Analysis of the motor performance of children with ASD and its relationship with personal and contextual variables.

Background: A high number of individuals with Autism Spectrum Disorder (ASD) present motor deficits. The objectives of this study were (1) to evaluate the motor performance of children with ASD and (2) to analyze the influence that sociodemographic variables and difficulties related to learning have in the development of motor deficits. Method: Participants were 23 boys and 5 girls with ASD between 4-14 years old. Impairments in motor development were evaluated using the Movement assessment battery for children-2 (MABC-2). Parents provided information on the personal and contextual variables of the participants through a sociodemographic questionnaire and they reported the motor skills of their children through the Checklist of the MABC-2. Results: The results suggest that most children with ASD present difficulties in balance and in fine and gross motor skills. Likewise, the analysis of the χ2 tests suggested that curricular adaptations, the presence of siblings and traits such as impulsivity, hyperactivity and speech difficulties are factors related to their motor development. Conclusions: The findings highlight the need to address these difficulties from an early age to stimulate and encourage their development.

Mindfulness Training for Children with ADHD and Their Parents: A Randomized Control Trial.

OBJECTIVE: The aim of this randomized control trial is to analyze the efficacy of a Mindfulness-based program (MYmind) in improving ADHD symptoms, associated problems, executive functions, and family functioning. METHOD: The sample was composed of 30 children (9-14 years old) with an ADHD diagnosis and their parents. Participants were randomized into two groups, the MYmind group (n = 15) and a wait-list group (n = 15). Participants were assessed in three time periods: pre-, post-intervention, and at 6-month follow-up. RESULTS: After the program, parents reported a decrease in parenting stress and improvements in parenting styles. Six months after the intervention, parents reported significant improvements in children's inattention symptoms, executive functions, learning problems, aggression, and peer relations. Overreactivity was the only variable that showed a decrease in both the post-test and follow-up periods. CONCLUSION: These results suggest that the MYmind program is a promising treatment for children with ADHD and their parents.

ADHD symptoms and learning behaviors in children with ASD without intellectual disability. A mediation analysis of executive functions.

In spite of its importance for education, the relationship between learning behaviors (LB), attention deficit hyperactivity disorder symptoms (ADHD) and executive functioning (EF) in children with autism spectrum disorder (ASD) has hardly been explored. The first objective of the present study was to compare children with ASD without intellectual disability and children with typical development (TD) on ADHD symptoms and learning behaviors: Motivation/competence, attitude toward learning, persistence on the task, and strategy/flexibility. The second objective was to analyze the mediator role of behavioral regulation and metacognition components of EF between ADHD symptoms and learning behaviors in children with ASD. Participants were 89 children between 7 and 11 years old, 52 with ASD and 37 with TD, matched on age and intelligence. Their teachers filled out questionnaires assessing executive functioning as well as learning behaviors. Parents and teachers reported on inattention and hyperactivity/impulsivity behaviors. Compared to children with TD, children with ASD presented significantly more ADHD symptoms and poorer learning behaviors. In addition, there were significant mediation effects of the behavioral regulation index (BRI) and metacognition index (MI) of EF, indicating that both are part of the route through which ADHD symptoms impact to learning behaviors of children with ASD.

Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems.

BACKGROUND: The underlying mechanisms of comorbidity between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are still unknown. Executive function (EF) deficits and theory of mind (ToM) have been the most investigated cognitive processes. AIMS: This study proposed to analyze EF, ToM and behavioral problems in children with ASD + ADHD, ADHD, ASD and typical development (TD). The relationship between ADHD and ASD symptoms with EF, ToM and behavioral problems in children with ASD + ADHD was also explored. METHODS AND PROCEDURES: Participants were 124 children between 7 and 11 years old (22 ASD + ADHD, 35 ADHD, 30 ASD, and 37 TD), matched on age and IQ. Teachers evaluated EF, and parents assessed ToM skills and behavioral problems through Strengths and Difficulties Questionnaire (SDQ). OUTCOMES AND RESULTS: Children with ASD + ADHD and ADHD showed impairments in EF whereas the difficulties in ToM skills of ASD + ADHD group were similar to ASD group. Inattention symptoms were significantly associated with EF metacognitive deficits and ToM difficulties in ASD + ADHD, while ASD symptoms were associated with total score in behavioral problems. CONCLUSIONS AND IMPLICATIONS: These findings show the complex difficulties of children with both ASD and ADHD and support the need to take these difficulties into account when designing the treatments.

