Teacher-reported Attention-deficit/hyperactivity Disorder Symptoms Research Articles

Anxiety and depression from age 3 to 8 years in children with and without ADHD symptoms

Childhood anxiety and depressive symptoms may be influenced by symptoms of attention deficit/hyperactivity disorder (ADHD). We investigated whether parent- and teacher-reported anxiety, depressive and ADHD symptoms at age 3 years predicted anxiety disorders and/or depression in children with and without ADHD at age 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. Parents of 3-year-olds were interviewed, and preschool teachers rated symptoms of anxiety disorders, depression and ADHD. At age 8 years (n = 783), Child Symptom Inventory-4 was used to identify children who fulfilled the diagnostic criteria for anxiety disorders and/or depression (hereinafter: Anx/Dep), and ADHD. Univariable and multivariable logistic regression analyses were used. In the univariable analyses, parent-reported anxiety, depressive and ADHD symptoms, and teacher-reported anxiety symptoms at age 3 years all significantly predicted subsequent Anx/Dep. In the multivariable analyses, including co-occurring symptoms at age 3 years and ADHD at 8 years, parent-reported anxiety and depressive symptoms remained significant predictors of subsequent Anx/Dep. At age 3 years, regardless of ADHD symptoms being present, asking parents about anxiety and depressive symptoms, and teachers about anxiety symptoms, may be important to identify children at risk for school-age anxiety disorders and/or depression.

Generalizable prediction of childhood ADHD symptoms from neurocognitive testing and youth characteristics

Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are believed to result from disrupted neurocognitive development. However, evidence for the clinical and predictive value of neurocognitive assessments in this context has been mixed, and there have been no large-scale efforts to quantify their potential for use in generalizable models that predict individuals’ ADHD symptoms in new data. Using data drawn from the Adolescent Brain Cognitive Development Study (ABCD), a consortium that recruited a diverse sample of over 10,000 youth (ages 9–10 at baseline) across 21 U.S. sites, we develop and test cross-validated machine learning models for predicting youths’ ADHD symptoms using neurocognitive abilities, demographics, and child and family characteristics. Models used baseline demographic and biometric measures, geocoded neighborhood data, youth reports of child and family characteristics, and neurocognitive tests to predict parent- and teacher-reported ADHD symptoms at the 1-year and 2-year follow-up time points. Predictive models explained 15–20% of the variance in 1-year ADHD symptoms for ABCD Study sites that were left out of the model-fitting process and 12–13% of the variance in 2-year ADHD symptoms. Models displayed high generalizability across study sites and trivial loss of predictive power when transferred from training data to left-out data. Features from multiple domains contributed meaningfully to prediction, including neurocognition, sex, self-reported impulsivity, parental monitoring, and screen time. This work quantifies the information value of neurocognitive abilities and other child characteristics for predicting ADHD symptoms and provides a foundational method for predicting individual youths’ symptoms in new data across contexts.

Chronic exposure to indoor air pollutants in association with attention-deficit/hyperactivity disorder symptoms in Chinese schoolchildren: A cross-sectional study

BackgroundWhile increasing studies confirmed the adverse effects of indoor air pollution (IAP) on cardiopulmonary systems, less is known about the impact of IAP on child’s brain. ObjectiveTo explore the associations between multiple indoor air pollutants exposures and attention-deficit/hyperactivity disorder (ADHD) symptoms in Chinese schoolchildren. MethodsWe invited 8630 individuals aged 6–12 years from an ongoing school-based cohort study across Guangzhou from April to May 2019. There are 7495 and 7245 children were respectively evaluated on the parent- and teacher-rated Conner’s Rating Scale-Revised, and 7087 children were assessed on both versions. Indoor air pollutants exposures including cooking oil fumes, incense burning, home renovation, and secondhand smoke, were measured using a questionnaire reported by parents and children, and further converted into an index. Generalized linear mixed-effects models were performed to evaluate the associations between indoor air pollutants exposures and ADHD index and the presence of ADHD symptoms. ResultsAs reported by parents, 321 (4.3%) children had ADHD symptoms. Each of the four pollutants was positively associated with higher ADHD index and higher odds of ADHD symptoms. Children exposed to 1, 2, and ≥ 3 types of indoor air pollutants had higher ADHD index and higher odds of ADHD symptoms than those non-exposed children. For parent-reported ADHD symptoms, the odds ratios ranged from 1.24 [95% confidence interval (CI): 0.92–1.67] to 2.73 (95% CI: 1.86–4.01). These associations were consistent in parent- and teacher-reported ADHD symptoms, and the combination of both. ConclusionIndoor air pollutants exposures were positively associated with higher prevalence of children’s ADHD symptoms assessed by whether parents or teachers.

