Learning disabilities and ADHD: overlapping spectrumn disorders

Conners 3-Self-Report Scale: An empirical support to the dimensionality of the content scales

The Conners' Rating Scales are one of the most used instruments for attention deficit/hyperactivity disorder (ADHD). Nonetheless, in the latest edition, the Inattention scale was not statistically supported. This study examined the dimensionality of the Italian version of the Conners 3-Self-Report scale testing both a five-factor structure including Inattention and a four-factor model combining Inattention and Learning Problems. Moreover, the generalizability of the detected structure through measurement invariance was verified. The Italian version of the scale was completed by 971 children (53% males, mean age: 12.76 years) randomly split in a calibration sample ( n = 464) and a validation sample ( n = 507). Confirmatory factor analyses detected a five-factor structure (i.e. Inattention, Hyperactivity/Impulsivity, Learning Problems, Defiance/Aggression, and Family Relations), and measurement invariance was confirmed. Findings provided statistical evidence for the Inattention subscale, supporting the Conners 3-Self-Report Scale as effectively aimed to assess the two dimensions of ADHD and its main comorbid difficulties.

Development and Evaluation of the Individuals With Learning Disabilities and/or Difficulties Perceived Discrimination Scale

The present two studies describe the development and psychometric evaluation of the Learning Disability/Difficulty Perceived Discrimination Scale used to assess the self-reported discrimination experiences of people with learning difficulties and/or disabilities. In Study 1 ( N = 202) an exploratory factor analysis yielded two factors, Inferior and Cheating the System. In Study 2 ( N = 216) a confirmatory factor analysis supported the stability of this two-factor correlated model and a bifactor model. Across studies, subscale and full-scale items offered evidence of good reliability, convergent validity, and concurrent validity. Preliminary support for a minority stress framework is explored. Limitations, research, and clinical work with learning difficulties and/or disabilities populations are discussed.

Age level vs grade level for the diagnosis of ADHD and neurodevelopmental disorders

A number of worldwide studies have demonstrated that children born later in the school year are more likely to receive an ADHD diagnosis than their same school-year peers. There is, however, variation in findings between countries. We aimed to confirm whether relative age is associated with ADHD diagnosis, with or without comorbidities, and to investigate whether relative age is associated with ADHD type and severity, and if this age relationship is in common with other neurodevelopmental disorder. We used the Lombardy Region's ADHD registry. Data on children aged 6 years and older from September 1, 2011 to December 31, 2017 were considered. We calculated incidence ratios to assess the inter-relations between relative age within the school year, using age at diagnosis of ADHD or of other psychiatric disorder, year of diagnosis, and total number of children born in Lombardy during the corresponding timeframe. Data on ADHD type, severity of diagnosed disorder clinical global impressions-severity scale, and repetition of a school-grade were also considered. 4081 children, 2856 of whom with ADHD, were identified. We confirmed that the cumulative incidence of ADHD diagnosis was greatest for younger children, in particular for boys, for whom the prevalence is greater. The relative age effect was not accounted for by ADHD comorbid disorders, ADHD of combined type or severity. The relative age effect was also observed for children with other neurodevelopmental disorders (without ADHD), with a similar profile as ADHD children: the incidence ratio was 1.78 (95% CI 1.07-2.97; p < 0.0247) for boys diagnosed before age ten. The findings have a potential implication for diagnostic and therapeutic practice, educational advice, and policies, besides to better plan and organize service systems and appropriately inform parents, children, and citizens.

Co-morbidities in Chinese children with attention deficit/hyperactivity disorder and reading disabilities

The co-morbidity of attention deficit/hyperactivity disorder (ADHD) and reading disorder (RD) is more frequent than expected. This investigation assessed the potential uniqueness of the co-morbidity of ADHD and RD and extended existing findings to the Chinese language. A parallel group design with a post hoc analysis of group differences was employed to compare 4 groups of children (30 with ADHD, 33 with RD, 28 with ADHD + RD, and 30 typically developing) regarding their reading comprehension, attention, reading-related abilities, and cognitive abilities. The findings indicated that children with RD and/or ADHD symptom(s) exhibited diverse cognitive profiles, and the distinguishing factor contributed to different inhibitions. Additionally, Chinese-speaking children with the co-morbid symptoms of RD and ADHD demonstrated greater deficits in auditory working memory and rapid naming than did the pure-deficit groups. Furthermore, although problems with phonological awareness were similar between the 2 groups, the deficiency of orthographic knowledge was more severe in children with RD than in the co-morbid group. The ADHD + RD group's cognitive and reading-related abilities displayed a relatively complicated pattern that should be considered in the diagnosis of either RD or ADHD and their remediation design.

Brain SPECT scans in students with specific learning disability: Preliminary results

Background and Objectives:

Brain single-photon emission computed tomography (SPECT) assesses brain function through measurement of regional cerebral blood flow. This study was conducted to assess whether students with newly diagnosed specific learning disability (SpLD) show any abnormalities in cerebral cortex perfusion.

Settings and Design:

Cross-sectional single-arm pilot study in two tertiary care hospitals.

Subjects and Methods:

Nine students with SpLD were enrolled. Brain SPECT scan was done twice in each student. For the first or “baseline“ scan, the student was first made to sit with eyes open in a quiet, dimly lit room for a period of 30–40 min and then injected intravenously with 20 mCi of 99mTc-ECD. An hour later, “baseline scan“ was conducted. After a minimum gap of 4 days, a second or “test scan“ was conducted, wherein the student performed an age-appropriate curriculum-based test for a period of 30–40 min to activate the areas in central nervous system related to learning before being injected with 20 mCi of 99mTc-ECD.

Statistical Analysis Used:

Cerebral cortex perfusion at rest and after activation in each student was compared qualitatively by visual analysis and quantitatively using NeuroGam™ software.

Results:

Visual analysis showed reduction in regional blood flow in temporoparietal areas in both “baseline“ and “test“ scans. However, when normalization was attempted and comparison done by Talairach analysis using NeuroGam software, no statistically significant change in regional perfusion in temporoparietal areas was appreciated.

