1
|
Peterson BS, Trampush J, Brown M, Maglione M, Bolshakova M, Rozelle M, Miles J, Pakdaman S, Yagyu S, Motala A, Hempel S. Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review. Pediatrics 2024; 153:e2024065854. [PMID: 38523599 DOI: 10.1542/peds.2024-065854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 03/26/2024] Open
Abstract
CONTEXT Correct diagnosis is essential for the appropriate clinical management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. OBJECTIVE This systematic review provides an overview of the available diagnostic tools. DATA SOURCES We identified diagnostic accuracy studies in 12 databases published from 1980 through June 2023. STUDY SELECTION Any ADHD tool evaluation for the diagnosis of ADHD, requiring a reference standard of a clinical diagnosis by a mental health specialist. DATA EXTRACTION Data were abstracted and critically appraised by 1 reviewer and checked by a methodologist. Strength of evidence and applicability assessments followed Evidence-based Practice Center standards. RESULTS In total, 231 studies met eligibility criteria. Studies evaluated parental ratings, teacher ratings, youth self-reports, clinician tools, neuropsychological tests, biospecimen, EEG, and neuroimaging. Multiple tools showed promising diagnostic performance, but estimates varied considerably across studies, with a generally low strength of evidence. Performance depended on whether ADHD youth were being differentiated from neurotypically developing children or from clinically referred children. LIMITATIONS Studies used different components of available tools and did not report sufficient data for meta-analytic models. CONCLUSIONS A valid and reliable diagnosis of ADHD requires the judgment of a clinician who is experienced in the evaluation of youth with and without ADHD, along with the aid of standardized rating scales and input from multiple informants across multiple settings, including parents, teachers, and youth themselves.
Collapse
Affiliation(s)
- Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, California
- Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Joey Trampush
- Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Morah Brown
- Southern California Evidence Review Center, Los Angeles, California
| | | | - Maria Bolshakova
- Southern California Evidence Review Center, Los Angeles, California
| | - Mary Rozelle
- Southern California Evidence Review Center, Los Angeles, California
| | - Jeremy Miles
- Southern California Evidence Review Center, Los Angeles, California
| | - Sheila Pakdaman
- Southern California Evidence Review Center, Los Angeles, California
| | - Sachi Yagyu
- Southern California Evidence Review Center, Los Angeles, California
| | - Aneesa Motala
- Southern California Evidence Review Center, Los Angeles, California
| | - Susanne Hempel
- Southern California Evidence Review Center, Los Angeles, California
| |
Collapse
|
2
|
Wiguna T, Minayati K, Kaligis F, Teh SD, Krishnandita M, Meriem Annisa Fitri N, Ismail RI, Fasha AH, Steven, Bahana R. Using the Indonesian Computer-Based Game Prototype as a Computer-Based Game Inventory for Executive Function in Children and Adolescents: A Confirmatory Factor Analysis and Concurrent Validity Study. Assessment 2024:10731911241234734. [PMID: 38439542 DOI: 10.1177/10731911241234734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Executive function influences children's learning abilities and organizes their cognitive processes, behaviors, and emotions. This cross-sectional study examined whether an Indonesian Computer-Based Game (ICbG) prototype could be used as a Computer-Based Game Inventory for Executive Function (CGIEF) in children and adolescents. The study was conducted with 200 children, adolescents, and their parents. The parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF) questionnaire, and the children and adolescents completed the CGIEF. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were performed using LISREL Version 8.80. The construct of CGIEF was valid/fit with normal theory-weighted least squares = 15.75 (p > .05). SEM analysis showed that the theoretical construct of the CGIEF was a valid predictor of executive function. The critical t value of the pathway was 2.45, and normal theory-weighted least squares was 5.74 (p > .05). The construct reliability (CR) for CGIEF was 0.91. Concurrent validity was assessed using the Bland-Altman plot, and the coefficient of repeatability (bias/mean) was nearly zero between the t scores of total executive functions of the CGIEF and BRIEF. This preliminary study showed that the CGIEF can be useful as a screening tool for executive dysfunction, metacognitive deficits, and behavioral regulation problems among children and adolescents in clinical samples.
Collapse
Affiliation(s)
- Tjhin Wiguna
- Department of Psychiatry, Child and Adolescent Psychiatry Division, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Kusuma Minayati
- Department of Psychiatry, Child and Adolescent Psychiatry Division, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Fransiska Kaligis
- Department of Psychiatry, Child and Adolescent Psychiatry Division, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Sylvia Dominic Teh
- Department of Psychiatry, Child and Adolescent Psychiatry Division, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | | | - Raden Irawati Ismail
- Department of Psychiatry, Child and Adolescent Psychiatry Division, Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | - Steven
- Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Raymond Bahana
- Faculty of Computer Science, Bina Nusantara-University, Jakarta, Indonesia
| |
Collapse
|
3
|
Tallberg P, Rastam M, Hallin AL, Perrin S, Gustafsson P. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:259-271. [PMID: 36126650 DOI: 10.1080/21622965.2022.2093113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from childhood/adolescence to young adulthood. This was done by examining possible improvements in parent-rated EF and performance-based measures of inattention and inhibition over a three-year interval and their relationship to ADHD outcomes in 137 clinically referred youth with ADHD (mean age = 12.4 years, SD = 3.1). Participants' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Swanson-Nolan-Pelham Scale at baseline and follow-up. Participants completed the Conners' Continuous Performance Test, Version II (CPT II) at baseline and follow-up. Statistical analyses were performed with Linear Mixed Models. The sex- and age-standardized measures Commission and Hit reaction time (RT) subscales of the CPT II and parent-rated metacognitive, and behavior regulation composites of the BRIEF were largely stable between measuring points. CPT Omissions, Hit RT standard error (reaction time variability), and parent-rated ADHD symptom scores improved slightly. BRIEF composites and reaction time variability were related to ADHD symptoms using longitudinal data. Overall, behavioral aspects of EF, as observed by parents in the home context, appear to play a significant role in the trajectory of childhood ADHD.
