ADHD Impairment Research Articles

Object Recognition Memory Deficits in ADHD: A Meta-analysis.

Object recognition memory allows us to identify previously seen objects. This type of declarative memory is a primary process for learning. Despite its crucial role in everyday life, object recognition has received far less attention in ADHD research compared to verbal recognition memory. In addition to the existence of a small number of published studies, the results have been inconsistent, possibly due to the diversity of tasks used to assess recognition memory. In the present meta-analysis, we have collected studies from Web of Science, Scopus, PubMed, and Google Scholar databases up to May 2023. We have compiled studies that assessed visual object recognition memory with specific visual recognition tests (sample-match delayed tasks) in children and adolescents diagnosed with ADHD. A total of 28 studies with 1619 participants diagnosed with ADHD were included. The studies were assessed for risk of bias using the Quadas-2 tool and for each study, Cohen's d was calculated to estimate the magnitude of the difference in performance between groups. As a main result, we have found a worse recognition memory performance in ADHD participants when compared to their matched controls (overall Cohen's d ~ 0.492). We also observed greater heterogeneity in the magnitude of this deficit among medicated participants compared to non-medicated individuals, as well as a smaller deficit in studies with a higher proportion of female participants. The magnitude of the object recognition memory impairment in ADHD also seems to depend on the assessment method used.

Two single arm trials of AKL-T01, a digital therapeutic for adolescents and adults with ADHD

Inattention symptoms represent a key driver of functional impairment in ADHD and often persist into adolescence and adulthood, underscoring a need for novel treatments targeting attentional control. We evaluated AKL-T01—a digital therapeutic that is FDA-cleared for children 8–12 y with ADHD—in adolescents and adults with ADHD in two independent single-arm trials: STARS-ADHD-Adolescent, a 4-week trial in adolescents 13–17 y (n = 162 enrolled), and STARS-ADHD-Adult, a 6-week trial in adults 18 and older (n = 221 enrolled). AKL-T01 was linked with improvements on the Test of Variables of Attention (TOVA®) Attention Comparison Score (ACS) of 2.6 (95% CI: 2.02, 3.26; p < 0.0001) in adolescents and 6.5 in adults (95% CI: 5.35, 7.57; p < 0.0001), along with improvements in secondary endpoints. 15 participants reported adverse device effects, all mild or moderate. Though limited by a single-arm design, results provide preliminary support for the safety and efficacy of AKL-T01 for adolescents and adults with ADHD.

Learning and Memory Impairments With Attention-Deficit/Hyperactivity Disorder

ADHD is a common chronic neurodevelopmental disorder and is characterized by persistent inattention, hyperactivity, impulsivity and are often accompanied by learning and memory impairment. Great evidence has shown that learning and memory impairment of ADHD plays an important role in its executive function deficits, which seriously affects the development of academic, cognitive and daily social skills and will cause a serious burden on families and society. With the increasing attention paid to learning and memory impairment in ADHD, relevant research is gradually increasing. In this article, we will present the current research results of learning and memory impairment in ADHD from the following aspects. Firstly, the animal models of ADHD, which display the core symptoms of ADHD as well as with learning and memory impairment. Secondly, the molecular mechanism of has explored, including some neurotransmitters, receptors, RNAs, etc. Thirdly, the susceptibility gene of ADHD related to the learning and impairment in order to have a more comprehensive understanding of the pathogenesis. Key words: Learning and memory • ADHD • Review

Navigating the Professional Journey for Adults with Attention Deficit/Hyperactivity Disorder: Challenges and Strategies

