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INTRODUCTION: Assessing childhood anxiety is complicated by differences between informants, particularly parents and children. We examined factors associated with mother- and child-report, to understand how children identified by each might differ. METHOD: Eighty-five children with anxiety disorders diagnosed by semi-structured interview, and 45 children without such disorders and their mothers completed a standardized anxiety questionnaire. Predictors of questionnaire scores by mother- and child-report were examined, and a comparison of children high- and low- on self- report was done. RESULTS: Child anxiety self-reports were best predicted by depressive symptoms, maternal psychopathology (self-report), and a support-seeking coping style (adjusted R(2) = .299). Maternal reports were best predicted by child functioning (clinician-rated) and maternal psychopathology (self-report) (adjusted R(2) = .305). Children high on self-report showed higher depressive symptoms (p = .001) and reported higher use of avoidant (p < .05) and support-seeking (p < .01) coping strategies than low self-reporters. Diagnosis was more significantly linked to maternal- than child-report (chi-square = 49.99, p <.001 for mother; 4.27, p<.05 for child). CONCLUSION: Depressive symptoms and coping style appear to predict children's self-reported anxiety, but clinicians may place greater emphasis on maternal report in assigning diagnoses, potentially missing some children with significant anxiety. [ABSTRACT FROM AUTHOR]

With increasing interest in studies evaluating treatment outcome in children with attention deficit hyperactivity disorder (ADHD), there is a need for treatment-sensitive instruments that are feasible, yield valid and reliable scores, and measure outcome in a 'time-locked' and 'situation- and symptom-specific' manner. These instruments are needed to evaluate the outcome for which the treatment is targeted at specific settings (e.g., school), specific times of day (e.g., the late afternoon or early evening medication dose), and specific symptoms (e.g., hyperactivity). The Telephone Interview Probe (TIP) was developed to meet this need for outcome research with children with ADHD. The present study evaluated the feasibility, reliability, validity, and treatment sensitivity of scores on the TIP scales (Inattention, Hyperactivity-Impulsivity, Oppositional Behavior, and Problem Situation). Psychometric properties of the TIP were evaluated using classical test theory, as well as generalizability theory. The TIP proved to possess all the attributes required for use in large-scale treatment studies. [ABSTRACT FROM AUTHOR]

This study investigated rapid automatized naming and effects of stimulant medication in school-age children with attention-deficit/hyperactivity disorder (ADHD) with and without concurrent reading disorder (RD). Two ADHD groups (67 ADHD only; 21 ADHD + RD) and a control group of 27 healthy age-matched peers were compared on four variables: color naming speed, letter naming speed, phonologic decoding, and arithmetic computation. Discriminant function analysis (DFA) was conducted to predict group membership. The four variables loaded onto two discriminant functions with good specificity: phonologic decoding, letter naming speed, and arithmetic defined the first function; color naming speed defined the second function. Both ADHD groups were significantly slower in color naming than controls, but did not differ from one another. DFA correctly classified 96% of the control group, 91% of ADHD + RD, and 82% of ADHD only. A subset of children in the ADHD groups participated subsequently in an acute, randomized, placebo-controlled, crossover trial with three single doses (10, 25, 20 mg) of methylphenidate. Methylphenidate selectively improved color-naming speed but had no effect on the speed of naming letters or digits. These findings challenge the tenet that naming speed deficits are specific to RD and implicate naming speed deficits associated with effortful semantic processing in ADHD, which are improved but not normalized by stimulant medication. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine whether deficient inhibitory control distinguishes children with a diagnosis of attention-deficit/hyperactivity (ADHD) disorder, conduct disorder (CD), and comorbid ADHD + CD from normally developing children. Participants were rigorously diagnosed children (age 7 to 12 years) with ADHD (N = 72), CD (N = 13) or ADHD + CD (N = 47) and 33 control children (NC). We studied inhibitory control using the stop-signal paradigm, a laboratory task that assessed the ability to inhibit an ongoing action. The ADHD group had significantly impaired inhibitory control compared to NC, CD, and ADHD + CD children. These results indicate that children with ADHD have deficient inhibition as measured in the stop-signal paradigm and that ADHD occurring in the presence of ADHD + CD may represent a phenocopy of CD rather than a variant of ADHD. [ABSTRACT FROM AUTHOR]

Abstract Background Among the most robust neural abnormalities differentiating individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) from typically developing controls are elevated levels of slow oscillatory activity (e.g., theta) and reduced fast oscillatory activity (e.g., alpha and beta) during resting-state electroencephalography (EEG). However, studies of resting state EEG in adults with ADHD are scarce and yield inconsistent findings. Methods EEG profiles, recorded during a resting-state with eyes-open and eyes-closed conditions, were compared for college students with ADHD (n = 18) and a nonclinical comparison group (n = 17). Results The ADHD group showed decreased power for fast frequencies, especially alpha. This group also showed increased power in the slow frequency bands, however, these effects were strongest using relative power computations. Furthermore, the theta/beta ratio measure was reliably higher for the ADHD group. All effects were more pronounced for the eyes-closed compared to the eyes-open condition. Measures of intra-individual variability suggested that brains of the ADHD group were less variable than those of controls. Conclusions The findings of this pilot study reveal that college students with ADHD show a distinct neural pattern during resting state, suggesting that oscillatory power, especially alpha, is a useful index for reflecting differences in neural communication of ADHD in early adulthood.

