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Elliott GR, Diner A, Sitbon E. An Objective Assessment of Effect of Stimulants on Attention in Individuals With ADHD. J Atten Disord 2024; 28:451-457. [PMID: 38197370 DOI: 10.1177/10870547231215285] [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: 01/11/2024]
Abstract
INTRODUCTION Currently, assessing ADHD treatment response to stimulants relies on rating scales and subjective questionnaires and sometimes a CPT. Such tools fall short of objective, quantifiable measurement of effect, especially in natural settings and can result in inconsistent treatment. METHOD We report results from two studies using a novel proof-of-concept approach. A preliminary trial of 10 individuals used a high-fidelity eye tracker; a second study of 100 individuals used webcams at the participants' homes. RESULTS Both studies evaluated stimulant effect using reading behavior analysis, being an ADHD symptom that stimulants affect and a major symptom patients want to improve. Both showed a significant change in reading behavior related to medication state, suggesting a clear, objective measure of stimulant effect. CONCLUSION Using ubiquitous hardware, investigators created a user-friendly treatment assessment platform where individuals can collect their own objective data within minutes in any setting where they have access to a web camera and computer.
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Affiliation(s)
- Glen R Elliott
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford School of Medicine, Palo Alto, CA, USA
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2
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Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study. CHILDREN 2023; 10:children10030415. [PMID: 36979973 PMCID: PMC10047892 DOI: 10.3390/children10030415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/13/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6–10 years with SLD/DCD. Methods: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers’ perceived notion of need and received two 45–60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Outcome and Results: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Conclusion and Implications: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. What this paper adds: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD.
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3
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Lee MM, Drury BC, McGrath LM, Stoodley CJ. Shared grey matter correlates of reading and attention. BRAIN AND LANGUAGE 2023; 237:105230. [PMID: 36731345 PMCID: PMC10153583 DOI: 10.1016/j.bandl.2023.105230] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 05/04/2023]
Abstract
Disorders of reading (developmental dyslexia) and attention (ADHD) have a high rate of comorbidity (25-40%), yet little is known about the neural underpinnings of this phenomenon. The current study investigated the shared and unique neural correlates of reading and attention in 330 typically developing children ages 8-18 from the Philadelphia Neurodevelopmental Cohort. Multiple regression analyses were used to identify regions of the brain where grey matter (GM) volume was associated with reading or attention scores (p < 0.001, cluster FDR p < 0.05). Better attention scores correlated with increased GM in the precuneus and higher reading scores were associated with greater thalamic GM. An exploratory conjunction analysis (p < 0.05, k > 239) found that GM in the caudate and precuneus correlated with both reading and attention scores. These results are consistent with a recent meta-analysis which identified GM reductions in the caudate in both dyslexia and ADHD and reveal potential shared neural correlates of reading and attention.
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Affiliation(s)
- Marissa M Lee
- Department of Psychology, American University, United States; Department of Neuroscience, American University, United States
| | - Brianne C Drury
- Undergraduate Program in Neuroscience, American University, United States
| | | | - Catherine J Stoodley
- Department of Psychology, American University, United States; Department of Neuroscience, American University, United States.
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4
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Zhou R, Dong P, Chen S, Qian A, Tao J, Zheng X, Cheng J, Yang C, Huang X, Wang M. The long-range white matter microstructural alterations in drug-naive children with ADHD: A tract-based spatial statistics study. Psychiatry Res Neuroimaging 2022; 327:111548. [PMID: 36279811 DOI: 10.1016/j.pscychresns.2022.111548] [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: 04/16/2022] [Revised: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND To investigate WM alterations, particularly the changes in long-range fibers, in drug-naive children with attention deficit hyperactivity disorder (ADHD), we conducted tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) data. MATERIALS AND METHODS In this study, 57 children with ADHD and 41 healthy controls (HCs) were enrolled. None of the enrolled ADHD children received any medication before data collection. WM changes were then correlated with clinical symptoms, including the hyperactivity index score and the impulsivity score. RESULTS ADHD children demonstrated decreased FA in the right forceps major, left inferior fronto-occipital fasciculus, and left genu Internal capsule. Moreover, higher RD was observed in the right forceps major, superior longitudinal fasciculus, and forceps major. The results of linear regression analysis including learning problem score, hyperactivity index score and impulsivity score showed that higher earning problem and hyperactivity/impulsivity symptom scores were negatively correlated with the mean FA value in the right forceps major, left IFOF and left genu Internal capsule. CONCLUSION Our results demonstrate that microstructural WM alterations and changes in the long-range WM connections are present in children with ADHD. We speculate that these changes may relate to the symptoms of hyperactivity and impulsivity.
