三种亚型注意缺陷多动障碍儿童智力结构特征的分析

目的探讨三种亚型注意缺陷多动障碍(ADHD)儿童智力结构特征的差异。方法根据美国精神障碍诊断与统计手册第4版对185例ADHD儿童进行诊断和临床分型,其中注意缺陷为主型65例,多动-冲动为主型8例,混合型112例。对3组患儿均使用韦氏儿童智力量表进行智力测试,并分析比较3组言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)以及10项测验结果。结果注意缺陷为主型PIQ显著低于混合型(P<0.05),3种亚型组间FIQ和VIQ比较差异无显著性(P>0.05);注意缺陷为主型填图测验结果显著低于混合型和多动-冲动型(P<0.05)。结论注意缺陷为主型ADHD与另两种亚型有不同的智力结构,注意缺陷为主型以右半球脑功能缺陷为主。     

脑电诊断及脑电生物反馈治疗对注意缺陷多动障碍患儿的作用

背景对注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童进行脑电诊断和脑电生物反馈治疗逐渐受到关注.目的探讨脑功能诊断治疗仪对ADHD患儿诊断的精确性和治疗的疗效.设计以ADHD患儿为研究对象的前瞻性观察对比研究.单位一所市级医院的心理科.对象选择2003-10/2004-5到鞍山市中心医院心理科多动症门诊就诊的儿童,共113例.纳入标准年龄6～14岁到多动症门诊就诊的儿童.排除标准患神经系统器质性疾病、广泛性发育障碍、精神发育迟滞、癫痫、精神病性障碍、听觉异常和视觉异常等疾病者.其中男88例,女25例,平均年龄为(10±3)岁.方法应用A620全自动脑功能诊断治疗仪对113例儿童进行脑电检测,按照美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)中ADHD的诊断标准对前来就诊的儿童进行诊断,计算脑电诊断的灵敏度、特异度;应用该仪器对27例ADHD患儿进行脑电生物反馈治疗,治疗前后检测患儿脑电波θ/β比值的变化,采用Conners儿童行为问卷评价治疗前后多动指数的变化.主要观察指标脑电波θ/β比值,Conners多动指数.结果脑电诊断ADHD的灵敏度为83.58%,特异度为82.61%;脑电生物反馈治疗后患儿的θ/β值为(8.26±4.05),较治疗前(12.38±7.96)明显下降(t=2.39,P＜0.05);Conners多动指数治疗后为(12.05±8.63),较治疗前(24.73±10.96)显著下降(t=4.72,P＜0.01).结论脑电诊断的灵敏度和特异度均较高,可以辅助诊断ADHD;脑电生物反馈治疗能够明显改善ADHD患儿的脑电异常和多动症状.     

经颅超声评估注意缺陷多动障碍儿童黑质回声的应用研究

目的利用经颅超声(TCS)技术分析儿童注意缺陷多动障碍(ADHD)患儿的超声神经影像学特点, 探讨TCS对辅助诊断儿童ADHD的临床应用价值。方法前瞻性纳入2021年8月至2022年8月于苏州市立医院和苏州大学附属儿童医院就诊的50例6～12岁ADHD儿童(ADHD组)和年龄匹配的45例健康儿童(对照组), ADHD的诊断以美国精神病学会《精神疾病诊断与统计手册》第5版(DSM-Ⅴ)为标准, 并根据患儿临床症状特征将其分为3种亚型, 其中注意缺陷为主型14例, 多动冲动为主型3例, 混合型33例。应用TCS观察两组儿童中脑黑质(SN)的变化, 测量SN强回声面积并计算SN强回声面积与中脑面积的比值(S/M), 比较两组间各参数的差异。采用Pearson相关分析法分析ADHD组SN强回声面积和S/M与DSM-Ⅴ评分的相关性。结果半定量分析:ADHD组SN强回声≥Ⅲ级比例明显大于对照组[96.00%(48/50)比13.33%(6/45), P<0.05]。定量分析:ADHD组SN强回声面积、S/M大于对照组[0.32(0.22, 0.38)cm2比0.00(0.00, 0.00)c...     