Collapse
Affiliation(s)
- Pia Tallberg
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Maria Rastam
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| |
Collapse
|
4
|
Rachel M, Jia H, Amina A, Perez-Garcia M, Kumar M, Wicherts JM. Psychometric evaluation of the computerized battery for neuropsychological evaluation of children (BENCI) among school aged children in the context of HIV in an urban Kenyan setting. BMC Psychiatry 2023; 23:373. [PMID: 37248481 DOI: 10.1186/s12888-023-04880-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Culturally validated neurocognitive measures for children in Low- and Middle-Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform development of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsychological Evaluation of Children (BENCI) is an openly available, computerized neuropsychological battery specifically developed to evaluate neurocognitive impairment. This study adapted the BENCI and evaluated its reliability and validity in Kenya. METHODOLOGY The BENCI was adapted using translation and back-translation from Spanish to English. The psychometric properties were evaluated in a case-control study of 328 children (aged 6 - 14 years) living with HIV and 260 children not living with HIV in Kenya. We assessed reliability, factor structure, and measurement invariance with respect to HIV. Additionally, we examined convergent validity of the BENCI using tests from the Kilifi Toolkit. RESULTS Internal consistencies (0.49 < α < 0.97) and test-retest reliabilities (-.34 to .81) were sufficient-to-good for most of the subtests. Convergent validity was supported by significant correlations between the BENCI's Verbal memory and Kilifi's Verbal List Learning (r = .41), the BENCI's Visual memory and Kilifi's Verbal List Learning (r = .32) and the BENCI's Planning total time test and Kilifi's Tower Test (r = -.21) and the BENCI's Abstract Reasoning test and Kilifi's Raven's Progressive Matrix (r = .21). The BENCI subtests highlighted meaningful differences between children living with HIV and those not living with HIV. After some minor adaptions, a confirmatory four-factor model consisting of flexibility, fluency, reasoning and working memory fitted well (χ2 = 135.57, DF = 51, N = 604, p < .001, RMSEA = .052, CFI = .944, TLI = .914) and was partially scalar invariant between HIV positive and negative groups. CONCLUSION The English version of the BENCI formally translated for use in Kenya can be further adapted and integrated in clinical and research settings as a valid and reliable cognitive test battery.
Collapse
Affiliation(s)
- Maina Rachel
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands.
- Brain and Mind Institute, Aga Khan University, Nairobi, 10834-00400, Kenya.
| | - He Jia
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Abubakar Amina
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Miguel Perez-Garcia
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi, 10834-00400, Kenya
| | - Jelte M Wicherts
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| |
Collapse
|
5
|
Marinopoulou M, Unenge Hallerbäck M, Bornehag CG, Billstedt E. Is WISC-IV Working Memory Index associated with ADHD symptoms in 7-8-year-olds? APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-10. [PMID: 36780371 DOI: 10.1080/21622965.2023.2176232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The Working Memory Index (WMI) in the Wechsler Intelligence Scale for Children (WISC) has been suggested to be associated with ADHD symptoms. The relationship between WMI and ADHD symptoms in the general population is not clear. The study aimed to examine the association between working memory (WM) and behavioral regulation (BR), and hyperactivity/inattention (HI) in a general population sample of 7-8-year-olds, and whether general intellectual functioning is associated with BR and HI. The study also examined if those with low WMI also fulfill elevated ADHD criteria. The study group (N = 865) was assessed with the WISC (Fourth edition), the Behavior Rating Inventory of Executive Function, the Strengths and Difficulties Questionnaire, and the Five to Fifteen Questionnaire, and divided into three groups based on WM function, and in relation to BR and/or HI problems. The associations between WM and BR, and WM and HI, including intellectual functioning as covariate, were examined. WM deficits were found in 22%, but the majority of those had no BR or HI problems. Four percent in the study group had WM deficits combined with BR and/or HI problems, and in about one third of those inattentive ADHD criteria were fulfilled. WM and prosocial behavior were associated with BR and HI. WM deficits measured with WISC WMI in 7-8-year-olds do not always signal BR and/or HI problems.