Contribution of Theory of Mind, Executive Functioning, and Pragmatics to Socialization Behaviors of Children with High-Functioning Autism.

Social difficulties are a key aspect of autism, but the intervening factors are still poorly understood. This study had two objectives: to compare the profile of ToM skills, executive functioning (EF), and pragmatic competence (PC) of children with high-functioning autism (HFA) and children with typical development (TD), and analyze their mediator role in social functioning. The participants were 52 children with HFA and 37 children with TD matched on age, intelligence quotient, and expressive vocabulary. Significant differences were found on measures of ToM, both explicit and applied, EF, and PC between children with HFA and TD. Multiple mediation analysis revealed that applied ToM skills and PC mediated the relations between autism symptoms and social functioning. Implications for social cognitive interventions to address these findings are discussed.

Social Cognition in Children with High-Functioning Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Associations with Executive Functions.

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders characterized by social impairments. The first objective of this study was to analyze social cognition deficits of children with ADHD, high-functioning ASD (HFASD), and typical development (TD) in their performance on explicit and applied measures of theory of mind (ToM). The second objective was to investigate the relationships between executive functions and social cognition in HFASD and ADHD. One hundred and twenty-six 7- to 11-year old children, 52 with HFASD, 35 with ADHD, and 39 with TD, performed the NEPSY-II social perception subtests. Parents estimated their children's ToM skills using the Theory of Mind Inventory (ToMI). Teacher-reported data from the Behavior Rating Inventory of Executive Function (BRIEF) were also obtained. The HFASD and ADHD groups showed worse performance on the verbal ToM task than the TD group, and only the performance of the HFASD group was significantly lower than the TD group on the contextual ToM task. Parents also estimated that the HFASD group had more difficulties on the applied ToM than the ADHD and TD groups. Furthermore, there is a different executive function-theory of mind link in the HFASD and ADHD groups: behavioral regulation processes such as inhibition and emotional control are more associated with social cognition in children with ADHD, whereas metacognitive processes such as initiation and planning have a strong association with social cognition in children with HFASD. These findings have implications for understanding social perception deficits in neurodevelopmental disorders, highlighting the need for early intervention.

The Impact of Inattention, Hyperactivity/Impulsivity Symptoms, and Executive Functions on Learning Behaviors of Children with ADHD.

Children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at risk of experiencing lower academic achievement compared to their peers without ADHD. However, we have a limited understanding of the mechanisms underlying this association. Both the symptoms of the disorder and the executive functions can negatively influence learning behaviors, including motivation, attitude toward learning, or persistence, key aspects of the learning process. The first objective of this study was to compare different components of learning behaviors in children diagnosed with ADHD and typically developing (TD) children. The second objective was to analyze the relationships among learning behaviors, executive functioning, and symptoms of hyperactivity/impulsivity in both groups. Participants were 35 children diagnosed with ADHD and 37 with TD (7-11 years old), matched on age and IQ. The teachers filled out the Behavior Rating Inventory of Executive Function (BRIEF) and the Learning Behaviors Scale, which evaluates Competence/motivation, Attitude toward learning, Attention/persistence, and Strategy/flexibility. In addition, parents and teachers filled out the DSM-5 diagnostic criteria for ADHD. ANOVAs showed significant differences between children with ADHD and TD children on all the learning behaviors. Moreover, in both the ADHD and TD groups, the behavioral regulation index of the BRIEF predicted the search for strategies, and the metacognition index was a good predictor of motivation. However, attitude toward learning was predicted by metacognition only in the group with ADHD. Therefore, the executive functions had greater power than the typical symptoms of inattention and hyperactivity/impulsivity in predicting learning behaviors of children with ADHD. The findings are in line with other studies that support the influence of the executive functions on performance, highlighting the importance of including their development as a top priority from early ages in the school setting in order to strengthen learning behaviors.

