1
|
Bhat V, Sengupta SM, Grizenko N, Joober R. Therapeutic response in children with ADHD: role of observers and settings. World J Pediatr 2020; 16:314-321. [PMID: 31965445 DOI: 10.1007/s12519-019-00332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 12/27/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aims at characterizing the extent of correlation of treatment response (TR) obtained in various observation settings (home, school, clinic) by different observers (parents, teachers, clinicians). METHODS Children with attention deficit hyperactivity disorder (ADHD) underwent a 2-week double-blind, randomized, cross-over clinical trial with methylphenidate and placebo, and various measures were obtained during the 2 weeks. Interrelationships of TR were examined using Pearson's correlation coefficients. RESULTS The study included 526 children (420 male, 106 female) with ADHD. TR between different observers shows a variable correlation between parents and teachers. No correlation is seen between parents/teacher evaluation of TR and laboratory-based measures (Continuous Performance Task; Restricted Academic Situation Scale). CONCLUSION The results firmly support the need to synthesize information from many sources in evaluating TR in ADHD.
Collapse
Affiliation(s)
- Venkat Bhat
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Sarojini M Sengupta
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Natalie Grizenko
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada. .,Department of Psychiatry, McGill University, Montreal, Canada. .,Department of Neurology and Neurosurgery, McGill University, Montreal, Canada. .,Department of Human Genetics, McGill University, Montreal, Canada.
| |
Collapse
|
2
|
Naumova D, Grizenko N, Sengupta SM, Joober R. DRD4 exon 3 genotype and ADHD: Randomised pharmacodynamic investigation of treatment response to methylphenidate. World J Biol Psychiatry 2019; 20:486-495. [PMID: 29182037 DOI: 10.1080/15622975.2017.1410221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Dopamine plays an important role in modulating attention and motor behaviours, dimensions altered in attention deficit/hyperactivity disorder (ADHD). Numerous association studies have linked dopamine receptor 4 (DRD4) to increased risk of ADHD. This study investigated the effect of DRD4 exon 3 polymorphism on child behaviours in response to treatment with methylphenidate. Methods: A total of 374 children diagnosed with ADHD (ages 6-12 years) were evaluated under three experimental conditions: baseline, placebo and MPH (0.5 mg/kg/day). This was a 2-week prospective within-subject, placebo-controlled, crossover trial. The Conners' Global Index for parents and for teachers was used to evaluate the behaviours of the children. One-way repeated measures analysis of variance was used to test the effect of the interaction between DRD4 genotype and experimental conditions. Results: A significant interaction between DRD4 genotype and treatment was detected when the child's behaviour was evaluated by the parents (P = 0.035, effect size of 0.014), driven by a better treatment response in children homozygous for long 7-repeat allele. Conclusions: According to the parent assessment, children homozygous for the long 7-repeat allele were more responsive to experimental condition. This is the largest pharmacogenetic investigation of the effect of DRD4 exon 3 polymorphism in childhood ADHD. Trial Registration: clinicaltrials.gov, identifier NCT00483106.