Abstract Background Math anxiety, defined as a negative affective response to mathematics, is known to have deleterious effects on math performance in the general population. However, the assumption that math anxiety is directly related to math performance, has not yet been validated. Thus, our primary objective was to investigate the effects of math anxiety on numerical processing in children with specific deficits in the acquisition of math skills (Developmental Dyscalculia; DD) by using a novel affective priming task as an indirect measure. Methods Participants (12 children with DD and 11 typically-developing peers) completed a novel priming task in which an arithmetic equation was preceded by one of four types of priming words (positive, neutral, negative or related to mathematics). Children were required to indicate whether the equation (simple math facts based on addition, subtraction, multiplication or division) was true or false. Typically, people respond to target stimuli more quickly after presentation of an affectively-related prime than after one that is unrelated affectively. Result Participants with DD responded faster to targets that were preceded by both negative primes and math-related primes. A reversed pattern was present in the control group. Conclusion These results reveal a direct link between emotions, arithmetic and low achievement in math. It is also suggested that arithmetic-affective priming might be used as an indirect measure of math anxiety.

Abstract Attention-deficit/hyperactivity disorder (ADHD), characterized by hyperactivity, impulsiveness and deficient sustained attention, is one of the most common and persistent behavioral disorders of childhood. ADHD is associated with catecholamine dysfunction. The catecholamines are important for response selection and memory formation, and dopamine in particular is important for reinforcement of successful behavior. The convergence of dopaminergic mesolimbic and glutamatergic corticostriatal synapses upon individual neostriatal neurons provides a favorable substrate for a three-factor synaptic modification rule underlying acquisition of associations between stimuli in a particular context, responses, and reinforcers. The change in associative strength as a function of delay between key stimuli or responses, and reinforcement, is known as the delay of reinforcement gradient. The gradient is altered by vicissitudes of attention, intrusions of irrelevant events, lapses of memory, and fluctuations in dopamine function. Theoretical and experimental analyses of these moderating factors will help to determine just how reinforcement processes are altered in ADHD. Such analyses can only help to improve treatment strategies for ADHD.

Abstract Background Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent, complex disorder which is characterized by symptoms of inattention, hyperactivity, and impulsivity. Convergent evidence from neurobiological studies of ADHD identifies dysfunction in fronto-striatal-cerebellar circuitry as the source of behavioural deficits. Recent studies have shown that regions governing basic sensory processing, such as the somatosensory cortex, show abnormalities in those with ADHD suggesting that these processes may also be compromised. Methods We used event-related magnetoencephalography (MEG) to examine patterns of cortical rhythms in the primary (SI) and secondary (SII) somatosensory cortices in response to median nerve stimulation, in 9 adults with ADHD and 10 healthy controls. Stimuli were brief (0.2 ms) non-painful electrical pulses presented to the median nerve in two counterbalanced conditions: unpredictable and predictable stimulus presentation. We measured changes in strength, synchronicity, and frequency of cortical rhythms. Results Healthy comparison group showed strong event-related desynchrony and synchrony in SI and SII. By contrast, those with ADHD showed significantly weaker event-related desynchrony and event-related synchrony in the alpha (8–12 Hz) and beta (15–30 Hz) bands, respectively. This was most striking during random presentation of median nerve stimulation. Adults with ADHD showed significantly shorter duration of beta rebound in both SI and SII except for when the onset of the stimulus event could be predicted. In this case, the rhythmicity of SI (but not SII) in the ADHD group did not differ from that of controls. Conclusion Our findings suggest that somatosensory processing is altered in individuals with ADHD. MEG constitutes a promising approach to profiling patterns of neural activity during the processing of sensory input (e.g., detection of a tactile stimulus, stimulus predictability) and facilitating our understanding of how basic sensory processing may underlie and/or be influenced by more complex neural networks involved in higher order processing.

