ORCID Profile
0000-0003-2812-303X
Current Organisation
Deakin University
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Publisher: Wiley
Date: 18-10-2014
DOI: 10.1111/JPC.12416
Abstract: This study aimed to compare multidisciplinary (MD) versus sole paediatrician (SP) assessment models for children with learning and/or behaviour difficulties. Children aged 4-12 years referred for an MD or SP assessment of learning and/or behavioural concerns were invited to participate. At baseline, parents completed surveys assessing child behaviour (Strengths and Difficulties Questionnaire SDQ) and quality of life (QoL) (Pediatric Quality of Life Inventory 4.0 PedsQL). Following the assessment, parents completed a survey evaluating their satisfaction with the assessment. Parents completed a survey at 3-4 months post-assessment assessing: (i) adherence to recommendations (ii) perceived changes in child functioning and (iii) child QoL and behaviour. The parents of 66 children (82% male) participated in the study. Parents reported satisfaction with both assessment models however, parents in the MD group reported better understanding of their child's difficulties than the SP group (P = 0.03). Parents in the MD group were less likely to report that 'recommendations were useful and practical' compared with the SP group (P = 0.01). There was no significant change in child behaviour or QoL in either group from baseline to 3-4 months post-assessment. Parents attending both clinics were satisfied with the assessment process. MD assessment of children with suspected learning and/or behavioural concerns appears to have the additional benefit of helping families to better understand their child's difficulties. Fewer families attending MD clinics reported that recommendations were useful and practical compared with the SP model.
Publisher: Informa UK Limited
Date: 25-11-2021
Publisher: Springer Science and Business Media LLC
Date: 29-10-2011
DOI: 10.1007/S10578-011-0264-Z
Abstract: Emerging evidence suggests that adolescent girls with Attention-Deficit/Hyperactivity Disorder (ADHD) are more socially impaired compared with their peers however, research has yet to elucidate the nature of this impairment. We investigated overt (e.g., physical, such as hitting or kicking or verbal, such as teasing and taunting) and relational (e.g., social manipulation, such as social exclusion) bullying and victimisation in adolescent girls with and without ADHD. Adolescent girls (mean age = 15.11) with (n = 22) and without (n = 20) ADHD and their primary caregivers completed measures of overt/relational bullying and victimisation and social impairment. Adolescent girls with ADHD experienced more social problems and more relational and overt victimisation than adolescent girls without ADHD. Although adolescent girls with ADHD engaged in more overt and relational bullying than adolescent girls without ADHD, this difference was not statistically significant. Oppositional Defiant Disorder symptoms appeared to be more strongly related to bullying behaviour, while victimisation appeared to be more strongly related to ADHD.
Publisher: SAGE Publications
Date: 28-07-2016
Abstract: Objective: This study aimed to determine whether the Strengths and Difficulties Questionnaire (SDQ) is an effective screening tool for identifying comorbid mental health difficulties in children with ADHD. Method: Parents of children with ADHD (5-13 years) completed the SDQ and the Anxiety Disorders Interview Schedule for DSM-IV–Parent Version (ADIS-C/P-IV). Data from both the measures were compared to determine congruent validity. Results: Analyses revealed that significant relationships exist between the SDQ total score and the total number of comorbidities on the ADIS-C/P-IV. The SDQ emotional problem and conduct problem scales were significantly related to internalizing and externalizing comorbidities on the ADIS-C/P-IV, respectively. Conclusion: While significant relationships were found between the SDQ and ADIS-C/P-IV across various domains, this relationship was stronger for externalizing comorbidities. Additional screening questions are required to effectively screen for less common internalizing comorbidities in children with ADHD, for ex le, major depression and panic disorder.
Publisher: SAGE Publications
Date: 14-01-2010
Abstract: Objective. To determine the information needs of parents of children with attention-deficit/hyperactivity disorder (ADHD). Method. A cross-sectional survey of parents recruited from pediatric hospital clinics, support groups, and newspaper advertisements in Victoria, Australia, was undertaken. Parents completed a questionnaire covering information sources accessed, the quality of this information, the information content they considered important and their preferred information modes. Results. Survey data were collected from 99 parents. Parents most frequently accessed information from pediatricians (89%), books (78%), general practitioners (65%), and schools (61%). Pediatricians were rated highest as a useful, trusted, easy-to-understand, and up-to-date information source. Parents placed most importance on causes and symptoms at the time of diagnosis. Parents preferred to receive verbal information from a professional (69%). Conclusion. Information provision for parents of children with ADHD is a continuous process. Although they access a range of sources and modes, parents prefer verbal information delivery.
Publisher: SAGE Publications
Date: 17-02-2023
DOI: 10.1177/10870547231155871
Abstract: This study examined associations between objective and subjective sleep parameters, and mental health symptoms (internalizing symptoms, externalizing symptoms, and irritability) and whether these relationships differed for adolescents with and without ADHD. Participants were 373 adolescents aged 10 to 19 years ( M = 13.21, SD = 2.37). Sleep was measured both via actigraphy and self- and parent-report scales. Mental health symptoms were measured via a range of validated measures. Few relationships were detected when examining actigraphy variables. Subjective sleep parameters were associated with almost all mental health variables. Some relationships were moderated by ADHD status, generally consistent with stronger relationships between subjective sleep quality and mental health in the non-ADHD group. Sleep problems, particularly subjective difficulties, are associated with a range of mental health outcomes, regardless of the presence of ADHD. Sleep problems may be a beneficial intervention target for adolescents experiencing mental health issues.
Publisher: Wiley
Date: 11-05-2023
DOI: 10.1111/JCPP.13818
Abstract: Attention deficit hyperactivity disorder (ADHD) and irritability commonly co‐occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co‐occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability. A community s le of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow‐up after 18‐months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity–impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability. Irritability was significantly higher among the ADHD group than controls however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive–impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability however, baseline irritability did not significantly predict change in ADHD symptoms. ADHD symptoms—particularly hyperactive–impulsive symptoms—predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain‐specific measures provides additional insight into this relationship.
Publisher: Wiley
Date: 27-02-2014
DOI: 10.1111/CCH.12036
Abstract: Attention-deficit/hyperactivity disorder (ADHD) is now the most common reason for a child to present to a paediatrician in Australia. Stimulant medications are commonly prescribed for children with ADHD, to reduce symptoms and improve function. In this study we investigated the factors that influence paediatricians' decisions about prescribing stimulant medications. In-depth, semi-structured interviews were conducted with paediatricians (n = 13) who were purposively recruited so as to s le a broad demographic of paediatricians working in erse clinical settings. Paediatricians were recruited from public outpatient and private paediatrician clinics in Victoria, Australia. The interviews were audio-recorded and transcribed verbatim for thematic analysis. Paediatricians also completed a questionnaire describing their demographic and practice characteristics. Our findings showed that the decision to prescribe is a dynamic process involving two key domains: (1) weighing up clinical factors and (2) interacting with parents and the patient along the journey to prescribing. Five themes relating to this process emerged from data analysis: comprehensive assessments that include history, examination and information from others influencing factors such as functional impairment and social inclusion previous success facilitating parental understanding including addressing myths and parental confusion and decision-making model. Paediatricians' decisions to prescribe stimulant medications are influenced by multiple factors that operate concurrently and interdependently. Paediatricians do not make decisions about prescribing in isolation rather, they actively involve parents, teachers and patients, to arrive at a collective, well-informed decision.
Publisher: Wiley
Date: 10-02-2017
DOI: 10.1111/JCPP.12688
Abstract: Children with Attention-Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non-ADHD controls. A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non-ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t-Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta-analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p-curve techniques. Twenty-one studies were included in the systematic review (ADHD = 1,209 Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow-up meta-analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05 weighted mean ES [WMES]: 1.04) expressive (10/10 met p < .05 WMES: 1.23) receptive (12/14 met p < .05 WMES: 0.97), and pragmatic language (4/4 studies met p < .05 WMES: 0.98) compared with controls. This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.
Publisher: Springer Science and Business Media LLC
Date: 2017
DOI: 10.1007/S11920-017-0753-2
Abstract: While it is well accepted that attention-deficit/hyperactivity disorder (ADHD) is a highly heritable disorder, not all of the risk is genetic. It is estimated that between 10 and 40% of the variance associated with ADHD is likely to be accounted for by environmental factors. There is considerable interest in the role that the prenatal environment might play in the development of ADHD with previous reviews concluding that despite demonstration of associations between prenatal risk factors (e.g. prematurity, maternal smoking during pregnancy) and ADHD, there remains insufficient evidence to support a definite causal relationship. This article provides an update of research investigating the relationship between prenatal risk factors and ADHD published over the past 3 years. Recently, several epidemiological and data linkage studies have made substantial contributions to our understanding of this relationship. In particular, these studies have started to account for some of the genetic and familial confounds that, when taken into account, throw several established findings into doubt. None of the proposed prenatal risk factors can be confirmed as causal for ADHD, and the stronger the study design, the less likely it is to support an association. We need a new benchmark for studies investigating the etiology of ADHD whereby there is an expectation not only that data will be collected prospectively but also that the design allows the broad range of genetic and familial factors to be accounted for.
Publisher: Wiley
Date: 12-03-2023
DOI: 10.1111/JSR.13830
Abstract: Adolescents with attention‐deficit/hyperactivity disorder (ADHD) often experience greater sleep difficulties compared to those without. However, findings are mixed, and other mental health conditions are often overlooked. This study aimed to examine the relationship between sleep problems, ADHD, and other mental health conditions in a s le of adolescents. Data from 373 adolescents aged 10–19 years was used as part of the wider ‘Healthy Brain Network’ study, which targets children and adolescents experiencing mental health and neurodevelopmental difficulties. Mental health conditions were assessed via a comprehensive assessment. Sleep was measured by self‐ and parent‐report, as well as via up to a month of actigraphy data. Actigraphy data were analysed using mixed‐methods modelling, while subjective sleep data were analysed using multiple regression. Subjectively‐reported sleep was generally worse in adolescents who had ADHD and other mental health conditions compared to those with ADHD but no other conditions. There were no associations between ADHD status and objective sleep measures or self‐reported measures, but a significant association was found between ADHD status and parent‐reported sleep difficulties, even when accounting for other conditions. Parent‐reported sleep problems were associated not only with ADHD, but also with anxiety, depression, and externalising disorders. The strength of association between ADHD and sleep problems is potentially not as strong as previously thought when considering the role of other mental health conditions. Clinicians should consider the role of other mental health conditions when sleep problems are present, and vice versa. The study also highlights the importance of comprehensive, multi‐informant assessment of mental health conditions, including sleep.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2014
Abstract: To examine the functional status (mental health, academic performance, peer problems) of a community-based s le of children who have attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls, and to investigate gender and subtype differences. Children aged 6 to 8 years were recruited through 43 Melbourne schools, using a 2-stage screening (parent and teacher Conners 3 ADHD index) and case confirmation (Diagnostic Interview Schedule for Children, Version IV [DISC-IV]) procedure. Outcome measures were mental health disorders (DISC-IV), academic performance (Wide Range Achievement Test 4), and peer problems (Strength and Difficulties Questionnaire). Unadjusted and adjusted linear and logistic regression were used to compare ADHD and non-ADHD controls. A total of 179 children who have ADHD and 212 non-ADHD controls were recruited. Compared with controls, children who had ADHD had higher odds of externalizing (odds ratio [OR], 11.0 95% confidence interval [CI], 5.6–21.6 P & .001) and internalizing (OR, 2.9 95% CI, 1.2–7.2 P = .02) disorders poorer reading (effect size, −0.66) and mathematics (effect size, −0.69) performance and more peer problems (P & .001). Boys and girls who had ADHD were equally impaired. Only 17% of children in our ADHD group had been previously diagnosed. Previous diagnosis was higher in the Combined group and for boys. In their second year of school, children who had ADHD performed worse than controls across all functional domains, yet only a minority had been formally diagnosed with ADHD. Findings highlight the need for earlier diagnosis and intervention.