Collapse
Affiliation(s)
- Darya Naumova
- Department of Human Genetics, McGill University , Montreal , QC , Canada
| | - Natalie Grizenko
- Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada
| | - Sarojini M Sengupta
- Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada
| | - Ridha Joober
- Department of Human Genetics, McGill University , Montreal , QC , Canada.,Douglas Mental Health University Institute , Verdun , QC , Canada.,Department of Psychiatry, McGill University , Montreal , QC , Canada.,Department of Neurology and Neurosurgery, McGill University , Montreal , QC , Canada
| |
Collapse
|
3
|
MacDonald B, Pennington BF, Willcutt EG, Dmitrieva J, Samuelsson S, Byrne B, Olson RK. Cross-Country Differences in Parental Reporting of Symptoms of ADHD. J Cross Cult Psychol 2019; 50:806-824. [PMID: 31303678 DOI: 10.1177/0022022119852422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous studies within the United States suggest there are cultural and contextual influences on how Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms are perceived. If such influences operate within a single country, they are likely to also occur between countries. In the current study, we tested whether country differences in mean ADHD scores also reflect cultural and contextual differences, as opposed to actual etiological differences. The sample for the present study included 974 participants from four countries tested at two-time points, the end of preschool and the end of 2nd grade. Consistent with previous research, we found lower mean ADHD scores in Norway and Sweden in comparison to Australia and the United States, and we tested four explanations for these country differences: 1) Genuine etiological differences, 2) Slower introduction to formal academic skills in Norway and Sweden than in the United States and Australia that indicated a context difference, 3) Under-reporting tendency in Norway and Sweden, or 4) Over-reporting tendency in the United States and Australia. Either under-or over-reporting would be examples of cultural differences in the perception of ADHD symptoms. Of these explanations, results of ADHD measurement equivalence tests across countries rejected the first three explanations and supported the fourth explanation: an over-reporting tendency in the United States and Australia. These findings indicate that parental reporting of ADHD symptoms is more accurate in Norway and Sweden than in Australia and the United States, and thus have important clinical and educational implications for how parental reporting informs an ADHD diagnosis in these countries.
Collapse
Affiliation(s)
| | | | | | | | | | - Brian Byrne
- University of New England and Linköping University
| | | |
Collapse
|
4
|
Abstract
BACKGROUND This study examined mental health outcomes in extremely preterm children (EPT) born at 23 to 25 weeks of gestation between 1992 and 1998 at 2 Swedish tertiary care centers that offered regional and active perinatal care to all live-born EPT infants. METHODS We assessed 132 (98%) of the 134 EPT survivors at 10 to 15 years of age alongside term-born controls. Behavioral and emotional problems were evaluated by using Achenbach's Child Behavior Checklist and Teacher Report Form and Conners' Parent and Teacher scales for attention-deficit/hyperactivity disorder. RESULTS Parents and teachers reported significantly more problems with internalizing behaviors as well as attention, social, and thought problems in EPT children than in controls, even when those with major neurodevelopmental disabilities (NDDs) were excluded. Multivariate analysis of covariance of the behavioral problems reported by parents and teachers revealed no interactions, but significant main effects emerged for group status (EPT versus control) and sex, with all effect sizes being medium to large and accounting for 8% to 14% of the variance. Compared with the controls, EPT children without NDDs had significantly increased rates of ≥90th percentile for total Conners' attention-deficit/hyperactivity disorder problem scores (parents: 40% vs 15%, odds ratio: 3.7, P < .001) (teachers: 24% vs 9%, odds ratio: 3.3, P = .005). The corresponding rates were higher in the total population. CONCLUSIONS EPT children with or without NDDs had behavioral problems characterized by a higher risk for anxiety and attention, social, and thought problems. These findings further strengthen the proposition that a preterm behavioral phenotype is recognizable in adolescents born EPT.
Collapse
Affiliation(s)
| | | | | | - Fredrik Serenius
- Units of Pediatrics and.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Bruno Hägglöf
- Child and Adolescent Psychiatry, Institute of Clinical Sciences, University of Umeå, Umeå, Sweden; and
| | | |
Collapse
|
5
|
Abstract
OBJECTIVE To explore the significance of adding father ratings to mother and teacher ratings in the assessment of ADHD symptoms in children. METHOD The ADHD Rating Scale-IV, the Child Behavior Checklist, and the Teacher Report Form were filled out by all three informants for a sample of 48 clinically referred children (79% boys) aged 6 to 15 (M = 10.1) years. RESULTS Correspondence between father and teacher reports on ADHD-specific symptoms (intraclass correlation coefficient [ICC] = .38) exceeded that between mothers and teachers (ICC = .23). Fathers rated their children as having fewer problems than did mothers and teachers on Total scale scores and the Inattention subscale of the ADHD Rating Scale-IV. Mother ratings were more sensitive to an ADHD diagnosis, whereas father ratings better predicted an ADHD diagnosis requiring the two-setting criterion. CONCLUSION The choice of parent informant and informant combination had a considerable impact on parent-teacher concordance and estimates of ADHD symptoms and subtypes in the child.
