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Kirk HE, Richmond S, Gaunson T, Bennett M, Herschtal A, Bellgrove M, Cornish K. A 5-week Digital Intervention to Reduce Attention Problems in Children With ADHD: A Double-Blind Randomized Controlled Trial. J Atten Disord 2024:10870547241256269. [PMID: 38804292 DOI: 10.1177/10870547241256269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. METHOD In this double-blind randomized controlled trial 55 children with ADHD (5-9 years) were allocated to the intervention (N = 28) or control program (N = 27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. RESULTS Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p < .044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. CONCLUSION Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD.
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Baweja R, Faraone SV, Childress AC, Weiss MD, Loo SK, Wilens TE, Waxmonsky JG. From Consensus Statement to Pills to Pixels: New Innovations in Attention-Deficit/Hyperactivity Disorder Care. J Child Adolesc Psychopharmacol 2024; 34:167-182. [PMID: 38686563 DOI: 10.1089/cap.2024.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Objectives: This review aims to present recent innovations and advancements in attention-deficit/hyperactivity disorder (ADHD) care, encompassing international consensus statement, new medication formulations, digital therapeutics, and neurostimulation devices. Methods: A comprehensive literature search of relevant articles published in the past five years was conducted, emphasizing the evidence base, efficacy, safety, and practical implications of these advancements. Results: The World Federation of ADHD Consensus Statement offers an updated diagnostic and treatment framework rooted in global scientific evidence. There are several newer ADHD medication formulations, including a nonstimulant (Viloxazine extended release) and the first transdermal amphetamine patch approved to treat ADHD. These options offer some unique benefits to personalize treatment based on symptom profile, lifestyle, preferences, and response. Digital tools offer additional means to restructure environments for individuals with ADHD, reducing impairment and reliance on others. In addition, digital therapeutics enhance access, affordability, personalization, and feasibility of ADHD care, complementing or augmenting existing interventions. Trigeminal nerve stimulation emerges as a well-tolerated nonpharmacological, device-based treatment for pediatric ADHD, with initial trials indicating effect sizes comparable to nonstimulant medications. Conclusions: These innovations in ADHD care represent clinically significant new treatment options and opportunities for personalized care. Health care professionals should integrate these developments into clinical practice, mindful of individual patient and family needs and preferences. Future research should assess long-term outcomes, cost-effectiveness, and acceptability of these innovations.
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Affiliation(s)
- Raman Baweja
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
| | - Stephen V Faraone
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Ann C Childress
- Center for Psychiatry and Behavioral Medicine, Las Vegas, Nevada, USA
| | - Margaret D Weiss
- Los Angeles Semel Institute, University of California, Los Angeles, California, USA
| | - Sandra K Loo
- Cambridge Health Alliance, Cambridge, Massachusetts, USA
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Ferguson C, Hobson C, Hedge C, Waters C, Anning K, van Goozen S. Disentangling the relationships between motor control and cognitive control in young children with symptoms of ADHD. Child Neuropsychol 2024; 30:289-314. [PMID: 36946244 DOI: 10.1080/09297049.2023.2190965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
Children with ADHD experience difficulties with motor and cognitive control. However, the relationships between these symptoms are poorly understood. As a step toward improving treatment, this study investigated associations between specific aspects of motor control and cognitive control in children with varying levels of hyperactive-impulsive symptoms. A heterogeneous sample of 255 children of 4 to 10 years of age (median = 6.50, MAD = 1.36) completed a battery of tests probing motor generation, visuomotor fluency, visuomotor flexibility, cognitive inhibition, verbal and visuospatial working memory, and cognitive flexibility. Their caregivers were interviewed regarding their hyperactive-impulsive symptoms. 25.9% of the main sample met diagnostic criteria for ADHD. Multiple linear regression analysis was used to determine whether specific aspects of motor control were associated with specific aspects of cognitive control, and whether any associations were moderated by hyperactive-impulsive symptoms. Additionally, cognitive modeling (the drift diffusion model approximated with EZ-DM) was used to understand performance on a cognitive inhibition task. Visuomotor fluency was significantly associated with cognitive inhibition. Visuomotor flexibility was significantly associated with cognitive flexibility. There were no significant moderation effects. Cognitive modeling was inconclusive. In conclusion, the ability to fluently perform visually guided continuous movement is linked with the ability to inhibit the effects of distracting information. The ability to spontaneously use visual information to flexibly alter motor responses is related to the ability to cognitively shift from one frame of mind to another. These relationships appear to be quantitatively and qualitatively similar across the childhood hyperactive-impulsive continuum as rated by parents.
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Affiliation(s)
- Cameron Ferguson
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Community Neurological Rehabilitation Service, Aneurin Bevan University Health Board, NHS Wales, Newport, United Kingdom
| | - Christopher Hobson
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Craig Hedge
- School of Psychology, Aston University, Aston, United Kingdom
| | - Cerith Waters
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Kate Anning
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
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Chaulagain A, Lyhmann I, Halmøy A, Widding-Havneraas T, Nyttingnes O, Bjelland I, Mykletun A. A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder. Eur Psychiatry 2023; 66:e90. [PMID: 37974470 PMCID: PMC10755583 DOI: 10.1192/j.eurpsy.2023.2451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/29/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD. METHODS We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria. RESULTS The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed. CONCLUSIONS Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.