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Affiliation(s)
- Ronghui Zhou
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Peng Dong
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo University, Ningbo 315000, China
| | - Shuangli Chen
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Andan Qian
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jiejie Tao
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiangwu Zheng
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jingliang Cheng
- Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Chuang Yang
- Department of Mental Health, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqi Huang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
| | - Meihao Wang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Poon K, Ho MSH, Wang LC. Examining Distinctive Working Memory Profiles in Chinese Children With Predominantly Inattentive Subtype of Attention-Deficit/Hyperactivity Disorder and/or Reading Difficulties. Front Psychol 2021; 12:718112. [PMID: 34759864 PMCID: PMC8573323 DOI: 10.3389/fpsyg.2021.718112] [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: 05/31/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Although evidence has shown that both RD and ADHD-I children suffer from working memory problems, inconsistencies in impaired modalities have been reported. This study aimed to (1) compare the three WM domains (i.e., verbal WM, visual-spatial WM, and behavioral WM) among pure ADHD-I, pure RD, comorbid ADHD-I+RD, and typical control groups and (2) examine the impact of comorbidity on the three WM domains. A Chinese sample of participants from Hong Kong included 29 children in the ADHD-I group, 78 children in the RD group, 31 children in the comorbid group (ADHD-I+RD), and 64 children in the TD control group. All participants completed the assessments individually. The findings showed that the children with ADHD-I and/or RD exhibited diverse cognitive profiles. In particular, RD was associated with verbal and visual-spatial working memory deficits, while ADHD-I was associated with behavioral working memory deficits. Interestingly, the comorbid condition demonstrated additive deficits of the two disorders but with greater deficits in behavioral working memory. These findings support the cognitive subtype hypothesis and provide a clearer picture of the distinctive working memory profiles of different groups, allowing for the development of intervention programs in the future.
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Affiliation(s)
- Kean Poon
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - Li-Chih Wang
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China.,Department of Special Education, National Tsing Hua University, Hsinchu, Taiwan
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Biotteau M, Tournay E, Baudou E, Destarac S, Iannuzzi S, Faure-Marie N, Castelnau P, Schweitzer E, Rodriguez D, Kemlin I, Dorison N, Rivier F, Carneiro M, Preclaire E, Barbarot S, Lauwers-Cancès V, Chaix Y. Reading Comprehension Impairment in Children With Neurofibromatosis Type 1 (NF1): The Need of Multimodal Assessment of Attention. J Child Neurol 2021; 36:625-634. [PMID: 33507832 DOI: 10.1177/0883073820981270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention span, which has been shown to have an impact on reading quality in many other conditions, is one of the main cognitive disorders of neurofibromatosis type 1 (NF1). The aim of this work is to observe the impact of attention on reading comprehension, in NF1 and non-NF1 children. A multicenter, cross-sectional study was conducted on 150 children (8-12 years old) with or without NF1 (75 NF1 vs 75 non-NF1; 72 female, 78 male), matched for age, sex, handedness, and reading level, thus forming a continuum from good to poor readers in both NF1 and non-NF1 groups. Children with intellectual deficiency or neurologic or psychiatric disorder were excluded. Attentional skills were assessed by combining a parent questionnaire (Child Behavior CheckList) and a performance-based assessment (Conner's Continuous Performance Test-Second Edition). Reading comprehension was assessed through a standardized reading comprehension test (ORLEC Lobrot). The performance-based attention scores were associated with text and sentence comprehension ability (P = .0235 and P = .0164, respectively), while indirect questionnaire attention scores were only associated with sentence comprehension (P = .0263). For both groups, the correlations between questionnaire and performance-based measures were low. We have shown that reading comprehension is greatly influenced by attention in NF1 and non-NF1, even if predictors of good reading comprehension also include IQ score and reading accuracy. Indirect observer-rated questionnaires and direct performance-based measures of attention do not assess the same variables, are linked to different components of reading skills, and are not interchangeable assessments of attention difficulties. Both assessments are complementary and must be used simultaneously, leading to recommendations that support multimodal assessment of attention.
