Journal Article Reviews.

Abstract

ADHD Dvorsky MR, Langberg JM, Evans SW, et al. The protective effects of social factors on the academic functioning of adolescents with ADHD. J Clin Child Adolesc Psychol. 2018;47:713–726. Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience clinically significant academic disadvantages (e.g., lower grades and standardized test scores, increased likelihood of school dropout). Research suggests that healthy social functioning (e.g., maintenance of close interpersonal relationships, appropriate use of prosocial behavior and skills, and social acceptance) during middle school may be an important protective factor for youth with ADHD because it has previously been associated with higher academic achievement and school involvement. The current study included adolescents (n 5 93; 72% male students, 78% Caucasian) with clinically confirmed ADHD (n 5 50 ADHD inattentive type [ADHD-I]; n 5 43 ADHD combined type) assessed in fifth (39.9%), sixth (31.1%), or seventh (29%) grade; adolescents were all assessed 18 months later. Approximately 47% of participants were prescribed medication. Comorbid conditions included 45% oppositional defiant disorder or conduct disorder, 27% anxiety, and 14% depressive disorder. Outcomes included selfand parent-reported measures of ADHD and oppositional symptoms, social skills, and perceived social acceptance. Academic outcomes included both objective (e.g., grade point average [GPA]) and subjective (e.g., teacher reported impairment ratings) functioning. Results showed that neither parentnor adolescent-rated social skills demonstrated protective effects for any academic outcome. Only ADHD-I was a significant risk factor for poor grades (b5 20.21, p 5 0.02) and teacher-rated impairment (b 5 0.28, p 5 0.04). The relationship between inattention and grades (e.g., mean GPA 5 2.47) was attenuated for adolescents with high social acceptance as reported both by parents (b 5 0.28, p 5 0.006) and the adolescents (b 5 0.32, p 5 0.04). For adolescents with low parent-reported social acceptance, the relationship between inattention and low grades (e.g., mean GPA 5 1.54) was stronger (t(93) 5 22.01, p 5 0.04). The authors stress the importance of considering the role of specific protective factors; pediatricians for youth with ADHD can encourage participation in interest-specific social groups or clubs. R.M. ADHD, prematurity Ask H, Gustavson K, Ystrom E, et al. Association of gestational age at birth with symptoms of attentiondeficit/hyperactivity disorder in children. JAMA Pediatr. 2018;172:749–756. Previous studies have demonstrated an association between prematurity and attention-deficit/hyperactivity disorder (ADHD). This study is unique in that it sought to explore differences in the association between ADHD symptoms and gestational age at 5 and 8 years of age and the potential impact of maternal/perinatal factors and sex on the association between symptoms of ADHD and gestational age at birth. The Norwegian Mother and Child Cohort Study was utilized for this study and included data for 113,227 children (49% girls, 28% born at term) who were born between January 1, 1999, and December 31, 2008. Included in this sample were 33,081 (49% girls, 29% born at term) same-sex, exposure-discordant siblings. Infants born between 22 and 33 weeks of gestation were considered early preterm. Infants born at 39 to 40 weeks of gestation were considered term. ADHD symptoms were measured with a parentcompleted Conner’s Parent Rating Scale-Revised at 5 years of age and the Parent/Teacher Rating Scale for Disruptive Behavior Disorders at 8 years of age. Sex of the infant, multiple birth status, small for gestational age status at birth, congenital malformation, maternal parity, and maternal vaginal bleeding before gestational week 13 were assessed as potential confounding variables. Consistent with previous studies, children born at an early preterm gestational age were more likely to be reported to have symptoms of ADHD (odds ratio [OR] 1.55 [95% confidence interval [CI], 1.29–1.85] at 5 years), inattention (OR 1.85 [95% CI, 1.55–2.14] at 8 years), and hyperactivity/ impulsivity (OR 1.52 [95% CI, 1.29–1.79] at 8 years) than children who were born at term. When adjusted for pregnancy/maternal risk factors, children born early preterm continued to demonstrate increased symptoms of ADHD (OR 1.63 [95% CI 1.24–2.57] at 5 years), inattention (OR 1.79 [95% CI, 1.24–2.57] at 8 years), and hyperactivity/impulsivity (OR 1.66 [95% CI, 1.14–2.43] at 8 years). When adjusted for pregnancy-related risk factors and compared with term-born siblings, children born early preterm were more likely to be reported to have symptoms of ADHD (OR 1.79 [95% CI, 1.04–3.08] at 5 years) and inattention (OR 1.75 [95% CI, 1.09–2.81] at 8 years) but not hyperactivity (OR 0.95 [95% CI,