IntroductionAttention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects approximately 5% of adults. Individuals with ADHD often display symptoms of inattention, including poor time management and difficulty concentrating and completing tasks. Hyperactivity frequently attenuates over time and transforms into inner restlessness, leading to workaholic behaviors. Impulsive symptoms, on the other hand, may manifest as irritability and low frustration tolerance.Objectives To describe the workplace challenges that adults with ADHD face and to explore strategies to improve their occupational outcomes.MethodsA non-systematic review of the clinical literature available in PubMed was conducted using the keywords: “employment” and “attention deficit hyperactivity disorder”.ResultsIndividuals diagnosed with ADHD, in contrast to those without the condition, statistically exhibit poorer job performance and increased lateness, job instability, workplace injuries, particularly traffic accidents, comorbid diseases, and financial problems. Therefore, they often work harder to compensate for their limitations however the findings regarding the health impact of such high job demands are inconsistent. Stimulant therapy during childhood is the main predictor of successful adult employment. Contrarily, risk factors for workplace impairment in ADHD include female gender, executive deficits, lower IQ, less education, combined/inattentive subtype, and history of substance abuse, depression, or anxiety. It was also demonstrated that ADHD individuals may thrive in manual and creative roles and hyperactivity can benefit self-employment. Psychiatrists should offer psychoeducation, along with psychostimulants if necessary, as it is the first-line treatment. Nonetheless, the long-term impact of pharmacological treatment on professional outcomes remains unclear. Although most employers lack ADHD knowledge, workplace strategies including well-defined duties, feedback, job control, and flexibility have been shown to effectively mitigate ADHD symptoms.Conclusions Evidence suggests that a significant amount of employees with ADHD face challenges in finding and keeping a job. Thus, identifying and treating ADHD in adulthood is imperative to help them selecting careers that align with their strengths and weaknesses, which are partially influenced by ADHD, and to promote optimal occupational health. This effort requires collaboration between psychiatry and occupational health professionals. Additionally, it is necessary to start implementing educational campaigns among workforce teams to effectively accommodate workers with ADHD. Further studies are needed to develop occupational programs and rehabilitating interventions tailored to this population.Disclosure of InterestNone Declared

Promising Effects of Socioemotional Skills Training in Bilingual Children With Attention and Behavioral Concerns

<h3>Research Objectives</h3> Bilingualism is present in every country of the world, class of society, and age group. Yet, monolingual-focused health practices, policies, and research dominate delivery of care, contributing to health disparities. To investigate the role of language in treatment delivery, the present study examined the effect of second language use on socioemotional skills in bilingual children with attention and behavioral concerns. <h3>Design</h3> A two-level (students, schools) cluster randomized controlled design accounted for treatment [Collaborative Life Skills (CLS) versus control] across 23 elementary schools. In addition, four schools received treatment in Spanish (parent group) and combination of Spanish and English (child skills training, classroom intervention). <h3>Setting</h3> The CLS program integrates empirically-supported treatments (parent training, classroom intervention, and child skills training) in school settings to encourage accessibility and sustainability. <h3>Participants</h3> Students were referred to the program by school staff for substantial inattention, hyperactivity/impulsivity, and/or related academic/social problems. We conducted secondary data analyses on 120 monolingual and 37 bilingual children (Grades 2-5, Mage=8.32, SDage = 1.08, 28% girls, 35% Latinx, 23% White, 18% Asian, 17% multiracial, 8% Black). <h3>Interventions</h3> Mental health professionals led nine 40-minute child group sessions during school hours. Modules targeted social functioning (e.g., self-control, friendship making, assertion) and independence (e.g., homework skills, routines). Socioemotional skills were taught through didactic instruction, behavioral rehearsal, and in-vivo practice. A reward-based contingency management program was used to manage behaviors and reinforce new skills. <h3>Main Outcome Measures</h3> ADHD symptoms, ADHD impairment. <h3>Results</h3> A mixed effects model revealed a treatment (CLS, control) by language status (bilingual, monolingual) interaction. A greater reduction in parent-reported impairment was found for bilingual children compared to monolingual children. <h3>Conclusions</h3> Socioemotional skills appear to especially benefit bilingual children with attentional and behavioral concerns. Future studies to understand mechanisms are warranted. Receiving socioemotional skills training in second language may help to down-regulate negative emotions, which may be conducive to learning socioemotional skills in clinical settings. <h3>Author(s) Disclosures</h3> No conflicts of interest to disclose.

