-WISC and DN: CAS, there was moderate correlation between them, the correlation coefficient was from 0.4 to 0.6. Conclusions These results show that the correlation between C-WISC and DN: CAS in children with ADHD is significant. The correlation coefficient shows diversity in the sub-tests of C-WISC and DN: CAS. Key words: Attention deficit hyperactivity disorder; Chinese Version Weehsler intelligence scale for children; Das-Naglieri cognitive assessment system; Correlation

ADHD Differences on the Stanford Binet Intelligence Scale, Fifth Edition

Background: Adolescents entering substance abuse treatment report clustered psychiatric symptoms and sexual risk behaviors representing differential levels of impairment and risk for maladaptive health outcomes. Objectives: To examine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) subtypes among adolescents receiving outpatient substance abuse treatment; To document group differences in (a) past-year psychiatric symptom scores and (b) sexual risk behaviors by ADHD subtype and gender. Methods: Self-report data were collected via structured interviews from 394 adolescents (280 males, M = 16.33 years, SD = 1.15 years), enrolled in an HIV/STI risk reduction intervention for adolescents receiving outpatient substance abuse treatment. ADHD diagnostic subtypes and other past-year psychiatric symptoms were assessed using the Brief Michigan Version of the Composite Internal Diagnostic Interview (UM-CIDI). Adolescents provided self-report data on sexual risk behaviors. Results: Multivariate analyses of variance (MANOVAs) documented that Inattentive and Hyperactive-Impulsive ADHD subtypes were significantly associated with higher scores for all past-year psychiatric symptoms. The combined ADHD subtype was significantly associated with higher scores for all psychiatric symptoms except affective disorder. Girls reported significantly higher mean symptoms than boys for alcohol abuse and dependence, anxiety, and affective disorder symptoms. Sexual risk behavior scores were not associated with ADHD status, but girls reported consistently higher scores for multiple risk behavior outcomes. Several psychiatric disorder symptoms were significant covariates of multiple sexual risk behaviors. Conclusion/Importance: Brief screenings for ADHD, other psychiatric disorders and sexual risk behaviors can provide data for tailoring substance abuse services to improve adolescent health outcomes for high-risk subgroups.

OBJECTIVE To study the intellectual characteristics of children with attention deficit hyperactivity disorder (ADHD) and developmental dyslexia (DD). METHODS A total of 55 children with ADHD and DD (ADHD+DD group), 150 children with ADHD alone (ADHD group), and 22 children with DD alone (DD group) were enrolled as subjects. Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to evaluate and compare intellectual characteristics among the three groups. RESULTS There were significant differences in the scores of full-scale intelligence quotient (FSIQ), verbal comprehension index, perceptual reasoning index, and working memory index among the three groups (P < 0.05):the ADHD+DD group had significantly lower scores of FSIQ, verbal comprehension index, perceptual reasoning index, and working memory index than the ADHD group, as well as a significantly lower FSIQ score than the DD group. A comparison of the 10 core subtests in WISC-IV showed that compared with the ADHD group, the ADHD+DD group had significantly lower scores of similarities, vocabulary, comprehension, recitation, picture concepts, matrix reasoning, and letter-number sequencing (P < 0.05). Compared with the DD group, the ADHD+DD group had significantly lower scores of vocabulary, similarities, picture concepts, matrix reasoning, and recitation (P < 0.05). CONCLUSIONS Compared with the children with ADHD alone, the children with ADHD and DD have more severe impairment of FSIQ, verbal comprehension, perceptual reasoning, and working memory, and therefore, it is suggested to enhance the training on similarities, vocabulary, matrix reasoning, picture concepts, and recitation for children with ADHD and DD in clinical practice.

Characteristics of ADHD subtypes in Japanese children and the association with obesity based on BMI-SD score.

