ADHD inattentive symptoms mediate the relationship between intelligence and academic performance in children aged 6-14

Can children and adolescents with ADHD use attention to maintain verbal information in working memory?

Children and adolescents with attentional-deficit/hyperactivity disorder (ADHD) present deficits in working memory (WM), but accounts for this phenomenon are still lacking. In this study, we used two variations of a complex-span task to test whether a specific WM mechanism, attentional refreshing, causes these deficits. Attentional refreshing is a maintenance strategy based on the sequential switch of attention between maintaining and processing information in WM. Its use is evidenced by a decrease in recall performance proportional to the distraction of attention away from the memoranda. In this study, we designed two experiments requiring children and adolescents with ADHD symptoms to maintain sequences of letters for subsequent recall, while performing a distracting task. In Experiment 1, the distracting task consisted of reading digits aloud. In Experiment 2, it consisted in making spatial judgements. The pace of the distracting tasks was varied to manipulate the level of attentional distraction. We observed that recall in ADHD participants was higher in the distracting conditions that give attention more opportunity to refresh letters. Moreover, ADHD participants had a similar recall performance to their age-matched typically developing peers. This study shows first evidence that individuals with ADHD can use attention to maintain verbal information in WM and calls for more research to understand their WM development.

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

BACKGROUND

The COVID-19 pandemic uprooted regular routines forcing many children to learn from home, requiring many adults to work from home, and cutting families off from support outside the home. Public health restrictions associated with the pandemic caused widespread psychological distress including depression and anxiety, increased fear, panic, and stress. These trends are particularly concerning for families raising neuroatypical children such as those with Attention-Deficit Hyperactivity Disorder (ADHD), as these children are already more likely than their typically developing peers to experience comorbid mental health issues, and to experience greater distress when required to stay indoors. Families with children who have ADHD are also at greater risk for experiencing heightened familial stress due to the challenges associated with managing ADHD behavioural symptoms, greater parental discord and divorce, and greater financial difficulties compared to other families. The current study engaged families comprised of at least one child diagnosed with ADHD to elucidate 1) the unique ways that the COVID-19 pandemic affected their mental health and 2) the specific barriers these families faced to maintaining optimal mental wellbeing.

METHODS AND FINDINGS

A total of 33 participants (15 parent-child dyads) engaged in virtual interviews. Content analysis revealed that the most frequently identified mental health effects for families were increased child anxiety and disconnectedness, as well as deteriorating parental mental health. The most frequently identified barriers to maintaining optimal mental wellbeing were lack of routine, lack of social interaction and social supports, and uncertainty and fear.

CONCLUSIONS

Findings underscore areas of need during times of large-scale social isolation, specifically for families with children who have ADHD. This work contributes to a growing body of research aimed at creating safeguards to support mental wellbeing for vulnerable families during times of crisis.

Desempenho em Aritmética de Estudantes com e sem Sintomas de TDAH

Resumo O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) é um transtorno que frequentemente acarreta prejuízos ao desempenho acadêmico. O presente estudo teve como objetivo verificar a extensão desses prejuízos no desempenho aritmético, comparando estudantes com sintomas de TDAH com o de seus pares sem TDAH. O desempenho aritmético de 93 estudantes com sintomas de TDAH e 447 estudantes sem TDAH, entre 7 e 16 anos, de escolas públicas de Porto Alegre (3º a 9º ano), foi avaliado pelo Subteste de Aritmética do TDE. Estudantes com sintomas de TDAH apresentaram escores mais baixos e uma quantidade maior de erros de procedimento do que os estudantes sem o transtorno. Os resultados sugerem que sintomas frequentes de TDAH têm relação com maior ocorrência de erros no desempenho em aritmética dos estudantes avaliados neste estudo.

Association between attention, nonverbal intelligence and school performance of school-age children with Autism Spectrum Disorder from a public health context in Brazil

BACKGROUND

Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction, restricted and repetitive behaviour, interests or activities. Difficulties in a broad spectrum of cognitive skills is often present, including attentional processes and nonverbal intelligence, which might be related to academic difficulties.