Conclusion:

Brain SPECT scan may serve as a robust tool to identify changes in regional brain perfusion in students with SpLD.

Item response theory analyses of the Delis-Kaplan Executive Function System card sorting subtest

In the current study, we examined the dimensionality of the 16-item Card Sorting subtest of the Delis-Kaplan Executive Functioning System assessment in a sample of 264 native English-speaking children between the ages of 9 and 15 years. We also tested for measurement invariance for these items across age and gender groups using item response theory (IRT). Results of the exploratory factor analysis indicated that a two-factor model that distinguished between verbal and perceptual items provided the best fit to the data. Although the items demonstrated measurement invariance across age groups, measurement invariance was violated for gender groups, with two items demonstrating differential item functioning for males and females. Multigroup analysis using all 16 items indicated that the items were more effective for individuals whose IRT scale scores were relatively high. A single-group explanatory IRT model using 14 non-differential item functioning items showed that for perceptual ability, females scored higher than males and that scores increased with age for both males and females; for verbal ability, the observed increase in scores across age differed for males and females. The implications of these findings are discussed.

Health Care Costs Associated With Parent-Reported ADHD: A Longitudinal Australian Population-Based Study

OBJECTIVE

To examine the health care costs associated with ADHD within a nationally representative sample of children.

METHOD

Data were from Waves 1 to 3 (4-9 years) of the Longitudinal Study of Australian Children ( N = 4,983). ADHD was defined by previous diagnosis and a measure of ADHD symptoms (Strengths and Difficulties Questionnaire [SDQ]). Participant data were linked to administrative data on health care costs. Analyses controlled for demographic factors and internalizing and externalizing comorbidities.

RESULTS

Costs associated with health care attendances and medications were higher for children with parent-reported ADHD at each age. Cost differences were highest at 8 to 9 years for both health care attendances and medications. Persistent symptoms were associated with higher costs ( p < .001). Excess population health care costs amounted to Aus$25 to Aus$30 million over 6 years, from 4 to 9 years of age.

CONCLUSION

ADHD is associated with significant health care costs from early in life. Understanding the costs associated with ADHD is an important first step in helping to plan for service-system changes.

Association between Exposure of Young Children to Procedures Requiring General Anesthesia and Learning and Behavioral Outcomes in a Population-based Birth Cohort

BACKGROUND

Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes.

METHODS

A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models.

RESULTS

For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability.

CONCLUSIONS

These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.

[Learning disorders in ADHD: How are they related?]

Learning difficulties in general and learning disabilities in particular are almost constant in attention deficit disorder with or without hyperactivity (ADHD). Despite a major research effort, the extent and diversity of these comorbid events still raise many questions about the exact nature of their pathogenetic condition (simple consequences of ADHD or specific related disorders?) and consequently the best way to support them. This article aims to present a brief review of the current data.

Poverty and Trends in Three Common Chronic Disorders

OBJECTIVES

For asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), the objectives were to (1) describe the percent increases in prevalence and comorbidity and how these vary by poverty status, and (2) examine the extent to which poverty status is a predictor of higher than average comorbid conditions.

METHODS

Secondary analyses of the National Survey of Children's Health for years 2003, 2007, and 2011-2012 were conducted to identify trends in parent reported lifetime prevalence and comorbidity among children with asthma, ADHD, and ASD and examine variation by sociodemographic characteristics, poverty status, and insurance coverage. Using 2011-2012 data, multivariable regression was used to examine whether poverty status predicted higher than average comorbid conditions after adjusting for other sociodemographic characteristics.

RESULTS

Parent-reported lifetime prevalence of asthma and ADHD rose 18% and 44%, respectively, whereas the lifetime prevalence of ASD rose almost 400% (from 0.5% to 2%). For asthma, the rise was most prominent among the poor at 25.8%. For ADHD, the percent change by poverty status was similar (<100% federal poverty level [FPL]: 43.20%, 100% to 199% FPL: 52.38%, 200% to 399% FPL: 43.67%), although rise in ASD was associated with being nonpoor (200% to 399% FPL: 43.6%, ≥400% FPL: 36.0%). Publicly insured children with asthma, ADHD, and ASD also had significantly higher odds (1.9×, 1.6×, 3.0×, respectively) of having higher than average comorbidities.

CONCLUSIONS

Poverty status differentially influenced parent-reported lifetime prevalence and comorbidities of these target disorders. Future research is needed to examine parent and system-level characteristics that may further explain poverty's variable impact.

Are There Executive Dysfunction Subtypes Within ADHD?

OBJECTIVE

Children with ADHD have heterogeneous behavioral and neuropsychological profiles. The aim of this study was to examine the possible utility of executive function (EF) subtypes within ADHD.

METHOD

Participants were 357 children aged 6 through 13 with a diagnosis of ADHD. Children completed a brief laboratory battery measuring EF, including response inhibition, response variability, speed, and set-shifting. Children also completed standardized intelligence and achievement testing.

RESULTS

Two-way cluster analysis of EF profiles of children with ADHD produced a three-cluster solution, labeled poor inhibitory control, poor set-shifting/speed, and intact task performance. Clusters significantly differed in measures of intelligence, academic achievement, and other disruptive behavior and anxiety/mood symptoms.

CONCLUSION

These findings further support the idea that children with ADHD have heterogeneous EF profiles and suggest that the theory of ADHD should consider these individual differences in EF profiles within the ADHD diagnostic category.

Test of the Definition of Learning Disability Based on the Difference between IQ and Achievement

A learning disability is commonly defined as a discrepancy between IQ and achievement. This has been criticized for identifying too many children as having a learning disability who have high IQs and average academic achievement. Such overidentification as actually occurred was assessed in 473 referred children (8–16 years, M= 10, SD = 2) with normal intelligence. Learning disability was defined as a significant discrepancy ( p<.05) between predicted and obtained achievement in reading, mathematics, or written expression on the Wechsler Individual Achievement Test. Predicted achievement was based on the child's WISC-III Full Scale IQ. Overidentification was considered to occur when a child scored at or above age level in reading, mathematics, and writing but still had a significant discrepancy between predicted and obtained achievement by virtue of a high IQ. Learning disability was diagnosed in 312 (66%) of the children. There was no overidentification because all children had one or more WIAT scores below the normative level for their age, i.e., < 100. Further, only 7% of the children were identified with a learning disability based on a WIAT score in the 90s. These children had a mean IQ of 123 and were rated by their teachers and parents as having learning problems.

