Associations Between Family Environment, Parenting Practices, and Executive Functioning of Children with and Without ADHD

We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported their children as exhibiting greater problems with behavioral control and metacognitive abilities, and described their family environments as less organized and higher in family conflict. Family environment and parenting practices were not correlated with behavioral control or metacognitive abilities in children with ADHD. In children without ADHD, higher levels of family cohesion, organization, and expressiveness, and lower levels of family conflict, were significantly correlated with greater behavioral control. Higher levels of family cohesion and organization were significantly and positively associated with regulation of metacognitive abilities in children without ADHD. In general, aspects of the family environment and parental limit setting appear to be associated with the development of executive functions in children not diagnosed with ADHD; however, family environment and parenting practices were not associated with executive functions in children diagnosed with ADHD.     

Talk About School Between Mothers and Children With or Without ADHD

Twenty mother-child dyads including a child with Attention Deficit Hyperactivity Disorder (ADHD) and 20 mother-child dyads containing a child without ADHD recorded a conversation about the children's school experiences. Mothers' ratings of their children's school-related performance were also assessed. Mothers of children with ADHD rated their children's behavioral conduct lower than did other mothers, and dyads including children with ADHD discussed behavioral conduct more and academics and interpersonal relationships less than did the other group of dyads. For ADHD dyads, less elaboration about children's interpersonal relationships was related to lower maternal ratings about children's school-related performance. The results are discussed in relation to potentially poorer developmental outcomes for many children with ADHD.     

ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents

Patterns of correlates, comorbidity and impairment associated with attention-deficit hyperactivity disorder (ADHD) in children and youth were examined in representative samples from the community and from treatment facilities serving medically indigent youth in Puerto Rico. Information from caretakers and youths was obtained using the Diagnostic Interview Schedule for Children, (version IV), measures of global impairment, and a battery of potential correlates. In the community (N = 1,896) and the treated samples (N = 763), 7.5 and 26.2% of the children, respectively, met criteria for DSM-IV ADHD in the previous year. Although the prevalence rates and degree of impairment differed, the general patterns of correlates, comorbidity and impairment were similar in both populations. The exceptions were associated with conduct disorder, anxiety, impairment in the ADHD comorbid group, and age factors that appeared to be related to selection into treatment.     

不同亚型ADHD儿童的视通道时距估计能力

本研究选取ADHD混合型儿童11名,ADHD注意缺损型儿童13名以及正常儿童15名,通过"平均估计长度"、"平均估计误差百分比"、"估计变异值"三个指标,考察不同亚型ADHD儿童在时距复制和言语估计上的稳定性和精确性。研究发现,在视觉刺激条件下,ADHD儿童的时距估计缺损并不受时距长度的影响;ADHD混合型儿童在多项任务中所表现的稳定性和精确性都差,而ADHD缺损型儿童只是稳定性差,说明ADHD混合型是ADHD中更严重的亚类型;ADHD儿童在时距估计任务中稳定性差,反映了其状态调节能力的落后。     

Family Microtransitions: Observing the Process of Change in Families with Adolescent Children

To read this article in Spanish, please see this article's Supporting Information on Wiley InterScience (http://interscience.wiley.com/journal/famp). To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ). The aim of the study is to explore the process of microtransitions in families with adolescent children. Original methodological procedures were designed in order to have families as the objects of study and to analyze data with particular attention to the family process of change. A family interview focused on the adolescent and family change was conducted with 12 families having an adolescent child. As indicators of change, we used coordination and oscillation. Our results highlight different patterns of family interactions, illustrating various ways through which families deal with change. Conclusive remarks focus on the theoretical relevance of the study, the method and the implications for family practice and policy.     

Story Comprehension in Children with ADHD

A wealth of research is available examining children's story comprehension. However, little attention has been directed toward understanding the story comprehension of children with attention deficit hyperactivity disorder (ADHD). The present paper attempts to integrate the developmental literature on children's story comprehension with the little that is known about the story comprehension processes of children with ADHD. This review is guided by a network model of story representation that emphasizes the structure of causal and enabling relations between story events. Examination of the available studies indicates that children with ADHD lag behind their peers in their understanding of causal relations, and that their attentional problems may contribute to difficulties in understanding factual information in the preschool years and causally related information in the elementary years. Some evidence also is presented suggesting that children with ADHD are less effective in taking advantage of story structure features in guiding their recall of story events. Suggestions for future research are offered that would elaborate our knowledge of the developmental progression in the processing of complex information by children with ADHD.     