Abstract Background Existing literature to date suggests a relationship between cognitive attention and working memory (WM), but the relationship between overt inattentive behaviour and WM is less clear. This study examined the relationship between WM and parent-rated inattentive behaviour in a community sample of 140 children aged 7–12 years. Methods Children completed 2 clinical (laboratory-based) measures of WM (auditory-verbal and visual-spatial) and a measure of real-life WM, designed specifically for this study, while their parents completed questionnaires about their child's inattentive behaviour and other areas of functioning. Results Findings indicated that poorer performance on WM tasks predicted inattentive behaviour. Conclusion These results are consistent with previous research linking WM deficits and poor attention in ADHD and normal populations. The present findings support a controlled attention model of WM.

Abstract Background Cognition in children with anxiety disorders (ANX) and comorbid Attention Deficit Disorder (ADHD) has received little attention, potentially impacting clinical and academic interventions in this highly disabled group. This study examined several cognitive features relative to children with either pure condition and to normal controls. Methods One hundred and eight children ages 8–12 and parents were diagnosed by semi-structured parent interview and teacher report as having: ANX (any anxiety disorder except OCD or PTSD; n = 52), ADHD (n = 21), or ANX + ADHD (n = 35). All completed measures of academic ability, emotional perception, and working memory. Clinical subjects were compared to 35 normal controls from local schools. Results Groups did not differ significantly on age, gender, or estimated IQ. On analyses of variance, groups differed on academic functioning (Wide Range Achievement Test, p < .001), perception of emotion (auditory perception of anger, p < .05), and working memory (backwards digits, p < .01; backwards finger windows, p < .05; Chipasat task, p < .001). ANX + ADHD and children with ADHD did poorly relative to controls on all differentiating measures except auditory perception of anger, where ANX + ADHD showed less sensitivity than children with ANX or with ADHD. Conclusion Though requiring replication, findings suggest that ANX + ADHD relates to greater cognitive and academic vulnerability than ANX, but may relate to reduced perception of anger.

1. Abstract Background Current concepts of Attention-Deficit/Hyperactivity Disorder (ADHD) emphasize the role of higher-order cognitive functions and reinforcement processes attributed to structural and biochemical anomalies in cortical and limbic neural networks innervated by the monoamines, dopamine, noradrenaline and serotonin. However, these explanations do not account for the ubiquitous findings in ADHD of intra-individual performance variability, particularly on tasks that require continual responses to rapid, externally-paced stimuli. Nor do they consider attention as a temporal process dependent upon a continuous energy supply for efficient and consistent function. A consideration of this feature of intra-individual response variability, which is not unique to ADHD but is also found in other disorders, leads to a new perspective on the causes and potential remedies of specific aspects of ADHD. The hypothesis We propose that in ADHD, astrocyte function is insufficient, particularly in terms of its formation and supply of lactate. This insufficiency has implications both for performance and development: H1) In rapidly firing neurons there is deficient ATP production, slow restoration of ionic gradients across neuronal membranes and delayed neuronal firing; H2) In oligodendrocytes insufficient lactate supply impairs fatty acid synthesis and myelination of axons during development. These effects occur over vastly different time scales: those due to deficient ATP (H1) occur over milliseconds, whereas those due to deficient myelination (H2) occur over months and years. Collectively the neural outcomes of impaired astrocytic release of lactate manifest behaviourally as inefficient and inconsistent performance (variable response times across the lifespan, especially during activities that require sustained speeded responses and complex information processing). Testing the hypothesis Multi-level and multi-method approaches are required. These include: 1) Use of dynamic strategies to evaluate cognitive performance under conditions that vary in duration, complexity, speed, and reinforcement; 2) Use of sensitive neuroimaging techniques such as diffusion tensor imaging, magnetic resonance spectroscopy, electroencephalography or magnetoencephalopathy to quantify developmental changes in myelination in ADHD as a potential basis for the delayed maturation of brain function and coordination, and 3) Investigation of the prevalence of genetic markers for factors that regulate energy metabolism (lactate, glutamate, glucose transporters, glycogen synthase, glycogen phosphorylase, glycolytic enzymes), release of glutamate from synaptic terminals and glutamate-stimulated lactate production (SNAP25, glutamate receptors, adenosine receptors, neurexins, intracellular Ca2+), as well as astrocyte function (α1, α2 and β-adrenoceptors, dopamine D1 receptors) and myelin synthesis (lactate transporter, Lingo-1, Quaking homolog, leukemia inhibitory factor, and Transferrin). Implications of the hypothesis The hypothesis extends existing theories of ADHD by proposing a physiological basis for specific aspects of the ADHD phenotype – namely frequent, transient and impairing fluctuations in functioning, particularly during performance of speeded, effortful tasks. The immediate effects of deficient ATP production and slow restoration of ionic gradients across membranes of rapidly firing neurons have implications for daily functioning: For individuals with ADHD, performance efficacy would be enhanced if repetitive and lengthy effortful tasks were segmented to reduce concurrent demands for speed and accuracy of response (introduction of breaks into lengthy/effortful activities such as examinations, motorway driving, assembly-line production). Also, variations in task or modality and the use of self- rather than system-paced schedules would be helpful. This would enable energetic demands to be distributed to alternate neural resources, and energy reserves to be re-established. Longer-term effects may manifest as reduction in regional brain volumes since brain areas with the highest energy demand will be most affected by a restricted energy supply and may be reduced in size. Novel forms of therapeutic agent and delivery system could be based on factors that regulate energy production and myelin synthesis. Since the phenomena and our proposed basis for it are not unique to ADHD but also manifests in other disorders, the implications of our hypotheses may be relevant to understanding and remediating these other conditions as well.