注意缺陷多动障碍和发声与多种运动联合抽动障碍儿童行为问题的关系

目的发声与多种运动联合抽动障碍(TS)和注意缺陷多动障碍(ADHD)之间行为问题进行比较,探讨两者之间的关系。方法对71例正常儿童、30例单纯TS、38例并发ADHD的TS(ADHD+TS)和32例单纯ADHD的父母采用CBCL量表进行行为评分、然后将4组儿童各因子分进行方差分析和两两比较。结果以上3组患儿均比正常儿童存在广泛的行为问题(P<0.01);两两比较发现:ADHD组社会功能评分最低(P<0.05),ADHD+TS组在攻击性问题、外向性问题和行为问题总分的评分最高(P<0.05);TS常常伴发强迫思维(P<0.01);ADHD特征性的伴发注意问题和冲动行为(P<0.01)。结论ADHD与TS存在广泛行为问题的重叠,ADHD+TS行为问题比单纯的ADHD和TS严重,TS的多数行为问题可能由于并发ADHD引起。     

脑电诊断及脑电生物反馈治疗对注意缺陷多动障碍患儿的作用

背景：对注意缺陷多动障碍(aftention denficit hyperactivity disorder，ADHD)儿童进行脑电诊断和脑电生物反馈治疗逐渐受到关注。目的：探讨脑功能诊断治疗仪对ADHD患儿诊断的精确性和治疗的疗效。设计：以ADHD患儿为研究对象的前瞻性观察对比研究。单位：一所市级医院的心理科。对象：选择2003-10／2004-5到鞍山市中心医院心理科多动症门诊就诊的儿童，共113例。纳入标准：年龄6～14岁到多动症门诊就诊的儿童、排除标准：患神经系统器质性疾病，广泛性发育障碍、精神发育迟滞、癫痫、精神病性障碍．听觉异常和视觉异常等疾病者。其中男88例，女25例，平均年龄为(10&;#177;3)岁。方法：应用A620全自动脑功能诊断治疗仪对113例儿童进行脑电检测，按照美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)中ADHD的诊断标准对前来就诊的儿童进行诊断，计算脑电诊断的灵敏度、特异度；应用该仪器对27例ADHD患儿进行脑电生物反馈治疗，治疗前后检测患儿脑电波θ／β比值的变化，采用Conners儿童行为问卷评价治疗前后多动指数的变化。主要观察指标：脑电波θ／β比值，Conners多动指数。结果：脑电诊断ADHD的灵敏度为83．58％，特异度为82．61％；脑电生物反馈治疗后患儿的θ／β值为(826&;#177;4．05)，较治疗前(12．38&;#177;7．96)明显下降(t=2．39，P&;lt;0．05)；Conners多动指数治疗后为(12．05&;#177;8．63)，较治疗前(24．73&;#177;10．96)显著下降(t=4．72，P&;lt;0．01)。结论：脑电诊断的灵敏度和特异度均较高，可以辅助诊断ADHD；脑电生物反馈治疗能够明显改善ADHD患儿的脑电异常和多动症状。     

盐酸托莫西汀与盐酸哌甲酯治疗儿童注意缺陷多动障碍的对比研究

目的比较盐酸托莫西汀(ATX)与盐酸哌甲酯(MPH)治疗儿童注意缺陷多动障碍(ADHD)的临床疗效及安全性。方法 78例ADHD患儿随机分为ATX组(n=39)和MPH组(n=39),分别口服ATX及MPH治疗8周后,依照注意缺陷多动障碍筛查(SNAP-Ⅳ)量表和Conners儿童行为问卷父母用量表(PSQ)分别评估2组临床疗效及ADHD症状的严重程度,采用副反应量表(TESS)比较2组安全性。结果治疗后,2组SNAP-Ⅳ量表中各因子评分、总评分及PSQ中各因子评分均显著降低(P0.01),而2组间SNAP-Ⅳ量表中各因子评分△值均无显著差异(P0.05),PSQ中ATX组焦虑因子及冲动因子△值显著大于MPH组(P0.05),其他因子△值、2组有效率及完全缓解率无显著差异(P0.05)。MHP组不良反应发生率41.03%(16/39)显著高于ATX组20.51%(8/39)(P0.05)。结论 ATX与MPH治疗ADHD的疗效相当,但ATX不良反应少,更具安全性。     