First-Year College Students With ADHD and/or LD

Students with attention-deficit/hyperactivity disorder (ADHD) and/or learning disabilities (LD) experience significant challenges in making the transition from high school to college. This study examined the ways first-year college students with ADHD, LD, ADHD+LD, and comparison peers differ in engagement, core self-evaluation, high school preparation behaviors, and goals/expectations. Participants were from the 2010 Cooperative Institutional Research Program Freshman Survey, including students with ADHD ( n = 5,511), LD ( n = 2,626), ADHD+LD ( n = 1,399), or neither disability ( n = 5,737). Controlling for SAT/ACT scores, family income, and parent education, students with ADHD, LD, or ADHD+LD differed from peers on self-ratings of academic and creative abilities and psychosocial functioning; school disengagement, substance use, and emotional difficulties during their last year of high school; reasons for attending college; and expectations for college activities. Several differences were found between disability groups. Implications for college support services and future research are discussed.

Differentiating Behavioral Ratings of Inattention, Impulsivity, and Hyperactivity in Children: Effects on Reading Achievement

OBJECTIVE

The purpose of the study is to differentiate between behaviors of ADHD: inattention, hyperactivity, and impulsivity and how each domain contributes to reading achievement in elementary school-aged children.

METHOD

Data from 131 children were collected, which include performance from reading fluency and comprehension measures as well as parent and teacher ratings of ADHD behaviors based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria.

RESULTS

Correlation and regression analyses revealed that inattentive behaviors were strongly linked to reading fluency and comprehension. Hyperactivity and impulsive behaviors did not predict reading achievement. A significant two-way interaction was found only for gender and inattention with reading comprehension as the outcome.

CONCLUSION

Many of the behaviors related to inattention strongly predicted reading fluency, reading comprehension, and overall reading ability. Boys who exhibited inattentive behaviors performed more poorly on reading comprehension measures than girls with inattentive behaviors.

Challenging the Assumptions About the Frequency and Coexistence of Learning Disability Types

A popular but unsubstantiated belief is that a reading disability is the most prevalent type of learning disability (LD), that LD in mathematics is rare, and that LD in written expression is very rare. In 485 clinical children administered the WISC-III and WIAT, 65 percent had LD. The most common was LD in written expression (92 percent), either alone (50 percent) or in combination with LD in reading and/or mathematics (42 percent). Only 4 percent of the children had LD in reading alone, and 4 percent had LD in mathematics alone. Total LD percentages for reading and mathematics were similar (33 percent and 32 percent). Children with writing problems had far greater difficulty with compositional skills than with spelling.

Knowledge and Attitudes About Attention-Deficit/Hyperactivity Disorder and Specific Learning Disorder in an Urban Indian Population

Attention-deficit/hyperactivity disorder (ADHD) and specific learning disorders (SLDs) are an important cause of scholastic backwardness among children and often go unrecognized. Few studies have examined knowledge and attitudes toward ADHD and SLD among school-aged children. To address this deficit, 120 school-aged children, attending a child guidance clinic in Mumbai, were interviewed using a questionnaire that examined children's knowledge and attitudes about ADHD and SLD. The results were compared both qualitatively and quantitatively with a frequently occurring medical illness, common cold. Approximately 80% to 100% of children were aware of their illness; however, a large variation was noted in the proportion of children (15%-80%) who could describe their symptoms, provide accurate attributions for their illness, and identify treatment modalities. Children with ADHD reported greater control over their illness. The study identified a significant lack of knowledge about ADHD and SLD among school-aged children in India and discusses implications of this finding.

Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is associated with lower than average intelligence quotient (IQ) scores. However, research done on this disorder often excludes participants based on lower than average IQ’s (i.e., between 70 and 85). The purpose of this paper is to alert researchers to the consequences of excluding participants based on IQ’s within this range and to highlight the importance of providing a clear rationale when choosing to exclude participants based on IQ. Next, we offer recommendations for researching ADHD and their relative benefits and drawbacks of these approaches. Overall this paper emphasizes that including participants who have lower than average IQ in research on ADHD may promote a more realistic understanding of the condition and in turn improve our ability to treat it.

Structure of the Wechsler Intelligence Scale for Children - Fourth Edition in a Group of Children with ADHD

Objective: This study used confirmatory factor analysis to examine the factor structure for the 10 core WISC–IV subtests in a group of children (N = 812) with ADHD.

Method: The study examined oblique four- and five-factor models, higher order models with one general secondary factor and four and five primary factors, and a bifactor model with a general factor and four specific factors.

Results: The findings supported all models tested, with the bifactor model being the optimum model. For this model, only the general factor had high explained common variance and omega hierarchical value, and it predicted reading and arithmetic abilities.

Conclusion: The findings favor the use of the FSIQ scores of the WISC-IV, but not the subscale index scores.

Screen-based behaviour in school-aged children with long-term illness

Background

Evidence is lacking on the screen-based behaviour of adolescents with a chronic condition. The aim of our study was to analyse differences in screen-based behaviour of adolescents by long-term illness, asthma and learning disabilities.

Methods

We used data from the cross-sectional Health Behaviour of School-aged Children study collected in 2014 among Slovak adolescents (age 13 to 15 years old, N = 2682, 49.7 % boys). We analysed the associations between screen-based behaviour and long-term illness, asthma and learning disabilities using logistic regression models adjusted for gender.