Publisher: Springer Science and Business Media LLC
Date: 16-05-2017
DOI: 10.1007/S00787-017-1000-4
Abstract: We aimed to examine the association between sleep problems and parenting and sleep hygiene in children with attention-deficit/hyperactivity disorder (ADHD). Participants included 5-13-year-old children with DSM 5 defined ADHD and a parent-reported moderate-to-severe sleep problem (N = 361). Sleep was assessed using the parent-reported Children's Sleep Habits Questionnaire. Parents also completed checklists assessing sleep hygiene, parenting consistency, and parenting warmth. Linear regression established prediction models controlling for confounding variables including child age and sex, ADHD symptom severity, comorbidities, medication use, and socio-demographic factors. More consistent parenting was associated with decreased bedtime resistance (β = -0.16) and decreased sleep anxiety (β = -0.14), while greater parental warmth was associated with increased parasomnias (β = +0.18) and sleep anxiety (β = +0.13). Poorer sleep hygiene was associated with increased bedtime resistance (β = +0.20), increased daytime sleepiness (β = +0.12), and increased sleep duration problems (β = +0.13). In conclusion, sleep hygiene and parenting are important modifiable factors independently associated with sleep problems in children with ADHD. These factors should be considered in the management of sleep problems in children with ADHD.
Publisher: Springer Science and Business Media LLC
Date: 09-07-2011
DOI: 10.1007/S00431-011-1524-4
Abstract: This study examined the relationship between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms in an Australian community-based s le. Children were screened for ADHD in their second year of formal schooling. Two hundred and two (202) primary caregivers completed validated measures of family quality of life (QoL), parent mental health, parenting styles and parental relationship quality. Compared with controls, parents of children screening positive for ADHD reported poorer family QoL in the domains of emotional impact (mean difference [MD] -20.1 95% CI -38.2 to -1.9, p = 0.03) and impact on family activities (MD -17.2 95% CI -27.9 to -6.5, p = 0.002), less parental warmth (MD -3.4 95% CI -6.0 to -0.9, p = 0.01) and higher parental depression (MD 6.8 95% CI 1.8 to 11.7, p = 0.009) and anxiety (MD 6.2 95% CI 1.7 to 10.6, p = 0.008) after adjusting for socio-demographic characteristics and child conduct symptoms. Parents of children screening positive for ADHD reported higher stress (MD 4.5 95% CI 1.2 to 7.1, p = 0.007) and more inconsistent (MD 3.0 95% CI 1.2 to 4.8, p = 0.002) and hostile (MD = 2.2 95% CI 1.0 to 3.4, p = 0.001) parenting after adjusting for socio-demographic factors only. No difference in parental relationship quality and parental inductive reasoning was identified. These findings suggest a strong association between poor family functioning and ADHD symptoms and carry implications for comprehensive ADHD management and the importance of seeing the child within the family context.
Publisher: SAGE Publications
Date: 13-10-2020
Abstract: To determine the financial and non-financial costs of Attention-Deficit/Hyperactivity Disorder (ADHD) across the lifespan. The population costs of ADHD in Australia were estimated for the financial year 2018 to 2019 using a prevalence approach to cost estimation across all ages. Financial (healthcare, productivity, education and justice systems, and deadweight losses) and non-financial costs were measured (Disability Adjusted Life Years (DALYs)). The total social and economic cost of ADHD in 2018 to 2019 were US$12.76 billion (range US$8.40 billion to US$17.44 billion, with per person costs of US$15,664 per year). Productivity costs made up 81% of the total financial costs, followed by deadweight losses (11%), and health system costs (4%). Loss in terms of wellbeing was significant (US$5.31 billion). There is a need to raise public awareness of the considerable socioeconomic impact and burden of ADHD in order to drive investment and policy decisions that improve identification and treatment of ADHD.
Publisher: Proceedings of the National Academy of Sciences
Date: 05-02-2018
Abstract: Identifying and explaining regional differences in tropical forest dynamics, structure, ersity, and composition are critical for anticipating region-specific responses to global environmental change. Floristic classifications are of fundamental importance for these efforts. Here we provide a global tropical forest classification that is explicitly based on community evolutionary similarity, resulting in identification of five major tropical forest regions and their relationships: ( i ) Indo-Pacific, ( ii ) Subtropical, ( iii ) African, ( iv ) American, and ( v ) Dry forests. African and American forests are grouped, reflecting their former western Gondwanan connection, while Indo-Pacific forests range from eastern Africa and Madagascar to Australia and the Pacific. The connection between northern-hemisphere Asian and American forests is confirmed, while Dry forests are identified as a single tropical biome.
Publisher: SAGE Publications
Date: 24-07-2020
Abstract: Background: ADHD commonly occurs with sleep problems and secondary cognitive impairments such as inhibitory control. Sleep problems may explain attentional lapses and inhibition performance variability in children with ADHD. This study applied Bayesian analyses to examine the relationship between ADHD symptoms, sleep problems, and inhibition. Methods: Participants included 73 children with ADHD and 73 non-ADHD controls, aged 10.5 to 13.5 years. The Stop Signal Task measured inhibition. Sleep problems were measured with the Adolescent Sleep Wake Scale and parent-report. Results: ADHD symptoms are associated with sleep problems and reaction time variability, however, sleep problems accounted for more variance in inhibition performance than both hyperactive and inattentive symptoms. Conclusion: Sleep problems account for inhibition performance over and above ADHD symptom severity in children with and without ADHD diagnoses. This suggests clinical utility in assessing sleep in children with manifestations of ADHD, and interventions targeting sleep problems concurrently with behavioral symptoms. This further adds to the discussion on overdiagnosis of ADHD due to behavioral presentations of underlying sleep disorders. Treatment for phenotypes of ADHD could be enhanced by targeting sleep problems, in addition to inhibition deficits and attentional lapses.
Publisher: Springer Science and Business Media LLC
Date: 25-05-2018
DOI: 10.1007/S00787-017-1008-9
Abstract: Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18 years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent-child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.
Publisher: BMJ
Date: 26-04-2016
DOI: 10.1136/ARCHDISCHILD-2015-310257
Abstract: To examine the association between autism spectrum disorder (ASD) symptoms and (a) social functioning, (b) mental health, (c) quality of life and (d) sleep in children with and without attention-deficit hyperactivity disorder (ADHD). Participants were 6–10-year-old children with ADHD (N=164) and without ADHD (N=198). ADHD was assessed via community-based screening (wave 1) and case confirmation using the Diagnostic Interview Schedule for Children IV (DISC-IV) (wave 2). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Outcome measures were social functioning (Strengths and Difficulties Questionnaire (SDQ)), mental health (DISC-IV, SDQ), quality of life (QoL, Pediatric Quality of Life Inventory 4.0) and sleep problem severity. Greater ASD symptoms were associated with more parent and teacher-reported peer problems and emotional and conduct problems. For every SD increase in SCQ scores, internalising (OR 1.8, 95% CI 1.3 to 2.6, p=0.001) and externalising disorders (OR 1.5, 95% CI 1.1 to 2.1, p=0.02) increased, QoL decreased by 6.7 units (p .001), and moderate/severe sleep problems increased (OR 1.5, 95% CI 1.0 to 2.2, p=0.04). Most findings held in analyses adjusting for socio-demographic factors, ADHD symptom severity and comorbidities (when not the outcome), with the exception of externalising disorders and sleep problems. ASD symptoms are associated with poorer functioning in children with ADHD. It is important to identify and potentially manage ASD symptoms in children with ADHD given that they exacerbate functional impairments in this already vulnerable group.
Publisher: Informa UK Limited
Date: 21-02-2022
Publisher: SAGE Publications
Date: 25-04-2023
DOI: 10.1177/10870547231168334
Abstract: To investigate the longitudinal associations between COVID-19 induced stress (related to COVID-19 restrictions/changes), attention-deficit/hyperactivity disorder (ADHD) symptoms, oppositional symptoms, and mental health outcomes (negative affect, anxiety, depression, and irritability) in children with ADHD during the COVID-19 pandemic. Parents of 140 Australian children with ADHD (aged 5–17 years) completed an online survey in May 2020 during stay-at-home restrictions and 12-months later. Baseline COVID-19 stress was associated with increased total ADHD symptom severity (β = .21, p = .007) and hyperactivity/impulsivity symptoms (β = .23, p = .002) at 12-months, after accounting for covariates (i.e., child age, gender, ADHD medication, socio-economic status, and baseline symptoms). Despite some indication of associations between baseline COVID-19 stress and 12-month oppositional symptoms and negative affect, these were attenuated when adjusting for baseline symptoms. The study provides initial evidence of the medium-term impacts of pandemic-related stress for children with ADHD.
Publisher: SAGE Publications
Date: 28-12-2021
DOI: 10.1177/00048674211065985
Abstract: Nascent evidence indicates that the mental health of parents and children has markedly declined during the COVID-19 pandemic. Considering disruptions to traditional face-to-face mental health services resultant from stay-at-home orders, the potential value of digital mental health interventions has become extremely apparent. Despite this, uptake of digital interventions remains poor, indicating that a better understanding is needed of factors that determine a willingness to use digital platforms. The present multi-wave, longitudinal study of 2365 Australian parents explored between-person and within-person predictors of intentions to use digital interventions during the pandemic. More than one-third of parents reported likely use of a self-guided and therapist-guided digital intervention, with the most endorsed reason for use being to support their child’s mental health. Between-person baseline predictors of higher intention ratings were parent’s prior mental illness, not living with a partner and recent environmental stressors. Within-person predictors of higher intention ratings were endorsement of mindful parenting strategies, child access to the Internet, better perceived management of child’s education, lower social support and financial hardship. Findings demonstrate that willingness to engage in digital interventions fluctuates in response to changing circumstances. Identifying novel ways to increase acceptance and uptake of digital interventions based on modifiable predictors established here is needed to realize the full potential of these modes of care in times of need.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2015
DOI: 10.1007/S10578-014-0515-X
Abstract: This study examined functional outcomes for children with ADHD by comorbidity status. Children with ADHD (5-13 years) were recruited from 21 pediatric practices and followed up 12 months later (n = 199). Parent and teacher-reported baseline and 12 month surveys measured peer problems, daily functioning, quality of life (QoL), parent mental health, and family QoL. The Anxiety Disorders Interview Schedule for Children IV assessed mental health comorbidities at baseline. Linear regression models were conducted, adjusting for socio-demographics, ADHD severity, and baseline functioning (where possible). In adjusted analyses, children with ADHD and co-occurring internalizing and externalizing comorbidities had poorer QoL, greater peer problems, and poorer family QoL, compared to children with ADHD alone. The parents of children with ADHD and internalizing and externalizing comorbidities alone, also reported poorer family QoL, compared to children with ADHD alone. Children with ADHD and co-occurring internalizing and externalizing comorbidities appear particularly vulnerable to poorer functioning.
Publisher: Wiley
Date: 07-2010
DOI: 10.1111/J.1440-1754.2010.01750.X
Abstract: Aim: To undertake a retrospective analysis of the patients referred with suspected attention deficit hyperactivity disorder (ADHD) to a multidisciplinary clinic at the Royal Children's Hospital, Melbourne between 2004 and 2007. This study aimed to determine the proportion of children diagnosed with ADHD, the frequency of comorbid diagnoses, and the level of functional impairment of referred children. Methods: Data regarding the demographic characteristics, clinical features, assessment findings and suggested management of patients who attended the ADHD Assessment Clinic were reviewed. Results: Sixty‐four children (58 males, 6 females) aged between age 4 and 8 years 11 months (M = 6.84, SD = 1.24) were referred. 43 children (67%) were diagnosed with ADHD and 32 (74%) of these were diagnosed with at least one comorbid condition, most commonly, oppositional defiant disorder (ODD 51%) and speech/language disorder (23%). Of the 21 children who were not diagnosed with ADHD, approximately one‐third were diagnosed with ODD and one‐third were diagnosed with a specific learning disorder. Overall, the children referred to the clinic had poor quality of life by caregiver report however, this did not differ between children who were diagnosed with ADHD and children who were not. Conclusion: Comprehensive evaluation of children with suspected ADHD resulted in an alternative primary diagnosis in one‐third of cases. Three‐quarters of children diagnosed with ADHD had one or more comorbid diagnoses. A multidisciplinary model of assessment can be effective in identifying a range of problems in this patient group, and help to inform targeted interventions.
Publisher: SAGE Publications
Date: 10-05-2017
Abstract: Objective: To describe the relationship between ADHD symptom severity and quality of life (QoL) across three time points over a 12-month period and investigate whether sleep modifies this relationship. Method: Children aged 5 to 13 years with ADHD were recruited from 21 pediatric practices across Victoria, Australia ( N = 392). Child QoL (parent-report) and ADHD symptoms (both parent- and teacher-report) were assessed at three time points (0, 6, and 12 months), and sleep was assessed at baseline (parent-report). Data were analyzed using Pearson’s correlations and autoregressive cross-lagged panel models. Results: Parent-reported ADHD symptoms predicted poorer QoL at each subsequent time point ( r = −.10 to −.13), and a small bidirectional relationship was observed between teacher-reported ADHD symptoms and QoL from 6 to 12 months. Sleep moderated the relationship between ADHD symptoms and QoL. Conclusion: Clinicians need to look beyond core ADHD symptoms to other factors that may be influencing QoL in children with ADHD.