Measurement Informed Care in Attention-Deficit/Hyperactivity Disorder (ADHD).

Measurement-informed care is a cornerstone of evidence-based practice and shared decision-making. A structured diagnostic interview specific to ADHD provides a globally agreed-on standard of evaluation. These interviews are accessible in the public domain in multiple languages and are helpful to clinicians new to the diagnosis of ADHD. Broad-based rating scales looking at multiple domains of psychopathology are critical to assuring recognition of comorbid diagnoses, which might otherwise be missed, differential diagnoses, and identification of the most prominent or treatable diagnosis. Recent innovations in computerized adaptive testing have improved the efficiency and accuracy of diagnostic screening. Rating scales specific to ADHD and disruptive behavior disorders establish the severity of the disorder and response to intervention. Age- and gender-normed symptom rating scales for ADHD capture clinically salient differences between what is normative in different demographic groups. An evaluation of functional impairment in ADHD has been critical to understanding the patient's perspective of the presenting problem. Best practice care for ADHD treatment goes beyond improvement to well-defined standards for both symptom and functional remission. Studies of executive function, emotional regulation, mind-wandering, and sluggish cognitive tempo have led to a richer understanding of the breadth and depth of associated deficits commonly experienced by ADHD patients. Psychometrically validated tools are available to complement every aspect of ADHD care and provide global standards for research.

Auditory time thresholds in the range of milliseconds but not seconds are impaired in ADHD

The literature on time perception in individuals with ADHD is extensive but inconsistent, probably reflecting the use of different tasks and performances indexes. A sample of 40 children/adolescents (20 with ADHD, 20 neurotypical) was engaged in two identical psychophysical tasks measuring auditory time thresholds in the milliseconds (0.25–1 s) and seconds (0.75–3 s) ranges. Results showed a severe impairment in ADHD for milliseconds thresholds (Log10BF = 1.9). The deficit remained strong even when non-verbal IQ was regressed out and correlation with age suggests a developmental delay. In the seconds range, thresholds were indistinguishable between the two groups (Log10BF = − 0.5) and not correlated with milliseconds thresholds. Our results largely confirm previous evidence suggesting partially separate mechanisms for time perception in the ranges of milliseconds and seconds. Moreover, since the evidence suggests that time perception of milliseconds stimuli might load relatively less on cognitive control and working memory, compared to longer durations, the current results are consistent with a pure timing deficit in individuals with ADHD.

Dimensions of physical activity as related to child attention-deficit/hyperactivity disorder symptoms and impairment

In efforts to explore adjunct/alternative treatments for ADHD, this study investigated the associations between dimensions of physical activity (PA) and children’s ADHD symptoms and impairment. Current evidence-based treatments include medication and behaviour management, but there is widespread consensus that more treatment options are desirable. Although there is increasing support for PA as an adjunct/alternative to existing treatment for ADHD, the interplay of specific dimensions of PA has not been studied. Fifty-one parents of children aged 6–12 years with ADHD filled out questionnaires. Hierarchical regression analysis indicated that only some dimensions of PA explained a statistically significant portion of the variance in ADHD symptoms, beyond that explained by typical demographic variables. PA dimensions did not account for a statistically significant portion of ADHD impairment. Refining the measurement of how long children have engaged in PA is a key step in generating evidence for PA as an adjunct or alternate treatment for ADHD, and developing guidelines to manage parental expectations for this treatment in the benefit of their children.

ADHD and Interfering Thoughts in High and Low Conflict Conditions

Background: Individuals with an ADHD diagnosis have increased levels of interfering thoughts, especially in the form of mind wandering. This was mostly investigated in sustained attention tasks; hence it is unclear whether the findings are only due to their difficulties in those types of tasks. Moreover, it is unclear how the amount of control invested in the task will affect those differences between control and ADHD groups. Method: ADHD and matched control groups performed the Stroop task under high and low conflict conditions while measuring their interfering thoughts level. Results: Individuals with ADHD have more interfering thoughts compared to a control group even when they are able to change their control level according to the task conflict. Conclusion: Interfering thoughts are an independent predictor of ADHD impairments, observed regardless of the degree of control invested in the task.