AIMS

In this study, the association between attentional skills and nonverbal intelligence to school performance of children with ASD was assessed.

METHODS AND PROCEDURES

32 children/adolescents between 8-14 years old, who attended a treatment unit linked to the public health system of São Paulo-Brazil participated in the study. The following instruments were utilized: Cancellation Attention Test; Raven's Coloured Progressive Matrices; and School Performance Test.

OUTCOMES AND RESULTS

After correlation analysis, statistically significant associations were found between attention and nonverbal intelligence with school performance. Regression analysis showed that attention drives school performance irrespective of nonverbal intelligence.

CONCLUSIONS AND IMPLICATIONS

Results evidence the link between attention and school performance in ASD, suggesting that attentional mechanisms may be a promising route to follow in the design of interventions for school improvement of children and adolescents with ASD.

Health-related quality of life in mothers of children with attention deficit hyperactivity disorder in Taiwan: The roles of child, parent, and family characteristics

BACKGROUND

No study has examined how child and maternal psychopathological difficulties and family factors contribute to the health-related quality of life (HRQOL) of mothers of children with attention deficit hyperactivity (ADHD).

AIMS

To investigate the impact of children's diagnosis of ADHD, children's and maternal psychopathology and significant sociodemographic variables of the children, parents and family on HRQOL of mothers of children with ADHD and those of children with typical development (TD) in Taiwan.

METHODS AND PROCEDURES

Children with ADHD (n = 257) and children with typical development (n = 324) and their mothers were recruited from a psychiatric clinic of a medical center and 10 elementary schools and four high schools in northern Taiwan. Maternal HRQOL was assessed with the World Health Organization Quality of Life - BREF, while the other factors were screened using the Chinese version of the Childhood Autism Spectrum Test for autistic traits, the Swanson, Nolan, and Pelham, version IV scale for ADHD symptoms, the Child Behavior Checklist for behavioral and emotional problems, The Center for Epidemiologic Studies Depression Scale for maternal depression and interpersonal problems, the Adult ADHD Self-report Scale for maternal ADHD symptoms, and the Family APGAR for family support.

OUTCOMES AND RESULTS

Mothers of children with ADHD had significantly worse HRQOL in all four domains compared with those of children with typical development. Multiple regressions found that factors consistently related to the HRQOL of mothers of children with ADHD and those of children with TD were maternal depression and perceived family support after controlling for several familial, parental and child variables. HRQOL of mothers of children with ADHD and those of children with TD was more closely related to her own and family factors rather than mother- or teacher-rated ADHD symptoms, clinical diagnosis of ADHD or psychopathology of the child.

CONCLUSIONS AND IMPLICATIONS

Screening for maternal HRQOL, depressive symptoms and family support systems and mental health services for mothers of children with ADHD are warranted based on these findings.

Early Attentional Modulation by Working Memory Training in Young Adult ADHD Patients during a Risky Decision-Making Task

Background: Working memory (WM) deficits and impaired decision making are among the characteristic symptoms of patients affected by attention deficit/hyperactivity disorder (ADHD). The inattention associated with the disorder is likely to be due to functional deficits of the neural networks inhibiting irrelevant sensory input. In the presence of unnecessary information, a good decisional process is impaired and ADHD patients tend to take risky decisions. This study is aimed to test the hypothesis that the level of difficulty of a WM training (WMT) is affecting the top-down modulation of the attentional processes in a probabilistic gambling task. Methods: Event-related potentials (ERP) triggered by the choice of the amount wagered in the gambling task were recorded, before and after WMT with a the dual n-back task, in young ADHD adults and matched controls. For each group of participants, randomly assigned individuals were requested to perform WMT with a fixed baseline level of difficulty. The remaining participants were trained with a performance-dependent adaptive n-level of difficulty. Results: We compared the ERP recordings before and after 20 days of WMT in each subgroup. The analysis was focused on the time windows with at least three recording sites showing differences before and after training, after Bonferroni correction ( p < 0.05 ). In ADHD, the P1 wave component was selectively affected at frontal sites and its shape was recovered close to controls' only after adaptive training. In controls, the strongest contrast was observed at parietal level with a left hemispheric dominance at latencies near 900 ms, more after baseline than after adaptive training. Conclusion: Partial restoration of early selective attentional processes in ADHD patients might occur after WMT with a high cognitive load. Modified frontal sites' activities might constitute a neural marker of this effect in a gambling task. In controls, conversely, an increase in late parietal negativity might rather be a marker of an increase in transfer effects to fluid intelligence.

