Clinical Presentation of Attention-Deficit/Hyperactivity Disorder in Preschool Children: The Preschoolers with Attention-Deficit/Hyperactivity Treatment Study (PATS)

Posner, Kelly; Melvin, Glenn; Murray, Desiree W.; Gugga, S. Sonia; Fisher, Prudence; Skrobala, Anne M.; Cunningham, Charles; Vitiello, Benedetto; Abikoff, Howard; Ghuman, Jaswinder K.; Kollins, Scott H.; Wigal, Sharon B.; Wigal, Tim; McCracken, James T.; McGough, James J.; Kastelic, Elizabeth; Boorady, Roy; Davies, Mark; Chuang, Shirley; Swanson, James M.; Riddle, Marak A; Greenhill, Laurence L.

doi:10.1089/cap.2007.0075

Cited by 130 publications

(98 citation statements)

References 45 publications

(48 reference statements)

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“…Children with symptoms of ADHD-IA were found to be even less impaired than children with ADHD-HI symptoms, although no firm conclusions can be drawn because of the small numbers involved in these studies. Clinical levels of inattentiveness seem to represent a rare phenomenon unless they are combined with ADHD-HI symptoms, and several large preschool samples have been unable to identify children with the ADHD-IA subtype (2,18,27,40). Inattentiveness and its clinical significance seem to be hard to evaluate in these young preschool children.…”

Section: Discussionmentioning

confidence: 99%

“…Both a community-based study (19) and a clinically based preschool study (27) have found minor gender differences in globally measured impairment related to ADHD. The study by Healey and colleagues found that non-referred boys were more impaired than non-referred girls according to teachers' reports but not according to parental ratings (6).…”

Section: Introductionmentioning

confidence: 99%

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Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

Bendiksen

Aase

Svensson

et al. 2013

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: We have limited knowledge of the impact of attention-deficit/hyperactivity disorder (ADHD) symptoms on the daily functioning of young preschool children. Objective: This study investigated the level of impairment related to symptoms of ADHD in different functional domains. It also addressed how impairment caused by ADHD was related to ADHD subtype, symptom load, gender, and the cooccurrence of oppositional defiant disorder, conduct disorder, or both. Method: Participating children (N = 807) who were 3.5 years old were recruited from a population-based sample included in The Norwegian Mother and Child Cohort Study. Children who scored above the 90th percentile for ADHD symptoms were included in the present sample. The assessment of the symptoms and functional impairment described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision, was based on parental ratings and the semi-structured psychiatric interview entitled "The Preschool Age Psychiatric Assessment." Results: Added burden and discord within family relationships were the areas that were most severely affected. All domain scores were strongly intercorrelated, and they were added to each child's total score. Children with symptoms of ADHD, inattentive type (mean [M], 3.5; standard deviation [SD], 3.4), or ADHD, hyperactive/impulsive type (M, 2.9; SD, 2.7), were significantly less impaired than children with symptoms of ADHD, combined type (M = 6.4; SD = 3.8; p < .001). Furthermore, co-occurring oppositional defiant disorder was associated with higher impairment scores (M, 6.1; SD, 4.3) than ADHD alone (M, 3.2; SD, 2.9; p < .001. About 30% of the variance of impairment score of ADHD was explained by symptoms of ADHD and co-occurring symptoms of oppositional defiant disorder and conduct disorder. Few gender differences were observed. Conclusion: Overall, these non-referred young children with clinical symptoms of ADHD were only modestly impaired. Impairment related to ADHD occurred mainly in the areas of family functioning, and it was associated with ADHD subtype and comorbidity. Still, it is important to assess the impact of ADHD symptoms and coexisting difficulties among preschoolers to identify children and families who are in need of early intervention efforts.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

Bendiksen

Aase

Svensson

et al. 2013

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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“…However, recent large-scale studies of preschool children with ADHD reveal that the opposite pattern may be true in the preschool years. In preschool children with moderate to severe ADHD studied as part of the multisite Preschool ADHD Treatment Study (PATS), the behavior of girls with ADHD was more deviant, relative to age-and sex-matched peers, than boys with ADHD on the Conners' Parent and Teacher Rating Scales [Posner et al, 2007]. However, the study of girls with ADHD in preschool presents a challenge, as the inattentive symptoms (more commonly observed in girls) are not as evident in the preschool years.…”

Section: Adhd In Girlsmentioning

confidence: 99%

The neurobiological profile of girls with ADHD

Mahone

Wodka

2008

Dev Disabil Res Revs

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Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and neurobiological basis of these deficits is less consistently observed. There is growing evidence that boys' and girls' brains develop and mature at different rates, suggesting that the trajectory of early anomalous brain development in ADHD may also be sex-specific. It remains unclear, however, whether earlier brain maturation observed in girls with ADHD is protective. In this review, we outline the current theory and research findings that seek to establish a unique neurobiological profile of girls with ADHD, highlighting sex differences in typical brain development and among children with ADHD. The review highlights findings from neurological, neurocognitive, and behavioral studies. Future research directions are suggested, including the need for longitudinal neuroimaging and neurobehavioral investigation beginning as early as the preschool years, and continuing through adolescence and adulthood, with consideration of identified sex differences in the development of ADHD.

