Carla Colomer

Parenting Stress in Families of Children with Autism Spectrum Disorder and ADHD.

The purpose of this study was to compare the parenting stress experienced by parents of 121 children from 5 to 9 years old with autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), comorbid ASD+ADHD, and typical development in different domains related to child and parent characteristics using the Parenting Stress Index. The three clinical groups presented greater perceived parenting stress than did the comparison group (CG). The ADHD group obtained higher levels of parenting stress related to attachment and depression than did the other groups. The ASD+ADHD group presented a unique profile of differences from the CG on Health and Spouse subscales. Results highlight the importance in clinical practice of considering parenting stress as a relevant variable for intervention in these clinical families.

Performance-based tests versus behavioral ratings in the assessment of executive functioning in preschoolers: associations with ADHD symptoms and reading achievement

The early assessment of the executive processes using ecologically valid instruments is essential for identifying deficits and planning actions to deal with possible adverse consequences. The present study has two different objectives. The first objective is to analyze the relationship between preschoolers’ performance on tests of Working Memory and Inhibition and parents’ and teachers’ ratings of these executive functions (EFs) using the Behavior Rating Inventory of Executive Function (BRIEF). The second objective consists of studying the predictive value of the different EF measures (performance-based test and rating scales) on Inattention and Hyperactivity/Impulsivity behaviors and on indicators of word reading performance. The participants in the study were 209 children in the last year of preschool, their teachers and their families. Performance-based tests of Working Memory and Inhibition were administered, as well as word reading measures (accuracy and speed). The parents and teachers filled out rating scales of the EF and typical behaviors of attention deficit hyperactivity disorder (ADHD) symptomatology. Moderate correlation values were found between the different EF assessments procedures, although the results varied depending on the different domains. Metacognition Index from the BRIEF presented stronger correlations with verbal working memory tests than with inhibition tests. Both the rating scales and the performance-based tests were significant predictors of Inattention and Hyperactivity/Impulsivity behaviors and the reading achievement measures. However, the BRIEF explained a greater percentage of variance in the case of the ADHD symptomatology, while the performance-based tests explained reading achievement to a greater degree. The implications of the findings for research and clinical practice are discussed.

Reading Performance of Young Adults With ADHD Diagnosed in Childhood: Relations With Executive Functioning.

Objective: To study reading performance of young adults with ADHD and its relation with executive functioning. Method: Thirty young adults with a childhood diagnosis of ADHD and 30 with normal development (ND) were compared on reading accuracy, fluency, and comprehension. Furthermore, ADHD with reading disabilities (ADHD+RD) and ADHD without reading disabilities (ADHD-RD) subgroups were compared using self-report and informant-report versions of the Behavior Rating Inventory of Executive Function–Adult version (BRIEF-A). Results: Adults with ADHD obtained significantly worse results than the ND adults on reading speed, responses to literal questions, and a cloze test. Although the comparison of the ADHD+RD and ADHD-RD groups did not show significant differences on the BRIEF-A subscales, the ADHD+RD group surpassed the critical percentile (85) on more subscales, with working memory and metacognition especially affected. Conclusion: The findings point out that reading should be assessed in individuals with ADHD as part of their evaluation to design effective early interventions.

Narratives of children with high-functioning autism spectrum disorder: A meta-analysis

BACKGROUND The aim of this meta-analysis was to analyze the narrative performance of children and adolescents with high-functioning Autism Spectrum Disorders (ASD) in terms of microstructure, macrostructure and internal state language. METHOD A systematic literature search yielded 24 studies that met the predetermined inclusion criteria. Effect sizes for each study were calculated for eight variables and analyzed using a random effects model. Intellectual ability, age and type of narrative were considered as potential moderators. RESULTS Results revealed that the children with ASD performed significantly worse than their peers on all the variables considered. CONCLUSIONS Findings are discussed taking into account the main explanatory psychological autism theories. Implications for intervention and orientations for future research are suggested.

Social Cognition in Children with High-Functioning Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Associations with Executive Functions

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders characterized by social impairments. The first objective of this study was to analyze social cognition deficits of children with ADHD, high-functioning ASD (HFASD), and typical development (TD) in their performance on explicit and applied measures of theory of mind (ToM). The second objective was to investigate the relationships between executive functions and social cognition in HFASD and ADHD. One hundred and twenty-six 7- to 11-year old children, 52 with HFASD, 35 with ADHD, and 39 with TD, performed the NEPSY-II social perception subtests. Parents estimated their childrens ToM skills using the Theory of Mind Inventory (ToMI). Teacher-reported data from the Behavior Rating Inventory of Executive Function (BRIEF) were also obtained. The HFASD and ADHD groups showed worse performance on the verbal ToM task than the TD group, and only the performance of the HFASD group was significantly lower than the TD group on the contextual ToM task. Parents also estimated that the HFASD group had more difficulties on the applied ToM than the ADHD and TD groups. Furthermore, there is a different executive function-theory of mind link in the HFASD and ADHD groups: behavioral regulation processes such as inhibition and emotional control are more associated with social cognition in children with ADHD, whereas metacognitive processes such as initiation and planning have a strong association with social cognition in children with HFASD. These findings have implications for understanding social perception deficits in neurodevelopmental disorders, highlighting the need for early intervention.