Collapse
Affiliation(s)
- Maria Marinopoulou
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Habilitation, Region Värmland, Karlstad, Sweden
| | - Maria Unenge Hallerbäck
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
6
|
Pino Muñoz M, Arán Filippetti V. Coping Strategies and Social Skills of School-Aged Children: Association with Performance-Based Measures and Behavioral Ratings of Executive Function. J Genet Psychol 2022:1-17. [DOI: 10.1080/00221325.2022.2156266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Mónica Pino Muñoz
- Escuela de Psicología, Departamento de Ciencias Sociales, Universidad del Bío Bío, Chillán, Chile
- Grupo de Investigación para el Desarrollo Emocional Cognitivo para el Aprendizaje (GIDECAP). Facultad de Educación y Humanidades, Universidad del Bío Bío, Chillán, Chile
| | - Vanessa Arán Filippetti
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento (CIICSAC), Universidad Adventista del Plata, Entre Ríos, Argentina
- Facultad de Humanidades, Educación y Ciencias Sociales, Universidad Adventista del Plata, Entre Ríos, Argentina
| |
Collapse
|
7
|
Zonneveld AK, Serpell Z, Parr T, Ellefson MR. Executive function measurement in urban schools: Exploring links between performance-based metrics and teacher ratings. Dev Sci 2022; 25:e13319. [PMID: 36106899 DOI: 10.1111/desc.13319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 01/13/2023]
Abstract
When compared to research centered on the executive function development of white, middle-class children, relatively little is known about their non-white, low socioeconomic status peers. In an effort to harmonize how executive functions are measured within under-represented contexts, the present study addresses gaps in the evaluation of everyday executive functioning to better understand whether behavior rating scales completed by teachers (BASC2EF - BASC executive function scale, 2nd edition; BASC3EF - BASC executive function scale, 3rd edition) capture distinctions between performance-based measures. This study includes two large samples of older, ethnic minority children from high-poverty backgrounds (Sample 1. N = 243; Mage = 9.28 years, SDage = 0.80; nfemale = 125; nAfricanAmerican = 216, nLatinAmerican = 15, nAsianAmerican = 6; Sample 2. N = 229; Mage = 10.02 years, SDage = 1.01; nfemale = 120; nAfricanAmerican = 132, nLatinAmerican = 92, nWhite = 3, nPacificIslander = 1). Based on structural equation models testing the links between computerized performance-based measures and the teacher rating scales, the results indicate that BASC2EF in its original form might be a good fit for some populations but there is not a strong factor structure for the current high-poverty samples. In addition, post-hoc analyses suggest that only including BASC2EF items also in BASC3EF or using BASC3EF is best practice for high-poverty populations. BASC3EF seems better able to capture different components of performance-driven tasks, whereas BASC2EF captures overall executive functioning better than individual tasks. These findings encourage continued questioning surrounding metrics used to assess everyday executive functions in older children from diverse backgrounds. HIGHLIGHTS: This study explores whether teacher ratings of children's everyday executive functioning (using standardized behavior rating scales) capture distinctions between performance-based measures. Results indicate that BASC2EF teacher rating scale (Karr & Garcia-Barrera, 2017) is not a good representation of everyday executive function behaviors by children from schools in high-poverty communities. The findings suggest that restricting BASC2EF analyses to only items included in BASC3EF (Reynolds & Kamphaus, 2015) or using BASC3EF for high-poverty populations. BASC3EF seems better able to capture the different components of performance-driven tasks, whereas BASC2EF captures overall executive functioning better than individual tasks.
Collapse
Affiliation(s)
| | - Zewelanji Serpell
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Teresa Parr
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | | |
Collapse
|
8
|
The three-year outcome of emotional symptoms in clinically referred youth with ADHD and their relationship to neuropsychological functions. Scand J Child Adolesc Psychiatr Psychol 2022; 10:72-86. [PMID: 35903554 PMCID: PMC9284941 DOI: 10.2478/sjcapp-2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Further knowledge is needed regarding long-term outcome of emotional symptoms, and the interplay between these symptoms and neuropsychological functioning in youth with attention deficit hyperactivity disorder (ADHD). Objective We aimed to explore the effect of performance-based neurocognitive functions and parent-rated behavioral executive functioning (EF) on self-rated and parent-rated internalizing symptoms longitudinally in clinically referred youth with ADHD (n = 137; mean age = 12.4 years). We also aimed to examine the change in self-rated emotional symptoms in the ADHD group and a Control group (n = 59; mean age = 11.9 years). Method At baseline, and three years later, parents completed rating scales of their child’s ADHD symptoms (Swanson Nolan Pelham Scale, Version IV – SNAP-IV), emotional symptoms (Five To Fifteen Questionnaire, Strengths, and Difficulties Questionnaire), and EF (Behavior Rating Inventory of Executive Function). At the same time, the child completed self-report measures of Anxiety, Depression, and Anger Inventories (the Beck Youth Inventories) and neurocognitive measures (Conner’s Continuous Performance Test, Version II (CPT-II), Working Memory and Processing Speed composites (Wechsler Intelligence Scales). Statistical analyses were linear and logistic mixed models. Results Using longitudinal data, parent- and self-ratings of emotional symptoms were associated with parent-ratings of EF behavior in youth with ADHD. Plan/organizing deficits were associated with Anxiety and Anger over and above other metacognitive subscales, while Emotional Control was related to Anger over and above other behavior regulation subscales. In the ADHD group, Anger symptoms improved across measuring points. When controlling for age, Anxiety, and Depression symptoms were largely stable in both groups, however at higher levels in the ADHD group. The differences in anxiety and depression symptoms across groups decreased over time. Conclusions The current study emphasizes the importance of identification, monitoring, and treatment of emotional symptoms, and behavioral aspects of EF in youth with ADHD.
