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Begum‐Ali J, Gossé LK, Mason L, Pasco G, Charman T, Johnson MH, Jones EJ. Infant sleep predicts trajectories of social attention and later autism traits. J Child Psychol Psychiatry 2023; 64:1200-1211. [PMID: 36991307 PMCID: PMC10952761 DOI: 10.1111/jcpp.13791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Children with neurodevelopmental disorders including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often experience sleep disturbances, but little is known about when these sleep differences emerge and how they relate to later development. METHODS We used a prospective longitudinal design in infants with a family history of ASD and/or ADHD to examine infant sleep and its relation to trajectories of attention and later neurodevelopmental disorders. We formed factors of Day and Night Sleep from parent-reported measures (including day/night sleep duration, number of naps in the day, frequency of night awakenings and sleep onset problems). We examined sleep in 164 infants at 5-, 10- and 14-months with/without a first-degree relative with ASD and/or ADHD who underwent a consensus clinical assessment for ASD at age 3. RESULTS By 14-months, infants with a first-degree relative with ASD (but not ADHD) showed lower Night Sleep scores than infants with no family history of ASD; lower Night Sleep scores in infancy were also associated with a later ASD diagnosis, decreased cognitive ability, increased ASD symptomatology at 3-years, and developing social attention (e.g., looking to faces). We found no such effects with Day Sleep. CONCLUSIONS Sleep disturbances may be apparent at night from 14-months in infants with a family history of ASD and also those with later ASD, but were not associated with a family history of ADHD. Infant sleep disturbances were also linked to later dimensional variation in cognitive and social skills across the cohort. Night Sleep and Social Attention were interrelated over the first 2 years of life, suggesting that this may be one mechanism through which sleep quality influences neurodevelopment. Interventions targeted towards supporting families with their infant's sleep problems may be useful in this population.
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Affiliation(s)
- Jannath Begum‐Ali
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Louisa K. Gossé
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Luke Mason
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
| | - Greg Pasco
- Psychology DepartmentInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Tony Charman
- Psychology DepartmentInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Mark H. Johnson
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
- Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Emily J.H. Jones
- Department of Psychological Sciences, Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
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Tsai SY, Tung YC, Wu WW, Lee CC. Sleep pattern regularity and measures of infant weight and length during the first 6 months. J Pediatr Nurs 2022; 64:e102-e108. [PMID: 34996681 DOI: 10.1016/j.pedn.2021.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the association between sleep pattern regularity and measures of weight and length in infants. DESIGN AND METHODS This was a prospective observational study conducted in a university-affiliated children's hospital in northern Taiwan. A total of 316 healthy infants recruited during their 6-month well-child checkups had their weight and recumbent length measured, and wore an actigraph on the ankle for a week. Based on average weekday, weekend, and all-week sleep durations, infants were categorized into 3 groups: regular sleep, weekend catch-up sleep, and weekend sleep curtailment. General linear model analyses were performed with the 3 sleep regularity groups as the primary predictor variable of interest and infant anthropometry as the dependent variable. RESULTS At risk of overweight, overweight, and obese was present in a total of 62 (19.6%) infants. In both unadjusted and adjusted models, infants in the weekend catch-up sleep group (30.4%) and those in the weekend sleep curtailment group (34.5%) had significantly higher weight-to-length ratios, body mass index, weight-for-age z-scores, and weight velocity of 6-month increments z-scores when compared with infants in the regular sleep group (35.1%, all p < 0.05). CONCLUSIONS Differences in weekday-weekend sleep exist as early as in the first 6 months of life, and both catch-up sleep and sleep curtailment over the weekend is associated with higher measures of weight and length in infants. PRACTICE IMPLICATIONS Sleep assessments in well-child checkups should include not only global assessments of average sleep duration but also address sleep patterns and their regularity.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan
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3