More than off-task: Increased freely-moving thought in ADHD

Off-task thought has been found to occur at high rates and is related to impairment in ADHD. However, off-task thought is heterogenous and it remains unclear which specific dimensions of off-task thought are more prevalent in this disorder. It is therefore important to dissociate different aspects of off-task thought in order to better understand the mechanisms underlying impairment. The current study focused on the dimension of constrained (focused) to freely moving off-task thought. Self-report and neurophysiological measures during a computerized attention tasks provided convergent evidence that individuals with ADHD not only have more off-task thought than those without, but also engaged in a greater proportion of freely moving off-task thought than non-ADHD controls. Overall, this work demonstrated differences in both the quantity and type of off-task thought in adults with ADHD. It provides novel insight into both the phenomenology of off-task thought, as well as potential mechanisms underlying impairment in ADHD.

Interpersonal negotiation impairment in ADHD: The critical role of comprehension processing

Social impairment is one of the most prevalent adverse outcomes ADHD-related. It is well established that this outcome is independent of externalizing behaviors and environmental factors. Little is known about the cognitive aspects related to it. We analyzed the Interpersonal Negotiation Strategies (INS) of children and adolescents with ADHD and discussed their contribution to understand interpersonal relationship deficits. The performance at INSI of 70 children and adolescents (41 ADHD and 29 clinical controls) were compared and related to the severity of ADHD and the presence of comorbidities. The INSS in ADHD was significantly deficient when compared with the control group (p < .01), independently of the age, gender, and the presence of comorbidities. The comprehension of the problem appeared as an important cognitive factor to contribute to this. These findings have a significant potential to contribute to the novel’s cognitive targets of treatment approaches.

Possible Age-Related Progression of Attentional Impairment in ADHD and Its Attenuation by Past Diagnosis and Treatment

Objective: The aim of the study is to evaluate attentional impairment in different age groups with ADHD. Method: In all, 58 children, 73 adolescents, and 104 adults with ADHD were evaluated using the Test of Variables of Attention (TOVA). Subjects with comorbidities or psychotropic treatment were not included. Results: Considering Response Time Variability (RTV), adults were 10.6 and 4.0 times more likely to be severely impaired (standard score < 40) than children and adolescents, respectively. Adults were twice as likely as adolescents to be very impaired (standard score< 70) in Omissions. Considering d′ (decrement of attentional performance over time), all severely impaired participants were adults. Age predicted impairment in Attention Performance Index (API), RTV, and d′, but not Omissions or Commissions. Past treatment with stimulants predicted less impairment in d′, past diagnosis predicted less impairment in RTV, and each predicted less impairment in Omissions and API. Conclusion: Adults had more attentional impairment than children and adolescents. Past diagnosis and treatment were associated with less ADHD-related attentional impairment.

“Smoking pot helps me focus”: A qualitative analysis of Internet forum discussions of ADHD and cannabis use