Collapse
|
9
|
Developing and feasibility testing of the Indonesian computer-based game prototype for children with attention deficit/hyperactivity disorder. Heliyon 2021; 7:e07571. [PMID: 34345741 PMCID: PMC8319002 DOI: 10.1016/j.heliyon.2021.e07571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/27/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to develop an Indonesian computer-based game prototype, including feasibility testing, targeted on attention deficit/hypersensitivity disorder (ADHD) clinical symptoms and executive function. The study comprised five steps. The first to third steps used an exploratory qualitative research design. The Delphi technique with FGD was applied to collect qualitative data. During the study, seven experts participated in ten FGDs. Feasibility testing was conducted as a one group pre- and post-test design that included ten children with drug-naïve ADHD without other mental or physical disorders. Feasibility data were collected before and after 20 training sessions with the Indonesian computer-based game prototype. The framework analysis was performed for qualitative data. Quantitative data were analyzed using the paired t-test, Pearson's correlation and Spearman's rank-order correlation. Outputs of the exploratory qualitative study were the Indonesian computer-based game prototype constructs and general agreements of the prototype,. The Indonesian computer-based game prototype construct comprised six components: reward-related processing, control inhibition, improved sustained attention, specific timing, increased arousal, and improved emotional regulation. After 20 sessions of training, several indicators decreased significantly, such as CATPRS-teacher rating (18.5 [5.31] vs. 12.9 [5.51], p = 0.047), BRIEF-GEC (64.80 [10.21] vs. 57.50 [7.51], p = 0.02), BRIEF-MI (66.1 [7.61] vs. 58.4 [7.56], p = 0.014), BRIEF-Initiate (66.6 [10.15] vs. 54.1 [6.49], p = 0.008), BRIEF-Working Memory (68.0 [6.89] vs. 60.9 [10.05], p = 0.02), and BRIEF-Organization of Material (60.7 [12.88] vs. 49.3 [11.79], p = 0.04). There was a low to moderate correlation between CATPRS-teacher and -parent rating and several BRIEF domains. Feasibility testing output also included the training procedure guideline. The present study indicated that the Indonesian computer-based game prototype could be used as a framework to develop a fixed computer-based game intervention for children with ADHD. However, further randomized controlled studies need to be conducted to show its effectiveness.
Collapse
|
10
|
Loo SK, Salgari GC, Ellis A, Cowen J, Dillon A, McGough JJ. Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder: Cognitive and Electroencephalographic Predictors of Treatment Response. J Am Acad Child Adolesc Psychiatry 2021; 60:856-864.e1. [PMID: 33068751 PMCID: PMC9714960 DOI: 10.1016/j.jaac.2020.09.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/12/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The current study applies a precision medicine approach to trigeminal nerve simulation (TNS), a Food and Drug Administration-approved neuromodulation treatment for attention-deficit/hyperactivity disorder (ADHD), by testing secondary outcomes of cognitive and electroencephalographic [EEG] predictors of treatment response among subjects from the original randomized controlled trial. METHOD Children aged 8 to 12 years with ADHD, were randomized to 4 weeks of active or sham TNS treatment, after which the sham group crossed over into 4 weeks of open-label treatment. TNS treatment responders (RESP) had an ADHD Rating Scale (ADHD-RS) Total score reduction of ≥25%, whereas nonresponders (NR) had <25% reduction posttreatment. Assessments included weekly behavioral ratings and pre-/posttreatment cognitive EEG measures. RESULTS The final sample was 25 RESP and 26 NR comprising 34 male and 17 female children, with a mean (SD) age of 10.3 (1.4) years. Baseline measures that significantly differentiated RESP from NR included: lower working memory, lower spelling and mathematics achievement, deficits on behavioral ratings of executive function (BRIEF), and lower resting state EEG power in the right frontal (F4) region (all p values <.05). Compared to NRs, responders showed significantly increased right frontal EEG power with TNS treatment, which was predictive of improved executive functions and ADHD symptomatology (β = 0.65, p < .001). When EEG findings and behavior were modeled together, the area under the curve (AUC) for BRIEF Working Memory scale was 0.83 (p = .003), indicating moderate prediction of treatment response. CONCLUSION Children with ADHD who have executive dysfunction are more likely to be TNS responders and show modulation of right frontal brain activity, improved/normalized executive functions, and ADHD symptom reduction. CLINICAL TRIAL REGISTRATION INFORMATION Developmental Pilot Study of External Trigeminal Nerve Stimulation for ADHD; http://clinicaltrials.gov; NCT02155608.
Collapse
|
11
|
Gutierrez M, Arán Filippetti V, Lemos V. Executive functioning in pediatric acute lymphoblastic leukemia: CHEXI parent-report vs performance-based assessment. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01524-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
12
|
Gutierrez M, Arán Filippetti V, Lemos V. The Childhood Executive Functioning Inventory (CHEXI) Parent and Teacher Form: Factor Structure and Cognitive Correlates in Spanish-speaking Children from Argentina. Dev Neuropsychol 2021; 46:136-148. [PMID: 33481636 DOI: 10.1080/87565641.2021.1878175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aims of the present study were: (1) to explore the CHEXI factor structure parent (n = 183) and teacher (n = 206) forms in Spanish-speaking children aged 6 to 11 years, (2) to analyze the relationship between parent- and teacher-rated data and performance-based measures of EF (including working memory, inhibition, and cognitive flexibility tasks) and academic achievement and (3) to examine the association between parents and teachers reports. Confirmatory Factor analysis (CFA) showed that the two-factor model including (1) Working memory and (2) Inhibition best fit the data. McDonald's Omega coefficient was adequate for both the total parents (ω = .98). and teachers' (ω = .98) scales. In addition, low and selective associations were found between performance and rater-based assessments. However, stronger associations were observed between CHEXI and academic performance with differences according to the informant (parents vs. teachers). Finally, low correlations were found between parents and teachers reports. Taken together, our results suggest that the CHEXI is a reliable measure to assess EF in Argentinean Spanish-speaking children, supporting existing evidence that proposes that ratings and performance-based measures would assess different underlying mental constructs. Clinical and educational implications for considering both perspectives during neuropsychological assessment, further including parent- and teacher-rated reports are discussed.