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Affiliation(s)
- Ashmita Chaulagain
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvild Lyhmann
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Anne Halmøy
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Olav Nyttingnes
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ingvar Bjelland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Arnstein Mykletun
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
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Robledo-Castro C, Lerma-Castaño PR, Bonilla-Santos G. Effect of Cognitive Training Programs Based on Computer Systems on Executive Functions in Children With ADHD: A Systematic Review. J Atten Disord 2023; 27:1467-1487. [PMID: 37477014 DOI: 10.1177/10870547231187164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND The purpose of this systematic review is to synthesize the existing literature reporting the effects of computerized cognitive trainings on the executive functions of children with ADHD. METHOD A systematic review was carried out following the PRISMA statement; the primary sources used were five electronic databases (Scopus, Science Direct, Pubmed, Springer, Taylor & Francis). RESULTS 20 articles met the eligibility criteria, data on the training characteristics and the effects on executive functions were extracted, followed by an analysis of bias and the methodological quality of the studies. The results of the studies were widely heterogeneous, largely associated with the variety of training programs and the measurement instruments used. The most studied executive functions were working memory and inhibitory control. Some of the studies reported that the intervention led to significant effects on working memory and attention (N = 7), and improvements in inhibitory control (N = 5) and planning (N = 4) were also reported. At the same time, others did not report the effects of the intervention on these processes. The assessment of the quality of the evidence showed important risk biases among the reviewed studies. CONCLUSION Some training based on computer systems showed positive effects on the executive functions of working memory, attention, and inhibitory control in children with ADHD. However, other training sessions did not show significant effects. In general, the evidence shows mixed results, a high diversity of measurement instruments, and high risks of bias between the studies. Therefore, the evidence has not been consistent about the general benefits of computerized training on the executive functions of children with ADHD.
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Affiliation(s)
| | - Piedad Rocio Lerma-Castaño
- Universidad Autónoma de Manizales, Caldas, Colombia
- Fundación Universitaria María Cano, Neiva Huila, Colombia
| | - Gisella Bonilla-Santos
- Fundación Universitaria María Cano, Neiva Huila, Colombia
- Universidad Surcolombiana, Neiva, Colombia
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Klenberg L, Teivaanmäki S, Närhi V, Kiuru N, Healey D. Effectiveness of ENGAGE in reducing difficulties in everyday executive functions among Finnish preschoolers: a randomized controlled trial. Child Neuropsychol 2023; 29:1341-1361. [PMID: 36617885 DOI: 10.1080/09297049.2022.2164568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023]
Abstract
Effective interventions applicable for young preschool-age children are needed to reduce the risk of widespread and sustained adversities that are linked to early executive function (EF) difficulties. This randomized controlled trial (RCT) examined the effectiveness of the play-based ENGAGE intervention in improving behavioral outcomes related to EFs among Finnish preschool-age children with hyperactivity and/or inattention problems. 95 children between 4 and 5 years of age and their parents were randomly assigned to the ENGAGE intervention or a waitlist control group. Parents and early childhood education (ECE) teachers rated the children's EF difficulties and problem behaviors at pre-intervention, post-intervention, and 5-month follow-up. Repeated measures linear mixed modeling was used to examine the effect of ENGAGE on child outcomes. Those receiving ENGAGE exhibited significantly greater decreases in parent-rated attentional problems, hyperactivity/impulsivity, and acting out behaviors than the control group did, with mostly moderate effect sizes. No consistent improvements in the teacher ratings of children's EF related difficulties were found in either group. Low dropout (8%) from the intervention and high acceptability ratings indicated that ENGAGE is a palatable intervention for parents. The present study showed that findings from an earlier RCT on ENGAGE conducted in New Zealand could be generalized to a different cultural setting, as the intervention effectively reduced young Finnish children's EF difficulties in the home context. Extending ENGAGE and other play-based interventions into different everyday contexts of children, such as ECE, could further enhance the beneficial effects on children's EFs and behavior.
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Affiliation(s)
| | - Sini Teivaanmäki
- Niilo Mäki Institute, Jyväskylä, Finland
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Vesa Närhi
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| | - Noona Kiuru
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Dione Healey
- Department of Psychology, University of Otago, Dunedin, New Zealand
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7
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Anning KL, Langley K, Hobson C, Van Goozen SHM. Dimensional associations between executive function processes and symptoms of ADHD, ASD, oppositional defiance and anxiety in young school-referred children. Cortex 2023; 167:132-147. [PMID: 37557009 DOI: 10.1016/j.cortex.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/28/2023] [Accepted: 06/20/2023] [Indexed: 08/11/2023]
Abstract
Executive function (EF) difficulties are implicated in Neurodevelopmental Disorders (NDDs), such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Because NDDs are highly comorbid and frequently co-occur with additional clinical problems, it is unclear how specific EF problems are associated with symptoms of ASD and ADHD, whilst accounting for co-occurring anxiety or oppositional defiance disorder (ODD) symptoms. The current study utilised a large sample of young children (n = 438, aged 4-8) referred to Cardiff University's Neurodevelopment Assessment Unit (NDAU) by teachers for cognitive and/or socio-emotional problems. As part of the referral process, the teachers completed the Strengths and Difficulties Questionnaire (SDQ), which revealed that most children displayed moderate to high hyperactivity (86%) and prosocial (73%) problems, as well as high levels of symptoms in other clinical domains (41% emotional, 61% conduct and 68% peer problems). Children completed tasks to assess episodic memory, cognitive inhibition, cognitive flexibility and visuomotor control, whilst parents completed questionnaires to measure symptoms of ASD, ADHD, anxiety and ODD. Dimensional analyses showed that poorer cognitive inhibition and visuospatial episodic memory were significantly associated with ADHD symptoms, whereas cognitive flexibility was negatively associated with ODD symptoms. Having more ASD symptoms was associated with fewer cognitive inhibition problems, whereas anxiety was associated with better cognitive flexibility. Our approach to assessment and analysis shows that specific cognitive processes are associated with distinct neurodevelopmental and clinical symptoms, which is ultimately relevant to early identification of and intervention for young children at risk of cognitive and/or socio-emotional problems.