Objective To explore the cognitive process in children with attention deficit hyperactivity disorder(ADHD) using Das-Naglieri Cognitive Assessment System(DN: CAS). Methods Sixty-one children with ADHD and sixty-one healthy controls were enrolled in this study.The cognition of all the studies individuals was evaluated by the DN: CAS. Results Compared with the control group, children with ADHD had significantly lower scores in planning[(24.18±5.64) scores vs (30.07±5.28) scores, t=-6.985, P<0.01], simultaneous processing[(33.97±7.64) scores vs (36.90±7.20) scores, t=-2.211, P<0.05], attention [(26.52±6.80) scores vs (31.21±5.86) scores, t=-4.909, P<0.01] in the 4 subtests of DN: CAS, and the total scores [(117.85±21.45) scores vs (132.48±17.95) scores, t=-5.286, P<0.01]are same.And there were significant differences in matching numbers [(8.77±2.33) scores vs (10.87±2.31) scores, t=-5.220, P<0.01], planned codes [(7.87±2.37) scores vs (9.44±2.61) scores, t=-4.006, P<0.01], planned connections[(7.54±2.29) scores vs (9.75±2.01) scores, t=-6.643, P<0.01]; verbal-spatial relations in simultaneous processing [(10.05±2.79) scores vs (11.23±3.19) scores, t=-2.382, P<0.05] and expressive attention[(9.02±2.47) scores vs (10.34±3.03) scores, t=-2.938, P<0.01], number detection [(8.16±2.31) scores vs (10.08±1.86) scores, t=-5.028, P<0.01], receptive attention [(9.34±3.68) scores vs (10.78±3.20) scores, t=-3.215, P<0.01] between ADHD group and the control group.There were significant differences of the percentile rank distribution of the scores between ADHD group and the control group in planning, attention and full score(all P<0.05). Conclusions Children with ADHD have cognitive deficits in the cognitive processing, and planning and attention deficits are the main features.The DN: CAS could be a useful tool in evaluating cognition of children with ADHD. Key words: Attention deficit hyperactivity disorder; Das-Naglieri: Cognitive Assessment System; Cognitive processing; Match study

Objective To explore the influence of Methylphenidate Hydrochloride prolonged-release tablets on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD). Methods Thirty ADHD children and 30 healthy controls were enrolled in this study, and the ADHD subjects were treated with Methylphenidate Hydrochloride prolonged-release tablets for (28±3) days.Pre-test and post-test by the Das-Naglieri: Cognitive Assessment System(DN: CAS) were done to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group with healthy control group were compared.The difference between before and after treatment of ADHD was also compared. Results Compared with healthy control group, there were lower of planning score [(21.86±4.61) scores vs.(29.33±5.06) scores], attention score[(25.00±4.57) scores vs.(29.83±3.79) scores], and the total scores [(111.93±13.95) scores vs.(127.26±15.53) scores] in ADHD group, and there were significant differences(t=-5.976, -4.455, -4.023, all P<0.05). The matching number, planned codes, planned connections, expressive attention, number detection and receptive attention scores were also lower in ADHD group, and there were significant differences(t=-4.787, -3.703, -4.991, -2.216, -2.488, -3.219, all P<0.05). Compared with healthy control group, there were lower of planning score with significant difference[(25.53±4.98) scores vs.(29.33±5.06) scores, t=-2.931, P<0.05] in ADHD group after treatment, matching number and planned codes were lower with significant difference(t=-2.654, -2.044, all P<0.05)in ADHD group after treatment.In ADHD group, the scores of planning [(25.53±4.98) scores vs.(21.86±4.61) scores], simultaneous processing [(36.10±7.10) scores vs.(34.13±6.04) scores], attention [(27.90±5.69) scores vs.(25.00±4.57) scores] and the total score [(121.50±16.55) scores vs.(111.93±13.95) scores] were significantly higher after treatment than that before treatment and there were significant differences(t=-5.679, -2.949, -3.869, -5.963, all P<0.05); matching number, planned codes, planned connections, nonverbal matrices, number detection, receptive attention and word series were significantly higher after treatment than that before treatment, and there were significant differences(t=-2.528, -3.209, -3.890, -2.276, -4.489, -2.208, -2.373, all P<0.05). Conclusion The Methylphenidate Hydrochloride prolonged-release tablets can improve the function of cognitive processing in children with ADHD, especially in attention. Key words: Methylphenidate Hydrochloride prolonged-release tablets; Das-Naglieri Cognitive Assessment System; Attention deficit hyperactivity disorder; Cognitive processing

Objective To investigate the behavior characteristics in different subtypes of untreated children with attention deficit hyperactivity disorder (ADHD) and their relationship with parental stress. Methods Eighty-eight children with ADHD and their parents were tested by Conners parents symptom questionnaire (PSQ) and Parenting Stress Index questionnaire (PSI), and the results were compared among different ADHD subtypes, and 31 cases of healthy children were selected as healthy control group. Results Compared with the healthy controls, the ADHD children showed more behavior problems in conduct disorder subscale (F=15.727, P=0.000), learning problem subscale (F=32.899, P=0.000), inattention/hyperactive disorder subscale (F=33.761, P=0.000)and hyperactive index subscale(F=28.394, P=0.000); among the 3 ADHD subtypes, combined subtype had the highest scores, and there were significant differences in conduct disorder subscale (t=2.226, P=0.029), inattention/hyperactive subscale (t=4.909, P=0.000) and hyperactive index subscale(t=2.871, P=0.005); compared with the healthy controls, the scores of PSI total stress(F=3.753, P=0.013), Parent Domain(F=2.879, P=0.039) and Child Domain(F=3.848, P=0.011)were significantly higher in the ADHD group, among those, combined subtype had the highest scores, and there was significant difference in the mood factor(t=2.231, P=0.028). The PSI total stress scores were positively correlated with the scores of learning problem subscale (r=0.224, P=0.011)and the scores of hyperactive index subscale(r=0.177, P=0.045). At last the learning problem factor entered the regression equation (t=2.588, P=0.011). Conclusions ADHD children have more behavior problems and parental stress, and parental stress is positively correlated with the severity of symptoms, especially in the combined subtype, which is particularly worthy of attention. Key words: Attention deficit hyperactivity disorder; Different subtypes; Behavior symptom; Parental stress