注意缺陷多动障碍的临床特征

注意缺陷多动障碍(ADHD)是美国精神疾病的分类系统(DSM-Ⅲ-R,DSM-Ⅳ)中的诊断用语,指发生于儿童的与心里发育水平不相适应的一组症状群,表现为注意力不集中或易分心、活动过多、情绪或行为冲动,部分病人还可以伴有品行问题、学习困难、认知障碍等,少部分成人会出现社会适应不良或职业技术困难。     

西宁地区儿童注意缺陷多动障碍与血铅水平的关系

目的：研究西宁地区儿童注意缺陷多动障碍（ADHD）与血铅水平的关系。方法：采用Conners量表筛查，结合美国精神协会制定的《精神病诊断统计手册》第四版（DSM—Ⅳ）明确诊断。采用原子吸收光谱仪进行血铅测定。结果：98例注意缺陷多动障碍患儿中61例血铅〉100ug／L,铅中毒发生率为62．35％（61／98）。对铅中毒的儿童进行驱铅治疗，比较治疗前后多动、冲动，注意力涣散症状，差异有显著性（P〈0.05）。结论：血铅增高与注意缺陷多动障碍有密切相关性。故在治疗注意缺陷多动障碍的同时，给予驱铅治疗非常必要。     

IVA-CPT法对哌甲酯缓释片治疗儿童注意缺陷多动障碍的疗效评估

目的通过对56例患注意缺陷多动障碍(ADHD)儿童进行哌甲酯缓释片治疗前后整合视听连续执行测试(IVA-CPT)数值的对比,探讨其治疗效果及疗效评估。方法所有入选患儿均在治疗前给予IVA-CPT测试,然后给予盐酸哌甲酯缓释片18 mg口服,1次/d,2⁴周随访一次,用药34周随访一次,用药3⁵个月再进行IVA-CPT测试。结果反应控制商数(视听)和注意商数(视听)治疗前后经配对t检验,差异均有统计学意义(P<0.01)。结论哌甲酯缓释片对ADHD患儿注意缺陷、控制力差,多动冲动等核心症状的改善有明显效果,而IVA-CPT检测对ADHD患儿的疗效具有直观、综合的评估作用。     

癫痫共患注意缺陷多动障碍患儿的临床特点及心理行为特征

目的:探讨癫痫共患注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿的临床特点及心理行为特征。方法:选取2019年10月至2021年12月海南省安宁医院收治并筛选入组的125例癫痫患儿,筛查共患ADHD发生情况。依据共患ADHD筛查诊断结果,分成癫痫组(单纯癫痫)与合并组(癫痫共患ADHD),收集相关资料并比较两组临床特点,采用Conners父母用症状问卷(Parent Symptom Questionnaire,PSQ)量表对两组患儿进行心理行为评估,分析癫痫共患ADHD患儿的心理行为特征。结果:125例癫痫患儿检出共患ADHD 34例(27.20%),其中ADHD类型以注意缺陷型为主,占64.719%(22/34)。合并组癫痫起病年龄<3岁、癫痫病程≥5年、使用≥2种抗癫痫药物(antiepileptic drugs,AEDs)、癫痫未控制的患儿分别占50.00%(17/34)、61.76%(21/34)、64.71%(22/34)、52.94%(18/34),均明显高于癫痫组的26.37%(24/91)、40....     

感觉统合训练联合盐酸哌甲酯治疗儿童注意缺陷多动障碍临床疗效分析

目的探讨感觉统合训练（SIT）联合盐酸哌甲酯治疗儿童注意缺陷多动障碍（ADHD）的临床疗效。方法对2009年1月-2013年3月就诊的96例ADHD患儿的临床资料行回顾性分析,并按随机数字表分组,研究组（n=48）联合SIT及盐酸哌甲酯治疗,对照组（n=48）单用盐酸哌甲酯治疗,比较两组儿童感觉统合能力发展评定量表、视听连续整合测试（IVA-CPT）、Conner行为评定量表、韦氏儿童智力量表（C-WISC）评分及不良反应情况。结果两组ADHD患儿治疗后感觉统合评定量表各项目评分,IVA-CPT中综合反应控制商数及综合注意力商数,C-WISC中操作量表智商、言语量表智商、全量表智商及注意/不分心因子评分均较之治疗前有明显提高;Conner行为评定量表中学习、品行、身心障碍、冲动、多动指数、焦虑因子评分均有下降,治疗前后比较差异有统计学意义（P〈0.05）。研究组加行SIT后感觉统合评定量表、IVA-CPT、Conner行为评定量表、C-WISC各项评分改善均较对照组明显,且不良反应明显少,两组比较差异有统计学意义（P〈0.05）。结论对于ADHD患儿,SIT联合盐酸哌甲酯治疗,有效且安全,值得推广。     