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Affiliation(s)
- Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK.
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Stephanie H M Van Goozen
- School of Psychology, Cardiff University, Cardiff, UK; Department of Clinical Neurodevelopmental Studies, Leiden University, Leiden, the Netherlands.
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Hudson JL, Minihan S, Chen W, Carl T, Fu M, Tully L, Kangas M, Rosewell L, McDermott EA, Wang Y, Stubbs T, Martiniuk A. Interventions for Young Children's Mental Health: A Review of Reviews. Clin Child Fam Psychol Rev 2023; 26:593-641. [PMID: 37488453 PMCID: PMC10465658 DOI: 10.1007/s10567-023-00443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.
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Affiliation(s)
- Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia.
| | - Savannah Minihan
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Wenting Chen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Talia Carl
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Michele Fu
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Lucy Tully
- School of Psychology, University of Sydney, Sydney, Australia
| | - Maria Kangas
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Linda Rosewell
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emma A McDermott
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Yiwen Wang
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Thomas Stubbs
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Dakwar-Kawar O, Mairon N, Hochman S, Berger I, Cohen Kadosh R, Nahum M. Transcranial random noise stimulation combined with cognitive training for treating ADHD: a randomized, sham-controlled clinical trial. Transl Psychiatry 2023; 13:271. [PMID: 37528107 PMCID: PMC10394047 DOI: 10.1038/s41398-023-02547-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
Non-invasive brain stimulation has been suggested as a potential treatment for improving symptomology and cognitive deficits in Attention-Deficit/Hyperactivity Disorder (ADHD), the most common childhood neurodevelopmental disorder. Here, we examined whether a novel form of stimulation, high-frequency transcranial random noise stimulation (tRNS), applied with cognitive training (CT), may impact symptoms and neural oscillations in children with ADHD. We conducted a randomized, double-blind, sham-controlled trial in 23 unmedicated children with ADHD, who received either tRNS over the right inferior frontal gyrus (rIFG) and left dorsolateral prefrontal cortex (lDLPFC) or sham stimulation for 2 weeks, combined with CT. tRNS + CT yielded significant clinical improvements (reduced parent-reported ADHD rating-scale scores) following treatment, compared to the control intervention. These improvements did not change significantly at a 3-week follow-up. Moreover, resting state (RS)-EEG periodic beta bandwidth of the extracted peaks was reduced in the experimental compared to control group immediately following treatment, with further reduction at follow-up. A lower aperiodic exponent, which reflects a higher cortical excitation/inhibition (E/I) balance and has been related to cognitive improvement, was seen in the experimental compared to control group. This replicates previous tRNS findings in adults without ADHD but was significant only when using a directional hypothesis. The experimental group further exhibited longer sleep onset latencies and more wake-up times following treatment compared to the control group. No significant group differences were seen in executive functions, nor in reported adverse events. We conclude that tRNS + CT has a lasting clinical effect on ADHD symptoms and on beta activity. These results provide a preliminary direction towards a novel intervention in pediatric ADHD.
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Affiliation(s)
- Ornella Dakwar-Kawar
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Noam Mairon
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Itai Berger
- Pediatric Neurology Unit, Assuta-Ashdod University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mor Nahum
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel.
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10
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Laifer LM, Tomaso CC, Chang OD, Phillips EM, James TD, Nelson JM, Espy KA, Alex Mason W, Nelson TD. Early executive control buffers risk for adolescent psychopathology during the COVID-19 pandemic. J Adolesc 2023; 95:1205-1219. [PMID: 37211897 PMCID: PMC10526894 DOI: 10.1002/jad.12195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on youth mental health, and there is a critical need for research examining individual factors that contribute to increased psychopathology during the pandemic. The current study explored whether executive control (EC) abilities in early childhood interact with COVID-related stress to attenuate risk for adolescent psychopathology during the first 6 months of the pandemic. METHODS Participants were 337 youth (49% female) living in a small midwestern city in the United States. Participants completed EC tasks when they were approximately 4.5 years old as part of a longitudinal study investigating cognitive development. At annual laboratory visits during adolescence and before the pandemic, participants (Mage = 14.57) reported on mental health symptoms. In July and August of 2020, participants (Mage = 16.57) reported on COVID-related stress and depression, anxiety, and trauma symptoms. RESULTS COVID-related stress was associated with increased internalizing problems after controlling for prepandemic symptom levels. Further, the impact of COVID-related stress on adolescent internalizing problems was moderated by preschool EC, with higher levels of EC buffering the effects of COVID-related stress on adolescent internalizing problems. CONCLUSIONS Findings highlight the importance of promoting EC early in development, as well as screening for EC deficits and implementing targeted intervention strategies across the lifespan to help reduce the impact of stress on adolescent internalizing problems.