Collapse
Affiliation(s)
- Henrik Sollie
- 1Kristiansund Hospital, Møre & Romsdal Health Trust, Norway
| | | | | |
Collapse
|
6
|
Cho SC, Kim HW, Kim BN, Shin MS, Yoo HJ, Kim JW, Bhang SY, Cho IH. Are Teacher Ratings and Parent Ratings Differently Associated with Children's Intelligence and Cognitive Performance? Psychiatry Investig 2011; 8:15-21. [PMID: 21519532 PMCID: PMC3079181 DOI: 10.4306/pi.2011.8.1.15] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 09/04/2010] [Accepted: 11/03/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The present study investigated whether teacher ratings and parent ratings of inattentive or hyperactive/impulsive symptoms were differently associated with intelligence or cognitive performance in Korean children. METHODS Six hundred sixty-seven children were recruited from nine schools in five Korean cities. The teachers and parents of 580 of these children (9.0±0.7 years old, 333 boys and 306 girls) completed the Korean version of the Attention-Deficit/Hyperactivity Disorder Rating Scales (K-ARS), and the children performed the abbreviated form of the Korean Educational Development Institute-Wechsler Intelligence Scales (KEDI-WISC) and a neurocognitive battery consisting of the continuous performance test, the Children's Color Trails Test, and the Stroop Color-Word Test. Diagnosis of full-syndrome and subthreshold attention-deficit/hyperactivity disorder (ADHD) were based on the Diagnostic Interview Schedule for Children Version-IV (DISC-IV). RESULTS The level of agreement between teacher and parent ratings was low (r=0.21-0.26) in children with full-syndrome and subthreshold ADHD and low to moderate (r=0.31-0.41) in the normative sample. Teacher-rated ARS showed significant correlations with most sub-scores of KEDI-WISC and the neurocognitive battery both in the normative sample (r=-0.50-0.37) and in children with full-syndrome and subthreshold ADHD (r=-0.26-0.29). Correlations between parent-rated ARS and cognitive tests were lower and were found in fewer subscales of tests. CONCLUSION These results suggest the importance of considering the teacher's report of a child's school functioning during the assessment of ADHD.
Collapse
Affiliation(s)
- Soo-Churl Cho
- Department of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo-Won Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Boong-Nyun Kim
- Department of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Sup Shin
- Department of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Won Kim
- Department of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Ulsan University Hospital, Ulsan, Korea
| | - In Hee Cho
- Department of Psychiatry, Gachon University of Medicine and Science, Incheon, Korea
| |
Collapse
|
7
|
Sayal K, Goodman R. Do parental reports of child hyperkinetic disorder symptoms at school predict teacher ratings? Eur Child Adolesc Psychiatry 2009; 18:336-44. [PMID: 19198923 DOI: 10.1007/s00787-009-0735-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Accepted: 10/12/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clinical practice guidelines for the evaluation of children with suspected hyperkinetic disorder or ADHD recommend that information is collected from teachers. METHODS Using the development and well-being assessment, parents of 5-16 year olds participating in the 1999 and 2004 British Child and Adolescent Mental Health Surveys were asked about symptoms relating to hyperkinetic disorder and reports of teacher complaints about these symptoms. We examined whether parental reports about symptoms at school reflect teacher ratings and can be relied upon by clinicians. RESULTS Parent reports about symptoms at school were moderately correlated with teacher ratings. If children potentially met criteria for hyperkinetic disorder based on parental ratings only, the positive predictive value (PPV) for a research diagnosis of hyperkinetic disorder was 47%. When parents reported high levels of symptoms at school in addition to sufficient parent-rated symptoms and impairment, the PPV for a diagnosis of hyperkinetic disorder increased to 59%. CONCLUSIONS In a community sample, we found that parental reports about symptoms at school have limited utility in predicting teacher ratings. Our findings highlight that it is desirable and worthwhile for clinicians to obtain direct information from the teacher. If this is unavailable, clinicians and researchers should be aware that "second-hand" information about symptoms at school is second best.