Results

We found no associations between screen-based behaviour and long-term illness, except that children with asthma had a 1.60-times higher odds of excessively playing computer games than healthy children (95 % confidence interval of odds ratio (CI): 1.11–2.30). Children with learning disabilities had 1.71-times higher odds of risky use of the Internet (95 % CI: 1.19–2.45).

Conclusion

Adolescents with a long-term illness or with a chronic condition or a learning disability do not differ from their peers in screen-based activities. Exceptions are children with asthma and children with learning disabilities, who reported more risky screen-based behaviour.

Movement Scaling in Children With ADHD-Combined Type

OBJECTIVE

The aim of the study was to investigate motor performance in children with ADHD using a size-scaling handwriting task.

METHOD

In all, 14 male children with ADHD and 14 typically developing (TD) children (age 7-15) wrote 10-mm and 40-mm cursive letter "l."

RESULTS

Children with ADHD were unable to maintain their writing accurately at 40 mm, falling short by several millimeters; this was not evident in the TD children. Children with ADHD also had slightly faster and more fluent writing than TD children.

CONCLUSION

It was concluded that children with ADHD have difficulties scaling handwriting movement in the larger 40-mm condition that may reflect poor planning and modulation of movement, despite having faster and more fluent movements.

A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil

Little is known about specific learning disorder (SLD) in low- and middle-income countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the second to sixth grades living in median cities from four different geographic regions in Brazil. A national test for academic performance covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver. A total of 1618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6% for global impairment, 5.4% for writing, 6.0% for arithmetic, and 7.5% for reading impairment. Attention-deficit/hyperactivity disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (p = 0.031). Anxiety disorders and ADHD were associated with SLD with arithmetic impairment. Significant differences were detected in prevalence rates among cities, and several socio-demographic correlates (age, gender, IQ, and socioeconomic status) were significantly associated with SLD with global impairment in our sample. Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment was significantly associated with psychiatric comorbidities.

[Minimal cerebral dysfunctions and ADHD in adulthood]

Attention deficit hyperactivity disorder (ADHD) is of great importance not only in children but also in adults; however, despite extensive research there are still many unsolved questions with respect to the diagnosis. Patients not only suffer from attention deficits and hyperactivity but also a variety of other problems, such as dyspraxia, problems with stimulus discrimination, dysgrammatism, legasthenia, or motor coordination problems. Furthermore, there are also psychopathological disorders, such as problems with memory, formal thinking, emotional modulation, drive and vegetative stability, in the sense of a psycho-organic syndrome. Such syndromes have long been known in psychiatry under terms, such as complex capacity disorders, minimal cerebral dysfunction (MCD), minimal brain dysfunction (MBD), mild psycho-organic syndrome, psycho-organic axis syndrome, mild cognitive impairment, developmental disorder and developmental biological syndrome. Etiological data with respect to genetics and early childhood brain trauma support the notion of a psychobiological disorder for complex cerebral dysfunction in the sense of a psycho-organic syndrome. Depending on the individual life and work situation, these additional symptoms of ADHD are in many cases of greater relevance for life adjustment than the core symptoms, depending on the individual life and work situations. The concept of minimal cerebral dysfunction describes the ADHD problem better and has a direct bearing on the diagnosis, therapy and sociomedical care of the patients.

A longitudinal study of risk and protective factors associated with successful transition to secondary school in youth with ADHD: prospective cohort study protocol

Background

Attention-Deficit/Hyperactivity Disorder (ADHD) has a significant impact on child and adolescent development, especially in relation to school functioning and academic outcomes. Despite the transition to high school being a potentially critical period for children with ADHD, most research in this period has focused on academic outcomes. This study aims to extend previous research by describing academic, school engagement, behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains.

Methods and design

The Moving Up study is a longitudinal, prospective cohort study of children with ADHD as they transition and adjust to high school (age 12–15 years). Data are collected through direct assessment and child, parent and teacher surveys. The primary outcome is academic achievement, obtained by linking to standardised test results. Secondary outcomes include measures of behaviour, ADHD symptoms, school engagement (attitudes and attendance), and social and emotional functioning, including depressive symptoms. The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children, using t-tests. Risk and protective factors to be examined using multiple regression include a child, family and school factors know to impact academic and school functioning.

Discussion

The Moving up study is the first Australian study prospectively designed to measure a broad range of student outcomes for children with ADHD during the high school transition period. Examining both current (cross sectional) and earlier childhood (longitudinal) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD. The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes.

The study is approved by The Royal Children’s Hospital Melbourne Human Research Ethics Committee (33206). Findings will be disseminated through peer-reviewed journals and conference presentations.

Writing abilities longitudinally predict academic outcomes of adolescents with ADHD

Students with attention-deficit/hyperactivity disorder (ADHD) often experience a host of negative academic outcomes, and deficits in reading and mathematics abilities contribute to these academic impairments. Students with ADHD may also have difficulties with written expression, but there has been minimal research in this area and it is not clear whether written expression abilities uniquely contribute to the academic functioning of students with ADHD. The current study included a sample of 104 middle school students diagnosed with ADHD (Grades 6-8). Participants were followed longitudinally to evaluate whether written expression abilities at baseline predicted student grade point average (GPA) and parent ratings of academic impairment 18 months later, after controlling for reading ability and additional relevant covariates. Written expression abilities longitudinally predicted both academic outcomes above and beyond ADHD and oppositional defiant disorder symptoms, medication use, reading ability, and baseline values of GPA and parent-rated academic impairment. Follow-up analyses revealed that no single aspect of written expression was demonstrably more impactful on academic outcomes than the others, suggesting that writing as an entire process should be the focus of intervention. (PsycINFO Database Record

Intimate Partner Victimization Among College Students With and Without Disabilities: Prevalence of and Relationship to Emotional Well-Being

Prior research indicates that both college students and individuals with disabilities are at an increased risk of experiencing intimate partner victimization (IPV). However, little is known about IPV risk and its relationship to emotional well-being among the intersection of these two populations. Utilizing a sample of approximately 20,000 college students from the American College Health Association's (ACHA) National College Health Assessment II (NCHA II), this study focuses on this overlooked intersection by examining IPV among college students with disabilities. Multivariate binary logistic regression models were used to estimate the relationship among disability, IPV, and emotional well-being. College students with disabilities were approximately twice as likely to experience IPV than their counterparts without disabilities. Students with mental disabilities and multiple disability types were found to have the greatest likelihood of experiencing IPV. Victims with disabilities were more likely than victims without disabilities to report experiencing depression symptoms, self-harm behavior, and stress. Recommendations for reducing and preventing IPV among a college student population are discussed.