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Affiliation(s)
- Lauren M Laifer
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Cara C Tomaso
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Olivia D Chang
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric M Phillips
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Tiffany D James
- Office of Research and Economic Development, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Jennifer Mize Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
- Office of Research and Economic Development, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Kimberly Andrews Espy
- Department of Neuroscience, Developmental and Regenerative Biology, University of Texas at San Antonio, San Antonio, Texas, USA
- Department of Psychiatry and Behavioral Science, University of Texas Health Science Center at San Antonio, Long School of Medicine, San Antonio, Texas, USA
| | - W Alex Mason
- Department of Child, Youth, & Family Studies, Nebraska Center for Research on Children, Youth, Families, and Schools, Lincoln, Nebraska, USA
| | - Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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11
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Li D, Li L, Zang W, Wang D, Miao C, Li C, Zhou L, Yan J. Effect of physical activity on attention in school-age children with ADHD: a systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1189443. [PMID: 37576338 PMCID: PMC10415683 DOI: 10.3389/fphys.2023.1189443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background: Attention problems are one of the core symptoms of Attention-deficit/hyperactivity disorder (ADHD) in children. Previous studies have shown that physical activity intervention has a positive impact on executive function in children and adolescents with ADHD, but there is limited research on attention problems in school-aged children with ADHD. There are still uncertainties about the appropriate physical activity interventions to improve attention problems in this population. This study conducted a Meta-analysis of randomized controlled trials (RCTs) related to physical activity intervention for attention problems in school-aged children with ADHD, providing a certain reference for precise intervention in attention problems for this population. Methods: We systematically searched the following databases up to October 2022: PubMed, Embase, Web of Science, and Cochrane Library, to identify RCTs that investigated the effects of physical activity interventions on children with ADHD. Two investigators independently conducted literature screening, extraction, and quality assessment. We performed a meta-analysis using Stata 15.1. Results: In total, we included 10 studies in this meta-analysis. The results indicated that physical activity intervention had a moderate effect in improving attention problems in school-aged children with ADHD (SMD = -0.48, 95% CI: 0.85, -0.07, p < 0.05). Furthermore, subgroup analysis showed that the effect of physical activity intervention was moderated by intervention type, frequency, and period, rather than the physical activity environment or single intervention time. Conclusion: Our study suggests that cognitively engaging exercise is more effective in improving attention problems in school-aged children with ADHD. Specifically, when cognitive-engaging exercise is used as the type of physical activity and the intervention frequency is less than 3 times per week, with an intervention period of less than weeks, it is most beneficial for improving attention problems in school-aged children with ADHD. However, we should also consider individual differences in children with respect to their ADHD symptoms and accurately evaluate each child's specific symptoms before intervention. Systematic Review Registration: identifier (CRD42022363255).
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Affiliation(s)
- Dong Li
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
- Department of International Culture Education, Chodang University, Muan, Republic of Korea
| | - Lan Li
- Universuty of Maine at Presque Isle, Presque Isle, ME, United States
| | - Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Deng Wang
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Chuyuan Miao
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Chenmu Li
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
| | - Li Zhou
- School of Sports and Health, Guizhou Medical University, Guiyang, China
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
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Carrick A, Hamilton CJ. Heated Behaviour in the Classroom for Children with FASD: The Relationship between Characteristics Associated with ADHD, ODD and ASD, Hot Executive Function and Classroom Based Reward Systems. CHILDREN 2023; 10:children10040685. [PMID: 37189934 DOI: 10.3390/children10040685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/17/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023]
Abstract
Possession of characteristics related to Attention Deficit Hyperactive Disorder, Oppositional Defiance Disorder, and Autism Spectrum Disorder in children prenatally exposed to alcohol contributes to challenges within the diagnostic pathway for Foetal Alcohol Spectrum Disorder (FASD). The presentation of these characteristics, though problematic for the children affected, may not result in referral for diagnosis; focusing on diagnostic thresholds masks the dimensional nature of these characteristics. Children with traits which are undiagnosed may not receive effective support and are often identified as exhibiting challenging behaviour. In the UK, children with undiagnosed Special Educational Needs (SEN) are more likely to experience school exclusion. Common across each condition are challenges to executive function associated with emotional regulation (hot-executive function). This study explored the relationship between characteristics of Attention Deficit Hyperactive Disorder, Oppositional Defiance Disorder, Autistic-Like Traits, and hot executive functions on the helpfulness of reward-based interventions for children with suspected or diagnosed FASD. Data were collected online using caregiver referral questionnaire screeners for each measure (Child Autism Quotient Questionnaire, Vanderbilt ADHD Parental Rating Scale and The Childhood Executive Functioning Inventory) for children aged 6–12 years with suspected or diagnosed FASD (n = 121). Between-group comparisons showed no significant difference in the reporting of Attention Deficit Hyperactive Disorder characteristics, Oppositional Defiance Disorder characteristics, Autistic-Like Traits, and executive function, regardless of diagnostic state. Multiple regression analyses indicated that these personality characteristics and executive functions were associated with the perception of the reward system helpfulness. However, this pattern was qualified by both the type of hot executive function challenged (significant for Regulation not Inhibition) and whether the child had an FASD diagnosis. Thus, a dimensional approach may strengthen our understanding of the child’s classroom experience and help overcome barriers to effective intervention and support.
