Prevalence of attention-deficit/hyperactivity disorder and intellectual disability among children with hydrocephalus

View More View Less
  • 1 School of Medicine,
  • | 2 School of Public Health,
  • | 3 Department of Neurosurgery, and
  • | 4 Department of Pediatrics, University of Alabama at Birmingham, Alabama
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $45.00
USD  $515.00
USD  $612.00
Print or Print + Online Sign in

OBJECTIVE

Little is known about the prevalence of attention-deficit/hyperactivity disorder (ADHD) in children with hydrocephalus. In this study, the authors assessed the prevalence of ADHD and its association with clinical and demographic factors, including intellectual disability (ID), a potential factor that can confound the diagnosis of ADHD.

METHODS

The authors conducted a cross-sectional study of children 6–12 years of age with hydrocephalus using parent telephone surveys. The Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) and the National Institute for Children’s Health Quality (NICHQ) Vanderbilt Assessment Scale were used to screen for ID and ADHD, respectively. Among children without ID, the authors identified those with ADHD and calculated a prevalence estimate and 95% confidence interval (Wald method). Logistic regression analysis was conducted to compare children with ADHD with those without ADHD based on demographics, family income, parental educational, etiology of hydrocephalus, and primary treatment. As a secondary analysis, the authors compared subjects with ID with those without using the same variables. Multivariable analysis was used to identify factors with independent association with ADHD and ID.

RESULTS

A total of 147 primary caregivers responded to the telephone questionnaire. Seventy-two children (49%) met the cutoff score for ID (CAIDS-Q). The presence of ID was significantly associated with lower family income (p < 0.001). Hydrocephalus etiology (p = 0.051) and initial treatment (p = 0.06) approached significance. Of children without ID (n = 75), 25 demonstrated a likely diagnosis of ADHD on the NICHQ, yielding a prevalence estimate of 0.33 (95% CI 0.22–0.44). No clinical or demographic variable showed significant association with ADHD.

CONCLUSIONS

These data indicate that the prevalence of ADHD among children with hydrocephalus (33%) is higher than among the general population (estimated prevalence in Alabama is 12.5%). ID is also common (49%). Routine screening for ADHD and ID in children with hydrocephalus may help to ensure that adequate resources are provided to optimize functional outcomes across development.

ABBREVIATIONS

ADHD = attention-deficit/hyperactivity disorder; CAIDS-Q = Child and Adolescent Intellectual Disability Screening Questionnaire; ETV = endoscopic third ventriculostomy; ID = intellectual disability; IEP = individualized education program; NICHQ = National Institute for Children’s Health Quality.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $515.00
USD  $612.00
  • 1

    Sharma A, Couture J. A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Ann Pharmacother. 2014;48(2):209225.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Tripp G, Wickens JR. Neurobiology of ADHD. Neuropharmacology. 2009;57(7-8):579589.

  • 3

    DuPaul GJ, Gormley MJ, Laracy SD. School-based interventions for elementary school students with ADHD. Child Adolesc Psychiatr Clin N Am. 2014;23(4):687697.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Haenlein M, Caul WF. Attention deficit disorder with hyperactivity: a specific hypothesis of reward dysfunction. J Am Acad Child Adolesc Psychiatry. 1987;26(3):356362.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Caye A, Swanson JM, Coghill D, Rohde LA. Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Mol Psychiatry. 2019;24(3):390408.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):12401250.

  • 7

    Asherson P, Buitelaar J, Faraone SV, Rohde LA. Adult attention-deficit hyperactivity disorder: key conceptual issues. Lancet Psychiatry. 2016;3(6):568578.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Caye A, Swanson J, Thapar A, et al. Life Span Studies of ADHD—conceptual challenges and predictors of persistence and outcome. Curr Psychiatry Rep. 2016;18(12):111.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788799.

  • 10

    Yuan W, Holland SK, Shimony JS, et al. Abnormal structural connectivity in the brain networks of children with hydrocephalus. Neuroimage Clin. 2015;8:483492.

