Management Of Attention Deficit Hyperactivity Disorder Research Articles

Socio-demographic and clinical profiles of children with attention deficit hyperactivity disorder in a tertiary care hospital of Kashmir

Abstract INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by hyperactivity, inattention, or both, often emerging before the age of 12 years. With a global impact on approximately 136 million children and adolescents, ADHD’s prevalence ranges from 5% to 6%. Despite its higher occurrence in males, ADHD can persist into adulthood, posing risks of substance misuse and vocational difficulties. MATERIALS AND METHODS: This study investigates the socio-demographic and clinical profiles of children aged 6–16 years diagnosed with ADHD in Kashmir. Using a cross-sectional analytic design, data were collected from 208 participants attending the Child Guidance and Wellbeing Center at the Institute of Mental Health and Neurosciences, Kashmir. RESULTS: The gender distribution highlights male predominance (69.2%), which aligns with established models. ADHD prevalence decreases with age, consistent with symptom reduction trends. Socio-economic analysis reveals a prevalence in the lower middle and upper lower classes, suggesting financial difficulties as a predictor of ADHD. The combined subtype of ADHD is the most prevalent (71.2%). CONCLUSION: These findings emphasize the need for tailored interventions and approaches to address ADHD’s diverse presentations in children and adolescents. Although the study acknowledges limitations such as sample size and cross-sectional design, it contributes novel insights into ADHD’s manifestation and underscores the importance of addressing unique characteristics associated with each subtype and age group. Such efforts can optimize ADHD management and outcomes for affected individuals.

Ayurvedic management of ADHD: A single case report

Ayurvedic management of ADHD: A single case report

How Positive Deviance in  High-Achieving Adults with ADHD can Inform Strength-Based Coaching and Life Design to Complement Traditional ADHD Management

How Positive Deviance in  High-Achieving Adults with ADHD can Inform Strength-Based Coaching and Life Design to Complement Traditional ADHD Management

Pharmacotherapy for attention deficit/hyperactivity disorder in youth with avoidant restrictive food intake disorder: a case series of patients prescribed stimulant medication in a partial hospitalization program for eating disorders

BackgroundAppetite suppression and weight loss are established potential side effects of most medications for attention deficit/hyperactivity disorder (ADHD). These side effects may be especially problematic when using stimulants to treat ADHD in the context of a restrictive eating disorder, such as avoidant restrictive food intake disorder (ARFID), although these diagnoses are often comorbid in children. This paper presents a combined approach to treating ADHD comorbid with ARFID using stimulant medication and behavior management within a partial hospitalization program (PHP) and intensive outpatient program (IOP)for eating disorders. The aim of this paper is to determine if the continued or new use of stimulant medication allows for adequate weight restoration by reviewing a series of cases receiving the combined treatment.Case presentationsConsecutive patients with a historical or new diagnosis of ADHD when presenting for treatment for ARFID were included in this case series. This series included 10 patients (8 male, 2 female) who received pharmacotherapy using stimulants and behavior management interventions involving structured mealtimes and contingency management. All treatment occurred within the context of a PHP/IOP for childhood eating disorders. All youth were able to effectively continue on stimulant medication, show clinical benefit in core ADHD symptoms, and able to gradually restore weight. In all cases, stimulant medications were not discontinued, but in some cases, doses were optimized (increased or decreased), switched to a different stimulant, or augmented with non-ADHD medication, such as mirtazapine, to support the management of ADHD while concurrently assisting in weight gain as necessary for the treatment of ARFID. Only one patient was newly started on a stimulant medication; as this was near the end of her treatment stay, limited conclusions can be drawn from this case.ConclusionsThese findings support the use of pharmacotherapy, including continuing stimulant medication, when combined with behavior management strategies as a potentially effective treatment approach for ADHD in youth with ARFID in the PHP/IOP setting. Future studies using more rigorous methodology, longer follow-up times, and within other treatment settings are needed.

Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition which is underdiagnosed and undertreated in women. For decades, the ADHD field has called for more insight into female-specific therapy. Preliminary findings postulate that changes in sex hormones during the menstrual cycle may influence the effectiveness of psychostimulant medication. Yet, pharmacotherapeutic interventions tailored to women with ADHD remain scarce. Previously, our group showed an increase in mood symptoms in the premenstrual week in women with ADHD. Premenstrual worsening of depressive and ADHD symptoms represent a treatment challenge. In our adult ADHD clinic, we noted several women describing exacerbation of their ADHD and depressive symptoms in the premenstrual week and/or insufficient effect of their established dosage of psychostimulant. We responded to the need expressed by these women by increasing their stimulant dosage in the premenstrual week, while monitoring the response and side effects. This community case study of nine consecutive women being treated for ADHD and co-occurring conditions (including depression and premenstrual dysphoric disorder), reports our local experience of increasing the individually prescribed psychostimulant dosage during the premenstrual period. We methodically monitored the effect of this increased dosage on ADHD symptoms, mood and somatic symptoms for the following 6-24 months. With premenstrual dose elevation, all nine women experienced improved ADHD and mood symptoms with minimal adverse events. Premenstrual inattention, irritability and energy levels improved, and now resembled the other non-premenstrual weeks more closely. All women decided to continue with the elevated premenstrual pharmacotherapy. Our preliminary results demonstrate potential benefits of increasing premenstrual psychostimulant dosage in women with ADHD, experiencing premenstrual worsening of ADHD and mood symptoms. The results concur with previous findings of diminished response to amphetamines in the late luteal phase. Increased dosage may help combat premenstrual worsening of cognitive and emotional symptoms in women with ADHD, with significant clinical implications. Better management of premenstrual ADHD and mood symptoms in vulnerable women can improve treatment outcome and meet an unmet need. However, implementation should be individually explored. Further investigation of luteal phase psychostimulant dose adjustment is required for safe, optimal and individualised treatment for women with ADHD.

Assessment of probiotic strain Lactobacillus acidophilus LB supplementation as adjunctive management of attention-deficit hyperactivity disorder in children and adolescents: a randomized controlled clinical trial

BackgroundThis study was designed to examine the possible efficacy of the probiotic strain Lactobacillus acidophilus LB (Lacteol Fort) on attention-deficit/hyperactivity disorder (ADHD) symptomatology and evaluate its influence on cognition function.MethodsIn this randomized controlled trial, 80 children and adolescents with ADHD diagnosis, aged 6–16 years, were included. The participants were randomly assigned to two groups: one group received probiotics plus atomoxetine, whereas the other group received atomoxetine only. ADHD symptomatology was assessed using the Conners Parent Rating Scale–Revised Long Version (CPRS-R-L) and Child Behavioral Checklist (CBCL/6–18). The participants were evaluated for their vigilance and executive function using Conner’s Continuous Performance Test (CPT) and Wisconsin Card Sort Test (WCST). Both groups were assessed at the beginning of the study and the end of the twelve weeks.ResultsThe probiotic group comprised 36 patients, whereas the control group comprised 40 patients in the final analysis after four patients dropped out of the trial. After 3 months of probiotic supplementation, a significant improvement in the CPRS-R-L and CBCL total T scores was observed compared with those in the control group (p = 0.032, 0.024, respectively). Additionally, the probiotic group demonstrated improved focus attention (target accuracy rate and omission errors;p = 0.02, 0.043, respectively) compared with the control group. An analysis of the Wisconsin Card Sorting Test (WCST) performance demonstrated that the probiotic group had significantly lower perseverative (p = 0.017) and non-perseverative errors (p = 0.044) but no significant differences compared to the control group.ConclusionLactobacillus acidophilus LB supplementation combined with atomoxetine for 3 months had a beneficial impact on ADHD symptomology and a favorable influence on cognitive performance. As a result, the efficacy of probiotics as an adjunctive treatment for managing ADHD may be promising.Trial registrationClinicalTrials.gov (identifier: NCT04167995). Registration date: 19–11-2019.

