Modeling the development of cognitive reserve in children: A residual index approach.

OBJECTIVE: To model cognitive reserve (CR) longitudinally in a neurodiverse pediatric sample using a residual index approach, and to test the criterion and construct validity of this index. METHOD: Participants were N = 115 children aged 9.5-13 years at baseline (MAge = 10.48 years, SDAge = 0.61), and n = 43 (37.4%) met criteria for ADHD. The CR index represented variance in Matrix Reasoning scores from the WASI that was unexplained by MRI-based brain variables (bilateral hippocampal volumes, total gray matter volumes, and total white matter hypointensity volumes) or demographics (age and sex). RESULTS: At baseline, the CR index predicted math computation ability (estimate = 0.50, SE = 0.07, p < .001), and word reading ability (estimate = 0.26, SE = 0.10, p = .012). Longitudinally, change in CR over time was not associated with change in math computation ability (estimate = -0.02, SE = 0.03, p < .513), but did predict change in word reading ability (estimate = 0.10, SE = 0.03, p < .001). Change in CR was also found to moderate the relationship between change in word reading ability and white matter hypointensity volume (estimate = 0.10, SE = 0.05, p = .045). CONCLUSIONS: Evidence for the criterion validity of this CR index is encouraging, but somewhat mixed, while construct validity was evidenced through interaction between CR, brain, and word reading ability. Future research would benefit from optimization of the CR index through careful selection of brain variables for a pediatric sample.

In-person versus online delivery of a behavioral sleep intervention (Sleeping Sound©) for children with ADHD: protocol for a parallel-group, non-inferiority, randomized controlled trial.

BACKGROUND: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience sleep difficulties such as difficulty initiating and maintaining sleep. Problem sleep may impact children's daily functioning and behaviors and exacerbate ADHD symptoms. Most effective behavioral interventions to improve sleep are conducted in person, limiting accessibility to treatment for individuals in remote or rural communities or those who are unable to attend a clinic. This trial aims to assess the efficacy of delivering an established behavioral intervention online, Sleeping Sound with ADHD©, compared to a face-to-face delivery mode. METHODS: This parallel group, non-inferiority, randomized controlled trial (RCT) will include at least 68 children, aged 5-12 years old with ADHD. Families of children will be recruited from private developmental and psychological clinics and social media, within the state of Western Australia (WA). Once written informed consent and baseline questionnaires are completed, families are randomized to receive the behavioral intervention either in-person or online via Telehealth services. The intervention targets the assessment and management of reported sleep problems, through two individual consultations and a follow-up phone call with a trained clinician. The sleep outcomes assessed consist of a parent-reported sleep questionnaire and actigraphy. DISCUSSION: To the best of our knowledge, this is the first RCT to investigate sleep treatment modality for children with ADHD. If effective, clinicians can provide an evidence-based sleep intervention in an accessible manner. TRIAL REGISTRATION: ANZCTR, ACTRN12621001681842 . Registered 9 December 2021-Retrospectively registered.

Assessing non-right-handedness and atypical cerebral lateralisation as predictors of paediatric mental health difficulties.

Research utilising handedness as a proxy for atypical language lateralisation has invoked the latter to explain increased mental health difficulties in left-/mixed-handed children. The current study investigated unique associations between handedness and language lateralisation, handedness and mental health, and language lateralisation and mental health, in children, to elucidate the role of cerebral lateralisation in paediatric mental health. Participants were N = 64 (34 females [52%]; MAge = 8.56 years; SDAge = 1.33; aged 6-12 years) typically developing children. Hand preference was assessed via a reaching task, language lateralisation was assessed using functional transcranial Doppler ultrasonography (fTCD) during an expressive language task, and mental health was assessed with the Strengths and Difficulties Questionnaire. As hypothesised, leftward hand preference predicted increased general mental health issues in children, with a strong relationship noted between leftward hand preference and the emotional symptoms subscale. Contrary to expectation, no relationship was found between direction of language lateralisation and general mental health issues, although exploratory analyses of subscales showed rightward lateralisation to predict conduct problems. Hand preference and direction of language lateralisation were also not significantly associated. The relatively weak relationship between manual and language laterality coupled with discrepancy regarding the predictive scope of each phenotype (i.e., hand preference predicts overall mental health, whereas language laterality predicts only conduct problems) suggests independent developmental pathways for these phenotypes. The role of manual laterality in paediatric mental health warrants further investigation utilising a neuroimaging method with higher spatial resolution.

Behavioral Sleep Interventions for Children With ADHD: A Systematic Review and Meta-Analysis.

OBJECTIVE: To evaluate intervention characteristics and components within behavioral sleep interventions in school-aged children with ADHD and examine evidence related to effectiveness. METHOD: A systematic review was conducted using PsycINFO, Embase, MEDLINE, PubMed, and OpenGray. The subsequent meta-analysis used sleep outcomes to produce comparable effect sizes (Hedges' g) and compare intervention effects between randomized controlled trials and pre-post studies. RESULTS: Eleven articles satisfied the inclusion criteria (562 children, across all groups, aged 5-14 years, M = 8.71). Studies reported improvements in sleep although there was marked heterogeneity between studies and limited use of objective sleep measures within them. On average, intervention groups improved more than control groups in the five randomized controlled trials (-0.46, 95% CI = [-0.58, -0.35], k = 4). CONCLUSION: The findings support the use of behavioral sleep interventions for school-aged children with ADHD. Findings suggest that brief, individualized intervention may be more effective than standardized.