Collapse
Affiliation(s)
- Marisel Gutierrez
- Consejo Nacional De Investigaciones Científicas Y Técnicas (CONICET), Buenos Aires, Argentina.,Centro Interdisciplinario De Investigaciones En Ciencias De La Salud Y Del Comportamiento (CIICSAC), Universidad Adventista Del Plata (UAP), Entre Ríos, Argentina.,Facultad De Humanidades, Educación Y Ciencias Sociales, Universidad Adventista Del Plata, Entre Ríos, Argentina
| | - Vanessa Arán Filippetti
- Consejo Nacional De Investigaciones Científicas Y Técnicas (CONICET), Buenos Aires, Argentina.,Centro Interdisciplinario De Investigaciones En Ciencias De La Salud Y Del Comportamiento (CIICSAC), Universidad Adventista Del Plata (UAP), Entre Ríos, Argentina.,Facultad De Humanidades, Educación Y Ciencias Sociales, Universidad Adventista Del Plata, Entre Ríos, Argentina
| | - Viviana Lemos
- Consejo Nacional De Investigaciones Científicas Y Técnicas (CONICET), Buenos Aires, Argentina.,Centro Interdisciplinario De Investigaciones En Ciencias De La Salud Y Del Comportamiento (CIICSAC), Universidad Adventista Del Plata (UAP), Entre Ríos, Argentina.,Facultad De Humanidades, Educación Y Ciencias Sociales, Universidad Adventista Del Plata, Entre Ríos, Argentina
| |
Collapse
|
13
|
McLuckie A, Landers AL, Rowbotham M, Landine J, Schwartz M, Ng D. Are Parent- and Teacher-Reported Executive Function Difficulties Associated With Parenting Stress for Children Diagnosed With ADHD? J Atten Disord 2021; 25:22-32. [PMID: 29482475 DOI: 10.1177/1087054718756196] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine the relationship between parenting stress and parent- and teacher-reported executive function difficulties (EFDs) for childhood ADHD. Method: A secondary analysis using linear regression was conducted on parent- and teacher-completed Behavior Rating Inventory of Executive Function and Parenting Stress Indexes for 5- to 12-year-olds (n = 243) with ADHD. Results: The linear combination of teacher- and parent-reported EFDs accounted for 49% of the variance in child-related parenting stress. Teacher-reported school-based EFDs were relatively inconsequential, having accounted for only 3% of this variance. This stress is best explained by EFDs with emotional control in the school environment and parent-reported EFDs with emotional control, inhibit, monitor, and shift. Conclusion: Parent-reported EFDs, and less so school-based EFDs, are related to parenting stress, but only in regard to EFDs likely underpinning behavioral outbursts and those likely underpinning the daily hassles of providing specialized care to children with ADHD.
Collapse
Affiliation(s)
| | - Ashley L Landers
- Virginia Polytechnic Institute and State University, Falls Church, USA
| | | | - Jeff Landine
- University of New Brunswick, Fredericton, Canada
| | | | - David Ng
- Queens University, Kingston, Ontario, Canada
| |
Collapse
|
14
|
Shum KKM, Zheng Q, Chak GS, Kei KTL, Lam CWC, Lam IKY, Lok CSW, Tang JWY. Dimensional structure of the BRIEF2 and its relations with ADHD symptoms and task performance on executive functions in Chinese children. Child Neuropsychol 2020; 27:165-189. [PMID: 32933354 DOI: 10.1080/09297049.2020.1817355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the dimensional structure of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in a Chinese sample of children with attention-deficit/hyperactivity disorder (ADHD)-related concerns and the correlations of the BRIEF2 with the children's ADHD symptoms and their performance on executive function (EF) tasks. Participants were 339 Chinese children aged 6-15 (M = 9.18 years, SD = 2.33; boys: 78.2%) recruited from 35 schools in Hong Kong. The results from confirmatory factor analyses revealed the best fit for a three-factor nine-scale model compared to a two-factor or single-factor model. Significant correlations were found between the BRIEF2 parent and teacher forms for the Behavioral Regulation Index and Cognitive Regulation Index, but not for the Emotion Regulation Index. Associations between performance on an EF task and the rating of the corresponding subscale on the BRIEF2 purportedly measuring the same EF construct were not consistently observed. Lastly, the BRIEF2 showed good convergent validity with the ratings of ADHD symptoms on the Swanson, Nolan, and Pelham Rating Scale Version IV (SNAP-IV). This study provided plausibly the first evidence on the dimensional structure of the BRIEF2 Parent and Teacher Forms in an Asian sample and confirmed the factorial validity of the Chinese version of the BRIEF2.