38 Efficacy of Caregiver Psychoeducation Sessions on Attention-Deficit/Hyperactivity Disorder and Executive Functioning Difficulties

Objective:Children with attention-deficit/hyperactivity disorder (ADHD) commonly exhibit impairments in their executive functions. Caregivers are primarily responsible for the daily management of their children's ADHD and executive functioning difficulties. Psychoeducation, a cornerstone of ADHD treatment, can empower caregivers by providing them the knowledge and resources they require to support their child with ADHD. This study examined the efficacy of a suite of six caregiver psychoeducation sessions delivered by a specialised ADHD service. Two of these sessions pertained to (i) Understanding ADHD and (ii) Executive Functioning in ADHD. The other four covered information around Family Self-Care and Stress Management, Social Connectedness and Communication, Sensory Processing and Self-Regulation in ADHD and, Medication.Participants and Methods:All sessions were delivered between May 2016 and July 2022, in 2 to 3-hour sessions each. Caregivers completed pre and post-session questionnaires, rating (i) their understanding of each of the topics, (ii) whether they identified effective strategies to help their child with ADHD meet their needs, and (iii) whether they improved their knowledge of resources they can access to assist with ADHD management. Altogether, 666 caregiver responses were collected across all sessions, 35% (n=234) of which were from the Understanding ADHD sessions and 4.2% (n = 28) from the Executive Functioning sessions.Results:Wilcoxon signed-rank tests with Bonferroni adjusted alpha level of 0.016 were conducted to examine each session's pre- and post-session responses. Results showed that the Understanding ADHD workshops impelled significant improvements in attendee-rated levels of topic understanding (z = -8.79, p <.001, r = -.41), strategies gained (z = -8.54, p <.001, r = -.40) and perceived resource accessibility (z = -6.40, p <.001, r = -.30). Attendees reported moderate to large improvements following the Executive Functioning in ADHD sessions, including in their topic understanding (z = -4.18, p <.001, r = -.57), strategies gained (z = -3.93, p <.001, r = -.54) and perceived resource accessibility (z = -4.23, p <.001, r = -.61). Improvements across all three areas were also noted across the other four caregiver sessions, except for the medication session where no significant changes in strategies gained and perceived access to resources were noted.Conclusions:This study provides evidence that caregiver sessions within a Tier-4 service are efficacious and can (i) meet caregivers' needs to better understand ADHD, executive functioning difficulties as well as of other ADHD-related issues, and (ii) may equip caregivers with the knowledge to access resources to appropriately manage their children with ADHD - a possible precursor to improved clinical and functional outcomes in children. That the session on ADHD medications only led to improved understanding of the topic but not to perceived gains in strategies or perceived access to strategies could be attributed to low pre-and post-session questionnaire response rates as well as to the nature of those sessions which were purely informative and did not discuss strategies and resources. Nonetheless, longitudinal studies, with control groups, should determine whether any post-intervention improvements are sustained over time and should establish whether these are associated with improved outcomes in children.

(035) Clinical Management of ADHD in Pediatric Cystic Fibrosis through the Lens of Triple Modulator Therapy Evacaftor-Tezacaftor-Ivacaftor

(035) Clinical Management of ADHD in Pediatric Cystic Fibrosis through the Lens of Triple Modulator Therapy Evacaftor-Tezacaftor-Ivacaftor

Evaluating the effectiveness of chess as a therapeutic tool in the comprehensive management of ADHD

Evaluating the effectiveness of chess as a therapeutic tool in the comprehensive management of ADHD

Recommendation forLong-term Management ofAdult Attention-Deficit/Hyperactivity Disorder inMilitary Populations, Veterans, andDependents: A Narrative Review.

