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Children with attention-deficit/hyperactivity disorder (ADHD) receive supports and services in general and special education classrooms in schools. The present study aimed to report the contents of individualized education programs (IEPs) for children with ADHD and to compare the behavior of children with ADHD who had IEPs versus those with ADHD who did not have IEPs. Two-hundred one children with ADHD participating in a summer treatment program (STP) were grouped by whether they had an IEP (N = 50 children) or not (N = 151). The content of the IEPs was descriptively reviewed. Further, children with and without IEPs were compared on measures of ADHD symptoms, aggressive behaviors, academic achievement, and psychosocial impairment. Groups were also compared on functioning in the STP setting on behavioral measures of rule-following, negative behaviors, and academic productivity in situations where intensive behavior modification procedures were and were not employed. The results indicated no significant differences between the two groups on any ratings or behavioral measures, with the exception of academic achievement scores (children in special education scored lower, on average). All children improved within the context of intensive behavioral intervention. The results are discussed in light of current approaches to supporting children with ADHD in schools.

Relationships between sluggish cognitive tempo (SCT) and age and IQ were investigated in children with autism and/or ADHD covering broader age and IQ ranges than in previous studies. Mothers rated 1436 children with autism and 1,056 with ADHD (2-17 years, IQs 9-149) on Pediatric Behavior Scale SCT items. Increasing age correlated with SCT in the autism, ADHD-Combined, and ADHD-Inattentive samples. SCT prevalence rates were 22% preschool, 29% early childhood, 41% late childhood, and 50% adolescence. Correlations between IQ and SCT were small and negative. SCT was lowest in children with above average intelligence. Children referred for autism and ADHD should be assessed for SCT, irrespective of IQ and age, given SCT's high prevalence and association with social and academic impairment.

Introduction: Findings regarding the relationship between IQ and comorbidity in autism and ADHD are inconsistent. Methods: Mothers rated 1,436 children with autism and 1,056 with ADHD without autism (IQs 9-149, ages 2-17) on the Pediatric Behavior Scale. Results: Children with IQs < 70 (vs. [greater than or equal to] 70) had less oppositional behavior, irritability, tantrums, conduct problems, generalized anxiety, and depression and more separation anxiety. Children with ADHD-Inattentive had less comorbidity than children with autism and children with ADHD-Combined. For autism, 80% had ADHD-Combined symptoms and 9% had ADHD-Inattentive symptoms. Most children with autism and with ADHD-Combined with IQs [greater than or equal to] 70 had oppositional defiant disorder, as did almost half with IQs < 70. For autism, 45% with IQs [greater than or equal to] 70 had generalized anxiety and 47% with IQs < 70 had separation anxiety. Conclusions: Given high rates of comorbid symptoms in autism and ADHD, clinicians should be alert to and assess for psychiatric comorbidity.

ObjectiveTo examine the impact of central nervous system (CNS) stimulants on the growth of children with attention-deficit/hyperactivity disorder (ADHD), and to assess the efficacy and feasibility of weight recovery interventions on growth.MethodA total of 230 children aged 5 to 12 years with ADHD with no history of chronic CNS stimulant use were randomly assigned to receive daily CNS stimulants (78%, primarily osmotic release oral system-methylphenidate [OROS-MPH]) or behavioral treatment (22%) for 30 months. After 6 months, children evidencing a decline in body mass index (BMI) of >0.5 z-units were randomized to 1 of 3 weight recovery treatments (WRTs): monthly monitoring of height/weight (MON) plus continued daily medication; drug holidays (DH) with medication limited to school days; or daily caloric supplementation (CS) with a 150-kcal supplement plus daily medication.ResultsBefore WRT assignment, medication was associated with significant reductions in standardized weight and height (p values

No study has analyzed the relative occurrence of a broad range of symptoms reported by mothers of children with autism, ADHD-Combined, and ADHD-Inattentive and typical controls. Mothers rated 1436 children with autism, 1056 with ADHD without autism, and 186 controls, 2-17 years, on 41 internalizing, externalizing, neurodevelopmental, and somatic problems. Most children with autism had symptoms of ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, and expressive language disorder and almost half had dysgraphia and receptive language disorder. Symptom overlap between autism and ADHD-Combined was high. Clinicians specializing in autism and ADHD must have expertise in evaluating and treating these comorbidities identified as most problematic by mothers in order to relieve family concerns and develop treatment plans relevant to families.

Little is known about the characteristics of academic overachievers, children whose achievement significantly exceeds IQ. Correlates of overachievement (achievement test scores = 1 SD above IQ), nondiscrepant achievement, and learning disability (LD; achievement = 1 SD below IQ) were analyzed in 1,543 children (739 ADHD, 285 autism, and 519 general population), 6-16 years of age. Significant correlates of the reading and math achievement groups were diagnosis (autism greatest overachievement, ADHD greatest LD), IQ (lowest in overachievers and highest in LD), and Working Memory scores relative to the child's IQ (close to or exceeding IQ in overachievers and lower than IQ in LD). Demographics (age, sex, race, and parent occupation) and parent and teacher ratings of psychopathology (e.g., behavior problems, anxiety, and depression) and personality characteristics (e.g., motivation and self-confidence) did not contribute significantly more to predicting overachievement and LD beyond that explained by IQ, diagnosis, and working memory. These findings suggest an underlying neurobiological etiology for both overachievement and LD.