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Affiliation(s)
- Maëlle Biotteau
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | - Elodie Tournay
- Epidemiology Department, Toulouse University Hospital, Toulouse, France
| | - Eloise Baudou
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | - Sandrine Destarac
- Pediatric Clinical Research Unit, Toulouse Clinical Investigation Center, Children's Hospital, Purpan University Hospital, Inserm U1436, Toulouse, France
| | - Stéphanie Iannuzzi
- Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | | | - Pierre Castelnau
- Pediatric Neurology, Clocheville Children's Hospital, Tours University Hospital, Tours, France.,UMR 1253, iBrain, University fo Tours, 27102Inserm, Tours, France.,School of Medicine, University of Tours Francois Rabelais, Tours, France
| | - Elisabeth Schweitzer
- Pediatric Neurology, Clocheville Children's Hospital, Tours University Hospital, Tours, France
| | - Diana Rodriguez
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France.,Inserm U1141, FHU I2-D2, Paris, France
| | - Isabelle Kemlin
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France
| | - Nathalie Dorison
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France
| | - François Rivier
- Department of Pediatric Neurology, Montpellier University Hospital, PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
| | - Maryline Carneiro
- Department of Pediatric Neurology & Reference Center for Language Disabilities, Montpellier University Hospital, France
| | - Elodie Preclaire
- Department of Pediatric Neurology & Reference Center for Language Disabilities, Montpellier University Hospital, France
| | | | | | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
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7
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Roberts GJ, Cho E, Garwood JD, Goble GH, Robertson T, Hodges A. Reading Interventions for Students with Reading and Behavioral Difficulties: a Meta-analysis and Evaluation of Co-occurring Difficulties. EDUCATIONAL PSYCHOLOGY REVIEW 2019. [DOI: 10.1007/s10648-019-09485-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Langer N, Benjamin C, Becker BLC, Gaab N. Comorbidity of reading disabilities and ADHD: Structural and functional brain characteristics. Hum Brain Mapp 2019; 40:2677-2698. [PMID: 30784139 DOI: 10.1002/hbm.24552] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/16/2019] [Accepted: 02/06/2019] [Indexed: 12/12/2022] Open
Abstract
Reading disabilities (RD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common developmental disorders. RD and ADHD frequently co-occur, which raises questions about how the disorders interact and to what extent they can be differentiated. To date, the underlying neural mechanisms leading to RD-ADHD comorbidity (COM) are not understood. In this study, structural and functional magnetic resonance imaging (fMRI) were combined with comprehensive behavioral testing in order to characterize the behavior, brain structure, and neural correlates of executive function, phonological processing and reading fluency in 60 children with clinical diagnoses of RD, ADHD, or COM, and controls. Whole-brain analyses of variance were performed on cortical thickness values and on the data of the three fMRI tasks to investigate overall group differences. To validate these findings, a region of interest analysis was performed in regions that have previously been shown to exhibit group differences in children with RD or ADHD using the same paradigms. The neuroimaging results demonstrated structural and functional atypicalities for COM in regions that are frequently associated with deficits in children with isolated ADHD or RD. A combination of shared and distinctive brain alterations between the clinical groups was identified, supporting the multiple deficit model for ADHD, RD, and its comorbidity.