Attention-deficit/hyperactivity disorder from preschool to school age: change and stability of parent and teacher reports

Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents (n = 783) and teachers (n = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent–teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.

Does rapid rebound height growth come at a neurocognitive cost for previously institutionalized youth?

Height growth faltering is associated with less optimal behavioral outcomes and educational achievement. Although catch-up growth after growth delay may result in developmental gains, it may also present as a double-edged sword, with consequences for neurocognitive functioning such as symptoms of inattention and hyperactivity. As previously institutionalized (PI) children experience height delays at adoption and catch-up growth after adoption, they provide a cohort to test associations between catch-up growth and attention deficit hyperactivity disorder (ADHD) symptoms. This study used latent growth curve modeling to examine how catch-up in height-for-age growth is related to attention problems in a population of PI youth followed from adoption in infancy through kindergarten. Participants were assessed within three months of arrival into their families (age at entry: 18-36 months). Anthropometrics were measured four times, approximately 7 months apart. Two visits measured behavioral outcomes with parent and teacher reports of ADHD, internalizing, and externalizing symptoms at age 5 and kindergarten. The slope of growth in height z-scores, but not the intercept, was positively associated with parent- and teacher-reported ADHD symptoms in children. A one standard deviation increase in the slope of height z-scores across four assessments was associated with a 0.252 standard deviation increase in ADHD symptoms after controlling for internalizing and externalizing problems, iron status, duration of institutional care, sex, and age. The slope of growth was also associated with internalizing but not externalizing symptoms. This study demonstrates that PI children exhibit individual trajectories of height growth postadoption. Higher rates of change in height-for-age growth were associated with increased ADHD symptoms. These results suggest that catch-up growth comes 'at the cost' of poor attention regulation and hyperactive behavior.

Increased hair cortisol in mothers of children with ADHD symptoms and psychosocial adversity background.

Parents of children with attention deficit hyperactivity disorder (ADHD) have shown high perceived parenting stress. Hence, physiological adjustment processes, involving the hypothalamic-pituitary-adrenal axis, seem possible. We hypothesized that (1) ADHD symptoms of the child predict an increase of maternal hair cortisol concentration (HCC), and (2) presence of psychosocial adversity amplifies the prediction. We analyzed a preschool-aged sample using a longitudinal design (T1, at the children's age of 4years; T2, 12 months later). 128 mothers and their children participated in the study. To determine HCC of the previous 3months, the first scalp-near 3cm hair segment was used. ADHD symptoms of the child were measured using teacher- and parent-report questionnaires and a clinical interview with the mother. The T1 teacher-reported ADHD symptoms score of the child was significantly positively associated with the mother`s T1 and T2 HCC score. In families with high psychosocial adversity, the prediction of an increase in maternal HCC by the teacher-reported ADHD symptoms of child was significantly stronger than in low-adversity families. In presence of psychosocial family adversity, ADHD symptoms of the child predicted an increase in the mother's HCC. As a continuously high cortisol level implicates health risks and might in turn affect parenting resources, the identifying of caregivers at risk through biological markers of stress could be helpful for planning targeted interventions. As our study is the first on this issue, cross-validation is needed.

Executive Functioning and Emotion Regulation in Children with and without ADHD.

Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.

Mother’s hair cortisol and symptoms of attention deficit hyperactivity disorder in her preschool child

Children with attention deficit hyperactivity disorder (ADHD) require increased caregiver assistance and supervision, and their parents have shown high perceived parenting stress. Hence, physiological adjustment processes in the caregivers, involving the hypothalamic-pituitary-adrenal axis, seem plausible. We analyzed the association between maternal hair cortisol concentration (HCC) and symptoms of ADHD in preschool-aged children. 150 mothers of 4–5-year-old children participated in the study. To determine the HCC, the first scalp-near 3 cm hair segment was used. ADHD symptoms of the child were measured using teacher- and parent-report questionnaires and a clinical interview with the mother. When controlling for several putative confounders, teacher-reported ADHD symptoms were significantly positively associated with mothers’ HCC. No associations of HCC with the mother-reported ADHD symptoms of the child emerged. It is possible that teacher-reported ADHD symptoms of the child reflect relevant ADHD symptoms more validly. As our study is the first on this issue, cross-validation is needed.