Reading Performance of Young Adults With ADHD Diagnosed in Childhood.

OBJECTIVE: To study reading performance of young adults with ADHD and its relation with executive functioning. METHOD: Thirty young adults with a childhood diagnosis of ADHD and 30 with normal development (ND) were compared on reading accuracy, fluency, and comprehension. Furthermore, ADHD with reading disabilities (ADHD+RD) and ADHD without reading disabilities (ADHD-RD) subgroups were compared using self-report and informant-report versions of the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A). RESULTS: Adults with ADHD obtained significantly worse results than the ND adults on reading speed, responses to literal questions, and a cloze test. Although the comparison of the ADHD+RD and ADHD-RD groups did not show significant differences on the BRIEF-A subscales, the ADHD+RD group surpassed the critical percentile (85) on more subscales, with working memory and metacognition especially affected. CONCLUSION: The findings point out that reading should be assessed in individuals with ADHD as part of their evaluation to design effective early interventions.

Narratives of children with high-functioning autism spectrum disorder: A meta-analysis.

BACKGROUND: The aim of this meta-analysis was to analyze the narrative performance of children and adolescents with high-functioning Autism Spectrum Disorders (ASD) in terms of microstructure, macrostructure and internal state language. METHOD: A systematic literature search yielded 24 studies that met the predetermined inclusion criteria. Effect sizes for each study were calculated for eight variables and analyzed using a random effects model. Intellectual ability, age and type of narrative were considered as potential moderators. RESULTS: Results revealed that the children with ASD performed significantly worse than their peers on all the variables considered. CONCLUSIONS: Findings are discussed taking into account the main explanatory psychological autism theories. Implications for intervention and orientations for future research are suggested.

Substance use in young adults with ADHD: Comorbidity and symptoms of inattention and hyperactivity/impulsivity / Consumo de sustancias en jóvenes adultos con TDAH: comorbilidad y síntomas de inatención e hiperactividad/impulsividad

Young adults with attention deficit hyperactivity disorder (ADHD) are at high risk of substance use (SU). The aims of the current study were: 1) to examine the use of alcohol, tobacco, marijuana and other illegal drugs by adults with and without ADHD; 2) to compare the oppositional, conduct, anxiety, depression, sleep and antisocial personality symptoms of ADHD adults with SU and ADHD adults without SU; 3) to examine the ability of ADHD symptoms and conduct problems to predict SU. A total of 93 young adults, 43 without ADHD and 50 with a childhood diagnosis of ADHD, who were part of the Spanish sample of the Multicenter ADHD Genetics (IMAGE) study, collaborated in a follow-up evaluation 10.1 years later. ADHD participants were divided into two groups based on the presence or absence of SU. Statistically significant differences were found between young adults with and without ADHD in their use of tobacco, marijuana and alcohol. A statistically significant association was also shown between externalization problems and a greater risk of SU. Conduct problems, to a greater degree than ADHD symptoms, affect SU in ADHD adults (AU)

