Prevalence of attention-deficit/hyperactivity disorder and autism in 12-year-old children: A population-based cohort.

AIM: To investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in a population-based birth cohort and correlate the findings with prenatal and perinatal factors. We hypothesized that children born preterm, having experienced preeclampsia or maternal overweight, would have an increased risk of ADHD or ASD. METHOD: A Swedish cohort of 2666 children (1350 males, 1316 females) has been followed from birth with parental and perinatal data. The National Board of Health and Welfare's registries were used to collect data regarding perinatal status and assigned diagnoses at the age of 12 years. RESULTS: The prevalence of ADHD and ASD was 7.6% and 1.1% respectively. Maternal obesity early in pregnancy resulted in a three-fold increased risk of ADHD in the child. Similarly, paternal obesity resulted in a two-fold increased risk. The association was significant also when adjusted for sex, preterm birth, smoking, and lower educational level. The prevalence of ASD was too low for statistically relevant risk factor analyses. INTERPRETATION: Our results corroborate earlier findings regarding prevalence and sex ratio for both ADHD and ASD. Maternal body mass index and preterm birth were correlated with an ADHD diagnosis at the age of 12 years.

Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes.

BACKGROUND: With increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) and with affirmation of applied behavior analysis (ABA) as an evidence-based standard of care for ASD, there has been a proliferation of agencies offering ABA services over the last several decades. Disagreement exists among ABA providers and health plans that reimburse those providers on the optimal number of hours of ABA services that should be reimbursed. This study aims to understand whether children who receive more hours of ABA therapy achieve better outcomes and to evaluate the impact of the COVID-19-induced shift to telehealth clinical supervision on outcomes. METHODS: A retrospective cohort analysis was performed using data from the Vineland 3 Comprehensive Interview Form to assess function throughout ABA treatment. Paired sample t tests, independent sample t tests, Cohen's D, and Pearson correlations were used to determine relationships between Vineland scores and input variables including hours of service and modality of supervision (in-person vs. telehealth). RESULTS: While statistically and clinically significant improvements in function were observed, children appear to have improved outcomes independent of the number of hours of service received. There were also no significant associations between modality of supervision and Vineland standard scores. CONCLUSIONS: These findings challenge prior research that demonstrated a linear dose-response relationship. By tailoring treatment dosage to the individual client's needs, providers may be able to better maximize functional progress of the client, to preserve family time, and to utilize health plan dollars more efficiently.

Half of the children with overweight or obesity and attention-deficit/hyperactivity disorder reach normal weight with stimulants.

AIM: Treatment of childhood obesity is often insufficient and may be aggravated by high co-occurrence of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether children with overweight or obesity normalised in weight when receiving stimulant treatment for ADHD. METHODS: Growth data of 118 children were obtained from medical records at outpatient paediatric and children's psychiatric services in the Gothenburg area, Sweden. The children were diagnosed with ADHD and were between 6 and 17 years at the start of stimulant treatment. The pre-treatment data act as an internal control where every child is their own control. RESULTS: At the start of treatment, 74 children had normal weight and 44 had either overweight or obesity. During the year with stimulants, the mean (SD) body mass index (BMI) in standard deviation score (SDS) decreased significantly: -0.72 (0.66) compared with 0.17 (0.43) during the year before treatment (p < 0.01). After one year with treatment, 43% of those with overweight or obesity had reached normal weight. CONCLUSIONS: Stimulant treatment for ADHD yields significant weight loss. In children with overweight or obesity and ADHD, this is an important finding showing additional benefit in terms of weight management.