Collapse
|
8
|
Farooqi A, Hägglöf B, Sedin G, Gothefors L, Serenius F. Mental health and social competencies of 10- to 12-year-old children born at 23 to 25 weeks of gestation in the 1990s: a Swedish national prospective follow-up study. Pediatrics 2007; 120:118-33. [PMID: 17606569 DOI: 10.1542/peds.2006-2988] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We investigated a national cohort of extremely immature children with respect to behavioral and emotional problems and social competencies, from the perspectives of parents, teachers, and children themselves. METHODS We examined 11-year-old children who were born before 26 completed weeks of gestation in Sweden between 1990 and 1992. All had been evaluated at a corrected age of 36 months. At 11 years of age, 86 of 89 survivors were studied and compared with an equal number of control subjects, matched with respect to age and gender. Behavioral and emotional problems, social competencies, and adaptive functioning at school were evaluated with standardized, well-validated instruments, including parent and teacher report questionnaires and a child self-report, administered by mail. RESULTS Compared with control subjects, parents of extremely immature children reported significantly more problems with internalizing behaviors (anxiety/depression, withdrawn, and somatic problems) and attention, thought, and social problems. Teachers reported a similar pattern. Reports from children showed a trend toward increased depression symptoms compared with control subjects. Multivariate analysis of covariance of parent-reported behavioral problems revealed no interactions, but significant main effects emerged for group status (extremely immature versus control), family function, social risk, and presence of a chronic medical condition, with all effect sizes being medium and accounting for 8% to 12% of the variance. Multivariate analysis of covariance of teacher-reported behavioral problems showed significant effects for group status and gender but not for the covariates mentioned above. According to the teachers' ratings, extremely immature children were less well adjusted to the school environment than were control subjects. However, a majority of extremely immature children (85%) were functioning in mainstream schools without major adjustment problems. CONCLUSIONS Despite favorable outcomes for many children born at the limit of viability, these children are at risk for mental health problems, with poorer school results.
Collapse
Affiliation(s)
- Aijaz Farooqi
- Division of Pediatrics, Department of Clinical Sciences, University Hospital, SE-901 85 Umeå, Sweden.
| | | | | | | | | |
Collapse
|
9
|
Tripp G, Schaughency EA, Clarke B. Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: contribution to diagnosis and differential diagnosis in clinically referred children. J Dev Behav Pediatr 2006; 27:209-18. [PMID: 16775518 DOI: 10.1097/00004703-200606000-00006] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated diagnostic utility of parent and teacher ratings in the attention-deficit hyperactivity disorder (ADHD) assessment and differential diagnosis of a clinical sample of children referred for suspected ADHD. Participants were 184 5- to 12-year-old children for whom the following were available: multimethod multi-informant assessment, firm decision regarding presence or absence of ADHD, and parent-completed Child Behavior Checklist and revised 48-item Conners Parent Rating Scale, and teacher-completed Teacher Report Form and 39-item Conners Teacher Rating Scale. Parent ratings of children diagnosed with and without ADHD were generally similar. In contrast, teachers rated students diagnosed with ADHD as displaying higher levels of behavioral difficulties. Discriminant function analyses indicated parent ratings of narrowband measures of ADHD and broadband measures of externalizing symptoms displayed high sensitivity. Teacher ratings outperformed parent ratings when considering sensitivity, specificity, and overall classification accuracy. For clinically recommended cut scores, teacher measures displayed good specificity and positive predictive power. Combining rating scales within informants. did not improve classification accuracy. Combining across parent and teacher measures produced results consistent with teacher ratings. Results support recommendations to include parent and teacher rating scales in ADHD assessment. Scales contributing most to classification accuracy were those designed to assess ADHD. Imperfect performance of rating scales supports recommendations to include other methodologies in diagnosis and differential diagnosis of ADHD.