Los jóvenes con trastorno por déficit de atención con hiperactividad (TDAH) tienen un elevado riesgo de uso de sustancias (US). Los objetivos del presente trabajo fueron: 1) analizar el consumo de alcohol, tabaco, marihuana y otras drogas ilegales en adultos con y sin TDAH; 2) comparar a los adultos con TDAH con y sin US en oposicionismo, problemas de conducta, ansiedad, depresión, sueño y personalidad antisocial; 3) determinar la capacidad de la sintomatología de TDAH y de los problemas de conducta para predecir el US. Noventa y tres jóvenes adultos, 43 sin TDAH y 50 con diagnóstico de TDAH en la infancia que participaron en el estudio Multicenter ADHD Genetics (IMAGE) colaboraron en una evaluación de seguimiento 10.1 años después. Los participantes con TDAH se dividieron en dos subgrupos según presencia o ausencia de US. Los jóvenes con y sin TDAH se diferenciaron significativamente en consumo de tabaco, marihuana y alcohol. Se constató una relación significativa entre los trastornos de conducta y US en adultos TDAH. Los problemas de conducta más que los síntomas de TDAH influyen en el US de adultos con TDAH (AU)

Substance use in young adults with ADHD: Comorbidity and symptoms of inattention and hyperactivity/impulsivity.

Young adults with attention deficit hyperactivity disorder (ADHD) are at high risk of substance use (SU). The aims of the current study were: 1) to examine the use of alcohol, tobacco, marijuana and other illegal drugs by adults with and without ADHD; 2) to compare the oppositional, conduct, anxiety, depression, sleep and antisocial personality symptoms of ADHD adults with SU and ADHD adults without SU; 3) to examine the ability of ADHD symptoms and conduct problems to predict SU. A total of 93 young adults, 43 without ADHD and 50 with a childhood diagnosis of ADHD, who were part of the Spanish sample of the Multicenter ADHD Genetics (IMAGE) study, collaborated in a follow-up evaluation 10.1 years later. ADHD participants were divided into two groups based on the presence or absence of SU. Statistically significant differences were found between young adults with and without ADHD in their use of tobacco, marijuana and alcohol. A statistically significant association was also shown between externalization problems and a greater risk of SU. Conduct problems, to a greater degree than ADHD symptoms, affect SU in ADHD adults.

Los jóvenes con trastorno por déficit de atención con hiperactividad (TDAH) tienen un elevado riesgo de uso de sustancias (US). Los objetivos del presente trabajo fueron: 1) analizar el consumo de alcohol, tabaco, marihuana y otras drogas ilegales en adultos con y sin TDAH; 2) comparar a los adultos con TDAH con y sin US en oposicionismo, problemas de conducta, ansiedad, depresión, sueño y personalidad antisocial; 3) determinar la capacidad de la sintomatología de TDAH y de los problemas de conducta para predecir el US. Noventa y tres jóvenes adultos, 43 sin TDAH y 50 con diagnóstico de TDAH en la infancia que participaron en el estudio Multicenter ADHD Genetics (IMAGE) colaboraron en una evaluación de seguimiento 10.1 años después. Los participantes con TDAH se dividieron en dos subgrupos según presencia o ausencia de US. Los jóvenes con y sin TDAH se diferenciaron significativamente en consumo de tabaco, marihuana y alcohol. Se constató una relación significativa entre los trastornos de conducta y US en adultos TDAH. Los problemas de conducta más que los síntomas de TDAH influyen en el US de adultos con TDAH.

Analysis of personal and family factors in the persistence of attention deficit hyperactivity disorder: results of a prospective follow-up study in childhood.

