Strategies for Coping with Time-Related and Productivity Challenges of Young People with Learning Disabilities and Attention-Deficit/Hyperactivity Disorder

Development of a digital mental health intervention for youth with ADHD: exploring youth perspectives on wants, needs, and barriers

Background

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder affecting five to eight percent of children and youth worldwide. Inattention, impulsivity, and hyperactivity are core symptoms, which often leads to comorbid disorders and impairments. Increased prevalence of ADHD among youth requires development of accessible and scalable interventions. Digital interventions for ADHD show promising results for adults, yet insight into youths perspectives and needs from digital ADHD interventions is lacking. This study is set in a person-based approach and explore what youths want and need from a therapist-guided digital intervention for ADHD.

Methods

Exploratory individual interviews were conducted with youths aged 13-16 years diagnosed with ADHD (N = 16). Participants with an ADHD diagnosis were recruited primarily via social media. The interview guide was based on research, treatment guidelines, and clinical expertise. The study applied reflexive thematic analysis, within a Big Q framework. Codes and themes were generated in Nvivo.

Results

Four main themes and sub-themes were generated: (1) Tailoring the intervention to youths with ADHD (Push the right buttons; Stumbling blocks), (2) Managing ADHD (Planning and Focus; Regulation and Balance; Social interactions), (3) Me and my ADHD (Insight and Understanding; Accept and Normalization), and (4) Balance between support and independence.

Discussion

The findings suggest that youths with ADHD prefer stimulating and interactive treatment and are aversive to overwhelming, passive content. The intervention and therapist should encourage empowerment by supporting the youths autonomy in managing their ADHD. Future research is needed to investigate feasibility for person-based approaches to digital mental health treatments. Furthermore, parent perspectives on digital treatment for youths with ADHD should be investigated.

Stigma and Stigma Resilience: Role of the Undergraduate and the Campus Environment

RATIONALE

Stigma permeates disability experiences and compounds disability-related challenges.

OBJECTIVE

Identify individual and environmental factors of stigmatizing experiences of college students with learning disabilities (LDs) and attention-deficit/hyperactivity disorder (ADHD).

METHODOLOGY

A qualitative descriptive design was used with a thematic analysis of 30 transcripts from group discussions among four cohorts of undergraduates with LD/ADHD (N = 52). The Person-Environment-Occupation-Performance Model was used in interpreting the stigmatizing experiences.

FINDINGS

The themes Perceived Misconceptions and Stigmatizing Actions describe key social-environmental factors. The theme Overcoming Stigmatizing Experiences elucidates key skills and processes for developing stigma resilience. These skills and processes were anchored in self-awareness and personally contextualized understanding of disability-related challenges and strengths, which were fostered during positive interactions with supportive others, such as instructors and mentors.

IMPLICATIONS

Findings illustrate the biopsychosocial nature of stigma and highlight the role of individual and social-environmental factors in building stigma resilience among young adults with LD/ADHD.

Autonomy lessons: Tips and tricks for building self-determination through the lens of a first time principal investigator

Early career faculty face many challenges, including establishing a career direction, building skills, balancing work and personal life demands, finding mentors, and establishing collegial relationships within their departments. Early career funding has been shown to augment future success in academia; less is known about the impact of early career funding on the social, emotional, and professional identity aspects of work life. One theoretical perspective to examine this issue is self-determination theory, a broad psychological paradigm explaining motivation, well-being, and development. Self-determination theory is predicated on the idea that fulfillment of three basic needs leads to the achievement of integrated well-being. Optimizing autonomy (a sense of choice and control), competence (sense of mastery), and relatedness (a sense of belonging) accompanies greater motivation, productivity, and perceived success. The authors share how applying for and implementing an early career grant affected these three constructs. Early career funding manifested challenges and beneficial outcomes in relationship to each of the three psychological needs and led to important lessons that may be generally applicable to faculty across a wide range of disciplines. The authors offer broad principles as well as specific grant-related strategies for optimizing autonomy, competence, and relatedness while applying for and executing a grant.[Box: see text].

