Category: ADHD - Child

PS3- #A23 - Optimizing Treatment Response in ADHD: Utility of Cognitive Subgroups in Predicting Response to Stimulant Medication

Friday, Nov 17
11:00 AM – 12:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: ADHD - Child / Adolescent | Treatment-Other | Externalizing

Stimulants for children with ADHD are the most common form of treatment (Visser et al., 2014); however, optimizing this treatment (e.g., medication class, dose) to derive therapeutic benefit involves trial-and-error heightening the risk for adverse effects as well as increased time during which a child may continue to experience difficulties. These limitations highlight the need for predictors of which treatments work for which children. Neurocognitive abilities (e.g., working memory, reaction time variability) represent a promising candidate for understanding ADHD (Nigg et al., 2005) and may have implications for predicting treatment responders and non-responders. Unfortunately, evidence for the utility of neurocognitive task performance in predicting medication response is mixed (Coghill et al., 2007; Johnston et al., 2015) which may reflect a failure of past studies to consider the heterogeneity of neurocognitive impairment in ADHD (Fair et al., 2012). This study aims to a) replicate the identification of subgroups of neurocognitive impairment in children with ADHD and b) examine the utility of cognitive performance on specific tasks within the domain of impairment (e.g., working memory in the working memory impaired group) for predicting stimulant response. Children with ADHD (n = 50) participating in a double-blind, within-subject, placebo crossover in the context of an intensive behavioral treatment program (i.e., Summer Treatment Program; Pelham et al., 2001) will complete tasks assessing domains of neurocognition (e.g., working memory, reaction time variability). Further, their behavioral response to medication will be assessed by a 10-minute math test and frequency of rule violations in recreational and academic settings (Pelham et al., 2001). We intend to replicate previously identified subgroups of children with neurocognitive impairment and examine the extent to which neurocognitive test performance predicts medication response to a wide range of dependent measures of functional impairment (e.g., 10-minute math test, frequency of rule violations) in a widely used and validated analogue summer setting (Fair et al., 2012; Pelham et al., 2010). It is expected that subgroups of neurocognitive impairment will be identified and that performance on a neurocognitive task in the domain of impairment will be a better predictor of treatment response relative to performance on neurocognitive tasks in non-impaired domains. For example, in children with ADHD who also exhibit working memory impairment it is expected that working memory performance will be a stronger predictor of treatment response relative to performance on an alternate task (e.g., behavioral inhibition). Results will be available by the time of the conference. 

Joseph Raiker

Assistant Professor
Florida International University
Miami, Florida

Mileini Campez

Graduate Student
Florida International University

Kelcey Little

Florida International University

Aaron Mattfeld

Assistant Professor
Florida International University

Amy Altszuler

Doctoral Student
Florida International University
Miami, Florida

Brittany Merrill

Florida International University

Fiona L. Macphee

Doctoral Student
Florida International University
Coral Gables, Florida

Elizabeth Gnagy

Florida International University

Andrew Greiner

Florida International University

Erika K. Coles

Director
Center for Children and Families at Florida International University

William E. Pelham

Distinguished Professor of Psychology and Psychiatry
Florida International University
Miami, Florida