Beneficial Effects of Behavioral Parent Training on Inhibitory Control in Children With Attention-Deficit/Hyperactivity Disorder: A Small-Scale Randomized Controlled Trial

Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions

INTRODUCTION

Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear.

METHODS

We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD.

RESULTS

Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions.

CONCLUSION

A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.

Behavioral Parent Training for School-Aged Children With ADHD: A Systematic Review of Randomized Control Trials

BACKGROUND

All guidelines for the treatment of ADHD in children include behavioral parent training in combination with other strategies. In the past, several systematic reviews have been carried out that were either outdated or not sufficiently specific to ADHD. We wanted to conduct a new review focusing on a specific ADHD population of school age (4-12 years) and on behavioral and cognitive programs. We aimed to test our hypothesis that behavioral parent training would improve parents' difficulties, children's symptomatology, and the quality of life of families with ADHD.

METHODS

PUBMED, PsychInfo, Web of Science, ERIC, and Cochrane databases were searched for original articles on randomized control trials on behavioral parent training group for children with ADHD aged from 4 to 12 years until July 2023.

RESULTS

A total of 20 studies were included in the systematic review. The results were divided into four categories: parent data, child data collected by parents, teachers, or researchers. A qualitative analysis revealed for parents, effects on parental stress, feelings of parental efficacy, and negative parental educational behavior. As regard children, only effects are noted for parental assessment, on ADHD symptomatology, externalized disorders, and social skills.

CONCLUSION

Despite the heterogeneity or small number of studies in some categories, BPTs have positive effects on both parents and children. There are no convincing results to support the generalization of progress. This would seem to indicate that it remains essential to consider actions specific to each problematic environment for the child.

Child ViReal Support Program: A Randomized Controlled Trial Study for Effective Support of Parents Raising Children with Attention Deficits

Attention deficit hyperactivity disorder (ADHD) results in various functioning impairments in children's lives and families. Parents of children with ADHD report high levels of parenting stress, low levels of parental self-efficacy, and use of more authoritarian and/or permissive parenting practices than parents of typically developing children. Intervention programs need to address both children's and parents' needs and multimodal intervention programs could cover this demand. The aim of this study was to examine the efficacy of "Child ViReal Support Program"-a multi-level evidence-based comprehensive program-on parenting stress, parental self-efficacy, parenting practices, and the core symptoms of children's ADHD. Families with a child diagnosed with ADHD (n = 16) were randomly allocated to two groups (PC and CP; P = parent training, C = child training), and a cross-over design was utilized. Participating parents completed, in four different times during the study, the Parenting Stress Index-Short Form, the Parenting Sense of Competence Scale, the Parenting Styles and Dimensions Questionnaire-Short Version, and the parent form of the ADHD Rating Scale-IV. Parents from both groups, after their participation in the parent training, demonstrated reduced parenting stress, enhanced parental self-efficacy, and increased the employ of democratic parenting practices. More than that, they reported decreased levels of inattention and impulsivity/hyperactivity for their children. Evidence-based multi-level intervention programs could produce positive effects on parents and children by incorporating effective methods and tools in accordance with the needs and the demands of the family context.

1H NMR Metabolomics and Lipidomics To Monitor Positive Responses in Children with Autism Spectrum Disorder Following a Guided Parental Intervention: A Pilot Study

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that is characterized by patients displaying at least two out of the classical symptoms, such as impaired social communication, impaired interactions, and restricted repetitive behavior. Early parent-mediated interventions, such as video modeling for parental training, were demonstrated to be a successful low-cost way to deliver care for children with ASD. Nuclear magnetic resonance (NMR)-based metabolomics/lipidomics has been successfully employed in several mental disorder studies. Metabolomics and lipidomics of 37 ASD patients (children, aged 3-8 years), who were divided into two groups, one control group with no parental-training intervention (N = 18) and the other in which the parents were trained by a video modeling intervention (ASD parental training, N = 19), were analyzed by proton NMR spectroscopy. Patients in the ASD parental-training group sera were seen to have increased glucose, myo-inositol, malonate, proline, phenylalanine, and gangliosides in their blood serum, while cholesterol, choline, and lipids were decreased, compared to the control group, who received no parental-training. Taken together, we demonstrated here significant changes in serum metabolites and lipids in ASD children, previously demonstrated to show clinical positive effects following a parental training intervention based on video modeling, delivered over 22 weeks. We demonstrate the value of applying metabolomics and lipidomics to identify potential biomarkers for clinical interventions follow-up in ASD.

Environmental pollution and attention deficit hyperactivity disorder: A meta-analysis of cohort studies

There is already knowledge of the extensive risk factors for attention deficit hyperactivity disorder (ADHD) and recent studies suggest that environmental pollution may contribute to an increase in the incidence of the disorder. The aim of our study was to perform a systematic review and meta-analysis of the risk of ADHD in people younger than 18 years old after exposure to environmental pollution. We searched the MEDLINE, Embase, SciELO, CINAHL, LILACS, Cochrane Central, and Web of Science databases and investigated the grey literature from inception until May 31, 2021. All cohort studies that provided data on exposure to environmental pollutants and ADHD in children and adolescents aged from zero to 18 years old were included. Two reviewers independently selected the studies and applied the quality criteria. If there was a divergence, a third reviewer contributed to the final decision. For the meta-analysis, risk ratios and their confidence intervals were calculated with the MetaXL 5.3 program, using the random effects model. In total, 21 articles were included in this systematic review, and 18 studies met the criteria for the meta-analysis, involving 134,619 participants. The meta-analysis suggested that children exposed to higher levels of heavy metal (RR: 2.41, 95% CI: 1.49-3.90), with low heterogeneity (I² = 39%), and lead (RR: 2.37, 95% CI: 1.28-4.40), with moderate heterogeneity (I² = 54%), are at greater risk of developing ADHD than those exposed to lower levels. This meta-analysis suggests that children exposed to higher levels of lead and heavy metal pollution are at greater risk of developing ADHD than those exposed to lower levels.