Parent SNAP-IV rating of attention-deficit/hyperactivity disorder: accuracy in a clinical sample of ADHD, validity, and reliability in a Brazilian sample

OBJECTIVE

To investigate the psychometric properties of the short or multimodal treatment study version of the Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scale, which measures attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms.

METHODS

Participants were 765 parents of children from 4 to 16 years old (641 non-attention-deficit/hyperactivity disorder and 124 attention-deficit/hyperactivity disorder children) from Belo Horizonte, Brazil, who reported sociodemographic characteristics and answered the SNAP-IV. Parents of the clinical sample also underwent the K-SADS-PL interview.

RESULTS

Age was significantly associated with SNAP-IV hyperactivity-impulsivity problems (r=-0.14), but not with inattention or oppositional defiant disorder. Sex was a significant influence on attention-deficit/hyperactivity disorder and oppositional defiant disorder severity (all p<0.001), with boys showing higher scores in the full sample, but not within the attention-deficit/hyperactivity disorder group. Exploratory and confirmatory factor analysis supports a three-factor structure of the SNAP-IV scale. Moderate-to-strong correlations were found between SNAP-IV and K-SADS-PL measures. All SNAP-IV scales showed very high internal consistency coefficients (all above 0.91). SNAP-IV inattention scores were the most predictive of attention-deficit/hyperactivity disorder diagnosis (AUC: 0.877 for the averaging rating method and the raw sum method, and 0.874 for the symptom presence/absence method).

CONCLUSION

The parent SNAP-IV showed good psychometric properties in a Brazilian school and clinical sample.

Comparability of an ADHD Latent Trait Between Groups: Disentangling True Between-Group Differences From Measurement Problems

OBJECTIVE

The aim of this study is to investigate measurement invariance (MI) for an ADHD latent trait across different sociodemographic groups (sex, age, and maternal education), IQs, and co-occurring psychiatric diagnoses.

METHOD

Participants were 2,299 children aged 6 to 14 years. ADHD symptoms were assessed by parent report using the Development and Well-Being Assessment (DAWBA). MI was tested through multigroup confirmatory factor analysis and multiple indicators multiple causes models.

RESULTS

In a bifactor model including a general ADHD factor and three specific factors (hyperactivity, inattention, and impulsivity), invariance properties were demonstrated and no individual items showed differential functioning. The ADHD general factor was higher in boys and in those with psychiatric disorders. Younger age predicted hyperactivity. Lower IQ and higher level of education of the mother predicted inattention.

CONCLUSION

The ADHD trait, as measured by the DAWBA, functions in the same way, and with equivalent scale, revealing true differences in ADHD symptoms based on those.

Intelligenzdiagnostik bei Kindern und Jugendlichen mit ADHS

Zusammenfassung. Mit seiner neuartigen Indexstruktur bietet die Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V; Wechsler, 2014 , 2017 ) eine differenzierte Messung kognitiver Fähigkeiten. Es wurden die Leistungen von Kindern und Jugendlichen mit ADHS (n = 103) in der WISC-V mit einer parallelisierten Kontrollgruppe verglichen. Zusätzlich zur Analyse der Leistungen auf signifikante Gruppenunterschiede wurden für alle fünf Indexwerte, den Gesamt-IQ sowie die entsprechenden Untertests Effektgrößen bestimmt und miteinander verglichen. Für die Kinder mit ADHS zeigten sich auf allen fünf Indizes und dem Gesamt-IQ signifikant niedrigere Leistungen, wobei die größten Effekte in den Bereichen Arbeitsgedächtnis, Fluides Schlussfolgern und Gesamt-IQ gefunden wurden. Spezifische Minderleistungen bei ADHS ließen sich auch auf Untertestebene identifizieren. Die Ergebnisse der vorliegenden Studie bestätigen, dass die WISC-V als valides und sensibles Instrument zur Erfassung kognitiver Defizite bei Kindern mit Aufmerksamkeitsstörungen angesehen werden kann. In der klinischen Praxis kann die WISC-V-Profilanalyse wichtige Informationen zu einer vorab diagnostizierten ADHS liefern.

