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Attention deficit hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder. Currently, the diagnosis and treatment of ADHD in children and adolescents is primarily centred on daytime functioning and the associated impairment of academic performance, although disrupted and restless sleep have been frequently reported in individuals with ADHD. Further, it has been recognised that sleep disorders not only intensify existing ADHD symptoms but in some cases can also mimic ADHD symptoms in the paediatric population with primary sleep disorders. Under the title ‘The blind spot: sleep as a child’s right issue?’, professionals from diverse disciplines, including medicine and social sciences as well as individuals with an interest in ADHD and sleep medicine, including laypeople, have initiated a unifying discourse. The objective of this discourse is to improve our understanding of the diagnosis and treatment of ADHD and disruptive behaviours and to develop personalised and precision medicine. Research has shown that the existing, primarily descriptive and categorical diagnostic systems do not capture the heterogeneous nature of youth with attentional and behavioural difficulties and the phenotypic expressions thereof, including nighttime behaviours and sleep. New strategies for clinical phenotyping and the exploration of patient-reported behaviours are necessary to expand our understanding and develop personalised treatment approaches. In this position paper, we outline gaps in the clinical care of ADHD and related sleep disturbances, review strategies for closing these gaps to meet the needs of individuals with ADHD, and suggest a roadmap for escaping the one-size-fits-all approach that has characterised ADHD treatment algorithms to date.
Attention deficit hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder. Currently, the diagnosis and treatment of ADHD in children and adolescents is primarily centred on daytime functioning and the associated impairment of academic performance, although disrupted and restless sleep have been frequently reported in individuals with ADHD. Further, it has been recognised that sleep disorders not only intensify existing ADHD symptoms but in some cases can also mimic ADHD symptoms in the paediatric population with primary sleep disorders. Under the title ‘The blind spot: sleep as a child’s right issue?’, professionals from diverse disciplines, including medicine and social sciences as well as individuals with an interest in ADHD and sleep medicine, including laypeople, have initiated a unifying discourse. The objective of this discourse is to improve our understanding of the diagnosis and treatment of ADHD and disruptive behaviours and to develop personalised and precision medicine. Research has shown that the existing, primarily descriptive and categorical diagnostic systems do not capture the heterogeneous nature of youth with attentional and behavioural difficulties and the phenotypic expressions thereof, including nighttime behaviours and sleep. New strategies for clinical phenotyping and the exploration of patient-reported behaviours are necessary to expand our understanding and develop personalised treatment approaches. In this position paper, we outline gaps in the clinical care of ADHD and related sleep disturbances, review strategies for closing these gaps to meet the needs of individuals with ADHD, and suggest a roadmap for escaping the one-size-fits-all approach that has characterised ADHD treatment algorithms to date.
Objectives Families of children with prenatal alcohol exposure (PAE) are diverse, raising children through birth, adoption, or fostering, including kinship care. Research has shown that caregivers of children with PAE often experience unique difficulties with parenting, which may differ across types of caregivers. Understanding the range of needs of these families is critical for program development; therefore, it is important to know which caregivers are represented in this research and how. Methods The current meta-analysis and scoping review examined the demographic characteristics of caregivers and children included in quantitative PAE caregiver-related research. Systematic database searches using key terms led to the inclusion of 15 relevant studies involving 593 participants in total. Results Most caregivers in the studies were adoptive parents, female, middled-aged, White, partnered, had obtained a high school education or higher, and resided in the United States. Most studies included caregivers of school-aged children diagnosed with FASD. Most studies recruited participants through pre-established lists and databases, collected data in person and for research purposes, and studied parenting stress. Attempts to study differences in representation based on research methods were unsuccessful due to a lack of differences within the literature. Conclusions The results of this study suggest that (a) non-adoptive parents, (b) caregivers who were male, non-White, non-partnered, less educated, and living outside of the United States, and (c) caregivers of adolescents, and caregivers raising children with PAE who have not received an FASD diagnosis are currently underrepresented in the research; however, this literature is limited and requires further research.
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