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e153 Online feasibility study about HIV-negative male couples substance use with weekly ecological momentary diary assessments Jason W. Mitchell 1, Francesca Davis1, Yue Pan2, Daniel J. Feaster1 1 Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States 2 University of Miami Miller School of Medicine, Miami, FL, United States Aims: To date, little is known about male couples’ use of substances despite the role that substance use plays in HIV seroconversion among gay men. The aims of the present study were twofold: (1) to assess whether panel dyadic data could be collected from HIV-negative male couples about their substance use using online weekly ecological momentary diary assessments; (2) to examine couples’ rates of substance use and contexts of their usage. Methods: A longitudinal study design using ecological momentary weekly electronic diaries was used to examine male couples substance use with/out sex, and the contexts of their usage over a 6-week period. Targeted facebook ads were used to recruit the sample along with a partner referral system to invite eligible participants’ main partners. 531 men took the screener; of these, 97 were eligible, consented and enrolled in the study. Results:Although97partneredmenenrolled, only 13male couples with both partners and 15 male couples with one partner participated in the study. Over the 6-week period, men’s engagement inUASwith theirmain partner, alcohol consumption, and use of erectile dysfunction medication, prescription pain medication (PPM), and/or illicit drug(s) varied. Men frequently usedmarijuana and/or alcohol in a variety of contexts including sex. Among the 13 male couples, both partner’s use of illicit drugs includingmarijuana (ICC 0.97, P 5 posts for analysis. Results: Qualitative analysis of individual posts indicated that Internet discussionparticipants emphasized the therapeutic effects of cannabis for ADHD – fewer endorsed either a null or harmful impact. Exploratory analysis also indicated that participants perceived fewer concerns about cannabis due to it being “natural,” that cannabis is perceived to improve impairment in ADHD (e.g., driving), distrust of the medical community regarding stimulant medication efficacy, and a preference for particular cannabis strains. Conclusions: Cannabis use in the US is changing and there is a need for further research of how cannabis impacts at-risk groups, such as those with ADHD. This qualitative study provides new insight into currentlyheldperceptions about cannabisuse inADHD. We propose a number of novel hypotheses guided by qualitative analysis ofweb-forumcontent,which canguide future quantitative e154 Abstracts / Drug and Alcohol Dependence 156 (2015) e102–e182 studies. This study also illustrates the potential use of web-based data to study substance use. Financial support: NIDA (K23 DA032577). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.418 Sex differences in intrinsic connectivity during FMRI stroop in cocaine-dependent and healthy comparison subjects Marci R. Mitchell 1, Elise E. DeVito1, I. Balodis1, Cheryl Lacadie2, Dustin Scheinost3, R. Todd Constable2, Robert Malison1, Kathleen M. Carroll 1, Marc N. Potenza1 1 Psychiatry, Yale University School of Medicine, New Haven, CT, United States 2 Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, United States 3 Biomedical Engineering, Yale University School of Medicine, New Haven, CT, United States Aims: Previouslywe found cocaine-dependent (CD) versus control subjects (HC) showed greater mean-adjusted connectivity in the ventral striatum, putamen, inferior frontal gyrus, anterior insula, thalamusandsubstantianigra.However, theextent towhich womenandmen showeddifferences in functional connectivitywas not previously examined. This study investigated sex differences in intrinsic connectivity distribution (ICD) in CD subjects during fMRI Stroop performance. Methods: 38 current CD (19 female) and 38 matched HC subjects (19 female) completed an fMRI Stroop task. Mean-adjusted ICD analyses were conducted to identify sex differences. Results: Both increases and decreases in connectivity were observed in all four comparisons (Females CD–HC; Males CD–HC; CD Males–Females; HC Males–Females), and an interaction between gender and diagnostic group implicated connectivity differences in the orbitofrontal cortex (OFC), ventral striatum, precuneus/cuneus, cingulate gyrus, and occipital lobe. Out-of-scanner behavioral Stroop data did not reveal differences between males and females between diagnostic groups, but did show sex differences within the CD group but not the HC group. Conclusions: Differences in intrinsic connectivity involved the OFC, cingulate, and striatum, areas implicated in cocaine dependence and cognitive processes including decision-making and inhibitory control. Differences in regions associated with language and visual processing were also observed. The extent to which these patterns of connectivity relate to clinically relevant measures of cocainedependencewarrants additional investigation. Financial Support: ORWH, OD, NIDA (K12-DA031050, R01DA020908, R01-DA035058, P50-DA09241, R01-DA019039, P20DA027844). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.419 Counselors’ views of providing patient-centered methadone treatment in a clinical trial Shannon G. Mitchell 1, Laura Monico1, Elizabeth Lertch1, Jan Gryczynski1, Sharon M. Kelly1, K.E. O’Grady2, Jerome H. Jaffe1, Robert P. Schwartz1 1 Friends Research Institute, Baltimore, MD, United States 2 University of Maryland, College Park, MD, United

