ADHD Rating Scale-IV Research Articles

Relations Between Distinct Dimensions of Physical Activity and Preschoolers' ADHD Symptoms.

This study examined the unique and interactive effects of PA volume and within-person fluctuations in PA volume (i.e., intraindividual variability in PA volume; PA-var) on preschoolers' (N = 141; 47.5% girls) ADHD symptoms. Preschoolers wore accelerometers during the school day over a 2-week period. Teachers reported on children's hyperactive, impulsive, and inattentive symptoms on the ADHD Rating Scale-IV Preschool Version. In the context of regression models, higher levels of PA-var were linked with lower levels of impulsive symptoms. Higher levels of PA volume were linked with higher levels of hyperactive and inattentive symptoms, but only when PA fluctuation (i.e., PAvar) was relatively low. Post hoc analyses with teacher-reported impairment as the outcome revealed a significant interaction such that the positive association between PA volume and impairment was stronger at lower, as compared to higher, levels of PA-var. Larger fluctuations in preschoolers' PA volume may indicate lower risk for displaying impulsive symptoms. Moreover, preschoolers with high levels of PA that remain relatively consistent throughout the day may be at increased risk for exhibiting hyperactive and inattentive symptoms and related impairment, suggesting they are unable to regulate their activity to meet expectations in the school environment.

Lisdexamfetamine's Efficacy in Treating Attention Deficit Hyperactivity Disorder (ADHD): A Meta-Analysis and Review.

Lisdexamfetamine dimesylate, a prodrug stimulant, appears to effectively treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adults. However, an analysis of the treatment effects of the two subscales (inattentiveness and hyperactivity) within the ADHD Rating Scale-IV (ADHD-RS-IV) has not yet been done to determine if clinical significance may be attributed to either one. Nor has there been a meta-analysis of the individual doses of lisdexamfetamine dimesylate. The current meta-analysis utilizes MEDLINE, Embase, Cochrane, PubMed, and clinicaltrials.gov to identify peer-reviewed studies. Selected studies were eligible if they met the following criteria: English language, randomized-controlled trials, and utilized the ADHD-RS-IV scale to assess the efficacy of lisdexamfetamine on treating ADHD in either children or adults. The primary studies utilized were published between January 2007 and April 2024. Many of these studies calculate effect sizes based on several dosages pooled together rather than by individual dosages. We conducted a random-effects meta-analysis to estimate the effect sizes for these pooled dosages on the full ADHD-RS-IV scale and its subscales, as well as to calculate effect sizes on the same scales based on the individual dosages. Our main outcome measures are the ADHD-RS-IV scale and its subscales in individual doses and pooled results in both children and adults. Adverse events during treatment were also analyzed based on stratified dosages. Eleven publications met our inclusion criteria. The analyses indicate that compared to placebo, lisdexamfetamine effectively alleviates the symptoms outlined by the ADHD-RS-IV. Moreover, there are no differences in the individual subscales or in the safety profile. Lisdexamfetamine demonstrates efficacy in treating the symptoms of ADHD, but we report that differing dosages did not yield significant differences in ADHD symptom management.

Examining Concordance Between the Clinical Assessment of Attention Deficit-Adult and the Barkley Adult ADHD Rating Scale-IV in a Sample of Adults Referred for ADHD

Examining Concordance Between the Clinical Assessment of Attention Deficit-Adult and the Barkley Adult ADHD Rating Scale-IV in a Sample of Adults Referred for ADHD

Atypical procedural learning in children with developmental coordination disorder: A combined behavioral and neuroimaging study

While procedural learning (PL) has been implicated in delayed motor skill observed in developmental coordination disorder (DCD), few studies have considered the impact of co-occurring attentional problems. Furthermore, the neurostructural basis of PL in children remains unclear. We investigated PL in children with DCD while controlling for inattention symptoms, and examined the role of fronto-basal ganglia-cerebellar morphology in PL. Fifty-nine children (6–14 years; nDCD = 19, ncontrol = 40) completed the serial reaction time (SRT) task to measure PL. The Attention-Deficit Hyperactivity Disorder Rating Scale-IV was administered to measure inattention symptoms. Structural T1 images were acquired for a subset of participants (nDCD = 10, ncontrol = 28), and processed using FreeSurfer. Volume was extracted for the cerebellum, basal ganglia, and frontal regions. After controlling for inattention symptoms, the reaction time profile of controls was consistent with learning on the SRT task. This was not the case for those with DCD. SRT task performance was positively correlated with cerebellar cortical volume, and children with DCD trended towards lower cerebellar volume compared to controls. Children with DCD may not engage in PL during the SRT task in the same manner as controls, with this differential performance being associated with atypical cerebellar morphology.