Publisher: SAGE Publications
Date: 30-05-2023
DOI: 10.1177/00048674231166329
Abstract: The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD. Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 ‘Attention Deficit Hyperactivity Disorder: Diagnosis and Management’ guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews. The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: adhdguideline.aadpa.com.au/ The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2017
DOI: 10.1007/S00787-017-1067-Y
Abstract: Both ADHD and trauma exposure are common childhood problems, but there are few empirical data regarding the association between the two conditions. The aims of this study were to compare lifetime prevalence of trauma exposure in children with and without ADHD, and to explore the association between trauma exposure and outcomes in children with ADHD. Children aged 6-8 years with ADHD (n = 179) and controls (n = 212) recruited from 43 schools were assessed for ADHD, trauma exposure and comorbid mental health disorders using the Diagnostic Interview Schedule for Children IV. Outcome data were collected by direct child assessment, parent report and teacher-report, and included ADHD symptom severity, internalizing and externalizing problems, quality of life, and academic functioning. Logistic and linear regression models were used to examine differences adjusted for child and family socio-demographics. Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16% OR: 1.99 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our s le suggests that clinicians should evaluate for trauma histories in children presenting with ADHD.
Publisher: SAGE Publications
Date: 15-03-2020
Abstract: Objective: To determine whether self-reported sleep hygiene practices are associated with self- and parent-reported behavioral sleep problems in adolescents with ADHD. Method: Participants included 79 adolescents with ADHD (13-17 years) and their parents. Adolescents were asked to report on their sleep hygiene (Adolescent Sleep Hygiene Scale) and sleep (Adolescent Sleep Wake Scale). Parents also reported on their adolescent’s sleep (Sleep Disturbance Scale for Children). Results: Poorer sleep hygiene was associated with higher total self-reported behavioral sleep problems and most self-reported sleep problems: falling asleep, reinitiating sleep, and returning to wakefulness. The association was also apparent for total parent-reported behavioral sleep problems, problems with initiating and maintaining sleep, and excessive somnolence. Conclusion: This study demonstrates small-to-moderate relationships between poor sleep hygiene practices and sleep problems in adolescents with ADHD, by both self- and parent-report.
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.SLEEP.2015.06.006
Abstract: This study aimed to examine the relationship between sleep problems and working memory in children aged 5-13 years with attention-deficit/hyperactivity disorder (ADHD). Children with ADHD were recruited into a randomized controlled trial from 21 paediatric practices in VIC, Australia. Cross-sectional data for intervention and control children were pooled at 6 months post randomization for the current analyses (n = 189). Children who met the Diagnostic Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for ADHD and had a parent-reported moderate/severe sleep problem that fulfilled diagnostic criteria for a behavioural sleep disorder were recruited into the study. Sleep was assessed by detailed parent (Children's Sleep Habits Questionnaire) and self-reports (Self-Sleep Report). Working memory was measured using the Working Memory Test Battery for Children (low and very low working memory defined as <25th and <10th percentiles, respectively). Analyses were adjusted for child age and gender, internalizing and externalizing comorbidities, and socio-economic status. Self-reported sleep problem severity was associated with poorer working memory for each standard deviation increase in self-reported sleep problems, working memory scores decreased by -3.8 points (95% confidence interval (CI): -6.7, -0.8 p = 0.01). There was some evidence that self-reported sleep problems were associated with low (p = 0.06) and very low working memory (p = 0.01). There was minimal evidence that parent-reported sleep problems were associated with poorer working memory with the exception of bedtime resistance problems. Behavioural sleep problems and working memory are associated in children with ADHD, particularly when sleep is assessed by self-report.
Publisher: Wiley
Date: 04-06-2023
DOI: 10.1111/JCPP.13835
Abstract: Sleep difficulties are common in children with attention‐deficit/hyperactivity disorder (ADHD). However, sleep problems are multifaceted and little is known about the variation in sleep difficulties across children with ADHD. We examined the profiles of sleep difficulties in children with ADHD and associated clinical factors (e.g. co‐occurring mental health conditions, stimulant use and parent mental health). Data from two harmonised studies of children with ADHD (total: N = 392, ages 5–13 years) were used. Parents completed measures of children's sleep, co‐occurring mental health conditions and their own mental health. Both parents and teachers completed measures of child ADHD symptoms and emotional and conduct symptoms. Latent profile analysis was used to identify sleep profiles, and multinomial logistic regression assessed clinical correlates of the groups. Five sleep profiles were identified: (a) insomnia/delayed sleep phase (36%), (b) generalised sleep difficulties at sleep onset and overnight (25%), (c) high anxious/bedtime resistance difficulties (11%), (d) overnight sleep difficulties including obstructive sleep apnoea and parasomnias (5%) and (e) no sleep difficulties (22%). Compared with the group without sleep difficulties, the generalised, anxious/bedtime resistance and insomnia/delayed sleep phase sleep had greater parent‐reported emotional and conduct symptoms, co‐occurring anxiety and increased parent mental health difficulties. The generalised and anxious/bedtime resistance groups also had greater parent‐reported ADHD symptoms, with the anxious/bedtime resistance sleep group also having more frequent co‐occurring depression and teacher‐reported emotional symptoms. The sleep difficulties experienced by children with ADHD are varied. Supports to help children with ADHD need to consider the particular profiles of sleep difficulties experienced and broader clinical characteristics. Tailored intervention approaches are likely needed (including a need to address parent mental health).
Publisher: Cambridge University Press (CUP)
Date: 09-2008
DOI: 10.1017/S1030011200025847
Abstract: Attention Deficit Hyperactivity Disorder (ADHD) can have a major impact on students’ functioning at school—academically and socially. This study examined parental perceptions of schools in relation to their understanding of ADHD, information provided and general support. Parents of consecutive children with ADHD seen at the Centre for Community Child Health, Royal Children’s Hospital, Melbourne completed a questionnaire that assessed their beliefs about ADHD and schools. Questionnaire data were obtained from 66 parents (43 mothers, 23 fathers) of patients aged from 6 to 19 years (M = 10.4). The results indicated that parents of children with ADHD perceive that teachers have inadequate understanding, and schools insufficient resources, to support their children’s special needs. Schools need more resources, and teachers need more training, to promote positive experiences and outcomes for children with ADHD.
Publisher: SAGE Publications
Date: 05-03-2021
Abstract: Objective: This study aimed to (a) identify longitudinal trajectories of emotional and conduct problems from middle childhood to early adolescence in a s le of 130 adolescents diagnosed with ADHD and (b) examine trajectories in relation to early adolescent academic achievement and engagement. Method: Group-based trajectory models (GBTMs) were constructed from the parent-rated strengths and difficulties questionnaire (SDQ) subscales of emotional and conduct problems at three time points, mean ages 10.7 years, 11.6 years, and 13.7 years. Associations between trajectories and adolescent academic achievement and engagement were examined using multivariate regression. Results: Four distinct trajectories were identified within each domain. High-persistent problem trajectories in each domain were associated with poorer achievement and lower school engagement compared with adolescents following persistent-low problem trajectories. Conclusion: Findings highlight the importance of early assessment and management of comorbid emotional and conduct problems for children with ADHD as they predict school difficulties during early high school. (J. of Att. Dis. XXXX XX(X) XX-XX)
Publisher: SAGE Publications
Date: 14-09-2020
Abstract: Objective: This study examined the association between autism spectrum disorder (ASD) symptom severity and academic outcomes and classroom functioning in a community-based s le of children with and without ADHD. Method: Participants included children with ADHD ( n =179) and a non-ADHD group ( n =212). ASD symptom severity, academic and learning skills, and classroom functioning were assessed via teacher report using the Social Skills Improvement System (SSIS ASD and Academic Competence subscales) and the Strengths and Difficulties Questionnaire (SDQ all subscales). Results: Children with ADHD had higher teacher-reported ASD symptoms than children without ADHD (β= .62, p .001). Greater teacher-reported ASD symptoms were associated with more behavioral difficulties in the classroom for children with ADHD (β= .50, p .001). There was little evidence of an association between academic competence and ASD symptom severity in children with ADHD (β= −.11, p = .15). Conclusion: ASD symptoms are associated with elevated classroom behavioral difficulties for children with ADHD.
Publisher: AMPCo
Date: 09-2017
DOI: 10.5694/MJA17.00134
Publisher: Psychology Press
Date: 14-04-0384
Publisher: Public Library of Science (PLoS)
Date: 05-07-2016
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.SLEEP.2015.09.019
Abstract: Behavioral sleep problems are common in children with attention deficit hyperactivity disorder (ADHD), and longitudinal studies have found sleep problems to be both a predictor and outcome of internalizing and externalizing problems. We investigated the potential bidirectional relationship between sleep problems and internalizing/externalizing problems. Children with ADHD, aged 5-13 years, were recruited from 21 pediatric practices across Victoria, Australia (N = 270). Across a 12-month period, at three time points, parents reported on their child's sleep problems (Children's Sleep Habits Questionnaire) and emotional and behavioral functioning (Strengths and Difficulties Questionnaire). Data were analyzed using autoregressive cross-lagged panel models. Sleep problem severity and emotional/behavioral problem severity were very stable across the 12-month period. Sleep problems at baseline predicted emotional problems at six months (r = 0.17, p < 0.01), and emotional problems at baseline predicted sleep problems at six months (r = 0.07, p < 0.05). However, there was no predictive relationship between sleep problems and emotional problems from 6-12 months. No bidirectional relationship was observed between sleep problems and conduct problems. In children with ADHD, there is weak evidence of a bidirectional relationship between sleep problems and emotional problems. These symptoms are also very stable over time therefore, the best treatment approach to improve overall functioning may be to target both sleep and emotional functioning in these children.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2009
Publisher: BMJ
Date: 05-2017
Publisher: Wiley
Date: 05-01-2017
DOI: 10.1111/BJEP.12140
Abstract: Students with attention/deficit hyperactivity disorder (ADHD) continue to languish behind their peers with regard to academic achievement and education attainment. School engagement is potentially modifiable, and targeting engagement may be a means to improve education outcomes. To investigate school engagement for students with ADHD during the crucial high school transition period and to identify factors associated with low school engagement. Participants are adolescents (12-15 years) in the first and third year of high school with diagnosed ADHD (n = 130). Participants were recruited from 21 paediatric practices. Cross-sectional study assessing school engagement. Data were collected through direct assessment and child, parent, and teacher surveys. School engagement is measured as student attitudes to school (cognitive and emotional) and suspension rates (behavioural). Multivariable regression analyses examined student, family, and school factors affecting engagement. In comparison with state data, students with ADHD in the first year of high school were less motivated (p < .01) and less connected to peers (p < .01). Overall, there was no discordance in third year attitudes. There were high rates of suspension in both years in comparison to state-wide suspensions (21% vs. 6%, p < .01). Explanatory factors for poor attitudes include adolescent depression, poor adolescent supervision, and devaluing education. Conduct problems and increased hyperactivity were related to increased likelihood of being suspended, whilst higher cognitive ability, family socio-economic status, and independent schools reduced risk. Potentially modifiable in idual and family factors including adolescent depression, behavioural problems, education values, and family supervision could be targeted to better manage the high school transition for students with ADHD.
Publisher: SAGE Publications
Date: 28-03-2016
Abstract: Objective: The aim of this study was to identify the child and parent/family correlates of anxiety in a community-based s le of children with ADHD. Method: Children (6-8 years) with ADHD ( n = 179) and controls ( n = 212) were assessed for ADHD and anxiety using the Diagnostic Interview Schedule for Children IV. Potential child and parent/family correlates were measured through direct assessments, and parent- and teacher-reported questionnaires. Associations were examined using univariate and multivariate logistic regression analyses. Results: One in four children with ADHD ( n = 44) met criteria for an anxiety disorder, compared with one in 20 controls ( n = 10). Anxiety was common in both boys and girls with ADHD. The strongest correlates of anxiety in multivariate analyses were ADHD subtype, primary caregiver psychosocial distress, and neighborhood socioeconomic disadvantage. Conclusion: Anxiety is common in children with ADHD. This study provides insight into the potential parent/family stressors that may increase risk for anxiety in children with ADHD.