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Shephard E, Zuccolo PF, Idrees I, Godoy PBG, Salomone E, Ferrante C, Sorgato P, Catão LFCC, Goodwin A, Bolton PF, Tye C, Groom MJ, Polanczyk GV. Systematic Review and Meta-analysis: The Science of Early-Life Precursors and Interventions for Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:187-226. [PMID: 33864938 DOI: 10.1016/j.jaac.2021.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate which early neurocognitive and behavioral precursors are associated with the development of attention-deficit/hyperactivity disorder (ADHD) and whether these are currently targeted in early interventions. METHOD We conducted 2 systematic reviews and meta-analyses of empirical studies to examine the following: (1) early-life (0-5 years) neurocognitive and behavioral precursors associated with familial likelihood for ADHD, an early ADHD diagnosis/elevated ADHD symptoms, and/or the presence of later-childhood ADHD; and (2) interventions delivered to children aged 0 to 5 years targeting the identified precursors or measuring these as outcomes. Standardized mean differences (Hedges' g) and pre-post-treatment change scores (SMD) were computed. RESULTS A total of 149 studies (165,095 participants) investigating 8 neurocognitive and behavioral domains met inclusion criteria for part 1. Multi-level random-effects meta-analyses on 136 studies revealed significant associations between ADHD and poorer cognitive (g = -0.46 [95% CIs: -0.59, -0.33]), motor (g = -0.35 [CIs: -0.48, -0.21]) and language (g = -0.43 [CIs: -0.66, -0.19]) development, social (g = 0.23 [CIs: 0.03, 0.43]) and emotional (g = 0.46 [CIs: 0.33, 0.58]) difficulties, early regulatory (g = 0.30 [CIs: 0.18, 0.43]) and sleep (g = 0.29 [CIs: 0.14, 0.44]) problems, sensory atypicalities (g = 0.52 [CIs: 0.16, 0.88]), elevated activity levels (g = 0.54 [CIs: 0.37, 0.72]), and executive function difficulties (g = 0.34 [CIs: 0.05, 0.64] to -0.87 [CIs: -1.35, -0.40]). A total of 32 trials (28 randomized, 4 nonrandomized, 3,848 participants) testing early interventions that targeted the identified precursors met inclusion criteria for part 2. Multi-level random-effects meta-analyses on 22 studies revealed significant intervention-related improvements in ADHD symptoms (SMD = 0.43 [CIs: 0.22, 0.64]) and working memory (SMD = 0.37 [CIs: 0.06, 0.69]). CONCLUSION Children aged 0 to 5 years with current or later-emerging ADHD are likely to experience difficulties in multiple neurocognitive/behavioral functions. Early interventions show some effectiveness in reducing ADHD symptoms, but their effects on neurocognitive/behavioral difficulties require further study.
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Affiliation(s)
- Elizabeth Shephard
- Drs. Shephard, Zuccolo, Prof. Polanczyk, Ms. Godoy, and Mr. Catão are with Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil; Drs. Shephard, Goodwin, Tye, and Prof. Bolton are with Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, United Kingdom.
| | - Pedro F Zuccolo
- Drs. Shephard, Zuccolo, Prof. Polanczyk, Ms. Godoy, and Mr. Catão are with Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Iman Idrees
- Ms. Idrees and Dr. Groom are with Institute of Mental Health, University of Nottingham, United Kingdom
| | - Priscilla B G Godoy
- Drs. Shephard, Zuccolo, Prof. Polanczyk, Ms. Godoy, and Mr. Catão are with Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Erica Salomone
- Dr. Salomone and Mss. Ferrante and Sorgato are with the University of Milan-Bicocca, Italy
| | - Camilla Ferrante
- Dr. Salomone and Mss. Ferrante and Sorgato are with the University of Milan-Bicocca, Italy
| | - Paola Sorgato
- Dr. Salomone and Mss. Ferrante and Sorgato are with the University of Milan-Bicocca, Italy
| | - Luís F C C Catão
- Drs. Shephard, Zuccolo, Prof. Polanczyk, Ms. Godoy, and Mr. Catão are with Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Amy Goodwin
- Drs. Shephard, Goodwin, Tye, and Prof. Bolton are with Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, United Kingdom
| | - Patrick F Bolton
- Drs. Shephard, Goodwin, Tye, and Prof. Bolton are with Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, United Kingdom; Prof. Bolton is also with The Maudsley NIHR Biomedical Research Centre in Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Charlotte Tye
- Drs. Shephard, Goodwin, Tye, and Prof. Bolton are with Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, United Kingdom
| | - Madeleine J Groom
- Ms. Idrees and Dr. Groom are with Institute of Mental Health, University of Nottingham, United Kingdom
| | - Guilherme V Polanczyk
- Drs. Shephard, Zuccolo, Prof. Polanczyk, Ms. Godoy, and Mr. Catão are with Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
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Biancardi C, Sesso G, Masi G, Faraguna U, Sicca F. Sleep EEG microstructure in children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis. Sleep 2021; 44:6081934. [PMID: 33555021 DOI: 10.1093/sleep/zsab006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/29/2020] [Indexed: 01/21/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is commonly associated with sleep problems, possibly due to shared pathophysiology. Microstructural sleep electroencephalographic (EEG) alterations may likely represent markers of disordered cortical maturation in ADHD, although literature data are still conflicting, deserving further assessment. After having systematically reviewed the literature, we included 11 studies from 598 abstracts, and assessed 23 parameters of cyclic alternating pattern (CAP), four parameters of sleep EEG power and one parameter of sleep graphoelements through 29 meta-analyses and, when possible, univariate meta-regressions. Slow wave activity (SWA) in ADHD was significantly higher in early childhood and lower in late childhood/adolescence compared to controls, with an inversion point at 10 years. Total CAP rate and CAP A1 index in non-rapid eye movement (NREM) stage 2 sleep, and CAP A1 rate in NREM sleep were significantly lower in ADHD patients than controls. SWA and CAP A1 changes are therefore possible markers of altered cortical maturation in ADHD, consistently with the neuropsychological deficits characterizing the disorder, likely fostering earlier detection of at-risk/milder conditions, and more tailored therapeutic interventions.