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Affiliation(s)
- Nicolas Langer
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program (URPP) Dynamics of Healthy Aging, Zurich, Switzerland.,Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
| | - Christopher Benjamin
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,Neurology, Neurosurgery & Psychology, Yale University, New Haven, Connecticut
| | - Bryce L C Becker
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,University of California, Berkeley, California
| | - Nadine Gaab
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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Noori F, Farahani S, Mokrian H, Asadi M, Mokrian H. Comparison of aural rehabilitation outcomes in presence and absence of back ground noise in hearing impaired children with and without attention deficit hyperactivity disorder (ADHD). Int J Pediatr Otorhinolaryngol 2018; 114:138-142. [PMID: 30262352 DOI: 10.1016/j.ijporl.2018.07.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE We sought to understand the extend of improvement in seven major skills to determine the best rehabilitation approach in hearing impaired young children with and without attention deficit and hyperactivity disorder (ADHD). METHODS Newsha developmental scale was assessed in 40 hearing impaired children with and without ADHD in two conditions, in which seven major skills (hearing, speech, receptive language, expressive language, cognition, social communication, and motor skills) were evaluated. Two separate analyses were conducted, each after six months of rehabilitation. The first six months rehabilitation was done by controlling background noise level, while the other six months rehabilitation was performed with background multi talker babble noise, and ADHD and non ADHD children performance were compared. RESULTS After the first six months of rehabilitation there were no significant difference in improvement in any of the major skills except for motor and cognition skills between hearing impaired ADHD and non ADHD children. After the second six months of rehabilitation the extend of improvement was equal in both groups. CONCLUSION The equal improvement of hearing impaired ADHD and non- Children with ADHD support the benefits of rehabilitation program in both groups. In addition, it seems background multi talker babble noise can facilitate the process of rehabilitation in ADHD group. As a result, it is important to understand the specific needs of hearing impaired children with ADHD in rehabilitation program to provide the best services and increase the chance for success.
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Affiliation(s)
- Fariba Noori
- Center of Rehabilitation for Deaf and Hard of Hearing Children, Parnian Rehabilitation Center, Padegan Street, Ghazvin, Iran
| | - Saeed Farahani
- Department of Audiology, Tehran University of Medical Science, Tehran, Iran
| | - Hermin Mokrian
- Center of Rehabilitation for Deaf and Hard of Hearing Children, Parnian Rehabilitation Center, Padegan Street, Ghazvin, Iran; Radiology Department, Hamedan University of Medical Science, Iran
| | - Mastoore Asadi
- Keremanshah State Welfare Organisation, Shahid Emami Street, Kermanshah, Iran
| | - Helnaz Mokrian
- Center of Rehabilitation for Deaf and Hard of Hearing Children, Parnian Rehabilitation Center, Padegan Street, Ghazvin, Iran; Department of Audiology, Tehran University of Medical Science, Tehran, Iran.
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10
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Froehlich T, Fogler J, Barbaresi WJ, Elsayed NA, Evans SW, Chan E. Using ADHD Medications to Treat Coexisting ADHD and Reading Disorders: A Systematic Review. Clin Pharmacol Ther 2018; 104:619-637. [PMID: 30053315 PMCID: PMC6141313 DOI: 10.1002/cpt.1192] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/11/2018] [Indexed: 11/10/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD), the most common pediatric neurobehavioral disorder, frequently presents with coexisting reading disorders (RDs). Despite this, it is unclear whether medication improves symptoms and function in children with comorbid ADHD and RD. We present a systematic review of studies investigating the effects of ADHD medications on ADHD symptoms, academic outcomes, and neuropsychological measures in this important group.
