Contrasting deficits on executive functions in Chinese delinquent adolescents with attention deficit and hyperactivity disorder symptoms and/or reading disability

Many studies reported high prevalence of reading disability (RD) and attention deficit hyperactivity disorder (ADHD) among delinquent adolescents. Very few have examined their cognitive profile. The present study compared the executive functions (EFs) and severity of delinquency in delinquent adolescents with RD and/or ADHD symptoms (AS). Delinquents with AS (n = 29), RD (n = 24), comorbidity AS + RD (n = 35) were recruited from juvenile institutions along with typically developing controls (n = 29) from local schools; all completed EF assessments and self-report questionnaires on delinquency. Results showed that pure AS group exhibited impaired inhibition while the pure RD group was weak in processing speed and visual memory. The comorbidity group showed unique impairments in interference control and significantly higher delinquency severity. The present findings suggest that comorbidity AS + RD may influence delinquency severity. It also provides a more comprehensive picture of the unique EF deficits associated with different groups, allowing for better matching for future identification and intervention programme.     

Early identification of Asperger syndrome in young children

This study was designed to identify items of the ADI-R that allow an early and sensitive identification of children with possible Asperger syndrome (AS). The aim was to obtain an economic short interview suitable for screening purposes. The study was based on data from a clinical sample of 5–18-year-old children and adolescents (mean age 10.9 years) with either Attention-Deficit Hyperactivity Disorder (ADHD; n = 43) or AS (n = 62). The introductory questions and 36 items, which contribute to the diagnostic algorithm of the ADI-R, were subjected to content analysis and stepwise discriminant function analysis. Eight meaningful items were found, which were shown to be good predictors of AS and to discriminate between the children with AS and those with ADHD. The short interview was especially useful for the assessment and screening of children up to 11 years in our sample, because in this subgroup, sensitivity was even higher (.92) and specificity was also excellent (.90). Eight items with high discriminatory power allowed sensitive and economic screening for young children with suspected AS.     

Social communication impairments in children and adolescents with Asperger syndrome: Slow response time and the impact of prompting

In the present study children and adolescents with Asperger syndrome (N = 13) and a matched control group of typically developing children and adolescents were presented with 26 vignettes of daily life situations, including irony, metaphors, contrary emotions, jealousy, social blunders, and understanding intentions. The participants in the AS group showed significant impairments in social communication. They needed significantly longer response times to solve the tasks and required significantly more prompt questions than the control persons. When analyzing the AS participants’ performances before any prompt questions had been given, their task performances were significantly poorer than after the prompts had been given indicating that without any prompt questions their task performance would have fallen markedly.     

Types and experiences of bullying in adolescents with an autism spectrum disorder

Being victimized by one's peers is a major problem in adolescence, and research has suggested that individuals with autism spectrum disorders (ASD) may experience higher rates of bullying than their typically-developing (TD) peers. However, it is currently unclear whether adolescents with ASD are victimized more by their peers simply because they are ‘different’. This study was designed to examine percentage rates across different types of bullying behaviour in adolescents with an ASD (n = 24), in comparison to a group of special-needs adolescents without an ASD (n = 22), and a group of typically developing peers (n = 24), to determine whether simply being ‘different’ leads to higher rates of victimization. We also examined the agreement between parental and self-reports of bullying behaviour experienced by these groups. Overall, more adolescents with ASD reported victimization than adolescents in the other two groups. In addition, those with ASD reported more social bullying in comparison to the other two groups and more physical bullying than the TD group. No difference was found between parental and self-reports for the bullying experienced by the adolescents with ASD or special needs; however, TD adolescents reported higher levels of victimization than their parents reported for them. Contributing factors for the victimization experienced by adolescents with an ASD are discussed.     