Online Learning is a Rollercoaster: Postsecondary Students With Learning Disabilities Navigate the COVID-19 Pandemic

Most of what researchers know about the challenges students with learning disabilities (LDs) experience during postsecondary education is based on experiences during face-to-face learning on campus. Less is known about challenges students with LD face during learning online-the mode of instruction students had to navigate during the COVID-19 pandemic. Therefore, the purpose of our research was to examine the lived experience of undergraduate students with LD during their first full semester of online instruction as a result of the pandemic. We interviewed six students in Western Canada and used a phenomenological approach to analyze their experiences. Overall, we extracted six main themes from their interviews. Two of these themes, (a) the broad impact of having LD and (b) accommodations during COVID-19, were specific to being a student with LD. The remaining four themes were more generally related to their overall student experience: (c) online learning is different, (d) the role of others, (e) emotional impact, and (f) resilience and perseverance. We discuss these results in terms of recommendations for future research and teaching in online learning environments.

A systematic review of actions aimed at university students with ADHD

University students with Attention Deficit Hyperactivity Disorder (ADHD) need to have a range of actions at their disposal that are tailored to their needs. The aim of this study is to analyse the actions of support for university students with ADHD by means of a systematic review of ERIC, WOS, and Scopus from 2017 to 2022, following the PICOC and PRISMA guidelines. A sample of 24 studies are analysed through the MAXQDA 2022 software. The results show two types of studies, on the one hand, supporting actions offered directly by universities to their students and, on the other, intervention programs from which university students have benefit but outside the university settings. Concerning the first type, universities mainly offer accommodations linked to exams, tutoring and online courses adapted to ADHD students. About the second type, programmes focused on cognitive-behavioural therapy, coaching and mindfulness have proven to be useful with ADHD university students. In this sense, further research is needed to analyze the viability of including these intervention programs for ADHD students at universities.

Evaluation of the "Let's Get Organized" group intervention to improve time management: protocol for a multi-centre randomised controlled trial

BACKGROUND

Time management skills are essential for living in modern society. People with mental or neurodevelopmental disorders typically have cognitive limitations, including affected time management, which might lead to poor occupational balance, low self-efficacy, and poor parental sense of competence. "Let's Get Organized" (LGO) is a recently developed manual-based group intervention to train time management skills. The aim of this trial is to evaluate the efficiency of the Swedish version of LGO (LGO-S) compared to treatment as usual (individual occupational therapy) to improve time management for adults with impaired time management skills due to mental or neurodevelopmental disorders. Furthermore, to evaluate if the intervention is a cost-effective way to improve the quality of life and time management skills of these individuals, we will conduct a health economic evaluation.

METHODS

The trial will have a multi-centre, open, parallel randomised controlled design. A total of 104 adults with cognitive limitations due to mental or neurodevelopmental disorders will be recruited from open psychiatric or habilitation care units. Outcomes will be measured before and after a 10-week intervention, with a follow-up 3 months after completing the intervention. The primary outcome will be self-assessed time management skills. Secondary outcomes will be e.g. self-assessed skills in organisation and planning, regulation of emotions, satisfaction with daily occupations, occupational balance, self-efficacy, and quality-adjusted life years.

DISCUSSION

A recent feasibility study has shown promising results for LGO-S, and a randomised trial will provide robust evidence for the possible efficacy of LGO-S in comparison to treatment as usual.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03654248 . Registered on 20 August 2018.

The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents: a qualitative study

BACKGROUND

When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs).

METHODS

Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method.

RESULTS

Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: 'Normalising'; 'Maintaining hope and a sense of the future'; 'Dealing with an uncertain future'; and 'Seeking Support'.

CONCLUSIONS

Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or 'better' place than they have been previously.