Systematic Review and Meta-analysis: The Science of Early-Life Precursors and Interventions for Attention-Deficit/Hyperactivity Disorder

Shephard, Elizabeth; Zuccolo, Pedro Fonseca; Idrees, Iman; Godoy, Patricia; Salomone, Erica; Ferrante, Camilla; Sorgato, Paola; Catão, Luís F.C.C.; Goodwin, Amy; Bolton, Patrick; Tye, Charlotte; Groom, Madeleine J.; Polanczyk, Guilherme Vanoni

doi:10.1016/j.jaac.2021.03.016

Cited by 41 publications

(45 citation statements)

References 204 publications

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“…A variety of emotional and behavioral problems were evaluated in eligible studies, but using different psychometric scales. Followed the previous study ( 41 ), we used integrated outcomes for emotional and behavioral problems; the items included in each integrated outcome are provided in Supplementary Table 2 . To facilitate statistical independence of the data ( 42 ), for studies that used more than one version of scales (i.e., self, parent, and teacher version) to measure the same ADHD symptoms, we combined the effect sizes to guarantee that each study would contribute one effect size per outcome domain (i.e., inattention, hyperactivity–impulsivity, emotional and behavior problems).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

et al. 2021

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Objective: To assess the effectiveness of physical activity (PA) intervention on attention-deficit/hyperactivity disorder (ADHD)-related symptoms.Method: Studies that investigated PA intervention for ADHD-related symptoms were identified through searching PubMed, Web of Science, Cochrane Library, and Embase databases from inception through June 2021. Standardized mean difference (SMD) with 95% confidence interval (CI) was used to assess the effectiveness of PA intervention on improving ADHD-related symptoms. The meta-analyses were conducted using fixed-effect or random-effect models according to the heterogeneity of the studies.Results: Nine before–after studies (232 participants) and 14 two-group control studies (162 participants/141 controls) were included in this meta-analysis. Combined results for before–after studies indicated significant improvements on all studied ADHD-related symptoms (inattention: SMD = 0.604, 95% CI: 0.374–0.834, p < 0.001; hyperactivity/impulsivity: SMD = 0.676, 95% CI: 0.401–0.950, p < 0.001; emotional problems: SMD = 0.416, 95% CI: 0.283–0.549, p < 0.001; behavioral problems: SMD = 0.347, 95% CI: 0.202–0.492, p < 0.001). Meta-analyses for two-group control studies further confirmed that PA intervention significantly improved the inattentive symptom (SMD = 0.715, 95% CI: 0.105, 1.325, p = 0.022). Subgroup analyses suggested significant beneficial effect on inattention symptoms in children. Moreover, closed motor skills were beneficial for hyperactive/impulsive problems (SMD = 0.671, p < 0.001), while open motor skills were beneficial for attention problems (SMD = 0.455, p = 0.049). When excluding studies with combined medication, the studies in unmedicated participants in before–after studies still showed significant results in all studied ADHD-related symptoms as in the overall analysis. Given the limited sample size, the best frequency and intensity of PA intervention need further investigation.Conclusion: Our results suggested that PA intervention could possibly improve ADHD-related symptoms, especially inattention symptoms. Closed-skill and open-skill activities could be beneficial for hyperactivity/impulsivity and inattention symptoms, respectively. Further high-quality randomized clinical trials with large sample size are needed.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

et al. 2021

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“…High heterogeneity has been reported in meta-analyses of many other neurocognitive functions in ADHD (e.g. Huang-Pollock et al, 2012;Shephard et al, 2021b) and might reflect variation in the clinical or neurocognitive presentation of the condition and/or co-occurring symptoms of other conditions, which may not have been thoroughly assessed in the studies included in our meta-analyses.…”

Section: Reduced Electrophysiological Correlates Of Internal But Not External Performance Monitoring In Adhdmentioning

confidence: 97%

A systematic review and meta-analysis of altered electrophysiological markers of performance monitoring in Obsessive-Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (GTS), Attention-Deficit/Hyperactivity disorder (ADHD) and Autism