Abstract Background Individuals with Attention-Deficit/Hyperactive Disorder (ADHD) have unexplained difficulties on tasks requiring speeded processing of colored stimuli. Color vision mechanisms, particularly short-wavelength (blue-yellow) pathways, are highly sensitive to various diseases, toxins and drugs that alter dopaminergic neurotransmission. Thus, slow color processing might reflect subtle impairments in the perceptual encoding stage of stimulus color, which arise from hypodopaminergic functioning. Presentation of hypotheses 1) Color perception of blue-yellow (but not red-green) stimuli is impaired in ADHD as a result of deficient retinal dopamine; 2) Impairments in the blue-yellow color mechanism in ADHD contribute to poor performance on speeded color naming tasks that include a substantial proportion of blue-yellow stimuli; and 3) Methylphenidate increases central dopamine and is also believed to increase retinal dopamine, thereby normalizing blue-yellow color perception, which in turn improves performance on the speeded color naming tasks. Testing the hypothesis Requires three approaches, including:1) direct assessment of color perception in individuals with ADHD to determine whether blue-yellow color perception is selectively impaired; 2) determination of relationship between performance on neuropsychological tasks requiring speeded color processing and color perception; and 3) randomized, controlled pharmacological intervention with stimulant medication to examine the effects of enhancing central dopamine on color perception and task performance Implications of hypothesis If substantiated, the findings of color perception problems would necessitate a re-consideration of current neuropsychological models of attention-deficit/hyperactivity disorder, guide psycho-education, academic instruction, and require consideration of stimulus color in many of the widely used neuropsychological tests.

Abstract Background The objective of the current study was to examine performance and correlates of performance on a decision-making card task involving risky choices (Iowa Gambling Task) in adolescents with ADHD and comparison controls. Forty-four participants with ADHD and 34 controls were administered measures of estimated intellectual ability, working memory, and the card task. Also, behavioural ratings were obtained from parents and teachers. Results Adolescents with ADHD scored lower on the measures of intellectual ability, working memory, and made less advantageous selections on the card task compared to controls. Performance on measures of intellectual ability and working memory were unrelated to card task performance in both the ADHD and control samples. Parent ratings of hyperactivity/impulsivity were significantly associated with card task performance in the adolescents with ADHD, but not in controls. Conclusion These findings demonstrate impaired decision-making in adolescents with ADHD, and the separability of motivational and executive function processes, supporting current dual pathway models of ADHD.

The article reports on a study showing that atomoxetine reduces symptom severity in children with attention deficit hyperactivity disorder as rated by their teacher. Adverse effects of the drug include abdominal pain and emotional disturbance which resulted to withdrawal of six children in the study.

Objective: ADHD has been associated with persistent problems of working memory. This study investigated the efficacy of an intensive and adaptive computerized working memory treatment (CWMT) at behavioral and neural levels. Method: College students ( n = 89; 40 females) with ADHD were randomized into a standard-length CWMT (45 min/session, 25 sessions, n = 29), shortened-length CWMT (15 min/session, 25 sessions, n = 32), and a waitlist group ( n = 28). Both CWMT groups received treatment for 5 days a week for 5 weeks. Lab sessions before and after CWMT assessed electroencephalography (EEG) indicators of working memory, behavioral indicators of working memory performance, and ADHD symptomatology. Results: No evidence was found for neural or any other behavioral transfer effects of improvement for the CWMT treatment groups over the active control or waitlist group. Conclusion: Our study does not provide evidence for the benefits of CWMT at neural or behavioral levels.