Children's ADHD Symptoms and Friendship Patterns across a School Year.

Symptoms of attention-deficit/hyperactivity disorder (ADHD) in elementary school-age children are associated with poor relationships with classroom peers, as indicated by poor social preference, low peer support, and peer victimization. Less is known about how friendship patterns relate to ADHD symptoms, or how friendships may buffer risk for negative peer experiences. Participants were 558 children in 34 classrooms (grades K-5). At the beginning (fall) and end (spring) of an academic year, children completed (a) sociometric interviews to index friendship patterns and social preference, and (b) self-report questionnaires about their support and victimization experiences from classmates. In fall, higher teacher-reported ADHD symptoms were associated with children having more classmates with no friendship ties (non-friends) and who the child nominated but did not receive a nomination in return (unreciprocated friends), and with having fewer classmates with mutual friendship ties (reciprocated friends) and who nominated the child but the child did not nominate in return (unchosen friends). Higher fall ADHD symptoms predicted more non-friend classmates, poorer social preference, and more victimization in the spring, after accounting for the same variables in fall. However, having many reciprocated friends (and to a lesser extent, many unchosen friends) in fall buffered against the trajectory between fall ADHD symptoms and poor peer functioning in spring. By contrast, having many unreciprocated friends in fall exacerbated the trajectory between fall ADHD symptoms and poor peer functioning in spring. Thus, elevated ADHD symptoms are associated with poorer friendship patterns, but reciprocated friendship may protect against negative classroom peer experiences over time.

Attention deficit/hyperactivity disorder and future expectations in Russian adolescents.

In recent years, there has been an increasing focus on the role of future expectations-the extent to which a future outcome is deemed likely-in the health and well-being of adolescents, with research linking future expectations to outcomes such as an increased likelihood of engaging in risky health behaviors. As yet, however, there has been no research on future expectations and attention deficit/hyperactivity disorder (ADHD) in adolescence. To address this research gap, the current study examined the association between ADHD symptoms/possible ADHD status and future expectations in a school-based sample of adolescents. Data were analyzed from 537 Russian adolescents (aged 12-17) with teacher-reported ADHD symptoms and self-reported future expectations. Logistic regression analysis was used to examine associations. In fully adjusted analyses, inattention symptoms/possible ADHD inattentive status was associated with lower future educational expectations, while a possible ADHD hyperactivity status was associated with increased odds for negative future expectations relating to work, family and succeeding in what is most important. The findings of this study suggest that greater ADHD symptoms/possible ADHD status in adolescence may be linked to an increased risk for negative future expectations across a variety of different life domains.

Young age at school entry and attention-deficit hyperactivity disorder-related symptoms during primary school: results of a prospective cohort study conducted at German Rudolf Steiner Schools

ObjectivesYoung age at school entry (ASE) for students has been related to their impaired mental health in higher grades. To avoid the negative health consequences of young ASE, preschool examinations...

Between- and within-person associations between negative life events and alcohol outcomes in adolescents with ADHD.

Escalations in alcohol use during adolescence may be linked with exposure to negative life events, but most of this research has focused on between-person associations. Moreover, adolescents with attention-deficit hyperactivity disorder (ADHD) may be an especially vulnerable population, reporting more life events and alcohol involvement and may even be more sensitive to the effects of life events on alcohol outcomes compared with those without ADHD. We tested the between- and within-person effects of the number and perceptions of negative life events on the development of alcohol use outcomes from age 14 to 17 years in 259 adolescents with and without ADHD using generalized estimating equations. Between-person differences in exposure to negative life events across adolescence, but not the perception of those events, were associated with a higher likelihood of alcohol use and drunkenness at age 17 years. Within-person differences in life events were associated with alcohol use above and beyond that predicted by an adolescents' typical trajectory over time. Parent- and teacher-reported ADHD symptoms were associated with more negative perceptions of life events and with greater alcohol use and drunkenness at age 17 years, but symptoms did not moderate the life event-alcohol association. Interventions should consider the variables that produce vulnerability to life events as well as the immediate impact of life events. That the accumulation of life events, rather than their perceived negativity, was associated with alcohol outcomes indicates that interventions targeting the reduction of negative events, rather than emotional response, may be more protective against alcohol use in adolescence. (PsycINFO Database Record

Circadian Sleep Patterns in Toddlers Born Preterm: Longitudinal Associations with Developmental and Health Concerns.

