Psychometric Properties of ADHD Symptoms in Toddlers

Screen Time and ADHD Behaviors in Chinese Children: Findings From Longitudinal and Cross-Sectional Data

OBJECTIVE

Research suggests that screen exposure presents a risk for ADHD behaviors in young children. However, the operationalization of screen exposure remains murky and longitudinal data is scarce. In this paper, we examined the relations between better operationalized daily screen time and behaviors of inattention and behaviors of hyperactivity/impulsivity in three cohorts of community samples of young Chinese children.

METHOD

Study 1 was longitudinal and included 111 children who were 3.6 years old (Range = 2.4-4.9; SD = 0.4) at Baseline and 4.8 years old (Range = 3.9-6.0; SD = 0.4) at Follow-Up. Study 2 was cross-sectional and included 172 children aged 4.9 years (Range = 3.0-7.1; SD = 1.0). Study 3 was also cross-sectional and included 313 children who were 6.9 years old (Range = 5.7-8.3; SD = 0.4). In each study, the parents reported how much time that their children spent daily on iPad/tablet, smart phone, and online games and watching TV in the previous week, and their children's behaviors of inattention (I/A) and hyperactivity/impulsivity (H/I).

RESULTS

Regression analysis revealed that in Study 1, controlling for child demographics, mother's education, family SES, and corresponding I/A or H/I scores at Baseline, screen time at Baseline predicted I/A scores (β = .27, p < .01) and H/I scores (β = .32, p < .001) at Follow-Up. Similarly, controlling for covariates, screen time predicted I/A scores (β = .25, p < .01) and H/I scores (β = .25, p < .01) in Study 2; I/A scores (β = 0.16, p < .01) and H/I scores (β = .15, p < .05) in Study 3.

CONCLUSION

Screen exposure was a risk for inattention and hyperactivity/impulsivity behaviors in urban Chinese children.

Assessing the relationship between maternal risk for attention deficit hyperactivity disorder and functional connectivity in their biological toddlers

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with increased risk for poor educational attainment and compromised social integration. Currently, clinical diagnosis rarely occurs before school-age, despite behavioral signs of ADHD in very early childhood. There is no known brain biomarker for ADHD risk in children ages 2-3 years-old.

METHODS

The current study aimed to investigate the functional connectivity (FC) associated with ADHD risk in 70 children aged 2.5 and 3.5 years via functional near-infrared spectroscopy (fNIRS) in bilateral frontal and parietal cortices; regions involved in attentional and goal-directed cognition. Children were instructed to passively watch videos for approximately 5 min. Risk for ADHD in each child was assessed via maternal symptoms of ADHD, and brain data was evaluated for FC.

RESULTS

Higher risk for maternal ADHD was associated with lower FC in a left-sided parieto-frontal network. Further, the interaction between sex and risk for ADHD was significant, where FC reduction in a widespread bilateral parieto-frontal network was associated with higher risk in male, but not female, participants.

CONCLUSIONS

These findings suggest functional organization differences in the parietal-frontal network in toddlers at risk for ADHD; potentially advancing the understanding of the neural mechanisms underlying the development of ADHD.

Early Development of ADHD and ODD Symptoms from the Toddler to Preschool Years

OBJECTIVE

ADHD and ODD are commonly co-occurring, but often studied individually. This study evaluated common trajectories of these disorders and explored how they co-develop in early childhood.

METHOD

Community parents (N = 273) completed online surveys about their 2-year-old. Children's inattention, hyperactivity/impulsivity, and oppositional defiant disorder symptoms over 2 years were examined using latent class, dual trajectory, and cross-lagged analyses.

RESULTS

Most children followed low symptom trajectories. A small portion showed high, moderate, or increasing trajectories. The hyperactive/impulsive domain of ADHD showed a declining symptoms group. Children in high ODD groups were likely to be in high ADHD symptom groups; the converse was true but probabilities were lower. Hyperactive/impulsive symptoms predicted ODD symptoms across time, more than vice versa.

CONCLUSION

The study extends the small body of literature assessing early development of ADHD and ODD. Findings suggest that earlier intervention for symptoms of ADHD may mitigate risk of developing ODD.