Impact of Attention-Deficit Hyperactivity Disorder on School Performance: What are the Effects of Medication?

Attention-deficit hyperactivity disorder (ADHD) affects an estimated 5-7 % of schoolchildren worldwide. School functioning and academic achievement are frequently impaired by ADHD and represent one of the main reasons children start ADHD medication. Multiple potential causal pathways exist between ADHD and impaired school performance. In this review, we decompose school performance into three components and assess the impact of ADHD and its treatments on academic performance (assessed by grade point average [GPA], time on-task, percentage of work completed as well as percent completed correctly), academic skills (as measured by achievement tests and cognitive measures), and academic enablers (such as study skills, motivation, engagement, classroom behavior and interpersonal skills). Most studies examined only the short-term effects of medication on school performance. In these, ADHD medications have been observed to improve some aspects of school performance, with the largest impact on measures of academic performance such as seatwork productivity and on-task performance. In a subset of children, these benefits may translate into detectable improvements in GPA and achievement testing. However, limited data exists to support whether these changes are sustained over years. Optimizing medication effects requires periodic reassessment of school performance, necessitating a collaborative effort involving patients, parents, school staff and prescribers. Even with systematic reassessment, behavioral-based treatments and additional school-based services may be needed to maximize academic performance for the many youth with ADHD and prominent impairments in school performance.

Increased Erythrocyte Eicosapentaenoic Acid and Docosahexaenoic Acid Are Associated With Improved Attention and Behavior in Children With ADHD in a Randomized Controlled Three-Way Crossover Trial

OBJECTIVE

To investigate effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on attention, literacy, and behavior in children with ADHD.

METHOD

Ninety children were randomized to consume supplements high in EPA, DHA, or linoleic acid (control) for 4 months each in a crossover design. Erythrocyte fatty acids, attention, cognition, literacy, and Conners' Parent Rating Scales (CPRS) were measured at 0, 4, 8, 12 months.

RESULTS

Fifty-three children completed the treatment. Outcome measures showed no significant differences between the three treatments. However, in children with blood samples (n = 76-46), increased erythrocyte EPA + DHA was associated with improved spelling (r = .365, p < .001) and attention (r = -.540, p < .001) and reduced oppositional behavior (r = -.301, p < .003), hyperactivity (r = -.310, p < .001), cognitive problems (r = -.326, p < .001), Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) hyperactivity (r = -.270, p = .002) and DSM-IV inattention (r = -.343, p < .001).

CONCLUSION

Increasing erythrocyte DHA and EPA via dietary supplementation may improve behavior, attention, and literacy in children with ADHD.

Phenotypic and genetic associations between reading comprehension, decoding skills, and ADHD dimensions: evidence from two population-based studies

BACKGROUND

The phenotypic and genetic associations between decoding skills and ADHD dimensions have been documented but less is known about the association with reading comprehension. The aim of the study is to document the phenotypic and genetic associations between reading comprehension and ADHD dimensions of inattention and hyperactivity/impulsivity in early schooling and compare them to those with decoding skills.

METHODS

Data were collected in two population-based samples of twins (Quebec Newborn Twin Study - QNTS) and singletons (Quebec Longitudinal Study of Child Development - QLSCD) totaling ≈ 2300 children. Reading was assessed with normed measures in second or third grade. Teachers assessed ADHD dimensions in kindergarten and first grade.

RESULTS

Both decoding and reading comprehension were correlated with ADHD dimensions in a similar way: associations with inattention remained after controlling for the other ADHD dimension, behavior disorder symptoms and nonverbal abilities, whereas associations with hyperactivity/impulsivity did not. Genetic modeling showed that decoding and comprehension largely shared the same genetic etiology at this age and that their associations with inattention were mostly explained by shared genetic influences.

CONCLUSION

Both reading comprehension and decoding are uniquely associated with inattention through a shared genetic etiology.

A New Approach to Investigate the Association between Brain Functional Connectivity and Disease Characteristics of Attention-Deficit/Hyperactivity Disorder: Topological Neuroimaging Data Analysis

Background

Attention-deficit/hyperactivity disorder (ADHD) is currently diagnosed by a diagnostic interview, mainly based on subjective reports from parents or teachers. It is necessary to develop methods that rely on objectively measureable neurobiological data to assess brain-behavior relationship in patients with ADHD. We investigated the application of a topological data analysis tool, Mapper, to analyze the brain functional connectivity data from ADHD patients.

Methods

To quantify the disease severity using the neuroimaging data, the decomposition of individual functional networks into normal and disease components by the healthy state model (HSM) was performed, and the magnitude of the disease component (MDC) was computed. Topological data analysis using Mapper was performed to distinguish children with ADHD (n = 196) from typically developing controls (TDC) (n = 214).

Results

In the topological data analysis, the partial clustering results of patients with ADHD and normal subjects were shown in a chain-like graph. In the correlation analysis, the MDC showed a significant increase with lower intelligence scores in TDC. We also found that the rates of comorbidity in ADHD significantly increased when the deviation of the functional connectivity from HSM was large. In addition, a significant correlation between ADHD symptom severity and MDC was found in part of the dataset.

Conclusions

The application of HSM and topological data analysis methods in assessing the brain functional connectivity seem to be promising tools to quantify ADHD symptom severity and to reveal the hidden relationship between clinical phenotypic variables and brain connectivity.