Aggressive and defiant behaviors in students are costly to schools, teachers, and students. In this paper, we summarize findings from meta-analyses, systematic reviews, and meta-reviews that examined school-based interventions for aggressive and defiant behaviors in students. Results of the review suggest that school-based interventions produce significant but small positive effects on aggression and defiance, with larger effects for interventions that are implemented with higher quality. Behavioral and cognitive behavioral techniques are key components of nearly all effective school interventions, whether interventions are student-directed or teacher-/environment-directed. Specific interventions with empirical support, as identified using the Blueprints for Healthy Youth Development and "What Works Clearinghouse" databases, are briefly summarized. Finally, recommendations are made for schools considering a school intervention for aggression and defiance, and important priorities for future research are outlined.

Most mental health disorders present by age 14 years but less than fifty percent youth receive any treatment. Most present to non-mental health disciplines secondary to mental health workforce deficits. Mental health access is lower in developing countries like Pakistan and worse in the rural areas of the country which houses majority of the population. The growing need to manage child and adolescent mental health disorders in a timely manner necessitates use of innovative professional training approaches to increase mental health workforce. Project ECHO is a hub-and-spoke model that uses videoconferencing to connect general providers ("spokes") with specialists (the "hub") overcoming the site and location specific barriers which often impede access. Our 12 month curriculum was developed to expand child and adolescent mental health workforce using ECHO platform. Participants (n = 227) completed surveys;78.3% were from healthcare sector including pediatrics, family community medicine and behavioral health specialties and the rest represented school counselors and community organizations. Interestingly, patients with anxiety disorders were most commonly seeking care from family/community medicine (p =.040) while mood and autism from pediatricians and psychiatrists. Knowledge and confidence of participants improved significantly after sessions (p = <.001). Most expressed satisfaction with the ECHO sessions (93.8%). Main barriers to implementing the evidence-based recommendations included time, clinic support and patient compliance. Results support interprofessional training to increase child and adolescent mental health workforce and reflect benefit of brief tele mentoring to improve training beyond profession specific competencies. Future studies should explore clinical and provider level outcomes with similar professional education approaches. [ABSTRACT FROM AUTHOR]

This study examined associations between parenting behaviors and school performance in children oversampled for externalizing behavior problems. Participants were 147 mothers (M[subscript age] = 36.46 years, SD = 5.66) and 110 fathers (M[subscript age] = 39.31 SD = 6.26) of 148 children (M[subscript age] = 9.64 years, SD = 1.59). The majority of children (83.7%) met diagnostic criteria for attention-deficit/hyperactivity disorder and/or oppositional defiant disorder or conduct disorder. Ratings of maternal and paternal effective control and emotional responsiveness were collected, and standardized achievement scores, teacher ratings of disruptive classroom behavior, and teacher ratings of student-teacher and student-peer relationships were used as indicators of school performance. Associations of medium size emerged between maternal parenting and school performance domains. In contrast, very few associations between paternal variables were demonstrated, with the exception of paternal reduction of child emotion being robustly associated with school performance variables. Exploratory analyses demonstrated that paternal positive involvement mitigated the negative effects of dysfunctional maternal behavior on spelling achievement and peer functioning. These findings point to the importance of considering parent functioning in the school performance of children with externalizing problems. Attention to addressing parenting difficulties common to many children with externalizing behavior problems may help to promote adaptive school functioning.

Objectives: Use of Synthetic and designer products, including synthetic marijuana (SM), among adolescents poses a major risk to public health. Little is known about the motivating factors of synthetic substance use in adolescents. This study examined the motivations, predictors, perceived risks and benefits, and differences with SM versus natural marijuana among adolescents. Methods: Between April 2016 and May 2018, a convenience sample of adolescents receiving substance use treatment from a local counseling center completed an anonymous survey to assess the use of natural and synthetic marijuana use, the Strengths and Difficulties Questionnaire to assess levels of current psychiatric symptoms and the Community Assessment of Psychic Experiences-Positive Scale to assess symptoms of psychosis. Results: A total of 80 adolescents (age range of 14-18 years; 71% male; 53% Caucasian) completed the study. Of these, 39 (49%) reported natural marijuana use (natural marijuana users) and 41 (51%) reported both synthetic and natural marijuana use (dual users). The most commonly reported reasons for using SM were its low cost and reduced risk of detection. Participants who were familiar with SM and reported a desire to avoid detection on drug tests were likelier to use SM (all P <.05). Dual users reported more benefits and risks associated with SM use when compared to natural marijuana users (P ⩽.05). The use of SM also heightened the perceived medical risks of natural marijuana, including seizures and respiratory issues (P <.05), compared with natural marijuana users. While dual users self-reported more conduct (P =.009) and externalizing problems (P =.024) when compared to natural marijuana users, there were no group differences in psychotic symptoms, nor correlations with the frequency of synthetic or natural marijuana use and psychotic symptoms except that persecutory ideation correlated with the frequency of natural marijuana use during the past 12 months (rp = 0.28, P =.04). Conclusions: These results suggest that reports of cost savings, and lack of detection on urine drug screens are common reasons for SM use in adolescents despite being aware of the risks of using SM. Perceived benefits of using synthetics and other novel substances appear diverse, and merit further exploration as a better understanding of what motivates adolescents to use specific novel substances may guide prevention and treatment efforts. [ABSTRACT FROM AUTHOR]