In addition to the higher burden of mental health disease in the military, there is a compounding antecedent association between behavioral health comorbidities and the treatment of attention-deficit/hyperactivity disorder (ADHD) in this population. Despite the low prevalence of new-onset ADHD in adults globally, the rate of stimulant (i.e., amphetamines) prescription is increasing. Stimulants can exacerbate mental health disease (often masquerading as ADHD symptomatology), precluding optimal treatment of the underlying etiology and imposing unnecessary dangerous side effects. This study aimed to evaluate the long-term safety and efficacy of stimulants for managing adult ADHD. A nine-member multidisciplinary team reviewed a PubMed search with the terms "adult," "ADHD," and "stimulant." Targeted PubMed and Google Scholar searches for "adult ADHD" paired with Food and Drug Administration -approved ADHD medications and Google Scholar literature using forward and reverse snowballing methods were performed for high-quality studies focusing on long-term treatment in ADHD. An evidence table and clinical algorithm were developed from the review. Of the 1,039 results, 50 articles were fully reviewed, consisting of 21 descriptive and experimental studies, 18 observational, and 11 systematic reviews and meta-analyses. Illustrative cases within the structured discussion of the results highlighted ADHD and psychiatric comorbidities, risks, harms, and benefits of stimulant use, medication mechanisms of action, and limitations of the current evidence. The dearth of high-quality studies on long-term ADHD management in adults fails to establish a causal relationship between stimulant use and physiological harm. Despite mixed evidence supporting the benefit of stimulants, there is clear evidence regarding the risk of harm. The serious risks of stimulants include arrhythmias, myocardial infarction, stroke/transient ischemic attack, sudden death, psychosis, and worsening of behavioral health disease. Additionally, there is a possible long-term risk of harm due to chronic sympathetic load (i.e., cardiovascular system remodeling). Stimulants pose a greater risk for addiction and abuse compared to other evidence-based nonstimulant medications that have similar effectiveness. Both stimulants and nonstimulants might promote favorable neuroanatomical changes for long-term improvement of ADHD symptoms, but nonstimulants (atomoxetine) have the pharmacological advantage of also mitigating the effects of sympathetic load (sympatholysis) and anxiety (anxiolysis). Given the physiological uncertainty of extended stimulant use for adults, especially older adults with vulnerable cardiovascular systems, clinicians should proceed cautiously when considering initiating or sustaining stimulant therapy. For long-term treatment of ADHD in adults, clinicians should consider nonstimulant alternatives (including behavioral therapy) due to the comparatively lower side effect risk and the possible additional benefit in patients with behavioral health comorbidities. Long-term safety of stimulant use for adults with ADHD is uncertain, as existing studies are limited in quality and duration. This is particularly important for military populations with higher rates of mental health conditions. Managing ADHD and related conditions requires prioritizing cardiovascular safety, especially for older adults. Nonstimulant options can be helpful, especially in comorbid psychiatric disease. Before treating ADHD, ruling out and controlling other behavioral health conditions is essential to avoid masking or worsening underlying issues and reducing unnecessary medication side effects.

Motor Vehicle Crash Risk in Older Adult Drivers With Attention-Deficit/Hyperactivity Disorder

Symptoms of attention-deficit/hyperactivity disorder (ADHD), such as inattentiveness and impulsivity, could affect daily functioning and driving performance throughout the life span. Previous research on ADHD and driving safety is largely limited to adolescents and young adults. To examine the prevalence of ADHD and the association between ADHD and crash risk among older adult drivers. This prospective cohort study collected data from primary care clinics and residential communities in 5 US sites (Ann Arbor, Michigan; Baltimore, Maryland; Cooperstown, New York; Denver, Colorado; and San Diego, California) between July 6, 2015, and March 31, 2019. Participants were active drivers aged 65 to 79 years at baseline enrolled in the Longitudinal Research on Aging Drivers project who were studied for up to 44 months through in-vehicle data recording devices and annual assessments. The data analysis was performed between July 15, 2022, and August 14, 2023. Lifetime ADHD based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a physician or other health professional that he or she had ADHD. The main outcomes were hard-braking events defined as maneuvers with deceleration rates of 0.4g or greater, self-reported traffic ticket events, and self-reported vehicular crashes. Multivariable negative binomial modeling was used to estimate adjusted incidence rate ratios (aIRRs) and 95% CIs of outcomes according to exposure status. Of the 2832 drivers studied, 1500 (53.0%) were women and 1332 (47.0%) were men with a mean (SD) age of 71 (4) years. The lifetime prevalence of ADHD in the study sample was 2.6%. Older adult drivers with ADHD had significantly higher incidence rates of hard-braking events per 1000 miles than those without ADHD (1.35 [95% CI, 1.30-1.41] vs 1.15 [95% CI, 1.14-1.16]), as well as self-reported traffic ticket events per 1 million miles (22.47 [95% CI, 16.06-31.45] vs 9.74 [95% CI, 8.99-10.55]) and self-reported vehicular crashes per 1 million miles (27.10 [95% CI, 19.95-36.80] vs 13.50 [95% CI, 12.61-14.46]). With adjustment for baseline characteristics, ADHD was associated with a significant 7% increased risk of hard-braking events (aIRR, 1.07; 95% CI, 1.02-1.12), a 102% increased risk of self-reported traffic ticket events (aIRR, 2.02; 95% CI, 1.42-2.88), and a 74% increased risk of self-reported vehicular crashes (aIRR, 1.74; 95% CI, 1.26-2.40). As observed in this prospective cohort study, older adult drivers with ADHD may be at a significantly elevated crash risk compared with their counterparts without ADHD. These findings suggest that effective interventions to improve the diagnosis and clinical management of ADHD among older adults are warranted to promote safe mobility and healthy aging.

