In this issue of MyADHD.com News:

Research Updates

Research Updates
ADHD symptoms may be moderated by mother's love. "Parent training programs have been proven to be effective, but in addition to emphasizing monitoring, control and consistent discipline, they might wish to encourage parents to express affection too," says Terrie Moffitt, a professor of psychology at King's College in London and the University of Wisconsin-Madison.

In a study of over 2,000 five-year-old twins, half of whom had low birth weight, researchers found a significant interaction between children's birth weight and maternal warmth in predicting mothers' and teachers' ratings of ADHD. Moffitt and her colleagues published their findings in a recent edition of the Journal of Counseling and Clinical Psychology (Vol. 72, No. 2). English psychiatrist, Sir Michael Rutter, of the Institute of Psychiatry in London, had previously argued that deprivation of caregiver warmth in the orphanage might be a key factor in a finding among Romanian orphans adopted into English families. These children displayed more problems with hyperactivity and intellectual deficits.

Moffitt and her colleagues coded a mother's warmth on a six-point scale, based on tone of voice, spontaneity, sympathy and empathy toward the child. Within the sample, 20% of twins had mothers who expressed low warmth, 37% had mothers who expressed moderate warmth, and 43% had mothers who expressed high warmth. Low-birth-weight children who had more warm, loving relationships with their mothers were less likely to be described as having ADHD symptoms by parents and teachers.

Stimulant medication improves certain aspects of cognitive functioning of children with mental retardation (MR) and ADHD. The MTA study results suggest that higher and more frequent stimulant dosing produces greater reductions in ADHD symptoms than lower and less frequent doses. Other investigations have also noted steady declines in ADHD symptoms at successively higher doses of stimulant medications, with the important caveat that the response of any child is highly individual. More studies have emerged examining ADHD in children with MR and have found that although children with ADHD/MR can be treated successfully with stimulants, their response is often more variable or idiosyncratic than that of children with ADHD in the general school-age population.

Pearson, et al. (2004) studied the treatment effects of MPH on cognitive functioning in children with ADHD/MR. They measured performance on tasks measuring sustained attention, visual and auditory selective attention, inhibition, and immediate memory in 24 children during a placebo-controlled, double-blind, crossover treatment trial with 0.15, 0.30, and 0.60 mg/kg b.i.d. dosages of methylphenidate (MPH). Their findings were consistent with those of the MTA study. Performance on tasks of sustained attention, selective attention, and inhibition/impulsivity improved significantly with MPH treatment. These improvements showed steady gains with successively higher doses of MPH. The clinical implications of these findings for treatment are that children with ADHD who also have mild to moderate MR can benefit from MPH treatment, and that a moderate dose of 0.6 mg/kg is associated with significant gains in cognitive performance, relative to pacebo.

The performance of children with ADHD on neuropsychological testing and real-world activities was studied by a group of researchers (Lawrence et al., 2004) who reported their findings in the Journal of Attention Disorders (Vol. 7, No. 3). Neuropsychological testing conducted in laboratory settings provides information to help us better understand executive function deficits associated with ADHD. The performance of 22 unmedicated boys with ADHD matched on age and IQ with 22 normally developing control boys was compared on neuropsychological tests (the Stroop and the Wisconsin Card Sorting Task) and on two real-life measures (performance during videogame play and staying on a prescribed route while going through a zoo).

While no group differences in executive function on the Stroop or zoo tasks were found, the ADHD group exhibited deficits in set-shifting as assessed by the WCST (perseverative errors and responses) and videogame play (fewer challenges completed). The ADHD group also showed slowed processing speed on the Stroop (slower color naming) and in the zoo activity (longer time to complete task), as well as a slower rate of acquisition of the sorting rule on the WCST (more trials to complete first category). Problems in goal-directed behavior at the zoo (number of deviations from designated route) were related to problems in set-shifting on the WCST (perseverative responding).

The investigators concluded that children with ADHD exhibit impairments in executive function and processing speed in real-world activities as well as in neuropsychological testing. Cognitive deficits detected by standardized neuropsychological testing are related to performance difficulties in real-world activities.

Parental ADHD and family functioning was studied by A. M. Chronis and colleagues and findings were published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2003 and summarized in a recent issue of the ADHD Report (2004). Investigators examined the psychosocial functioning of the spouse and children of adults with ADHD in 33 families compared to 26 families without parental ADHD. Children were screened for psychopathology and social maladjustment and spouses were assessed by DSM-IV diagnoses and the quality of their marital relationship. The findings indicated that children who had a parent with ADHD showed greater psychopathology and greater instances of co-morbidities. The study underscores the importance of the non-ADHD spouse to family functioning when the other parent has the disorder.

July's Featured myADHD.com's Tools
Treatment tools in myADHD.com can help children better understand and manage angry feelings and behavior using cognitive therapy strategies. Subscribers to myADHD.com can view the forms below and print them for use in their practice, classroom, or home. Visit myADHD.com Treatment Tools for details.
No. 4300 Identifying Thoughts and Feelings That Lead to Anger
No. 4301 Changing Angry Thoughts to Calm Thoughts
No. 4302 Identifying Feelings
No. 4303 Keeping an Anger Log
No. 4304 Forgiving Others
No. 4305 Do's and Don'ts of Managing Conflict