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Affiliation(s)
- Carlo Biancardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianluca Sesso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Masi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Ugo Faraguna
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federico Sicca
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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ADHD and sleep: recent advances and future directions. Curr Opin Psychol 2019; 34:50-56. [PMID: 31629217 DOI: 10.1016/j.copsyc.2019.09.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/19/2019] [Accepted: 09/06/2019] [Indexed: 12/17/2022]
Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) frequently have sleep disturbances, daytime sleepiness, and/or circadian rhythm abnormalities. This article reviews recent advancements and key future directions: examining group differences across the life span, advancing a developmental psychopathology perspective, moving from correlation to causation, conceptualizing ADHD as a 24-hour disorder, understanding sleep in relation to other health behaviors, and evaluating sleep in interventions for individuals with ADHD. This is an exciting time in the empirical study and clinical care of sleep disturbances and circadian rhythm alterations in individuals with ADHD. As research continues to advance, studies are increasingly using large samples and longitudinal/experimental research designs to test hypotheses that will ultimately allow for a more robust and sophisticated understanding of sleep and ADHD.
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6
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Atun-Einy O, Tonetti L, Boreggiani M, Natale V, Scher A. Infant motor activity during sleep: Simultaneous use of two actigraphs comparing right and left legs. Hum Mov Sci 2017; 57:357-365. [PMID: 28964551 DOI: 10.1016/j.humov.2017.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/16/2017] [Accepted: 09/18/2017] [Indexed: 01/21/2023]
Abstract
Motor asymmetry during the first hours of sleep documented in adults found higher activity in the non-dominant limb. The stage of development at which such asymmetries first appear is unknown. Twenty healthy infants were followed from 7 to 12months of age, at 3-week intervals, comparing motor activity of the right and left legs during sleep using twin actigraphs (AMI). Hour-by-hour analysis of the first seven hours of nocturnal sleep found no consistent difference in activity levels between the right and left legs. Using the standard algorithm for infants, which provides an overall estimate of sleep quality, revealed discrepancies in night waking episodes (Right versus Left) in 33% of the nights. Results pertaining to leg movement suggest that motor asymmetry is not yet present during the first year of life. However, given the large discrepancies in the detection of night waking, further investigation of the developmental course of circadian motor asymmetry is warranted.
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Affiliation(s)
- Osnat Atun-Einy
- Department of Physical Therapy, University of Haifa, Haifa, Israel.
| | - Lorenzo Tonetti
- Department of Psychology, University of Bologna, Bologna, Italy.
| | | | - Vincenzo Natale
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - Anat Scher
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel.
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7
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Becker SP, Sidol CA, Van Dyk TR, Epstein JN, Beebe DW. Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: A systematic review. Sleep Med Rev 2016; 34:94-121. [PMID: 27818086 DOI: 10.1016/j.smrv.2016.07.004] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 01/09/2023]
Abstract
Substantial research attention has been devoted to understanding the importance and impact of sleep in children and adolescents. Traditionally, this has focused on mean sleep variables (e.g., a child's "typical" or average sleep duration), yet research increasingly suggests that intraindividual variability (IIV) of sleep/wake patterns (sometimes referred to as sleep variability or night-to-night variability) regularly occurs and may have implications for adjustment. A systematic search of five electronic databases identified 52 empirical studies published between 2000 and 2015 that examined correlates of sleep IIV in children and adolescents, with a recent increase in the publication rate of such studies. Identified studies were often atheoretical and included post hoc analyses, though IIV in select aspects of sleep does appear to be associated with increasing age/pubertal status, non-White race, physical and neurodevelopmental conditions (e.g., attention-deficit/hyperactivity disorder; autism), psychopathology symptoms (e.g., anxiety, depression, inattention), body weight, stress, aspects of cognitive functioning, and poorer sleep functioning/habits. The limited intervention work examining sleep IIV in adolescents is promising, though studies are needed using more rigorous intervention designs. Clinical sleep recommendations may not only need to address overall sleep duration and sleep habits but also the stability of sleep duration and timing. It will be important for future research examining sleep IIV in children and adolescents to use a developmental framework in advancing theory pertaining to the causes, mechanisms, moderators, and outcomes of sleep IIV in youth, and a conceptual model is proposed to help guide such efforts.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Craig A Sidol
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jeffery N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Observed temperament from ages 6 to 36 months predicts parent- and teacher-reported attention-deficit/hyperactivity disorder symptoms in first grade. Dev Psychopathol 2016; 29:107-120. [PMID: 26751219 DOI: 10.1017/s0954579415001236] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study tested the prospective association between observational indicators of temperament, which were obtained across multiple assessments when children were 6-36 months of age, and parent and teacher reports of children's attention-deficit/hyperactivity disorder (ADHD) behaviors, when children were in first grade. Data were drawn from the Family Life Project and included 1,074 children for whom temperament and either parent- or teacher-reported ADHD behavioral data were available. The results of variable-centered regression models indicated that individual differences in temperament regulation, but not temperamental reactivity, was uniquely predictive of parent- and teacher-reported ADHD behaviors. Latent profile analyses were used to characterize configurations of temperamental reactivity and regulation. Person-centered regression models were subsequently estimated in which temperamental profile membership replaced continuous indicators of temperamental reactivity and regulation as predictors. The results of person-centered regression models indicated that temperamental reactivity and regulation both contributed (both alone and in combination) to the prediction of subsequent ADHD behaviors. In general, the predictive associations from early temperament to later ADHD were of modest magnitude (R 2 = .10-.17). Results are discussed with respect to interest in the early identification of children who are at elevated risk for later ADHD.