A community-based strength training programme increases muscle strength and physical activity in young people with Down syndrome: A randomised controlled trial

This randomised controlled trial investigated the effects of a student-led progressive resistance training (PRT) programme in adolescents and young adults with Down syndrome. Sixty-eight young people with Down syndrome (30 female, 38 male; mean age 17.9 ± 2.6 years) and mild to moderate intellectual disability were randomly allocated to a PRT programme (n = 34) or a social group (n = 34). Participants in the PRT group trained twice a week for 10 weeks at a community gymnasium with a physiotherapy student mentor using pin-loaded weight machines. Participants in the social group completed a 10-week programme of social activities also with a student mentor once a week for 90 min. Work performance, muscle strength and physical activity levels were assessed at weeks 0, 11 and 24 by an assessor blind to group allocation. Data were analysed using ANCOVA with baseline measures as covariate. Participants attended 92% of their scheduled sessions. There was no difference between the groups on work task performance. The PRT group increased their upper and lower limb strength at week 11 compared to the control group, but only their lower limb muscle strength at week 24. There was a significant difference in physical activity levels in favour of the PRT group at week 24 but not at week 11. PRT using a student mentor model helps young people with Down syndrome become stronger and more physically active but its effect on work task performance is unclear.     

Daily life impairments associated with self-reported childhood/adolescent attention-deficit/hyperactivity disorder and experiences of diagnosis and treatment: Results from the European Lifetime Impairment Survey

The Lifetime Impairment Survey assessed impairment and symptoms of attention-deficit/hyperactivity disorder (ADHD) in children/adolescents from six European countries. Parents/caregivers of children/adolescents aged < 20 years with ADHD (ADHD group; n = 535) and without ADHD (control group; n = 424) participated in an online survey. History of ADHD diagnosis was self-reported. ADHD and control groups were compared using impairment and symptom scales; higher scores indicate greater impairment. Mean (SD) age at ADHD diagnosis was 7.0 (2.8) years, following consultation of 2.7 (2.6) doctors over 20.4 (23.9) months. Parents/caregivers (64%; 344/535) reported frustration with some aspect of the diagnostic procedure; 74% (222/298) were satisfied with their child's current medication. ADHD had a negative impact on children/adolescents in all aspects of life investigated. The ADHD group had a higher mean (SD) school impairment score (2.7 [0.7]) compared with the control group (2.1 [0.7]; P < 0.001) and were more likely to be in the bottom of their class (P < 0.001). These data provide insights into impairments associated with ADHD in childhood/adolescence, and identify areas for improvement in its management and treatment.     

Executive function and attention in young adults with and without Developmental Coordination Disorder – A comparative study

The current research aimed at examining the executive function (EF) of young adults with Developmental Coordination Disorder (DCD) in comparison to young adults without DCD. The study used a randomized cohort (N = 429) of young adults with DCD (n = 135), borderline DCD (n = 149) and control (n = 145), from a previous study. This initial cohort was asked to participate in the current study three to four years later. Twenty-five individuals with DCD (mean age = 24 years, 1 month [SD = 0.88]; 18 males), 30 with borderline DCD (mean age = 24 years, 2 month [SD = 0.98]; 18 males) and 41 without DCD (mean age = 25 years, 2 months [SD = 1.91]; 20 males) participated in this study. Participants completed the BRIEF-A questionnaire, assessing EF abilities and the WURS questionnaire, assessing attention abilities. The DCD and borderline DCD groups had significantly lower EF profiles in comparison with the control group but no significant differences were found between the DCD and borderline DCD groups. While a high percentage of attention problems were found in both DCD groups, the executive functioning profiles remained consistent even when using the attention component as a covariate. The study results suggest that young adults with DCD have EF problems which remain consistent with or without attention difficulties.     

Effects of eye gaze directions of facial images on looking behaviour and autonomic responses in adolescents with autism spectrum disorders

It has been suggested that atypical eye contact of individuals with autism spectrum disorders (ASDs) arises from an unusually high level of autonomic activity elicited by another person's gaze. The present study investigated visual fixation duration and autonomic reactivity (heart rate, skin conductance response) simultaneously, while adolescents looked towards photographs of neutral faces, with either direct eye gaze, averted eye gaze or closed eyes. Both cognitively able adolescents with ASD (n = 31, mean age = 16 years, mean IQ = 104) and typically developing (TD) adolescents (n = 34, mean age = 16 years, mean IQ = 108) looked significantly longer towards the eye region of faces with direct eye gaze compared with faces with averted eye gaze or closed eyes. The adolescents with ASD did not show higher levels of autonomic activity than TD adolescents while they were instructed to look at the eye region. This suggests that looking at the eye region of static faces does not particularly trigger high autonomic arousal in adolescents with ASD.     

Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement

During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n = 70 hospitalizations, mean age = 15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean = 84.3 (±94.9) days), patients doubled on average their GAFS scores (mean = 17.66 (±9.05) at admission vs. mean = 31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n = 20 (28%), including epilepsy: n = 10 (14%) and painful medical conditions: n = 10 (14%)], environmental causes [n = 17 (25%) including lack of treatment: n = 11 (16%) and adjustment disorder: n = 6 (9%)], and non-ASD psychiatric condition [n = 33 (48%) including catatonia: n = 5 (7%), major depressive episode: n = 6 (9%), bipolar disorder: n = 4 (6%), schizophrenia: n = 6 (9%), other/unknown diagnosis: n = 12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge. Severity of autism at admission was the only negative predictor (p < .001). Painful medical conditions (p = .04), non-ASD psychiatric diagnoses (p = .001), prior usage of specialized ASD care programs (p = .004), functional language (p = .007), as well as a higher number of challenging behaviors upon admission (p = .001) were associated with higher GAFS scores at discharge. Clinical severity at admission, based on the number of challenging behaviors (r = .35, p = .003) and GAFS score (r = −.32, p = .008) was correlated with a longer inpatient stay. Longer hospitalization was however correlated (r = .27, p = .03) with higher GAFS score at discharge even after adjustment for confounding factors. Challenging behaviors among adolescents with ASD may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic illness such as epilepsy or acute pain. The management of these behavioral challenges requires a unified, multidisciplinary approach.     

Physical activity and self-determined motivation of adolescents with and without autism spectrum disorders in inclusive physical education

The main purpose of this study was to compare the objectively measured physical activity (PA) and the motivation process between adolescents with (n = 25) and without (n = 75) autism spectrum disorders (ASD) in inclusive physical education (PE); and assess the associations of the PA levels to a sequence of motivational processes. Independent t-tests revealed significant PA and motivational process differences between adolescents with and without ASD. External regulation was positively correlated with the percentage of time that adolescents with ASD spent in moderate PA (r₂₅ = 0.58, p < .01) and moderate-to-vigorous PA (r₂₅ = 0.50, p < .05), and this extrinsic motive was associated with their needs of being attached or related in the class (r₂₅ = 0.53, p < .01). No significant associations of PA in PE on the motivational sequences of adolescents without ASD were observed. It is concluded that adolescents with ASD had less PA levels in PE and lower motives toward PE than adolescents without ASD, and external regulation was important in facilitating PA participation in adolescents with ASD.     

Psychiatric symptoms in children and adolescents with higher functioning autism spectrum disorders on the Development and Well-Being Assessment

The Development and Well-Being Assessment (DAWBA) parent interview was used to assess psychiatric symptoms in children and adolescents with higher functioning autism spectrum disorders (ASD) (n = 60; age range 6.5–16.7) and in typically developing (TD) children and adolescents (n = 60; age range 6.9–16.2). Psychiatric symptoms were reported in the ASD group (68%) significantly more compared to the TD group (12%). Specifically, emotional disorders, attention deficit hyperactivity disorder/hyperkinesis, and tic disorders were significantly more frequent in the ASD group compared to the TD group. Routine screening and early identification of these symptoms could have important implications for planning interventions and thus outcome in individuals with higher functioning ASD. The DAWBA would be a useful interview for this purpose, since it can also be easily and quickly administered in clinics not specialized in psychiatry.     