Reliability of Telepsychiatry Assessments Using the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV for Children With Neurodevelopmental Disorders and Their Caregivers: Randomized Feasibility Study.

Given the global shortage of child psychiatrists and barriers to specialized care, remote assessment is a promising alternative for diagnosing and managing attention-deficit/hyperactivity disorder (ADHD). However, only a few studies have validated the accuracy and acceptability of these remote methods. This study aimed to test the agreement between remote and face-to-face assessments. Patients aged between 6 and 17 years with confirmed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnoses of ADHD or autism spectrum disorder (ASD) were recruited from multiple institutions. In a randomized order, participants underwent 2 evaluations, face-to-face and remotely, with distinct evaluators administering the ADHD Rating Scale-IV (ADHD-RS-IV). Intraclass correlation coefficient (ICC) was used to assess the reliability of face-to-face and remote assessments. The participants included 74 Japanese children aged between 6 and 16 years who were primarily diagnosed with ADHD (43/74, 58%) or ASD (31/74, 42%). A total of 22 (30%) children were diagnosed with both conditions. The ADHD-RS-IV ICCs between face-to-face and remote assessments showed "substantial" agreement in the total ADHD-RS-IV score (ICC=0.769, 95% CI 0.654-0.849; P<.001) according to the Landis and Koch criteria. The ICC in patients with ADHD showed "almost perfect" agreement (ICC=0.816, 95% CI 0.683-0.897; P<.001), whereas in patients with ASD, it showed "substantial" agreement (ICC=0.674, 95% CI 0.420-0.831; P<.001), indicating the high reliability of both methods across both conditions. Our study validated the feasibility and reliability of remote ADHD testing, which has potential benefits such as reduced hospital visits and time-saving effects. Our results highlight the potential of telemedicine in resource-limited areas, clinical trials, and treatment evaluations, necessitating further studies to explore its broader application. UMIN Clinical Trials Registry UMIN000039860; http://tinyurl.com/yp34x6kh.

Is Attention-Deficit/Hyperactivity Disorder (ADHD) a Dimension or a Category? What Does the Relationship Between ADHD Traits and Psychosocial Quality of Life Tell Us?

Objective: The question of whether attention-deficit/hyperactivity disorder (ADHD) is a discrete category or a continuous dimension remains clinically relevant. We report the first examination of this question from the viewpoint of the relationship between ADHD traits and psychosocial quality of life (QoL), and whether the level of QoL declines markedly around a certain high ADHD trait range suggestive of a categorical boundary. Methods: Parents/caregivers of 1,967 schoolchildren aged 6 to 11 from the general population completed the Pediatric Quality of Life Inventory and the ADHD-Rating Scale IV. Piecewise linear and non-linear regression analyses were performed. Results: No evidence for a non-linear association or an abrupt change in the rate of decrease in QoL was observed in the high end of the ADHD traits continuum. Instead, the relationship was consistent with linearity. Conclusion: Psychosocial QoL gradually declines in a linear manner as ADHD trait levels increase providing further support for a dimensional model.

Limited usefulness of neurocognitive functioning indices as predictive markers for treatment response to methylphenidate or neurofeedback@home in children and adolescents with ADHD.