Relações entre saúde mental e falhas cognitivas no dia a dia: papel dos sintomas internalizantes e externalizantes

RESUMO Objetivo Falhas cognitivas são erros cometidos no dia a dia como perda de compromissos, falta de palavras ao conversar, dificuldades de memorizar o que é lido, erros de orientação, entre outros. Sintomas psiquiátricos internalizantes e externalizantes podem contribuir para a ocorrência de falhas cognitivas. O presente estudo objetiva avaliar como sintomas internalizantes e externalizantes contribuem para a ocorrência de falhas cognitivas no dia a dia. Métodos Foram avaliados 366 voluntários utilizando o Questionário de Falhas Cognitivas (CFQ) e as escalas Self-Reporting Questionnaire-20 (SRQ-20), como medida de sintomas internalizantes, e Adult Self-Report Scale (ASRS-18), como medida de sintomas externalizantes. Os participantes foram classificados com base nos pontos de corte da SRQ-20 e ASRS-18 para a criação de quatro grupos: hígido, internalizante, externalizante e misto. Comparamos os grupos por meio de ANOVA e testamos a associação das variáveis estudadas por meio de correlações. Resultados Todas as escalas apresentaram correlações fortes entre si (r > 0,500, p < 0,001). A comparação dos grupos sugere que participantes com escores clínicos de sintomas internalizantes e externalizantes apresentam mais falhas quando comparados ao grupo hígido (d = 0,86 e d = 1,00), mas não apresentam diferenças entre si (d = 0,21). Participantes do grupo misto apresentaram mais falhas que o grupo hígido (d = 2,01), internalizante (d = 1,31) e externalizante (d = 1,05). Conclusão Tanto sintomas internalizantes quanto externalizantes contribuem para a ocorrência de falhas cognitivas no dia a dia. Observamos ainda um efeito aditivo de ambos os sintomas.

Multiple Intelligences Profiles of Children with Attention Deficit and Hyperactivity Disorder in Comparison with Nonattention Deficit and Hyperactivity Disorder

BACKGROUND

Attention deficit and hyperactivity disorder (ADHD) is a common psychological problem during childhood. This study aimed to evaluate multiple intelligences profiles of children with ADHD in comparison with non-ADHD.

MATERIALS AND METHODS

This cross-sectional descriptive analytical study was done on 50 children of 6-13 years old in two groups of with and without ADHD. Children with ADHD were referred to Clinics of Child and Adolescent Psychiatry, Isfahan University of Medical Sciences, in 2014. Samples were selected based on clinical interview (based on Diagnostic and Statistical Manual of Mental Disorders IV and parent-teacher strengths and difficulties questionnaire), which was done by psychiatrist and psychologist. Raven intelligence quotient (IQ) test was used, and the findings were compared to the results of multiple intelligences test. Data analysis was done using a multivariate analysis of covariance using SPSS20 software.

RESULTS

Comparing the profiles of multiple intelligence among two groups, there are more kinds of multiple intelligences in control group than ADHD group, a difference which has been more significant in logical, interpersonal, and intrapersonal intelligence (P < 0.05). There was no significant difference with the other kinds of multiple intelligences in two groups (P > 0.05). The IQ average score in the control group and ADHD group was 102.42 ± 16.26 and 96.72 ± 16.06, respectively, that reveals the negative effect of ADHD on IQ average value. There was an insignificance relationship between linguistic and naturalist intelligence (P > 0.05). However, in other kinds of multiple intelligences, direct and significant relationships were observed (P < 0.05).

CONCLUSIONS

Since the levels of IQ (Raven test) and MI in control group were more significant than ADHD group, ADHD is likely to be associated with logical-mathematical, interpersonal, and intrapersonal profiles.

Does mindfulness meditation improve attention in attention deficit hyperactivity disorder?

Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function.