Psychological Co-morbidity in Children with Specific Learning Disorders

Children under 19 years of age constitute over 40% of India's population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs) exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder) is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common) to depression, anxiety, suicide etc., to substance abuse (least common). Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most) given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

Teacher Attitudes Towards Students Who Exhibit ADHD-Type Behaviours

Attention-deficit/hyperactivity disorder, its diagnosis and its treatment have been controversial since the 1970s (Kean, 2012), with opinions differing with respect to the diagnostic process, whether it in fact exists, or if it is an excuse for poor parenting and teaching (Maras, Redmayne, Hall, Braithwaite, & Prior, 1997). There are currently few studies that directly examine demographic characteristics as an indicator of teacher knowledge of ADHD and their attitudes towards ADHD-type behaviours. In this pilot study of teachers in Sydney public schools, we examined teacher knowledge about ADHD, their attitudes towards students who exhibit behaviours associated with ADHD, and the impact of demographic characteristics on their opinions and attitudes. We set out to discover the levels of overall knowledge teachers possess regarding ADHD, the attitudes teachers hold towards ADHD and its associated inattentive/hyperactive behaviours, and if any demographic characteristics can predict these attitudes.

Exploratory factor analysis and multiple regression analysis were performed to establish the existence of groups of variables with respect to teacher knowledge of ADHD and teacher attitudes towards ADHD-type behaviours and any demographic predictors of teacher attitudes. Analysis showed that, overall, teachers exhibit an adequate (50–85% correct responses to knowledge test questions) knowledge of ADHD, but less sound knowledge in some areas than others, for example, aetiology. Analysis also demonstrated that there are some significant demographic predictors of teacher attitudes; however, further research is needed to verify these preliminary findings.

Psychosocial treatments for ADHD: a systematic appraisal of the evidence

OBJECTIVE

Children with learning disabilities often experience comorbid ADHD, impacting on the effectiveness of interventions for those children. In addition to pharmacologic intervention, clinicians and educators employ a variety of psychosocial methods to address the behavioral and social issues that arise in children with ADHD, including those with co-occurring learning disabilities. Numerous systematic reviews and meta-analyses have been conducted examining treatment studies using psychosocial interventions for children with ADHD. Because of the importance of such reviews to evidence based clinical and educational practice, it is essential that reviews be conducted with rigorous methodologies to avoid bias in conclusions (Schlosser, Wendt, & Sigafoos, 2007). The purpose of this study was to evaluate the quality of systematic reviews and meta-analyses conducted for psychosocial treatments of ADHD in children.

METHOD

Electronic databases were searched for peer-reviewed, English language studies of psychosocial treatments for ADHD in children up to 18-years-old from 1998 to 2010. Twenty-one studies were identified that met inclusion criteria (13 systematic reviews, 8 meta-analyses). Independent examiners used the quality rating scale proposed by Auperin, Pignon, and Pynard (1997) to rate the characteristics of good systematic reviews and meta-analyses.

RESULTS

Results indicated that certain methodological characteristics were common across trials reviewed, yet shortcomings were common among most reviews, including inadequate descriptions of data extraction methods and lack of quality ratings for trials included in the reviews.

CONCLUSION

Synthesis of findings from the five top-rated reviews and the literature on ADHD suggest that psychosocial treatments contribute to improvements on behavioral and social outcomes. How ADHD and LD interplay in treatment outcomes is largely unexplored.

Factors Influencing Risk and Recovery from Sport-Related Concussion: Reviewing the Evidence

Identifying factors that influence the risk and recovery from sport-related concussion (SRC) has become an important part of the clinical management of the injury. Consensus statements and clinical anecdotes have suggested several factors (i.e., history of migraine headaches) that may increase risk or lead to a protracted recovery from SRC. In the current paper, we will present evidence supporting primary and secondary risk factors listed in current consensus statements and relevant literature on emerging factors proposed to influence SRC risk and recovery.

"Complex" attention-deficit hyperactivity disorder, more norm than exception? Diagnoses and comorbidities in a developmental clinic

OBJECTIVE

Current recommendations for evaluation and diagnosis of attention-deficit hyperactivity disorder (ADHD) are meant for primary care settings and may not adequately address the needs of children seen in subspecialty developmental-behavioral pediatric settings who may have higher rates of comorbid developmental, learning, and psychiatric disorders. The authors sought to characterize the diagnostic complexity of school-aged children diagnosed with ADHD after comprehensive multidisciplinary evaluation in a subspecialty developmental-behavioral pediatric clinic.

METHODS

The authors conducted a retrospective medical record review of 144 patients aged 7 to 11 years who were consecutively evaluated by an interdisciplinary team (developmental-behavioral pediatrician, psychologist, educator) in a school-age clinic within a developmental-behavioral pediatrics tertiary care center from January 1, 2009 to December 31, 2009.

RESULTS

After comprehensive evaluation, rates of ADHD diagnosis increased from 32.6% (n = 47) preevaluation to 54.2% (n = 78) postevaluation (p < .0001). Rates of learning disorders among children receiving a final diagnosis of ADHD increased from 2.6% (n = 2) preevaluation to 50% (n = 39) postevaluation. (p < .0001). Among children receiving a final diagnosis of ADHD, 73.1% (n = 57) were diagnosed with at least 1 comorbid psychiatric, developmental, or learning disorder.

CONCLUSIONS

Among school-aged children diagnosed with ADHD in a developmental-behavioral pediatric subspecialty setting, a comprehensive evaluation including developmental, neuropsychological, and educational assessments yielded high rates of comorbid psychiatric, developmental, and learning disorders. This supports the need to provide comprehensive interdisciplinary assessment for such children to ensure the identification and treatment of not only the core symptoms of ADHD but also the comorbidities that may otherwise go unrecognized and therefore not optimally treated.