Collapse
Affiliation(s)
- Gail Tripp
- Department of Psychology, University of Otago, Dunedin, New Zealand.
| | | | | |
Collapse
|
10
|
Aase H, Sagvolden T. Infrequent, but not frequent, reinforcers produce more variable responding and deficient sustained attention in young children with attention-deficit/hyperactivity disorder (ADHD). J Child Psychol Psychiatry 2006; 47:457-71. [PMID: 16671929 DOI: 10.1111/j.1469-7610.2005.01468.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The underlying behavioral/psychological processes of attention-deficit/hyperactivity disorder are unclear. Motivational factors, related to dopamine dysfunction, may play an important role in the development of the behavioral symptoms. Particularly, infrequent, but not frequent, reinforcers have been suggested to be associated with altered responding and deviant behavior in children with ADHD. The present study was designed to analyze the influence of reinforcement frequency on operationalized measures of hyperactivity, impulsiveness, sustained attention, and response variability. METHODS Fifty-six boys, half of whom were diagnosed with ADHD, completed a computerized task presented as a game with two squares on the screen. One square was associated with reinforcement. The task required responses by the computer mouse under contingencies alternating between variable interval schedules of short (mean 2 s) and long (mean 20 s) durations. Reinforcers were cartoon pictures and small trinkets. RESULTS Overall, there was no difference between children with ADHD and comparison children when reinforcers were given frequently. Statistically significant differences on measures of sustained attention and variability, but not hyperactivity and impulsiveness, were found during infrequent reinforcement only. Age effects interacted with group effects on sustained attention, showing that group differences were found in the young children only. Surprisingly, older comparison children showed increased response variability and no learning. CONCLUSIONS When reinforcers are infrequent, children with ADHD show deficient sustained attention and increased variability in responding. Computer experience may have interfered with measures of hyperactivity and impulsiveness. The unexpectedly poor performance of the older comparison children may have been due to inefficient reinforcers or to verbally governed behavior overruling reinforcer effects. Reinforcer characteristics and experimental procedures are important factors influencing findings in studies investigating motivational factors. The study provides some support for the dynamic developmental theory of ADHD predicting relationships between neurobiological deficits, altered reinforcement mechanisms, and treatment recommendations.
Collapse
Affiliation(s)
- Heidi Aase
- Norwegian Center for Studies of Conduct Problems and Innovative Practice, UNIRAND Ltd, University of Oslo, Norway.
| | | |
Collapse
|
11
|
Abstract
OBJECTIVE To investigate whether parents are accurate informants of child hyperactivity symptoms and impairment at school. METHOD Parents of a community sample of 93 children with pervasive hyperactivity completed rating scales about their child's behaviour at home and school. These were compared with teacher ratings. RESULTS Parent ratings about school correlate more closely with parent (home) than teacher ratings. Such ratings systematically under-estimate teacher ratings and are influenced by the child's behaviour at both home and school as well as parental mental health. However, a parental report of impairment for the child at school is likely to be accurate. CONCLUSION There are limitations in relying on parental accounts of school behaviour if teacher ratings are unavailable. As such ratings may under-identify children with ADHD and discrepancies between parent and teacher ratings may reflect actual differences in behaviour, this suggests that ratings are required from both sets of informants.
Collapse
Affiliation(s)
- K Sayal
- Department of Child Psychiatry, Institute of Psychiatry, Denmark Hill, London, UK.