Collapse
Affiliation(s)
| | - Que Zheng
- Department of Psychology, The University of Hong Kong , Hong Kong
| | | | | | | | - Iris Kit-Yee Lam
- Department of Psychology, The University of Hong Kong , Hong Kong
| | | | | |
Collapse
|
15
|
Spring-Assisted Strip Craniectomy Versus Cranial Vault Remodeling: Long-Term Psychological, Behavioral, and Executive Function Outcomes. J Craniofac Surg 2020; 31:2101-2105. [DOI: 10.1097/scs.0000000000006806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
16
|
Executive Functioning and Activity in Children: a Multimethod Examination of Working Memory, Inhibition, and Hyperactivity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1143-1153. [PMID: 32557161 DOI: 10.1007/s10802-020-00665-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Two primary methods of quantifying executive functioning include self- or other-reports (i.e., questionnaire-based EF) and cognitive test performance (i.e., task-based EF). Despite their lack of concordance with one another and relatively inconsistent associations with attention-deficit/hyperactivity disorder (ADHD) symptoms, both approaches have been utilized in attempts to advance our understanding of the role of EF in symptoms of ADHD. The current study is the first to incorporate a direct assessment of behavior (i.e., actigraphy) to further clarify the relation between EF and hyperactivity using a multi-method approach in a sample of children with a range of ADHD symptoms. Fifty-two children between the ages of 8 and 12 completed a testing session during which performance on working memory and inhibition computerized tasks, as well as actigraphy data, were collected. Additionally, parent reports of hyperactivity/impulsivity, working memory, and inhibition were obtained. As expected, questionnaire-based measures of working memory and inhibition were strongly associated with parent-reported hyperactivity/impulsivity, whereas only the latter was associated significantly with mechanically assessed movement. In contrast, task-based working memory performance was more strongly associated with parent-reported hyperactivity/impulsivity relative to task-based inhibition. Further, both task-based working memory and task-based inhibition were similarly associated with mechanically-assessed movement. Finally, compared to questionnaire-based EF, both measures of task-based EF accounted for more variance in objectively-assessed movement. Collectively, these results highlight the measurement issues in the present literature, the importance of careful task and questionnaire design, and the value that alternative approaches (e.g., actigraphy) may provide with respect to advancing our understanding of EF.
Collapse
|
17
|
Vaidya CJ, You X, Mostofsky S, Pereira F, Berl MM, Kenworthy L. Data-driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders. J Child Psychol Psychiatry 2020; 61:51-61. [PMID: 31509248 PMCID: PMC6906253 DOI: 10.1111/jcpp.13114] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impairment of executive function (EF), the goal-directed regulation of thoughts, actions, and emotions, drives negative outcomes and is common across neurodevelopmental disorders including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). A primary challenge to its amelioration is heterogeneity in symptom expression within and across disorders. Parsing this heterogeneity is necessary to attain diagnostic precision, a goal of the NIMH Research Domain Criteria Initiative. We aimed to identify transdiagnostic subtypes of EF that span the normal to impaired spectrum and establish their predictive and neurobiological validity. METHODS Community detection was applied to clinical parent-report measures in 8-14-year-old children with and without ADHD and ASD from two independent cohorts (discovery N = 320; replication N = 692) to identify subgroups with distinct behavioral profiles. Support vector machine (SVM) classification was used to predict subgroup membership of unseen cases. Preliminary neurobiological validation was obtained with existing functional magnetic resonance imaging (fMRI) data on a subsample (N = 84) by testing hypotheses about sensitivity of EF subgroups versus DSM categories. RESULTS We observed three transdiagnostic EF subtypes characterized by behavioral profiles that were defined by relative weakness in: (a) flexibility and emotion regulation; (b) inhibition; and (c) working memory, organization, and planning. The same tripartite structure was also present in the typically developing children. SVM trained on the discovery sample and tested on the replication sample classified subgroup membership with 77.0% accuracy. Split-half SVM classification on the combined sample (N = 1,012) yielded 88.9% accuracy (this SVM is available for public use). As hypothesized, frontal-parietal engagement was better distinguished by EF subtype than DSM diagnosis and the subgroup characterized with inflexibility failed to modulate right IPL activation in response to increased executive demands. CONCLUSIONS The observed transdiagnostic subtypes refine current diagnostic nosology and augment clinical decision-making for personalizing treatment of executive dysfunction in children.