Previous research investigating language in attention-deficit hyperactivity disorder (ADHD) has demonstrated several deficits in many aspects. However, no previous study employed quantitative methodology providing objective measures that could be compared among different studies with diverse samples. To fill this gap, we used network analysis to investigate how ADHD symptomatology impacts narrative discourse, a complex linguistic task considered to be an ecological measure of language. Fifty-eight adults (34 females and 24 males) with a mean age of 26 years old and a mean of 17 years of educational level were administered the Adult Self-Rating Scale for ADHD symptomatology. They also completed the State-Trait Anxiety Inventory, the Beck Depression Inventory and the Urgency, Premeditation, Perseverance, Sensation Seeking Behavior Scale. Intelligence quotient was calculated. Individuals were asked to tell a story based on a wordless picture book. Speech was recorded and transcribed as an input to SpeechGraphs software. Parameters were total number of words (TNW), number of loops of one node (L1), repeated edges (RE), largest strongly connected component (LSC) and average shortest path (ASP). Verbosity was controlled. Statistical analysis was corrected for multiples comparisons and partial correlations were performed for confounding variables. After controlling for anxiety, depression, IQ, and impulsiveness ADHD symptomatology was positively correlated with L1 and negatively correlated with LSC. TNW was positively correlated with ADHD symptoms. In a subdomain analysis, both inattention and hyperactivity-impulsivity were negatively correlated with LSC. Only hyperactivity-impulsivity positively correlated with TNW and L1. Results indicated a correlation between ADHD symptoms and lower connectedness in narrative discourse (as indicated by higher L1 and lower LSC), as well as higher total number of words (TNW). Our results suggest that the higher the number of ADHD symptoms, the less connectivity among words, and a higher number of words in narrative discourse., Competing Interests: The authors have declared that no competing interests exist.

Objective: This study used latent class analysis to identify patterns of co-occurrence among common childhood difficulties (inattention/hyperactivity, internalizing, externalizing, peer problems, and reading difficulties). Method: Parents and teachers of 501 children ages 6 to 9 provided mental health and social ratings, and children completed a reading task. Results: Four latent classes were identified in the analysis of parent ratings and reading: one with inattention/hyperactivity, externalizing, peer problems, and internalizing difficulties; one with inattention/hyperactivity and reading difficulties; one with internalizing and peer problems; and one normative class. The analysis of teacher ratings and reading also identified four latent classes: one with inattention/hyperactivity and externalizing, one with inattention/hyperactivity and reading difficulties, one with internalizing problems, and one normative class. Children in latent classes characterized by one or more difficulties were more impaired than children in the normative latent class 1 year later. Conclusion: The results highlight the need for multifaceted interventions.

Students in many western countries struggle to achieve acceptable standards in numeracy despite its recognition as an important 21st century skill. As commercial math programs remain a staple of classroom instruction, investigations of their effectiveness are essential to inform decision-making regarding how to invest limited resources while maximizing student gains. We conducted a cluster randomized-controlled trial of the effectiveness of JUMP Math, a distinctive math program whose central tenets are empirically supported, for improving elementary math achievement (clinical trial.gov no. NCT02456181). The study involved 554 grade 2 (primary) and 592 grade 5 (junior) students and 193 teachers in 41 schools, in an urban-rural Canadian school board. Schools were randomly assigned to use either JUMP Math or their business-as-usual, problem-based approach to math instruction. We tracked student progress in math achievement on standardized and curriculum-based measures of computation and problem solving, for 2 consecutive school years. Junior students taught with JUMP Math made significantly greater progress in computation than their non-JUMP peers but the groups did not differ significantly in problem solving. Effects took hold relatively quickly, replicating the results from an earlier pilot study. Primary students in the non-JUMP group made significantly greater gains in problem solving and computation in year 1. But those taught with JUMP Math made significantly greater gains in problem solving and the groups did not differ in computation, in year 2. The positive effects of JUMP Math are noteworthy given that the JUMP Math teachers were likely still adjusting to the new program. That these positive findings were obtained in an effectiveness study (i.e. in real-world conditions), suggests that JUMP Math may be a valuable evidence-based addition to the teacher's toolbox. Given the importance of numeracy for 21st century functioning, identifying and implementing effective math instruction programs could have far-reaching, positive implications., Competing Interests: Bruce Ferguson and Tracy Solomon received funding from Jump Math for other projects and activities.

Objective: The marked increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students gives rise to questions about how best to diagnose in this setting. The aim of the present study was to calculate ADHD prevalence in a large non-clinical sample of medical students using a stepwise design and to determine whether ADHD diagnosis varies if interviewees use additional probing procedures to obtain examples of positive DSM items., Methods: A total of 726 students were screened with the Adult Self-Report Scale (ASRS) and invited for an interview with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) adapted for adults., Results: The ASRS was positive for 247 students (37%), although only 83 (7.9%) received an ADHD diagnosis. ASRS sensitivity and specificity rates were 0.97 and 0.40, respectively. Probing procedures were used with a subgroup of 226 students, which decreased the number of ADHD diagnoses to 12 (4.5%)., Conclusion: Probing for an individual's real-life examples during the K-SADS interview almost halved ADHD prevalence rate based on the ASRS and K-SADS, which rendered the rate consistent with that typically reported for young adults. In reclassified cases, although examples of inattention did not match the corresponding DSM item, they often referred to another DSM inattention item.