Attention-deficit hyperactivity disorder in Egyptian medical students and how it relates to their academic performance.

The neurobehavioral disorder, known as attention-deficit hyperactivity disorder (ADHD), is characterized by impulsivity, hyperactivity, and a lack of focus. In addition, it is connected to poor academic performance. The purpose of this study was to determine the prevalence of ADHD and its effect on their academic performance among medical students. This web-based cross-sectional study was conducted among medical students of four medical colleges during December 2021 and April 2022. Data was collected using a self-administered questionnaire comprising Wender Utah Rating Scale and adult ADHD Self-Report Scale [ASRS]. The link to Google Form survey was distributed to students through academic emails and WhatsApp. Data analyzed using SPSS; Chisquare test or Fisher's exact test as appropriate, were used to determine statistical significance. A total of 990 students filled online questionnaire; 54.7% were females.. The estimated prevalence of ADHD in Egyptian medical students was 11%. Students who had childhood ADHD were significantly linked with the present ADHD (r = 0.54, P < 0.001). There was a negative correlation between the ASRS score for ADHD and students' GPA (r = 0.2, P < 0.001). No statistically significant association was observed between ADHD and sex, type of university, and academic level. of the students. ADHD is prevalent among medical students. Since most of our students with adult ADHD also had preexisting childhood ADHD, it is crucial that the primary care services, especially school health services, have appropriate standards for the early identification and management of ADHD. Health authorities should conduct a comprehensive health education campaign to raise public awareness of ADHD and its risk factors, the clinical picture, and the burden.

Update on Identifying and Evaluating Quality Measures for Adult Attention-Deficit/Hyperactivity Disorder

The limited recognition and treatment of attention-deficit/hyperactivity disorder (ADHD) in adults has been studied in the research setting and addressed in the clinical education setting during recent years. Despite these efforts, health care professionals continue to struggle with the management of adult ADHD in everyday practice. To better evaluate and measure meaningful practice metrics, a set of 10 key quality measures (QMs) that can help improve health care outcomes in adult ADHD was identified using a combination of evidence-based literature reviews and expert consensus. Subsequently, these QMs were field-tested in a sample of 71,310 adult ADHD patients in the primary care setting and behavioral health clinics over the course of a decade to assess whether these measures were attained. The results allowed us to understand how the clinician approach to diagnosing and treating ADHD has evolved in the past few years and highlighted the ongoing challenges in practice variation by clinicians caring for patients with adult ADHD. In turn, this information also guides our understanding of the next steps needed to improve the quality of care provided to adults with ADHD in different care settings. Accordingly, the American Professional Society of ADHD and Related Disorders (APSARD) assembled a guidelines committee to create a set of clinical practice guidelines to provide practitioners with a standardized, evidence-based approach to diagnosing and treating ADHD in adults. [ Psychiatr Ann . 2023;53(10):444–448.]