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Affiliation(s)
- Andrea Carrick
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Colin J. Hamilton
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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Westwood SJ, Parlatini V, Rubia K, Cortese S, Sonuga-Barke EJS. Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): a meta-analysis of randomized controlled trials with blinded and objective outcomes. Mol Psychiatry 2023; 28:1402-1414. [PMID: 36977764 PMCID: PMC10208955 DOI: 10.1038/s41380-023-02000-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 03/30/2023]
Abstract
This meta-analysis investigated the effects of computerized cognitive training (CCT) on clinical, neuropsychological and academic outcomes in individuals with attention-deficit/hyperactivity disorder (ADHD). The authors searched PubMed, Ovid, and Web of Science until 19th January 2022 for parallel-arm randomized controlled trials (RCTs) using CCT in individuals with ADHD. Random-effects meta-analyses pooled standardized mean differences (SMD) between CCT and comparator arms. RCT quality was assessed with the Cochrane Risk of Bias 2.0 tool (PROSPERO: CRD42021229279). Thirty-six RCTs were meta-analysed, 17 of which evaluated working memory training (WMT). Analysis of outcomes measured immediately post-treatment and judged to be "probably blinded" (PBLIND; trial n = 14) showed no effect on ADHD total (SMD = 0.12, 95%CI[-0.01 to -0.25]) or hyperactivity/impulsivity symptoms (SMD = 0.12, 95%[-0.03 to-0.28]). These findings remained when analyses were restricted to trials (n: 5-13) with children/adolescents, low medication exposure, semi-active controls, or WMT or multiple process training. There was a small improvement in inattention symptoms (SMD = 0.17, 95%CI[0.02-0.31]), which remained when trials were restricted to semi-active controls (SMD = 0.20, 95%CI[0.04-0.37]), and doubled in size when assessed in the intervention delivery setting (n = 5, SMD = 0.40, 95%CI[0.09-0.71]), suggesting a setting-specific effect. CCT improved WM (verbal: n = 15, SMD = 0.38, 95%CI[0.24-0.53]; visual-spatial: n = 9, SMD = 0.49, 95%CI[0.31-0.67]), but not other neuropsychological (e.g., attention, inhibition) or academic outcomes (e.g., reading, arithmetic; analysed n: 5-15). Longer-term improvement (at ~6-months) in verbal WM, reading comprehension, and ratings of executive functions were observed but relevant trials were limited in number (n: 5-7). There was no evidence that multi-process training was superior to working memory training. In sum, CCT led to shorter-term improvements in WM, with some evidence that verbal WM effects persisted in the longer-term. Clinical effects were limited to small, setting specific, short-term effects on inattention symptoms.
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Affiliation(s)
- Samuel J Westwood
- Department of Psychology, Institute of Psychiatry, Psychology, Neuroscience, King's College London, London, UK
- School of Social Science, University of Westminster, London, UK
| | - Valeria Parlatini
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Ren X, Wu Q, Cui N, Zhao J, Bi HY. Effectiveness of digital game-based trainings in children with neurodevelopmental disorders: A meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104418. [PMID: 36603312 DOI: 10.1016/j.ridd.2022.104418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Digital game-based training programs have recently been used to train the cognitive abilities of children with neurodevelopmental disorders (NDDs). However, the effects of training remain controversial. The present meta-analysis explored the effectiveness of digital game-based training in children with NDDs and examined the possible moderators of its effects. Twenty-nine studies with cognitive outcomes in 1535 children were included in the present meta-analysis. The results showed that digital game-based training could significantly enhance the core cognitive abilities of children with each type of NDDs and that training could be used remotely. Meanwhile, task content and game features of digital game-based interventions separately make unique and significant contributions to the training effects, suggesting that the combination of training content and game features could efficiently improve children's cognition. Although the present study revealed that the training benefits could be maintained over a period of time, more studies are needed to explore the retention effects of digital game-based training. The present study provides a comprehensive understanding of the training effects of digital game-based interventions and new insights for future cognitive training design and application.
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Affiliation(s)
- Xiaoyu Ren
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Qianbing Wu
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Nan Cui
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Jing Zhao
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China.
| | - Hong-Yan Bi
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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15
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Lambek R, Sonuga-Barke EJS, Lange AM, Carroll DJ, Daley D, Thomsen PH. Parent Training for ADHD: No Generalization of Effects From Clinical to Neuropsychological Outcomes in a Randomized Controlled Trial. J Atten Disord 2023; 27:98-107. [PMID: 36314486 DOI: 10.1177/10870547221130108] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We examined whether neuropsychological function in ADHD can be improved by the New Forest Parenting Programme (NFPP), that combines standard parenting strategies with self-regulatory skills training, or predict ADHD and quality of life (QoL) treatment effects. METHOD Participants were 93 medication-naive preschool children with ADHD (3-7 years) randomized to either NFPP (n = 49) or treatment as usual (TAU; n = 44) in a recent randomized trial. Laboratory measures of executive function, reaction time variability, and delay of gratification were collected along with parent ratings of ADHD and QoL at baseline and post treatment. Ratings were collected again at 3-month follow-up. RESULTS NFPP did not improve neuropsychological function (compared to TAU), and baseline neuropsychological function did not predict treatment-related ADHD or QoL effects. CONCLUSION Although NFPP includes a neuropsychological training element and has been shown to improve several clinical outcomes, it did not improve the neuropsychological functions it targets.
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Richmond S, Kirk H, Gaunson T, Bennett M, Bellgrove MA, Cornish K. Digital cognitive training in children with attention-deficit/hyperactivity disorder: a study protocol of a randomised controlled trial. BMJ Open 2022; 12:e055385. [PMID: 35710251 PMCID: PMC9207754 DOI: 10.1136/bmjopen-2021-055385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning. Children with ADHD are developmentally vulnerable, with the disorder linked to emotional regulation difficulties, behavioural disturbances, as well as academic challenges. Emerging evidence suggests that children with ADHD may benefit from cognitive training interventions, including those focused on attention. This study aims to assess the immediate and long-term efficacy of an attention training intervention in children with ADHD. METHODS AND ANALYSIS This study is a preregistered, parallel, double blind, randomised controlled trial. Participants will comprise 104 children with a diagnosis of ADHD aged 5-8 years 11 months. Participants will be randomly allocated to either an adaptive, digital game-based (1) attention training programme (intervention) or (2) a numeracy programme (control). Both programmes will be delivered on a touchscreen tablet, and children will complete five 20 min sessions per week for a 5-week period at home (25 sessions in total). Assessments of the primary outcome (ie, attention and inhibitory control) and secondary outcomes (ie, selective attention, interference control, sustained attention, inhibition, behavioural attention, impairment in everyday functioning, working memory and executive functioning) will occur at preintervention, immediately postintervention and at 3-month follow-up. Multivariate linear regression will be employed to examine primary and secondary outcomes. The data analyst will be blinded to group membership. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Monash University HREC (20495). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities. TRIAL REGISTRATION NUMBER ACTRN12620000964910, UTN U1111-1250-2620.