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“…Bu oran çalışmamızda, literatüre yakın oranlarda (%60,1) saptanmıştır. Yazın bilgisinde eştanılar sıklık sırasına göre, KOKGB (%40), kaygı bozuklukları (%34), DB (%14), tik bozukları (%11), duygudurum bozuklukları (%4) ve artmış oranda iletişim bozuklukları olarak belirtilmiştir (26,27) . Çalışmamızda, tek tek eştanı oranlarına bakıl-dığında, bu çalışmalardan farklı olarak iletişim bozukluklarının (%12,4) KOKGB'dan (%11,9) az da olsa yüksek oranda saptanmıştır.…”

Section: Discussionunclassified

“…Erken başlangıçlı DEHB olgularında agresyon KOKB ve DB eştanıları, geç başlangıçlı DEHB olgularında ise anksiyete/depresyon eştanıları daha sık rapor edilmiştir ve YDB'larının erkeklerde daha yük-sek oranlarda olduğu bilinmektedir (23,27) . Çalışmamızda, bu yazın bilgisi ile uyumlu olarak 5 yaş grubunda 3 ve 4 yaş grubuna göre hem daha fazla eştanı hem de daha fazla ilaç tedavisi tercih edildiği, yine ilaç tedavi seçeneklerinin 5 yaş ve erkek çocuk-larda anlamlı fazla olduğu gözlenmiştir.…”

Section: Discussionunclassified

The prevalance of attention deficit hyperactivity disorder and the frequency of medication use among preschool children in a district children hospital

Kutlu¹,

Binici²

2017

BUCH

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Bir bölge çocuk hastanesinde okul öncesi dikkat eksikliği, hiperaktivite bozukluğu prevalansı ve ilaç kullanım sıklığıThe prevalance of attention deficit hyperactivity disorder and the frequency of medication use among preschool children in a district children hospital Yöntem: Çocuk ve Ergen Ruh Sağlığı ve hastalıkları polikliniklerine başvuran ve ICD-10 tanı kriterlerine göre DEHB tanısı konan 36-60 ay yaş aralığındaki çocukları dosyaları taranmıştır. Mental retardasyon, duygudurum bozuklukları, anksiyete bozuklukları, otizm spektrum bozuklukları, kronik tıbbi hastalık ve dosyalarda eksik veri olan çocuklar çalışma dışında bırakılmıştır. Bulgular: 218 DEHB tanılı okul öncesi çocuk çalışma grubunu oluşturmuştur. DEHB prevalansı okul öncesi çocuklarda %7,8'dir. Hastaların 61'inde (%28) bir komorbid hastalık vardır ve %32,1 oranında en sık eştanı yıkıcı davranış bozuklukları (karşıt olma, karşı gelme bozukluğu+davranım bozukluğu) olmuştur. Psikososyal tedavi olguların 116 (%53,2) iken, 102 (%46,8) çocuğa psikofarmakolojik tedavi başlanmıştır İlaç tedavisi olarak en sık önerilen psikofarmakolojik ajan risperidon olmuştur. Otuz altı-kırk sekiz ay yaş grubuna göre 49-60 ay yaş grubunda daha fazla komorbidite saptanmış ve ilaç tedavisinin kullanıldığı belirlenmiştir. Eştanı sayısının fazlalığı ilaç tedavisi seçeneğini tercih etmede belirleyici olduğu saptanmıştır (p<0,05). Sonuç: Psikosoyal tedavi ilk sırada tedavi seçeneği olsa da ilaç tedavisi de gerekli gibi görünmek-tedir. İlk sırada tercih edilen psikofarmakolojik ajan Risperidon olmuştur. İlaç tedavisini tercih edilmesinde daha büyük yaş ve eştanı sayısının fazlalığı belirleyici gibi görünmektedir.Anahtar kelimeler: Dikkat eksikliği hiperaktivite bozukluğu, okulöncesi dönem, yaygınlık, eştanı, psikofarmakoloji ABSTRACT Objective: This study analyzed the prevelance of Attention Deficit Hyperactivity Disorder (ADHD) and frequency of medication use among preschool children in a district children hospital between January 1 and December 31, 2016. Methods: We reviewed the medical files of children who admitted to the outpatient clinics of Child and Adolescent Psychiatry within the age range of 36 to 60 months, diagnosed with preschool ADHD (PS-ADHD) according to ICD-10 criteria. Children with comorbid intellectual disability, mood disorders, anxiety disorders, autism spectrum disorders and chronic medical disorders were excluded from the study. Medical files with incomplete data were not included in the analysis. Results: The study sample consisted of 218 preschool children with ADHD. The prevalance of ADHD among preschool children was 7.8 percent Sixty-one (28%) patients had at least one comorbid disorder and the disruptive behaviour disorders (oppositional defiant and conduct disorder) were the most common diagnoses with tha rate of 32.1 percent. Treatment with psychosocial interventions was applied to 116 (53.2%) children, whereas 102 (46.8%) children were started on pharmacotherapy. Risperidone was the most prescribed medication at a rate of 98%. In children withi...

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Clinical Presentation of Attention-Deficit/Hyperactivity Disorder in Preschool Children: The Preschoolers with Attention-Deficit/Hyperactivity Treatment Study (PATS)

Abstract: Preschoolers with moderate to severe ADHD experience high co-morbidity and impairment, which have implications for both assessment and treatment.

Cited by 130 publications

References 45 publications

Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

The neurobiological profile of girls with ADHD

The prevalance of attention deficit hyperactivity disorder and the frequency of medication use among preschool children in a district children hospital

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