7-10岁学龄儿童ADHD筛查研究

用SDQ（家长版）对上海10所小学二至四年级学生进行测查,以探求被试的ADHD症状表现,锁定ADHD高风险儿童。结果：（1）男生ADHD得分偏高（p<.01）,但女生在红橙两个级别内的百分数均高于男生;（2）9岁被试的ADHD得分分布最分散,占男生ADHD红色级别的比例最大,在女生ADHD得分中均值最大;（3）红橙两个级别为高风险级别。结论：（1）9岁是ADHD症状表现最严重的年龄;（2）女生具有更高的ADHD风险;（3）ADHD高风险被试晒出率：男生14.4%,女生17.4%。     

Methodological Issues in the Assessment of Medication Effects in Children Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders in school-aged children and is usually treated with stimulant medications, including methylphenidate (MPH; Ritalin®, Ritalin-LA®, Concerta®, Metadate®, or Focalin®) and other drug compounds (e.g., Adderall®, Adderall-XR®, or Dexedrine). Assessment of school behavior and performance is a critical component in determining the safety and efficacy of these medications. This paper reviews methodological issues in assessing drug effects in school settings by considering features of the independent variable (the medication), the dependent variables (the endpoints selected for assessment), and the design (the structure of the assessment). In addition, we consider recent conceptual advances in understanding the behavioral mechanisms of action of drugs used to treat ADHD that may influence the structure and interpretation of medication assessments.     

Understanding Triadic and Family Group Interactions During Infancy and Toddlerhood

This paper outlines recent conceptual and methodological developments in the assessment of triadic and family group process during infancy and toddlerhood. Foundations of the emerging family group process are identified, and conditions specific to the assessment of the family during the early phases of family formation are summarized. Both microanalytic and global approaches to evaluating mother–father–child interactions are discussed. We highlight both similarities and differences in the strategies and methods employed by several different investigators who have been studying the group dynamics of families with infant and toddler children, and underscore several important family patterns and emerging themes that appear to be cutting across these different methods and measurement strategies. Preliminary evidence for the validity and clinical significance of family-level assessments is summarized, and directions currently being pursued by researchers engaged in studies of the family triad are outlined. We close by identifying several conceptual and clinical issues that remain to be addressed by subsequent work.     

Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

To scale up evidence-based treatment of conduct problems, parent management training, Oregon model (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groups with and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined group's behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems.     

The Relationship Between Sluggish Cognitive Tempo and Impairment in Children With and Without ADHD

This study examined impairment in multiple domains of functioning in children with and without ADHD who present with high or low levels of sluggish cognitive tempo (SCT) while taking into account the total symptom ratings of ADHD. Participants were 584 children in kindergarten through eighth grade (55.7 % male, 91.7 % Caucasian), drawn from five archival datasets. Two, 2 (SCT groups: high and low) x 3 (ADHD Status: ADHD-I, ADHD-C, and non-ADHD) MANCOVAs were conducted with the total ADHD symptom ratings and child age as covariates. One MANCOVA was conducted on scores on the teacher Impairment Rating Scale (IRS; Fabiano et al. Journal of Clinical Child and Adolescent Psychology 35:369–385, 2006) and the other on the 6 scores on the parent IRS. The results indicated that the presence of SCT symptoms was associated with greater functional impairment at home according to parent report while it was associated with less functional impairment at school according to teacher report. Thus, the relationship between SCT symptoms and impairment differs depending on the informant and the context in which impairment is evaluated.     

Assessing Stress in Families of Children with ADHD: Preliminary Development of the Disruptive Behavior Stress Inventory (DBSI)

This paper describes the initial development of the Disruptive Behavior Stress Inventory (DBSI). This 40-item measure, which provides indices of the number of stressors experienced during the past 6 months and the rated stressfulness of these events, is designed to assess behavior-related family stress experienced by families of children with attention-deficit/hyperactivity disorder (ADHD). Findings provide strong support for the internal consistency of the DBSI and suggest adequate test-retest reliability. Support for the validity of the measure is suggested by findings that DBSI stress indices differentiate between parents of children with ADHD and those with no history of this disorder. Additional support is provided by findings that scores on the DBSI also differentiate between parents of children with ADHD, combined type and parents of children with ADHD, inattentive type. It is suggested that this measure may provide useful clinical information regarding stress levels in families of children with ADHD and that it may be of potential value as an ADHD treatment outcome measure.     

Heart Rate Variability and Sustained Attention in ADHD Children

The major goal of the current study was to investigate the association between continuous performance tests (CPTs) and the heart rate variability (HRV) of attention deficit hyperactivity disorder (ADHD) children. The HRV, specifically the 0.10-Hz component, may be considered to be a psychophysiological index of effort allocation (motivation): The less effort the subject allocates, the greater the 0.10-Hz component. Results indicated that, compared to controls, ADHD subjects had a greater 0.10-Hz component, which was associated with poor test performance over time. Thus, using a psychophysiological measure, we were able to confirm the clinical concept of ADHD from a motivational perspective.     