Publisher: Public Library of Science (PLoS)
Date: 11-05-2015
Publisher: Elsevier BV
Date: 09-2014
Publisher: Wiley
Date: 07-06-2016
DOI: 10.1111/CCH.12364
Abstract: The symptoms of attention-deficit/hyperactivity disorder (ADHD) are non-specific, and a range of possible causes and comorbidities need to be considered in children referred for assessment. To examine the factors associated with ADHD diagnosis following multidisciplinary assessment. Children underwent multidisciplinary evaluation including parent and teacher questionnaires semi-structured interview to screen for internalizing and externalizing diagnoses paediatric, psychology and special education assessments and case conference. Predictors of ADHD diagnosis were examined in univariable and multivariable logistic regression models. Data from 190 assessments (82% male, mean age 6.8 years) were included. ADHD was diagnosed in 132 (70%) cases, of which 77% had one or more comorbidities. In children not diagnosed with ADHD, 60% had one or more alternate diagnosis made. Teacher-reported ADHD symptom severity and learning difficulties were the strongest predictors of ADHD diagnosis. The pattern of comorbid/alternative diagnoses was similar between those diagnosed with ADHD and those not diagnosed with ADHD. Direct report from teachers is the most critical element of the clinical dataset for the evaluation for ADHD. These findings emphasize the importance of cross-situational impairment to ADHD diagnosis. The frequency and similarity of diagnoses in both groups highlight the overlapping nature of childhood developmental disorders, and the importance of evaluating for comorbid disorders regardless of the primary diagnosis.
Publisher: Informa UK Limited
Date: 03-2012
DOI: 10.1080/09297049.2011.601288
Abstract: The association between specific language impairment (SLI), attention deficit/hyperactivity disorder (ADHD), and working memory (WM) was examined. WM has been implicated in language acquisition and models of ADHD however, evidence for WM deficits in SLI and ADHD has been inconsistent. The components of Baddeley's WM model were investigated in 18 children with SLI, 16 children with ADHD, 11 children with comorbid SLI+ADHD, and 24 typically developing (TD) children. The presence of SLI resulted in deficits in more components of WM than the presence of ADHD indicating that children with SLI are more vulnerable to WM deficits than those with ADHD.
Publisher: SAGE Publications
Date: 19-03-2020
Abstract: Objective: To characterize head movements in children with ADHD using an ex-Gaussian distribution and examine associations with out-of-scanner sustained attention. Method: Fifty-six children with ADHD and 61 controls aged 9 to 11 years completed the Sustained Attention to Response Task (SART) and resting-state functional magnetic resonance imaging (fMRI). In-scanner head motion was calculated using ex-Gaussian estimates for mu, sigma, and tau in delta variation signal and framewise displacement. Sustained attention was evaluated through omission errors and tau in response time on the SART. Results: Mediation analysis revealed that out-of-scanner attention lapses (omissions during the SART) mediated the relationship between ADHD diagnosis and in-scanner head motion (tau in delta variation signal), indirect effect: B = 1.29, 95% confidence interval (CI) = [0.07, 3.15], accounting for 29% of the association. Conclusion: Findings suggest a critical link between trait-level sustained attention and infrequent large head movements during scanning (tau in head motion) and highlight fundamental challenges in measuring the neural basis of sustained attention.
Publisher: Wiley
Date: 12-06-2016
DOI: 10.1111/CCH.12363
Abstract: We aimed to examine health-related impairments in young children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls and explore differences in children with ADHD by gender, ADHD subtype and mental health co-morbidity status. Children with ADHD (n = 177) and controls (n = 212) aged 6-8 years were recruited across 43 schools in Melbourne, Australia following a screening (Conners 3 ADHD Index) and case confirmation procedure (Diagnostic Interview Schedule for Children IV). Direct and blinded assessments of height and weight were used to calculate body mass index z-score and to identify overweight/obesity. Parents reported on child global health, sleep problems and physical injuries. Unadjusted and adjusted (socio-demographic factors and co-morbidities) logistic and linear regression were conducted to compare health-related impairments between (1) children with and without ADHD (2) boys and girls with ADHD (3) children with ADHD-inattentive and ADHD-combined types and (4) children with ADHD by internalizing and externalizing disorder status. Children with ADHD had poorer global health than controls when adjusted for socio-demographic characteristics (OR: 2.0 95% CI 1.1, 3.9) however, this attenuated after adjusting for co-morbidities. In adjusted analyses, children with ADHD had increased odds of moderate/large sleep problems (OR: 3.1 95% CI 1.4, 6.8), compared with controls. There were no differences between children with and without ADHD in terms of physical injuries or overweight/obesity. Findings were similar when excluding children taking ADHD medication, and health-related impairments did not differ between boys and girls with ADHD. Children with ADHD-combined type had higher BMI z-scores than controls in adjusted analyses (P = 0.04). Children with ADHD and co-occurring internalizing and externalizing co-morbidities were particularly vulnerable to health-related impairments. Young children with ADHD experience a number of health-related impairments, which are exacerbated by the presence of internalizing and externalizing co-morbidities. Clinicians should consider the broader health of children with ADHD in clinical consultations.
Publisher: Elsevier BV
Date: 2015
Publisher: SAGE Publications
Date: 21-12-2021
DOI: 10.1177/00048674211065365
Abstract: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world’s first long and strict lockdowns over July–October 2020, while the rest of Australia experienced ‘COVID-normal’ with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, in idual and COVID-19-related factors associated with mental health trajectories. Online community s le of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children’s Anxiety Scale). Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [β] = 0.09–0.46), parent/child diagnoses (β = 0.07–0.21), couple conflict (β = 0.07–0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (β = 0.12–0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers ( lingtax.shinyapps.io/CPAS_trend/ ). Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.SLEEP.2013.10.018
Abstract: Sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), yet little is known about sleep medication use in this population. The aim of this study was to describe sleep medication use, as well as associated child and family characteristics in school-aged children with ADHD. Sleep medication use was ascertained using a prospective parent-completed seven-night sleep and medication log. Exposure variables included socio-demographic characteristics, total sleep problem severity (Children's Sleep Habits Questionnaire), ADHD severity and subtype (ADHD Rating Scale IV), ADHD medication use, internalising and externalising co-morbidities (Anxiety Disorders Interview Schedule for Children/Parent version IV) and parent mental health (Depression Anxiety Stress Scale). Two hundred and fifty-seven children with ADHD participated and of these 57 (22%) were taking sleep medication (melatonin 14% and clonidine 9%). Sleep medication use was associated with combined-type ADHD and ADHD medication use. The presence of co-occurring internalising and externalising co-morbidities was also associated with sleep medication use in ad hoc analyses. Sleep medication use is common in children with ADHD and is associated with combined-type ADHD and use of ADHD medication. Further research is needed on the broad functional benefits and long-term safety of sleep medication in this population.
Publisher: SAGE Publications
Date: 17-02-2023
DOI: 10.1177/10870547231155438
Abstract: To investigate the association between children’s health-related quality of life (HRQoL) and childhood attention-deficit/hyperactivity disorder (ADHD). Databases were systematically searched for peer-reviewed literature published between 2010 and 2022. Two reviewers independently screened and assessed the quality of included studies. Meta-analysis was conducted for studies that used the Pediatric Quality of Life Inventory (PedsQL). Twenty-three studies were included, with most rated as “good” quality. Meta-analysis found “very large” effect in both parent- (Hedges’ g −1.67, 95% CI [−2.57, −0.78]) and child-reported (Hedges’ g −1.28, 95% CI [−2.01, −0.56]) HRQoL for children with ADHD compared to children without ADHD. No difference between parent- and child-reported HRQoL in children with and without ADHD was found. However, parent-reported HRQoL was lower than child-reported HRQoL among children with ADHD. ADHD was associated with substantially poorer children’s HRQoL. Among children with ADHD, parents rated their children’s HRQoL lower than the children themselves.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
Publisher: SAGE Publications
Date: 05-03-2020
Abstract: Objective: Peer social functioning difficulties characteristic of ADHD persist into adolescence, but the efficacy of interventions for this age group remains unclear. Method: A systematic search of nonpharmacological interventions for adolescents with ADHD (10–18 years) identified 11 trials addressing social functioning, of which eight were included in meta-analyses. Results: Random effects meta-analyses of four randomized trials found no differences in social functioning between treatment and control groups by parent- ( g = −0.08 [−0.34, 0.19], k = 4, N = 354) or teacher-report ( g = 0.17 [−0.06, 0.40], k = 3, N = 301). Meta-analyses of nonrandomized studies indicated participants’ social functioning improved from baseline to postintervention by parent-report, but not teacher- or self-report. All trials had a high risk of bias. Conclusion: These results highlight the paucity of research in this age group. There is little evidence that current interventions improve peer social functioning. Clearer conceptualizations of developmentally relevant targets for remediation may yield more efficacious social interventions.
Publisher: SAGE Publications
Date: 04-12-2018
Abstract: Objective: This study (a) compared behavioral sleep problems in children with comorbid ADHD and autism spectrum disorder (ASD) with those with ADHD and (b) examined child/family factors associated with sleep problems. Method: Cross-sectional study comparison of 392 children with a confirmed ADHD diagnosis (ADHD+ASD, n=93, ADHD, n=299) recruited from 21 peadiatric practises in Victoria, Australia. Data were collected from parents. Key measures included the Child Sleep Habits Questionnaire (CSHQ). Results: Children with ADHD + ASD experienced similar levels and types of behavioral sleep problems compared with those with ADHD. In both groups, the presence of co-occurring internalizing and externalizing comorbidities was associated with sleep problems. Sleep problems were also associated with parent age in the ADHD + ASD group and poorer parent mental health in the ADHD group. Conclusion: Findings suggest comorbid ASD is not associated with increased behavioral sleep problems in children with ADHD and that co-occurring internalizing and externalizing comorbidities may flag children in these groups with sleep problems.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2017
Publisher: SAGE Publications
Date: 11-11-2021
Abstract: Objective: Although autism spectrum disorder (ASD) symptoms are associated with poorer functioning in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear which ASD symptom domains are most impairing. This study investigated whether specific ASD symptom domains were associated with child functioning in children with ADHD. Method: Parents of 164 children with ADHD completed a diagnostic interview to assess ADHD and comorbidities. Parents reported on ASD symptoms (Social Communication Questionnaire) and child quality of life (Pediatric Quality of Life Inventory 4.0). Parents and teachers completed the Strengths and Difficulties Questionnaire (emotional, conduct, and peer problems). Results: Repetitive and stereotyped behaviors were independently associated with emotional ( p = .02) and conduct ( p = .03) problems, and poorer quality of life ( p = .004). Reciprocal social interaction deficits were independently associated with peer problems ( p = .03). Conclusion: Reciprocal social interaction deficits and repetitive and stereotyped behaviors are important areas that should be focused on in ADHD assessment and treatment.
Publisher: SAGE Publications
Date: 07-2013
Abstract: Objective: To examine the health care costs associated with ADHD within a nationally representative s le of children. Method: Data were from Waves 1 to 3 (4-9 years) of the Longitudinal Study of Australian Children ( N = 4,983). ADHD was defined by previous diagnosis and a measure of ADHD symptoms (Strengths and Difficulties Questionnaire [SDQ]). Participant data were linked to administrative data on health care costs. Analyses controlled for demographic factors and internalizing and externalizing comorbidities. Results: Costs associated with health care attendances and medications were higher for children with parent-reported ADHD at each age. Cost differences were highest at 8 to 9 years for both health care attendances and medications. Persistent symptoms were associated with higher costs ( p .001). Excess population health care costs amounted to Aus$25 to Aus$30 million over 6 years, from 4 to 9 years of age. Conclusion: ADHD is associated with significant health care costs from early in life. Understanding the costs associated with ADHD is an important first step in helping to plan for service-system changes.