Children born preterm are at elevated risk for several developmental and health concerns. Early sleep patterns may be associated with these concerns. The current study assesses the associations between toddler circadian sleep/activity patterns and later developmental, behavioral, attentional, and health concerns in this at-risk population. We examined circadian sleep/activity patterns at 2 years of age in 99 children born preterm. Child cognitive skills were tested at 3 years of age, and behavior, attention, and health concerns were reported at 3 and 6 years of age. First, sleep/activity data collected via actigraphy were assessed using time series analysis (TSA). For this, we assessed how each child's sleep/activity pattern compared to a specified 24-hour circadian cycle (SCC) with an adjustment for daytime napping. Second, in a series of regression models child sleep/activity parameters from the TSA were assessed with child gender, prematurity, and family sociodemographic assets as covariates. Toddlers with patterns that closely aligned with the SCC had higher abbreviated intelligence quotient scores at 3 years of age. Additionally, at 6 years these children had a lower risk for illness-related medical visits. Higher toddler average activity level was associated with fewer teacher-reported attention-deficit hyperactivity disorder symptoms and a lower risk for illness-related medical visits. The novel approach used in this study to index child circadian patterns provides a pattern-based analysis of sleep/activity, which may prove to be developmentally consequential. With replication, these findings may help practitioners promote optimal cognitive and health development via circadian sleep supports in infants born preterm.

Methylphenidate Tied to Improved ADHD Symptoms in Kids

Methylphenidate may help improve symptoms of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, according to a Cochrane meta-analysis published in the BMJ . Researchers analyzed the results of 185 randomized trials comparing methylphenidate with placebo in 12,000 patients aged 3 to 21 years with ADHD. Few trials lasted more than 6 months. Methylphenidate was associated with clinically meaningful improvement in teacher-reported ADHD symptoms. More than a quarter …

Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).

Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).

ADHD Symptoms in American Indian/Alaska Native Boys and Girls.

Despite the commonality of attention-deficit/hyperactivity disorder (ADHD), the diagnostic criteria are based largely on research with European American boys. Much less research is available regarding the prevalence of ADHD in other groups, specifically American Indian/Alaska Native (AI/AN) children. Moreover, research on sex differences in ADHD has typically not included AI/AN children. The current study examined parent- and teacher-reported ADHD symptoms in 72 AI children from one region in the Southern U.S., with a focus on sex differences. Data showed that AI children may have more pronounced sex differences in ADHD symptomology than is found in studies with primarily European American children. Implications, limitations, and future directions are discussed.

Treatment of Children With Attention-Deficit/Hyperactivity Disorder (ADHD) and Irritability: Results From the Multimodal Treatment Study of Children With ADHD (MTA)

ObjectiveClinically impairing irritability affects 25% to 45% of children with attention-deficit/hyperactivity disorder (ADHD); yet, we know little about what interventions are effective in treating children with ADHD and co-occurring irritability. We used data from the Multimodal Treatment Study of Children With ADHD (MTA) to address 3 aims: to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder (ODD); to examine whether ADHD treatment is effective in treating irritability; and to examine how irritability influences ADHD treatment outcomes.MethodSecondary analyses of data from the MTA included multivariate analyses, and intent-to-treat random-effects regression models were used.ResultsIrritability was separable from other ODD symptoms. For treating irritability, systematic stimulant treatment was superior to behavioral management but not to routine community care; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone, but not to medication alone. Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups.ConclusionTreatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD. Moreover, irritability does not appear to influence the response to treatment of ADHD.Clinical trial registration informationMultimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://www.clinicaltrials.gov; NCT00000388.

