Link between ADHD and family troubles

A study found a link between children with ADHD and suffering from family troubles.

New research indicates that children with attention-deficit hyperactivity disorder may be more likely to be part of families that are affected by poverty, divorce, neighborhood violence and substance abuse.

"Our findings suggest that children with ADHD experience significantly higher rates of trauma than those without ADHD," study author Dr. Nicole Brown said in a news release from the American Academy of Pediatrics. "Providers may focus on ADHD as the primary diagnosis and overlook the possible presence of a trauma history, which may impact treatment."

The researchers analyzed the answers of parents of 65,680 children aged 6-17 who responded to a 2011 survey. About 12 percent of the kids had been diagnosed with ADHD, and their parents reported higher rates of various problems than the parents of kids without ADHD did.

"Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," said Brown, an assistant professor of pediatrics at The Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York City.

The findings are to be presented Tuesday at the annual meeting of the Pediatric Academic Societies in Vancouver, Canada. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

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Risk of ADHD higher in children whose parents are depressed or violent

A study shows that young children whose parents are depressed or are involved in partner violence are more likely to develop ADHD by age 6.

Preschoolers whose parents reportdepression and intimate partner violence may be more likely to develop attention-deficit/hyperactivity disorder (ADHD) by the age of 6, new research suggests.

And young children with depressed moms may be more likely to receive prescription drugs to treat behavioral and mental health issues down the road.

"Our study indicates that preschoolers who are diagnosed with ADHD are more likely to have been exposed to both intimate partner violence and parental depression within the first three years of life than their peers not exposed to either risk factor," said study author Dr. Nerissa Bauer, an assistant professor of pediatrics at Indiana University School of Medicine, in Indianapolis.

"There has been increasing awareness that certain psychosocial risk factors can impact the behavioral presentation of children at very young ages," she said. Still, not all children who are exposed to maternal depression and intimate partner violence will develop ADHD, she noted.

"There are other factors that can be associated with a child's higher likelihood of being diagnosed with ADHD, including a family history of ADHD," Bauer explained.

ADHD symptoms can include impulsiveness, hyperactivity and difficulty focusing.Kids with ADHD may have difficulty in school, holding down jobs and sustaining relationships. They are also at greater risk for alcohol or substance abuse, depression and anxiety disorders. Treatment typically involves medication and behavioral modifications.

"Pediatricians and family practitioners know to routinely screen for the presence of these psychosocial risk factors because of the potential negative effects on the child," Bauer said. "Families who experience intimate partner violence will need help, not only to make sure the victims stay safe from physical harm, but there [are] also psychological effects."

The study, which appeared online Feb. 4 in the journal JAMA Pediatrics, included more than 2,400 children who were 3 years old. Parents who brought them to four different pediatric community clinics filled out questionnaires regarding their personal history of depression and domestic violence while in the pediatricians' waiting room.

Fifty-eight caregivers reported a history of intimate partner violence and depression before their child turned 3. In addition, 69 reported a history of intimate partner violence and 704 had symptoms of depression during this time frame. Close to 66 percent of the parents reported neither depression nor intimate partner violence. Children who were exposed to intimate partner violence and/or parental depression were four times more likely to be diagnosed with ADHD by the age of 6.

What's more, 2.9 percent of kids whose parents reported depression received prescription drugs to treat behavioral and mental health issues, compared with 1.6 percent of children whose parents did not report a history of depression. Medications included those that treat anxiety, depression and sleep problems.

While the study showed an association, it did not prove a cause-and-effect link between intimate partner violence and/or maternal depression and likelihood of anADHD diagnosis.

Experts said the findings make sense, but more study is needed.

"This study adds to the already robust literature revealing that early life experiences can have profound effects on brain development," said Dr. Michael Duchowny, a pediatric neurologist at Miami Children's Hospital. "While heredity is known to play a strong role in the expression of ADHD symptoms, the study further suggests that additional environmental factors operating during the formative years of brain maturation are also significant."

New York City-based child psychoanalyst Dr. Leon Hoffman said the new findings make sense. "Unquestionably, intimate partner violence and maternal depression have a profound effect on children," he said.

Exactly how to deal with this is another story, said Hoffman, who is the co-director of the New York Psychoanalytic Society's Pacella Parent Child Center. "This is a public health problem that needs a lot of funds if reasonably effective programs are to be developed," he noted.

Dr. Rachel Klein, professor of child and adolescent psychiatry at NYU Langone Medical Center in New York City, said the study shows an association based on how parents answered certain questions, but it can't say how, or even if, maternal depression and intimate partner violence predict a child's risk of ADHD.

"If parents are worried, ask the pediatrician to evaluate your child for possible ADHD or refer the child to a mental health professional," she added.

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Violence and Crime Doesn’t Fit in with Autism Diagnosis

An analysis of the school shooting in Connecticut discusses how tying violent crime to autism or Asbergers diagnosis is not accurate.

As investigators begin to piece together a profile of Connecticut school massacre gunman Adam Lanza, much is being speculated about his possible Asperger's Syndrome diagnosis. But to suggest a tie between autism and violent, sociopathic tendencies is to undermine the large body of research and progress that's been made in understanding the disorder, says autism expert and Executive Director of the Kinney Center for Autism Education and Support at Saint Joseph's University Michelle Rowe, Ph.D.

"We know that children and adults with autism are often misunderstood," she says. "Small talk is not especially easy. Those on the spectrum have trouble understanding sarcasm. They struggle to understand basic social rules -- how to take turns, how to make eye contact.

"We also know that people with autism are not sociopaths. There is no evidence or research that suggests a link between autism and planned violence."

Rowe points to critical differences in the brains of so-called "neuro-typicals" and those on the autism spectrum.

"The prefrontal cortex (the front part of the brain, just above the eyebrows, that most people know as the frontal lobe) helps "neuro-typicals" make sense of the world," she explains. "We make eye contact and assess facial expressions. This is the brain's way of helping us connect with people. Without that skill -- that ability -- wouldn't we all be misunderstood?"

It's a much different world for people living with autism than it was just 10 years ago, Rowe adds. Awareness is at an all-time high. Services are expanding and those on the autism spectrum are being mainstreamed in schools all across the country.

"We've come too far and we know too much to revert back to the days when people with disabilities were locked up out of fear," says Rowe. "We shouldn't fear autism-- not now-- not when we understand more than we ever have about it."

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