This is the fourth and final study designed to develop International Classification of Functioning, Disability and Health (ICF, and children and youth version, ICF-CY) core sets for attention-deficit hyperactivity disorder (ADHD). To investigate aspects of functioning and environment of individuals with ADHD as documented by the ICF-CY in clinical practice settings. An international cross-sectional multi-centre study was applied, involving nine units from eight countries: Denmark, Germany, India, Italy, Portugal, Saudi Arabia, Sweden and Taiwan. Clinicians and clinical researchers rated the functioning level of 112 children, adolescents and adults with ADHD using the extended ICF-CY checklist version 2.1a. The ratings were based on a variety of information sources, such as medical records, medical history, clinical observations, clinical questionnaires, psychometric tests and structured interviews with participants and family members. In total, 113 ICF-CY categories were identified, of which 50 were related to the activities and participation, 33 to environmental factors and 30 to body functions. The clinical study also yielded strengths related to ADHD, which included temperament and personality functions and recreation and leisure. The study findings endorse the complex nature of ADHD, as evidenced by the many functional and contextual domains impacted in ADHD. ICF-CY based tools can serve as foundation for capturing various functional profiles and environmental facilitators and barriers. The international nature of the ICF-CY makes it possible to develop user-friendly tools that can be applied globally and in multiple settings, ranging from clinical services and policy-making to education and research.

Attention-Deficit Hyperactivity Disorder (ADHD) encompasses other symptoms besides inattention, hyperactivity, and impulsivity, such as language problems. ADHD can have a non-remitting course and is also found in older individuals, although there are no studies on language problems in elderly individuals with the disorder., Objective: To investigate the presence of language impairment in older adults with ADHD., Methods: Language impairment was investigated in three older ADHD adults, and compared with two matched control subjects using a narrative discourse task. The transcript discourses were evaluated based on the Trabasso Model for discourse analysis, and then processed by the Speech Graph Analysis software., Results: Compared to control subjects, ADHD patient discourse had more Plot components and their networks exhibited more Edges. The patients had higher scores on the Narrative Inefficiency, Density and Diameter Indexes as well as on the Average Clustering Coefficient. The networks of control subjects were sequential, with little or no recursiveness, whereas those of ADHD subjects were convoluted., Conclusion: Our results suggest that language deficits described in children, adolescents and young adults with ADHD may persist in older adults with the disorder., Competing Interests: Disclosure: Conflicts of interest are reported at the end of the paper. Conflict of interests. Paulo Mattos was on the speakers’ bureau and acted as a consultant for Shire in the previous five years; he also received travel awards to participate in scientific meetings from the company. Rosemary Tannock has received fees for unrestricted scientific talks from Shire, Eli Lilly, Medice, and OpoPharma in the past five years. Rafael Coelho has received travel awards to participate in scientific meetings from Shire.

Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) are often characterized by deficits in working memory (WM), which manifest in academic, professional, and mental health difficulties. To better understand the underlying mechanisms of these presumed WM deficits, we compared adults with ADHD to their peers on behavioral and neural indices of WM. We used a visuospatial change detection task with distractors which was designed to assess the brain's ability to effectively filter out distractors from WM, in addition to testing for effects of WM load. Twenty-seven unmedicated adults with ADHD were compared to 27 matched peers on event-related potential (ERP) measures of WM, i.e., the contralateral delay activity (CDA). Despite severe impairments in everyday life functioning, findings showed no difference in deficits in behavioral tests of working memory for adults with ADHD compared to their peers. Interestingly, there were differences in neural activity between individuals with ADHD and their peers showing that the CDA of individuals with ADHD did not distinguish between high, distractor, and low memory load conditions. These data suggest, in the face of comparable behavioral performance, a difference in neural processing efficiency, wherein the brains of individuals with ADHD may not be as selective in the allocation of neural resources to perform a WM task., Competing Interests: The authors declare there are no competing interests.

Background: Attention-deficit/hyperactivity disorder (ADHD) is proposed to be a neuropsychologically heterogeneous disorder that encompasses two distinct sub-groups, one with executive function (EF) deficits and one with delay aversion (DA). However, such claims have often been based on studies that have operationalized neuropsychological deficits using a categorical approach - using intuitive but rather arbitrary, clinical cut-offs. The current study applied an alternative empirical approach to sub-grouping in ADHD, latent profile analysis (LPA), and attempted to validate emerging subgroups through clinically relevant correlates., Methods: One-hundred medication-naïve children with ADHD and 96 typically developing children (6-14 years) completed nine EF and three DA tasks as well as an odor identification test. Parents and teachers provided reports of the children's behavior (ADHD and EF). Models of the latent structure of scores on EF and DA tests were contrasted using confirmatory factor analysis (CFA). LPA was carried out based on factor scores from the CFA and sub-groups were compared in terms of odor identification and behavior., Results: A model with one DA and two EF factors best fit the data. LPA resulted in four sub-groups that differed in terms of general level of neuropsychological performance (ranging from high to very low), odor identification, and behavior. The sub-groups did not differ in terms of the relative EF and DA performance. Results in the ADHD group were replicated in the control group., Conclusions: While EF and DA appear to be dissociable constructs; they do not yield distinct sub-groups when sub-grouping is based on a statistical approach such as LPA.