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Affiliation(s)
- Sally Richmond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Tori Gaunson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Meg Bennett
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Chen IC, Chen CL, Chang CH, Fan ZC, Chang Y, Lin CH, Ko LW. Task-Rate-Related Neural Dynamics Using Wireless EEG to Assist Diagnosis and Intervention Planning for Preschoolers with ADHD Exhibiting Heterogeneous Cognitive Proficiency. J Pers Med 2022; 12:jpm12050731. [PMID: 35629153 PMCID: PMC9143733 DOI: 10.3390/jpm12050731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
This study used a wireless EEG system to investigate neural dynamics in preschoolers with ADHD who exhibited varying cognitive proficiency pertaining to working memory and processing speed abilities. Preschoolers with ADHD exhibiting high cognitive proficiency (ADHD-H, n = 24), those with ADHD exhibiting low cognitive proficiency (ADHD-L, n = 18), and preschoolers with typical development (TD, n = 31) underwent the Conners’ Kiddie Continuous Performance Test and wireless EEG recording under different conditions (rest, slow-rate, and fast-rate task). In the slow-rate task condition, compared with the TD group, the ADHD-H group manifested higher delta and lower beta power in the central region, while the ADHD-L group manifested higher parietal delta power. In the fast-rate task condition, in the parietal region, ADHD-L manifested higher delta power than those in the other two groups (ADHD-H and TD); additionally, ADHD-L manifested higher theta as well as lower alpha and beta power than those with ADHD-H. Unlike those in the TD group, the delta power of both ADHD groups was enhanced in shifting from rest to task conditions. These findings suggest that task-rate-related neural dynamics contain specific neural biomarkers to assist clinical planning for ADHD in preschoolers with heterogeneous cognitive proficiency. The novel wireless EEG system used was convenient and highly suitable for clinical application.
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Affiliation(s)
- I-Chun Chen
- International Ph.D. Program in Interdisciplinary Neuroscience, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Department of Physical Medicine and Rehabilitation, Ton-Yen General Hospital, Hsinchu 30268, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-L.C.); (L.-W.K.)
| | - Chih-Hao Chang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Zuo-Cian Fan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Yang Chang
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | | | - Li-Wei Ko
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Department of Electronics and Electrical Engineering, Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Drug Development and Value Creation Research Center, Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-L.C.); (L.-W.K.)
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18
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Audiffren M, André N, Baumeister RF. Training Willpower: Reducing Costs and Valuing Effort. Front Neurosci 2022; 16:699817. [PMID: 35573284 PMCID: PMC9095966 DOI: 10.3389/fnins.2022.699817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
The integrative model of effortful control presented in a previous article aimed to specify the neurophysiological bases of mental effort. This model assumes that effort reflects three different inter-related aspects of the same adaptive function. First, a mechanism anchored in the salience network that makes decisions about the effort that should be engaged in the current task in view of costs and benefits associated with the achievement of the task goal. Second, a top-down control signal generated by the mechanism of effort that modulates neuronal activity in brain regions involved in the current task to filter pertinent information. Third, a feeling that emerges in awareness during effortful tasks and reflects the costs associated with goal-directed behavior. The aim of the present article is to complete this model by proposing that the capacity to exert effortful control can be improved through training programs. Two main questions relative to this possible strengthening of willpower are addressed in this paper. The first question concerns the existence of empirical evidence that supports gains in effortful control capacity through training. We conducted a review of 63 meta-analyses that shows training programs are effective in improving performance in effortful tasks tapping executive functions and/or self-control with a small to large effect size. Moreover, physical and mindfulness exercises could be two promising training methods that would deserve to be included in training programs aiming to strengthen willpower. The second question concerns the neural mechanisms that could explain these gains in effortful control capacity. Two plausible brain mechanisms are proposed: (1) a decrease in effort costs combined with a greater efficiency of brain regions involved in the task and (2) an increase in the value of effort through operant conditioning in the context of high effort and high reward. The first mechanism supports the hypothesis of a strengthening of the capacity to exert effortful control whereas the second mechanism supports the hypothesis of an increase in the motivation to exert this control. In the last part of the article, we made several recommendations to improve the effectiveness of interventional studies aiming to train this adaptive function."Keep the faculty of effort alive in you by a little gratuitous exercise every day."James (1918, p. 127).
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Affiliation(s)
- Michel Audiffren
- Research Centre on Cognition and Learning, Centre National de la Recherche Scientifique, University of Poitiers, Poitiers, France
| | - Nathalie André
- Research Centre on Cognition and Learning, Centre National de la Recherche Scientifique, University of Poitiers, Poitiers, France
| | - Roy F. Baumeister
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
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Groves NB, Chan ESM, Marsh CL, Gaye F, Jaisle EM, Kofler MJ. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front Psychiatry 2022; 13:1034722. [PMID: 36561637 PMCID: PMC9763728 DOI: 10.3389/fpsyt.2022.1034722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Approximately 48-54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation. METHODS This preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8-13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls). RESULTS Results of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1-2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2-4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings. DISCUSSION To determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03324464].