Children with ADHD in Residential Care

Little is known about the characteristics or functioning of children with ADHD in residential care as compared to their non-ADHD peers. This study evaluated data on 538 children with (n = 125) and without (n = 413) ADHD in residential care to determine demographic, mental health, behavioral, and treatment (i.e., medication use) characteristics. Results revealed that both groups presented elevated risks, however, scores for children with ADHD indicated even greater levels of need. Specifically, differences were found between the two groups on demographics (e.g., family reunification status, restrictiveness of prior out-of-home placements), behavior (e.g., attention problems, rule-breaking and aggressive behaviors) and medication status. Findings suggest there is a need for aftercare services to help support families as children transition from care, interventions to address behavior, and medication management through assessment and monitoring.     

RD,ADHD, and their comorbidity from a dual route perspective

In order to achieve further insight into the comorbidity of reading disorder (RD) and attention deficit/hyperactivity disorder (ADHD), lexical processing and rapid naming were studied in RD and ADHD. The Dual Route Cascaded model postulates that lexical processing contains two parallel processes: lexical route processing and sublexical route processing. An orthographic decision task and a phonological decision task were used to measure lexical and sublexical route processing, respectively. In addition, a rapid naming task was used to compare 27 children with RD, 18 children with ADHD, 20 children with ADHD+RD, and 29 controls. RD and ADHD shared impairments in accuracy of orthographic and phonological decision making as well as in rapid naming, which suggest that RD and ADHD may be overlapping disorders that share deficits in both lexical route and sublexical route processing. RD was dissociated from ADHD by being slower in both orthographical and phonological decision making that indicates unique deficits in RD on lexical and sublexical speed.     

Family Correlates of Oppositional and Conduct Disorders in Children With Attention Deficit/Hyperactivity Disorder

Comorbidities among children with ADHD are key determinants of treatment response, course, and outcome. This study sought to separate family factors (parental psychopathology and parenting practices) associated with comorbid Oppositional Defiant Disorder (ODD) from those associated with Conduct Disorder (CD) among children with Attention Deficit/Hyperactivity Disorder. Clinic-referred families (n = 149) were diagnosed using DSM-IV criteria. Parents completed measures of parenting practices. Comorbid ODD and CD were significantly associated with maternal negative/ineffective discipline. Comorbid CD, but not ODD, was significantly associated with lack of maternal warmth and involvement, paternal negative/ineffective discipline, and with paternal Antisocial Personality Disorder (APD). However, the risk of CD posed by parenting appeared concentrated among children without a father having APD. While consistent discipline appears important for addressing comorbid ODD and CD, paternal psychopathology and the quality of the relationship between mother and child may pose risk specifically for comorbid CD. Efforts to prevent and/or treat CD should consider not only provision of structure and prudent discipline, but also the affective qualities of the relationship between the primary caretaker and child.     

激活水平对两亚型ADHD儿童反应执行与抑制能力的影响

研究选取了混合型ADHD儿童14名,注意缺陷型ADHD儿童16名以及正常儿童18名,考察了在不同激活水平下,两亚型ADHD儿童之间,及其与正常儿童之间的反应执行能力与抑制能力的异同。采用传统的go/no-go任务,并将刺激间的时间间隔设置为1秒、4秒、8秒三种条件,分别对应高、中、低三种激活水平。结果发现,(1)与正常儿童相比,ADHD儿童的反应执行能力更容易受到激活水平的影响,且两亚型ADHD儿童受到的影响模式基本一致。具体而言:在高激活水平下,ADHD儿童与正常儿童差异最小;在中、低激活水平下,ADHD儿童与正常儿童差异增大,表明ADHD儿童状态调节能力落后。(2)两亚型ADHD儿童的功能缺损模式不同,混合型儿童在状态调节和反应抑制两方面都存在缺损,且其反应抑制缺陷不受激活水平影响;注意缺陷型儿童仅在状态调节方面受损。     

Informing Evidence-Based Assessment of ADHD in Veterans and Service Members

Attention-deficit/hyperactivity disorder (ADHD) is diagnosed in approximately 2.5% to 5% of the population, and though epidemiological studies of ADHD in veterans and service members are lacking, available evidence suggests that there may be a higher prevalence of ADHD in service members than in the general population. Assessment of ADHD in military populations is complicated by the higher prevalence rates of many other disorders with symptoms that overlap those of ADHD (e.g., posttraumatic stress disorder), making differential diagnosis an important aspect of the evaluation of ADHD. Although the diagnostic interview remains the gold standard for the evaluation and diagnosis of ADHD with adults, several different types of psychological measures have been developed and validated that can aid the evaluation. Future epidemiological research focused on prevalence and comorbidity rates in military samples is warranted to better understand the scope and complexity of the diagnosis. In addition, continued study of diagnostic assessment techniques, including validity testing and neurocognitive performance of veterans and service members with ADHD, particularly postdeployed veterans pursuing higher education, is warranted. This article reviews relevant findings and identifies initial recommendations for clinicians and researchers.