In his book "Die Geschichte von dem Zappel-Philipp," the German psychiatrist Heinrich Hoffmann (1809-1894) offers a clinical vignette which raises the question of the description of a disobedient child or presenting hyperactivity symptoms. This article describes the historical context and the biographical aspects related to this interesting approach to describing a psychiatric syndrome to children and adults. It also underlines the importance of a global approach of ADHD that considers the familial environment and situational context of symptoms.

Early self-regulation predicts school readiness, academic success, and quality of life in adulthood. Its development in the preschool years is rapid and also malleable. Thus, preschool curricula that promote the development of self-regulation may help set children on a more positive developmental trajectory. We conducted a cluster-randomized controlled trial of the Tools of the Mind preschool curriculum, a program that targets self-regulation through imaginative play and self-regulatory language (Tools; clinical trials identifier NCT02462733). Previous research with Tools is limited, with mixed evidence of its effectiveness. Moreover, it is unclear whether it would benefit all preschoolers or primarily those with poorly developed cognitive capacities (e.g., language, executive function, attention). The study goals were to ascertain whether the Tools program leads to greater gains in self-regulation compared to Playing to Learn (YMCA PTL), another play based program that does not target self-regulation specifically, and whether the effects were moderated by children's initial language and hyperactivity/inattention. Two hundred and sixty 3- to 4-year-olds attending 20 largely urban daycares were randomly assigned, at the site level, to receive either Tools or YMCA PTL (the business-as-usual curriculum) for 15 months. We assessed self-regulation at pre-, mid and post intervention, using two executive function tasks, and two questionnaires regarding behavior at home and at school, to capture development in cognitive as well as socio-emotional aspects of self-regulation. Fidelity data showed that only the teachers at the Tools sites implemented Tools, and did so with reasonable success. We found that children who received Tools made greater gains on a behavioral measure of executive function than their YMCA PTL peers, but the difference was significant only for those children whose parents rated them high in hyperactivity/inattention initially. The effect of Tools did not vary with children's initial language skills. We suggest that, as both programs promote quality play and that the two groups fared similarly well overall, Tools and YMCA PTL may be effective curricula choices for a diverse preschool classroom. However, Tools may be advantageous in classrooms with children experiencing greater challenges with self-regulation, at no apparent cost to those less challenged in this regard.

To evaluate the relative efficacy of two reading programs with and without adjunctive stimulant medication for children with attention-deficit/hyperactivity disorder and comorbid reading disorder (ADHD+RD). Sixty-five children (7-11 years in age) were assigned randomly to one of three intensive remedial academic programs (phonologically or strategy-based reading instruction, or general academic strategy and social skills training) in combination with either immediate-release methylphenidate or placebo. Multiple-blind procedures were used for medication/placebo, given twice daily. Children received 35 hours of instruction in 10 weeks, taught by a trained teacher in a separate school classroom, in small matched groups of 2 to 3. Children's behavior and reading abilities were assessed before and after intervention. Stimulant medication produced expected beneficial effects on hyperactive/impulsive behavioral symptoms (reported by classroom teachers) but none on reading. Children receiving a reading program showed greater gains than controls on multiple standardized measures of reading and related skills (regardless of medication status). Small sample sizes precluded interpretation of possible potentiating effects of stimulant medication on reading skills taught in particular reading programs. Intensive reading instruction, regardless of treatment with stimulant medication, may be efficacious in improving reading problems in children with ADHD+RD and warrants further investigation in a large-scale study.

Objective: The aim of this study was to evaluate whether a shortened-length session of CogMed Working Memory Training (CWMT) would be a suitable active control group and evaluate study protocol to aid in design refinements for a larger randomized controlled trial (RCT)., Method: Thirty-eight post-secondary students diagnosed with ADHD were randomized into 25 sessions of standard (45 min/session) or shortened (15 min/session) CWMT, or into a waitlist control group., Results: There was no significant difference in completion rate or training index score between the standard- and shortened-length groups indicating that both groups showed improvement and put forth good effort during training., Conclusion: Preliminary findings suggest that shorter training sessions may induce similar levels of engagement, motivation, and expectancy of improvement in participants. We conclude that a larger scale RCT that utilizes shortened-length training as an active control group is warranted, but that a few modifications to the study protocol will be required.