Publisher: Springer Science and Business Media LLC
Date: 06-04-2011
DOI: 10.1007/S10802-011-9504-8
Abstract: This study examined the prenatal, postnatal and demographic predictors of parent-reported attention-deficit/hyperactivity disorder (ADHD) in an Australian population-based s le. Participants were families participating in the Longitudinal Study of Australian Children. There were approximately even numbers of males (51%) and females (49%) in the s le. Predictors of parent-reported ADHD status at Wave 2 (children aged 6-7 years) which were measured at Wave 1 (children aged 4-5 years) included cigarette smoking and alcohol use during pregnancy (prenatal factors) maternal postnatal depression, intensive care at birth, birth weight, and gestation (postnatal factors) and child gender, primary caregiver education, income, family composition, and maternal age at childbirth (socio-demographic factors). We found that male gender, cigarette smoking during pregnancy, and maternal postnatal depression were the only significant predictors (at the 5% level) of ADHD in the adjusted analysis (N = 3,474). Our results are consistent with previous findings that male gender and cigarette smoking during pregnancy are risk factors for ADHD. In addition, we found that postnatal depression was predictive of parent-reported ADHD.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.SLEEP.2011.02.006
Abstract: To evaluate the feasibility and helpfulness of a behavioral sleep program for children with ADHD, and explore the impact of different program dosages on child and family outcomes. Randomised trial comparing a brief (1 session, n=13) and extended (2-3 sessions, n=14) sleep program in children with ADHD (aged 5-14 years) and at least one behavioral sleep disorder (American Academy of Sleep Medicine Criteria). Outcomes included helpfulness and use of interventions, child sleep (parent-reported sleep problem Child Sleep Habits Questionnaire), ADHD symptoms (ADHD IV Rating Scale), daily functioning (Daily Parent Rating of Evening and Morning Behavior), quality of life (Pediatric Quality of Life Inventory), and caregiver mental health (Depression Anxiety Stress Scales). Twenty-seven families (63% of those eligible) took part. Most parents would recommend the program to others (95%) and found the strategies helpful. Five months post-randomisation, 67% of parents in both groups reported that their child's sleep problems had resolved. Child quality of life, daily functioning, and parental anxiety also improved in the extended group only (Cohen's d: 0.39, 0.47 and 0.50, respectively). There was minimal change in ADHD symptom scores from baseline to 5 months in either group. A behavioral sleep intervention in children with ADHD is feasible to deliver and improves child sleep by parent report. The extended program resulted in greater improvements in child and caregiver outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.ACAP.2013.03.009
Abstract: To study the characteristics of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Australia, and the assessment and management practices of their pediatricians. A 2-week practice audit was conducted in a large representative s le of Australian general/community pediatricians. Pediatricians completed an audit form for all patients seen. Demographic details, diagnoses, treatments, and referrals made were recorded for each consultation. A total of 199 pediatricians completed the audit (response rate 66%). There were 1528 consultations with patients with ADHD. Eighty percent of the subjects were male, and mean age at diagnosis was 9.1 years (range 3-19 years). Most patients (60%) had 1 or more comorbidity identified, although the reported rates of anxiety (8%) and oppositional defiant disorder (15%) were lower than expected. Patients with ADHD were more likely than patients with other diagnoses to be seen in private practice settings (76% vs. 65% P < .001). Children with ADHD were referred to numerous services at diagnosis, most commonly psychology (32%). Stimulant medication or atomoxetine was prescribed for 40% at initial diagnosis and 80% at continuing consultation. Overall, methylphenidate was the most common medication prescribed (63%), with a minority prescribed dex hetamine, atomoxetine, or clonidine. Eighteen percent were prescribed 2 or more medications. Medication prescription was predicted by age but not by gender or socioeconomic status. ADHD is the most frequent diagnosis seen by Australian pediatricians, with some patients being seen into early adult life. Comorbidities appear to be inconsistently identified, with some possibly underdiagnosed. Older children are more likely to be prescribed medication.
Publisher: SAGE Publications
Date: 20-12-2010
Abstract: Objective: This study aimed to investigate the agreement between parent- and child-reported quality of life (QoL) and the self-perceptions of children with ADHD. Method: A cross-sectional survey of school-aged children with ADHD and their parents was undertaken. Results: Parents reported their child’s QoL as lower than the children rated themselves in most QoL domains. Children reporting higher QoL than their parents had higher self-worth, than children who reported lower QoL. There was no difference in ADHD or oppositional symptoms or child age for children reporting higher versus lower QoL than their parents. Children reported experiencing ADHD symptoms and positive aspects in taking stimulant medication. Conclusion: It is important to elicit the report of both parents and children for understanding the functional impairment of children with ADHD. Children who report lower child QoL than their parents have lower overall self-worth these children may be at risk for developing internalizing difficulties.
Publisher: SAGE Publications
Date: 21-07-2022
DOI: 10.1177/10870547221112941
Abstract: Previous studies at child and youth mental health services (CYMHS) suggest that children with ADHD have poorer outcomes compared to those with other diagnoses. This study investigates this in more detail. Children with ADHD were compared to those with ASD and those with emotional disorders, on routinely collected outcomes at CYMHS in Australia ( N = 2,513) and the Netherlands ( N = 844). Where the emotional disorders group reached a similar level of emotional symptoms at the end-of-treatment as the ADHD and ASD groups, the latter two groups still had higher scores on ADHD and ASD symptoms (attention and peer problems). The poorer outcomes were mainly explained by higher severity at baseline. In Australia, an ADHD and/or ASD diagnosis also independently contributed to worse outcomes. Those with neurodevelopmental disorders within both countries had poorer outcomes than those with emotional disorders. Services should aim to optimize treatment to ensure best possible outcomes.
Publisher: SAGE Publications
Date: 20-08-2016
Abstract: Irritable mood is common in children with attention-deficit/hyperactivity disorder. Research to date has primarily comprised cross-sectional studies thus, little is known about the antecedents of irritability. Furthermore, existing cross-sectional studies generally focus on the association between irritability and comorbidities and do not examine broader aspects of functioning. Finally, previous research has neglected to include child-report of irritability. This study aimed to address these gaps using data from a longitudinal study of children with attention-deficit/hyperactivity disorder. Children aged 5–13 years (mean = 10.2 standard deviation = 1.9) with attention-deficit/hyperactivity disorder were recruited from pediatric practices across Victoria, Australia. This study reports on those who had reached adolescence (12 years or older, mean = 13.8 standard deviation = 1.2) at the 3-year follow-up ( n = 140). Internalizing and externalizing problems were measured using the Strengths and Difficulties Questionnaire. At follow-up, parent-reported and adolescent self-reported irritability was assessed using the Affective Reactivity Index. Parent and adolescent outcomes measured at follow-up included attention-deficit/hyperactivity disorder symptom severity, sleep, behavior and parent mental health. Children with externalizing problems at age 10 had higher parent-reported irritability (β = 0.31, 95% confidence interval = [0.17,–0.45], p = 0.001) in adolescence. Cross-sectional analyses found that irritability was associated with increased attention-deficit/hyperactivity disorder symptom severity and sleep problems poorer emotional, behavioral and social functioning and poorer parent mental health. Our findings highlight the importance of assessing for and managing early conduct problems in children with attention-deficit/hyperactivity disorder, as these predict ongoing irritability which, in turn, is associated with poorer functioning across a number of domains.
Publisher: Springer Science and Business Media LLC
Date: 13-11-2019
DOI: 10.1186/S12888-019-2276-3
Abstract: Up to 60% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) meet diagnostic criteria for at least one anxiety disorder, including Social, Generalized and/or Separation Disorder. Anxiety in children with ADHD has been shown to be associated with poorer child and family functioning. Small pilot studies suggest that treating anxiety in children with ADHD using cognitive-behavioral therapy (CBT) has promising benefits. In a fully powered randomized controlled trial (RCT), we aim to investigate the efficacy of an existing CBT intervention adapted for children with ADHD and comorbid anxiety compared with usual care. This RCT is recruiting children aged 8–12 years ( N = 228) from pediatrician practices in Victoria, Australia. Eligibility criteria include meeting full diagnostic criteria for ADHD and at least one anxiety disorder (Generalized, Separation or Social). Eligible children are randomized to receive a 10 session CBT intervention (Cool Kids) versus usual clinical care from their pediatrician. The intervention focuses on building child and parent skills and strategies to manage anxiety and associated impairments including cognitive restructuring and graded exposure. Minor adaptations have been made to the delivery of the intervention to meet the needs of children with ADHD including increased use of visual materials and breaks between activities. The primary outcome is change in the proportion of children meeting diagnostic criteria for an anxiety disorder at 5 months randomization. This will be assessed via diagnostic interview with the child’s parent (Anxiety Disorders Interview Schedule for Children V) conducted by a researcher blinded to intervention condition. Secondary outcomes include a range of child (e.g., anxiety symptoms, ADHD severity, behavior, quality of life, sleep, cognitive functioning, school attendance) and parent (e.g., mental health, parenting behaviors, work attendance) domains of functioning assessed at 5 and 12 months post-randomization. Outcomes will be analyzed using logistic and mixed effects regression. The results from this study will provide evidence on whether treating comorbid anxiety in children with ADHD using a CBT approach leads to improvements in anxiety and/or broader functional outcomes. This trial was prospectively registered: Current Controlled Trials ISRCTN59518816 ( 10.1186/ISRCTN59518816 ). The trial was first registered 29/9/15 and last updated 15/1/19.
Publisher: Oxford University Press
Date: 06-2018
DOI: 10.1093/MED/9780198739258.003.0030
Abstract: The chapter ‘ADHD and sleep’ provides an overview of what is known about sleep in children with ADHD. The chapter begins by discussing normal sleep patterns across the lifespan, how sleep is regulated, and the consequences of insufficient sleep. It then reviews the literature relating to the prevalence and potential causes of sleep problems in children with ADHD. The chapter then provides an overview of both subjective and objective assessment methods of sleep in children with ADHD before reviewing the evidence for and providing recommendations for treatment of sleep problems in children with ADHD. The chapter concludes with suggestions for the future.
Publisher: SAGE Publications
Date: 14-12-2022
Abstract: The present study examined the impact of Attention Deficit Hyperactivity Disorder (ADHD) on core educational outcomes in two large community cohorts of Australian school children. Academic (reading and numeracy) and non-academic (school engagement, attendance, peer victimization, and parental expectations) outcomes were compared between children with ADHD, subthreshold ADHD, and controls when children were in grade 5 (M age = 10.5). Data were drawn from the Longitudinal Study of Australian Children birth cohort (LSAC Both subthreshold ADHD and ADHD groups had poorer outcomes on all measures, with medium effects sizes. Differences were not evident between subthreshold ADHD and ADHD groups. Educational outcomes examined in this study highlight the educational risk for upperprimary school children with ADHD or subthreshold ADHD, in comparison to their peers. Monitoring these outcomes is necessary to inform policy, practice, and intervention.