Online feasibility study about HIV-negative male couples substance use with weekly ecological momentary diary assessments

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e153 Online feasibility study about HIV-negative male couples substance use with weekly ecological momentary diary assessments Jason W. Mitchell 1, Francesca Davis1, Yue Pan2, Daniel J. Feaster1 1 Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States 2 University of Miami Miller School of Medicine, Miami, FL, United States Aims: To date, little is known about male couples’ use of substances despite the role that substance use plays in HIV seroconversion among gay men. The aims of the present study were twofold: (1) to assess whether panel dyadic data could be collected from HIV-negative male couples about their substance use using online weekly ecological momentary diary assessments; (2) to examine couples’ rates of substance use and contexts of their usage. Methods: A longitudinal study design using ecological momentary weekly electronic diaries was used to examine male couples substance use with/out sex, and the contexts of their usage over a 6-week period. Targeted facebook ads were used to recruit the sample along with a partner referral system to invite eligible participants’ main partners. 531 men took the screener; of these, 97 were eligible, consented and enrolled in the study. Results:Although97partneredmenenrolled, only 13male couples with both partners and 15 male couples with one partner participated in the study. Over the 6-week period, men’s engagement inUASwith theirmain partner, alcohol consumption, and use of erectile dysfunction medication, prescription pain medication (PPM), and/or illicit drug(s) varied. Men frequently usedmarijuana and/or alcohol in a variety of contexts including sex. Among the 13 male couples, both partner’s use of illicit drugs includingmarijuana (ICC 0.97, P 5 posts for analysis. Results: Qualitative analysis of individual posts indicated that Internet discussionparticipants emphasized the therapeutic effects of cannabis for ADHD – fewer endorsed either a null or harmful impact. Exploratory analysis also indicated that participants perceived fewer concerns about cannabis due to it being “natural,” that cannabis is perceived to improve impairment in ADHD (e.g., driving), distrust of the medical community regarding stimulant medication efficacy, and a preference for particular cannabis strains. Conclusions: Cannabis use in the US is changing and there is a need for further research of how cannabis impacts at-risk groups, such as those with ADHD. This qualitative study provides new insight into currentlyheldperceptions about cannabisuse inADHD. We propose a number of novel hypotheses guided by qualitative analysis ofweb-forumcontent,which canguide future quantitative

Motor imagery skills of children with Attention Deficit Hyperactivity Disorder and Developmental Coordination Disorder

Up to 50% of children with ADHD experience motor impairment consistent with DCD. Debate continues as to whether this impairment is linked to inattention or is a genuine motor deficit. This study aimed to determine whether (1) inattention was greater in ADHD+DCD than in ADHD alone and (2) motor imagery deficits observed in DCD were present in ADHD+DCD. Four groups aged 7-12years–ADHD, combined type, with motor impairment (ADHD+DCD; N=16) and alone (ADHD; N=14), DCD (N=10) and typically developing comparison children (N=18) participated. Levels of inattention did not differ between ADHD groups. On an imagined pointing task, children with DCD did not conform to speed accuracy trade-offs during imagined movements, but all other groups did. However, on a hand rotation task, both the ADHD+DCD and DCD groups were less accurate than the non-motor impaired groups, a finding not explained by differences in IQ, age, or working memory capacity. Overall, there was evidence that children with ADHD+DCD experience genuine motor control impairments indicating the impact of motor impairment in ADHD and its causal risk factors require more study. Motor impairment in ADHD should not be dismissed as a by-product of inattention.

Does age of onset of impairment impact on neuropsychological and personality features of adult ADHD?