注意缺陷多动障碍儿童服用盐酸托莫西汀治疗的有效性和安全性研究

目的 注意缺陷多动障碍（ADHD）儿童服用盐酸托莫西汀治疗12周,评价其疗效和安全性.方法 共110例ADHD儿童,口服盐酸托莫西汀治疗12周,在第0、4、8、12周,采用Swanson儿童行为量表第4版（SNAP-Ⅳ）评分量表和第0和12周Conners父母问卷评估疗效,副反应量表评估用药安全性.结果 SNAP-Ⅳ量表显示评分在第4周、第8周、第12周与基线相比明显降低,且与基线相比有统计学差异（P＜0.01）;在第12周时,Conners父母问卷评分与基线相比,6个观察因子（品行问题、学习问题、心身障碍、冲动-多动、焦虑、多动指数）评分均降低,且有统计学意义（P＜0.01）.最多见的副反应是消化系统症状,发生率约为30％,主要表现为食欲减退或厌食;其次是神经系统症状,发生率为4.55％,但所有的副反应均为轻度或可疑.结论 ADHD儿童服用盐酸托莫西汀有效,起效较慢,无严重不良反应,使用安全,但要及时处理出现的药物不良反应,提高用药依从性.     

Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder

Background: Attention-deficit/hyperactivity disorder (ADHD) is a CNS disorder that has its onset in childhood, but often persists into adulthood. There is growing recognition that adult ADHD can result in multiple negative consequences for individuals. ADHD is also often associated with a number of comorbid psychiatric disorders. Atomoxetine (ATX), a nonstimulant, selective noradrenergic reuptake inhibitor, was approved in the United States in 2002 for the treatment of ADHD in children and adolescents, as well as adults. We review here the safety and efficacy of ATX in adults with ADHD, including data in special populations, functional outcomes, as well as provider and patient real-world perceptions. Methods: We searched the databases Embase, MEDLINE and PsycINFO using the terms ‘ADHD’ and ‘adult’ and ‘ATX’ capturing publications from January 1, 1998, to March 27, 2014. Only publications in English were considered. Results: ATX demonstrated significantly greater improvement than placebo (PBO) on the Conners Adult ADHD Rating Scale-Investigator rated:Screening Version (CAARS-Inv:SV) in all trials (N = 6; total score difference ranged from ?3.5 to ?5.5). For long-term trials using the CAARS-Inv:SV, ATX demonstrated significantly greater improvement than PBO in three of four trials (total score differences ranged from ?0.1 to ?6.0). In short-term studies, ATX showed significantly greater improvement than PBO on the Adult ADHD Quality-of-Life scale total score in three of three studies, but results were mixed on the Sheehan Disability Scale. Three studies of ATX have reported statistically significant improvement (compared with PBO) on the Behavior Rating Inventory of Executive Function-Adult Version Self Report scale. The most common adverse events (occurring in ≥ 10% of patients taking ATX) were nausea, dry mouth, decreased appetite, insomnia and fatigue. Conclusions: ATX is an important treatment option for the right patient. ATX can provide long-term, consistent symptom relief and functional improvement for adults with ADHD.     