Prepubertal methylphenidate leads to sex-dependent differences in probabilistic discounting

Prescription psychostimulants, such as methylphenidate (MPH), have served as a first line treatment for ADHD and associated developmental disorders since 1961. Psychostimulants has been shown to improve attention, response inhibition, and reduce hyperactivity in patients with ADHD, as well as in non-clinical human populations and animals. While there is a considerable amount of preclinical research investigating the effects of stimulant medications on reward sensitivity and basic learning in male rats, less is understood about their effects in females. Further, there are competing theories on the long-term cognitive impact of MPH, specifically in children who do not have ADHD. To this end, Long-Evans female and male rats were exposed to methylphenidate (0, 2.5, 5 mg/kg, BID, IP) for 20 days during early development (PD10-29). After discontinuation of MPH into adulthood, rats (beginning PD 60) were trained and tested for risk-preference using a 2-choice probabilistic discounting task. For this task, rats were given an option between a 'large-risky' choice (3 sugar pellets delivered on a probabilistic VR schedule) and 'small-certain' choice (1 sugar pellet delivered on a FR schedule). Rats were subsequently tested on an open field conflict test. The results demonstrate that prepubertal exposure to MPH can have lasting effects on decision-making. Specifically, female rats treated with 2.5 mg/kg MPH displayed a decrease in preference for the risky option, whereas male rats treated with the same dose showed an overall increase in preference compared to sex-matched controls. Irrespective of sex, rats treated with 2.5 mg/kg MPH also demonstrated a decrease in anxiety/inhibitory behavior on the modified open field test compared to controls. These results were not due to differences in locomotor behavior. Overall, the study contributes to the growing body of evidence to suggest that MPH exposure early in development can have a sex-dependent impact on decision-making in adulthood.

Using Mechanical Turk to Study Parents and Children: An Examination of Data Quality and Representativeness

Objective: Mechanical Turk (MTurk) is a popular data collection tool that is increasingly used to study parents and children. We examined the quality of data obtained via MTurk, the representativeness of parents on MTurk, and whether the wording of MTurk recruitment materials is related to sample characteristics.Method: Participants were 650 parents with children aged 4 to 17 recruited for two separate studies (64.6% female, 83.8% Caucasian, mean age = 37.6 years). The Mental Health Survey (N = 322) recruitment materials described a study about mental health and the Health Survey (N = 328) materials only referenced health; both surveys restricted participation to parents in the United States (U.S.). Parents completed measures about demographics, mental health service seeking history, and parent and youth psychopathology.Results: Participants provided reliable responses on study measures, with low rates of missing data. Participants were more female, less racially/ethnically diverse, and more educated than the U.S. population, and also had more children per household. Over 40% of parents and 30% of children had previously received mental health services and many scored in the clinical range on measures of psychopathology. Contrary to hypotheses, mental health help seeking was higher in the Health Survey than the Mental Health survey.Conclusions: MTurk is a feasible method for child and adolescent clinical psychology research, although participants may not be fully demographically representative of the general population and could possibly be better considered an at-risk or clinical sample than a community sample.

Structure of ADHD/ODD Symptoms in Spanish Preschool Children: Dangers of Confirmatory Factor Analysis for Evaluation of Rating Scales

Confirmatory factor analysis (CFA) is often used to evaluate attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptom ratings by parents and teachers. An ADHD-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and ODD three-factor model is usually the best model. Acceptable CFA models, however, can hide symptoms with poor convergent and discriminant validity. To demonstrate this issue, CFA models (i.e., cross-loadings set to zero) along with exploratory CFA models (i.e., cross-loadings allowed) were applied to parent (n = 308) and teacher (n = 258) ratings of ADHD/ODD symptoms with Spanish preschool children (M_age = 4.78, SD = .84, 56% boys). While the three-factor CFA model provided an acceptable-fit with moderate to substantial symptom-factor loadings, the three-factor exploratory CFA model, however, found a large number of the symptoms failed to show convergent and discriminant validity. These outcomes argue for the use of exploratory CFA procedures in the initial evaluation of ADHD/ODD rating scales.