Prevalence of ADHD and Related Factors in Some Asian Countries: A Systematic Review and Meta-Analysis Protocol

Abstract: &#x0D; Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Despite extensive research, a gap remains in understanding ADHD prevalence and associated factors in select Asian countries.&#x0D; Objectives: This systematic review and meta-analysis protocol aims to estimate ADHD prevalence, identify associated factors, assess study quality, and explore sources of heterogeneity in Asian countries.&#x0D; Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases will be systematically searched for observational studies reporting ADHD prevalence and associated factors. Study selection, data extraction, and quality assessment will be conducted by two independent reviewers. Pooled prevalence will be estimated using a random-effects meta-analysis if homogeneity is present. Subgroup analyses and meta-regression will explore heterogeneity. Factors associated with ADHD will be synthesized narratively.&#x0D; Results: The protocol outlines a comprehensive methodology for estimating ADHD prevalence and examining associated factors in Asian countries, including Iran, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, Jordan, Iraq, Syria, Lebanon, Yemen, and the United Arab Emirates (UAE). Findings will be instrumental in shaping interventions and strategies for ADHD management in the region.&#x0D; Conclusion: This systematic review and meta-analysis protocol will bridge knowledge gaps regarding ADHD prevalence and associated factors in select Asian countries. By adhering to rigorous methodologies and the PRISMA guidelines, the study aims to contribute to informed clinical practices, public health policies, and future research initiatives tailored to the unique context of the region.&#x0D;

Clinical study to evaluate the efficacy of Mentosoothe Compound in the management of Attention Deficit / Hyperactivity Disorder

Introduction: DSM-5 defines Attention-Deficit/Hyperactivity Disorder as having a persistent pattern of hyperactivity or inattention. This affects social, emotional, cognitive, and academic performance, behavioural skills in children and adolescents. The suffering child should have more than 6 symptoms of a particular type. Due to aetiology of Dhee Dhriti and Smriti, which results in imbalance of Kala and Karma and leads to incorrect interaction of the senses with their aims (Asatmyendriyartha Samyoga), gives rise to inattention, hyperactivity and impulsivity. Considering the nature of symptomatologic manifestation, it can be correlated with Unmada, more specifically Vata-Pittaja Unmada. Ayurveda addresses ADHD with both internal medicines and external therapies. Mentosoothe compound is such a polyherbal compound it contains Medhya, Balya, Deepana and Rasayana drugs in extract form. Aim of the present study to evaluate the efficacy of mentosoothe compound in the management of Attention-Deficit/Hyperactivity Disorder. Objective of the study is to promote cognitive performance with improvement in the quality of life by providing an effective and safe treatment option. Materials and Methods: The present study will be conducted as a randomized clinical study including minimum 40 patients, divided into two groups. Mentosoothe compound A and Mentosoothe compound B will be given to groups with fixed dosages. Assessment will be done on every 15th day during 2 months of clinical trial and final follow up will be done one month after completion of clinical trial. Result: The results will give the data on comparative effectiveness of the Mentosoothe compounds on ADHD. Discussion and Conclusion: The outcome of this trial will render a way forward to effective management of ADHD in children.

Sleep problems in children and adolescents in an attention deficit hyperactivity disorder service.

Sleep problems are common amongst children and adolescents with attention deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate sleep problems in children and adolescents attending a specialist ADHD service. This was a cross-sectional online survey combined with a retrospective chart review, conducted in the ADHD Assessment, Diagnosis, Management, initiation, Research and Education (ADMiRE) service, the first public specialist ADHD service for young people in Ireland. Participants were caregivers of children and adolescents with ADHD attending ADMiRE. Sleep was assessed using The Children's Sleep Habits Questionnaire (CSHQ) and ADHD symptoms were assessed using an abbreviated version of the Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP-IV). Details regarding patient demographics, co-morbidities and medication were collected from patient records. Eighty-four percent of young people scored above the clinical cut-off for a sleep disorder. The most frequently reported sleep problems were related to sleep onset and sleep duration, and 64% of respondents met the criteria for two or more sleep problems. ADHD severity was associated with greater sleep problems. Co-morbid physical, neurodevelopmental, and mental health disorders as well as stimulant use were not associated with greater sleep problems. Sleep problems are very common amongst children and adolescents with ADHD. This study has demonstrated an association between more sleep problems and ADHD severity. These findings highlight the need for both effective ADHD treatment to ensure optional sleep in young people as well as effective interventions for sleep problems to prevent worsening of ADHD symptoms.