Collapse
Affiliation(s)
- Chandan J. Vaidya
- Department of Psychology, Georgetown University, Washington DC 20057,Children’s Research Institute, Children’s National Health System, Washington DC 20010
| | - Xiaozhen You
- Children’s Research Institute, Children’s National Health System, Washington DC 20010
| | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD 21205
| | - Francisco Pereira
- Machine Learning Team, National Institute of Mental Health, Bethesda, MD 20814
| | - Madison M. Berl
- Children’s Research Institute, Children’s National Health System, Washington DC 20010
| | - Lauren Kenworthy
- Children’s Research Institute, Children’s National Health System, Washington DC 20010
| |
Collapse
|
18
|
Schneider H, Ryan M, Mahone EM. Parent versus teacher ratings on the BRIEF-preschool version in children with and without ADHD. Child Neuropsychol 2020; 26:113-128. [PMID: 31094642 PMCID: PMC6858515 DOI: 10.1080/09297049.2019.1617262] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Caregiver rating scales represent an important component of comprehensive child neuropsychological assessments for conditions such as Attention-deficit/Hyperactivity Disorder (ADHD); however, low inter-rater reliability (parent vs. teacher) often complicates interpretation. It has been challenging to identify the factors contributing to inter-rater variability, particularly when parents and teachers complete slightly different versions of the same rating scale. The present study examined the associations between parent- and teacher-reported executive functions in 84 children, ages 4-5 years, with and without symptoms of ADHD, using the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P). Use of the BRIEF-P allows for direct comparison of symptom ratings because parents and teachers complete the exact same measure. Significant associations between raters were observed on 4 of 5 BRIEF-P subscales when rating children with ADHD, but on only 1 subscale when rating typically developing (TD) children. The Shift scale in particular displayed low, non-significant inter-rater association in both groups. Significant group-by-rater interactions were observed for Working Memory and Plan/Organize scales, and driven by larger inter-rater T-score discrepancies in the TD group, such that teachers rated children as having more symptoms than parents. Conversely, examination of raw scores reflected no significant rater differences in the TD group, but significant or nearly significant differences on multiple scales in the ADHD group, such that parents rated more symptoms than teachers. Inter-rater associations for the BRIEF-P appear to vary based on who is being rated (i.e., children with or without ADHD), the specific subscales, and whether standardized or raw scores are analyzed.
Collapse
Affiliation(s)
| | | | - E. Mark Mahone
- Kennedy Krieger Institute, Baltimore, MD;,Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
19
|
Pino Muñoz M, Arán Filippetti V. Confirmatory Factor Analysis of the BRIEF-2 Parent and Teacher Form: Relationship to Performance-Based Measures of Executive Functions and Academic Achievement. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:219-233. [PMID: 31522525 DOI: 10.1080/21622965.2019.1660984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We conducted two empirical studies to (1) explore the dimensionality of the Behavior Rating Inventory of Executive Function-2 (BRIEF-2) parent and teacher forms, (2) examine the association between the parent and teacher reports, and (3) analyze the relationship between the BRIEF-2 ratings and performance-based measures of executive functions (EFs) (including working memory, inhibition, and shifting tasks) and academic achievement in children. In Study 1 (n = 212 parents; n = 111 teachers), confirmatory factor analysis (CFA) showed that a three-factor solution that included the indices of (1) behavior regulation, (2) emotion regulation, and (3) cognitive regulation best fit the data. In Study 2 (n = 275 8- to 12-year-old Spanish-speaking children), selective and low correlations were found between performance- and rater-based measures of EFs. In addition, low to moderate correlations were found between parent and teacher reports. However, the three indices of both forms of the BRIEF-2 were associated with the diverse academic domains analyzed, although differences emerged depending on the informant (teacher vs. parent). Our results support the hypothesis that the two EF measures document different underlying processes. The clinical and educational implications of considering both perspectives in the assessment of EFs in children with typical development and in children with neurodevelopmental disorders are discussed.
Collapse
Affiliation(s)
- Mónica Pino Muñoz
- Escuela de Psicología, Departamento de Ciencias Sociales, Universidad Del Bío Bío, Chillán, Chile
| | - Vanessa Arán Filippetti
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental (CIIPME), Buenos Aires, Argentina. Universidad Adventista del Plata, Facultad de Humanidades, Educación y Ciencias Sociales, Entre Ríos, Argentina
| |
Collapse
|
20
|
Using the Delis–Kaplan Executive Function System Tower Test to Examine ADHD Sensitivity in Children: Expanding Analysis Beyond the Summary Score. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2019. [DOI: 10.1007/s40817-019-00068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
21
|
Davidson F, Rusak B, Chambers C, Corkum P. The Impact of Sleep Restriction on Daytime Functioning in School-Age Children With and Without ADHD: A Narrative Review of the Literature. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2018. [DOI: 10.1177/0829573518770593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this narrative review was to synthesize the existing literature on the impact of sleep on daytime functioning in both typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD). Correlational studies in children suggest that insufficient sleep and impaired daytime functioning are significantly associated; however, this does not address the causal relationships between sleep and daytime functioning. The review results indicated that there is limited experimental sleep manipulation research in children. In the eight studies that employed experimental methods to examine sleep restriction, the consequences of insufficient sleep were greatest for attention and inconsistent for other domains, such as cognition and emotion regulation. Despite the significant co-occurrence of ADHD and sleep problems, the experimental sleep research focused on the daytime impact of shorter sleep in children with ADHD is extremely limited and as such more research is needed.
Collapse
Affiliation(s)
| | | | | | - Penny Corkum
- Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
22
|
Egan KN, Cohen LA, Limbers C. Parent–child agreement on the Behavior Rating Inventory of Executive Functioning (BRIEF) in a community sample of adolescents. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 8:264-271. [DOI: 10.1080/21622965.2018.1438896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kaitlyn N. Egan
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| | - L. Adelyn Cohen
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| | - Christine Limbers
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| |
Collapse
|
23
|
Wittke K, Spaulding TJ. Which Preschool Children With Specific Language Impairment Receive Language Intervention? Lang Speech Hear Serv Sch 2018; 49:59-71. [DOI: 10.1044/2017_lshss-17-0024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/22/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose
Potential biases in service provision for preschool children with specific language impairment (SLI) were explored.