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9
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Lev Ari L, Shulman S. Sleep, daily activities, and their association with mood states among emerging adults. BIOL RHYTHM RES 2013. [DOI: 10.1080/09291016.2012.692251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Meltzer LJ, Montgomery-Downs HE, Insana SP, Walsh CM. Use of actigraphy for assessment in pediatric sleep research. Sleep Med Rev 2012; 16:463-75. [PMID: 22424706 PMCID: PMC3445439 DOI: 10.1016/j.smrv.2011.10.002] [Citation(s) in RCA: 427] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 10/03/2011] [Accepted: 10/14/2011] [Indexed: 02/02/2023]
Abstract
The use of actigraphs, or ambulatory devices that estimate sleep-wake patterns from activity levels, has become common in pediatric research. Actigraphy provides a more objective measure than parent-report, and has gained popularity due to its ability to measure sleep-wake patterns for extended periods of time in the child's natural environment. The purpose of this review is: 1) to provide comprehensive information on the historic and current uses of actigraphy in pediatric sleep research; 2) to review how actigraphy has been validated among pediatric populations; and 3) offer recommendations for methodological areas that should be included in all studies that utilize actigraphy, including the definition and scoring of variables commonly reported. The poor specificity to detect wake after sleep onset was consistently noted across devices and age groups, thus raising concerns about what is an "acceptable" level of specificity for actigraphy. Other notable findings from this review include the lack of standard scoring rules or variable definitions. Suggestions for the use and reporting of actigraphy in pediatric research are provided.
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Affiliation(s)
- Lisa J. Meltzer
- National Jewish Health, 1400 Jackson Street, G311, Denver, CO
80206, 303-398-1837 (P), 303-270-2141 (F)
| | | | - Salvatore P. Insana
- University of Pittsburgh Medical Center, 3811 O’Hara
Street, E-1107, Pittsburgh, PA 15213, 412-246-6943 (P)
| | - Colleen M. Walsh
- Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104,
215-662-3189 (P)
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Johnston C, Mash EJ, Miller N, Ninowski JE. Parenting in adults with attention-deficit/hyperactivity disorder (ADHD). Clin Psychol Rev 2012; 32:215-28. [PMID: 22459785 PMCID: PMC4838457 DOI: 10.1016/j.cpr.2012.01.007] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 12/16/2011] [Accepted: 01/30/2012] [Indexed: 12/23/2022]
Abstract
Although the validity of adult ADHD is well established and research has identified a variety of impairments associated with the condition in adults, study of how ADHD impacts an adult's ability to parent has been relatively neglected. Parenting is a particularly important domain of functioning given the familial nature of the disorder and emerging evidence that parenting behaviors play a role in the development or maintenance of child ADHD symptoms, comorbid psychopathologies, and other associated difficulties. In this paper, we focus on three broad categories of cognitive dysfunction proposed across models of ADHD - cognitive processes (e.g., working memory, planning, and inhibitory control), self-regulation deficits (e.g., self-monitoring of performance to detect errors or the need for regulation of behavior and/or emotions), and motivational or arousal difficulties (e.g., response to incentives, delay aversion). We consider how these deficits may lead to impairments in the parenting behaviors of effective behavioral control and emotional responsiveness, and review the available evidence regarding parenting in adults with ADHD symptoms. We conclude by noting the limitations in existing studies, and argue for further research that is theoretically grounded in how core deficits of ADHD may be related to dimensions of parenting. The implications of an improved understanding of how ADHD impacts parenting for the development of early intervention or prevention programs are outlined.
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Affiliation(s)
- Charlotte Johnston
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
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