Earlier studies exploring the value of executive functioning (EF) indices for assessing treatment effectiveness and predicting treatment response in attention-deficit/hyperactivity disorder (ADHD) mainly focused on pharmacological treatment options and revealed rather heterogeneous results. Envisioning the long-term goal of personalized treatment selection and intervention planning, this study comparing methylphenidate treatment (MPH) and a home-based neurofeedback intervention (NF@Home) aimed to expand previous findings by assessing objective as well as subjectively reported EF indices and by analyzing their value as treatment and predictive markers. Children and adolescents (n = 146 in the per protocol sample) aged 7-13 years with a formal diagnosis of an inattentive or combined presentation of ADHD were examined. We explored the EF performance profile using the Conners Continuous Performance Task (CPT) and the BRIEF self-report questionnaire within our prospective, multicenter, randomized, reference drug-controlled NEWROFEED study with sites in five European countries (France, Spain, Switzerland, Germany, and Belgium). As primary outcome for treatment response, the clinician-rated ADHD Rating Scale-IV was used. Patients participating in this non-inferiority trial were randomized to either NF@home (34-40 sessions of TBR or SMR NF depending on the pre-assessed individual alpha peak frequency) or MPH treatment (ratio: 3:2). Within a mixed-effects model framework, analyses of change were calculated to explore the predictive value of neurocognitive indices for ADHD symptom-related treatment response. For a variety of neurocognitive indices, we found a significant pre-post change during treatment, mainly in the MPH group. However, the results of the current study reveal a rather limited prognostic value of neurocognitive indices for treatment response to either NF@Home or MPH treatment. Some significant effects emerged for parent-ratings only. Current findings indicate a potential value of self-report (BRIEF global score) and some objectively measured neurocognitive indices (CPT commission errors and hit reaction time variability) as treatment markers (of change) for MPH. However, we found a rather limited prognostic value with regard to predicting treatment response not (yet) allowing recommendation for clinical use. Baseline symptom severity was revealed as the most relevant predictor, replicating robust findings from previous studies.

The effects of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with attention deficit hyperactivity disorder: a pilot RCT.

Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder characterized by inattention, hyperactivity, and impulsivity. We hypothesized that chiropractic adjustments could improve these symptoms by enhancing prefrontal cortex function. This pilot study aimed to explore the feasibility and efficacy of 4 weeks of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with ADHD. 67 children with ADHD were randomly allocated to receive either chiropractic adjustments plus usual care (Chiro+UC) or sham chiropractic plus usual care (Sham+UC). The Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS), Swanson, Nolan and Pelham Teacher and Parents Rating Scale (SNAP-IV), and ADHD Rating Scale-IV were used to assess outcomes at baseline, 4 weeks, and 8 weeks. Feasibility measures such as recruitment, retention, blinding, safety, and adherence were recorded. Linear mixed regression models were used for data analysis. 56 participants (mean age ± SD: 10.70 ± 3.93 years) were included in the analysis. Both the Chiro+UC and Sham+UC groups showed significant improvements in total and subscale ADHD scores at 4 weeks and 8 weeks. However, there were no significant differences between the two groups. This pilot study demonstrated that it was feasible to examine the effects of chiropractic adjustment when added to usual care on ADHD outcomes in children. While both groups showed improvements, the lack of significant between-group differences requires caution in interpretation due to the small sample size. Further research with larger samples and longer follow-up periods is needed to conclusively evaluate the effects of chiropractic adjustments on ADHD in children.

Altered brain functional connectivity in patients with resistance to thyroid hormone ß.

To investigate changes in brain network organization and possible neurobehavioral similarities to attention-deficit hyperactivity disorder (ADHD), we measured changes in brain resting-state functional connectivity (rs-fMRI) and cognitive domains in patients with resistance to thyroid hormone β (RTHβ) and compared them with those in healthy control subjects. In this prospective case-control study, twenty-one participants with genetically confirmed RTHβ were matched with 21 healthy controls. The Adult ADHD Self-Report Scale (ASRS-v1.1) and ADHD Rating Scale-IV were used to assess self-reported symptoms of ADHD. A voxel-wise and atlas-based approach was used to identify changes in the brain networks. The RTHβ group reported behavioral symptoms similar to those of ADHD. We found evidence of weaker network integration of the lingual and fusiform gyri in the RTHβ group, which was mainly driven by weaker connectivity to the bilateral insula and supplementary motor cortex. Functional connectivity between regions of the default mode network (angular gyrus/middle temporal gyrus) and regions of the cognitive control network (bilateral middle frontal gyrus) was increased in RTHβ patients compared to healthy controls. Increased connectivity between regions of the default mode network and the dorsolateral prefrontal cortex is frequently reported in ADHD and is interpreted to be associated with deficits in attention. Our finding of weaker connectivity of the lingual gyrus to the bilateral insula (salience network) in RTHβ patients has also been reported previously in ADHD and may reflect decreased habituation to visual stimuli and increased distractibility. Overall, our observations support the notion of neuropsychological similarities between RTHβ and ADHD.