Publisher: BMJ
Date: 04-2017
Publisher: American Medical Association (AMA)
Date: 05-02-2017
Publisher: SAGE Publications
Date: 28-03-2023
DOI: 10.1177/00048674231161504
Abstract: The Strengths and Difficulties Questionnaire is a widely used screening tool for emotional and behavioural problems in children. Recent quantitative analyses have raised concerns regarding its structural validity in Aboriginal and Torres Strait Islander communities. This paper aims to extend upon existing findings by analysing the factor structure of both the parent- and teacher-reported Strengths and Difficulties Questionnaire in this population across a broader age range than in previous studies. Participants were the caregivers and teachers of 1624 Aboriginal and Torres Strait Islander children (820 male, 804 female) aged 2–15 years from Waves 2–11 of the Longitudinal Study of Indigenous Children. The majority of children were Aboriginal living in major cities and inner regional areas. Internal consistency was estimated with McDonald’s Omega. Exploratory structural equation modelling was conducted to investigate the factor structure of the parent-reported and teacher-reported versions of the Strengths and Difficulties Questionnaire. Responses from teachers demonstrated higher internal consistency than responses from parents, which was unacceptably low across most age groups. The purported five-factor structure of the Strengths and Difficulties Questionnaire failed to be replicated across both parent- and teacher-reported questionnaires. The results of bifactor and hierarchical exploratory structural equation models also failed to approximate the higher-order summary scales. These results indicate that the Strengths and Difficulties Questionnaire subscales and summary scores do not provide a valid index of emotional and behavioural problems in Aboriginal and Torres Strait Islander children. The Strengths and Difficulties Questionnaire should not be used with Aboriginal and Torres Strait Islander children.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2014
Abstract: To examine the prevalence of language problems in children with attention-deficit/hyperactivity disorder (ADHD) versus non-ADHD controls, and the impact of language problems on the social and academic functioning of children with ADHD. Children (6 to 8 years) with ADHD (n = 179) and controls (n = 212) were recruited through 43 Melbourne schools. ADHD was assessed by using the Conners 3 ADHD Index and the Diagnostic Interview Schedule for Children IV. Oral language was assessed by using the Clinical Evaluation of Language Fundamentals, fourth edition, screener. Academic functioning was measured via direct assessment (Wide Range Achievement Test 4) and teacher report (Social Skills Improvement System). Social functioning was measured via parent and teacher report (Strengths and Difficulties Questionnaire Social Skills Improvement System). Logistic and linear regression models were adjusted for sociodemographic factors and child comorbidities. Children with ADHD had a higher prevalence of language problems than controls after adjustment for sociodemographic factors and comorbidities (odds ratio, 2.8 95% confidence interval [CI], 1.5 to 5.1). Compared with children with ADHD alone, those with language problems had poorer word reading (mean difference [MD], −11.6 95% CI, −16.4 to −6.9 effect size, −0.7), math computation (MD, −11.4 95% CI, −15.0 to −7.7 effect size, −0.8), and academic competence (MD, −10.1 95% CI, −14.0 to −6.1 effect size, −0.7). Language problems were not associated with poorer social functioning. Children with ADHD had a higher prevalence of language problems than controls, and language problems in children with ADHD contributed to markedly poorer academic functioning.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.RIDD.2015.09.016
Abstract: This study examined the prevalence of autism spectrum disorder (ASD) symptoms in a community-based s le of children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. We also examined the relationship between ASD symptoms and ADHD subtype, ADHD symptom severity and child gender. Participants were 6-10-year-old children (164 ADHD 198 non-ADHD control) attending 43 schools in Melbourne, Australia, who were participating in the Children's Attention Project. ADHD was assessed in two stages using the parent and teacher Conners' 3 ADHD index and the Diagnostic Interview Schedule for Children IV (DISC-IV). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Unadjusted and adjusted linear and logistic regression examined continuous and categorical outcomes, respectively. Children with ADHD had more ASD symptoms than non-ADHD controls (adjusted mean difference=4.0, 95% confidence interval (CI) 2.8 5.3, p<0.001, effect size=0.7). Boys with ADHD had greater ASD symptom severity than girls with ADHD (adjusted mean difference=2.9, 95% CI 0.8 5.2, p=0.01, effect size=0.4). Greater ADHD symptom severity was associated with greater ASD symptom severity (regression co-efficient=1.6, 95% CI 1.2 2.0, p<0.001). No differences were observed by ADHD subtype. Greater hyperactive/impulsive symptoms were associated with greater ASD symptoms (regression coefficient=1.0 95% CI 0.0 2.0, p=0.04) however, this finding attenuated in adjusted analyses (p=0.45). ASD symptoms are common in children with ADHD. It is important for clinicians to assess for ASD symptoms to ensure appropriate intervention.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Publisher: Wiley
Date: 12-11-2021
DOI: 10.1111/CAMH.12521
Abstract: Worry about climate change may be associated with poorer mental health but also with greater political engagement. We determined trajectories of climate change‐related worry over adolescence and whether these were associated with depression symptoms and greater engagement with news and politics in late adolescence. At ages 10–11, 12–13, 16–17 and 18–19 years, adolescents participating in the Kindergarten cohort of the Longitudinal Study of Australian Children rated their worry about climate change. At age 18–19 years, participants reported on depression symptoms and engagement with news and politics. Latent profile analysis determined trajectories of climate change‐related worry across all time points ( N = 2244). Linear regression analyses examined the association between trajectories and outcomes at 18–19 years. Thirteen per cent ( n = 290) of adolescents had high persistent worry. The largest proportions had moderate ( n = 559, 24.9%) or increasing worry ( n = 546, 24.3%), followed by persistent low worry ( n = 376, 16.8%), slightly decreasing worry ( n = 297, 13.2%) and steeply decreasing worry ( n = 176, 7.8%). Adolescents with high persistent worry had higher depression symptoms at age 18–19 years compared to the moderate group, while those with increasing worry did not. The high persistent and increasing worry groups reported greater engagement with news and politics across several measures. This is the first study to track climate‐related worry and outcomes in young people across adolescence. A substantial number of Australian adolescents experience high or increasing worry about climate change, which is associated with greater societal engagement.
Publisher: BMJ
Date: 09-11-2016
DOI: 10.1136/ARCHDISCHILD-2015-309520
Abstract: This study investigated prevalence, types and predictors of professional service use in families of children identified with attention deficit hyperactivity disorder (ADHD) in the community. Setting: children with ADHD were identified through 43 schools using parent and teacher screening questionnaires (Conners 3 ADHD Index) followed by case confirmation using the Diagnostic Interview Schedule for Children Version IV. Parents completed a survey about professional service use in the last 12 months. Main outcome measures : data on variables potentially associated with service use were collected from parents (interview and questionnaires), teachers (questionnaires) and children (direct assessment). Logistic regression was used to examine predictors of service use in univariate and multivariable analyses. The s le comprised 179 children aged 6–8 years with ADHD. Over one-third (37%) had not received professional services in the last 12 months. The strongest predictors of service use were older child age (adjusted OR=3.0, 95% CI 1.0 to 8.9, p=0.05), and the degree to which the child's behaviour impacted on the family (adjusted OR=2.0, 95% CI 1.3 to 3.3, p=0.007), after controlling for ADHD subtype and severity, externalising comorbidities, academic achievement and parent-reported impairment. A substantial proportion of children with ADHD are not accessing professional services. Our findings suggest that the child's age and the impact of the child's behaviour on the family are the strongest predictors of service use. Given the demonstrated benefits from various interventions in ADHD, there is a need to improve case identification and referral for services.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2020
Publisher: SAGE Publications
Date: 17-08-2015
Abstract: The aim of this study was to identify the prevalence of parent-reported autism spectrum disorder diagnosis in Australia, and examine the developmental profile of children with autism spectrum disorder compared to their peers. Secondary analyses were undertaken on data from the Longitudinal Study of Australian Children. Children were recruited at kindergarten (K cohort) and birth (B cohort), and subsequently completed two-yearly ‘waves’ of assessments. Autism spectrum disorder diagnostic status was ascertained at Wave 4 along with age of diagnosis by parent report. Standardised tools were used to assess children’s quality of life, behaviour, receptive vocabulary and non-verbal intelligence. Prevalence of autism spectrum disorder was 2.5% (95% confidence interval = [2.0, 3.0]) in the B cohort compared to 1.5% (95% confidence interval = [1.2, 2.0]) in the K cohort. In both cohorts, children with autism spectrum disorder had poorer mean quality of life, emotional-behavioural functioning and receptive vocabulary compared with non-autism spectrum disorder peers, and a higher proportion of children with autism spectrum disorder had problems in these areas. However, between 6% and 9% of children with moderate to severe autism spectrum disorder and 12–20% with mild autism spectrum disorder were not reported to have problems with social interaction. The prevalence of a parent-reported diagnosis of autism spectrum disorder before age 7 in Australia was higher in the B cohort. Data from future Longitudinal Study of Australian Children waves will clarify whether autism spectrum disorder has been diagnosed earlier in the B cohort or if there is a continued increase in prevalence. Future waves will also provide crucial information about the types and severity of problems experienced during the primary and secondary school years which will assist service planning.
Publisher: Springer Science and Business Media LLC
Date: 11-03-2016
Publisher: SAGE Publications
Date: 04-05-2015
Abstract: Objective: This pilot randomized controlled trial examined the acceptability and feasibility of a cognitive-behavioral therapy (CBT) intervention for children with ADHD and anxiety, and provided preliminary information on child and family outcomes. Method: Children with ADHD and anxiety (8-12 years) were randomized to receive an adapted version of the Cool Kids CBT program or usual clinical care. Key outcomes included feasibility and acceptability of the intervention (participant enrollment, drop-out, intervention session attendance), remission of anxiety assessed via diagnostic interview, ADHD symptom severity, quality of life (QoL), and parent mental health. Results: Twelve children participated (67% uptake). Most families attended all 10 intervention sessions, with no drop-outs. Intervention participants had marked improvements in both child and family well-being by parent and teacher report, including anxiety, ADHD symptom severity, QoL, and parent mental health. Conclusion: Non-pharmacological interventions may improve important domains of functioning for children with ADHD and anxiety, including ADHD symptom severity.
Publisher: American Psychological Association (APA)
Date: 03-2022
DOI: 10.1037/SPQ0000465
Abstract: Among the many impacts of the Coronavirus disease (COVID-19) pandemic, one of the most dramatic was the immediate closure of in-person schooling in March/April 2020 when parents were faced with much greater responsibility in supporting their children's learning. Despite this, few studies have examined parents' own perspectives of this experience. The aims of this preliminary study were to (a) identify challenges, benefits, and useful strategies related to remote learning and (b) examine differences in findings across two countries, between parents of youth with and without attention-deficit/hyperactivity disorder (ADHD), and between parents of children and adolescents. To address these aims, parent responses to open-ended questions on the Home Adjustment to COVID-19 Scale (HACS Becker, Breaux, et al., 2020) were examined across three studies conducted in the United States and Australia (N = 606, children: 68.5% male, ages 6-17 years). The challenges most frequently expressed by parents included the child's difficulty staying on task (23.8% of parents), lack of motivation (18.3%), remote learning factors (17.8%), and lack of social interaction (14.4%). The most frequently expressed strategy related to using routines and schedules (58.2%) and the biggest benefit was more family time (20.3%). Findings were largely consistent across countries, ADHD status, and age, with a few notable group differences. Given that the most common challenges involved child- (e.g., difficulties with staying on task and motivation), parent- (e.g., balancing remote learning with work responsibilities), and school- (e.g., remote instruction difficulties) related factors, there is a need for improved support across these systems going forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Publisher: Wiley
Date: 04-2016
DOI: 10.1111/JPC.13091
Abstract: In a s le of newly diagnosed children with attention-deficit/hyperactivity disorder (ADHD), the aims were to examine (1) paediatrician assessment and management practices (2) previous assessments and interventions (3) correspondence between parent-report and paediatrician identification of comorbidities and (4) parent agreement with diagnosis of ADHD. cross-sectional, multi-site practice audit with questionnaires completed by paediatricians and parents at the point of ADHD diagnosis. private ublic paediatric practices in Western Australia and Victoria, Australia. paediatricians: elements of assessment and management were indicated on a study-designed data form. Parents: ADHD symptoms and comorbidities were measured using the Conners 3 ADHD Index and Strengths and Difficulties Questionnaire, respectively. Sleep problems, previous assessments and interventions, and agreement with ADHD diagnosis were measured by questionnaire. Twenty-four paediatricians participated, providing data on 137 patients (77% men, mean age 8.1 years). Parent and teacher questionnaires were used in 88% and 85% of assessments, respectively. Medication was prescribed in 75% of cases. Comorbidities were commonly diagnosed (70%) however, the proportion of patients identified by paediatricians with internalising problems (18%), externalising problems (15%) and sleep problems (4%) was less than by parent report (51%, 66% and 39%). One in seven parents did not agree with the diagnosis of ADHD. Australian paediatric practice in relation to ADHD assessment is generally consistent with best practice guidelines however, improvements are needed in relation to the routine use of questionnaires and the identification of comorbidities. A proportion of parents do not agree with the diagnosis of ADHD made by their paediatrician.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2016
DOI: 10.1007/S00787-016-0861-2
Abstract: Autism spectrum disorder (ASD) symptoms are elevated in populations of children with attention-deficit/hyperactivity disorder (ADHD). This study examined cross-sectional associations between ASD symptoms and family functioning in children with and without ADHD. Participants were recruited to a longitudinal cohort study, aged 6-10 years (164 ADHD 198 controls). ADHD cases were ascertained using community-based screening and diagnostic confirmation from a diagnostic interview. ASD symptoms were measured using the Social Communication Questionnaire. Outcome variables were parent mental health, family quality of life (FQoL), couple conflict and support, and parenting behaviours. After adjustment for a range of child and family factors (including other mental health comorbidities), higher ASD symptoms were associated with poorer FQoL across all three domains emotional impact (p = 0.008), family impact (p = 0.001) and time impact (p = 0.003). In adjusted analyses by subgroup, parents of children with ADHD+ASD had poorer parent self-efficacy (p = 0.01), poorer FQoL (p ≤ 0.05), with weak evidence of an association for less couple support (p = 0.06), compared to parents of children with ADHD only. Inspection of covariates in the adjusted analyses indicated that the association between ASD symptoms and most family functioning measures was accounted forby child internalising and externalising disorders, ADHD severity, and socioeconomic status however, ASD symptoms appear to be independently associated with poorer FQoL in children with ADHD. The presence of ASD symptoms in children with ADHD may signal the need for enhanced family support.
Publisher: Springer Science and Business Media LLC
Date: 21-07-2016
DOI: 10.1007/S10803-016-2874-6
Abstract: This study examined relationships between executive functioning (EF) and ADHD/ASD symptoms in 339 6-8 year-old children to characterise EF profiles associated with ADHD and ADHD + ASD. ADHD status was assessed using screening surveys and diagnostic interviews. ASD symptoms were measured using the Social Communication Questionnaire, and children completed assessments of EF. We found the EF profile of children with ADHD + ASD did not differ from ADHD-alone and that lower-order cognitive skills contributed significantly to EF. Dimensionally, ASD and inattention symptoms were differentially associated with EF, whereas hyperactivity symptoms were unrelated to EF. Differences between categorical and dimensional findings suggest it is important to use both diagnostic and symptom based approaches in clinical settings when assessing these children's functional abilities.