  • 11

    Mataró M, Junqué C, Poca MA, Sahuquillo J. Neuropsychological findings in congenital and acquired childhood hydrocephalus. Neuropsychol Rev. 2001;11(4):169178.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Burmeister R, Hannay HJ, Copeland K, Fletcher JM, Boudousquie A, Dennis M. Attention problems and executive functions in children with spina bifida and hydrocephalus. Child Neuropsychol. 2005;11(3):265283.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016.J Clin Child Adolesc Psychol. 2018;47(2):199212.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Burro F, Cama A, Lertora V, Veneselli E, Rossetti S, Pezzuti L. Intellectual efficiency in children and adolescents with spina bifida myelomeningocele and shunted hydrocephalus. Dev Neuropsychol. 2018;43(3):198206.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Perera B, Courtenay K. ADHD and challenging behaviour in people with intellectual disability: should we screen for ADHD?. Psychiatr Danub. 2017;29(suppl 3):562564.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    McClain MB, Hasty Mills AM, Murphy LE. Inattention and hyperactivity/impulsivity among children with attention-deficit/hyperactivity-disorder, autism spectrum disorder, and intellectual disability. Res Dev Disabil. 2017;70:175184.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Neece CL, Baker BL, Crnic K, Blacher J. Examining the validity of ADHD as a diagnosis for adolescents with intellectual disabilities: clinical presentation. J Abnorm Child Psychol. 2013;41(4):597612.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Persson EK, Hagberg G, Uvebrant P. Disabilities in children with hydrocephalus—a population-based study of children aged between four and twelve years. Neuropediatrics. 2006;37(6):330336.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    McKenzie K, Paxton D, Murray G, Milanesi P, Murray AL. The evaluation of a screening tool for children with an intellectual disability: the Child and Adolescent Intellectual Disability Screening Questionnaire. Res Dev Disabil. 2012;33(4):10681075.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    McKenzie K, Murray G, Murray A, et al. Child and Adolescent Intellectual Disability Screening Questionnaire to identify children with intellectual disability. Dev Med Child Neurol. 2019;61(4):444450.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    McKenzie K, Murray GC, Murray AL. The validity of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) with children aged 6-7 years, 11 months: a brief report. Psychiatry Res. 2013;210(2):675677.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K. Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol. 2003;28(8):559567.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    Porter SC, Guo CY, Molino J, Toomey SL, Chan E. The influence of task environment and health literacy on the quality of parent-reported ADHD data. Appl Clin Inform. 2012;3(1):2437.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Stevenson J, Cate IP. The nature of hyperactivity in children and adolescents with hydrocephalus: a test of the dual pathway model. Neural Plast. 2004;11(1-2):1321.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Dalen L, Sonuga-Barke EJ, Hall M, Remington B. Inhibitory deficits, delay aversion and preschool AD/HD: implications for the dual pathway model. Neural Plast. 2004;11(1-2):111.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288(6):728737.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Keenan HT, Hall GC, Marshall SW. Early head injury and attention deficit hyperactivity disorder: retrospective cohort study. BMJ. 2008;337:a1984.

  • 28

    Nam JY, Choi Y, Jung MK, et al. The effect of neonatal hypothyroidism and low family income on intellectual disability: a population-based cohort study. PLoS One. 2018;13(11):e0205955.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Hair NL, Hanson JL, Wolfe BL, Pollak SD. Association of child poverty, brain development, and academic achievement. JAMA Pediatr. 2015;169(9):822829.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Obi O, Van Naarden Braun K, Baio J, Drews-Botsch C, Devine O, Yeargin-Allsopp M. Effect of incorporating adaptive functioning scores on the prevalence of intellectual disability. Am J Intellect Dev Disabil. 2011;116(5):360370.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Peasgood T, Bhardwaj A, Biggs K, et al. The impact of ADHD on the health and well-being of ADHD children and their siblings. Eur Child Adolesc Psychiatry. 2016;25(11):12171231.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Galéra C, Melchior M, Chastang JF, Bouvard MP, Fombonne E. Childhood and adolescent hyperactivity-inattention symptoms and academic achievement 8 years later: the GAZEL Youth study. Psychol Med. 2009;39(11):18951906.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Harstad E, Levy S. Attention-deficit/hyperactivity disorder and substance abuse. Pediatrics. 2014;134(1):e293e301.

  • 34

    Molina BSG, Howard AL, Swanson JM, et al. Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study. J Child Psychol Psychiatry. 2018;59(6):692702.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 225 225 160
Full Text Views 21 21 20
PDF Downloads 30 30 28
EPUB Downloads 0 0 0