Objective. To investigate the association between two attention deficit/hyperactivity disorder (ADHD) subtypes—combined and inattentive subtypes—and parental stress in a Taiwanese population. Method. One hundred and nine children with ADHD were interviewed using the MINI Kid questionnaire. The children were divided into combined and inattentive subtypes. The level of parenting stress was measured with the self-report Parenting Stress Index and Parental Symptom Scale (Symptom Check List, SCL-90). The data were used to identify child and parental risk factors. Results. Combined subtype was highly associated with parental stress. Parents of children in this group were significantly younger, had a poorer understanding of ADHD, and had significantly higher levels of marital discord, parenting stress, parental symptoms, and life stress (all P<0.05). Multivariate analysis revealed that age of mother, child with comorbidity diagnosis, and parents with poor understanding of ADHD were significantly associated with the combined subtype relative to inattentive subtype (all P<0.05). Conclusion. The combined subtype of ADHD is associated with more parental psychopathology and stress than the inattentive subtype and the presence of combined subtype may indicate that such a child is at greater risk than the inattentive subtype for comorbid conditions such as oppositional defiant disorder and conduct disorder.

Epidemiological and clinical studies suggest that attention deficit hyperactivity disorder (ADHD) and reading disability co-occur more frequently than would be expected by chance. The purposes of this study were to (i) assess the frequency of Japanese syllabary (Kana) reading disability (RD) and (ii) measure the psychometric properties of the Das-Naglieri Cognitive Assessment System (DN-CAS) in a clinic-referred sample of Japanese children with ADHD. Twenty children with ADHD aged 8-13 years were evaluated using both Kana reading tasks and the DN-CAS. Seven children (35%) showed excessive reading time in at least two of four Kana reading tasks and were diagnosed as ADHD plus RD. The children with ADHD plus RD took significantly longer to read a single mora, four-syllable words, and short sentences. There was no significant difference in the time it took the children with ADHD plus RD to read four-syllable non-words compared to the children with ADHD only. The children with ADHD plus RD had significantly lower simultaneous-processing scores in the DN-CAS compared to children with ADHD but not RD. Children with ADHD should be given Kana reading tasks because RD is highly comorbid with ADHD. DN-CAS is a useful method for evaluating cognitive processing in children with ADHD with or without RD.

Attention deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity and impulsivity. In this study, we investigated group differences in dynamic functional connectivity (dFC) between 113 children with inattentive (46 ADHDI) and combined (67 ADHDC) ADHD and 76 typically developing (TD) children using resting-state functional MRI data. For dynamic connectivity analysis, the data were first decomposed into 100 independent components, among which 88 were classified into eight well-known resting-state networks (RSNs). Three discrete FC states were then identified using k-means clustering and used to estimate transition probabilities between states in both patient and control groups using a hidden Markov model. Our results showed state-dependent alterations in intra and inter-network connectivity in both ADHD subtypes in comparison with TD. Spending less time than healthy controls in state 1, both ADHDI and ADHDC were characterized with weaker intra-hemispheric connectivity with functional asymmetries. In this state, ADHDI further showed weaker inter-hemispheric connectivity. The patients spent more time in state 2, exhibiting characteristic abnormalities in corticosubcortical and corticocerebellar connectivity. In state 3, a less frequently state observed across the ADHD and TD children, ADHDC was differentiated from ADHDI by significant alterations in FC between bilateral temporal regions and other brain areas in comparison with TD. Across all three states, several strategic brain regions, mostly bilateral, exhibited significant alterations in both static functional connectivity (sFC) and dFC in the ADHD groups compared to TD, including inferior, middle and superior temporal gyri, middle frontal gyri, insula, anterior cingulum cortex, precuneus, calcarine, fusiform, superior motor area, and cerebellum. Our results show distributed abnormalities in sFC and dFC between different large-scale RSNs including cortical and subcortical regions in both ADHD subtypes compared to TD. Our findings show that the dynamic changes in brain FC can better explain the underlying pathophysiology of ADHD such as deficits in visual cognition, attention, memory and emotion processing, and cognitive and motor control.

State, trait anxiety and selective attention differences in Attention Deficit Hyperactivity Disorder (ADHD) subtypes

Attention and executive functions profile in drug naive ADHD subtypes