Young children’s pre-academic and social skills: role of parents’ locus of control and children’s ADHD behaviours

ABSTRACT Our study examined young children’s pre-academic and social skills in relation to parental locus of control and children’s behaviours of ADHD. The participants were parents of 1,502 children from four Chinese kindergartens (Mage = 4.59, SD = 0.93; Girls: 51.40%). Data on six domains of children’s pre-academic and social skills, parental external and internal locus of control, and children’s inattention and hyperactivity/impulsivity were obtained with the Early Learning and Development for Children Aged 3 to 6 years, the Parental Locus of Control scale, and the ADHD Rating Scale-IV Preschool Home Version respectively. Hierarchical regression results showed that controlling for other variables, higher scores in parental external locus of control and child inattention behaviours significantly predicted lower scores in all six domains, while higher scores in internal locus of control and child hyperactivity/impulsivity behaviours predicted higher scores in all six domains (R 2 ranged from 18.0% to 47.0%). Noticeably, parental locus of control explained a smaller amount of the variance (1.0–5.0%) than behaviours of ADHD (5.0–11.0%) in the children’s outcomes.

A Digital Mental Health Support Program for Depression and Anxiety in Populations With Attention-Deficit/Hyperactivity Disorder: Feasibility and Usability Study.

A total of 1 in 2 adults with attention-deficit/hyperactivity disorder (ADHD) struggles with major depressive or anxiety disorders. The co-occurrence of these disorders adds to the complexity of finding utility in as well as adherence to a treatment option. Digital therapeutic solutions may present a promising alternative treatment option that could mitigate these challenges and alleviate symptoms. This study aims to investigate (1) the feasibility and acceptance of a digital mental health intervention, (2) participants' engagement and retention levels, and (3) the potential efficacy with respect to anxiety and depression symptoms in a population with ADHD. Our main hypothesis was that a digital, data-driven, and personalized intervention for adults with coexisting ADHD and depressive or anxiety symptoms would show high engagement and adherence, which would be accompanied by a decrease in depressive and anxiety symptoms along with an increase in quality of life and life satisfaction levels. This real-world data, single-arm study included 30 adult participants with ADHD symptomatology and coexisting depressive or anxiety symptoms who joined a 16-week digital, data-driven mental health support program. This intervention is based on a combination of evidence-based approaches such as cognitive behavioral therapy, mindfulness, and positive psychology techniques. The targeted symptomatology was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Barkley Adult ADHD Rating Scale-IV. Quality of life aspects were evaluated using the Satisfaction With Life Scale and the Life Satisfaction Questionnaire, and user feedback surveys were used to assess user experience and acceptability. The study retention rate was 97% (29/30), and high engagement levels were observed, as depicted by the 69 minutes spent on the app per week, 5 emotion logs per week, and 11.5 mental health actions per week. An average decrease of 46.2% (P<.001; r=0.89) in depressive symptoms and 46.4% (P<.001; r=0.86) in anxiety symptoms was observed, with clinically significant improvement for more than half (17/30, 57% and 18/30, 60%, respectively) of the participants. This was followed by an average increase of 23% (P<.001; r=0.78) and 20% (P=.003; r=0.8) in Satisfaction With Life Scale and Life Satisfaction Questionnaire scores, respectively. The overall participant satisfaction level was 4.3 out of 5. The findings support the feasibility, acceptability, and value of the examined digital program for adults with ADHD symptomatology to address the coexisting depressive or anxiety symptoms. However, controlled trials with larger sample sizes and more diverse participant profiles are required to provide further evidence of clinical efficacy.

Using Visual Displays in a Manualized Cognitive-Behavioral Treatment for Adults With ADHD and Comorbid Mood or Anxiety Disorders: A Pilot Study

Attention-deficit/hyperactivity disorder (ADHD) in adults is a major health concern, often occurring with other disorders and functional, occupational, and relational deficits. Unfortunately, many treatment studies for adults with ADHD exclude comorbid mood or anxiety disorders. The present two-part study sought to identify the feasibility, acceptability, and preliminary effectiveness of a treatment for adults with ADHD and comorbid mood or anxiety disorders that used modules from evidence-based cognitive-behavioral (CB) and mindfulness interventions for adult ADHD and mood or anxiety disorders. Selection of modules for each participant’s treatment was guided by participant input (e.g., top problems) and personalized visual displays. Visual displays included a CB case formulation and intraindividual network analyses, using pretreatment ecological momentary assessment (EMA) data completed two or three times a day to assess ADHD and comorbid symptoms. All 9 (6 women) participants completed the pretreatment standardized measures—however, completion of EMA data by 6 participants provides mixed support for the feasibility of utilizing EMA with ADHD adults. Nevertheless, the results indicate feasibility for using this CB treatment combining manualized interventions with treatment personalization using complex visual displays from available EMA data. Seven of 9 (77.8%) participants achieved a reliable change and 5 (55.6%) achieved a clinically significant change in total ADHD symptoms (Barkley Adult ADHD-IV Rating Scale) at posttreatment and/or 3-month follow-up. Inattention symptoms reliably decreased in all participants.