| | | |
Collapse
|
12
|
Abstract
Although much has been written about the agreement of parents and teachers regarding the diagnosis of attention-deficit/hyperactivity disorder (ADHD), some uncertainty remains about their agreement when assessing change during drug treatment. To address this issue, we analyzed data from a placebo-controlled short-term study and an open-label long-term study of ADHD children treated with OROS methylphenidate (MPH). Both reporters agreed that OROS MPH was efficacious for symptoms of inattention/overactivity and oppositionality/defiance and that the effect was greater for inattention/overactivity than oppositionality/defiance. Thus, in clinical trials, having two reports may not be absolutely essential for assessing the efficacy of ADHD medications. We also computed diagnostic efficiency statistics and found a high probability that parents would confirm teacher reports of therapeutic improvement and a somewhat lower probability that teachers would confirm parent reports of therapeutic improvement. In contrast, neither reporter was likely to confirm the other reporter's report of no improvement or worsening. Thus, when given a report of no improvement from one setting, clinicians cannot be certain about clinical status in the other setting. For symptoms of oppositionality and defiance, we also saw that parent- teacher agreement about improvement was better than agreement about lack of improvement. However, for these symptoms, teacher reports were somewhat better predictors of parent reports than vice-versa.
Collapse
Affiliation(s)
- Stephen V Faraone
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
| | | | | |
Collapse
|
13
|
Abstract
BACKGROUND We have previously shown that infants who were extremely low birth weight (ELBW) are particularly vulnerable to problems related to inattention and hyperactivity at school age. It is not known whether these problems persist to adolescence. OBJECTIVE To explore and compare the levels of psychopathology in a regional cohort of ELBW infants and sociodemographically matched term controls as reported by teens and their parents. DESIGN/METHODS Cross-sectional cohort study/geographically defined region. PARTICIPANTS TEENS: ELBW 141/169 (83%) and control 122/145 (84%), aged 12 to 16 years. PARENTS: ELBW 143/169 (85%) and control 123/145 (85%). Both cohorts and their parents completed the Ontario Child Health Study-Revised questionnaire with 6 behavioral subsca1es: conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), overanxious, separation anxiety, and depression. RESULTS By teen self-report, there were no significant differences between ELBW and control teens on any of the 6 subscale scores. However, parents of ELBW teens reported significantly higher scores than parents of control for depression and ADHD based on 2-way analysis of variance (group x gender). Comparison within teen/parent dyads showed that both cohorts of teens reported significantly higher scores than their parents. Multivariable analyses on behavioral subscale scores demonstrated a number of variables that were significant predictors by parent report: group (ELBW vs control), gender, family function, developmental quotient, maternal mood, and socioeconomic status; no predictors were significant by teen report. There were no statistically significant interaction effects for any of the models. These models explained a greater percent of the variance in behavioral scores for parents than for teens (12.5%-22.0% vs 3.4%-8.2%). Results were similar when teens with neurosensory impairment were excluded. CONCLUSIONS This study is unique in the inclusion of both parent and teen self-report of behaviors. Significant differences were apparent only by parent report for ADHD and depression among ELBW teens. Significant predictors of behavioral scores for parents include group, gender, family function, developmental quotient, maternal mood, and socioeconomic status.
Collapse
Affiliation(s)
- Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
| | | | | | | | | |
Collapse
|
14
|
Abstract
A population study of 409 seven-year-old children in a middle-sized Swedish town was performed. All children were examined by the same doctor and evaluated by means of parent interview, motor examinations, and teacher reports on behaviour in the classroom. Follow-up was carried out 8 months later. The rate of severe problems in the fields of attention deficit-hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and deficits in attention, motor control, and perception (DAMP) (the combination of ADHD and DCD) was 6.1%, with boys being affected more frequently than girls. There was considerable overlap between ADHD and DCD, with about half of each diagnostic group also meeting criteria for the other diagnosis. Attention deficits at diagnosis strongly predicted attention deficits at follow-up. If parents had noted attention deficits in the home setting, then teachers almost always independently agreed that there were similar problems in the classroom. However, the reverse did not always apply. Clumsiness also showed striking stability over time. The diagnosis of DAMP, particularly severe DAMP, had a stronger association with classroom dysfunction and with high Conners scores than did diagnoses of ADHD or DCD. It is concluded that DAMP may be a clinically valid diagnostic construct.
Collapse
Affiliation(s)
- B Kadesjö
- Department of Child and Adolescent Psychiatry University of Göteborg, Sahlgren University Hospital, Sweden
| | | |
Collapse
|
15
|
|