Method
In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with articulation disorders receiving treatment (ARTIC-T) to determine if knowing service provision status influenced the results of Study 1.
Results
In Study 1, the SLI-T group was rated by teachers as having poorer executive functioning than children in the SLIT-NT group, and the SLI-T group also came from families whose mothers had more education. These 2 variables alone predicted SLI-T and SLI-NT group membership with 84% accuracy. In Study 2, the ARTIC-T group were perceived as having comparable executive functioning to the SLI-NT group and better than the SLI-T group, indicating that teachers' knowledge of service provision did not influence their ratings of children's executive functioning.
Discussion
Preschool children with SLI, whose mothers have higher education levels and whose teachers perceive them as having poorer executive functioning, are more likely to receive intervention. Recognizing service delivery biases is critical for improving early provision of intervention for this population.
Collapse
|
24
|
Krieger V, Amador-Campos JA. Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales. Child Neuropsychol 2017; 24:1063-1087. [PMID: 29041835 DOI: 10.1080/09297049.2017.1386781] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to analyze performance on measures of neuropsychological and behavioral executive functions (EF) in adolescents with attention deficit hyperactivity disorder (ADHD), and to evaluate the utility of performance-based tests for predicting scores on behavioral EF ratings. One hundred eighteen adolescents (75 ADHD and 43 controls) aged 12-16 years performed neuropsychological tests and completed a behavior rating scale of EF. The ADHD group presented significantly lower scores than controls on Full Scale IQ (FSIQ) and all indexes of the WISC-IV, except the verbal comprehension index (VCI). The ADHD group had significantly lower scores on performance-based tests of working memory, planning and inhibition, and on EF rating scales. Scores on the cognitive EF working memory, planning and flexibility modestly predicted performance on behavioral EF. The results suggest that the combined use of performance-based tests and rating scales provides valuable complementary information that can improve the assessment of executive domains in ADHD.
Collapse
Affiliation(s)
- Virginia Krieger
- a Department of Clinical Psychology and Psychobiology, Faculty of Psychology , University of Barcelona , Barcelona , Spain
| | - Juan Antonio Amador-Campos
- a Department of Clinical Psychology and Psychobiology, Faculty of Psychology , University of Barcelona , Barcelona , Spain.,b Institute of Neuroscience , University of Barcelona (UBneuro) , Barcelona , Spain
| |
Collapse
|
25
|
The Behavior Rating Inventory of Executive Function (BRIEF) to Identify Pediatric Acute Lymphoblastic Leukemia (ALL) Survivors At Risk for Neurocognitive Impairment. J Pediatr Hematol Oncol 2017; 39:174-178. [PMID: 28085741 PMCID: PMC5364064 DOI: 10.1097/mph.0000000000000761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neurocognitive problems, including executive dysfunction, are potential late effects of pediatric acute lymphoblastic leukemia treatment. Surveillance for neurocognitive impairment in a timely and efficient manner is imperative to ongoing clinical care. We sought to determine if the Behavior Rating Inventory of Executive Function (BRIEF) Parent Form identified leukemia survivors with cognitive impairment. In this 28-site cross-sectional study, parents of 256 children, a mean of 8.9±2.2 years after treatment for standard-risk precursor-B acute lymphoblastic leukemia and in first remission, completed the BRIEF. We used a multivariate logistic regression to calculate the association between elevated scores on 3 composite BRIEF indices (Behavioral Regulation Index, Metacognition Index, Global Executive Composite [GEC]) and special education and attention-deficit/hyperactivity disorder (ADHD) outcomes. All BRIEF index scores were significantly associated with receipt of special education services or ADHD. The BRI was most strongly associated with ADHD (odds ratios=4.33; 95% confidence interval, 1.72-10.9). The GEC was most strongly associated with ADHD (odds ratios=4.46; 95% confidence interval, 1.77-11.22). Elevated scores on the BRIEF GEC were associated with low sensitivity (24.1 to 39.1) for detecting the outcomes but better specificity (range, 87.7 to 89.3). These results suggest that the parent-completed BRIEF is associated with clinical outcomes but is not a sensitive tool to identify leukemia survivors that require a comprehensive neuropsychological assessment.
Collapse
|
26
|
The role of sleep quality and quantity in moderating the effectiveness of medication in the treatment of children with ADHD. ACTA ACUST UNITED AC 2016; 9:31-38. [PMID: 27515452 DOI: 10.1007/s12402-016-0204-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
Abstract
The current study examined: (1) whether long-acting stimulant medication is effective in improving performance on measures of memory, attention, and academic productivity; and (2) whether sleep impacts the relationship between medication and performance. Participants were 21 newly diagnosed, medication-naïve children (mean age = 9.1 years) with ADHD, who participated in a 4-week blinded placebo-controlled randomized trial of long-acting MPH. Participants underwent assessments of sleep (i.e., polysomnography) and of cognitive performance. Long-acting stimulant medication was found to be an effective treatment for enhancing alerting attention, executive attention, working memory, and academic productivity, but resulted in poorer sleep. Moreover, sleep duration was found to impact the treatment response to medication, in that longer sleep duration at baseline was related to improved executive attention. These results underscore the importance of evaluating and monitoring sleep when prescribing stimulant medication as a treatment for ADHD in children.
Collapse
|