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.SLEEP.2015.08.015
Abstract: Behavioral sleep problems are ideally measured using a combination of objective and subjective measures. However, this is not always feasible. Thus, a global subjective measure has been used to assess sleep problems in children with attention deficit hyperactivity disorder (ADHD), yet it is unclear how this relates to more detailed multidimensional measures of sleep problems. In children with ADHD, parent report of a global measure of sleep problem severity (classified no/mild versus moderate/severe) is compared with the following: (1) a 7-Day Sleep Log and (2) the validated Children's Sleep Habits Questionnaire (CSHQ). This study recruited 392 children with ADHD (aged 5-13 years) from 50 pediatric practices across Victoria, Australia. All caregivers completed the CSHQ, and 257 children prospectively completed the 7-Day Sleep Logs. Sleep log data identified distinct sleep patterns according to parent-reported sleep problem severity children with moderate/severe sleep problems slept 30 min less per day, took longer to fall asleep, and experienced more night awakenings. This pattern was also repeated across the CSHQ, where children with moderate/severe sleep problems experienced more problematic sleep symptoms across all domains (effect sizes: 0.5-1.1 all p < 0.001). A subjective, global measure of sleep problem severity appears to be a useful tool for the initial assessment of sleep problems in children with ADHD when more extensive measures are not feasible, as it is reflective of well-established multidimensional measures. However, further research is required to determine its validity.
Publisher: Wiley
Date: 25-05-2023
DOI: 10.1002/JCV2.12170
Abstract: ADHD (attention‐deficit/hyperactivity disorder) affects 5% of children on average. Despite the high need to access services for ADHD treatment, not all children with ADHD utilise healthcare services equally. This study aims to systematically synthesise evidence of equity and equality in health service use/costs and health‐related quality of life (HRQoL)/wellbeing of children with ADHD across socioeconomic (SES) classes. The literature search was conducted across seven databases (Academic Search complete, MEDLINE Complete, PsycINFO, ERIC, Global Health, CINAHL and EconLit). The search was limited to peer‐reviewed articles published to 23 rd January 2023 in English and focused on children. Study quality was assessed using the Critical Appraisal Skills Program (CASP), Joanna Briggs Institute (JBI) and Mixed Methods Appraisal Tool (MMAT) checklists. 25 out of 1207 articles were eligible for inclusion. The results showed that SES was associated with different types of healthcare utilisation. Only three studies were found on HRQoL/well‐being. Children with ADHD from low SES families had lower HRQoL than children from high SES families. This study found that a social gradient exists in both healthcare service use and children's HRQoL among those with ADHD.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2016
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.SLEEP.2014.06.004
Abstract: Behavioral sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), yet their persistence or otherwise is unknown. We examined behavioral sleep problem trajectories, types of sleep problems experienced, and associated risk rotective factors. Prospective cohort study. Twenty-one pediatric practices across Victoria, Australia. A total of 195 children with ADHD (5-13 years). Sleep problem trajectories classified as never, transient, or persistent on the basis of sleep problem severity measured at baseline, 6, and 12 months. Explanatory variables: Types of sleep problems, internalizing and externalizing comorbidities, ADHD symptom severity and medication use, autism spectrum disorder, caregiver mental health, and sociodemographic factors. Multinomial logistic regression models. Sleep problems fluctuated over 12 months, but for 10% of children they persisted. In adjusted analyses, co-occurring internalizing and externalizing comorbidities were a risk factor for persistent (odds ratio (OR) 9.2, 95% confidence interval (CI) 1.6, 53.9, p = 0.01) and transient (OR 3.7, 95% CI 1.5, 8.8, p = 0.003) sleep problems, while greater ADHD symptom severity and poorer caregiver mental health were risk factors for persistent and transient sleep problems, respectively. Sleep problems in children with ADHD are commonly transient, but in a subgroup they are characterized as persistent. Early preventive/intervention strategies should target children at risk of persistent sleep problems.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2014
Abstract: Although anxiety is common in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear how anxiety influences the lives of these children. This study examined the association between anxiety comorbidities and functioning by comparing children with ADHD and no, 1, or ≥2 anxiety comorbidities. Differential associations were examined by current ADHD presentation (subtype). Children with diagnostically confirmed ADHD (N = 392 5–13 years) were recruited via 21 pediatrician practices across Victoria, Australia. Anxiety was assessed by using the Anxiety Disorders Interview Schedule for Children—IV. Functional measures included parent-reported: quality of life (QoL Pediatric Quality of Life Inventory 4.0), behavior and peer problems (Strengths and Difficulties Questionnaire), daily functioning (Daily Parent Rating of Evening and Morning Behavior), and school attendance. Teacher-reported behavior and peer problems (Strengths and Difficulties Questionnaire) were also examined. Linear and logistic regression controlled for ADHD severity, medication use, comorbidities, and demographic factors. Children with ≥2 anxiety comorbidities (n = 143 39%) had poorer QoL (effect size: –0.8) and more difficulties with behavior (effect size: 0.4) and daily functioning (effect size: 0.3) than children without anxiety (n = 132 36%). Poorer functioning was not observed for children with 1 anxiety comorbidity (n = 95 26%). Two or more anxiety comorbidities were associated with poorer functioning for children with both ADHD-Inattentive and ADHD-Combined presentation. Children with ADHD demonstrate poorer QoL, daily functioning and behavior when ≥2 anxiety comorbidities are present. Future research should examine whether treating anxiety in children with ADHD improves functional outcomes.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2013
Publisher: Springer Science and Business Media LLC
Date: 16-03-2015
DOI: 10.1007/S00787-014-0530-2
Abstract: Behavioral sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), as are internalizing and externalizing comorbidities. The prevalence of these difficulties and the extent to which they co-exist in children with ADHD could inform clinical practice, but remains unclear. Therefore, we examined the association between sleep problems and internalizing and externalizing comorbidities in children with ADHD. Children aged 5-13 years were recruited from 21 pediatric practices across Victoria, Australia (N = 392). Internalizing and externalizing comorbidities (none, internalizing, externalizing, co-occurring) were assessed by the telephone-administered Anxiety Disorders Interview Schedule for Children IV/Parent version. Sleep problem severity was assessed by primary caregiver report (no, mild, moderate or severe problem). Moderate/severe sleep problems were confirmed using International Classification of Sleep Disorders. Seven specific sleep problem domains (bedtime resistance, sleep anxiety, sleep onset delay, sleep duration, night waking, parasomnias and daytime sleepiness) were assessed using the Children's Sleep Habits Questionnaire. Data were analyzed using adjusted logistic and linear regression models. Compared to children without comorbidities, children with co-occurring internalizing and externalizing comorbidities were more likely to have moderate/severe sleep problems (adjusted OR 2.4, 95 % CI 1.2 4.5, p = 0.009) and problematic sleep across six of seven sleep domains. Children with either comorbidity alone were not at risk of moderate/severe sleep problems, but at the sleep domain level, children with internalizing alone had more sleep anxiety, and those with externalizing alone had less night waking. In conclusion, children with ADHD experiencing co-occurring internalizing and externalizing comorbidities are at an increased risk of sleep problems.
Publisher: Springer Science and Business Media LLC
Date: 07-10-2021
Publisher: Informa UK Limited
Date: 13-10-2017
Publisher: Wiley
Date: 18-01-2023
DOI: 10.1111/JCPP.13752
Abstract: Understanding the unmet needs of healthcare consumers with attention‐deficit/hyperactivity disorder (ADHD) (in iduals with ADHD and their caregivers) provides critical insight into gaps in services, education and research that require focus and funding to improve outcomes. This review examines the unmet needs of ADHD consumers from a consumer perspective. A standardised search protocol identified peer‐reviewed studies published between December 2011 and December 2021 focusing on consumer‐identified needs relating to ADHD clinical care or research priorities. 1,624 articles were screened with 23 studies that reviewed examining the needs of ADHD consumers from Europe, the U.K., Hong Kong, Iran, Australia, the U.S.A. and Canada. Consumer‐identified needs related to: treatment that goes beyond medication (12 studies) improved ADHD‐related education/training (17 studies) improved access to clinical services, carer support and financial assistance (14 studies) school accommodations/support (6 studies) and ongoing treatment efficacy research (1 study). ADHD consumers have substantial unmet needs in clinical, psychosocial and research contexts. Recommendations to address these needs include: improving access to and quality of multimodal care provision incorporating recovery principles into care provision fostering ADHD health literacy and increasing consumer participation in research, service development and ADHD‐related training/education.
Publisher: SAGE Publications
Date: 24-04-2021
Abstract: Objective: Examine in idual factors associated with peer victimization (PV) in adolescents with attention-deficit/hyperactivity disorder (ADHD) and to examine the association between PV and educational outcomes. Method: Participants were 121 adolescents ( M age = 13.62, SD = 1.03 89% boys) with diagnosed ADHD. Using path analysis, we tested whether general adolescent factors (ADHD symptoms, comorbid autism spectrum disorder, cognitive and social functioning, and age) were associated with experiences of PV, and associations between PV and academic outcomes. Results: Deficits in working memory (WM) and peer relationship problems were weakly and moderately associated with PV, respectively. PV was in turn was associated with adolescents’ attitudes about school, academic competence, and academic achievement. Conclusion: Adolescents with poor social skills and/or WM difficulties who have ADHD may be particularly vulnerable to being victimized by peers. Failure to identify and manage PV during early adolescence may be connected to poor educational outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: BMJ
Date: 20-01-2015
DOI: 10.1136/BMJ.H68
Abstract: To examine whether behavioural strategies designed to improve children's sleep problems could also improve the symptoms, behaviour, daily functioning, and working memory of children with attention deficit hyperactivity disorder (ADHD) and the mental health of their parents. Randomised controlled trial. 21 general paediatric practices in Victoria, Australia. 244 children aged 5-12 years with ADHD attending the practices between 2010 and 2012. Sleep hygiene practices and standardised behavioural strategies delivered by trained psychologists or trainee paediatricians during two fortnightly consultations and a follow-up telephone call. Children in the control group received usual clinical care. At three and six months after randomisation: severity of ADHD symptoms (parent and teacher ADHD rating scale IV-primary outcome), sleep problems (parent reported severity, children's sleep habits questionnaire, actigraphy), behaviour (strengths and difficulties questionnaire), quality of life (pediatric quality of life inventory 4.0), daily functioning (daily parent rating of evening and morning behavior), working memory (working memory test battery for children, six months only), and parent mental health (depression anxiety stress scales). Intervention compared with control families reported a greater decrease in ADHD symptoms at three and six months (adjusted mean difference for change in symptom severity -2.9, 95% confidence interval -5.5 to -0.3, P=0.03, effect size -0.3, and -3.7, -6.1 to -1.2, P=0.004, effect size -0.4, respectively). Compared with control children, intervention children had fewer moderate-severe sleep problems at three months (56% v 30% adjusted odds ratio 0.30, 95% confidence interval 0.16 to 0.59 P<0.001) and six months (46% v 34% 0.58, 0.32 to 1.0 P=0.07). At three months this equated to a reduction in absolute risk of 25.7% (95% confidence interval 14.1% to 37.3%) and an estimated number needed to treat of 3.9. At six months the number needed to treat was 7.8. Approximately a half to one third of the beneficial effect of the intervention on ADHD symptoms was mediated through improved sleep, at three and six months, respectively. Intervention families reported greater improvements in all other child and family outcomes except parental mental health. Teachers reported improved behaviour of the children at three and six months. Working memory (backwards digit recall) was higher in the intervention children compared with control children at six months. Daily sleep duration measured by actigraphy tended to be higher in the intervention children at three months (mean difference 10.9 minutes, 95% confidence interval -19.0 to 40.8 minutes, effect size 0.2) and six months (9.9 minutes, -16.3 to 36.1 minutes, effect size 0.3) however, this measure was only completed by a subset of children (n=54 at three months and n=37 at six months). A brief behavioural sleep intervention modestly improves the severity of ADHD symptoms in a community s le of children with ADHD, most of whom were taking stimulant medications. The intervention also improved the children's sleep, behaviour, quality of life, and functioning, with most benefits sustained to six months post-intervention. The intervention may be suitable for use in primary and secondary care.Trial registration Current Controlled Trials ISRCTN68819261.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2022
DOI: 10.1007/S10578-022-01338-3
Abstract: The COVID-19 pandemic has markedly impacted functioning for children and adolescents including those with attention-deficit/hyperactivity disorder (ADHD). We explored home learning difficulties (HLD) during COVID-19 restrictions in Australian children (aged 5–17) with ADHD, aiming to: (1) describe home learning experiences, and (2) examine associations between child anxiety (i.e., concurrent anxiety symptoms and pre-existing anxiety disorder status) and HLD. Baseline data from the longitudinal ADHD COVID-19 Survey were used ( n = 122). Parents reported on school factors and HLD pre-existing anxiety and co-occurring difficulties anxiety, ADHD, and oppositional symptoms demographics and medications. Parents retrospectively reported more children often looked forward to school pre-pandemic, than during the pandemic. Anxiety symptoms, but not pre-existing anxiety disorder status, were associated with HLD after accounting for covariates. ADHD inattention symptoms were also associated with HLD. Results support recommendations to continue pre-pandemic supports to assist with ADHD symptoms during home learning, and strategies/supports for families are discussed.
