Browsing by Subject "ADHD"
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Item Autism Spectrum Disorder with and Without Co-Occurring Attention Deficit Hyperactivity Disorder: An Analysis of Pathways to Diagnosis and Intervention in a National Sample(2018-05) Thomi, Morgan S.; Mathew, Stephen O.; Miller, Haylie L.; Patterson, Rita M.; Lovely, Rehana S.Autism Spectrum Disorder (ASD) is diagnosed in 1 out of 68 children. Recent changes to diagnostic guidelines permit clinicians to assign co-occurring diagnoses of ASD and Attention Deficit-Hyperactivity Disorder (ADHD). It is important for researchers and clinicians to be aware of groups vulnerable to delayed or incomplete diagnosis. In this retrospective review of data from the CDC Survey of Pathways to Diagnostics and Services (SPDS) and the National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (DTAT), we sought to assess the impact of race, ethnicity, sex, poverty level, and diagnosing provider type on age of first concern and age of final diagnosis in children diagnosed with ASD, ADHD, and ASD+ADHD. We predicted that age of first concern and age of final diagnosis would vary by sex, race, poverty level, identifier of first symptoms, provider type, and comorbidities. Parents/guardians of 5,959 children aged 3-17 completed the surveys; in the current sample, 2,966 cases were from DTAT and 2,993 were from SPDS. We used a series of ANOVAs to assess differences in the variables of interest by group. Age of first concern was significantly impacted (p [less than] 0.05) by Race, Race x Poverty Level, and Race x Poverty Level x Sex for the ASD+ADHD group. Age of final diagnosis was not significantly impacted (p [greater than] 0.05) by Poverty Level, Race x Poverty Level, and Sex x Race x Poverty Level for the ASD group. Identifier of first symptoms significantly impacted (p [less than] 0.05) age of first concern for all groups, while identifier of first concerns only significantly impacted (p [less than] 0.05) the ASD and ADHD groups. Post-hoc analyses revealed specific patterns of risk. Specific combinations of demographic factors increase vulnerability for later diagnosis. These findings suggest that provider- and patient-centered education is needed to increase surveillance in at-risk populations.Item Differences in Risk of Injury Between Stimulant-Treated and Untreated ADHD Patients(2006-08-01) Segars, Larry W.; Sandhu, Raghbir; Lykens, KristineSegars, Larry W., Differences in Risk of Injury between Stimulant-Treated and Untreated ADHD Patients. Doctor of Public Health (Epidemiology), August 2006, 63 pp, 7 tables, 0 illustrations, references, 78 titles. ADHD is a common psychiatric disorder of childhood and adolescence that also occurs in adults and spans the life of the patient. ADHD is characterized by lack of focus, distractibility, and poor concentration. Limited data have been generated focusing on ADHD patients and the association with an increased risk of injury. Unfortunately, no study has been published evaluating the effect of stimulant treatment for ADHD on the risk of injury requiring ambulatory medical care. This research utilized four concatenated years, specifically 1998-2001, of the National Ambulatory Medical Care Survey (NAMCS). This dissertation is comprised of five chapters beginning with a description of ADHD, its characteristics, diagnosis, and treatment. This overview chapter is followed by a complete review of the literature describing the publication’s which assessed the association between ADHD and the risk of injury. The next chapter is a thorough review of the NAMCS and its methodology. The concatenated dataset captured 889 office visits associated with a diagnosis of ADHD, 666 of which were also related to the prescription of a stimulant for the management of ADHD. Using NAMCS’s weight variable these values produced a national estimate of 21,223,391 office visits associated with the ADHD diagnosis and 15,604,329 office visits associated with the prescription of a stimulant for ADHD. This research determined that there was a borderline statistically significant increased association with the prescription of a stimulant for the treatment of ADHD and the risk of injury requiring treatment in an ambulatory medical care setting. Interestingly, compared to patient’s who recorded their race as Caucasian, patients who recorded their race as “Other”; representing the races of Asian, Native Hawaiian/Other Pacific Islander, or American Indian/Alaska Native, and individuals indicating more than one race, had a statistically significant increased risk of injury necessitating treatment in an ambulatory medical care setting. Potential theories for this unique finding, along with the limitations of this research, are provided in the final discussion chapter.Item The Effect of Attention Deficit Hyperactivity Disorder (ADHD) on Vestibular Outcomes Following a Sports-Related Concussion (SRC)(2021-05) Gilliland, Taylor J.; Millar, J. Cameron; Gwirtz, Patricia A.; Mathew, Stephen O.Purpose: The goal of this study was to examine the effects of a history of Attention Deficit Hyperactivity Disorder (ADHD) on vestibular outcomes following a sports related concussion (SRC) in adolescents. Hypothesis: History of ADHD in adolescent athletes will be associated with worsened vestibular outcomes following an SRC, including longer recovery time and more severe symptoms such as worsened dizziness and balance. Methods: This case-control study included patients aged 13-21 years who were seeking treatment at the Baylor Scott and White Sports Concussion Program for an SRC. Measures for neuropsychology and vestibular therapy initial evaluation were analyzed. Results: The sample size consisted of 166 patients. The data suggested a higher prevalence of dizziness in patients with a history of ADHD. Patients with a history of ADHD were also more likely to be referred to vestibular therapy. Vertical vestibulo-ocular reflex (VOR) testing during vestibular ocular motor screening (VOMS) was more provocative for dizziness in patients with ADHD. Measures from the vestibular therapy evaluation indicated patients with a history of ADHD were more likely to display abnormalities during VOR x1 testing. There was no significant difference in balance measures between patients with and without ADHD. Conclusion: These results indicate that adolescents with a history of ADHD may experience a protracted recovery time following an SRC, worsened performance on VOMS, as well as a more abnormal VOR when compared to patients without a history of ADHD.