Neuroanatomical and Neuropsychological Correlates of the Cerebellum in Children With Attention-Deficit/Hyperactivity Disorder–Combined Type

Studies of healthy individuals and those with cerebellar damage have implicated the cerebellum in a variety of cognitive and behavioral processes. Decreased cerebellar volume has been found in children with attention-deficit/hyperactivity disorder (ADHD) and differentially related to behavioral outcomes. The present study investigated whether smaller cerebellar vermis volume was present in children with ADHD-combined type (ADHD-C) compared with controls and whether volume related to parent- and teacher-reported levels of ADHD symptomatology. T1-weighted magnetic resonance images and parent- and teacher-reported ADHD symptoms were acquired for 32 children diagnosed with ADHD-C and 15 typically developing controls. Participants were right-handed, had no comorbid diagnoses of learning disabilities, conduct disorder, or affective/mood disorder, and were 9 to 15 years of age. Participants with ADHD-C showed significantly smaller volume in the posterior inferior vermis compared with controls. No statistically significant differences were observed for cerebral volume, anterior vermis volume, posterior superior volume, or total cerebellar volume. Regression analyses indicated that a significant amount of the variance in parent-reported Behavior Assessment System for Children, Second Edition, Hyperactivity and Attention and Conners Restless/Impulsive ratings was explained by volume of the posterior inferior vermis. Consistent with previous studies, children with ADHD had smaller volume in the posterior inferior vermis. New findings emerged with smaller volume of the posterior inferior vermis predicting a significant amount of the variance in parent-reported hyperactivity, attention, and restlessness/impulsivity. Thus, symptoms of hyperactivity and inattention in ADHD may be partly explained by smaller volume of the cerebellar vermis and its connections within the cerebrum.

Parent Report of ADHD Symptoms of Early Adolescents: A Confirmatory Factor Analysis of the Disruptive Behavior Disorders Scale

The Disruptive Behavior Disorders (DBD) scale includes the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. This study examined only the ADHD items of the DBD scale. This scale is frequently used for assessing parent- and teacher-reported ADHD symptoms. Although some research on teacher report exists, little is known about the factor structure of parent-reported ADHD for this scale, particularly for early adolescents. Confirmatory factor analysis was used to assess the fit of a priori specified, theoretically based models of ADHD. Participants were 250 parents of early adolescents ( M = 12 years, SD = 1.53), who completed the ADHD items of the DBD scale. A two-factor model of hyperactivity/ impulsivity and inattention provided the best fit to item responses, but localized areas of misfit were present. Alternate wording for a few items was proposed. Implications of the findings and directions for future research are discussed.

Study protocol: the sleeping sound with attention-deficit/hyperactivity disorder project.

BackgroundUp to 70% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience sleep problems including difficulties initiating and maintaining sleep. Sleep problems in children with ADHD can result in poorer child functioning, impacting on school attendance, daily functioning and behaviour, as well as parental mental health and work attendance. The Sleeping Sound with ADHD trial aims to investigate the efficacy of a behavioural sleep program in treating sleep problems experienced by children with ADHD. We have demonstrated the feasibility and the acceptability of this treatment program in a pilot study.Methods/DesignThis randomised controlled trial (RCT) is being conducted with 198 children (aged between 5 to 12 years) with ADHD and moderate to severe sleep problems. Children are recruited from public and private paediatric practices across the state of Victoria, Australia. Upon receiving informed written consent, families are randomised to receive either the behavioural sleep intervention or usual care. The intervention consists of two individual, face-to-face consultations and a follow-up phone call with a trained clinician (trainee consultant paediatrician or psychologist), focusing on the assessment and management of child sleep problems. The primary outcome is parent- and teacher-reported ADHD symptoms (ADHD Rating Scale IV). Secondary outcomes are child sleep (actigraphy and parent report), behaviour, daily functioning, school attendance and working memory, as well as parent mental health and work attendance. We are also assessing the impact of children's psychiatric comorbidity (measured using a structured diagnostic interview) on treatment outcome.DiscussionTo our knowledge, this is the first RCT of a behavioural intervention aiming to treat sleep problems in children with ADHD. If effective, this program will provide a feasible non-pharmacological and acceptable intervention improving child sleep and ADHD symptoms in this patient group.Trial RegistrationCurrent Controlled Trials ISRCTN68819261. ISRCTN: ISRCTN68819261