Spelling errors among children with ADHD symptoms: the role of working memory

Research has shown that children with attention deficit/hyperactivity disorder (ADHD) may present a series of academic difficulties, including spelling errors. Given that correct spelling is supported by the phonological component of working memory (PWM), the present study examined whether or not the spelling difficulties of children with ADHD are emphasized when children's PWM is overloaded. A group of 19 children with ADHD symptoms (between 8 and 11 years of age), and a group of typically developing children matched for age, schooling, gender, rated intellectual abilities, and socioeconomic status, were administered two dictation texts: one under typical conditions and one under a pre-load condition that required the participants to remember a series of digits while writing. The results confirmed that children with ADHD symptoms have spelling difficulties, produce a higher percentages of errors compared to the control group children, and that these difficulties are enhanced under a higher load of PWM. An analysis of errors showed that this holds true, especially for phonological errors. The increased errors in the PWM condition was not due to a tradeoff between working memory and writing, as children with ADHD also performed more poorly in the PWM task. The theoretical and practical implications are discussed.

Classroom-based high-intensity interval activity improves off-task behaviour in primary school students

This study examined the effects of an acute bout of brief, high-intensity interval exercise on off-task classroom behaviour in primary school students. A grade 4 class (n = 24) and a grade 2 class (n = 20) were exposed to either a no-activity break or an active break that consisted of "FUNtervals", a high-intensity interval protocol, on alternating days for 3 weeks. No-activity days consisted of a 10-min inactive break while FUNterval days consisted of a 4-min FUNterval completed within a 10-min break from regular class activities. Off-task behaviour was observed for 50 min after each no-activity/FUNterval break, with the amount of time students spent off-task (motor, passive, and verbal behaviour) being recorded. When comparing no-activity breaks with FUNtervals the grade 4 class demonstrated reductions in both passive (no activity = 29% ± 13% vs. FUNterval = 25% ± 13%, p < 0.05, effect size (ES) = 0.31) and motor (no activity = 31% ± 16% vs. FUNterval = 24% ± 13%, p < 0.01, ES = 0.48) off-task behaviour following FUNtervals. Similarly, in the grade 2 class, passive (no activity = 23% ± 14% vs. FUNterval = 14% ± 10%, p < 0.01, ES = 0.74), verbal (no activity = 8% ± 8% vs. FUNterval = 5% ± 5%, p < 0.05, ES = 0.45), and motor (no activity = 29% ± 17% vs. FUNterval = 14% ± 10%, p < 0.01, ES = 1.076) off-task behaviours were reduced following FUNtervals. In both classrooms the effects of physical activity were greatest in those students demonstrating the highest rates of off-task behaviour on no-activity days. These data demonstrate that very brief high-intensity bouts of exercise can improve off-task behaviour in grade 2 and 4 students, particularly in students with high rates of such behaviour.

Sex-dependent impacts of low-level lead exposure and prenatal stress on impulsive choice behavior and associated biochemical and neurochemical manifestations

A prior study demonstrated increased overall response rates on a fixed interval (FI) schedule of reward in female offspring that had been subjected to maternal lead (Pb) exposure, prenatal stress (PS) and offspring stress challenge relative to control, prenatal stress alone, lead alone and lead+prenatal stress alone (Virgolini et al., 2008). Response rates on FI schedules have been shown to directly relate to measures of self-control (impulsivity) in children and in infants (Darcheville et al., 1992, 1993). The current study sought to determine whether enhanced effects of Pb±PS would therefore be seen in a more direct measure of impulsive choice behavior, i.e., a delay discounting paradigm. Offspring of dams exposed to 0 or 50ppm Pb acetate from 2 to 3 months prior to breeding through lactation, with or without immobilization restraint stress (PS) on gestational days 16 and 17, were trained on a delay discounting paradigm that offered a choice between a large reward (three 45mg food pellets) after a long delay or a small reward (one 45mg food pellet) after a short delay, with the long delay value increased from 0s to 30s across sessions. Alterations in extinction of this performance, and its subsequent re-acquisition after reinforcement delivery was reinstated were also examined. Brains of littermates of behaviorally-trained offspring were utilized to examine corresponding changes in monoamines and in levels of brain derived neurotrophic factor (BDNF), the serotonin transporter (SERT) and the N-methyl-d-aspartate receptor (NMDAR) 2A in brain regions associated with impulsive choice behavior. Results showed that Pb±PS-induced changes in delay discounting occurred almost exclusively in males. In addition to increasing percent long delay responding at the indifference point (i.e., reduced impulsive choice behavior), Pb±PS slowed acquisition of delayed discounting performance, and increased numbers of both failures to and latencies to initiate trials. Overall, the profile of these alterations were more consistent with impaired learning/behavioral flexibility and/or with enhanced sensitivity to the downshift in reward opportunities imposed by the transition from delay discounting training conditions to delay discounting choice response contingencies. Consistent with these behavioral changes, Pb±PS treated males also showed reductions in brain serotonin function in all mesocorticolimbic regions, broad monoamine changes in nucleus accumbens, and reductions in both BDNF and NMDAR 2A levels and increases in SERT in frontal cortex, i.e., in regions and neurotransmitter systems known to mediate learning/behavioral flexibility, and which were of greater impact in males. The current findings do not fully support a generality of the enhancement of Pb effects by PS, as previously seen with FI performance in females (Virgolini et al., 2008), and suggest a dissociation of the behaviors controlled by FI and delay discounting paradigms, at least in response to Pb±PS in rats. Collectively, however, the findings remain consistent with sex-dependent differences in the impacts of both Pb and PS and with the need to understand both the role of contingencies of reinforcement and underlying neurobiological effects in these sex differences.

The multidimensional anxiety scale for children: a further validation with Australian adolescents with and without ADHD

OBJECTIVE

To examine the factor structure of the Multidimensional Anxiety Scale for Children (MASC) with Australian adolescents with and without ADHD.

METHOD

The MASC was administered to 210 high school-aged adolescents (109 males, 101 females), 115 of whom were clinically diagnosed as ADHD (86 males, 29 females). The remaining 95 were non-ADHD community comparisons.

RESULTS

Analyses supported a three-factor model, with a reduced item pool, which combined the Harm Avoidance and Separation Anxiety scales together. This model was invariant across younger and older participants, and across boys and girls. The model was largely invariant across ADHD and non-ADHD groups. The ADHD group had significantly higher Physical Symptom factor scores than the non-ADHD group.

