EVALUATION OF EXECUTIVE FUNCTIONING AND BEHAVIOUR IN YOUNG ADOLESCENTS WITH ADHD: A FOLLOW-UP STUDY. (18th May 2018)

• Record Type: Journal Article
• Authors: Lemay, Jean-Francois; Hai, Tasmia; Kubas, Hanna; MacMaster, Frank
• Is Part Of: Paediatrics & Child Health. Volume 23(2018)Supplement 1
• Page Start: e34
• Page End: e34
• Publication Date: 2018-05-18
• Subjects: Pediatrics -- Periodicals; Children -- Health and hygiene -- Periodicals; 618.92
• DOI: 10.1093/pch/pxy054.088
• Languages: English
• ISSNs: 1205-7088

Abstract

Abstract: BACKGROUND: Executive functioning (EF) impairment is frequent in the ADHD population. Psychostimulant medications (e.g. Methylphenidate [MPH]) are considered effective in reducing EF symptomatology. Limited studies have investigated the long-term effects of MPH on EF in young adolescents with ADHD (A-ADHD). OBJECTIVES: To evaluate EF and behaviour challenges across three time points in A-ADHD who were involved in a MPH treatment trial. EF and behavioural functioning were evaluated using two separate parent questionnaires. DESIGN/METHODS: A total of 21 A-ADHD (males=62%; n =13), ages 9–14 ( M =12.33 years, SD =1.55 years) were evaluated at three separate time points: 1) Baseline (BL : no medication); 2) Best Dose (BD : following a 4-week trial of MPH treatment); and 3) long term Follow-Up (FU : defined as up to 2 years following best dose). Parents completed two behaviour rating scales: Behaviour Rating Inventory of Executive Functioning (BRIEF) and Behaviour Assessment System for Children (BASC-2). Repeated measures analyses of variance (RmANOVA) were conducted measuring changes in EF and behavioural challenges over the three time points (BL, BD, and FU ). RESULTS: Significant differences were obtained in EF ratings over time on the BRIEF Behavioural Regulation Index (BRIEF-BRI; F (2, 36) = 20.71, p < 0.001) and Metacognition Index (BRIEF-MI; F (2, 36) = 26.83, p < 0.001). Pairwise comparison indicated a) significant decrease in symptom ratings for both indexes between time points BL and BD, and b) significant increase in symptom ratings for indexes between time points BD and FU . Similarly, behavioural ratings obtained on all BASC-2 indexes (Externalizing Problems, Internalizing Problems, Behavioral Symptoms, and Adaptive Skills) revealed a significant effect of time ( F (2, 36) range = 4.55 to 26.28, p range = <.001 to <.05). Pairwise comparison indicated a) significant decrease in symptom ratings across all BASC-2 indexes between BL and BD, and b) increase in symptom ratings across all BASC-2 indexes between BD and FU time points. Therefore, parent ratings indicated clinically significant difficulties with EF and behaviour during BL and FU and average EF and behaviour scores during BD . CONCLUSION: During follow-up, parents of A-ADHD continue to report challenges in EF and in all aspects of behaviours and adaptive skills. Although parents reported positive changes during the MPH trial (BD), these behavioural improvements were not seen at follow-up. The combined use of screening tools for EF (BRIEF) and behaviour (BASC-2) might be of interest to paediatricians when monitoring medication responses in young adolescents with ADHD.