Objective: Attention Deficit / Hyperactivity Disorder (ADHD) and Chronic Tic Disorder (CTD) are two common and frequently co-existing disorders, probably following an additive model. But this is not yet clear for the basic sensory function of colour processing sensitive to dopaminergic functioning in the retina and higher cognitive functions like attention and interference control. The latter two reflect important aspects for psychoeducation and behavioural treatment approaches., Methods: Colour discrimination using the Farnsworth-Munsell 100-hue Test, sustained attention during the Frankfurt Attention Inventory (FAIR), and interference liability during Colour- and Counting-Stroop-Tests were assessed to further clarify the cognitive profile of the co-existence of ADHD and CTD. Altogether 69 children were classified into four groups: ADHD (N = 14), CTD (N = 20), ADHD+CTD (N = 20) and healthy Controls (N = 15) and compared in cognitive functioning in a 2×2-factorial statistical model., Results: Difficulties with colour discrimination were associated with both ADHD and CTD factors following an additive model, but in ADHD these difficulties tended to be more pronounced on the blue-yellow axis. Attention problems were characteristic for ADHD but not CTD. Interference load was significant in both Colour- and Counting-Stroop-Tests and unrelated to colour discrimination. Compared to Controls, interference load in the Colour-Stroop was higher in pure ADHD and in pure CTD, but not in ADHD+CTD, following a sub-additive model. In contrast, interference load in the Counting-Stroop did not reveal ADHD or CTD effects., Conclusion: The co-existence of ADHD and CTD is characterized by additive as well as sub-additive performance impairments, suggesting that their co-existence may show simple additive characteristics of both disorders or a more complex interaction, depending on demand. The equivocal findings on interference control may indicate limited validity of the Stroop-Paradigm for clinical assessments.

Although universal screening for mental health difficulties is increasingly recognized as a way to identify children who are at risk and provide early intervention, little research exists to inform decisions about screening, such as the choice of informants and the type of information collected. The present study examined the incremental validity of teacher- and parent-rated (primarily mothers) symptoms and impairment in a non-referred sample of early elementary school children (n = 320, 49 % boys, ages 6 to 9) in terms of predicting impairment as rated by a different teacher 1 year later. Teacher-rated symptoms and impairment and parent-rated impairment were each unique predictors of later impairment; however, parent-rated symptoms did not contribute to the prediction of later impairment above and beyond these other indicators. The results indicate that, when screening for mental health difficulties in the school system, impairment ratings collected across settings add useful information, but it may not be necessary to use parent symptom ratings when teacher symptom ratings are available.

Objective: The current study introduces the Parental Emotional Response to Children Index (PERCI), a new questionnaire specifically designed to measure parents' emotional response to ADHD and related behaviors (delay discounting and delay aversion)., Method: The PERCI was completed by parents of 6- to 14-year-old children with ( n = 126) and without ( n = 160) ADHD., Results: Factor analysis confirmed five separate subscales with acceptable psychometric properties. Parents of children with ADHD reported a stronger emotional response to ADHD behaviors than parents of typically developing children and inattention symptoms evoked the strongest emotional response in parents regardless of child diagnostic status., Conclusion: Parents' emotional responses appear to be differentiated in terms of specific ADHD-related triggers mapping onto the different domains of ADHD and delay-related responses. Further research is required to understand changes in parental emotional responses over time and their impact on children's developmental trajectories.

Working memory and response control are conceptualized as functions that are part of a closely connected and integrated executive function system mediated by the prefrontal cortex and other related brain structures. In the present paper, we asked whether effects of intensive and adaptive computerized working memory training (CWMT) would generalize to enhancements in response control at behavioral and neural levels. A total of 135 postsecondary students with Attention-Deficit/Hyperactivity Disorder (ADHD), a condition associated with executive function impairments, were randomized into a Standard-length CWMT (45-min /session, 25 sessions), Shortened-length CWMT (15min/session, 25 sessions), and a waitlist group. Both training groups received CWMT for 5 days a week for 5 weeks long. All participants completed a Go-Nogo task while neural activity was measured using Electroencephalography (EEG), before and after CWMT. Behavioral results showed trend level evidence (p=0.061) for benefits of CWMT on response control (i.e., improved accuracy of Go responses). Among several neural measures results showed statistically significant changes after CWMT only for the Go trial ERP N2 and P3 in frontal electrodes (p=0.039 and 0.001, respectively). However, given the lack of relationship between behavioral and neural changes and especially the clear lack of predicted does effects (i.e., standard length > short length > control), we conclude that there is no convincing evidence that the working memory training per se changes neural activation patterns in untrained executive functions. The positive finding of general training related changes in this study should have no clinical implications, but may contribute to the literature in better understanding the relationship between neural plasticity and transfer., (Published by Elsevier Ltd.)