Child ViReal Support Program: A Randomized Controlled Trial Study for Effective Support of Parents Raising Children with Attention Deficits.

Attention deficit hyperactivity disorder (ADHD) results in various functioning impairments in children's lives and families. Parents of children with ADHD report high levels of parenting stress, low levels of parental self-efficacy, and use of more authoritarian and/or permissive parenting practices than parents of typically developing children. Intervention programs need to address both children's and parents' needs and multimodal intervention programs could cover this demand. The aim of this study was to examine the efficacy of "Child ViReal Support Program"-a multi-level evidence-based comprehensive program-on parenting stress, parental self-efficacy, parenting practices, and the core symptoms of children's ADHD. Families with a child diagnosed with ADHD (n = 16) were randomly allocated to two groups (PC and CP; P = parent training, C = child training), and a cross-over design was utilized. Participating parents completed, in four different times during the study, the Parenting Stress Index-Short Form, the Parenting Sense of Competence Scale, the Parenting Styles and Dimensions Questionnaire-Short Version, and the parent form of the ADHD Rating Scale-IV. Parents from both groups, after their participation in the parent training, demonstrated reduced parenting stress, enhanced parental self-efficacy, and increased the employ of democratic parenting practices. More than that, they reported decreased levels of inattention and impulsivity/hyperactivity for their children. Evidence-based multi-level intervention programs could produce positive effects on parents and children by incorporating effective methods and tools in accordance with the needs and the demands of the family context.

The Prevalence of Video Game Addiction and Its Relation to Anxiety, Depression, and Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents in Saudi Arabia: A Cross-Sectional Study.

Background and objective Video games have become a popular source of entertainment among children and adolescents, not only targeting the young generation but also increasingly popular among older demographics as well. This study aimed to assess the association between video game addiction and depression, anxiety, and attention deficit hyperactivitydisorder (ADHD) among children and adolescents in Saudi Arabia. Materials and methods This was a cross-sectional studyinvolving Saudi adolescents aged 12-16 years. A self-administered online survey was distributed on social media (Twitter, WhatsApp, and Snapchat). The surveyaddressed sociodemographic characteristics (i.e., age, gender, area of residence city, etc.). Arabic versions of the Patient Health Questionnaire-9 (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (PHQ-GAD7), the ADHD Rating Scale-IV (ADHD-RS), and the seven-item GameAddiction Scale(GAS-7) questionnaires were distributed as well, including Arabic terms for depression, anxiety, and ADHD. Results A total of 393 surveys were completed (males: 58.3% vs. females: 41.7%). Of note, 63.1% of the respondents reported playing video games every day with an average of more than five hours of gaming time per day (25.2%). The prevalence of video game addiction was 62.1%. Independent risk factors of video game addiction included being young in age, playing video games every day, playing more than three hours per day, and playing multiplayer games. Furthermore, our findings suggestthat a higher video game addiction score is correlated with higher scores in inattention, anxiety, and depression. Conclusion This study found a high prevalence of video game addiction amongSaudi children and adolescents. Excessivevideo game playing negatively influences mental health and leads to issues including anxiety, depression, and ADHD. Also, younger males with an increased rate of regular playtime were more likely to exhibit video game addiction in comparison to the rest of the population. Further research is required to more comprehensively assess the prevalence rate of video game addiction and its effect on the mental health of the younger generation within the region.

Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in Fourth- and Fifth-Year Medical Students at the Universidad Regional Del Sureste, Oaxaca, Mexico

Purpose: Attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder characterized by a high pattern of impulsivity, excessive motor activity, and high levels of inattention. Due to the misunderstanding and misinformation inherent on the part of teachers toward the diagnosis and recognition of this disorder, as well as the repercussions of this problem going unnoticed in the academic, emotional, and social life of university students who suffer from it, we present ADHD as the research topic of this work.&#x0D; Methodology: This is a descriptive cross-sectional study, the target population is constituted by fourth- and fifth-year students of the Faculty of Medicine and Surgery of the Universidad Regional del Sureste, enrolled in the 2021-2022 cycle. The instrument used was the ADHD Rating Scale IV (ADHD-RS-IV), a questionnaire used to diagnose ADHD in children, but that was later used to diagnose ADHD in adults. Consists of 18 questions, 9 including symptoms of inattention and 9 including symptoms of hyperactivity/impulsivity.&#x0D; Results: The prevalence of ADHD in the target population was 7.4%. The most frequent clinical subtype was inattention with 6%, of which 57% were women. 3.41% were detected with hyperactivity, of which 58% were women. Regarding the combined type, a prevalence of 2% was found, of which 43% are women.&#x0D; Conclusion: A small association was found between educational level and ADHD; this relationship can be explained by the fact that as the educational level advances, higher performance in attentional processes is necessary; therefore, the higher the academic demands, the more likely it is that latent cognitive deficits in students will become evident.

Prevalence of Attention Deficit Hyperactivity Disorder Among Children in Makkah Region, Saudi Arabia.

Introduction Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children and is described as a disease involving loss of self-control. The core symptoms of ADHD are inattentiveness, impulsivity, and motor unrest. Furthermore, poor concentration, distraction, hyperactivity, and poor academic achievement at school or at home are other symptoms. ADHD, like other prevalent medical disorders such as asthma and schizophrenia, may be impacted by several genes and has multiple contributing causes that are not all related to each other. The management of ADHD contains multimodal treatments, starting with psycho-education for parents and the child or adolescent patient in an age-appropriate manner called cognitive behavioral therapy. The worldwide prevalence rate of ADHD among children is 7.2% and, in some countries, can be higher and reach 15.5%; studies show the average prevalence of ADHD in the Kingdom of Saudi Arabia(KSA) is 9.2%. Method A descriptive cross-sectional study was conducted from December 2022 to January 2023 among children who live in Makkah between the ages of 4 and 14 years old via an online survey that contained the ADHD Rating Scale-IV for parents/teachers, and caregivers based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. The scale was translated into Arabic and contains 18 questions about ADHD symptoms. Result The overall prevalence of combined ADHD among children in Makkah is 52.5% (n=203 out of 387); most of them were males (30.8%) and 21.7% were females (P=0.09), and most of the combined ADHD prevalence was between the ages of 11 and 14 (20.4%), then the age of 4-7 (16.8%), and 15.3% of them were between 8 and 10 years old. Additionally, the results show a higher prevalence of combined ADHD in Makkah city (33.1%) (n=121) in comparison to rural areas 19.4% (n=82) (P=0.132). Conclusion The aim of the study was to measure the prevalence rate of ADHD in the Makkah region. The study showed a high prevalence rate of ADHD (52.5%) among children in Makkah; the study was carried out online using an ADHD scale, and more accurate results could be found by using face-to-face interviews and including both parents and teachers.

Psychometric Properties of the Turkish version of the Child and Adolescent Behavior Inventory Sluggish Cognitive Tempo Scale (CABI-SCT) in Children and Adolescents.

Sluggish cognitive tempo (SCT) (cognitive disengagement syndrome) (CDS) describes a cluster of symptoms including slowness, lethargy, and daydreaming. This study aims to evaluate the psychometric properties of the Turkish version of the Child and Adolescent Behavior Inventory (CABI-SCT) scale and its relationship to other psychological difficulties. A total of 328 children and adolescents aged between 6-18years were included in the study. CABI-SCT, Revised Child Anxiety and Depression Scale (RCADS), Barkley Child Attention Scale (BCAS), ADHD Rating Scale-IV, and Strengths and Challenges Questionnaire (SDQ) were administered to parents of participants. Reliability analysis demonstrated good internal consistency and reliability. Confirmatory factor analysis indicated that the one-factor model of the Turkish version of CABI-SCT is an acceptable construct. This study supports the validity and reliability of the Turkish version of CABI-SCT for use in children and adolescents providing initial data concerning the psychometric properties and difficulties associated with the Turkish version of the CABI-SCT.

