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BackgroundMisconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base.MethodsWe reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder.ResultsWe generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents.ConclusionsMany findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

Background: Amphetamines increase dopamine levels in mid-brain regions which, in turn, impact top-down executive function. Repeated exposure is linked to substance use disorders. Nonetheless, amphetamines are used to manage attention-deficit/hyperactivity disorder (ADHD) and eating-related disorders. In ADHD, amphetamines upregulate a system characterised by low dopaminergic tone, assisting to improve executive function. A similar process might be at play with eating disorders; however, the effect of amphetamine treatment on executive function in this case has not been thoroughly considered. Methods: Participants (N = 52, Mage = 47.06, SD = 12.29) with a body mass index of 25–60 were randomised to treatment (6-week dexamphetamine titration) or control (placebo) groups. They completed an executive function measure—Barkley Deficits in Executive Functioning Scale (BDEFS-SF)—and response inhibition task—Stop-Signal Task (SST)—at Baseline, throughout titration, at Maintenance, and at Follow-up. Mixed effects models examined whether BDEFS-SF score or the SST variable, stop-signal reaction time (SSRT), changed across sessions as a function of treatment. Results: There was no effect of group (p = 0.440), but an effect of session (p = 0.024) on BDEFS-SF, with scores at Time 2 (p = 0.011, 95% CI [0.47, 3.49]) and Maintenance (p = 0.022, 95% CI [−4.89, −0.39]), respectively, higher and lower than other timepoints. There was no group by session interaction (p = 0.659). R2 (conditional) = 0.74; ICC = 0.73. There was an effect of group (p = 0.039) and session (p < 0.001) on SSRT, but no interaction (p = 0.707). Baseline SSRT was significantly longer than the mean of all subsequent timepoints (p < 0.001, 95% CI [16.29, 33.84]). R2 (conditional) = 0.47; ICC = 0.39. Conclusions: There was no discernible impact of amphetamine treatment for obesity on executive function. Our results suggest some variation related to sample size and/or practice effects. Thus, while treatment appears unlikely to render individuals susceptible to substance use disorders, parallels with ADHD might be overstated. [ABSTRACT FROM AUTHOR]

Aim: Previous studies suggest a lack of a unified approach in identifying and addressing children with obesity while being inpatients in individual Australian hospitals. Our study aimed to describe current clinical practice across Australia and identify discrepancies that can aid in developing a more unified response to children identified with obesity as hospital inpatients. Methods: A cross‐sectional exploratory online survey was distributed to major paediatric in‐patient departments in Australia, with a response rate of 68%. Questions focused on education, identification, interventions and attitudes towards a national protocol. Results: Twenty percent of respondents indicated that staff in their department regularly record body mass index, 66% address weight issues and only 8% consistently refer to appropriate outpatient services. Although 88% of respondents believe that a national protocol for addressing paediatric obesity would be beneficial, respondents emphasised concerns regarding their local resources. Conclusion: Our study can inform the development of a guideline for a unified response to opportunistically identify children with overweight and obesity as inpatients. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is frequently associated with oppositional defiant disorder (ODD). The Mental Effort Reward Imbalances Model (MERIM) explains this observational association as follows: in ADHD a disproportionate level of mental effort is required for sustaining concentration for achievement; in ODD the subjective experience of reward for achievement is less than normal. In combination, these mechanisms predispose to reductions in motivation and achievement, and to low mood, oppositional behaviour, and reward seeking. Self-regulation has been used as a management strategy in ADHD, with interventions directed towards encouraging individuals to evaluate and reinforce positive behaviour. Using the logic of the MERIM, self-management strategies would be directed towards encouraging the individual to attribute value to a task or activity with the goal of obtaining the emotional outcome of feeling good about themselves through their achievement. We describe the use of two such strategies: positive rumination and positive reappraisal. These could potentially lead to improvements in functioning, enhancing the quality of life of affected individuals and resulting in fewer incidents of destructive, reward-seeking behaviour in relation to those around them.