CONCLUSION

The MASC is useful for assessing anxiety in adolescents with and without ADHD, but items reflecting the Harm Avoidance and Separation Anxiety scales may need revising.

Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology

Attention deficit hyperactivity disorder (ADHD) is a common condition with a high societal burden. The present guidelines summarise current literature, generating expert consensus recommendations for the treatment of ADHD in children and adults. These guidelines also provide a review of recent research in the fields of neuroimaging, neuropsychology and genetics of ADHD. Novel discoveries in these areas have informed physiological models for the disease. Since the publication of the previous British Association for Psychopharmacology guidelines in 2008, new drugs have been licensed and further compounds are being investigated. The publication of randomised controlled trials of psychological interventions has contributed to the range of treatment options for ADHD. As the disorder has been diagnosed more frequently there has been greater focus on comorbid conditions and how they impact treatment. Services have continued to develop for the treatment of ADHD in adults and care agreements have been introduced to facilitate access to treatment.

Association between childhood specific learning difficulties and school performance in adolescents with and without ADHD symptoms: a 16-year follow-up

OBJECTIVE

The authors investigated whether childhood specific learning difficulties (SLDs) predict later school performance in adolescents with ADHD symptoms (ADHDs) and how SLDs associate with educational aspirations.

METHOD

In the Northern Finland Birth Cohort 1986 (n = 9,432), data about children were collected using questionnaires for parents and teachers at ages 7 and 8 and for parents and adolescents at ages 15/16. Information on school performance was obtained from a national register.

RESULTS

The occurrence of SLDs at 8 years was 19.9% (n = 1,198), ADHDs at 15/16 years was 8.0% (n = 530), and comorbid ADHDs and SLDs was 3.0% (n = 179). Having ADHDs but not SLDs or having both was associated with a significantly lower mean value in school grades for theoretical subjects. Adolescents with comorbid ADHDs and SLDs repeated a grade more often, and their educational aspirations were less ambitious than those in other groups.

CONCLUSION

ADHDs and SLDs have a negative influence on academic achievements.

Long-term temporal stability of measured inattention and impulsivity in typical and referred children

OBJECTIVE

This study investigates the stability of measured inattention and impulsivity in children.

METHOD

The Gordon Diagnostic System (GDS) assesses inattention and impulsivity and has been administered in the same manner since its 1983 publication. GDS scores were compared between the 1983 standardization sample and a recent typical sample of 445 children, 562 children with ADHD-Combined (ADHD-C) type, 235 with ADHD-Inattentive (ADHD-I) type, and 231 with autism.

RESULTS

Typical children earned a GDS composite standard score of 100, consistent with the normal mean of 100 in the 1983 standardization sample. Means for children with ADHD-C, ADHD-I, and autism were 70, 78, and 76, respectively, approximately two standard deviations below the normal mean.

CONCLUSION

As measured by the GDS, children are no more or less inattentive and impulsive today than in 1983, suggesting that inattention and impulsivity are stable neurobiological traits largely unaffected by cultural, educational, and environmental factors.

Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes

This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder, but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support, and are referred to as having achieved "optimal outcomes." Performance of 32 individuals who achieved optimal outcomes, 41 high-functioning individuals with a current autism spectrum disorder diagnosis (high-functioning autism), and 34 typically developing peers was compared on measures of decoding, reading comprehension, mathematical problem solving, and written expression. Groups were matched on age, sex, and nonverbal IQ; however, the high-functioning autism group scored significantly lower than the optimal outcome and typically developing groups on verbal IQ. All three groups performed in the average range on all subtests measured, and no significant differences were found in performance of the optimal outcome and typically developing groups. The high-functioning autism group scored significantly lower on subtests of reading comprehension and mathematical problem solving than the optimal outcome group. These findings suggest that the academic abilities of individuals who achieved optimal outcomes are similar to those of their typically developing peers, even in areas where individuals who have retained their autism spectrum disorder diagnoses exhibit some ongoing difficulty.

Examining the relationships between attention deficit/hyperactivity disorder and developmental coordination disorder symptoms, and writing performance in Japanese second grade students

The purpose of this study was to explore the relationships between attention deficit/hyperactivity disorder and developmental coordination disorder symptoms and writing performance in Japanese second grade students from regular classrooms. The second grade students (N=873) in Japanese public elementary schools participated in this study. We examined a variety of writing tasks, such as tracing, copying, handwriting (Hiragana and Katakana), and spelling (Hiragana, Katakana, and Kanji). We employed the Japanese version of the home form ADHD-rating scale (ADHD-RS) and the Japanese version of the Developmental Coordination Disorder Questionnaire (DCDQ-J) to assess the developmental characteristics of the participating children. Seven writing performance scores were submitted to a principal component analysis with a promax rotation, which yielded three composite scores (Spelling Accuracy, Tracing and Copying Accuracy, and Handwriting Fluency). A multiple regression analysis found that inattention predicted Spelling Accuracy and Handwriting Fluency and that hyperactive-impulsive predicted Handwriting Fluency. In addition, fine motor ability predicted Tracing and Copying Accuracy. The current study offered empirical evidence suggesting that developmental characteristics such as inattention and fine motor skill are related to writing difficulties in Japanese typical developing children.

Planum temporale morphology in children with developmental dyslexia

The planum temporale is a highly lateralized cortical region, located within Wernicke's area, which is thought to be involved in auditory processing, phonological processing, and language. Research has linked abnormal morphology of the planum temporale to developmental dyslexia, although results have varied in large part due to methodological inconsistencies in the literature. This study examined the asymmetry of the planum temporale in 29 children who met criteria for dyslexia and 26 children whose reading was unimpaired. Leftward asymmetry of the planum temporale was found in the total sample and this leftward asymmetry was significantly reduced in children with dyslexia. This reduced leftward asymmetry in children with dyslexia was due to a planum temporale that is larger in the right hemisphere. This study lends support to the idea that planum temporale asymmetry is altered in children with developmental dyslexia.