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Emma M Jaisle
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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20
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Working memory and reaction time variability mediate the relationship between polygenic risk and ADHD traits in a general population sample. Mol Psychiatry 2022; 27:5028-5037. [PMID: 36151456 PMCID: PMC9763105 DOI: 10.1038/s41380-022-01775-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/19/2022] [Accepted: 09/02/2022] [Indexed: 01/14/2023]
Abstract
Endophenotypes are heritable and quantifiable traits indexing genetic liability for a disorder. Here, we examined three potential endophenotypes, working memory function, response inhibition, and reaction time variability, for attention-deficit hyperactivity disorder (ADHD) measured as a dimensional latent trait in a large general population sample derived from the Adolescent Brain Cognitive DevelopmentSM Study. The genetic risk for ADHD was estimated using polygenic risk scores (PRS) whereas ADHD traits were quantified as a dimensional continuum using Bartlett factor score estimates, derived from Attention Problems items from the Child Behaviour Checklist and Effortful Control items from the Early Adolescent Temperament Questionnaire-Revised. The three candidate cognitive endophenotypes were quantified using task-based performance measures. Higher ADHD PRSs were associated with higher ADHD traits, as well as poorer working memory performance and increased reaction time variability. Lower working memory performance, poorer response inhibition, and increased reaction time variability were associated with more pronounced ADHD traits. Working memory and reaction time variability partially statistically mediated the relationship between ADHD PRS and ADHD traits, explaining 14% and 16% of the association, respectively. The mediation effect was specific to the genetic risk for ADHD and did not generalise to genetic risk for four other major psychiatric disorders. Together, these findings provide robust evidence from a large general population sample that working memory and reaction time variability can be considered endophenotypes for ADHD that mediate the relationship between ADHD PRS and ADHD traits.
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21
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Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, Newcorn JH, Gignac M, Al Saud NM, Manor I, Rohde LA, Yang L, Cortese S, Almagor D, Stein MA, Albatti TH, Aljoudi HF, Alqahtani MMJ, Asherson P, Atwoli L, Bölte S, Buitelaar JK, Crunelle CL, Daley D, Dalsgaard S, Döpfner M, Espinet S, Fitzgerald M, Franke B, Gerlach M, Haavik J, Hartman CA, Hartung CM, Hinshaw SP, Hoekstra PJ, Hollis C, Kollins SH, Sandra Kooij JJ, Kuntsi J, Larsson H, Li T, Liu J, Merzon E, Mattingly G, Mattos P, McCarthy S, Mikami AY, Molina BSG, Nigg JT, Purper-Ouakil D, Omigbodun OO, Polanczyk GV, Pollak Y, Poulton AS, Rajkumar RP, Reding A, Reif A, Rubia K, Rucklidge J, Romanos M, Ramos-Quiroga JA, Schellekens A, Scheres A, Schoeman R, Schweitzer JB, Shah H, Solanto MV, Sonuga-Barke E, Soutullo C, Steinhausen HC, Swanson JM, Thapar A, Tripp G, van de Glind G, van den Brink W, Van der Oord S, Venter A, Vitiello B, Walitza S, Wang Y. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neurosci Biobehav Rev 2021; 128:789-818. [PMID: 33549739 PMCID: PMC8328933 DOI: 10.1016/j.neubiorev.2021.01.022] [Citation(s) in RCA: 423] [Impact Index Per Article: 141.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. METHODS We 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. RESULTS We 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. CONCLUSIONS Many 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.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, Psychiatry Research Division, SUNY Upstate Medical University, Syracuse, NY, USA; World Federation of ADHD, Switzerland; American Professional Society of ADHD and Related Disorders (APSARD), USA.
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Child and Adolescent Psychiatrist's Representative, Zentrales-ADHS-Netz, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing, China; Beijing Key Laboratory of Mental Disorders, Beijing, China; Beijing Institute for Brain Disorders, Beijing, China; Asian Federation of ADHD, China; Chinese Society of Child and Adolescent Psychiatry, China
| | - Joseph Biederman
- Clinical & Research Programs in Pediatric Psychopharmacology & Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Jeffrey H Newcorn
- American Professional Society of ADHD and Related Disorders (APSARD), USA; Departments of Psychiatry and Pediatrics, Division of ADHD and Learning Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martin Gignac
- Department of Child and Adolescent Psychiatry, Montreal Children's Hospital, MUHC, Montreal, Canada; Child and Adolescent Psychiatry Division, McGill University, Montreal, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | | | - Iris Manor
- Chair, Israeli Society of ADHD (ISA), Israel; Co-chair of the neurodevelopmental section in EPA (the European Psychiatric Association), France
| | - Luis Augusto Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - Li Yang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton,UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; University of Nottingham, Nottingham, UK
| | - Doron Almagor
- University of Toronto, SickKids Centre for Community Mental Health, Toronto, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | - Mark A Stein
- University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Turki H Albatti
- Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Haya F Aljoudi
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Mohammed M J Alqahtani
- Clinical Psychology, King Khalid University, Abha, Saudi Arabia; Saudi ADHD Society, Saudi Arabia
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Science, Moi University School of Medicine, Eldoret, Kenya; Brain and Mind Institute, and Department of Internal Medicine, Medical College East Africa, the Aga Khan University, Kenya; African College of Psychopharmacology, Kenya; African Association of Psychiatrists, Kenya
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Sweden; Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Cleo L Crunelle
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Dept. of Psychiatry, Brussel, Belgium; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine University of Nottingham, Nottingham, UK; NIHR MindTech Mental Health MedTech Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany; Zentrales-ADHS-Netz, Germany
| | | | | | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Professional Board, ADHD Europe, Belgium
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Catharina A Hartman
- University of Groningen, Groningen, the Netherlands; University Medical Center Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; ADHD Across the Lifespan Network from European College of Neuropsychopharmacology(ECNP), the Netherlands
| | | | - Stephen P Hinshaw
- University of California, Berkeley, CA, USA; University of California, San Francisco, CA, USA
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Chris Hollis