Motor imagery for walking: A comparison between cerebral palsy adolescents with hemiplegia and diplegia

The goal of the study was to investigate whether motor imagery (MI) could be observed in cerebral palsy (CP) participants presenting a bilateral affected body side (diplegia) as it has been previously revealed in participants presenting a unilateral body affected sided (hemiplegia). MI capacity for walking was investigated in CP adolescents diagnosed with hemiplegia (n = 10) or diplegia (n = 10) and in adolescents with typical motor development (n = 10). Participants were explicitly asked to imagine walking before and after actually walking toward a target located at 4 m and 8 m. Movement durations for executed and imagined trials were recorded. ANOVA and Pearson's correlation analyses revealed the existence of time invariance between executed and imagined movement durations for the control group and both groups of CP participants. However, results revealed that MI capacity in CP participants was observed for the short distance (4 m) but not for the long distance (8 m). Moreover, even for short distance, CP participants performed worse than typical adolescents. These results are discussed inline of recent researches suggesting that MI in CP participants may not depend on the side of the lesion.     

Transitioning pediatric patients receiving ketogenic diets for epilepsy into adulthood

PurposeTo examine the process for transitioning adolescents on dietary management for intractable epilepsy to adult neurologic care.MethodsTen patients, ages 6–16 years when the ketogenic or modified Atkins diet was initiated, were identified; age at transition was 18–43 years. All patients were seen at Johns Hopkins Hospital, Baltimore, Maryland.ResultsSeven remain on diets (4 Ketogenic, 3 modified Atkins diet) at this time with mean diet duration of 15.5 years (range 4–32 years). Most patients had excellent but not complete seizure control and several had recurrence or worsening of seizures with attempts to wean dietary therapy, hence the need to continue. Three main transition options were utilized: (1) continue being followed in pediatric clinic (n = 2), (2) establish care with an adult neurologist (n = 2), or 3) receive care from the Adult Epilepsy Diet Center (n = 6). Those patients followed in the Adult Epilepsy Diet Center were slightly more likely to remain on dietary therapy following transition (5/6 vs. 1/4, p = 0.12).ConclusionIt is important for adolescents with epilepsy receiving ketogenic diets to have transition plans in place for when they become adults. Adult epilepsy diet centers are the ideal option when possible.     

Empathic accuracy in adolescents with autism spectrum disorders and adolescents with attention-deficit/hyperactivity disorder

In research on theory of mind (ToM) in individuals with an autism spectrum disorder (ASD) mainly static mind-reading tasks were used. In this study both a static (Eyes Test) and a more naturalistic (empathic accuracy task) ToM measure were used to investigate the perspective taking abilities of adolescents with ASD (n = 13), adolescents with attention-deficit/hyperactivity disorder (ADHD; n = 13) and typically developing adolescents (n = 18). An innovative aspect concerns the standard stimulus tapes of the empathic accuracy task, which showed interactions between dyads of one adolescent with ADHD and one adolescent without ADHD. In this way, we were able to compare the ‘readability’ of the thoughts and feelings of adolescents with and without ADHD. The results clearly demonstrate the impairment in perspective taking abilities of adolescents with ASD, both on the static and naturalistic mind-reading task. Moreover, the empathic accuracy task seems to be a useful and promising method to assess ToM abilities in adolescents, with or without clinical problems. Finally, thoughts and feelings of target persons with ADHD seemed to be less easy to read than the thoughts and feelings of typically developing target persons.     

Executive functioning as a predictor of peer victimization in adolescents with and without an Autism Spectrum Disorder

The present study examined pragmatic language and executive functions (EF) as predictors of peer victimization in three groups: high-functioning adolescent boys with an Autism Spectrum Disorder (ASD) (n = 30); typically developing adolescent boys (n = 40); and adolescent boys (n = 22) without ASD with special education needs (SN). Controlling for age and bullying others, regression analyses revealed EF as measured by the Behavior Rating Inventory of Executive Functioning (Gioia et al., 2000) to be a significant predictor across all types of peer victimization (physical, social, and verbal) regardless of group membership. It is concluded that EF may play a pivotal role in explaining why some SN adolescents with and without ASD are at-risk for peer victimization.     