Executive attention modulates the facilitating effect of electronic storybooks on information encoding in preschoolers

Interactive features and multimedia elements in electronic storybooks might enhance knowledge acquisition in children due to the playful learning experience they provide. However, to date, there is no systematic research on the long-term efficacy of storybooks, and the individual cognitive factors that influence information processing when using these apps. Therefore, in Experiment 1, we focused on long-term improvements. Children (M = 5.55 years, SD = 0.51, N = 33) were divided into an Interactive App group (N = 16) and a Print Book group (N = 17), then they were exposed to a story. Their recall performance was measured immediately after the exposure and three weeks later. In Experiment 2, we focused on individual differences in cognitive factors (working memory and sustained attention). Children (M = 5.56 years, SD = 0.62, N = 32) were exposed to three stories with interactive, multimedia-only elements and an audio-only condition. Caregivers were asked to fill out the ADHD Rating Scale-IV regarding each child. According to our results, in Experiment 1, children in the Interactive App group performed better compared to the Print Book group and this improvement persisted over time. In Experiment 2, we replicated the results of Experiment 1, however, children with poorer sustained attentional abilities performed worse in multimedia and interactive conditions compared to the audio-only condition. Our results indicate that electronic storybooks can facilitate learning because they enhance encoding efficacy. However, the benefit is only evident in children with good attentional control abilities. Our results guide parents and educators on how to choose and design age-appropriate applications for learning.

Long-Term Effects of an Oligoantigenic Diet in Children with Attention-Deficit/Hyperactivity Disorder (ADHD) on Core Symptomatology

In the early 1920s, it was discovered that nutrition is associated with what is known today as Attention-Deficit/Hyperactivity Disorder (ADHD) and that certain foods can worsen the symptoms. In previous studies, approximately 60% of the participants experience at least a 40% reduction in ADHD symptoms after an oligoantigenic diet (OD). The purpose of this study was to evaluate ADHD symptoms in children approximately 3.5 years after completing a 4-week oligoantigenic diet. Among 28 participants who completed the 4-week diet, 21 were re-assessed for this study after 3.5 years. The severity of ADHD symptoms was assessed with the ADHD-Rating-Scale-IV (ARS). Of 21 participants, 14 fulfilled the responder criterion, whereas 7 did not. At follow-up, 28% of the participants were taking medication. The mean ARS total score improved significantly from T1: M = 29.62 (SD = 9.80) to T2: M = 15.86 (SD = 8.56) between the time points before and after the diet (d = -1.91). There was also a lower ARS total score at the follow-up T5: M = 16.00 (SD = 10.52) compared to before the diet (d = -1.17). This study shows that individually adjusted nutrition significantly improved the ADHD symptomatology of the participants long-term. This suggests that an oligoantigenic diet with subsequent individual nutritional recommendations could become an additional treatment option for children with ADHD.

Neurofeedback for Attention Deficit Disorder in preschoolers (NeFAP): A randomized, sham-controlled, efficacy study protocol of a novel non-pharmacological therapy

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is an impairing condition that widely affects a child's life. Current treatment guidelines for preschool-aged children suggest prescribing evidence-based parent or teacher-administered behavior therapy (BT) as the first line of treatment. Psychostimulants can be prescribed for non-respondents and moderate-to-severe cases, but they have side effects. Alternative therapy is neurofeedback, which has already shown effectiveness in the older children population but not in preschoolers. Objective: To evaluate if neurofeedback associated with behavioral therapy is superior in efficacy compared to sham neurofeedback plus behavioral therapy for treating newly diagnosed ADHD in preschoolers.Methods: This will be a multicenter, randomized, single-blinded, parallel-group, superiority phase III study including 274 patients in five sites. Participants are children aged 4 to 6 years old with a confirmed diagnosis of moderate-severe ADHD by a treating physician. Both groups will receive 48 neurofeedback or sham sessions in 24 weeks plus BT, with 6-month follow-up up to 36 months. The primary outcome is the improvement of ADHD symptoms measured by the ADHD Rating Scale-IV (ADHD-RS-IV). After six months, participants will be allowed to use medication if needed. Therefore, one of our secondary endpoints will be time-to-medication. Two hundred seventy-four participants will be enrolled.Discussion: The NeFAP study is an innovative study of NF to treat symptoms of ADHD in preschoolers. If positive results are obtained, it may change the treatment landscape for preschoolers who typically have difficulty adhering to drug-based treatments.