OBJECTIVES: To study the course of ADHD during childhood and analyze possible personal and family predictor variables of the results. METHOD: Sixty-one children with ADHD who were between 6 and 12 years old at the baseline assessment were evaluated 30 months later (mean age at baseline: 8.70 ± 1.97; mean age at follow-up: 10.98 ± 2.19). Status of ADHD in follow-up was identified as persistent (met DSM-IV-TR criteria according to parents' and teachers' ratings), contextually persistent (met ADHD criteria according to one informant, and there was functional impairment) and remitted ADHD (with subthreshold clinical symptomatology). Associated psychological disorders of the three groups were analyzed in the follow-up with the Conners' Rating Scales. The groups were compared on ADHD characteristics (symptoms of ADHD and impairment), child psychopathology, executive functioning (EF; inhibition, working memory) and parenting characteristics (parental stress and discipline styles) at baseline. RESULTS: At the follow-up, 55.7% of the children continued to meet the DSM-IV-TR criteria for ADHD, 29.5% showed contextual persistence, and 14.8% presented remission of the disorder. The persistent and contextually persistent ADHD groups showed more associated psychological disorders. Inattention, oppositional problems, cognitive problems and impairment at baseline distinguished the remitted ADHD children from the persistent and contextually persistent ADHD children. Moreover, the persistent groups had significantly more emotional liability and higher parental stress than the group in remission, while no differences in EF where found among the groups. CONCLUSIONS: ADHD children continue to present symptoms, as well as comorbid psychological problems, during adolescence and early adulthood. These findings confirm that persistence of ADHD is associated with child psychopathology, parental stress and impairment in childhood.

Performance-based tests versus behavioral ratings in the assessment of executive functioning in preschoolers: associations with ADHD symptoms and reading achievement.

The early assessment of the executive processes using ecologically valid instruments is essential for identifying deficits and planning actions to deal with possible adverse consequences. The present study has two different objectives. The first objective is to analyze the relationship between preschoolers' performance on tests of Working Memory and Inhibition and parents' and teachers' ratings of these executive functions (EFs) using the Behavior Rating Inventory of Executive Function (BRIEF). The second objective consists of studying the predictive value of the different EF measures (performance-based test and rating scales) on Inattention and Hyperactivity/Impulsivity behaviors and on indicators of word reading performance. The participants in the study were 209 children in the last year of preschool, their teachers and their families. Performance-based tests of Working Memory and Inhibition were administered, as well as word reading measures (accuracy and speed). The parents and teachers filled out rating scales of the EF and typical behaviors of attention deficit hyperactivity disorder (ADHD) symptomatology. Moderate correlation values were found between the different EF assessments procedures, although the results varied depending on the different domains. Metacognition Index from the BRIEF presented stronger correlations with verbal working memory tests than with inhibition tests. Both the rating scales and the performance-based tests were significant predictors of Inattention and Hyperactivity/Impulsivity behaviors and the reading achievement measures. However, the BRIEF explained a greater percentage of variance in the case of the ADHD symptomatology, while the performance-based tests explained reading achievement to a greater degree. The implications of the findings for research and clinical practice are discussed.

Influence of the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and comorbid disorders on functioning in adulthood / Influencia de los síntomas del Trastorno por Déficit de Atención con Hiperactividad (TDAH) y trastornos comórbidos en el funcionamiento en la edad adulta

BACKGROUND: ADHD is a chronic disorder that generally has a negative effect on socio-personal adaptation. The objectives of the current study were to examine the adaptive functioning in the daily lives of adults with ADHD compared to adults without the disorder and to test the influence of ADHD symptoms and comorbid problems on different areas of adaptive functioning. METHOD: Seventy-seven adults between 17 and 24 years old, 40 with a clinical diagnosis of combined-subtype ADHD in childhood and 37 controls, filled out the Weiss Functional Impairment Scale, the Weiss Symptom Record and Conners' Adult ADHD Rating Scale. RESULTS: Significant differences were found between adults with and without ADHD in family and academic functioning. Moreover, the ADHD symptomatology as a whole predicted significant deficiencies in the family environment and self-concept, whereas inattention specifically predicted worse academic performance and life skills. The comorbidities mainly affected the family and risky activity domains (dangerous driving, illegal behaviors, substance misuse and sexually inappropriate behaviors). CONCLUSIONS: The results illustrate the importance of developing a multimodal approach to helping ADHD adults cope with associated comorbid disorders, offering them supportive coaching in organizing daily activities, and incorporating the family and/or partner in the treatment plan