脑电反馈治疗儿童注意缺陷多动障碍的疗效

背景脑电生物反馈治疗注意缺陷多动障碍(attention defici thyperactivity,ADHD)逐渐受到关注,但听觉和视觉注意分类研究报告较少.目的探讨脑电反馈治疗ADHD的有效性.设计随机、治疗前后自身对照研究.地点和对象将南京脑科医院儿童心理卫生门诊符合美国精神障碍诊断与统计手册第4版标准的30例ADHD儿童作为研究对象.干预由研究组成员对研究对象进行脑电生物反馈治疗,分别于治疗开始前、训练20次及40次后用整合视听连续执行测试(integrated visual and auditory continuous performance test,IVA-CPT)对患儿评定.主要观察指标综合反应控制商数和综合注意力商数.结果经过20次训练,息儿综合反应控制商数由87.38±15.7l,上升到98.56±10.78(t=4.59,P＜0.01),综合注意力商数由70.38±16.22,上升到88.94±16.37(t=4.68,P＜0.01);经过40次训练,患儿综合反应控制商数上升到107.00±8.43(t=5.38,P＜0.01),综合注意力商数上升到104.56±12.67(t=8.76,P＜0.01),与训练前相比,各脑电反馈商数均有显著改善(P＜0.01).结论脑电反馈治疗对ADHD的疗效肯定,对有明显注意缺陷患儿训练时间要比多动一冲动为主患儿训练时间为多.     

“视、听、动”模式功能训练对儿童注意缺陷多动障碍的干预效果

目的 研究＂视、听、动＂模式功能训练对儿童注意缺陷多动障碍的干预效果.方法 采用随机对照研究的方法,把100例儿童注意缺陷多动障碍（ADHD）患儿随机分为研究组和对照组,每组各50例.研究组在服用安慰剂的同时,采用＂视、听、动＂模式功能训练法,对照组给予哌甲酯口服,并定期安排工娱活动.两组均干预6个月,并于入组的0,6个月各进行1次Conners儿童行为量表和肝肾功能及心电图检查,对结果进行比较.结果 6个月时研究组Conners儿童行为量表评分率及平均成绩变化与对照组比较,差异无统计学意义（P＞0.05）;研究组实验室检查异常率明显低于对照组,差异有统计学意义（P＜0.05）.结论 ＂视、听、动＂模式功能训练对儿童注意缺陷多动障碍有与药物治疗相似的治疗效果,但避免了服药带来的毒副作用,切实可行,值得临床推广应用.     

A Phase III,Randomized, Placebo-controlled Trial to Assess the Efficacy and Safety of Once-daily SPN-812 (Viloxazine Extended-release) in the Treatment of Attention-deficit/Hyperactivity Disorder in School-age Children

PurposeThe limitations of current US Food and Drug Administration (FDA)–approved medications for the treatment of attention-deficit/hyperactivity disorder (ADHD) set the need for the development of novel, effective, and tolerable medications to treat this disorder. The purpose of this study was to evaluate whether treatment with SPN-812 (viloxazine extended-release) significantly reduces symptoms of ADHD in children.MethodsThis study was a randomized, double-blind, placebo-controlled 6-week trial to assess the efficacy and safety of once-daily 100- and 200-mg SPN-812 in the treatment of ADHD in male and female children 6–11 years of age. Inclusion criteria required subjects to have a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, ADHD diagnosis, an ADHD-Rating Scale-5 (ADHD-RS-5) score ≥28, a Clinical Global Impression-Severity score ≥4, and for subjects to be free of ADHD medication ≥1 week before randomization. The primary efficacy endpoint was the change from baseline (CFB) at end of study (EOS) in ADHD-RS-5 Total score. Key secondary endpoints included Clinical Global Impression-Improvement (CGI-I) scores at EOS and CFB at EOS in the Conners 3–Parent Short Form (Conners 3–PS) Composite T-score and the Weiss Functional Impairment Rating Scale–Parent (WFIRS–P) Total average score. Safety assessments included adverse events (AEs), laboratory tests, vital signs, physical examinations, ECGs, and the Columbia-Suicide Severity Rating Scale. The primary efficacy endpoint was analyzed by using a mixed model for repeated measures; all secondary measures were analyzed by using an ANCOVA model.ResultsA total of 477 subjects were randomized to treatment (intent-to-treat population, n = 460). The majority of subjects were male (63%) and either White (51.3%) or African American (43.7%). The demographic and baseline characteristics between the groups were similar. Statistically significant improvements in ADHD-RS-5 Total score were observed in both the 100- and 200-mg/day SPN-812 treatment groups compared to placebo at week 1 of treatment (P = 0.0004 and P = 0.0244, respectively), which was maintained through EOS (P = 0.0004 and P < 0.0001). Significant improvements were also observed at EOS in the CGI-I scale (P = 0.0020 and P < 0.0001), Conners 3–PS Composite T-score (P = 0.0003 and P = 0.0002), and WFIRS–P Total average score (P = 0.0019 and P = 0.0002) versus placebo. Treatment-related AEs reported in ≥5% of subjects included somnolence, decreased appetite, and headache. The discontinuation rate due to AEs was <5%.ImplicationsSPN-812 significantly reduced ADHD symptoms in children and was well tolerated. SPN-812 may prove to be an effective treatment for children with ADHD. ClinicalTrials.gov identifier: NCT03247530.     