Publisher: BMJ
Date: 02-2014
Publisher: Wiley
Date: 13-03-2022
DOI: 10.1111/JCPP.13590
Abstract: Behavioural sleep problems are common in children with autism spectrum disorder (ASD) however, evidence for the efficacy of behavioural sleep interventions is limited. This study examined the efficacy of a brief behavioural sleep intervention in autistic children. It was hypothesised that the intervention would reduce overall child sleep problems (primary outcome), in addition to improvements in children’s social, emotional, cognitive, academic functioning, and quality of life, and parent/caregivers’ stress, quality of life, and mental health (secondary outcomes). A randomised controlled trial was conducted with participants randomised via a computer‐generated sequence to the sleeping sound intervention ( n = 123) or treatment as usual ( n = 122) group. Participants comprised 245 children with an ASD diagnosis. Inclusion criteria were as follows: confirmation of DSM IV or DSM‐5 diagnosis of ASD, participants aged between 5 and 13 years and parent/caregiver report of moderate–severe sleep problems. Exclusion criteria were as follows: parent/caregiver intellectual disability or lacking sufficient English to complete questionnaires and child participant with co‐occurring medical conditions known to impact sleep. The intervention group received the sleeping sound intervention (2 × 50‐min face‐to‐face sessions plus follow‐up phone call) by a trained clinician. Change in children’s sleep problems was measured by the Children’s Sleep Habits Questionnaire (CSHQ) at 3 months post randomisation. Parents/caregivers of children in the intervention group reported a reduction in child sleep problems at 3 months post randomisation (effect size: E.S −0.7). There were also small effects in a number of child (internalising symptoms, emotional behavioural disturbance and quality of life) and parent/caregiver (mental health, parenting stress and quality of life) outcomes however, these did not remain significant when controlling for multiple comparisons. The sleeping sound ASD intervention is an efficacious and practical way to reduce sleep problems for autistic children. This brief behavioural intervention has the potential to be embedded easily into the Australian healthcare system.
Publisher: Springer Science and Business Media LLC
Date: 12-2010
Abstract: Up to 70% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience sleep problems including difficulties initiating and maintaining sleep. Sleep problems in children with ADHD can result in poorer child functioning, impacting on school attendance, daily functioning and behaviour, as well as parental mental health and work attendance. The Sleeping Sound with ADHD trial aims to investigate the efficacy of a behavioural sleep program in treating sleep problems experienced by children with ADHD. We have demonstrated the feasibility and the acceptability of this treatment program in a pilot study. This randomised controlled trial (RCT) is being conducted with 198 children (aged between 5 to 12 years) with ADHD and moderate to severe sleep problems. Children are recruited from public and private paediatric practices across the state of Victoria, Australia. Upon receiving informed written consent, families are randomised to receive either the behavioural sleep intervention or usual care. The intervention consists of two in idual, face-to-face consultations and a follow-up phone call with a trained clinician (trainee consultant paediatrician or psychologist), focusing on the assessment and management of child sleep problems. The primary outcome is parent- and teacher-reported ADHD symptoms (ADHD Rating Scale IV). Secondary outcomes are child sleep (actigraphy and parent report), behaviour, daily functioning, school attendance and working memory, as well as parent mental health and work attendance. We are also assessing the impact of children's psychiatric comorbidity (measured using a structured diagnostic interview) on treatment outcome. To our knowledge, this is the first RCT of a behavioural intervention aiming to treat sleep problems in children with ADHD. If effective, this program will provide a feasible non-pharmacological and acceptable intervention improving child sleep and ADHD symptoms in this patient group. Current Controlled Trials ISRCTN68819261. ISRCTN: ISRCTN68819261
Publisher: Springer Science and Business Media LLC
Date: 30-06-2016
Publisher: SAGE Publications
Date: 06-08-2021
Abstract: Children with attention-deficit/hyperactivity disorder (ADHD) experience more sleep problems than their typically developing peers. In addition, their parents experience higher rates of mental health difficulties relative to parents of children without ADHD. Cross-sectional studies have reported associations however, longitudinal studies have not yet been conducted. This study aimed to investigate potential bidirectional relationships between sleep problems in children with ADHD and maternal mental health difficulties (i.e. overall mental health, depression, anxiety, stress) over a 12-month period. Female caregivers of 379 children with ADHD (5–13 years) reported on their child’s sleep (Children’s Sleep Habits Questionnaire) and their own mental health (Depression Anxiety Stress Scale) at three time points over a 12-month period (baseline, 6-months, and 12-months). Autoregressive cross-lagged panel analyses were used to analyze the data, controlling for child age, child sex, ADHD symptom severity, ADHD medication use, comorbidities (autism spectrum disorder, internalizing disorders, and externalizing disorders), caregiver age, and socioeconomic disadvantage. Child sleep problems and maternal mental health difficulties were highly stable across the 12-month period. In addition, longitudinal relationships were evident, with child sleep problems at 6-months predicting both overall maternal mental health difficulties and maternal anxiety at 12-months. However, child sleep problems at 6-months did not predict maternal depression or maternal stress at 12-months. There was little evidence that maternal mental health difficulties predicted child sleep problems over the 12-month period. This study demonstrates that despite the stability in child sleep problems and maternal mental health difficulties over time, sleep problems in children with ADHD contribute to later maternal mental health difficulties. This suggests that sleep interventions to improve child sleep may lead to an improvement in maternal mental health over time. It also suggests a need to be aware of the potential mental health difficulties being experienced by mothers who have children with sleep problems.
Publisher: Springer International Publishing
Date: 2016
Publisher: Cambridge University Press (CUP)
Date: 09-2008
Publisher: Informa UK Limited
Date: 06-05-2014
DOI: 10.3109/17549507.2014.898095
Abstract: This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative s les of children. Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311 p = .002) for each additional wave of language difficulties. Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.
Publisher: SAGE Publications
Date: 17-12-2020
Abstract: To examine the impact of COVID-19 restrictions among children with attention-deficit/hyperactivity disorder (ADHD). Parents of 213 Australian children (5–17 years) with ADHD completed a survey in May 2020 when COVID-19 restrictions were in place (i.e., requiring citizens to stay at home except for essential reasons). Compared to pre-pandemic, children had less exercise (Odds Ratio (OR) = 0.4 95% CI 0.3–0.6), less outdoor time (OR = 0.4 95% 0.3–0.6), and less enjoyment in activities (OR = 6.5 95% CI 4.0–10.4), while television (OR = 4.0 95% CI 2.5–6.5), social media (OR = 2.4 95% CI 1.3–4.5), gaming (OR = 2.0 95% CI 1.3–3.0), sad/depressed mood (OR = 1.8 95% CI 1.2–2.8), and loneliness (OR = 3.6 95% CI 2.3–5.5) were increased. Child stress about COVID-19 restrictions was associated with poorer functioning across most domains. Most parents (64%) reported positive changes for their child including more family time. COVID-19 restrictions were associated with both negative and positive impacts among children with ADHD.
Publisher: SAGE Publications
Date: 26-03-2021
DOI: 10.1177/10870547211003671
Abstract: This review aimed to understand the broader community’s attitudes toward ADHD, which could facilitate public health interventions to improve outcomes for in iduals with ADHD. A standardized protocol identified peer-reviewed studies focusing on attitudes of broader community s les, published from January 2014 to February 2020 (inclusive). A total of 1,318 articles were screened and 10 studies were included, examining attitudes of broader community s les from Australia, Sweden, Germany, Finland, Korea, Indonesia, and the United States. Findings revealed that broader community s les displayed varying degrees of ADHD-related knowledge, negative attitudes (that ADHD is over-diagnosed that pharmacological treatment is not acceptable that those with ADHD are more likely to exhibit poor behavior), and a desire for maintaining social distance from in iduals with ADHD. Findings suggest that community attitudes are generally negative toward those with ADHD. Targeted mental health literacy could provide an important avenue for improving the broader community’s attitudes toward those with ADHD.
Publisher: BMJ
Date: 11-2022
DOI: 10.1136/BMJOPEN-2022-064920
Abstract: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which affects 5% of children globally. In Australia, it is estimated that 4.1% of children and adolescents have ADHD. While research has examined the treatment and outcomes of children with ADHD attending public mental health services during their time in the public system in Australia, it is not known what treatment they received before and after these treatment episodes, which will provide a more complete understanding of these children’s treatment journey. We will link clinical data from cohorts of children and adolescents treated in the public child and youth mental health and/or child development services in Brisbane, Melbourne and Sydney to the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and National Death Index. MBS data will demonstrate the treatment journey with respect to clinicians seen, and treatment episodes from the public health service data sets will be examined to assess if the type and intensity of treatment are related to treatment outcomes. PBS data will reveal all psychotropic medications prescribed, allowing an examination of not just ADHD medications, but also other psychotropics which may indicate co-occurring conditions (eg, anxiety and mood disorders). Statistical analyses will include descriptive statistics to describe the rates of specific medications and clinician specialties seen. Linear and logistic regression will be used to model how treatment and sociodemographic variables relate to routinely collected outcome measures in the public health system while controlling for covarying factors. This study has been approved by the following institutional ethics committees: (1) Children’s Health Queensland Hospital and Health Service (HREC/21/QCHQ/76260), (2) The University of Queensland (2021/HE002143) and (3) The Australian Institute of Health and Welfare (EO2021/4/1300). Findings will be disseminated through peer-reviewed journals, conferences, professional associations and to public mental health services that treat ADHD.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: American Medical Association (AMA)
Date: 04-2008
DOI: 10.1001/ARCHPEDI.162.4.336
Abstract: To determine the prevalence of sleep problems in children with attention-deficit/hyperactivity disorder (ADHD) and their associations with child quality of life (QOL), daily functioning, and school attendance caregiver mental health and work attendance and family functioning. Cross-sectional survey. Pediatric hospital outpatient clinic, private pediatricians' offices, and ADHD support groups in Victoria, Australia. Schoolchildren with ADHD. Main Exposure Attention-deficit/hyperactivity disorder. Primary measure was caregivers' reports of their children's sleep problems (none, mild, or moderate or severe). Secondary outcomes were (1) child QOL (Pediatric Quality of Life Inventory), daily functioning (Daily Parent Rating of Evening and Morning Behavior scale), and school attendance, (2) caregiver mental health (Depression Anxiety Stress Scale) and work attendance, and (3) family functioning (Child Health Questionnaire subscales). Caregivers also reported on how their pediatrician treated their children's sleep problems. Two hundred thirty-nine of 330 (74%) eligible families completed the survey. Child sleep problems were common (mild, 28.5% moderate or severe, 44.8%). Moderate or severe sleep problems were associated with poorer child psychosocial QOL, child daily functioning, caregiver mental health, and family functioning. After adjusting for confounders, all associations held except for family impacts. Compared with children without sleep problems, those with sleep problems were more likely to miss or be late for school, and their caregivers were more likely to be late to work. Forty-five percent of caregivers reported that their pediatricians had asked about their children's sleep and, of these, 60% reported receiving treatment advice. Sleep problems in children with ADHD are common and associated with poorer child, caregiver, and family outcomes. Future research needs to determine whether management of sleep problems can reduce adverse outcomes.
Start Date: 2014
End Date: 2018
Funder: National Health and Medical Research Council
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End Date: 2019
Funder: National Health and Medical Research Council
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End Date: 2020
Funder: National Health and Medical Research Council
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End Date: 2015
Funder: National Health and Medical Research Council
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End Date: 2019
Funder: National Health and Medical Research Council
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End Date: 2013
Funder: National Health and Medical Research Council
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End Date: 2017
Funder: National Health and Medical Research Council
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End Date: 2016
Funder: National Health and Medical Research Council
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End Date: 2019
Funder: National Health and Medical Research Council
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