ANTECEDENTES: el TDAH es un trastorno crónico que afecta la adaptación sociopersonal. Los objetivos de este estudio fueron comprobar el funcionamiento adaptativo de adultos con TDAH en comparación a adultos sin el trastorno y analizar la influencia de la inatención e hiperactividad/impulsividad y de los trastornos comórbidos en este funcionamiento. MÉTODO: la muestra incluyó 77 adultos entre 17 y 24 años, 40 con un diagnóstico de TDAH subtipo combinado y 37 controles que cumplimentaron el Weiss Functional Impairment Scale, el Weiss Symptom Record y el Conners' Adult ADHD Rating Scale. RESULTADOS: se encontraron diferencias significativas entre adultos con y sin TDAH en el funcionamiento familiar y académico. Además, la sintomatología de TDAH predijo déficits significativos en el ámbito familiar y en el autoconcepto y concretamente la inatención predijo un peor funcionamiento académico y de habilidades cotidianas. Las comorbilidades influyeron principalmente en los dominios familiar y de actividades de riego (conducción temeraria, conductas ilegales, abuso de sustancias y conductas sexuales inapropiadas). CONCLUSIONES: los resultados reflejan la importancia de desarrollar un enfoque multimodal en adultos con TDAH para tratar los trastornos comórbidos, ofreciéndoles entrenamiento para la organización de actividades diarias e incorporando a la familia y/o pareja en el plan de tratamiento

Influence of the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and comorbid disorders on functioning in adulthood.

BACKGROUND: ADHD is a chronic disorder that generally has a negative effect on socio-personal adaptation. The objectives of the current study were to examine the adaptive functioning in the daily lives of adults with ADHD compared to adults without the disorder and to test the influence of ADHD symptoms and comorbid problems on different areas of adaptive functioning. METHOD: Seventy-seven adults between 17 and 24 years old, 40 with a clinical diagnosis of combined-subtype ADHD in childhood and 37 controls, filled out the Weiss Functional Impairment Scale, the Weiss Symptom Record and Conners' Adult ADHD Rating Scale. RESULTS: Significant differences were found between adults with and without ADHD in family and academic functioning. Moreover, the ADHD symptomatology as a whole predicted significant deficiencies in the family environment and self-concept, whereas inattention specifically predicted worse academic performance and life skills. The comorbidities mainly affected the family and risky activity domains (dangerous driving, illegal behaviors, substance misuse and sexually inappropriate behaviors). CONCLUSIONS: The results illustrate the importance of developing a multimodal approach to helping ADHD adults cope with associated comorbid disorders, offering them supportive coaching in organizing daily activities, and incorporating the family and/or partner in the treatment plan.

Narrative writing competence and internal state terms of young adults clinically diagnosed with childhood attention deficit hyperactivity disorder.

OBJECTIVE: The first objective of this study was to compare the written expression competence of young adults with attention deficit hyperactivity disorder (ADHD) with that of young adults without ADHD on three types of measures: indicators of the story's microstructure with regard to productivity and morphosyntax; indicators of the macrostructure (story grammar); and expressions of the mental states of the story's characters (internal state language). The second objective consisted of determining the relationships among the different narrative writing measures and the ADHD behavior ratings of inattention and hyperactivity obtained using the family observer report. METHOD: The sample was composed of 54 participants, aged from 18 to 24, divided equally into a group with a childhood clinical diagnosis of combined subtype ADHD and a control group without ADHD. Written composition was assessed using a narrative task based on a sequence of images. RESULTS: As expected, the young adults with ADHD obtained significantly worse results than the control group on the majority of the parameters of the story's microstructure and macrostructure. Likewise, they included a significantly lower number of terms about the characters' mental states. A correlation was also observed between measures of narrative competence and core symptoms of ADHD, as well as between the use of words with an emotional content and estimations related to core symptoms of ADHD. CONCLUSION: The findings of this study point out that expressive writing should be assessed in individuals with ADHD as part of screening and comprehensive evaluation. More research is needed to design and implement effective interventions in this area.