Metacognitive skills and working memory in children with ADHD and the ICTs’ Role

Metacognition and working memory from executive functions are higher order cognitive processes that undergo steady improvements throughout childhood. They are of great importance for daily functioning in a variety of domains, including academic achievement. Both concepts have been intensively researched, but little literature has attempted to link them theoretically and empirically. Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a high prevalence and high heterogeneity, which is identified as early as childhood, causing problems in almost every aspect of the ADHD child's life. In this paper, we will present research data from around the world that link working memory and metacognitive skills to the development or management of ADHD.

Effect of Mahapaishacika Ghrta in the Management of ADHD - Case Series

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most commonly diagnosed childhood psychiatric disorder. It is a neuro-developmental disorder characterized by problems in paying attention and hyperactivity–impulsivity which is inappropriate for the age of the child. Children with ADHD have been found to have Cognitive deficits, lower IQ, Impaired social relationships with in the family and with peers as well as poor study skills and lower academic achievement. The disease most commonly affects the children of age group 6 to 12. Despite being most commonly studied and diagnosed mental disorder in children, the cause is yet not known in majority cases. W.H.O. (World Health Organization) estimated that it affected 39 million people as of 2013. ADHD prevalence is estimated to be 5% for the Indian pediatric population. 5 to 7% children are getting affected with similar rates in various countries. It is found more commonly in boys than in girls (ratio 3:1). In Ayurveda, disorders related to psychiatric and behavioral disturbances are discussed under the chapter of Unmada. The cardinal features of ADHD resemble features of Vata-pitta predominant Unmada. This disorder affects mind as well as body because of having Adhishṭhana in both Sharīra and Mana. Five diagnosed cases of ADHD from OPD of Manassanthi, Vaidyaratnam P S Varier Ayurveda College, Kottakkal, were given Mahapaishacika Ghrta in a dose of 10ml twice daily 1 hour after food for 1 month period. Severity of symptoms was assessed by using Conner’s Revised Rating Scale on 0th day, 16th day, 31st day and after 15 days. There was a significant improvement in the Conner’s Revised Rating Scale after Ayurvedic management and follow up.

Application of Herbs and Dietary Supplements in ADHD Management.

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder, which is characterised by a distinct clinical pattern of inattention, hyperactivity as well as impulsivity, which in turn interferes with the day-to-day activities of the affected individual. Although conventional allopathic medications have been found to provide symptomatic relief, they are accompanied by a plethora of side effects that overshadow and outweigh the potential therapeutic benefits. Hence, various alternative approaches in the management of Attention Deficit Hyperactivity Disorder (ADHD) are actively being investigated. Over the past few decades, numerous studies have been initiated and have delved into potential alternative strategies in the treatment and management of ADHD. The primary focus of this article is to discuss the etiology, pathophysiology coupled with a financial background as well as alternative strategies in the treatment and management of ADHD. A review of the literature on the clinical trialson alternative treatment approaches for ADHD showed that, plants and dietary supplements have beneficial effects on ADHD management. But in-depth studies still need to be conducted because the trials reported till now have a smaller sample size and need to be scaled up to get a broader understanding and knowledge of the potential impact of alternative forms of natural treatment on the patient population with ADHD. Also, the manufacturer of the alternative formulations needs to develop effective protocols and processes for the safe, effective, and robust manufacturing of such natural remedies, which fall in line with the expectation of the FDA to gain regulatory clearance for its manufacturing and sale, which can lead to better therapeutic outcomes in patients.

Nutrition in the Management of ADHD: A Review of Recent Research.

Various nutrients and diet quality have been suggested to be involved in the pathophysiology of ADHD. The purpose of this review was to examine data from recent cohort studies and dietary interventions to determine whether nutrition may play a role in the management of ADHD. Preliminary evidence suggests that minerals might have beneficial effects on ADHD symptomatology. Probiotics might offer novel strategies to prevent or treat ADHD. Inverse associations between adherence to "healthy" diets and ADHD symptoms have been observed. Children with ADHD responding to the few-foods diet (or oligoantigenic diet) with an elimination of individually identified food items show substantially improved behavior and cognitive functioning. Evidence from recent research does not allow any recommendations regarding the use of micronutrients or probiotics in the management of ADHD. The few-foods diet may become an additional therapeutic option for children with ADHD.