Bellato

Norman

Idrees

et al. 2021

Neuroscience & Biobehavioral Reviews

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Altered performance monitoring is implicated in obsessive-compulsive disorder (OCD), Gilles de la Tourette syndrome (GTS), attention-deficit/hyperactivity disorder (ADHD) and autism. We conducted a systematic review and meta-analysis of electrophysiological correlates of performance monitoring (error-related negativity, ERN; error positivity, Pe; feedback-related negativity, FRN; feedback-P3) in individuals with OCD, GTS, ADHD or autism compared to control participants, or associations between correlates and symptoms/traits of these conditions. Meta-analyses on 97 studies (5890 participants) showed increased ERN in OCD (Hedge's g=0.

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“…Our finding that parenting stress at 9–10 months associated ADHD symptoms in adolescence, with increasing strength at 18 and 36 months, raises the question of what differences emerge from 9 to 36 months in children who later develop ADHD that underlie this increase in parenting stress. Sleep disturbances between 0 and 5 years are associated with ADHD in adolescence ( 29 , 30 ), and are associated with poorer parent mental health ( 31 ). Recent studies have also found heightened emotional reactivity at 6 and 9 months to be associated with ADHD, suggesting temperamental differences may emerge around this period ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Self-Reported Maternal Parenting Stress From 9 m Is Longitudinally Associated With Child ADHD Symptoms at Age 12: Findings From a Population-Based Birth Cohort Study

et al. 2022

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BackgroundAttention-deficit/hyperactivity disorder (ADHD) develops in early childhood and carries lifelong impact, but early identification and intervention ensure optimal clinical outcomes. Prolonged or excessive parenting stress may be a response to infant behavioral differences antecedent to developmental disorders such as ADHD, and therefore represents a potentially valuable inclusion in routine early-life assessment. To investigate the feasibility of using routinely-collected self-reported maternal parenting stress as a risk marker for child ADHD, this study investigated the longitudinal association between maternal parenting stress from 1 to 36 months after childbirth and child ADHD in early adolescence.MethodsThe sample comprised 2,638 children (1,253 girls) from the Tokyo Teen Cohort population-based birth cohort study. Mothers recorded parenting stress five times from 1 to 36 months following childbirth in the Maternal and Child Health Handbook, a tool used for routine early-life assessment in Japan. Nine years later, mothers evaluated their child's ADHD symptoms at 12 y using the hyperactivity/inattention subscale from the Strength and Difficulties Questionnaire.ResultsApproximately 7.5% of parents reported that they had parenting stress at 36 m after childbirth. 6.2% of children were evaluated as above the cut-off for ADHD symptoms at 12 y. Parenting stress at 1 and 3–4 m was not associated with child ADHD symptoms at 12 y. However, child ADHD symptoms at 12 y was significantly associated with parenting stress at 9–10 m (unadjusted OR = 1.42, p =.047, 95% CI [1.00, 2/00]), 18 m (unadjusted OR = 1.57, p =.007, 95% CI [1.13, 2.19]) and 36 m (unadjusted OR = 1.67, p =.002, 95% CI [1.20, 2.31]). These associations remained after adjustment for child's sex, age in months and family income.ConclusionsWe identified associations between parenting stress at 9–10, 18 and 36 m after childbirth and child ADHD symptoms at 12 years old. Self-reported parenting stress data may have utility as an early indicator for ADHD risk. Participation in early-life health checks, assessment of parenting stress, and tailoring support to family needs should be promoted for early identification and intervention for ADHD.

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Systematic Review and Meta-analysis: The Science of Early-Life Precursors and Interventions for Attention-Deficit/Hyperactivity Disorder

Cited by 41 publications

References 204 publications

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis of altered electrophysiological markers of performance monitoring in Obsessive-Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (GTS), Attention-Deficit/Hyperactivity disorder (ADHD) and Autism

Self-Reported Maternal Parenting Stress From 9 m Is Longitudinally Associated With Child ADHD Symptoms at Age 12: Findings From a Population-Based Birth Cohort Study

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