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK; NIHR MindTech MedTech Co-operative, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Scott H Kollins
- Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - J J Sandra Kooij
- Amsterdam University Medical Center (VUMc), Amsterdam, the Netherlands; PsyQ, The Hague, the Netherlands; European Network Adult ADHD, the Netherlands; DIVA Foundation, the Netherlands; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Tingyu Li
- Growth, Development and Mental Health Center for Children and Adolescents, Children's Hospital of Chongqing Medical University, Chongqing, China; National Research Center for Clinical Medicine of Child Health and Disease, Chongqing, China; The Subspecialty Group of Developmental and Behavioral Pediatrics, the Society of Pediatrics, Chinese Medical Association, China
| | - Jing Liu
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; The Chinese Society of Child and Adolescent Psychiatry, China; The Asian Society for Child and Adolescent Psychiatry and Allied Professions, China
| | - Eugene Merzon
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Leumit Health Services, Tel Aviv, Israel; Israeli Society of ADHD, Israel; Israeli National Diabetes Council, Israel
| | - Gregory Mattingly
- Washington University, St. Louis, MO, USA; Midwest Research Group, St Charles, MO, USA
| | - Paulo Mattos
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Brazilian Attention Deficit Association (ABDA), Brazil
| | | | | | - Brooke S G Molina
- Departments of Psychiatry, Psychology, Pediatrics, Clinical & Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joel T Nigg
- Center for ADHD Research, Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Diane Purper-Ouakil
- University of Montpellier, CHU Montpellier Saint Eloi, MPEA, Medical and Psychological Unit for Children and Adolescents (MPEA), Montpellier, France; INSERM U 1018 CESP-Developmental Psychiatry, France
| | - Olayinka O Omigbodun
- Centre for Child & Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Child & Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
| | | | - Yehuda Pollak
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Israel; The Israeli Society of ADHD (ISA), Israel
| | - Alison S Poulton
- Brain Mind Centre Nepean, University of Sydney, Sydney, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Ravi Philip Rajkumar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany; German Psychiatric Association, Germany
| | - Katya Rubia
- World Federation of ADHD, Switzerland; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany
| | - Julia Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany; Zentrales-ADHS-Netz, Germany
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France; International Collaboration on ADHD and Substance Abuse (ICASA), the Netherlands; DIVA Foundation, the Netherlands
| | - Arnt Schellekens
- Radboud University Medical Centre, Donders Institute for Brain, Cognition, and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - Anouk Scheres
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Renata Schoeman
- University of Stellenbosch Business School, Cape Town, South Africa; South African Special Interest Group for Adult ADHD, South Africa; The South African Society of Psychiatrists/Psychiatry Management Group Management Guidelines for ADHD, South Africa; World Federation of Biological Psychiatry, Germany; American Psychiatric Association, USA; Association for NeuroPsychoEconomics, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and the MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Henal Shah
- Topiwala National Medical College & BYL Nair Ch. Hospital, Mumbai, India
| | - Mary V Solanto
- The Zucker School of Medicine at Hofstra-Northwell, Northwell Health, Hemstead, NY, USA; Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), USA; American Professional Society of ADHD and Related Disorders (APSARD), USA; National Center for Children with Learning Disabilities (NCLD), USA
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - César Soutullo
- American Professional Society of ADHD and Related Disorders (APSARD), USA; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany; Louis A. Faillace MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hans-Christoph Steinhausen
- University of Zurich, CH, Switzerland; University of Basel, CH, Switzerland; University of Southern Denmark, Odense, Denmark; Centre of Child and Adolescent Mental Health, Copenhagen, Denmark
| | - James M Swanson
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Wales, UK
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Geurt van de Glind
- Hogeschool van Utrecht/University of Applied Sciences, Utrecht, the Netherlands
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, the Netherlands
| | - Saskia Van der Oord
- Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; European ADHD Guidelines Group, Germany
| | - Andre Venter
- University of the Free State, Bloemfontein, South Africa
| | - Benedetto Vitiello
- University of Torino, Torino, Italy; Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Yufeng Wang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
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Mattera S, Rojas NM, Morris PA, Bierman K. Promoting EF With Preschool Interventions: Lessons Learned From 15 Years of Conducting Large-Scale Studies. Front Psychol 2021; 12:640702. [PMID: 34248742 PMCID: PMC8264511 DOI: 10.3389/fpsyg.2021.640702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
In the past two decades, a growing number of early childhood interventions that aim to improve school readiness have also targeted children's executive function (EF), building on the theory that promoting EF skills in preschool may play a key role in reducing the substantial gaps in school readiness and later achievement associated with family income. Despite the expansion of school readiness interventions across preschool, research evidence is mixed regarding what works to promote EF development and the impact of these interventions on children's EF skills, and subsequently, their academic and behavioral outcomes. This paper reviews four intervention approaches designed to support school readiness that may also improve children's EF skills by: (a) encouraging adaptive classroom behaviors, (b) improving social-emotional learning, (c) promoting play and direct training of EF skills, and (d) improving cognitive skills related to EF. We describe program effects from rigorous trials testing these approaches, including summarizing the takeaways from four large-scale intervention research studies conducted by the authors, involving over 5,000 children. We conclude by exploring open questions for the field and future directions for research and intervention program development and refinement.
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Affiliation(s)
| | - Natalia M Rojas
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Pamela A Morris
- Department of Applied Psychology, New York University, New York, NY, United States
| | - Karen Bierman
- Department of Psychology, Pennsylvania State University, State College, PA, United States
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