NIH issues consensus statement on attention-deficit/hyperactivity disorder.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder without validated objective markers. Eye movement studies may be useful in providing objective criteria for characterizing the disorder. METHODS: We compared 53 children (29 girls) with ADHD to 44 healthy control children (18 girls) on a 21-sec fixation task. Large saccades (> 4 degrees ) away from the fixation point were analyzed. RESULTS: Children with ADHD made more large saccades that interrupted fixation than did control children (p =.001). Mean scores of the ADHD group did not change significantly with subsequent retesting on placebo (p =.11); however, there was poor intrasubject correlation (r =.16). CONCLUSIONS: Both boys and girls with ADHD made significantly more intrusive saccades during fixation than did control subjects, possibly reflecting intrinsic neurologic dysfunction; however, a probable "floor effect" obviates conclusions about the reliability of this measure.

Attention Deficit Disorder with Hyperactivity↗

PubMed2001

Excess beta activity in children with attention-deficit/hyperactivity disorder: an atypical electrophysiological group.

Studies of children with attention deficit/hyperactivity disorder (ADHD) have typically found elevated levels of slow wave activity in their EEGs, but in two of our previous studies, a small subset of ADHD children with excess beta activity in the EEG was identified. The aim of this study was to determine whether children with excess beta activity represent a distinct electrophysiological subtype of ADHD, to quantify the differences in their EEGs, and to determine if this group of children with ADHD have behavioural profiles different from other children with ADHD. Results indicated that children with excess beta represent a small independent subset of children diagnosed with ADHD, which primarily consists of children with a diagnosis of ADHD combined type. Behaviourally, this group was similar to other children with ADHD, although the excess-beta group were more prone to temper tantrums and to be moody. The excess in beta activity was found primarily in the frontal regions and may be associated with frontal lobe self-regulation and inhibition control.

Attention Deficit Disorder with Hyperactivity↗

PubMed2001

Evaluation and treatment of ADHD.

Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychologic conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. The stimulants methylphenidate and dextroamphetamine remain the pharmacologic agents of first choice for the management of ADHD. These agents are equally effective in improving the core symptoms of the disorder, but individual children may respond better to one stimulant medication than to another. Achievement of maximal benefit may require titration of the initial dosage and dosing before breakfast, before lunch and in the afternoon. The family physician should tailor the treatment plan to meet the unique needs of the child and family. Psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in the child with ADHD.

Attention Deficit Disorder with Hyperactivity↗