Preschool attention deficit hyperactivity disorder: Evaluation of sleep, temperament, social cognition, executive functions, neurodevelopmental stages and effects of family training on symptom changes

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) affects development and functionality of children in almost all fields including learning, behavior, family and peer relationships, physical safety and emotional progress. Except for this data, it is stated that preschool children with ADHD differ from typically developing children in terms of their essential features such as sleep, appetite, eating habits and executive functions, temperament and emotion recognition. Objective: In our study it is aimed to evaluate sleep pattern, temperament, social cognition, executive function and neurodevelopmental stages of 3 to 6-year-old ADHD cases by comparing these outcomes with control cases and to re-test alteration of symptom severity of ADHD cases 6 months later than family training programme which is applied to parents' of the cases. Method: In our study 47 ADHD and 47 healthy control cases are included. Patient group is made up of cases who refer to Ege University Faculty of Medicine Child and Adolescent Psychiatry 0-6 Age Outpatient Clinic. DSM-IV criteria used for diagnostic assesment of ADHD. Child Behavior Checklist/ 2-3, Preschool Behaviour Checklist, Aberrant Behaviour Checklist, Conners' Parent Rating Scale Long Form-Revised, Parent Assessment of Pre-school Behavior Scale, The Short Temperament Scale for Children, Behaviour RatingInventory of Executive Function-Preschool Version, Children's Sleep Habits Questionnaire, Children's Eating Behaviour Questionnaire, Parent Attitude Research Instrument administered by parents of cases. Beck Depression Inventory, State and Trait Anxiety Inventory, Brief Symptom Inventory used for screening parent's psychopathology. Conners' Teacher Rating Scale- Revised/Long administered by teachers of cases. Ankara Developmental Screening Inventory, Emotion Recognition and Theory of Mind subtests of NEPSY are administered. ADHD group was enrolled to a family training programme. All cases in the ADHD group were followed up without encounting for enrolling family training programme and at sixth month symptom changes and effects of family training on symptom changes were re-evaluated. Results: In comparation of ADHD and healhty control group we have found difference in sleep patterns, bed time resistance, parasomnia and sleep time. In all the subtests temperament features were statistically different (p<0,05). In the field of social cognition, there was no difference between ADHD and healthy controls for theory of mind, but there was difference in emotion recognition. For executive functions, there were different results for different age groups. Especially in inhibition, working memory, planning/organization components there was a significant difference between ADHD and healthy control groups (p<0,05). There was a significant difference in fine motor skill developments of ADHD and control groups (p<0,05). For the effects of family training on symptom change there was a significant difference in hyperactivity levels, but there was no such difference in other symptoms. Social cognition and executive functions couldn't be evaluated for effect of family training. Conclusion: As result of our study it was detected that ADHD cases differ from healty controls with regard to sleep pattern, temparement, social cognition and developmental milestones but not in terms of symptom severity except for hyperactivity 6 months later than family training programme which administered to parents of the cases.