Neurological soft signs in patients with attention deficit hyperactivity disorder aged 6 to 18 years old at a University Hospital: A cross-sectional study

Purpose@#Attention defi cit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children persisting into adulthood. Evidence suggests that the condition is etiologically related to delayed brain maturation. The detection of the presence of neurological soft signs can be a means to assess neuromaturation. The objective of this study was to assess the prevalence of neurological soft signs in ADHD patients and determine any correlation between the presence of neurological soft signs with age, gender, severity and type of ADHD which could give further insights into this disorder.@*Methods@#A cross-sectional study was conducted at the Child Neurology and Developmental Pediatrics outpatient clinic which included patients 6-18 years old diagnosed with ADHD as well as healthy controls. Patients with other neurodevelopmental conditions (intellectual disability, metabolic disorder, cerebral palsy, abnormal MRI fi ndings), or any condition that may lead to failure to complete the given tasks such as physical handicaps were excluded. Neurological soft signs were measured by utilizing the Physical and Neurological Evaluation for Soft Signs (PANESS) scale.@*Key Findings@#A total of 48 patients between 6 and 18 years of age (24 ADHD patients and 24 healthy controls) were examined. Neurological soft signs were signifi cantly higher in patients with ADHD and were present regardless of gender, type and severity of ADHD. ADHD patients performed worse on the given tasks as evidenced by higher PANESS scores. There was a weak negative correlation between neurological soft signs and age indicating that soft sign scores decrease with increasing age. There was no statistically signifi cant difference in neurological soft sign scores between those with medication versus without treatment, except for dysrhythmia which was signifi cantly higher in the drug-naive group.@*Significance@#Neurological soft signs are common in patients with ADHD and add scientifi c evidence to the predictive value of neurological soft signs as indicators of the severity of functional impairment in ADHD. The prevalence of neurological soft signs is much higher in children with ADHD than in controls which may have the potential to improve sensitivity in the diagnosis of ADHD.

We got to move it, move it: The lived experiences of family carers of youth with chronic neurodevelopmental disorders as they enter into adult health care

Background and objective @#Neurodevelopmental disabilities in adolescents have signifi cant effects on medical and social function. One of these challenges is their transition into adult care. Parental involvement is critical because these young adults may have more diffi culties in making informed decisions independently. Thus, the transition process involves not only the direct health care needs of the young adult, but the needs and concerns of the parents or carers who are instrumental in guiding that process. This study aims to explore the expectations and experiences of family carers of youths with chronic neurodevelopmental disorders who have undergone or are about to undergo transition into adult healthcare in a Filipino-based health care system.@*Methods@#A descriptive phenomenology was used to gain an in-depth understanding of parents’ perceptions and experiences of their youths’ transition process from a pediatric to an adult health care setting. The results were analyzed manually using Colaizzi’s method, which involves integrating both the destructured and restructured analysis principles of phenomenology. Purposive sampling was used to interview 13 family carers of 13 youths with various neurodevelopmental disorders using a semi-structured interview questionnaire.@*Results @#Despite the lack of information on the transition process, our study found that carers did not have a strong inclination to resist the transition event. Most of the carers treat the health care provider as a major decision maker in determining the timing and manner of transition, adopting a “doctor knows best” attitude. Several other hindrances and facilitators to successful transition were also identifi ed and are similar to the current literature.@*Conclusion @#This study provides a greater understanding of carers’ perceptions and experiences of transition care for youths with neurodevelopmental disorders in the local setting. They exhibited trust and confi dence in the medical profession as a whole, and had a “doctor knows best” attitude that may enable successful transitioning.

Neurological soft signs in ADHD patients 6 to 18 years old at a university hospital: A cross-sectional study

PURPOSE@#Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children which persists into adulthood. Evidence suggests that the condition is etiologically related to delayed brain maturation. Detection of the presence of neurological soft signs can be a means to assess neuromaturation. The objective of this study was to assess the prevalence of neurological soft signs in ADHD patients and to determine any correlation between the presence of neurological soft signs with age, gender, severity, and type of ADHD which could give further insights into this disorder.@*METHODS@#A Cross-sectional study was conducted at the Child Neurology and Developmental Pediatrics outpatient clinic which included patients 6-18 years old diagnosed with ADHD as well as healthy controls. Patients with other neurodevelopmental conditions (intellectual disability, metabolic disorder, cerebral palsy, abnormal MRI findings), or any condition that may lead to failure to complete the given tasks such as physical handicap were excluded. Neurological soft signs were measured by utilizing the Physical and Neurological Evaluation for Soft Signs (PANESS) scale.@*KEY FINDINGS@#A total of 48 patients between 6 and 18 years of age (24 ADHD patients and 24 healthy control) were examined. Neurological soft signs were significantly higher in patients with ADHD and were present regardless of gender, type, and severity of ADHD. ADHD patients performed worse on given tasks as evidenced by higher PANESS scores. There was a weak negative correlation between neurological soft signs and age, indicating that soft sign scores decrease with increasing age. There was no statistically significant difference in neurological soft signs scores between those with medication versus without treatment, except for the dysrhythmia which was significantly higher in the drug-naive group.@*SIGNIFICANCE@#Neurological soft signs are common in patients with ADHD and add scientific evidence to the predictive value of neurological soft signs as indicators of the severity of functional impairment in ADHD. The prevalence of neurological soft signs is much higher in children with ADHD than in controls which may have the potential to improve sensitivity in the diagnosis of ADHD.