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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.

Objective: To further define the nature of working memory (WM) impairments in children with combined-type ADHD. Method: A total of 40 Children with ADHD and an age and gender-matched control group (n = 40) completed two measures of visuo-spatial WM and two measures of verbal WM. The effects of age and learning/language difficulties on performance were evaluated. Results: Children with ADHD obtained significantly lower scores than controls on measures of both visuo-spatial and verbal WM. The impairments in verbal WM were age related. Conclusion: Children with ADHD exhibit impaired visuo-spatial WM performance. Younger (less than 8 years), but not older, children with ADHD demonstrate impairments in verbal WM. This latter result may explain the previously reported inconsistent performance of children with ADHD on verbal WM tasks. The importance of taking a developmental perspective in WM research is stressed. (Contains 4 tables.)

This review considers the hypothesis that changes in dopamine signalling might account for altered sensitivity to positive reinforcement in children with ADHD. The existing evidence regarding dopamine cell activity in relation to positive reinforcement is reviewed. We focus on the anticipatory firing of dopamine cells brought about by a transfer of dopamine cell responses to cues that precede reinforcers. It is proposed that in children with ADHD there is diminished anticipatory dopamine cell firing, which we call the dopamine transfer deficit (DTD). The DTD theory leads to specific and testable predictions for human and animal research. The extent to which DTD explains symptoms of ADHD and effects of pharmacological interventions is discussed. We conclude by considering the neural changes underlying the etiology of DTD.

The current study has two aims: (1) to examine associations between the emotional content of parent-child past event conversations and two aspects of children's self-concept--moral self and self-esteem; and (2) to examine the degree to which talk about past events is uniquely associated with self-concept when compared with talk about ongoing events and situations. Fifty-one five- and six-year-old New Zealand children and their parents discussed four emotional past events and two ongoing conflicts. Children's moral self, self-esteem and language ability were also assessed. When parents referred to a greater number of positive emotions and evaluations, regardless of conversation type, their children had higher self-esteem. Past event talk also uniquely predicted children's self-esteem: Parents who used more explanations during conversations regarding past negative emotions, and more explanations and confirmations of past positive emotions, had children with higher self-esteem. We discuss these results with respect to an autobiographical memory approach to self-concept development.

We used global ratings to compare the family (parent[s]-child) interactions of 51 clinic-referred children with ADHD and 32 non problem children. Children and parent(s) were videotaped while engaging in problem solving and game playing activities. Independent coders, blind to children's diagnostic status, rated the interactions using measures designed to assess interaction competence and quality. Significant group differences emerged between the ADHD and control groups during problem solving on the interaction quality measures of Warmth, Engagement and Communication. Comparisons of the interactions of families of children with ADHD, with (ADHD W) and without (ADHD W/O) comorbid disruptive behavior disorders, were non significant, although increased symptomology was associated with reduced Warmth and Engagement during problem solving. Irrespective of group membership family interactions were more positive during game playing versus problem solving.

The aim of this study was to examine associations between children's temperament, parent-child goodness-of-fit, and the emotional content of parent-child conversations about past events. Fifty one New Zealand 5- and 6-year-old children and their parents discussed 4 emotional past events. Parents rated children's temperament along 15 dimensions associated with effortful control, extroversion, and negative affect. Parents then rated their own expectations of children's temperament, from which parent-child goodness-of-fit was assessed. Children rated as higher in effortful control were involved in more emotional past-event conversations. Children whose negative affect ratings corresponded more closely with parental expectations were also involved in more emotional conversations. Our findings provide preliminary support for an association between temperament and narrative content. (Contains 7 tables and 2 footnotes.)

This study assessed the effectiveness of a targeted 9-week parent stress management program (PSM) on the parenting stress, mood, family functioning, parenting style, locus of control, and perceived social support of parents of children diagnosed with DSM-IV ADHD. Sixty-three parents from 42 families were randomly assigned to 1 of 2 conditions: immediate treatment or wait-list control. Results of the randomized control trial showed that for mothers, completion of the PSM program was accompanied by significant reductions in parent-domain parenting stress together with significant improvements in parenting style (verbosity, laxness, overreactivity). For fathers, completion of the program was associated with a reduction in verbosity only. Anonymously completed consumer satisfaction questionnaires demonstrated a high degree of satisfaction with the PSM program.

Altered motivational processing is purported to contribute to ADHD symptoms. A stronger preference for immediate over delayed reward is well documented in ADHD. However, little attention has been paid to children's capacity to withhold responding until a "better" reward becomes available, and their actions while waiting. Using a novel computer task, we examine the ability of children with and without ADHD to wait to collect a large reward in the presence of a small available reward. The effects of a reward-predicting cue on response times and response choices are also explored. Data from 136 children (6–12 years), 90 with ADHD and 46 typically developing (TD) children, are included. The children could collect a small immediately available reward or wait to access a larger reward after a variable delay, its imminent availability sometimes signaled by a cue. Subsequent probe trials explored the effects of longer waiting times and disruption of the cue-reward association. As expected, children with ADHD collected the small immediately available reward more often than TD children. Importantly, they were more likely to terminate waiting once commenced, collecting the small reward or attempting to collect the large reward early. The cue decreased their response time but disrupted their waiting when it no longer consistently predicted reward. Children with ADHD were more likely to abandon efforts to wait, especially when wait times were extended and when expected rewards failed to appear. Behavioral interventions for ADHD should take into account reduced waiting capacity that extends beyond children's preference for immediate reward. [ABSTRACT FROM AUTHOR]

This systematic review synthesizes the empirical literature examining pragmatic language in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a taxonomy of pragmatic language, we compared the pragmatic language profiles of children with ADHD to those of typically developing (TD) children and children with autism. Three databases were searched up to October 2019: PsychInfo; PubMed; and CSA Linguistics and Language Behavior Abstracts. We included 34 studies reporting on 2,845 children (ADHD = 1,407; TD = 1,058; autism = 380). Quality and risk of bias assessments included sample size and representativeness; measure reliability and validity; and missing data management. Children with ADHD were found to have higher rates of pragmatic difficulties than their TD peers. Specific difficulties were identified with inappropriate initiation, presupposition, social discourse, and narrative coherence. Children with ADHD appear to differ from those with autism in the degree of their pragmatic language impairments. General language skills contribute to, but do not explain, pragmatic difficulties in samples of children with ADHD. Though the extant evidence is limited, a preliminary profile of the pragmatic language impairments in children with ADHD is indicated. This supports a call for evidence-based interventions that include pragmatic language skills training. [ABSTRACT FROM AUTHOR]