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Affiliation(s)
- Tanya Froehlich
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Jason Fogler
- Division of Developmental Medicine, Boston Children’s Hospital, Boston MA
- Harvard Medical School, Boston, MA
| | - William J. Barbaresi
- Division of Developmental Medicine, Boston Children’s Hospital, Boston MA
- Harvard Medical School, Boston, MA
| | - Nada A. Elsayed
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine
| | | | - Eugenia Chan
- Division of Developmental Medicine, Boston Children’s Hospital, Boston MA
- Harvard Medical School, Boston, MA
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11
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Hendren RL, Haft SL, Black JM, White NC, Hoeft F. Recognizing Psychiatric Comorbidity With Reading Disorders. Front Psychiatry 2018; 9:101. [PMID: 29636707 PMCID: PMC5880915 DOI: 10.3389/fpsyt.2018.00101] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 03/13/2018] [Indexed: 01/06/2023] Open
Abstract
Reading disorder (RD), a specific learning disorder (SLD) of reading that includes impairment in word reading, reading fluency, and/or reading comprehension, is common in the general population but often is not comprehensively understood or assessed in mental health settings. In education settings, comorbid mental and associated disorders may be inadequately integrated into intervention plans. Assessment and intervention for RD may be delayed or absent in children with frequently co-occurring mental disorders not fully responding to treatment in both school and mental health settings. To address this oversight, this review summarizes current knowledge regarding RDs and common comorbid or co-occurring disorders that are important for mental health and school settings. We chose to highlight RD because it is the most common SLD, and connections to other often comorbid disorders have been more thoroughly described in the literature. Much of the literature we describe is on decoding-based RD (or developmental dyslexia) as it is the most common form of RD. In addition to risk for academic struggle and social, emotional, and behavioral problems, those with RD often show early evidence of combined or intertwined Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition childhood disorders. These include attention deficit hyperactivity disorder, anxiety and depression, disruptive, impulse-control, and conduct disorders, autism spectrum disorders, and other SLDs. The present review highlights issues and areas of controversy within these comorbidities, as well as directions for future research. An interdisciplinary, integrated approach between mental health professionals and educators can lead to comprehensive and targeted treatments encompassing both academic and mental health interventions. Such targeted treatments may contribute to improved educational and health-related outcomes in vulnerable youth. While there is a growing research literature on this association, more studies are needed of when to intervene and of the early and long-term benefits of comprehensive intervention.
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Affiliation(s)
- Robert L Hendren
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.,Dyslexia Center, University of California San Francisco, San Francisco, CA, United States
| | - Stephanie L Haft
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Jessica M Black
- School of Social Work, Boston College, Chestnut Hill, MA, United States
| | - Nancy Cushen White
- Dyslexia Center, University of California San Francisco, San Francisco, CA, United States.,Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States
| | - Fumiko Hoeft
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.,Dyslexia Center, University of California San Francisco, San Francisco, CA, United States.,University of California Multi-Campus Precision Learning Center (PrecL), San Francisco, CA, United States.,Haskins Laboratories, New Haven, CT, United States.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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12
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Steward T, Mestre-Bach G, Fernández-Aranda F, Granero R, Perales JC, Navas JF, Soriano-Mas C, Baño M, Fernández-Formoso JA, Martín-Romera V, Menchón JM, Jiménez-Murcia S. Delay discounting and impulsivity traits in young and older gambling disorder patients. Addict Behav 2017; 71:96-103. [PMID: 28288442 DOI: 10.1016/j.addbeh.2017.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/23/2017] [Accepted: 03/04/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Impulsivity is understood to be a multidimensional construct involving aspects such as impulsive choice and impulsive traits. Delay discounting, the tendency to place greater value in immediate rewards over larger, long-term rewards, has been associated with maladaptive choices in gambling disorder (GD). Delay discounting is known to evolve with age; though no study to date has evaluated the interactions between impulsivity, GD severity and age in treatment-seeking patients. OBJECTIVES We aimed to examine whether associations between delay discounting and impulsivity traits differed between younger and older-aged GD patients. Secondly, we sought to untangle the mediating role of impulsivity in determining gambling behavior in these two age groups. METHODS GD patients (N=335) were evaluated using the UPPS-P Impulsive Behavior Scale and a delay discounting task. Structural Equation Modeling (SEM) was used to explore associations between impulsivity measures and gambling severity in young (18-30years) and old (31-70) GD patients. RESULTS No differences in delay discounting were found between young and old GD patients. Significant correlations between delay discounting and urgency levels (the tendency to act rashly under emotional states) were identified only in the young GD group. Path analyses also revealed both positive and negative urgency to be a mediator of GD severity levels in young GD patients. DISCUSSION AND CONCLUSIONS Significant associations between impulsive choice and positive urgency are only present in young gamblers, suggesting that positive urgency influence choice behavior to a greater degree at younger ages. Implications for targeted interventions are discussed.
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