Attitudes towards people with intellectual disabilities: A comparison of young people from British South Asian and White British backgrounds

Research with South Asian families of individuals with intellectual disabilities (ID) suggests an increased fear of stigma and isolation from the community. Evidence on attitudes towards ID among the wider community is very limited and was the focus of the present study. Responses were collected from 737 college students aged 16–19 using the Community Living Attitudes Scale – ID version. Results indicated that British South Asians (n = 355) were less in favour of the social inclusion of people with ID than White British young people (n = 382). British South Asian adolescents were more likely to hold the view that people with ID should be sheltered and not empowered. It is proposed that future inclusion policies integrate ethnic minority views whose religious and cultural values do not always conform to the core values of social inclusion policies. It is also proposed that culturally specific school based interventions could be introduced with the aims of decreasing stigma and fostering attitudes in line with the aims of normalisation.     

The sleep macroarchitecture of children at risk for depression recruited in sleep centers

ObjectiveThe primary aim of this study was to compare the sleep macroarchitecture of children and adolescents whose mothers have a history of depression with children and adolescents whose mothers do not.MethodPolysomnography (PSG) and Holter electroencephalogram (EEG) were used to compare the sleep architecture of 35 children whose mothers had at least one previous depressive episode (19 boys, aged 4–18 years, “high-risk” group) and 25 controls (13 males, aged 4–18 years, “low-risk” group) whose mothers had never had a depressive episode. The total sleep time, wakefulness after sleep onset (WASO), sleep latency, sleep efficiency, number of awakenings per hour of sleep, percentages of time spent in each sleep stage, rapid eye movement (REM) latency and the depressive symptoms of participants were measured.ResultsIn children (4–12 years old), the high-risk group exhibited significantly more depressive symptoms than controls (P = 0.02). However, PSG parameters were not significantly different between high-risk children and controls. In adolescents (13–18 years old), the high-risk subjects presented with significantly more depressive symptoms (P = 0.003), a significant increase in WASO (P = 0.019) and a significant decrease in sleep efficiency compared to controls (P = 0.009).ConclusionThis study shows that children and adolescents born from mothers with a history of at least one depressive episode had significantly more depressive symptoms than controls. However, only high-risk adolescents presented with concurrent alterations of sleep macroarchitecture.     

Why do young adolescents bully? Experience in Malaysian schools

IntroductionTo determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.MethodsThis is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.ResultsOnly male gender (OR = 7.071, p = 0.01*, CI = 1.642–30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR = 2.285, p = 0.00*, CI = 1.507–3.467) and inattentive ADHD symptoms reported by teachers (OR = 1.829, p = 0.03*, CI = 1.060–3.154) and parents (OR = 1.709, p = 0.03*, CI = 1.046–2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR = 0.729, p = 0.01*, CI = 0.580–0.915) and teachers (OR = 0.643, p = 0.02*, CI = 0.440–0.938) were protective against bullying behavior despite the influence of conduct behavior (OR = 3.160, p = 0.00*, CI = 1.600–6.241). Internalizing behavior, that is, withdrawn (OR = 0.653, p = 0.04*, CI = 0.436–0.977) and somatic complaints (OR = 0.619, p = 0.01*, CI = 0.430–0.889) significantly protect against bullying behavior.DiscussionsRecognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.     

Large artery intracranial stenosis in young adults with ischaemic stroke

Large artery intracranial stenosis (ICS) is a common finding in stroke patients, but is much less prevalent in Western countries than in Asia and in young adults than in the elderly. We investigated the prevalence and causes of ICS among French young adults with ischaemic stroke. Clinical and radiological data of patients aged 18–54 years treated consecutively for acute ischaemic stroke in the anterior circulation at a tertiary stroke centre were analysed retrospectively. Patients with > 50% ICS were identified. ICS was evaluated using TOF-MRA, vessel wall-MRI, digital subtraction angiography and CT-angiography. A total of 316 patients were included. ICS was diagnosed in 29 patients, resulting in a prevalence of 9.2% (95% CI, 6.2 to 13.3). The leading cause of ICS was atherosclerosis (n = 13), ahead of moyamoya disease (n = 4), dissection (n = 2), vasculitis (n = 2), and reversible cerebral vasoconstriction syndrome (n = 1). The cause of ICAS could not be determined in 7 patients. ICS was found in nearly one in 10 ischaemic strokes among French young adults. Atherosclerosis was the leading cause of ICS. The cause of ICS could not be determined in almost a quarter of the patients.