Teacher Attention-deficit/hyperactivity Disorder Rating Scale Research Articles

Identifying comorbid ADHD in autism: Attending to the inattentive presentation

BackgroundThere are high rates of comorbidity between ADHD and ASD; however, there has been limited work parsing rates by ADHD presentation. In addition, commonly used questionnaires have demonstrated reduced utility in capturing ADHD symptoms in individuals with ASD. We examined the prevalence of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) parsed by DSM-5 presentation in clinic-referred youth with Autism Spectrum Disorder (ASD) without intellectual disability (ID). We compared common rating scales to determine which most effectively identified comorbid ADHD. MethodWe examined comorbid ADHD diagnoses from archival assessment data for 419 youth with ASD without ID. We examined diagnostic discriminability of the parent and teacher ADHD Rating Scale (ADHD R-S), and Attention and ADH Problems Scales of the Child Behavior Checklist and Teacher Report Form using receiver operating characteristic (ROC) curves. Hierarchical logistic regression was used to examine measures’ unique contribution to ADHD diagnosis. ResultsSixty-one percent of the study sample met DSM-5 criteria for an attention disorder. ADHD, Combined (ADHD-C) represented the largest proportion of ADHD diagnoses (76.8%), followed by Inattentive (ADHD-I;19.7%), Hyperactive/Impulsive (.02%), and Un-/Other Specified (.02%). Measures provided greater diagnostic discriminability in identifying ADHD-C relative to ADHD-I. The ADHD R-S inattentive symptom count provided the greatest discriminability for both subtypes and was the only scale that provided clinically meaningful differentiation between those with ASD only and ASD + ADHD-I. ConclusionsThese results support using the ADHD R-S to capture comorbid ADHD symptoms in ASD. The findings underscore the need for more thorough examination of inattentive symptoms to rule out ADHD-I.

Psychometric properties of the parent and teacher ADHD Rating Scale (ADHD-RS): measurement invariance across gender, age, and informant.

Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood and adolescence. Rating the severity of psychopathology and symptom load is essential in daily clinical practice and in research. The parent and teacher ADHD-Rating Scale (ADHD-RS) includes inattention and hyperactivity/impulsivity subscales and is one of the most frequently used scales in treatment evaluation of children with ADHD. An extended version, mADHD-RS, also includes an oppositional defiant disorder subscale. The partial credit Rasch model, which is based on item response theory, was used to test the psychometric properties of this scale in a sample of 566 Danish school children between 6 and 16 years of age. The results indicated that parents and teachers had different frames of reference when rating symptoms in the mADHD-RS. There was support for the unidimensionality of the three subscales when parent and teacher ratings were analyzed independently. Nonetheless, evidence for differential item functioning was found across gender and age for specific items within each of the subscales. The findings expand existing psychometric information about the mADHD-RS and support its use as a valid and reliable measure of symptom severity when used in age- and gender-stratified materials.

Buspirone Versus Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder: A Double-Blind and Randomized Trial

The efficacy and side effects of buspirone compared with methylphenidate (MPH) in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). A total of 34 children with ADHD as defined by DSM-IV-TR were randomized to buspirone or methylphenidate dosed on weight-adjusted basis at buspirone (0.5 mg/kg/day) and methylphenidate (0.3-1 mg/kg/day) for a 6-week double-blind clinical trial. The principle measures of outcome were the teacher and parent ADHD Rating Scale. The side effects were assessed by the special side effect checklist of each drug. In both groups, the scores of teacher and parent ADHD Rating Scale significantly declined on the 6th week as compared to baseline (p = 0.001). These effects were observed in the subscales too. No significant differences were observed between the two protocols on the total scores of parent and teacher ADHD Rating Scale, but methylphenidate was superior to buspirone in decreasing the symptoms of inattention. The side effects of buspirone were mild and rare in comparison with MPH. Buspirone has a favorable side-effects profile. It also has clinically and statistically significant impacts on improving the ADHD symptoms in children. These preliminary findings of the efficacy of buspirone in children with ADHD need large and cross-over studies.