The consideration of age of onset of impairment as part of the ADHD diagnosis is controversial and has been a revisited issue with the emergence of the new classifications in Psychiatry. The aim of this study is to compare patients with early and late onset of ADHD impairment in terms of neuropsychological and personality characteristics. Adult patients with ADHD (n = 415) were evaluated in the ADHD outpatient program at Hospital de Clínicas de Porto Alegre, Brazil. The diagnostic process for ADHD and comorbidities was based on DSM-IV criteria. The comparison between the two ages of onset groups (before 7; n = 209 or from 7 to 12 years; n = 206) was performed with ANOVA, followed by Stepwise forward regression analyses to restrict the number of comparisons and access the possible effect of multiple confounders. Patients with early onset ADHD present higher scores in novelty seeking in both analyses (respectively P = 0.016 and P = 0.002), but similar cognitive and attention features as compared with the late onset group. These data add to previous evidence that despite a more externalizing profile of early onset ADHD, the overall performance is similar reinforcing the need for awareness and inclusion of the late onset group in DSM-V diagnostic criteria.

Does methylphenidate improve social impairment in ADHD?

Does methylphenidate improve social impairment in ADHD?

Handwriting in Children With ADHD

Objective: Children with ADHD–combined type (ADHD-CT) display fine and gross motor problems, often expressed as handwriting difficulties. This study aimed to kinematically characterize the handwriting of children with ADHD using a cursive letter l’s task. Method: In all, 28 boys (7-12 years), 14 ADHD-CT and 14 typically developing (TD), without developmental coordination disorder (DCD) or comorbid autism, wrote a series of four cursive letter l’s using a graphics tablet and stylus. Results: Children with ADHD-CT had more inconsistent writing size than did TD controls. In addition, ADHD-CT symptom severity, specifically inattention, predicted poorer handwriting outcomes. Conclusion: In a sample of children with ADHD-CT who do not have DCD or autism, subtle handwriting differences were evident. It was concluded that handwriting might be impaired in children with ADHD in a manner dependent on symptom severity. This may reflect reports of underlying motor impairment in ADHD.

Novel Measures of Response Performance and Inhibition in Children with ADHD

Fifteen children with ADHD aged 8 to 12 years and age and gender matched controls performed two different stopping tasks to examine response performance and inhibition and their respective moment-to-moment variability. One task was the well-established stop-signal task, while the other was a novel tracking task where the children tracked a spaceship on the screen until an alarm indicated they should stop. Although performance was discrete in the stop signal task and continuous in the tracking task, in both tasks latencies to the stop signal were significantly slowed in children with ADHD. Go performance and variability did not significantly differ between ADHD and control children in either task. Importantly, stopping latency in the novel spaceship tracking task also was more variable in children with ADHD. As stopping variability cannot be measured using the standard stop signal task, the new task offers compelling support for the heretofore untested prediction that stopping is both slowed and more variable in children with ADHD. The results support a response inhibition impairment in ADHD, whilst limiting the extent of an intra-trial variability deficit.

Sibling Relationships Among Children With ADHD

Objective: This study investigated the quality of sibling relationships among children with ADHD relative to those without ADHD. Additional analyses examined whether externalizing and internalizing problems comorbid with ADHD affected sibling relationships. Method: Participants were 77 children with ADHD and 14 nonproblem control children. Sibling relationships were assessed via three informants: mother report, self-report, and sibling report. Results: In analyses utilizing hierarchical linear modeling to combine data from the three informants, children with ADHD showed increased conflict in sibling relationships, relative to nonproblem children. Comorbid externalizing problems were associated with less warmth/ closeness and increased conflict in the sibling relationship and largely accounted for the finding that children with ADHD showed greater sibling relationship problems. Comorbid internalizing problems were associated with less warmth/closeness in the sibling relationship. Conclusion: It is recommended that sibling relationships be incorporated into theories of social impairment in ADHD. (J. of Att. Dis. 2008;11(4) 482-492)