Do Parents of Children with ADHD Know the Disease? Results from a Cross-Sectional Survey in Zhejiang, China

Parental ADHD knowledge and medical visit status of school-aged children in Shanghai

INTRODUCTION

The diagnosis and care of children and adolescents with neurodevelopmental disorders presents a public health crisis in China. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent conditions. Many Chinese children and adolescents with ADHD are underdiagnosed and undertreated. This study aimed to evaluate the awareness and attitude parents have about ADHD, and investigated potential factors influencing ADHD medical visit status among school-aged children in Shanghai.

METHODS

A random cluster sampling method was used, and four primary schools in Shanghai were selected. One class was randomly selected from each grade, including students and their parents. Parents completed the Swanson, Nolan, and Pelham Version IV Questionnaire (SNAP-IV) parent form and questionnaire concerning ADHD awareness, knowledge, attitude and status of ADHD medical visit. Descriptive analysis was conducted on the overall results and logistic regression analysis was performed to explore the influencing factors of ADHD medical visit.

RESULTS

We received 617 valid questionnaires. There were 313 boys (50.7%) and 304 girls (49.2%), with a median age of 8 years old (p25 = 7, p75 = 9). 42.4% parents believed they had some knowledge about ADHD, and 73.5% of them thought ADHD was a neurologically based disorder or neurological condition by nature. Parental ADHD information came from the following sources: Internet/TV (n = 458, 74.2%), families/friends (n = 267, 43.2%), print publication (n = 208, 33.7%), psychiatrists/pediatricians (n = 192, 31.1%), schools/teachers (n = 186, 30.1%) and other ADHD patients (n = 48, 7.7%). When children had ADHD-like behaviors, most parents (61.5%) educated children to behave themselves, 59.1% parents tried to get help from psychiatrists/pediatricians, 55.5% of them would ask psychologist for help. In terms of the ADHD prevalence, the SNAP-IV positive screen rate was 4.3% (n = 27). Only 33.3% (9/27) of parents went to the hospital for consultation and treatment. Multivariate logistic regression model showed that parental knowledge about ADHD (OR = 13.67, 95%CI: 1.72, 144.39, P = 0.01) was significantly correlated with the medical visit. Parents with sufficient knowledge of ADHD tend to visit hospital for help when they thought their children had ADHD related symptoms.

CONCLUSIONS

The majority of parents accepted ADHD as a neurodevelopmental disorder by nature, but some parents still had certain misunderstandings about ADHD. The main source of information for parents to obtain information about ADHD was through the TV/Internet. Parents' perceptions and knowledge were key to whether children received appropriate treatment for their ADHD. However, medical visits to address ADHD among school-aged children were still lower than expected. Government and healthcare institutes should work to improve ADHD public awareness and to help patients and their families gain access to mental health resources.

Exploring the Effects of Repetitive Transcranial Magnetic Stimulation on Comorbid Sleep Disorders in Preschool Children with Attention-Deficit Hyperactivity Disorder

Background

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurological developmental disorders in children, and sleep disorders (SDs) are a common comorbidity in children with ADHD. There are currently no pharmacological treatment options for SD in children with ADHD of preschool age (4-6 years). Repetitive transcranial magnetic stimulation (rTMS) is a novel, non-invasive neuromodulation technique. This study explores the effectiveness of rTMS for comorbid SDs in preschool-aged children with ADHD.

Methods

Thirty-five children of preschool age with ADHD and comorbid SDs were recruited for this study. The children were divided into a parent behavior management training (PBMT) group (n = 19) and a repetitive transcranial magnetic stimulation combined with parent behavior management training group (n = 16). Both groups underwent 8 weeks of treatment. The children's SD scores were assessed using the Chinese Children's Sleep Habits Questionnaire, were measured before the start, at the end, and 4 weeks after the end of the intervention, and were used to measure the effects. Within-group differences were compared using a repeated-measures analysis of variance, and between-group differences were compared using an independent samples t-test and Mann-Whitney U-test.

Results

Both the PBMT group and the rTMS combined with the PBMT group significantly improved the SDs of preschool-aged children with ADHD (P < .001), but the effect of the intervention was more pronounced in the rTMS combined with the PBMT group (P < .001) and lasted longer than the PBMT group (P = .004).

Conclusion

Repetitive transcranial magnetic stimulation is a promising non-pharmacological therapy to improve SD in preschool-aged children with ADHD.

A Prospective Study of an Early Prediction Model of Attention Deficit Hyperactivity Disorder Based on Artificial Intelligence

OBJECTIVE

To explore the relationship between the Parent Symptom Questionnaire (PSQ) and attention deficit hyperactivity disorder (ADHD) in China, and the application value of PSQ questionnaire.

METHOD

Two hundred two children aged 3 to 14 years were enrolled in this study. Statistical methods were used to screen characteristic factors and explore the relationship between PSQ items and ADHD. Machine learning algorithms were used to evaluate the clinical application value of PSQ in screening ADHD.

RESULTS

By Mean-Whitney U test, LASSO regression and decision tree, 44, 24 and 12 items were screened out from PSQ with high correlation with ADHD. Then the above items were classified, and the accuracy reached more than 90%. Moreover, the items of ADHD hyperactivity index of PSQ under artificial intelligence algorithm are different from those of PSQ.

CONCLUSION

There are some differences in the items of hyperactivity index between the PSQ and ADHD in China. The artificial intelligence algorithm model of ADHD children based on PSQ scale has a high accuracy.