Objective: The Review of health services for children, young people and families within the NSW Health system identified that novel models of care were needed to improve access to clinical management for people with ADHD. The present study aimed to evaluate GPs' knowledge of and attitudes towards ADHD and the challenges and opportunities for a more substantial role for GPs in ADHD management. Method: An online survey of Australian GPs was conducted, with recruitment via email invitation. Results: Out of 230 respondents, 213 surveys could be analysed. Of these, 97% believed ADHD was a genuine condition, with 90% identifying inattention as a primary symptom. Most (92%) had seen and diagnosed ADHD within the past year. Prevalent concerns included inadequate access to specialist assessment and treatment; 77% felt that GPs should have a more substantial role in ADHD management. Barriers included lack of time, knowledge and experience. Conclusions: There was willingness amongst respondents take on a greater role in managing individuals with ADHD. However, a need for further training and education was highlighted. The Australian Evidence-Based Clinical Practice Guideline for ADHD may resolve an identified need for clinical guidance. [ABSTRACT FROM AUTHOR]

Objective: This structured survey sought to identify barriers to recognising and reporting potential child abuse by medical officers and nursing staff in the EDs of three Western Sydney hospitals. These include a large metropolitan teaching hospital, a small metropolitan hospital and a rural hospital. Methods: A mixed approach of qualitative and quantitative study methodology was used to survey potential participants. The electronic survey was distributed to participants to assess knowledge and experiences with identifying child abuse presenting to the ED over a 6‐month period. A descriptive analysis of the data was performed. Results: A total of 121 responses were received from 340 potential participants, giving a participation rate of 35%. The majority of the respondents were senior medical officers (38/110, 34%) or registered nurses (35/110, 32%). The study participants perceived the lack of time as the most significant barrier to reporting child abuse (85/101, 84%). This was followed by a lack of education (35/101, 34%), resources (33/101, 32%) and support (30/101, 29%). Conclusion: The combination of hospital, departmental and individual staff issues such as time limitations, lack of resources, education and support are potential barriers to reporting suspected child abuse. We recommend tailored teaching sessions, improved reporting procedures and increased support from senior staff to overcome these barriers. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to characterise and compare the biopsychosocial characteristics of children admitted with failure to thrive (FTT), subdivided into those with underlying medical complexities (categorised as organic FTT – OFTT) and those with none (categorised as non‐organic FTT – NOFTT), with a focus on the medical, nutritional, feeding skills and psychosocial domains. Methods: A retrospective review of medical records was conducted in children admitted with FTT from January 2010 to December 2020. Descriptive statistics were used for data analysis. Results: A total of 353 children were included, with the mean age of presentation 0.82 ± 2.05 years (OFTT 1.16 ± 2.50 years, NOFTT 0.49 ± 1.41 years, P = 0.002). Approximately, half of the children were classified as having OFTT. These children had lower birth weights, were more likely to have a history of intrauterine growth restriction and had longer hospital stays. The NOFTT group had significantly more abnormal feeding strategies identified in their caregivers, whereas the OFTT group had more delayed feeding skills and oral aversion. There was no significant difference in psychosocial domains, with both groups having a comparably high risk of abuse and neglect. Conclusions: The classification of FTT as non‐organic or organic based purely on psychosocial parameters did not reflect the complex nature of FTT within our local population. These groups had different medical variables, and caregiver feeding strategies. A multidisciplinary team approach is recommended for the assessment and intervention for children with FTT to address these domains and the complex interactions between them. [ABSTRACT FROM AUTHOR]

The article discusses the challenges Australians face in accessing specialist treatment for attention-deficit/hyperactivity disorder (ADHD) and the strain it puts on general practitioners (GPs). A pilot program in Australia aims to empower GPs to diagnose and treat ADHD independently through specialized training and supervision. The initial results show success in patient satisfaction, prescription management, and referral knowledge, with plans to expand the program to include adults and other districts in Australia. The ultimate goal is to increase the capacity for treating ADHD and provide holistic care to patients of all ages with ADHD. [Extracted from the article]

Although treatment of attention deficit hyperactivity disorder (ADHD) usually involves specialist input, the GP plays an important role in assessment and arranging nonpharmacological treatment while waiting for a paediatric appointment. Assessment of a child showing typical ADHD features of inattention, hyperactivity or impulsivity focuses on whether the behaviour is out of proportion to his or her developmental level and whether it is causing functional impairment. [ABSTRACT FROM AUTHOR]