Comorbidity between attention deficit hyperactivity disorder and reading disabilities: implications for assessment and treatment

Comorbidity of attention deficit hyperactivity disorder (ADHD) and reading disabilities (RD) is greater than what would occur by chance. Considering the well-documented adverse impact of both ADHD and RD on development, the presence of both conditions may lead to particularly poor outcomes for affected people. This chapter, which reviews 43 research studies carried out in the last decade that have focused on the link between ADHD and RD, is divided into two broad nuclei of contents. First, studies are described that contribute information about characteristics of the comorbid phenotype. Second, studies related to procedures directed toward evaluation and intervention in this problem are analyzed. The review carried out does not make it possible to extract definitive results on the exact nature of ADHD and RD comorbidity or, even less, reach conclusions about its causes. However, the literature-based evidence shows a cognitive profile of ADHD+RD characterized by failure of various functions that can produce more severe functional deficits and worse neuropsychological, academic, and behavioral outcomes. Furthermore, the analysis of the set of results from the studies shows a limited efficacy of pharmacological and psychopedagogical treatments, and highlights the need for continued research on this topic. From a clinical and educational standpoint, the conclusions derived from this review underline the importance of performing an exhaustive evaluation of children and adolescents with symptoms of ADHD and/or RD, in order to be able to plan interventions with greater possibilities of success in each case.

The Impact of Inattention, Hyperactivity/Impulsivity Symptoms, and Executive Functions on Learning Behaviors of Children with ADHD

Children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at risk of experiencing lower academic achievement compared to their peers without ADHD. However, we have a limited understanding of the mechanisms underlying this association. Both the symptoms of the disorder and the executive functions can negatively influence learning behaviors, including motivation, attitude toward learning, or persistence, key aspects of the learning process. The first objective of this study was to compare different components of learning behaviors in children diagnosed with ADHD and typically developing (TD) children. The second objective was to analyze the relationships among learning behaviors, executive functioning, and symptoms of hyperactivity/impulsivity in both groups. Participants were 35 children diagnosed with ADHD and 37 with TD (7–11 years old), matched on age and IQ. The teachers filled out the Behavior Rating Inventory of Executive Function (BRIEF) and the Learning Behaviors Scale, which evaluates Competence/motivation, Attitude toward learning, Attention/persistence, and Strategy/flexibility. In addition, parents and teachers filled out the DSM-5 diagnostic criteria for ADHD. ANOVAs showed significant differences between children with ADHD and TD children on all the learning behaviors. Moreover, in both the ADHD and TD groups, the behavioral regulation index of the BRIEF predicted the search for strategies, and the metacognition index was a good predictor of motivation. However, attitude toward learning was predicted by metacognition only in the group with ADHD. Therefore, the executive functions had greater power than the typical symptoms of inattention and hyperactivity/impulsivity in predicting learning behaviors of children with ADHD. The findings are in line with other studies that support the influence of the executive functions on performance, highlighting the importance of including their development as a top priority from early ages in the school setting in order to strengthen learning behaviors.

Substance use in young adults with ADHD: Comorbidity and symptoms of inattention and hyperactivity/impulsivity

Young adults with attention deficit hyperactivity disorder (ADHD) are at high risk of substance use (SU). The aims of the current study were: 1) to examine the use of alcohol, tobacco, marijuana and other illegal drugs by adults with and without ADHD; 2) to compare the oppositional, conduct, anxiety, depression, sleep and antisocial personality symptoms of ADHD adults with SU and ADHD adults without SU; 3) to examine the ability of ADHD symptoms and conduct problems to predict SU. A total of 93 young adults, 43 without ADHD and 50 with a childhood diagnosis of ADHD, who were part of the Spanish sample of the Multicenter ADHD Genetics (IMAGE) study, collaborated in a follow-up evaluation 10.1 years later. ADHD participants were divided into two groups based on the presence or absence of SU. Statistically significant differences were found between young adults with and without ADHD in their use of tobacco, marijuana and alcohol. A statistically significant association was also shown between externalization problems and a greater risk of SU. Conduct problems, to a greater degree than ADHD symptoms, affect SU in ADHD adults.

Contribution of Theory of Mind, Executive Functioning, and Pragmatics to Socialization Behaviors of Children with High-Functioning Autism

Social difficulties are a key aspect of autism, but the intervening factors are still poorly understood. This study had two objectives: to compare the profile of ToM skills, executive functioning (EF), and pragmatic competence (PC) of children with high-functioning autism (HFA) and children with typical development (TD), and analyze their mediator role in social functioning. The participants were 52 children with HFA and 37 children with TD matched on age, intelligence quotient, and expressive vocabulary. Significant differences were found on measures of ToM, both explicit and applied, EF, and PC between children with HFA and TD. Multiple mediation analysis revealed that applied ToM skills and PC mediated the relations between autism symptoms and social functioning. Implications for social cognitive interventions to address these findings are discussed.

Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems

BACKGROUND The underlying mechanisms of comorbidity between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are still unknown. Executive function (EF) deficits and theory of mind (ToM) have been the most investigated cognitive processes. AIMS This study proposed to analyze EF, ToM and behavioral problems in children with ASD + ADHD, ADHD, ASD and typical development (TD). The relationship between ADHD and ASD symptoms with EF, ToM and behavioral problems in children with ASD + ADHD was also explored. METHODS AND PROCEDURES Participants were 124 children between 7 and 11 years old (22 ASD + ADHD, 35 ADHD, 30 ASD, and 37 TD), matched on age and IQ. Teachers evaluated EF, and parents assessed ToM skills and behavioral problems through Strengths and Difficulties Questionnaire (SDQ). OUTCOMES AND RESULTS Children with ASD + ADHD and ADHD showed impairments in EF whereas the difficulties in ToM skills of ASD + ADHD group were similar to ASD group. Inattention symptoms were significantly associated with EF metacognitive deficits and ToM difficulties in ASD + ADHD, while ASD symptoms were associated with total score in behavioral problems. CONCLUSIONS AND IMPLICATIONS These findings show the complex difficulties of children with both ASD and ADHD and support the need to take these difficulties into account when designing the treatments.