Ginkgo biloba for Attention-Deficit/Hyperactivity Disorder in children and adolescents: A double blind, randomized controlled trial

Although stimulants are highly effective in controlling the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), some children will not respond to, or are intolerant of stimulants. Thus, the desire for safe and effective nonstimulant medications has risen during the past several years. Ginkgo biloba has been suggested in the treatment of dementia and memory impairment. We hypothesized that G.biloba would be beneficial for treatment of ADHD, and this could be evaluated in a double blind, randomized, parallel group comparison of G.biloba (Ginko T.D. Tolidaru, Iran) and methylphenidate. Fifty outpatients (39 boys and 11 girls) with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of Ginko T.D. at a dose of 80-120 mg/day depending on weight (80 mg/day for <30 kg and 120 mg/day for >30 kg) (group 1) or methylphenidate at a dose of 20-30 mg/day depending on weight (20 mg/day for <30 kg and 30 mg/day for >30 kg (group 2) for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale- IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -6.52+/-11.43 (mean+/-S.D.) and -15.92+/-11.44 (mean+/-S.D.) for Ginko T.D. and methyphenidate, respectively for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -0.84+/-6.79 (mean+/-S.D.) and -14.04+/-8.67 (mean+/-S.D.) for Ginko T.D. and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the Ginko T.D. and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of G.biloba was less effective than methylphenidate in the treatment of ADHD.

Reboxetine versus methylphenidate in treatment of children and adolescents with attention deficit-hyperactivity disorder

Attention deficit-hyperactivity disorder (ADHD) is a common psychiatric diagnosis among children and adolescents. This study has been conducted to evaluate the efficacy and tolerability of reboxetine in comparison with methylphenidate in treatment of children and adolescents with ADHD. Thirty three children, 7-16 years of age, diagnosed with ADHD, participated in a 6-week, double-blind clinical trial with reboxetine (4-6 mg/d) and methylphenidate (20-50 mg/d) in two divided doses. The principal measure of the outcome was the Teacher and Parent ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline, 14, 28, and 42 days after the start of medication. No significant differences were observed between the two protocols on the Parent (P = 0.26) and Teacher (P = 0.97) ADHD Rating Scale scores and in treatment dropouts. A significant improvement in ADHD symptoms was observed over the 6 weeks of treatment for Parent ADHD Rating Scale (P < 0.001) and Teacher ADHD Rating Scale score in both groups (P < 0.001). The most common adverse effects reported with reboxetine were drowsiness and anorexia with mild to moderate severity. The study revealed that reboxetine may be beneficial in treatment of ADHD. Further studies are required to clarify the potential therapeutic effects on comorbid depression and anxiety and adverse effect profile.

Passiflora incarnata in the treatment of attention-deficit hyperactivity disorder in children and adolescents

Background: Attention-deficit hyperactivity disorder (ADHD) is a common early-onset childhood disorder that is estimated to occur in 3 to 5% of school-aged children. Stimulants are the first-line medication in the pharmacotherapy of ADHD. Nevertheless, approximately 30% of children and adolescents either do not respond to or do not tolerate stimulants. Therefore, new treatments, including alternative medicine, are still needed. Passion flower consists of the fragmented or cut, dried aerial parts of Passiflora incarnata L., and is a folk remedy for anxiety and ADHD. However, there is no evidence-based document that confirms its efficacy in the treatment of ADHD. Objectives: We hypothesized that passion flower would be beneficial for the treatment of ADHD and report the results of a controlled trial of tablets of passion flower and methylphenidate in the treatment of this disorder. Patients & methods: A total of 34 children with ADHD as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) were randomized to receive tablets of passiflora or methylphenidate, dosed on a weight-adjusted basis. Group 1 received passiflora 0.04 mg/kg/day (twice daily) and group 2 received methylphenidate 1 mg/kg/day (twice daily) in an 8-week, doubleblind, randomized clinical trial. The principal measure of outcome was the Parent and Teacher ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline, 14, 28, 42 and 56 days after the medication was started. Results: No significant differences were observed between passiflora and methylphenidate on the Parent and Teacher Rating Scale scores over the course of the trial (F = 0.007, df = 1, p = 0.93; and F = 0.006, df = 1, p = 0.94, respectively). Both treatment groups demonstrated significant clinical benefit over the period of treatment as assessed by both parents and teachers. Although the number of dropouts in the methylphenidate group was higher than in the Passiflora group, there was no significant difference between the two protocols in terms of dropouts. In addition, decreased appetite and anxiety/nervousness were observed more often in the methylphenidate group. Conclusions: The results suggest that passiflora may be a novel therapeutic agent for the treatment of ADHD. In addition, a tolerable sideeffect profile may be considered as one of the advantages of passiflora. Nevertheless, our study is relatively small and our results require confirmation in a larger study.