First-Year College Students With ADHD and/or LD.

Students with attention-deficit/hyperactivity disorder (ADHD) and/or learning disabilities (LD) experience significant challenges in making the transition from high school to college. This study examined the ways first-year college students with ADHD, LD, ADHD+LD, and comparison peers differ in engagement, core self-evaluation, high school preparation behaviors, and goals/expectations. Participants were from the 2010 Cooperative Institutional Research Program Freshman Survey, including students with ADHD ( n = 5,511), LD ( n = 2,626), ADHD+LD ( n = 1,399), or neither disability ( n = 5,737). Controlling for SAT/ACT scores, family income, and parent education, students with ADHD, LD, or ADHD+LD differed from peers on self-ratings of academic and creative abilities and psychosocial functioning; school disengagement, substance use, and emotional difficulties during their last year of high school; reasons for attending college; and expectations for college activities. Several differences were found between disability groups. Implications for college support services and future research are discussed.

School-based interventions for elementary school students with ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) experience significant difficulties with behavior, social functioning, and academic performance in elementary school classrooms. Although psychotropic medication may enhance classroom behavior, pharmacologic treatment is rarely sufficient in addressing the many challenges encountered by individuals with ADHD in school settings. This article describes 3 evidence-based strategies including behavioral, academic, and self-regulation interventions. Future directions for research on school-based interventions are discussed.

Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment.

Attention-deficit/hyperactivity disorder (ADHD) and learning disability (LD) can co-occur for a significant minority of children with each disorder. A total of 17 studies (2001-2011) examining ADHD-LD comorbidity were reviewed, revealing a higher mean comorbidity rate (45.1%) than has been obtained previously. Higher comorbidity may be the result of including students with writing disorders, not just reading and/or math disabilities. Proposed DSM-5 criteria for both disorders will likely affect comorbidity rates; however, it is unclear whether such rates will increase or decrease. Regardless of the specific impact of DSM revisions, academic skill and/or performance deficits should be assessed for students with ADHD as part of screening, comprehensive evaluation, and treatment monitoring. Comprehensive intervention services for students with comorbid ADHD and LD will require empirically supported treatment strategies that address both disorders and that are implemented across school and home settings.

Epigenetics: genetics versus life experiences.

Epigenetics is the field of research that examines alterations in gene expression caused by mechanisms other than changes in DNA sequence. ADHD is highly heritable; however, epigenetics are considered relevant in potentially explaining the variance not accounted for by genetic influence. In this chapter, some of the well-known processes of epigenetics, such as chromosome organization, DNA methylation, and effects of transcriptional factors are reviewed along with studies examining the role of these processes in the pathophysiology of ADHD. Potential epigenetic factors conferring risk for ADHD at various developmental stages, such as alcohol, tobacco, toxins, medications, and psychosocial stressor are discussed. Animal studies investigating ADHD medications and changes in CNS Gene/Protein Expression are also explored since they provide insight into the neuronal pathways involved in ADHD pathophysiology. The current limited data suggest that identification of the epigenetic processes involved in ADHD is extremely important and may lead to potential interventions that may be applied to modify the expression of deleterious, as well as protective, genes.

Methylphenidate transdermal system: clinical applications for attention-deficit/hyperactivity disorder.

The methylphenidate transdermal system (MTS) provides a novel method of delivery for methylphenidate, a well-studied and effective medication for attention-deficit/hyperactivity disorder. The MTS achieves two major goals. First, the delivery system allows for administration throughout the day with a single patch, thus improving adherence. Second, it is the first approved attention-deficit/hyperactivity disorder medication that is not administered orally, thus bypassing gastrointestinal absorption and first-pass metabolism through the enteric circulation. In this article, we review the current data on MTS, including preclinical, clinical and post-marketing studies, and compare efficacy and tolerability to currently available treatments.