Oxidative stress in children with attention deficit hyperactivity disorder

ObjectiveThe aim of this study was to investigate oxidative stress in ADHD children.Design and methodsLevels of oxidant parameters malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHDG), advanced oxidation protein products (AOPP) and antioxidant parameters paraoxonase (PON1) and thiol levels were measured in thirty children with ADHD (27 boys, 3 girls) who were firstly diagnosed according to DSM-IV and thirty healthy children (18 boys, 12 girls) aged 6–12 years.ResultsThe levels of the oxidant parameters MDA and 8-OHDG were statistically significantly lower in ADHD children compared to the controls. We did not find a significant difference between the groups regarding AOPP, PON1, and thiol levels.ConclusionWe found low levels of some oxidants and no difference of antioxidant parameters in ADHD children. Our study points out that there may not be a direct relationship between oxidative stress and ADHD.     

Brain dopamine transporter levels in treatment and drug naïve adults with ADHD

Attention deficit hyperactivity disorder (ADHD) is the most frequent psychiatric disorder in children, yet data are sparse on its pathophysiology. Particularly relevant are the dopamine transporters since these are the main targets of stimulant medications used for ADHD treatment. Though some imaging studies have shown increases in dopamine transporters in ADHD others have not and their role in the neurobiology of ADHD remains unclear. Here we investigate dopamine transporters in ADHD subjects with control of potentially confounding factors (previous medication and/or drug histories, comorbidity) and their association with clinical symptoms. Positron emission tomography and [11C]cocaine were used to measure dopamine transporters in 20 never medicated adults with ADHD and 25 controls. Dopamine transporters were lower in left caudate (13%, p < 0.05) and in left nucleus accumbens (p < 0.005) in ADHD subjects than in controls. In putamen dopamine transporters did not differ between groups but were associated with scores of inattention (Conners Adult Attention Rating Scale) both in ADHD subjects (p < 0.005) and in controls (p < 0.005). Thus, for a given transporter level the scores for inattention were on average five times greater in ADHD subjects than in controls. These results do not corroborate increases in dopamine transporters in ADHD subjects and show that in some they are reduced. It also provides evidence that dopamine transporter levels modulate attention but suggest that additional pathology (e.g., prefrontal or cingulostriatal pathways, noradrenergic neurotransmission) is necessary to account for the large differences in inattention observed between controls and ADHD subjects.     

Attention-deficit/hyperactivity disorder: diagnostic assessment methods used by advanced practice registered nurses

BACKGROUND: Children presenting with symptoms of attention-deficit/hyperactivity disorder (ADHD) have become highly prevalent in primary care practice; however, advanced practice registered nurses (APRNs) diagnostic methods used to identify and diagnose this disorder are greatly understudied. AIM: This study aimed to identify APRNs recognition and diagnostic practices of children who were suspected of having an ADHD diagnosis. It also addressed APRNs comfort levels with treating and diagnosing ADHD, along with certain diagnostic methods and their perceived accuracy of these methods. METHODS: This nonexperimental exploratory research study used a self-administered questionnaire to gather information about diagnostic methods used by APRNs who diagnose children with ADHD, treat the disorder, or did both. RESULTS AND DISCUSSION: The questionnaires identified that the APRNs were following the American Academy of Pediatrics diagnostic guidelines for diagnosing ADHD in children more closely than other health care providers (pediatricians and family physicians). The results of this study also indicated that most APRNs were very comfortable to comfortable making an ADHD diagnosis (52.5%), and 64.4% reported the same level of comfort with treating ADHD. These findings indicate that the majority of APRNs surveyed who works with children are comfortable with diagnosing and treating ADHD.